Publication Name	World Journal of Hepatology
Manuscript ID	125101
DOI	10.4254/wjh.125101
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Observational Study
Article Title	Peripheral immune landscape in hepatitis B virus-related acute-on-chronic liver failure: Tumor necrosis factor-α, M1-like macrophages, and lymphocyte exhaustion
Manuscript Source	Unsolicited Manuscript
All Author List	Ying Lin, Hui-Hui Chen, Dong-Yang Zhong, Wei-Zhen Chen, Bing-Wang Jie, Yu-Wei Shen, Dan Xie and Shi Ouyang
Funding Agency and Grant Number	Funding Agency Grant Number Guangdong Basic and Applied Research Foundation 2023A1515220242 2024 Tertiary Education Scientific research project of Guangzhou Municipal Education Bureau 2024312257 2025 National College Students’ Innovation and Entrepreneurship Training Program of Guangzhou Medical University S202510570044 Artificial Liver Special Foundation of Beijing iGandan Foundation iGandanF-1082023-RGG023
Corresponding Author	Shi Ouyang, Department of Infectious Diseases, Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital, Guangzhou Medical University, No. 621 Gangwan Road, Huangpu District, Guangzhou, Guangdong Province, Guangzhou 510799, Guangdong Province, China. ouyangshi@gzhmu.edu.cn
Key Words	Acute-on-chronic liver failure; Peripheral immune remodeling; Immune crosstalk; Macrophage polarization; Tumor necrosis factor-alpha
Core Tip	Our research provides direct clinical phenotypic validation at the protein and cellular levels. In a prospective cross-sectional study of 97 subjects, utilizing least absolute shrinkage and selection operator and multivariable logistic regression with false discovery rate correction, we identified elevated tumor necrosis factor-alpha (TNF-α) as an independent associated factor. Furthermore, we characterized ‘TNF-α-M1 polarization-lymphocyte exhaustion’ and ‘M2 polarization-neutrophil activation’ as sets of associated features. These findings highlight TNF-α as a key immunopathological associated factor and a potential focus for future therapeutic research.
Citation	Lin Y, Chen HH, Zhong DY, Chen WZ, Jie BW, Shen YW, Xie D, Ouyang S. Peripheral immune landscape in hepatitis B virus-related acute-on-chronic liver failure: Tumor necrosis factor-α, M1-like macrophages, and lymphocyte exhaustion. World J Hepatol 2026; In press DOI: https://doi.org/10.4254/wjh.125101
PDF	125101-in-press.pdf

Received	2026-07-03 08:21
Peer-Review Started	2026-07-03 08:22
First Decision by Editorial Office Director
Return for Revision	2026-07-11 13:45
Revised	2026-07-24 18:29
Publication Fee Transferred	2026-08-28 12:37
Second Decision by Editor	2026-11-05 03:30
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-11-05 07:52
Articles in Press	2026-11-05 07:52
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5182 (online)
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