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A compelling body of evidence suggests that the accumulation of lipid species derived from sphingolipid metabolism, such as ceramides, contributes significantly to the structural and functional tissue damage observed in more severe grades of MASLD by triggering inflammatory and fibrogenic mechanisms

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Iron accumulation drives the Fenton and Haber-Weiss reactions, generating ROS that induce lipid peroxidation, leading to oxidative damage to subcellular structures (88)