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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]

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

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]

In-vivo production of branched-chain amino acids, branched-chain keto acids, and -hydroxy -methylbutyric acid