TNF and rheumatoid arthritis: Remicade (infliximab) was the first anti‐TNF‐α monoclonal antibody approved for the treatment of rheumatoid arthritis and Crohn's disease[5] followed by many other TNF‐α inhibitors, including adalimumab, etanercept, rituximab, and abatacept.[6] However, clinical trials based on the systemic administration of anti‐TNF‐α monoclonal antibodies in patients with sepsis‐induced ALI have been unsuccessful in improving survival.[7, 8] Because of these failures, some investigators have focused on the pulmonary administration of anti‐TNF‐α monoclonal antibodies.