Quantification of Systemic Inflammation by a Gene Score Uncovers Relevant Features on Acutely Decompensated Cirrhosis

Acutely decompensated cirrhosis (ADC) is related to systemic inflammation (SI) due to activation of the innate-immune system. Acute-on-Chronic Liver Failure (ACLF) is the extreme expression of this process. We developed a gene score to quantify SI in ADC. Overall design: Whole-blood RNA-seq was performed in 700 patients (Cohort 1) (Figure 1A), 383 from the PREDICT study and 317 from the ACLARA study, explored by whole-blood RNA sequencing (RNA-seq) within 2 days after hospital admission (time 1, T1). In 375 of these patients (Sub-cohort 1a), a second RNA-seq was performed at T2 (median duration of the T1-T2 period 7 days; 75% CI: 5- 8 days). Finally, 51 patients from Sub-cohort 1a, who were explored by one or two additional RNA-seq after T2, formed the Sub-cohort 1b. The CLF-SIG score was designed in Cohort 1. The early course of CLIF-SIG score was estimated in Sub-cohort 1a and more in detail in Sub-cohort 1b. Cohort 1 and Sub-cohort 1a included patients with and without ACLF at T1. Sub-cohort 1b included only patients without ACLF. Whole-blood RNA-seq was also performed in 25 healthy subjects as a control group.