A Ratiometric Benzimidazole-Based Fluorescent Probe for The Recognition of Phosgene in Solution and Gaseous Phases.

Considering the high toxicity and widespread application of phosgene, there is an urgent need to develop a simple and sensitive method for detecting phosgene. In this work, we designed and synthesized a novel ratiometric fluorescent probe 1 containing fluorophores of benzimidazole and benzothiazole. Probe 1 showed excellent sensitivity (< 30 s) and selectivity (LOD = 3.82 nM) for phosgene and significant ratiometric fluorescence changes. In addition, 1-loaded polystyrene membrane test strips were used to conveniently and efficiently detect phosgene gas (0.5 ppm) via the naked eye and the RGB APP of the smartphone, indicating that this probe has great potential for phosgene detection in the gaseous phase.

Characteristics of phosgene aspiration lung injury analyzed based on transcriptomics and proteomics.

Background: Phosgene is a chemical material widely used worldwide. No effective method has been developed to reverse its pathological injuries. Some studies have shown that neuronal inflammation in lung tissue is involved, but the specific mechanism has not been reported. Objective: To analyze the expression alterations of whole transcriptome gene sequencing bioinformatics and protein expression profile in lung tissue after phosgene aspiration lung injury (P-ALI) and find the main factors and pathways affecting the prognosis of P-ALI. Methods: Rat models of P-ALI were made by phosgene. Rats were divided into a P-ALI group and a blank group. Hematoxylin-eosin (HE) staining and lung wet/dry ratio measurement were used to evaluate the lung injury. The levels of inflammatory factors were measured by ELISA. High-throughput sequencing was used to measure the expression profile of each gene. Protein expression profiles were determined by label-free relative quantification of the differential proteome. Results: Lung injury such as the disordered structure of alveolar wall and inflammatory factors (IL-1ß, IL-18, and IL-33) were significantly increased in the P-ALI group (p < 0.05). There were 225 differentially expressed lncRNAs, including 85 upregulated and 140 downregulated genes. They were also the genomes with the most significant changes in transcriptome gene expression, mainly constituting cytoplasmic, synaptic structures and transporters, and involved in amino acid and carbon metabolism. There were 42 differentially expressed circRNAs, including 25 upregulated genes and 17 downregulated genes, mainly involved in cell composition, growth, differentiation, and division. There were only 10 differentially expressed miRNAs genes, all upregulated and mainly involved in the inflammatory response pathway. Proteome identification showed 79 differentially expressed proteins. KEGG enrichment analysis showed that it was mainly involved in the N-glycan biosynthesis pathway. Conclusion: We discovered that differentially regulated genes (lncRNAs, circRNAs, and miRNAs) were primarily associated with neuronal reflexes and synaptic signaling, including neurotransmitter transmission, ion signaling pathway conduction, neuronal projection, and synaptic vesicle circulation. They affected inflammatory factors and other metabolic pathways. This finding could be explored in future studies.

Galectin-3 inhibition ameliorates alveolar epithelial cell pyroptosis in phosgene-induced acute lung injury.

Phosgene is a type of poisonous gas that can cause acute lung injury (ALI) upon accidental exposure. Casualties still occur due to phosgene-induced acute lung injury (P-ALI) from accidents resulting from improper operations. The pathological mechanisms of P-ALI are still understudied. Thus, we performed scRNA-seq on cells isolated from all subpopulations of the BALF in P-ALI and found that Gal3 expression was significantly higher in the gas group than in the control group. Further analysis revealed a ligand-receptor correspondence between alveolar macrophages (AMs) and alveolar epithelial cells (AEC), with Gal3 playing a key role in this interaction. To confirm and elaborate on this discovery, we selected four time points during the previous week: sham (day 0), day 1, day 3, and day 7 in the P-ALI mouse model and found that Gal3 expression was significantly elevated in P-ALI, most abundantly expressed in AM cells. This was further confirmed with the use of a Gal3 inhibitor. The inhibition of Gal3 and elimination of AMs in mice both attenuated epithelial cell pyroptosis, as confirmed in in vitro experiments, and revealed the Gal3/caspase-8/GSDMD signaling pathway. These findings suggest that Galectin-3 inhibition can ameliorate AEC pyroptosis by inhibiting the Gal3/caspase-8/GSDMD signaling pathway, thus reducing alveolar damage in mice with P-ALI. This finding provides novel insights for improving treatment efficacy for P-ALI.

