Shuai et al146 identified a novel, purinergic mechanisms by which ectonucleoside triphosphate diphosphohydrolase-1/ENTPD1 (CD39)–mediated ATP-adenosine signaling regulates TGF-β/Smad3 signaling during HSC-T6 activation and alcohol-related liver fibrosis. The gene discussed is SMAD3; the disease is Hepatic fibrosis.