Numerous studies have shown thatC. sinensis ESPs play pathogenic roles in the progression of hepatic fibrosis and CCA.C. sinensis ESPs have been reported to promote the activation of HSCs and the pathogenesis of hepatic fibrosisvia TLR4 and the TGF-β/SMADs signaling pathway, exhibiting the crucial role of TLR4 in host defenses againstC. sinensis and the pathogenesis of clonorchiasis[90]. Here, TGFB1 is linked to Hepatic fibrosis.