Shirai et al. also suggested that the interactive effect between Ang II and LPS-TLR4 played a pivotal role in liver fibrosis development in nonalcoholic steatohepatitis, which may be through activation of myeloid differentiation factor 88 (MyD88), NF-κB and TGF-β expressions. This evidence concerns the gene MYD88 and metabolic dysfunction-associated steatohepatitis.