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In mitochondria, ROS, in particular O 2 , accumulate under conditions of limited ADP

This morphological change suggests the induction of mitochondrial oxidative stress and fragmentation

Microbial-associated molecular patterns, such as LPS, translocate to the liver through the damaged gut barrier, are recognized by TLR4 on the surface of Kupffer cells, activate the downstream MyD88/NF-B signaling pathway, drive the massive release of pro-inflammatory cytokines (such as TNF-, IL-1, IL-6), and thereby initiate and maintain the inflammatory state of the liver, which is crucial in the pathogenesis of ALD and NASH

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