Another study showed that MSCs-derived exosomes effectively targeted HSCs and reduced fibrosis, which was accompanied by decreased pro-fibrotic markers, such as α-SMA, collagen I. Additionally, low levels of serum circDIDO1 in these exosomes were found to correlated with liver failure clinically, and serum exosomal circDIDO1 had a well diagnostic value for liver fibrosis in patients with liver failure [94]. This evidence concerns the gene ACTA1 and liver failure.