2018; Fusco et al. 2020; Huang et al. 2020). However, the exact role of HMGB1 in tissue injury induced by AP and subsequent local or systemic inflammatory responses remains to further explore (Kang et al. 2014). Studies have found that HMGB1, as an inflammatory mediator, can stimulate the inflammatory cascade reaction and lead to SIRS, which is intimately associated in the intestinal lymphatic pathway and plays a crucial role in SAP-ALI (Christgen and Kanneganti 2021; Tang et al. 2021). Here, HMGB1 is linked to acute respiratory distress syndrome.