This issue of Critical Care presents a novel human genomics study showing that variants of thrombomodulin (TM) and the endothelial protein C receptor (EPCR), but not protein C, are associated with mortality and organ dysfunction (ventilation-free and organ failure-free days) in ARDS—that is, they are prognostic biomarkers [1]. The gene discussed is THBD; the disease is acute respiratory distress syndrome.