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172 Genes involved in pathways related to oxidative stress and antioxidant defense might therefore be potential genetic modifiers in AATD-related liver diseases, and warrant further investigation

Meanwhile, the expansion of pathogenic bacteria (e.g., Escherichia coli , Collinsella) due to the growth of Proteobacteria and Actinobacteria contributes to vascular endothelial dysfunction, aggravated myocardial fibrosis, impaired bile acid reabsorption, and increased pro-inflammatory factor secretion, thereby directly exacerbating myocardial injury (Rizzatti et al., 2017)