The "dual-target, dual-drug" intervention-PT targeting the PDLIM1 axis and EMS selectively disrupting PDAP1-mediated IL-1β maturation-effectively quelled systemic inflammation and attenuated ALI pathology in both in vivo and organoid models.<h4>Discussion</h4>This study elucidates a novel metabolic-immune coupling mechanism in pulmonary polarization, shifting the focus from pan-inflammatory suppression toward precision immunomodulation. Here, PDLIM1 is linked to acute respiratory distress syndrome.