The activation of TLR4 on Kupffer cells (liver macrophages) promotes the transformation of fatty liver to steatohepatitis through the TLR4-Myd88-NFκB pathway and, together with leukocytes, releases inflammatory cytokines (TNF-α, TGF-β, IL1-β, and CCL2) that act on hepatic stellate cells, promoting liver fibrosis [93]. This evidence concerns the gene TLR4 and Hepatic fibrosis.