One possible explanation for the anti-fibrotic effect of this combination therapy is that linagliptin prevents the infiltration of macrophages (F4/80 positive cells) into lobular lesions, while empagliflozin inhibits the hepatic expression of proinflammatory cytokines such as IL-6, TNF-α, and MCP-1, which are regarded as hallmarks of NASH [28]. Here, TNF is linked to metabolic dysfunction-associated steatohepatitis.