ER stress is caused by an excess of unfolded or misfolded proteins in the ER and has been shown to be important in the pathogenesis of several liver diseases including non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH), chronic viral hepatitis, alpha-1-antitrypsin deficiency, and alcohol-related liver diseases [6–9]. This evidence concerns the gene SERPINA1 and metabolic dysfunction-associated steatotic liver disease.