In a rat high-fat and high-cholesterol (HFC) diet-induced NASH model, significant increases in chymase and MMP-9 activity were observed in livers with NASH, and the development of steatosis, inflammatory cell accumulation, and fibrosis in the liver was significantly prevented by administration of a chymase inhibitor before the HFC diet [53]. This evidence concerns the gene CMA1 and metabolic dysfunction-associated steatohepatitis.