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Kudolo GB, Wang W, Elrod R, et al

The gut-liver axis plays a critical role in the pathogenesis of NAFLD, with altered gut microbiota contributing to hepatic inflammation and fat accumulation

Interestingly, NAC has been used in medicine for decades as a treatment for paracetamol overdose and is recognised by the WHO as an essential medicine

There are also genetic predispositions that render certain individuals susceptible to developing autoimmune diseases (83) and even after Epstein-Barr virus (EBV) infection (84), such as human leukocyte antigen (HLA) variants (84, 85) that have experienced selective pressures whilst co-evolving with pathogens (86, 87)