In such cases, angiotensin II receptor blocker (ARB) is not able to attenuate MMP-9 and TGF-β actions; however, a chymase inhibitor could have attenuating effects via inhibition of MMP-9 and TGF-β activation, indicating a potential treatment course for the prevention of NASH progression. This evidence concerns the gene MMP9 and metabolic dysfunction-associated steatohepatitis.