A number of external stimuli and cell types converge upon HSCs to promote their activation (Fig. 3). Hepatocytes. Damage to hepatocytes in diseases associated with parenchymal liver injury, such as NASH and viral infection, can elicit inflammation and fibrosis. A growing list of mediators, including ROS161, Hh ligands49, 162 and nucleotides163, facilitate this process. DAMPs released from dying hepatocytes might directly or indirectly promote HSC activation and fibrosis.