Knowledge derived from the disciplines of molecular biology and genetics has the potential to improve the course and outcome of patient with acquired respiratory distress syndrome (ARDS) in the future. Through genomics-based research we may gain a more comprehensive understanding of ARDS and characterize the immunophenotypes of individual patients. This type of information then can be used to modulate host inflammatory response more rationally, either in the form of anti-inflammatory therapies or of strategies to augment host inflammatory immune mechanisms when clinically appropriate. In addition, future advances in molecular biology may allow for therapeutic strategies that incorporate powerful endogenous cellular defense molecules and mechanisms.