In the pathogenesis of ARDS, gram-negative bacteria are the predominant cause (Bos and Ware 2022; Umbrello et al. 2016), with bacterial lipopolysaccharide (LPS) interacting with Toll-like receptor 4 to induce the production of interleukin (IL)-1β and tumor necrosis factor (TNF)-α (Domscheit et al. 2020; Zhou et al. 2018). The gene discussed is TNF; the disease is acute respiratory distress syndrome.