Phosgene Toxicity Clinical Manifestations and Treatment: A Systematic Review.

Exposure to phosgene, a colourless poisonous gas, can lead to various health issues including eye irritation, a dry and burning throat, vomiting, coughing, the production of foamy sputum, difficulty in breathing, and chest pain. This systematic review aims to provide a comprehensive overview of the clinical manifestations and treatment of phosgene toxicity by systematically analyzing available literature. The search was carried out on various scientific online databases to include related studies based on inclusion and exclusion criteria with the use of PRISMA guidelines. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Thirteen articles were included in this study after the screening process. Inhalation was found to be the primary health problem of phosgene exposure with respiratory symptoms such as coughing and dyspnea. Chest pain and pulmonary oedema were also observed in some cases. Furthermore, pulmonary crackle was the most common reported physical examination. Beyond respiratory tract health issues, other organs involvements such as cardiac, skin, eye, and renal were also reported in some studies. The symptoms can occur within minutes to hours after exposure, and the severity of symptoms depends on the amount of inhaled phosgene. The findings showed that bronchodilators can alleviate symptoms of bronchoconstriction caused by phosgene. Oxygen therapy is essential for restoring oxygen levels and improving respiratory function in cases of hypoxemia. In severe cases, endotracheal intubation and invasive mechanical ventilation are used for artificial respiration, along with the removal of tracheal secretions and pulmonary oedema fluid through suctioning as crucial components of supportive therapy.

A novel 2-(2-aminophenyl) imidazo [1,5-a] pyridine-based fluorescent probe for rapid detection of phosgene.

Phosgene is a highly concealed and highly toxic gas that seriously threatens human health and public security. Therefore, the detection of phosgene is of great significance to world security. Herein, a new type of fluorescent probe based on 2-(2-aminophenyl) imidazo [1,5-a] pyridine is reported for the rapid detection of phosgene. The probe itself only emits a faint green fluorescence, while phosgene allows it to produce a strong blue fluorescence. During the recognition process, phosgene interacts simultaneously with both amino site and imidazole moiety in the probe molecule, resulting in a four-ring-fused rigid structure with high fluorescence quantum yield. The probe not only has the characteristics of high efficiency, high sensitivity (detection limit 2.68 nM), and high selectivity, but also has remarkable spectral changes. Finally, a portable test strip is used to detect phosgene in the gas phase, and the fluorescent color change of the test strip can be easily observed. The most exciting thing is that the portable test strip with the probe PMPY-NH2 can produce a strong fluorescence response to 1 ppm of phosgene, which is far lower than the level of phosgene that seriously threatens to human health.

An in-silico porcine model of phosgene-induced lung injury predicts clinically relevant benefits from application of continuous positive airway pressure up to 8 h post exposure.

We present the first computational model of the pathophysiological consequences of phosgene-induced lung injury in porcine subjects. Data from experiments previously performed in several cohorts of large healthy juvenile female pigs (111 data points from 37 subjects), including individual arterial blood gas readings, respiratory rate and heart rate, were used to develop the computational model. Close matches are observed between model outputs (PaO2 and PaCO2) and the experimental data, for both terminally anaesthetised and conscious subjects. The model was applied to investigate the effectiveness of continuous positive airway pressure (CPAP) as a pre-hospital treatment method when treatment is initiated at different time points post exposure. The model predicts that clinically relevant benefits are obtained when 10 cmH2O CPAP is initiated within approximately 8 h after exposure. Supplying low-flow oxygen (40%) rather than medical air produced larger clinical benefits than applying higher CPAP pressure levels. This new model can be used as a tool for conducting investigations into ventilation strategies and pharmaceutical treatments for chemical lung injury of diverse aetiology, and for helping to refine and reduce the use of animals in future experimental studies.

