The rationale of such combinations of CK-18 with pro-inflammatory cytokines and/or adipokines are based on the underlying pathophysiologic mechanisms of steatohepatitis [54–56], since most patients are known to also have obesity and obesity related low-grade inflammation with dysregulated adipokine profiles (e.g., lower circulating levels of adiponectin which is an anti-inflammatory adipokine) [25]. The gene discussed is KRT18; the disease is obesity due to melanocortin 4 receptor deficiency.