Hepatic COX-2 activity and PGE2 concentrations also correlate with serum ALT and hepatic NF-κB (Eeckhaut et al., 2013), suggesting that COX-2/PGE2 is an important pathway in the development of NAFLD and that arecoline protects against hepatic injury through the PGE2/arachidonic acid metabolism pathway to achieve therapeutic effects in NAFLD. Here, NFKB1 is linked to metabolic dysfunction-associated steatotic liver disease.