eprintid: 10203683 rev_number: 20 eprint_status: archive userid: 699 dir: disk0/10/20/36/83 datestamp: 2025-01-21 15:35:09 lastmod: 2025-01-21 15:35:09 status_changed: 2025-01-21 15:35:09 type: poster metadata_visibility: show sword_depositor: 699 creators_name: Alkhouri, Naim creators_name: Akbary, Kutbuddin creators_name: Ren, Yayun creators_name: Naoumov, Nikolai creators_name: Chng, Elaine creators_name: Tai, Dean creators_name: Brees, Dominique title: Comparative Evaluation of Zonal Fibrosis Patterns in Pediatric and Adult Metabolic Dysfunction-associated Steatohepatitis Biopsies Using Second Harmonic Generation/two Photon Excitation-based qFibrosis Analysis ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 note: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent among children, constituting the most common chronic liver ailment. Prior studies of liver biopsies from pre-adolescent children with metabolic dysfunction-associated steatohepatitis (MASH) identified an alternate pattern characterized by zone 1 centered steatosis, inflammation, and fibrosis, usually without ballooning, which may progress to advanced fibrosis. The aim of this study was to evaluate pediatric MASH biopsies using Second Harmonic Generation (SHG)/Two-Photon Excitation (TPE) microscopy and Artificial Intelligence (AI) analysis and compare the fibrosis patterns and distribution with biopsies from adults with MASH. // Methods: Nine unstained biopsies from children (aged 8 to 16 years) with MASH underwent SHG/TPE and AI analysis, yielding qFibrosis continuous values categorized into qFibrosis stages, based on pre-defined cut-offs. Biopsies were segregated into early (qF0/qF1/qF2; n=3) and advanced (qF3/qF4; n=6) fibrosis groups. Comparative analysis involved an adult cohort from a MASH clinical trial (NCT02855164), similarly categorized into early (n=96) and advanced (n=60) fibrosis stages. Fibrosis distribution in both cohorts was plotted on radar maps illustrating portal; periportal; perisinusoidal (zone 2), pericentral and central vein fibrosis, with zonal differences statistically significant at p≤0.05 by Spearman test. // Results: In the early fibrosis groups, pediatric biopsies exhibited significantly greater perisinusoidal (PS) (p=0.03) and more portal fibrosis compared to adults. In advanced fibrosis groups, pediatric biopsies demonstrated significantly less portal fibrosis (p=0.02) along with markedly increased PS fibrosis (p=0.01) compared to adult biopsies. Additionally, pediatric biopsies in advanced fibrosis group had more fibrosis in periportal (PP) and pericentral (PC) regions compared to adult biopsies. // Conclusion: This quantitative digital evaluation of MASH fibrosis highlights significant differences in zonal fibrosis distribution in pediatric MASH biopsies compared to adults. During the early fibrosis stage, pediatric biopsies show increased perisinusoidal and portal fibrosis in contrast to their adult counterparts. At advanced stages, there is significantly less portal fibrosis in pediatric biopsies compared to adults, although perisinusoidal fibrosis remains significantly greater in the pediatric group. The observed differences in fibrosis patterns hold potential implications for accurate assessment of fibrosis regression in pediatric MASH clinical trials. date: 2024-10 date_type: published publisher: LIPPINCOTT WILLIAMS & WILKINS official_url: https://doi.org/10.1097/hep.0000000000001077 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2351747 doi: 10.1097/HEP.0000000000001077 lyricists_name: Naoumov, Nikolai lyricists_id: NNAOU69 actors_name: Naoumov, Nikolai actors_id: NNAOU69 actors_role: owner full_text_status: public pres_type: paper publication: Hepatology volume: 80 number: S1 pagerange: S563-S564 pages: 2 event_title: AASLD The Liver Meeting event_location: San Diego, California, USA event_dates: Oct 2024 issn: 0270-9139 book_title: HEPATOLOGY citation: Alkhouri, Naim; Akbary, Kutbuddin; Ren, Yayun; Naoumov, Nikolai; Chng, Elaine; Tai, Dean; Brees, Dominique; (2024) Comparative Evaluation of Zonal Fibrosis Patterns in Pediatric and Adult Metabolic Dysfunction-associated Steatohepatitis Biopsies Using Second Harmonic Generation/two Photon Excitation-based qFibrosis Analysis. Presented at: AASLD The Liver Meeting, San Diego, California, USA. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10203683/1/AASLD2024_Pediatric%20vs%20Adult%20NASH_comparison%20Alkhouri.pdf