{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:50:19Z","timestamp":1792785019046,"version":"4.5.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"National 12th 5-year Plan for Hepatitis Research","award":["No.2012ZX10002004-011"],"award-info":[{"award-number":["No.2012ZX10002004-011"]}]},{"name":"National 13th 5-Year Plan for Hepatitis Research","award":["No.2017ZX10203201-007"],"award-info":[{"award-number":["No.2017ZX10203201-007"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-09620-9","type":"journal-article","created":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T03:38:21Z","timestamp":1752377901000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical differences between HBV and alcohol related ACLF in a WGO classification multicenter study"],"prefix":"10.1038","volume":"15","author":[{"given":"Qian","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxuan","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaotian","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiale","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caiyan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liaoyun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanhua","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaojie","family":"Xin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongping","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"issue":"Suppl 1","key":"9620_CR1","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1016\/j.jhep.2020.11.047","volume":"75","author":"R Moreau","year":"2021","unstructured":"Moreau, R., Gao, B., Papp, M., Banares, R. & Kamath, P. S. Acute-on-chronic liver failure: A distinct clinical syndrome. J. Hepatol. 75(Suppl 1), S27\u2013S35. https:\/\/doi.org\/10.1016\/j.jhep.2020.11.047 (2021).","journal-title":"J. Hepatol."},{"key":"9620_CR2","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.jhep.2024.03.036","volume":"81","author":"AV Kulkarni","year":"2024","unstructured":"Kulkarni, A. V. & Sarin, S. K. Acute-on-chronic liver failure-steps towards harmonization of the definition!. J. Hepatol. 81, 360\u2013366. https:\/\/doi.org\/10.1016\/j.jhep.2024.03.036 (2024).","journal-title":"J. Hepatol."},{"key":"9620_CR3","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.1016\/j.cgh.2024.04.018","volume":"22","author":"A Aggarwal","year":"2024","unstructured":"Aggarwal, A. et al. Definitions, etiologies, and outcomes of acute on chronic liver failure: A systematic review and meta-analysis. Clin. Gastroenterol. Hepatol. 22, 2199-2210 e2125. https:\/\/doi.org\/10.1016\/j.cgh.2024.04.018 (2024).","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"9620_CR4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2020.100176","volume":"3","author":"G Zaccherini","year":"2021","unstructured":"Zaccherini, G., Weiss, E. & Moreau, R. Acute-on-chronic liver failure: Definitions, pathophysiology and principles of treatment. JHEP Rep. 3, 100176. https:\/\/doi.org\/10.1016\/j.jhepr.2020.100176 (2021).","journal-title":"JHEP Rep."},{"key":"9620_CR5","doi-asserted-by":"publisher","first-page":"225","DOI":"10.14309\/ajg.0000000000001595","volume":"117","author":"JS Bajaj","year":"2022","unstructured":"Bajaj, J. S. et al. Acute-on-chronic liver failure clinical guidelines. Am. J. Gastroenterol. 117, 225\u2013252. https:\/\/doi.org\/10.14309\/ajg.0000000000001595 (2022).","journal-title":"Am. J. Gastroenterol."},{"key":"9620_CR6","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1007\/s12072-019-09946-3","volume":"13","author":"SK Sarin","year":"2019","unstructured":"Sarin, S. K. et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): An update. Hepatol. Int. 13, 353\u2013390. https:\/\/doi.org\/10.1007\/s12072-019-09946-3 (2019).","journal-title":"Hepatol. Int."},{"key":"9620_CR7","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1136\/gutjnl-2017-314641","volume":"67","author":"T Wu","year":"2018","unstructured":"Wu, T. et al. Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure. Gut 67, 2181\u20132191. https:\/\/doi.org\/10.1136\/gutjnl-2017-314641 (2018).","journal-title":"Gut"},{"key":"9620_CR8","doi-asserted-by":"publisher","unstructured":"Liver, F., Artificial Liver Group, C. S. o. I. D. C. M. A., Severe Liver, D. & Artificial Liver Group, C. S. o. H. C. M. A. [Guideline for diagnosis and treatment of liver failure]. Zhonghua Gan Zang Bing Za Zhi 27, 18\u201326, https:\/\/doi.org\/10.3760\/cma.j.issn.1007-3418.2019.01.006 (2019).","DOI":"10.3760\/cma.j.issn.1007-3418.2019.01.006"},{"key":"9620_CR9","doi-asserted-by":"publisher","unstructured":"European Association for the Study of the, L. EASL Clinical Practice Guidelines on acute-on-chronic liver failure. J. Hepatol. 79, 461\u2013491, https:\/\/doi.org\/10.1016\/j.jhep.2023.04.021 (2023).","DOI":"10.1016\/j.jhep.2023.04.021"},{"key":"9620_CR10","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1097\/HEP.0000000000000671","volume":"79","author":"CJ Karvellas","year":"2024","unstructured":"Karvellas, C. J. et al. AASLD practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis. Hepatology 79, 1463\u20131502. https:\/\/doi.org\/10.1097\/HEP.0000000000000671 (2024).","journal-title":"Hepatology"},{"key":"9620_CR11","doi-asserted-by":"publisher","unstructured":"Moreau, R. et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 144, 1426\u20131437, 1437 e1421\u20131429, https:\/\/doi.org\/10.1053\/j.gastro.2013.02.042 (2013).","DOI":"10.1053\/j.gastro.2013.02.042"},{"key":"9620_CR12","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1053\/j.gastro.2014.05.005","volume":"147","author":"R Jalan","year":"2014","unstructured":"Jalan, R. et al. Toward an improved definition of acute-on-chronic liver failure. Gastroenterology 147, 4\u201310. https:\/\/doi.org\/10.1053\/j.gastro.2014.05.005 (2014).","journal-title":"Gastroenterology"},{"key":"9620_CR13","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1002\/hep.21563","volume":"45","author":"PS Kamath","year":"2007","unstructured":"Kamath, P. S., Kim, W. R., Advanced Liver Disease Study, G. The model for end-stage liver disease (MELD). Hepatology 45, 797\u2013805. https:\/\/doi.org\/10.1002\/hep.21563 (2007).","journal-title":"Hepatology"},{"key":"9620_CR14","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1053\/j.gastro.2006.02.010","volume":"130","author":"SW Biggins","year":"2006","unstructured":"Biggins, S. W. et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology 130, 1652\u20131660. https:\/\/doi.org\/10.1053\/j.gastro.2006.02.010 (2006).","journal-title":"Gastroenterology"},{"key":"9620_CR15","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1016\/j.jhep.2014.06.012","volume":"61","author":"R Jalan","year":"2014","unstructured":"Jalan, R. et al. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J. Hepatol. 61, 1038\u20131047. https:\/\/doi.org\/10.1016\/j.jhep.2014.06.012 (2014).","journal-title":"J. Hepatol."},{"key":"9620_CR16","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1016\/j.jhep.2021.05.026","volume":"75","author":"J Li","year":"2021","unstructured":"Li, J. et al. Development and validation of a new prognostic score for hepatitis B virus-related acute-on-chronic liver failure. J. Hepatol. 75, 1104\u20131115. https:\/\/doi.org\/10.1016\/j.jhep.2021.05.026 (2021).","journal-title":"J. Hepatol."},{"key":"9620_CR17","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1002\/hep.29581","volume":"67","author":"S Macdonald","year":"2018","unstructured":"Macdonald, S. et al. Cell death markers in patients with cirrhosis and acute decompensation. Hepatology 67, 989\u20131002. https:\/\/doi.org\/10.1002\/hep.29581 (2018).","journal-title":"Hepatology"},{"key":"9620_CR18","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1002\/hep.28740","volume":"64","author":"J Claria","year":"2016","unstructured":"Claria, J. et al. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure. Hepatology 64, 1249\u20131264. https:\/\/doi.org\/10.1002\/hep.28740 (2016).","journal-title":"Hepatology"},{"key":"9620_CR19","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1136\/gutjnl-2020-323395","volume":"71","author":"J Li","year":"2022","unstructured":"Li, J. et al. PBMC transcriptomics identifies immune-metabolism disorder during the development of HBV-ACLF. Gut 71, 163\u2013175. https:\/\/doi.org\/10.1136\/gutjnl-2020-323395 (2022).","journal-title":"Gut"},{"key":"9620_CR20","doi-asserted-by":"publisher","first-page":"5170","DOI":"10.3390\/ijms22105170","volume":"22","author":"SY Liu","year":"2021","unstructured":"Liu, S. Y., Tsai, I. T. & Hsu, Y. C. Alcohol-related liver disease: Basic mechanisms and clinical perspectives. Int. J. Mol. Sci. 22, 5170. https:\/\/doi.org\/10.3390\/ijms22105170 (2021).","journal-title":"Int. J. Mol. Sci."