The discrepancies of statistical significance between hepatocytes acquired from MCD diet rats and Hep3B cells on the expression of ER stress markers in the group of TNF-α only and the groups of both TNF-α and PTX may be attributed to nonuniform pattern of downstream of ER stress markers, especially ATF4, CHOP, and GADD34 in human and animal subjects with NAFLD and NASH [10]. Here, ATF4 is linked to metabolic dysfunction-associated steatohepatitis.