Extracellular HMGB1, a potent pro-inflammatory mediator (Wang et al. 1999), can initiate an inflammatory response, facilitating the progression of sepsis and ALI (Entezari et al. 2014; Abraham et al. 2000; Kolliputi et al. 2010; Crapo et al. 1982; Liu et al. 2008). This evidence concerns the gene HMGB1 and acute respiratory distress syndrome.