},{"key":"9620_CR21","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.jhep.2015.01.029","volume":"63","author":"H Li","year":"2015","unstructured":"Li, H. et al. Submassive hepatic necrosis distinguishes HBV-associated acute on chronic liver failure from cirrhotic patients with acute decompensation. J. Hepatol. 63, 50\u201359. https:\/\/doi.org\/10.1016\/j.jhep.2015.01.029 (2015).","journal-title":"J. Hepatol."},{"key":"9620_CR22","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.jceh.2021.12.010","volume":"12","author":"MP Ballester","year":"2022","unstructured":"Ballester, M. P., Sittner, R. & Jalan, R. Alcohol and acute-on-chronic liver failure. J. Clin. Exp. Hepatol. 12, 1360\u20131370. https:\/\/doi.org\/10.1016\/j.jceh.2021.12.010 (2022).","journal-title":"J. Clin. Exp. Hepatol."},{"key":"9620_CR23","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1038\/nrgastro.2015.35","volume":"12","author":"A Louvet","year":"2015","unstructured":"Louvet, A. & Mathurin, P. Alcoholic liver disease: Mechanisms of injury and targeted treatment. Nat. Rev. Gastroenterol. Hepatol. 12, 231\u2013242. https:\/\/doi.org\/10.1038\/nrgastro.2015.35 (2015).","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"9620_CR24","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1002\/hep.27077","volume":"60","author":"JS Bajaj","year":"2014","unstructured":"Bajaj, J. S. et al. Survival in infection-related acute-on-chronic liver failure is defined by extrahepatic organ failures. Hepatology 60, 250\u2013256. https:\/\/doi.org\/10.1002\/hep.27077 (2014).","journal-title":"Hepatology"},{"key":"9620_CR25","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1056\/NEJMra1914900","volume":"382","author":"V Arroyo","year":"2020","unstructured":"Arroyo, V., Moreau, R. & Jalan, R. Acute-on-chronic liver failure. N. Engl. J. Med. 382, 2137\u20132145. https:\/\/doi.org\/10.1056\/NEJMra1914900 (2020).","journal-title":"N. Engl. J. Med."},{"key":"9620_CR26","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1111\/jgh.12787","volume":"30","author":"Y Shi","year":"2015","unstructured":"Shi, Y. et al. Increased delayed mortality in patients with acute-on-chronic liver failure who have prior decompensation. J. Gastroenterol. Hepatol. 30, 712\u2013718. https:\/\/doi.org\/10.1111\/jgh.12787 (2015).","journal-title":"J. Gastroenterol. Hepatol."},{"key":"9620_CR27","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1053\/jhep.2001.22172","volume":"33","author":"PS Kamath","year":"2001","unstructured":"Kamath, P. S. et al. A model to predict survival in patients with end-stage liver disease. Hepatology 33, 464\u2013470. https:\/\/doi.org\/10.1053\/jhep.2001.22172 (2001).","journal-title":"Hepatology"},{"key":"9620_CR28","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1002\/hep.27795","volume":"62","author":"Y Shi","year":"2015","unstructured":"Shi, Y. et al. Acute-on-chronic liver failure precipitated by hepatic injury is distinct from that precipitated by extrahepatic insults. Hepatology 62, 232\u2013242. https:\/\/doi.org\/10.1002\/hep.27795 (2015).","journal-title":"Hepatology"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-09620-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-09620-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-09620-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T03:38:23Z","timestamp":1752377903000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-09620-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,13]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["9620"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-09620-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,13]]},"assertion":[{"value":"20 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"25292"}}