Elevated serum levels of several cytokines, including TNF-α, sTNF-αR1, sTNF-αR2, IL-2, IL-2R, IL-4, IL-6, IL-8, IL-10, and interferon-γ, have been described in patients with ACLF [19,22], whereas other studies reported normal TNF-α levels in patients with ACLF or acute liver failure [20,22,24]. Here, IL4 is linked to acute liver failure.