The continuous inflammation and activation of matrix metalloproteinase (MMP) 9 and 12 and tissue inhibitor of metalloproteinase 1 (TIMP-1) can be followed by alterations in the lung extracellular matrix, which can occur earlier in ARDS and contribute to decreased lung function (González-López and Albaiceta, 2012; Bittencourt-Mernak et al., 2017). The gene discussed is TIMP1; the disease is acute respiratory distress syndrome.