CTLA4 and metabolic dysfunction-associated steatohepatitis: We found significantly higher expression of genes related to senescence (e.g., PTPRC, TIGIT, and TNF) and exhaustion (e.g., PDCD1, CTLA4, LAG3, and TNFRSF9) in CD4+ and CD8 + T cells from participants with NASH (Fig. 4c, d), implying an association between T-cell dysfunction and the progression of liver disease in humans.