The transition from NAFLD to NASH in ob/ob mice depends on Toll-Like Receptor 4 (TLR4) expression [36]: GDF11 interacts with the TLR4/NF-kBp65 pathways in other inflammatory disorders [37, 38], and it was unclear if this occurs also in NAFLD/NASH. This evidence concerns the gene TLR4 and metabolic dysfunction-associated steatotic liver disease.