HMGB1 and acute respiratory distress syndrome: HMGB1 is required for post‐APAP injury inflammation and has been shown to be pivotal in the progression of APAP‐ALI, and hepatocyte‐specific HMGB1 deficiency improves survival.14 In a clinical setting, HMGB1 serves as a promising sensitive and specific biomarker of APAP‐ALI, outperforming alanine aminotransferase (ALT) as a marker of progression and as an indicator of outcome.2, 10 The initial APAP‐induced hepatocyte necrosis results in an initial release of all‐thiol HMGB1.