Yamagishi et al. [62] found that in an obesity-induced hepatocellular carcinoma model, senescent hepatic stellate cells cleave and activate IL-33 by CELA1 protease, and IL-33 in the activated state was released via Gasdermin D into the tumor microenvironment. This evidence concerns the gene CELA1 and obesity due to melanocortin 4 receptor deficiency.