Sirt1 activation increases LPS-induced expression of tight junction proteins (TJs) in VECs, enhancing endothelial junctions to ensure vascular integrity, while this study suggests that Rho/ROCK inhibition may be a target for Sirt1 to reduce endothelial tight junction permeability to mitigate sepsis-associated ALI [167]. Here, SIRT1 is linked to acute respiratory distress syndrome.