Paving the Way towards Sustainability of Polyurethanes: Synthesis and Properties of Terpene-Based Diisocyanate.

Due to growing concerns about environmental issues and the decline of petroleum-based resources, the synthesis of new biobased compounds for the polymer industry has become a prominent and timely topic. P-menthane-1,8-diamine (PMDA) is a readily available compound synthesized from turpentine, a cheap mixture of natural compounds isolated from pine trees. PMDA has been extensively used for its biological activities, but it can also serve as a source of valuable monomers for the polymer industry. In this work, commercial PMDA (ca. 85% pure) was purified by salinization, crystallization, and alkali treatment and then converted into p-menthane-1,8-diisocyanate (PMDI) through a phosgene-free synthesis at room temperature. A thorough analytical study using NMR techniques (1H, 13C, 13C-1H HSQC, 13C-1H HMBC, and 1H-1H NOESY) enables the characterization of the cis-trans isomeric mixtures of both PMDA and PMDI. These structural studies allowed for a better understanding of the spatial configuration of both isomers. Then, the reactivity of PMDI with a primary alcohol (benzyl alcohol) was studied in the presence of nine different catalysts exhibiting different activation modes. Finally, the use of PMDI in the synthesis of polyurethanes was explored to demonstrate that PMDI can be employed as a new biobased alternative to petrochemical-based isocyanates such as isophorone diisocyanate (IPDI).

Alpha-1 antitrypsin protects against phosgene-induced acute lung injury by activating the ID1-dependent anti-inflammatory response.

Phosgene is widely used as an industrial chemical, and phosgene inhalation causes acute lung injury (ALI), which may further progress into pulmonary edema. Currently, an antidote for phosgene poisoning is not known. Alpha-1 antitrypsin (α1-AT) is a protease inhibitor used to treat patients with emphysema who are deficient in α1-AT. Recent studies have revealed that α1-AT has both anti-inflammatory and anti-SARS-CoV-2 effects. Herein, we aimed to investigate the role of α1-AT in phosgene-induced ALI. We observed a time-dependent increase in α1-AT expression and secretion in the lungs of rats exposed to phosgene. Notably, α1-AT was derived from neutrophils but not from macrophages or alveolar type II cells. Moreover, α1-AT knockdown aggravated phosgene- and lipopolysaccharide (LPS)-induced inflammation and cell death in human bronchial epithelial cells (BEAS-2B). Conversely, α1-AT administration suppressed the inflammatory response and prevented death in LPS- and phosgene-exposed BEAS-2B cells. Furthermore, α1-AT treatment increased the inhibitor of DNA binding 1 (ID1) gene expression, which suppressed NF-κB pathway activation, reduced inflammation, and inhibited cell death. These data demonstrate that neutrophil-derived α1-AT acts as a self-protective mechanism, which protects against phosgene-induced ALI by activating the ID1-dependent anti-inflammatory response. This study may provide novel strategies for the treatment of patients with phosgene-induced ALI.

Accidental Phosgene Poisoning: A Case Report and Short Review of Management.

BACKGROUND: Phosgene is a chemical used in the manufacture of plastics and pesticides. Phosgene remains one of the most dangerous of today's high-volume chemicals, as evidenced by the deaths and widespread evacuations caused by its release in industrial accidents. The respiratory system is most severely harmed by exposure to phosgene. CASE PRESENTATION: A 39-year-old male patient arrived feeling short of breath, nauseous, and tachypnoeic after being exposed to triphosgene gas at work. Upon examination, the patient's oxygen saturation (spo2) was 72% without oxygen, 95% on 15 L of oxygen (o2), hemodynamically unstable, and transferred to the intensive care unit (ICU) for additional care. A ventilator was started in non-invasive mode, and antibiotics were administered based on an initial CT scan of the chest that revealed bilateral fluffy alveolar deposits. The same course of treatment was continued on day two. Chest X-ray shadows improved starting on day three. Saturation is 95% after weaning off Niv support and placing 5 L of o2. He was discharged with oral medications once he was hemodynamically stable. CONCLUSION: An incidental phosgene poisoning is described in detail here, along with its clinical symptoms and treatment. It is critical to suspect phosgene gas exposure and monitor such patients to save lives.

