In this study, through microarray analysis, we initially found that the downstream genes of TCA cycle: ACLY, ACO1, CS, DLAT, DLST, FH, IDH1, IDH3A, MDH1,MDH2, PDHA1, PDHB, SDHA, SUCLA2, and SUCLG2, had substantially reduced expression in blood of septic-ALI patients compared to healthy donors. Here, MDH1 is linked to acute respiratory distress syndrome.