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In this context, the increased extracellular glutamate can bind to its receptor, the metabotropic glutamate receptor 5 (mGluR5) on the stellate cell surface, stimulating it to synthesize 2-arachidonoylglycerol (2-AG) [155], which in turn, once released into the extracellular space, binds to the cannabinoid receptor-1 (CB1R) on hepatocytes, triggering a mechanism of de novo lipogenesis and therefore of fat accumulation [156] (Figure 7)

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Beyond GLP-1 and amylin pathways, modulation of the ghrelin axis [Figure 1] represents a promising avenue for future therapeutic development [21]