A new highly sensitive fluorescent probe for visualization of phosgene in liquid and gas phases.

Phosgene is an important and widely used highly toxic chemical that poses a serious potential threat to public health and property if leaked or abused. Therefore, developing an efficient and convenient detection method for phosgene is of great significance. In this work, we synthesized a novel fluorescent probe, BCyP, based on benzohemicyanine for highly selective and sensitive detection of phosgene in both liquid and gas phases. The probe uses amino alcohol as a specific recognition group for phosgene and does not fluoresce due to the strong intramolecular charge transfer effect (ICT). However, in the presence of phosgene, the amino alcohol part in the probe can form oxazolidinone in situ with phosgene, reducing the ICT effect in the probe molecule and lighting fluorescence, thus realizing the selective phosgene detection. The probe exhibits good specificity towards phosgene, with significant fluorescence enhancement (approximately 400-fold), a remarkable Stokes shift (139 nm), a fast response speed (less than 17 s), and a low detection limit (0.12 ppm). Additionally, we prepared a phosgene detection paper strip loaded with the probe on filter paper and combined it with color recognition software on a smartphone to achieve visual detection of phosgene in the gas phase.

A novel benzo hemicyanine-based fluorescent probe for susceptible visualizing detection of phosgene.

Leakage and misuse of phosgene, a common and highly hazardous industrial chemical, have always constituted a safety risk. Therefore, it is crucial to develop sensitive detection methods for gaseous phosgene. This work describes the design and development of a new fluorescent dye based on benzohemicyanine, as well as the synthesis of fluorescent probes for the sensitive detection of gaseous phosgene. Due to the excellent intramolecular charge transfer (ICT) effect from the strong electron-donating impact of the o-aminophenol group on benzo hemicyanine, the probe does not emit fluorescence. When the probe reacts with phosgene, the ICT effect is inhibited, and the result exhibits observable green fluorescence, thereby visualizing the response to phosgene. The probe offers exceptional sensitivity, a rapid response, and a low phosgene detection limit. In addition, we developed probe-loaded, portable test strips for the quick and sensitive detection of phosgene in the gas phase. Finally, the constructed probe-loaded test strips were utilized effectively to monitor the simulated phosgene leakage.

Transcriptional Characterization of Bronchoalveolar Lavage Fluid Reveals Immune Microenvironment Alterations in Chemically Induced Acute Lung Injury.

Purpose: Chemically induced acute lung injury (CALI) has become a serious health concern in our industrialized world, and abnormal functional alterations of immune cells crucially contribute to severe clinical symptoms. However, the cell heterogeneity and functional phenotypes of respiratory immune characteristics related to CALI remain unclear. Methods: We performed scRNA sequencing on bronchoalveolar lavage fluid (BALF) samples obtained from phosgene-induced CALI rat models and healthy controls. Transcriptional data and TotalSeq technology were used to confirm cell surface markers identifying immune cells in BALF. The landscape of immune cells could elucidate the metabolic remodeling mechanism involved in the progression of acute respiratory distress syndrome and cytokine storms. We used pseudotime inference to build macrophage trajectories and the corresponding model gene expression changes, and identified and characterized alveolar cells and immune subsets that may contribute to CALI pathophysiology based on gene expression profiles at single-cell resolution. Results: The immune environment of cells, including dendritic cells and specific macrophage subclusters, exhibited increased function during the early stage of pulmonary tissue damage. Nine different subpopulations were identified that perform multiple functional roles, including immune responses, pulmonary tissue repair, cellular metabolic cycle, and cholesterol metabolism. Additionally, we found that individual macrophage subpopulations dominate the cell-cell communication landscape. Moreover, pseudo-time trajectory analysis suggested that proliferating macrophage clusters exerted multiple functional roles. Conclusion: Our findings demonstrate that the bronchoalveolar immune microenvironment is a fundamental aspect of the immune response dynamics involved in the pathogenesis and recovery of CALI.

