DAMPs bind and activate pattern recognition receptors (PRRs) on Kupffer cells, including Toll-like receptor 4 (TLR4), which is upregulated in NASH livers, leading to nuclear translocation of a master transcriptional regulator of inflammation, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) (161). Here, TLR4 is linked to metabolic dysfunction-associated steatohepatitis.