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In the current study, we are the first to isolate and characterize EVs isolated from human precision\u2010cut liver slices (PCLS), obtained from both healthy and metabolic dysfunction\u2010associated steatohepatitis (MASH) cirrhotic livers. PCLS derived from patients can faithfully represent disease conditions in humans. EVs were isolated from human PCLS after incubating in normal medium or modified medium that mimics the pathophysiological environment of metabolic dysfunction associated liver disease (MASLD). MASH PCLS produced higher amounts of EVs compared to healthy PCLS (<jats:italic>p<\/jats:italic> &lt; 0.001). Mass spectrometry revealed that around 300 proteins were significantly different in EVs derived from MASH PCLS versus healthy PCLS (FDR &lt; 0.05), irrespective of the type of medium. Significantly changed EV proteins were largely involved in signalling receptor binding function and showed potential in promoting fibrosis. In the liver, these ligand\u2010associated receptors are highly expressed in hepatic stellate cells, and the MASH EVs functionally promoted the activation of hepatic stellate cells. Furthermore, the amounts of EpCAM and ITGA3 in EVs were positively associated with the progression of MASLD, which suggests the use of liver\u2010derived EVs as potential biomarkers for MASLD. Characterization of EVs derived from human PCLS may assist future studies in investigating the pathogenesis and identifying liver\u2010specific EVs as biomarkers of MASLD.<\/jats:p>","DOI":"10.1002\/jex2.70043","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T22:27:22Z","timestamp":1746052042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Characterization of Extracellular Vesicles Derived From Human Precision\u2010Cut Liver Slices in Metabolic Dysfunction\u2010Associated Steatotic Liver Disease"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1529-0875","authenticated-orcid":false,"given":"Yana","family":"Geng","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Technology and Biopharmacy, Groningen Research Institute of Pharmacy University of Groningen  Groningen the 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