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Finally, the gut microbiome may contribute to NAFLD pathogenesis: an increased intestinal permeability could lead to the entry of endotoxins in portal circulation and activation, through toll-like receptor 4, of Kupffer cells, with consequent inflammation (5053)

Six subjects withdrew from the study before completing all four trials due to scheduling constraints or loss of interest

The enzymes involved include FADS2, FADS1, and elongase 2 or elongase 5