ANGPTL4 and acute respiratory distress syndrome: Angptl4, a multifunctional cytokine involved in inflammation and endothelial injury [35], with higher serum levels linked to reduced lung function and systemic inflammation in chronic obstructive pulmonary disease (COPD) patients [36], and correlated with disease severity and mortality in ARDS patients [37, 38, 39], was highly upregulated in DM lungs, highlighting its role in lung inflammation.