Furthermore, the clearance of NETs by macrophages is also impaired in ALD, which exacerbates hepatic inflammation and injury.49 55 56 Accumulation of uncleared NETs can trigger additional immune responses, amplifying the cycle of inflammation and tissue damage in the liver.49 55 56 A key biomarker that has gained attention in ALD is the neutrophil-to-lymphocyte ratio (NLR), which has emerged as a strong predictor of mortality and acute kidney injury in patients with ALD.57 58 The NLR reflects the balance between the innate and adaptive immune responses, with elevated levels indicating an increased inflammatory state driven by neutrophils.57 58 Higher NLR values have been associated with worse clinical outcomes, making it a useful tool for risk stratification and guiding treatment decisions in patients with ALD.57 58 In summary, despite their well-established role in promoting liver injury through ROS production and inflammatory signalling, neutrophils also play a protective role by facilitating liver repair and regeneration
A Closer Look at the Biological Themes Behind Gut Dysbiosis Conversely, when the gut microbiome is disrupted, a state known as dysbiosis, which can be triggered by poor dietary habits, antibiotic use, chronic stress, or aging, the populations of beneficial bacteria decline, GLP-1 and PYY secretion decreases, and the gut barrier becomes more permeable
For high-burden nations like India, the opportunity extends to prevention: pairing affordable drugs with community programs could bend the curve on obesity-driven diabetes
However, some of the symptoms were thought to be unrelated with the lesions
