Ang-II pathways are related to pathologic features of ARDS and Ang-II is not only a vasoconstrictor but also interferes with adaptive immunity through the stimulation of macrophages and other immune cells [44] in addition to enhancing inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6. Here, TNF is linked to acute respiratory distress syndrome.