Metabolic Dysfunction-associated Steatotic Liver Disease Diminishes the Efficacy of miR-125b-5p-engineered MSC Therapy for Hepatocellular Carcinoma via HK2 Upregulation: A Multimodal Theranostic Study

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality, underscoring the need for effective therapies. Although miR-125b-5p shows therapeutic potential, its efficacy in metabolic dysfunction-associated steatotic liver disease (MASLD)-related HCC and the underlying mechanisms remain unclear. In this study, we aimed to develop an MRI-trackable miR-125b-5p-engineered MSC platform for HCC therapy and to determine whether MASLD attenuates its antitumor efficacy through metabolic reprogramming.