Returning to our initial hypothesis that transfer of miR-181a-5p via MSC-derived EVs might alter OS in PD, we came across evidence in our study revealing that miR-181a–2–3p shuttled by MSC-derived EVs could be transferred into SH-SY5Y cells, where miR-181a–2–3p exerted inhibitory effects on OS in NAFLD via downregulation of the EGR1/NOX4/p38 MAPK axis. The gene discussed is NOX4; the disease is metabolic dysfunction-associated steatotic liver disease.