MMP9 and acute liver failure: MMP-9 has a proven role in different hepatic disease such as the following: liver fibrogenesis; alcoholic liver cirrhosis (stage C) and hepatocellular carcinoma (HCC); promoting tumor invasion and metastasis; contributing to loss of blood–brain barrier integrity and edema during acute liver failure; accelerating liver regeneration and improving early-stage brain injuries in acute liver failure/fulminant hepatic failure [15].