We believe that the classical pathology of liver disease in CF including periductal inflammation, DR, periportal fibrosis, and focal biliary cirrhosis may be explained by our observations, in addition to previously described mechanisms such as Rous sarcoma oncogene cellular homolog (Src)-dependent Toll-like receptor-4 activation (Fiorotto, 2016). The gene discussed is TLR4; the disease is cystic fibrosis.