Besides Kupffer cells, TLR4 is expressed by other hepatic cells, including HSCs, hepatocytes and cholangiocytes and LPS/TLR4 axis plays a critical role in the pathogenesis and progression of fatty liver diseases, as demonstrated by increased levels of portal endotoxins and TLR4 hepatic expression in experimental NASH [252,253]. This evidence concerns the gene TLR4 and metabolic dysfunction-associated steatohepatitis.