Stimulation of hepatocytes by adipose tissue-derived exosomes leads to dysregulation of the TGF-β pathway (63), whereas stimulation of hepatic stellate cells by adipose tissue-derived exosomes upregulates the hepatic extracellular matrix (ECM) expression of fibrinogen activator inhibitor-1, matrix metalloproteinase (MMP)-7 and tissue inhibitor of metalloproteinases-1 and inhibits PPAR -γ expression to promote liver fibrosis (76, 77). This evidence concerns the gene TGFB1 and Hepatic fibrosis.