Acute lung injury (ALI) is a life-threatening clinical syndrome during the clinical course in critically ill patients. The identification of novel biomarkers for early diagnosis and finding more effective treatments of ALI are topics on current research. High mobility group box-1 protein (HMGB1) is a late inflammatory mediator associated with sepsis

malignancy

and immune disease. Expression of HMGB1 may reflect the severity of inflammation and tissue damage

which indicates a potential role for HMGB1 as a prognostic biomarker and a potential target for blocking inflammatory pathways in ALI. Several studies have shown that HMGB1 regulates autophagy. Autophagy

also called typeⅡprogrammed cell death

is an important biological process which maintains cellular homeostasis. Studies have shown that HMGB1 and autophagy are involved in the pathogenesis of many lung diseases including ALI

while the underlying specific mechanisms remain to be determined. This review provides an update on the role of HMGB1 and autophagy in ALI.