Increased prevalence of MPO-positive Kupffer cells in NASH. A: Representative immunofluorescent double stainings of HNP1-3 (green) and MPO (red) in the liver of different subjects with NASH. All neutrophils showing HNP1-3 staining are also MPO positive. Occasionally, MPO-containing cells negative for HNP1-3 can be observed (see white arrows; magnification, upper panel, ×100; lower panel, ×200). B: Left panel, Double staining for CD68 (green) and MPO (brown) in liver sections of five different subjects with NASH, showing colocalization of CD68 and MPO (see black arrows). The elongated morphology of double-labeled cells indicates that they represent Kupffer cells (magnification, ×600). Right panels, Immunofluorescent double stainings of CD68 (green) and MPO (red) indicate that subjects with NASH frequently exhibit Kupffer cells containing MPO (see white arrows; magnification, upper panel, ×200; lower panel, ×100). C: Comparable CD68-positive cell number in the liver of severely obese subjects with NASH and subjects with simple steatosis (P = 0.28).