The accumulation of free cholesterol in the liver stimulated the expression of sphingomyelin synthase 1 (Sms1) in NASH and demonstrated through in vitro experiments that SMS1 exacerbated liver injury, hepatitis, and liver fibrosis by affecting NLRC4-mediated hepatocyte pyroptosis, but had no effect on steatosis [68]. The gene discussed is SGMS1; the disease is steatosis.