Changes in cell-cell signaling patterns linked to fibrosis and other TCDD-induced hepatotoxic responses include increased TGFβ signaling, which promotes the development of NASH 82, 83, increases in signaling by multiple collagens and laminins, which contribute to liver fibrosis, and decreases in intercellular connections for several growth factor signaling pathways associated with pathological effects of TCDD, including EGF, IGF and FGF 91, 92. This evidence concerns the gene IGF1 and metabolic dysfunction-associated steatohepatitis.