Studies had indicated that TLR4 signaling pathway was one of the key factors in the pathogenesis of different chronic liver diseases including NAFLD (Soares et al., 2010; Roh and Seki, 2013) and was associated with the progression of NASH (Zhang et al., 2013; Kapil et al., 2016). Here, TLR4 is linked to metabolic dysfunction-associated steatotic liver disease.