Establishment and Characterization of Mouse Metabolic dysfunction-associated steatohepatitis-related Hepatocellular carcinoma organoids

Metabolic dysfunction-associated steatohepatitis is a form of chronic liver inflammation associated with metabolic syndrome, such as obesity and a major cause of hepatocellular carcinoma. Multi-biotics, a soymilk fermented with lactic acid bacteria, are known to alleviate obesity by lowering lipid profile. In this study, we investigated efficacy of multi-biotics in MASH-related HCC using mouse model fed choline-deficient L-amino acid-defined high-fat diet, and determined that tumor regression was not affected by multi-biotics. We established mouse MASH-related HCC organoids, and performed RNA-sequencing to identify transcriptomic features in MASH-HCC treated multi-biotics. We also examined response of MASH-related HCC to four HCC treatment drugs, and MASH-related HCC treated multi-biotics was good response to Lenvatinib. We established Lenvatinib-resistant MASH-related HCC organoids by administrating repeatedly Lenvatinib, and identified enriched pathways in Lenvatinib-resistant models. This study provides a tool for studying MASH-related HCC treatment and Lenvatinib resistance by establishing the MASH-related HCC and Lenvatinib resistance organoid model. Overall design: To investigate the effect of multi-biotics on MASH-related HCC, a mouse organoid was established, and changes that occurred when treated with multi-biotics were confirmed through transcriptomic analysis. To investigate the effect of multi-biotics in MASH-related HCC treated with Lenvatinib, we confirmed what transcriptomic changes occurred through RNA-seq.