In classic, cis-mediated signalling IL-6 binds to its membrane-bound receptor mIL-6R that is present on immune cells and modulates Janus kinases (JAKs) and signal transducer and activator of transcription 3 (STAT3); in trans-mediated signalling IL-6 binds to its soluble receptor sIL-6R, potentially impacting all cell surfaces; while in trans-mediated presentation, IL-6 binds to mIL-6R on immune cells leading to downstream T cell signalling precipitating acute respiratory distress syndrome.7 IL-6 inhibitors are known to suppress cis and trans signalling but not trans presentation. The gene discussed is IL6; the disease is acute respiratory distress syndrome.