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The increased oxidative stress seems to be the second hit in the progression from NAFL to NASH: the increase in ROS and consequently in lipid peroxidation has been associated to hepatocellular damage, inflammation, and eventual fibrosis due to the activation of hepatic stellate cells

PubMed Central , Redox Biology , vol

GPxs, which participate in the processes of antioxidant protection and detoxification, are important enzymes that directly regulate ROS levels [28]

Maldonado J, Gil-Campos M, Maldonado-Lobon JA, Benavides MR, Flores-Rojas K, Jaldo R, Jimenez Del Barco I, Bolivar V, Valero AD, Prados E, Penalver I, Olivares M (2019) Evaluation of the safety, tolerance and efficacy of 1-year consumption of infant formula supplemented with Lactobacillus fermentum CECT5716 Lc40 or bifidobacterium breve CECT7263: a randomized controlled trial