01/27/2026
Metabolic dysfunction-associated steatohepatitis (MASH) is a common chronic liver disease in children and a leading cause of liver transplantation. While researchers have made strides in understanding MASH in adults, the disease is clinically different in children, and no current pediatric therapies exist. The research team is among the first in the nation to use innovative organoid technology to create cell models of pediatric liver disease for study in a culture dish. The research is designed to gain a better understanding of pediatric MASH and new insights to develop therapies for children.
Metabolic dysfunction-associated steatohepatitis (MASH) is the most common chronic liver disease in children and a leading cause of liver transplantation in children and adults worldwide. Characterized by fat deposits in the liver, MASH can cause liver inflammation, scarring, cirrhosis, and potentially a need for liver transplant. It’s estimated that MASH affects up to 38% of children with obesity, but the disease can occur in children who are not overweight. While researchers have made strides in understanding MASH in adults, the disease is clinically different in children and progresses more rapidly.
"There are currently no approved therapies for children with MASH," said Brian DeBosch, MD, PhD, a pediatric gastroenterologist at Riley Children’s Health, and a noted expert in the study of liver disease in both children and adults. “Optimized nutrition and exercise are our current mainstays for treating MASH in children, and while lifestyle changes should always be part of the equation, they often don’t fully address the disease or stop its progression.”
Understanding the biology of pediatric MASH, a first step in finding effective treatments, is difficult and limited by current basic science research models that don’t adequately reflect childhood liver disease. Dr. DeBosch’s Heartland-funded research aims to develop bioengineered liver “organoids”— in this case, mini models of pediatric liver disease—using innovative technology developed by his research partner Sunghee (Estelle) Park, PhD. An assistant professor of biomedical engineering at Purdue University, Dr. Park uses advanced platforms and patient-derived stem cells to create miniature organ models. These models help in understanding how diseases develop and progress.
Research using liver organoids is novel, even in adult liver studies. Harnessing this technology to investigate pediatric MASH, Dr. DeBosch and Dr. Park may be among the first in the nation to use organoid technology to create cell models of pediatric liver disease for study in a culture dish. Mimicking the biology of a liver inside a patient, the organoids are engineered to give the research team the best glimpse into what makes pediatric MASH unique—and ultimately, new insights to develop much-needed therapies.
“We hope this research will help us identify nutritional and pharmacological interventions best suited for children and adolescents with MASH,” said Dr. DeBosch, who is also a professor of pediatrics at Indiana University School of Medicine. “For the benefit of these children, we must go beyond the common advice to simply ‘eat less,’ to making better, more intentional recommendations that are rooted in a deeper, scientifically proven understanding of what contributes to MASH in children.”
A Project of the Heartland Children’s Nutrition Collaborative
This work is made possible through a generous gift to the Riley Children’s Foundation from the Ricks Family Foundation, led by Riley physician Christina Ricks, MD, and her husband David A. Ricks. Their support fuels the Heartland Children’s Nutrition Collaborative—a joint effort between the IU School of Medicine Department of Pediatrics and Purdue’s Department of Food Science—to uncover how early‑life nutrition can influence lifelong health outcomes.