Increased hepatic production of Th1-related cytokines IFN, IL-12, and TNF triggered hepatitis in choline-deficient-diet-fed steatotic mice109, as well as elevation of genes toward a Th1 cell differentiation when comparing NASH patients to those without NASH110.Transgenerational gut dysbiosis in the same male/ female fish from BPA lineage could have activated Th2 cell activation that could interfere with IL-4/STAT6 axis on insulin sensitivity, leading to the inhibition of PPARa, lipolytic gene111. Here, NELFCD is linked to metabolic dysfunction-associated steatohepatitis.