Primary Human Tissue Models for Metabolic Dysfunction‐Associated Liver Disease ‐ toward Streamlining Drug Discovery with Patient‐Derived Assays
Open accessAbstract
Metabolic dysfunction‐associated steatotic liver disease (MASLD) and its progressive form metabolic dysfunction‐associated steatohepatitis (MASH) are prevalent chronic liver diseases that are closely linked to metabolic syndrome, type 2 diabetes, and cardiovascular complications. Despite their rising incidence and growing socioeconomic burden, effective therapies remain limited. Traditional preclinical models often fail to replicate the complexity of human MASLD, particularly in capturing the interplay between patient‐specific predisposition, metabolic dysfunction, immune activation and progressive fibrosis. In this review, a comprehensive overview of emerging human‐based in vitro and ex vivo platforms is provided for use in MASLD research, including conventional 2D cultures, organoids, 3D spheroids, precision‐cut liver slices, microphysiological systems, and bioprinted constructs. Their utility is evaluated for modeling different stages of MASLD and MASH and their alignment with key disease hallmarks is discussed. Furthermore, the different models are assessed for their capability to model pathophysiologically relevant nutritional exposure, to emulate genetic risk factors, to reflect the complex hepatic cell repertoire and to conduct high‐throughput drug screenings. Recent successful applications of MASLD and MASH models are highlighted in drug discovery and development. Together, these insights aim to guide the refinement of human MASLD models to narrow the translational gap in MASH drug development.
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For tasks related to disease progression (inflammation, fibrosis), as well as for rigorous studies of drug metabolism and toxicity, HepG2 should be used with caution, preferably as part of more complex systems (co-cultures, 3D platforms) or in combination with alternative models (HepaRG, primary hepatocytes).
“For tasks related to disease progression (inflammation, fibrosis), as well as for rigorous studies of drug metabolism and toxicity, HepG2 should be used with caution, preferably as part of more complex systems (co-cultures, 3D platforms) or in combination with alternative models (HepaRG, primary hepatocytes) [158,159,160,161].”
From The HepG2 Cell Line as a Model for Studying Metabolic Dysfunction-Associated Steatotic Liver Disease (2026) · cites this paper as [161]
In “Model Systems for Hepatic Steatosis and Early MASLD” (page unavailable), the review says hepatoma cell lines have limited physiological relevance and lack the full complement of cytochrome P450 enzymes; it also describes HepaRG as more metabolically competent. In “Model Systems for MASH and Fibrosis” (page unavailable), it says co-cultures are required to capture the cell interactions underlying inflammation and fibrosis and that most MASH co-culture models use 3D tissues. These passages support caution with HepG2 and the use of more complex models, but do not specifically recommend combining HepG2 with HepaRG or primary hepatocytes for rigorous drug-metabolism and toxicity studies. (LLM, conf=0.84)
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Cited by
Sorted by citations
The HepG2 Cell Line as a Model for Studying Metabolic Dysfunction-Associated Steatotic Liver Disease
Kotlyarova, A., Iskrina, A., & Kotlyarov, S. (2026) · International journal of molecular sciences · doi:10.3390/ijms27083399 · Cited by 5 · see citing works
- Authors
- Youhanna, S., Taebnia, N., Liang, Y., Cheng, N., Wang, Y., Michel, M., & Lauschke, V. M.
- Affiliations
- Karolinska University Hospital (SE)
- Karolinska Institutet (SE)
- Zhejiang University (CN)
- College of Pharmaceutical Sciences Zhejiang University Hangzhou 310058 China
- Corresponding author
- Youhanna, Sonia
- Taebnia, Nayere
- Lauschke, Volker M.
- Venue
- Advanced Biology
- Publisher
- Wiley
- Published
- 2025-11-07
- Volume
- 9
- Issue
- 12
- Pages
- e00337-e00337
- ISSN
- 2701-0198 (ISSN-L)
- PMC
- PMC12712776
- OpenAlex
- W4415990198
- Cited by
- 9
- References
- 19
- Citations by year
- 2026: 9
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Advanced Biology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- Funders
- Knut och Alice Wallenbergs Stiftelse (WASPDDLS22:006)
- Novo Nordisk Fonden (NNF23OC0084420, NNF23OC0085944)
- Vetenskapsrådet (2024‐03401, 2021‐02801, 2023‐03015)
- HORIZON EUROPE European Research Council (101170408)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Physical Sciences › Engineering › Biomedical Engineering › 3D Printing in Biomedical Research
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- nonalcoholic steatohepatitis, non-alcoholic fatty liver disease, organoids, multicellular spheroids, precision-cut liver slices, microphysiological systems, high-throughput drug screening, liver fibrosis, metabolic syndrome, drug development
- MeSH terms
- Fatty Liver, Humans, Liver, Models, Biological, Drug Discovery, Non-alcoholic Fatty Liver Disease
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