NFE2L2 and Hepatic fibrosis: Additionally, spermidine has been shown to protects against alcohol- and LPS-induced liver injury by reducing oxidative stress and inflammation,111 mitigates hepatic fibrosis through Nuclear factor (erythroid-derived 2)-like 2 (Nrf2)-dependent pathways,113 and prevents fibrosis-associated hepatocellular carcinoma via MAP1S (Microtubule-associated protein 1S)-mediated autophagy.115