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It is proposed that HE in ACLF is clinically distinct from that in acute decompensation driven by diverse pathological mechanisms in each entity [31], underscoring the multifactorial pathogenesis of this condition

MTX is the most commonly used anti-rheumatic drug, and it is often used in combination with other drugs (glucocorticoids or non-steroidal anti-inflammatory drugs) to achieve better therapeutic effects

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Key microbial groups involved in this process include Firmicutes, such as Lachnoclostridium, Clostridium hathewayi, Clostridium asparagiformis, and Clostridium sporogenes, as well as Proteobacteria, such as Escherichia coli MS 200-1, Escherichia fergusonii, Proteus penneri, Edwardsiella tarda, and Desulfovibrio desulfuricans

LIAS has also been identified as a key regulator of cuproptosis