HMGB1 and acute respiratory distress syndrome: In addition, the high-mobility group box-1 protein (HMGB1), a late inflammatory mediator, can induce ALI by promoting NF-kB nuclear translocation, which can result in the release of inflammatory cytokines that further promote the release of HMGB1, resulting in a positive feedback loop that amplifies the inflammatory cascade (Entezari et al. 2014; Lee et al. 2018).