In the setting of liver fibrosis, acetyltransferase 2A (KAT2A) modulates the level of H3K9 acetylation at the promoters of fibrotic genes, potentially through interaction with Smad4, leading to the upregulation of genes associated with HSCs activation, such as fibronectin (FN) and plasminogen activator inhibitor 1 (PAI1) [82]. This evidence concerns the gene SMAD4 and Hepatic fibrosis.