In contrast, the mRNA and protein expression of PGC-1α and NRF2, which are essential for mitochondrial biogenesis (thereby increasing lipid metabolism and decreasing ROS formation [54]), decreased in NASH mice, whereas it was maintained in pan PPAR-iMSC-EVs-treated mice (Fig. 7A, B). The gene discussed is PPARGC1A; the disease is metabolic dysfunction-associated steatohepatitis.