As can be seen in Fig. 7B, treatment with Necrostatin-1 before the exosomes addition confirms the fundamental role of NAFLD patients exosomes in RIP-1 phosphorylation and necroptosis activation; what can be observed, in cells treated for 24 h with Necrostatin-1, and then treated with exosomes from healthy subjects and subjects affected by NAFLD for 48 h, is a significant decrease in phospho-RIP-1 (Fig. 7B, **P < 0.001) compared to the expression of this protein in cells treated only with exosomes. This evidence concerns the gene RIPK1 and metabolic dysfunction-associated steatotic liver disease.