HSPA5 and metabolic dysfunction-associated steatohepatitis: Furthermore, in NASH patients there is a significant increase in hepatic messenger RNA levels of markers of ER stress (activating transcription factor 4 (ATF4), glucose-regulated protein 78 (GRP78), and C/EBP homologous protein (CHOP)) and autophagy (Beclin-1) compared with NAS patients.