In infections caused by gram-negative bacteria (such as Escherichia coli and Salmonella typhimurium), LPS stimulates the release of inflammatory factors by binding to toll-like receptor 4 on the surface of macrophages.25 Compared with certain existing models, the ACLF mouse model in this study includes features such as chronic liver injury, acute liver injury, bacterial infection, massive neutrophil infiltration, cytokine storm, hepatocyte damage, necrosis and apoptosis, and poor prognosis, which mimics the complex prognostic situation of clinical ACLF. This evidence concerns the gene TLR4 and bacterial infectious disease.