Three different ways were described: upregulation of matrix metallopeptidase 9 (MMP-9) [76], downregulation of tissue inhibitor of metalloproteinase-1 (TIMP-1) mRNA expression [73] and decrease of matrix metallo-proteinase-2 [62] which was observed in NASH-models. Here, MMP9 is linked to metabolic dysfunction-associated steatohepatitis.