CASP9 and metabolic dysfunction-associated steatotic liver disease: In fact, it has been demonstrated that HSC apoptosis is an essential feature of NASH-related liver fibrosis and may be correlated with NAFLD severity.34 Increased expression of the miR-130a-3p-activated initiator caspase-9 and effector caspase-3 prompts the proteolytic cleavage of PARP, leading to cellular disassembly and apoptosis.