In the hyperoxia-induced ALI animal model, epithelial cells release EVs enriched in caspase-3, which are internalized by macrophages, triggering the secretion of pro-inflammatory molecules such as TNF-α, IL-6, and macrophage inflammatory protein 2 (MIP-2) through activation of Rho-associated protein kinase 1 (ROCK1) (Moon et al., 2015). This evidence concerns the gene IL6 and acute respiratory distress syndrome.