Both the ABCB11 and NR1H4 genes encode proteins involved in bile processing: ATP binding cassette transporter encoded by ABCB11 is a membrane-bound transport protein that exports of bile salts into canaliculi, whereas NR1H4 encodes a nuclear receptor activated by bile acids that regulates their synthesis and transport.9 Iwata et al88 evaluated the ABCB11 1331C allele and NRIH4 variants, comparing UK patients—358 with NAFLD, 206 with chronic hepatitis C and 110 controls undergoing biopsy for metastatic disease. Here, ABCB11 is linked to metabolic dysfunction-associated steatotic liver disease.