TNF and Hepatic fibrosis: The activation of hepatic stellate cells (HSCs), which express alpha-smooth muscle actin (α-SMA) and secrete and synthesize ECM and various autocrine or paracrine cytokines, such as tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β) and interleukin 6 (IL-6), is a crucial link in the occurrence of liver fibrosis.