The major findings of this study were as follows: (1) serum S1Plevels were significantly lower in ARDS patients than in healthy controls; (2) reducedserum S1P levels in ARDS patients were associated with more organ dysfunction and highermortality; and (3) the S1P rs3743631, rs907045polymorphisms are associated with susceptibility to ARDS. Here, MBTPS1 is linked to acute respiratory distress syndrome.