Patients with ARDS had significantly lower serum S1P levels(median 303.0 nmol/L, IQR 221.3–418.5 nmol/L) than controls (median 930.5 nmol/L, IQR733.2–1153.4 nmol/L, P < 0.001) (Fig. 1a).Gender bias was not detected in both controls and patients (Fig. 1b). This evidence concerns the gene MBTPS1 and acute respiratory distress syndrome.