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Microbial components may enter the systemic circulation via a impaired intestinal barrier in the form of extracellular vesicles (EVs), and bind to pathogen recognition receptors (PRRs) in the liver as pathogen-associated molecular patterns (PAMPs) (Wang R

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A 2017 meta-analysis concluded that silymarin led to only minimal reductions in liver enzymes without clinical relevance or evidence of reversing histological damage [33]