On the other hand, given the critical role of gp78 in ERAD-regulating ER homeostasis, it is conceivable that a defect of gp78-mediated ERAD processes can lead to chronic ER stress and has a significant impact on cell viability, particularly for cells bearing a heavy burden of misfolded proteins and might be associated with NASH. Here, AMFR is linked to metabolic dysfunction-associated steatohepatitis.