These changes were consistent with the changes in IL-1β, TNF-α, and IL-10 levels observed through ELISA (Fig. 1b–d), suggesting that VNS can promote the transformation of macrophages from M1 to M2 in ARDS rats by acting on α7nAchR, and affect the secretion of inflammatory factors and inflammatory response. Here, IL1B is linked to acute respiratory distress syndrome.