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Liver immune microenvironment in NASH patients. In NASH patients, liver immune tolerance is lost and tips towards pro-inflammation. The IL-15 triggers decreased FOXO1 expression and activates the residential CD8+PD1+ T-cells. These residential T-cells, upon encounter with the acetate secreted by steatotic hepatocytes, release TNF, which triggers hepatocyte cell death through a FAS–ligand-dependent manner. This process is thought to bring about the NASH to NASH-HCC transition.
