In patients with compensated cirrhosis, monocytes increase their expression of HLA-DR and increase the spontaneous production of TNF (due to the alteration in the inducible suppressor of TNF) and IL-10; however, when the disease progresses—for example, patients with ACLF and acute decompensation of cirrhosis had increased numbers of MER receptor tyrosine kynase (MERKT)-expressing monocytes and macrophages—this results in a decrease in the activation of TLR and pro-inflammatory cytokines and an increase in anti-inflammatory cytokines (IL-10). Here, TNF is linked to Cirrhosis.