Although the significance of cytokeratin degradation during apoptosis is unclear, it is suggested that caspase cleavage of the cytokeratin proteins including CK18 is likely to facilitate the formation of apoptotic bodies and amplify the apoptotic signal28, as reflected by our immunohistochemistry staining showing that M30 and cleaved-caspase3 were elevated in liver from NASH patients but rarely detected in simple steatosis and normal liver tissue. This evidence concerns the gene KRT18 and metabolic dysfunction-associated steatohepatitis.