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Some amount of ROS is critical for normal T cell survival and maturation, and appropriate physiologic upregulation of ROS levels is needed for T cell receptor activation and downstream signaling that leads to T helper cell type 1 (Th1) differentiation and production of pro-inflammatory cytokines, such as IFN- and TNF- (63)

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Figure 2 More recently, a multiple hits theory has been proposed, with the addition of other pathogenic factors in NAFLD development: low-grade chronic inflammation, genetic and epigenetic mutations, and intestinal microbiota