Research Topic

Acute-On-Chronic Liver Failure: Natural History, Mechanism, And Treatment

About this Research Topic

Recently, acute-on-chronic liver failure (ACLF) is recognized as a critically-ill disease that develops on the basis of chronic liver diseases frequently due to acute precipitating events. ACLF is a highly dynamic and fatal disease, with a high prevalence in patients with decompensated cirrhosis, which imposes a heavy burden on health systems. The prediction of outcome is critical but difficult despite the presence of various prognostic systems. The only definite therapy for ACLF is liver transplantation, which is however limited by a shortage of donor organs. Other emerging therapies include artificial liver support systems, cell therapies, and GM-CSF, the efficacies of which have not been confirmed. Less is known about the mechanisms underlying the pathogenesis of ACLF.

For this Research Topic, we would like to create a forum for studies on the prediction of clinical outcomes of ACLF. This includes studies on how it evolves during the natural history and the major risk factors that shape disease outcomes, as well as identification of the optimal prognostic model among available ones and development of novel tools to improve the accuracy. We would also like to bring together recent advances in the development of novel therapies for ACLF. This includes elucidating the underlying mechanisms from multifaceted perspectives using animal models or biosamples of patients that would lead to the discovery of potential therapeutic targets, as well as evaluating the efficacy and safety of emerging therapies such as artificial liver supporting, cell therapy, and GM-CSF therapies.

We welcome submissions of Original Research, Brief Research Report, and Review articles covering (but not limited to) the following aspects:
• To characterize the natural history of ACLF including the precipitants, clinical course, complications, risk factors, short-term and long-term outcomes. (clinical studies)
• To investigate underlying uncontrolled hepatic and systemic inflammation of ACLF from aspects of virology, immunology, genome, transcriptome, epigenome, metabolism, and microbiome that leads to the identification of potential biomarkers or therapeutical targets. (basic or translational studies)
• To develop clinical models or biomarker-guiding models to accurately predict the short-term outcome of ACLF. (clinical or translational studies)
• To evaluate the efficacy and safety of emerging therapies such as artificial liver supporting systems, cell therapy, and GM-CSF therapies, and so on. (clinical studies)


Keywords: Viral hepatitis, acute-on-chronic liver failure, natural history, pathogenesis, treatment


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

Recently, acute-on-chronic liver failure (ACLF) is recognized as a critically-ill disease that develops on the basis of chronic liver diseases frequently due to acute precipitating events. ACLF is a highly dynamic and fatal disease, with a high prevalence in patients with decompensated cirrhosis, which imposes a heavy burden on health systems. The prediction of outcome is critical but difficult despite the presence of various prognostic systems. The only definite therapy for ACLF is liver transplantation, which is however limited by a shortage of donor organs. Other emerging therapies include artificial liver support systems, cell therapies, and GM-CSF, the efficacies of which have not been confirmed. Less is known about the mechanisms underlying the pathogenesis of ACLF.

For this Research Topic, we would like to create a forum for studies on the prediction of clinical outcomes of ACLF. This includes studies on how it evolves during the natural history and the major risk factors that shape disease outcomes, as well as identification of the optimal prognostic model among available ones and development of novel tools to improve the accuracy. We would also like to bring together recent advances in the development of novel therapies for ACLF. This includes elucidating the underlying mechanisms from multifaceted perspectives using animal models or biosamples of patients that would lead to the discovery of potential therapeutic targets, as well as evaluating the efficacy and safety of emerging therapies such as artificial liver supporting, cell therapy, and GM-CSF therapies.

We welcome submissions of Original Research, Brief Research Report, and Review articles covering (but not limited to) the following aspects:
• To characterize the natural history of ACLF including the precipitants, clinical course, complications, risk factors, short-term and long-term outcomes. (clinical studies)
• To investigate underlying uncontrolled hepatic and systemic inflammation of ACLF from aspects of virology, immunology, genome, transcriptome, epigenome, metabolism, and microbiome that leads to the identification of potential biomarkers or therapeutical targets. (basic or translational studies)
• To develop clinical models or biomarker-guiding models to accurately predict the short-term outcome of ACLF. (clinical or translational studies)
• To evaluate the efficacy and safety of emerging therapies such as artificial liver supporting systems, cell therapy, and GM-CSF therapies, and so on. (clinical studies)


Keywords: Viral hepatitis, acute-on-chronic liver failure, natural history, pathogenesis, treatment


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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Submission Deadlines

22 August 2021 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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Topic Editors

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Submission Deadlines

22 August 2021 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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