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Periostin (POSTN) is a profibrotic mediator predicted to be regulated by microRNA\u201019a\u20103p (miR\u201019a\u20103p), but the relevance of this axis in ARDS\u2010associated pulmonary fibrosis remains unclear. Honokiol (HKL), a phytochemical derived from\n                      <jats:italic>Magnolia officinalis<\/jats:italic>\n                      , possesses antioxidant and anti\u2010inflammatory properties. This study investigated whether HKL modulates the miR\u201019a\u20103p\/POSTN axis in ARDS\u2010associated lung injury and fibrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Experimental Approach<\/jats:title>\n                    <jats:p>Serum POSTN and miR\u201019a\u20103p levels were measured in patients with ARDS and correlated with severity. Mechanistic studies were performed using a lipopolysaccharide (LPS)\u2010induced lung injury mouse model and macrophage\u2013epithelial and macrophage\u2013fibroblast co\u2010culture systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>Patients with ARDS exhibited elevated serum POSTN and reduced miR\u201019a\u20103p, which were inversely correlated and associated with indices of disease severity. HKL attenuated LPS\u2010induced lung injury and fibrotic responses, accompanied by reduced POSTN expression and preserved miR\u201019a\u20103p levels. Dual\u2010luciferase reporter assays supported a regulatory interaction between miR\u201019a\u20103p and POSTN. HKL was associated with alterations in macrophage phenotype and reduced macrophage\u2010associated POSTN expression. In co\u2010culture systems, manipulation of miR\u201019a\u20103p in macrophages modulated epithelial apoptotic signalling and fibroblast activation. In vitro loss\u2010of\u2010function experiments suggested that miR\u201019a\u20103p contributes, at least in part, to HKL\u2010associated protective effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Implications<\/jats:title>\n                    <jats:p>The miR\u201019a\u20103p\/POSTN axis may represent a regulatory pathway associated with ARDS\u2010related lung injury and fibrosis. HKL attenuated experimental injury and fibrotic responses in association with this axis. These findings support further pharmacological investigation of HKL in ARDS\u2010associated lung injury and fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bph.70580","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:35:11Z","timestamp":1785400511000},"page":"6329-6351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Honokiol regulates Acute respiratory distress syndrome (ARDS)\u2010associated pulmonary fibrosis via the miR\u201019a\u20103p\/POSTN axis"],"prefix":"10.1111","volume":"183","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8593-8492","authenticated-orcid":false,"given":"Weilun","family":"Liu","sequence":"first","affiliation":[{"name":"School of Medicine, College of Medicine Fu Jen Catholic University  New Taipei City Taiwan"},{"name":"Department of Critical Care Medicine Fu Jen Catholic University Hospital, Fu Jen Catholic University  New 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