Bing Xu and colleagues analyzed human NAFLD/NASH liver tissues and showed that the levels of GSDMD and the pyrophosphorylation-induced fragment GSDMD-N were both increased, and more importantly, hepatic levels of the GSDMD-N protein were significantly increased patients with NASH and were related to NAFLD activity scores and fibrosis 62. Here, GSDMD is linked to metabolic dysfunction-associated steatohepatitis.