TNF and metabolic dysfunction-associated steatohepatitis: Unfortunately, liver fibrosis was exacerbated after anti-PD1 treatment in NASH-HCC models.554 Mechanistically, unconventionally activated CD8+PD1+ T cells accumulate progressively in NASH liver, but anti-PD1 treatment promotes the infiltration of CD8+PD1+ T cells population and secretion of TNF-α, leading to the increase of inflammation, fibrosis, and tumorigenesis.554,555 Cytotoxic CD8T+ cells that are suppressed in cancer accumulate in NASH and increase more after anti-PD1 therapy.