Another study on non-alcoholic steatohepatitis (NASH) demonstrated that C. spinosa extract, especially when combined with (30), synergistically reduced hepatic inflammation, fibrosis, and oxidative stress by modulating TGF-β/Smad signalling [113].C. spinosa also alleviated acute colitis in rats by reducing TNF-α, IL-6, and oxidative stress markers while enhancing antioxidant defences superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). This evidence concerns the gene TGFB1 and metabolic dysfunction-associated steatohepatitis.