Studies have found that the expression of TLR9 serves as a biomarker that determines presence and severity of encephalopathy in acute liver failure and cirrhosis, which can be used as a useful biomarker that differentiates those who develop high grade HE from those who do not[53]; Furthermore, Adipocytokine signaling pathway and Apoptosis are also worthy of attention. This evidence concerns the gene TLR9 and Encephalopathy.