The downregulation of miR-744 expression in mast cell-derived exosomes was a critical factor for inducing ferroptosis and inflammation in HBE cells under ARDS conditions via the regulation of miR-744, GPX4, ALOX15, ACSL4, IL-6, and TNF-α levels, thereby influencing cell viability and migration through a novel pathogenic mechanism. This evidence concerns the gene ACSL4 and acute respiratory distress syndrome.