In addition, an increase in activation of CD4+ T lymphocytes was documented both in peripheral blood and liver (based on the expression of HLA-DR) (226); Th17 was found to be more abundant in the liver of patients with NASH than in those with NAFL and in circulating blood of NASH patients Th17/Treg ratio was found to be higher than that of NAFL ones. Here, CD4 is linked to metabolic dysfunction-associated steatohepatitis.