BBC3 and metabolic dysfunction-associated steatohepatitis: The cytokeratin-18 sheet (CK18) segment generated by Caspase-3 can be used as a marker to predict the severity of NASH.302,303 Palmitatic acid stimulation activated tumor necrosis factor-related apoptosis-inducing ligand receptor 2 (TRAIL-R2), leading to caspase-dependent cell death in hepatocytes.304 ER stress upregulates proapoptotic proteins, including p53 upregulated modulator of apoptosis (PUMA), Bim, and TRAIL-R2 via CHOP or JNK.305–307 PUMA and Bim promote hepatocyte death via the mitochondrial apoptotic pathway.