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Causes and progression factors of liver inflammation Direct damage caused by alcohol metabolites Ethanol metabolism in the liver occurs through three primary pathways: the alcohol dehydrogenase (ADH) pathway in the hepatocyte cytosol, the cytochrome P450 2E1 (CYP2E1) pathway in the endoplasmic reticulum, and the catalase (CAT) pathway in peroxisomes [18]

Bacterial phyla such as Bacillota, Actinomycetota, and Pseudomonadota have been identified as key contributors to TMA formation, though not every bacterium within these groups possesses TMA-producing capacity [15, 25, 26]

Rosen MJ, Karns R, Vallance JE, Bezold R, Waddell A, Collins MH, et al

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