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IL-1 and TNF trigger the activity of phospholipase (PL) A2, COX-2, and nitric oxide (NO) synthase that increases the production of platelet-activating factor, leukotrienes, prostanoids and nitric oxide

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This review synthesizes current knowledge on the epidemiology, pathogenesis, and management of this neurohepatic syndrome, highlighting the urgent need for standardized diagnostic criteria and validated biomarkers to improve clinical recognition and patient outcomes