This study was the first to explore the changes of iron metabolism indicators in ALI/ARDS of sepsis, clarify the importance of ferroptosis in the occurrence and development of ALI/ARDS of sepsis, and reveal the role and specific mechanism of MUC1 in regulating ferroptosis, as well as the sensitization of vitamin E. MUC1 can inhibit Keap1, increase the phosphorylation level of GSK3β, and promote Nrf2 entry into the nucleus, thus improving the expression level of GPX4, sensitizing vitamin E, inhibiting ferroptosis, and alleviating acute lung injury in sepsis. This evidence concerns the gene KEAP1 and acute respiratory distress syndrome.