While we propose that HMGB1 could serve as a prognostic marker for ARDS in a military related trauma model, potentially adding valuable information for early diagnosis of ARDS, it should be noted that due to the complexity of the pathogenesis of ARDS, many risk factors other than inflammatory response are currently under investigation for their relationship with ARDS development, including circular RNA (81), microRNA (82), factors related to mitochondrial dysfunction (83), metabolomics (84), or even a combination of two biomarkers (36) or a panel of biomarkers (85). Here, HMGB1 is linked to acute respiratory distress syndrome.