Immune Stratification for Precision Care in Decompensated Cirrhosis and ACLF

Decompensated cirrhosis and acute-on-chronic liver failure (ACLF) represent critical stages of chronic liver disease, characterized by rapid deterioration, multi-organ dysfunction, and high short-term mortality. Despite advances in clinical management, outcomes remain highly variable — largely because immune dysregulation, a central driver of disease progression, manifests differently across patients.Emerging evidence highlights the complexity of the immune landscape in these conditions, encompassing systemic inflammation, immune paresis, gut-barrier disruption, and dysbiosis. Yet immune profiling is rarely integrated into clinical decision-making, and a clear framework for immune-guided stratification is still lacking.This Research Topic aims to consolidate current knowledge and stimulate new research at the intersection of immunology, hepatology, and precision medicine. We welcome Original Research, Reviews, and Clinical Studies addressing immune biomarkers, endotyping strategies, therapeutic targets, and novel tools — including multi-omics and artificial intelligence — that can translate immune stratification into personalised, precision care pathways for patients with decompensated cirrhosis and ACLF. Topic editors: Rashi Sehgal, Mojahidul Islam Source: https://www.frontiersin.org/research-topics/82947/immune-stratification-for-precision-care-in-decompensated-cirrhosis-and-aclf