For example, NETs in ALI/ARDS inflammation induced M1 pro-inflammatory macrophage polarization [48], whereas in diabetic wounds, NETs upregulated NLRP3 and pro-IL-1β levels via the TLR-4/TLR-9/NF-κB signaling pathway in macrophages, sustaining a local pronged inflammatory response [85]. Here, TLR4 is linked to acute respiratory distress syndrome.