Recent studies have pointed out that platelets can also play a role in liver injury as biopsy results showed that the number of platelets is associated with disease severity in NAFLD.33 Platelets passing through hepatic sinusoids can be activated by LPS and the number of TLR4+ platelets is positively correlated with serum LPS level in NAFLD patients, suggesting that LPS may activate platelets through TLR4 signaling pathway. Here, TLR4 is linked to metabolic dysfunction-associated steatotic liver disease.