HIF1A and Hepatic fibrosis: Furthermore, CTS could serve as an important link in cholesterol mediated liver fibrosis since an excess accumulation of cholesterol in hepatocytes results in hypoxic conditions and excessive generation of nitric oxide and mitochondrial ROS that aggravates the activity of oxygen-sensing transcription factor hypoxia-inducible factor HIF-1α, a significant regulator of liver fibrosis [112,124,141,142,143,144] and a potent activator of profibrotic redox-signaling molecule iNOS that is involved in the pathophysiology of cholesterol-induced liver fibrosis [124].