TNF and metabolic dysfunction-associated steatohepatitis: It is likely that amnion-derived MSC-EVs attenuated the inflammatory response in the NASH rat model by suppressing the activation of Kupffer cells, especially M1 macrophages, and down-regulating the expression of the inflammatory cytokines (TNF-α, IL-1β, and IL-6), rather than by shifting the M1/M2 macrophages ratio [164].