Furthermore, microRNA-199a (miR-199a) upregulation in AMs during Gram-negative bacterial sepsis also aggravates the sepsis-induced ALI, which can be prevented by the activation of sirtuin 1 [SIRT1 (Silent information regulator 2 homolog 1), an NAD+-dependent class III protein deacetylase or histone deacetylase regulating cell growth, differentiation, stress resistance, oxidative damage, and metabolism] (238, 239). This evidence concerns the gene SIRT1 and acute respiratory distress syndrome.