The enhancement of the extracellular adenosine pathway during ARDS via HIF-1α can be enhanced in a number of ways, including the induction of extracellular 5′-nucleosidase (conversion of extracellular AMP to adenosine) via the transcriptional enzyme production of adenosine, a known HIF-1α target gene [83] to increase protection against the effects of extracellular adenosine signaling during ALI to promote cell and tissue repair. The gene discussed is HIF1A; the disease is acute respiratory distress syndrome.