We read with great interest the finding that maladaptive emergency granulopoiesis (EG) predicts poor outcomes in patients hospitalized with acutely decompensated cirrhosis.1 The identification of a prognostic eigengene reflecting neutrophil differentiation and immunosuppression significantly advances our understanding of systemic inflammation as the key determinant of progression toward acute-on-chronic liver failure (ACLF). However, several points merit further discussion.
We read with great interest the finding that maladaptive emergency granulopoiesis (EG) predicts poor outcomes in patients hospitalized with acutely decompensated cirrhosis.1 The identification of a prognostic eigengene reflecting neutrophil differentiation and immunosuppression significantly advances our understanding of systemic inflammation as the key determinant of progression toward acute-on-chronic liver failure (ACLF). However, several points merit further discussion.