The pathways of danger-associated molecular patterns (DAMPs), IL-33 (ST2) and coagulation drive ARDS and MV, whereas final outcome is dominated by excess of a proinflammatory state through the IL-6, IL-33 and DAMPs pathways, as well as by decreased levels of the anti-inflammatory pathways IL-38 and IL-1ra. The gene discussed is IL1RL1; the disease is acute respiratory distress syndrome.