Chen et al. proposed that ERN1 may regulate TXNDC5 through Xbp1 mRNA splicing in lung fibroblasts [48] and that it plays a role in NAFLD, in which DDIT3, caspase-12, and JNK participate in ER stress by enhancing its activities [76]. Here, XBP1 is linked to metabolic dysfunction-associated steatotic liver disease.