The selective PPARα activator pemafibrate was recently found to counter hepatocyte ballooning in STAM NASH without affecting hepatic steatosis and inflammation27, and the selective PPARδ agonist seladelpar improved steatosis and hepatocyte ballooning in (foz/foz) mice under atherogenic diet15 without a pronounced effect on hepatic inflammation. This evidence concerns the gene PPARD and metabolic dysfunction-associated steatohepatitis.