Xie BY, Ma YR, Ren ZG. Letter to the Editor: Unlinking lymphocyte counts from disease severity in patients with acute-on-chronic liver failure. World J Gastroenterol 2026; 32(25): 117033 [DOI: 10.3748/wjg.117033]
Corresponding Author of This Article
Zhi-Gang Ren, MD, PhD, Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, Jianshe East Road, Zhengzhou 450052, Henan Province, China. fccrenzg@zzu.edu.cn
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Gastroenterology & Hepatology
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letter
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Xie BY, Ma YR, Ren ZG. Letter to the Editor: Unlinking lymphocyte counts from disease severity in patients with acute-on-chronic liver failure. World J Gastroenterol 2026; 32(25): 117033 [DOI: 10.3748/wjg.117033]
World J Gastroenterol. Jul 7, 2026; 32(25): 117033 Published online Jul 7, 2026. doi: 10.3748/wjg.117033
Letter to the Editor: Unlinking lymphocyte counts from disease severity in patients with acute-on-chronic liver failure
Bo-Ya Xie, Ya-Rong Ma, Zhi-Gang Ren
Bo-Ya Xie, The First Clinical Medical College of Zhengzhou University, Zhengzhou University, Zhengzhou 450001, Henan Province, China
Ya-Rong Ma, Zhi-Gang Ren, Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, Zhengzhou 450052, Henan Province, China
Author contributions: Xie BY was responsible for conceptualization, initial draft preparation, production of the figure, and manuscript revision; Ma YR was responsible for review and revision of the manuscript; Ren ZG was responsible for conceptualization, review and critical revision of the manuscript; all of the authors have read and approved the final manuscript.
AI contribution statement: DeepSeek was used as a language polishing tool. The AI language model DeepSeek as an auxiliary tool during the preparation and writing of this study. Its specific use was limited to language expression optimization, including grammar checking and sentence polishing for parts of the manuscript to improve the fluency of English writing. I solemnly declare that all core scholarly content of this study, including the conception of the research questions and formulation of hypotheses; data collection and analysis; interpretation of results and derivation of scientific conclusions, was completed independently by me (and my co-authors). The main arguments, original viewpoints, and final manuscript were all independently developed by me. The AI tool did not participate in any critical steps requiring originality or creative judgment.
Supported by Prevention and Control of Emerging and Major Infectious Diseases-National Science and Technology Major Project, No. 2025ZD01906305; Natural Science Foundation Key Project of Henan Province, No. 232300421124; and Henan Zhongyuan Medical Science and Technology Innovation and Development Foundation, No. ZYYC202301ZD.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Zhi-Gang Ren, MD, PhD, Department of Infectious Diseases, State Key Laboratory of Antiviral Drugs, Pingyuan Laboratory, Jianshe East Road, Zhengzhou 450052, Henan Province, China. fccrenzg@zzu.edu.cn
Received: November 26, 2025 Revised: January 26, 2026 Accepted: February 6, 2026 Published online: July 7, 2026 Processing time: 216 Days and 4.8 Hours
Abstract
We have carefully reviewed the recent study by Peng et al published in World Journal of Gastroenterology. Studies have indicated the presence of widespread lymphopenia in patients with acute-on-chronic liver failure (ACLF), along with rapid reconstitution of natural killer cells and B cells following liver transplantation. Furthermore, the absolute counts of peripheral blood lymphocyte subsets are not significantly correlated with the etiology of ACLF, multiple disease severity scores, or long-term prognosis after liver transplantation. This “negative result” may suggest that the immunopathology of ACLF cannot be fully captured by simple cell counts alone. We need to focus on the functional status of peripheral blood lymphocyte subsets and implement dynamic monitoring based on these subsets.
Core Tip: Commenting on the study by Peng et al, we offer insights into the finding that absolute counts of peripheral blood lymphocyte subsets are not significantly correlated with the etiology of acute-on-chronic liver failure, severity scores across multiple diseases, or long-term outcomes after liver transplantation. We believe that greater emphasis should be placed on monitoring the functional status of peripheral blood lymphocytes to better understand disease progression.
