INS and metabolic dysfunction-associated steatohepatitis: In terms of therapeutic application, small clinical studies reported anti-viral, anti-oxidative, anti-inflammatory, and insulin-sensitizing effects of silymarin in different etiologies of chronic liver disease, including ALD, NASH, and viral hepatitis [363,364,365,366].Thus, silymarin administration for four weeks reduced oxidative stress, fibrosis score, and activation of HSCs as well as Kupffer cells in a CCl4 based rat model of liver fibrosis [367,368].