In particular, H3K18la upregulates the transcription of early growth response 1 (EGR1), increasing the production of heparanase (HPSE), an enzyme responsible for glycocalyx degradation and endothelial barrier dysfunction; interestingly, H3K18la levels correlate with sepsis-associated ARDS (Acute Respiratory Distress Syndrome) severity. The gene discussed is HPSE; the disease is acute respiratory distress syndrome.