ACTA1 and metabolic dysfunction-associated steatohepatitis: In rhesus monkeys fed HFD for 2 years, expression of hepatic CCN2, TGF-β αSMA, and Smad 3 were increased in simple steatosis compared to healthy controls and in fibrosing NASH compared to simple steatosis, with CCN2 correlating positively with the severity of fibrosis [63].