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Background: ACLF remains poorly defined entity, largely because of the considerable heterogeneity in the mode of clinical presentation. Though ACLF has very high mortality, it has a potential of reversibility. Dysregulated immune response may facilitate disease progression. Understanding the pathogenesis of hepatocellular injury in liver could help to initiate early interventional approaches. Aim: To study the immune profile in hepatic parenchyma, peripheral vein (PV) and hepatic vein blood (HV) in ACLF patients and compared with the healthy control (HC). Patients and Methods: Thirty well characterized ACLF patients and eight healthy controls were recruited. Transjugular liver biopsy, HV and PV blood collected from ACLF patients and PV blood from healthy controls. Mononuclear cells isolated from blood by Ficoll Hypaque and from biopsy by mechanical disruption by BD Medimachine. Results: Frequencies of …