Early in the disease, Kupffer cells rapidly divide and secrete cytokines and chemokines such as IL-1, TNF-α, MCP-1, and C-C motif chemokine ligand (CCL)5 [142], reflecting their involvement in controlling the inflammatory response in NASH and their major role in recruiting inflammatory cells to the liver [143,144]. Here, TNF is linked to metabolic dysfunction-associated steatohepatitis.