A Reactome pathway enrichment analysis revealed that several DEGs in individuals with moderate and more advanced NAFLD, as compared to individuals with no/mild NAFLD, were associated with the immune system (upregulated: BIRC3, CD53, CD86, CXCL10, FCER1G, HLA-DRA, HLA-DMB, HPSE, PAG1, PSMB9) and extracellular matrix organization (upregulated: ADAMTS5, ASPN, COL1A1, COL3A1, ICAM1, LOXL4, MMP9, THBS1, VCAN, VCAM1; downregulated DMD, MMP17,,) (Fig 3). This evidence concerns the gene MMP9 and metabolic dysfunction-associated steatotic liver disease.