There could be a common link between ASM and hepatotoxicity that involves endoplasmic reticulum stress and cholesterol loading of mitochondria [52] that are highly abundant in hepatocytes, possibly via mechanisms of transcriptional regulation recently identified for mitochondrial defects in lysosomal storage disorders, like Niemann–Pick disease caused by a genetic defect in the ASM encoding gene (Yambire K.F. et al. preprint under revision). The gene discussed is SMPD1; the disease is lysosomal storage disease.