Direct markers which instead reflect liver fibrosis contain biomarkers of collagen synthesis or degradation, extracellular matrix glycoproteins, proteoglycans, and glycosaminoglycans (PIIINP: amino-terminal Propeptide of type III Procollagen; TIMP-1: Tissue Inhibitor of Metalloproteinase; TNF: Tumor Necrosis Factor; MMP: Matrix MetalloProteinase) must be consider. The gene discussed is TNF; the disease is Hepatic fibrosis.