ACTA2 and metabolic dysfunction-associated steatohepatitis: Notably, palmitic acid increased the number of isolated exosomes from hepatocytes and then directly transfected exosomal miR-192 into HSCs to enhance the expression of fibrosis-associated genes including TGFb1, Acta2 and Col1a1, which accelerated the progression from steatosis to non-alcoholic steatohepatitis (NASH) 27.