TNF and Hepatic fibrosis: For example, inflammatory cytokines such as IL-1β and TNF-α can upregulate the expression and activity of TGF-β, thereby activating the TGF-β/SMAD signaling pathway, promoting the proliferation and differentiation of fibroblasts (Kang et al., 2023), as well as the synthesis and secretion of extracellular matrix, thereby accelerating liver fibrosis and the progression from MASLD to MASH (Zhang et al., 2024).