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The Kupffer cells respond by secreting pro-inflammatory cytokines and chemokines that drive a systemic inflammatory response and the recruitment of myeloid effector cells to the liver.53 Neutrophils have been reported to be among the earliest cells to arrive and may contribute to local tissue damage through the production of reactive oxygen species and the release of proteases.54 Other studies have failed to replicate this finding, and the role of neutrophils in early tissue injury remains controversial.55 Infiltrating monocytes, initially proinflammatory in function, mature within the liver to monocyte derived macrophages which have important tissue repair functions.56 In the systemic compartment, patients exhibit a numerical and functional deficit in circulating monocytes that renders them susceptible to infections.57 Understanding the innate immune response to liver injury – the balance between pro-inflammatory and tissue restorative functions and between local hepatic and systemic effects – will be vital to improving treatments and outcomes for patients with acute liver failure.58 In vivo imaging, while not a new technique, has been revolutionised over the past decades by improvements in fluorescence microscopy and surgical preparation

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Karyopyknotic cells in the affected brain areas (0–4), cerebral (NTP-7, Level 3), cerebellar cortex (NTP-7, Level 6), hippocampus, thalamus, and hypothalamus (NTP-7, Level 3) were analyzed as follows (score 0 indicates no change): score 1: a few karyopyknotic of neuronal cells (≤20%)