Macrophage-mediated immune responses are an essential cause of hepatocyte injury during the development of NAFLD.25 The accumulation of large amounts of lipids exposes macrophages to prolonged “antigenic” stimuli, inducing the production of IL-6 and causing a sustained inflammatory response.26 In addition, inflammation of adipose tissue causes liver injury. Here, IL6 is linked to metabolic dysfunction-associated steatotic liver disease.