PPARG and metabolic dysfunction-associated steatotic liver disease: After depleting PPARγ in macrophages, the therapeutic effect of thiazolidinediones disappeared, suggesting that PPARγ was required for the modulatory effects of macrophages on the liver microenvironment [86] Clinically, patients with nonalcoholic fatty liver disease who received pioglitazone in a Phase 2 clinical trial (NCT00633282) showed reduced ALT and AST activities, which indicated that PPARγ activation effectively protected against liver damage.