Several other biomarkers have been studied to distinguish NASH in children, including cathepsin D, serum cytokeratin 18, angiopoietin-2, and cytokines such as total activated plasminogen activator inhibitor 1 (PAI-1), PAI-1, IL-8, and soluble IL-2 receptor alpha (sIL2Rα) [36,37,38,39]. The gene discussed is CTSD; the disease is metabolic dysfunction-associated steatohepatitis.