In this study, we combined in vivo CLP-induced ALI mouse model with the in vitro LPS-challenged mouse pulmonary microvascular endothelial cell (MPVEC) model, measured the expression of circEXOC5 in ALI, examined its functional impacts on inflammation and autophagy, and explored the underlying mechanisms, with specific focus on PTBP1, Skp2, and Runx2. This evidence concerns the gene SKP2 and acute respiratory distress syndrome.