However, in NASH patients, the level of NK cells in the liver parenchyma is increased, which directly activates hepatic stellate cells through the activation of receptors NKG2D, NKp46, and p38/PI3K/AKT pathways, and promotes the development of liver fibrosis (23, 47, 48). This evidence concerns the gene NCR1 and metabolic dysfunction-associated steatohepatitis.