PTTG1 promotes CD34+CD45+ cells to repair the pulmonary vascular barrier via activating the VEGF-bFGF/PI3K/AKT/eNOS signaling pathway in rats with phosgene-induced acute lung injury.

Accidental exposure to phosgene can cause acute lung injury (ALI), characterized by uncontrolled inflammation and impaired lung blood-gas barrier. CD34+CD45+ cells with high pituitary tumor transforming gene 1 (PTTG1) expression were identified around rat pulmonary vessels through single-cell RNA sequencing, and have been shown to attenuate P-ALI by promoting lung vascular barrier repair. As a transcription factor closely related to angiogenesis, whether PTTG1 plays a role in CD34+CD45+ cell repairing the pulmonary vascular barrier in rats with P-ALI remains unclear. This study provided compelling evidence that CD34+CD45+ cells possess endothelial differentiation potential. Rats with P-ALI were intratracheally administered with CD34+CD45+ cells transfected with or without PTTG1-overexpressing and sh-PTTG1 lentivirus. It was found that CD34+CD45+ cells reduced the pulmonary vascular permeability and mitigated the lung inflammation, which could be reversed by knocking down PTTG1. Although PTTG1 overexpression enhanced the ability of CD34+CD45+ cells to attenuate P-ALI, no significant difference was found. PTTG1 was found to regulate the endothelial differentiation of CD34+CD45+ cells. In addition, knocking down of PTTG1 significantly reduced the protein levels of VEGF and bFGF, as well as their receptors, which in turn inhibited the activation of the PI3K/AKT/eNOS signaling pathway in CD34+CD45+ cells. Moreover, LY294002 (PI3K inhibitor) treatment inhibited the endothelial differentiation of CD34+CD45+ cells, while SC79 (AKT activator) yielded the opposite effect. These findings suggest that PTTG1 can promote the endothelial differentiation of CD34+CD45+ cells by activating the VEGF-bFGF/PI3K/AKT/eNOS signaling pathway, leading to the repair of the pulmonary vascular barrier in rats with P-ALI.

Competition of hydrogen, tetrel, and halogen bonds in COCl2-HOX (X=F, Cl, Br, I) complexes.

The present study investigates the competition between hydrogen, halogen, and tetrel bonds from the interaction of COCl2 with HOX using quantum chemistry simulations at the MP2/aug-cc-pVTZ computational level, in which five configurations were optimized, including adducts I -V. Two hydrogen bonds, two halogen bonds, and two tetrel bonds were obtained for five forms of adducts. The compounds were investigated using spectroscopic, geometry, and energy properties. Adduct I complexes are more stable than others, and adduct V halogen bonded complexes are more stable than adduct II complexes. These results are in agreement with their NBO and AIM results. The stabilization energy of the XB complexes depends on the nature of both the Lewis acid and base. The stretching frequency of the O-H bond in adducts I, II, III, and IV displayed a redshift, and a blue shift was observed in adduct V. The results for the O-X bond showed a blue shift in adducts I and III and a red shift in adducts II, IV, and V. The nature and characteristics of three types of interactions are investigated via NBO analysis and atoms in molecules (AIM).

Discrimination of phosgene from cyanogen chloride in recovered chemical munitions using tagged neutron interrogation with high-resolution gamma-ray spectroscopy.

The associated particle (AP) technique has recently been used with a high-purity germanium γ-ray spectrometer to assess its capability to improve field identification of recovered chemical warfare (CW) materiel through prompt gamma-ray neutron activation analysis (PGNAA) measurements. A particularly challenging pair of CW agents commonly found in recovered munitions are phosgene (CG) and cyanogen chloride (CK), which have two of three elements in common, i.e. chlorine and carbon, but differ in the third being either oxygen or nitrogen. The detection of both latter elements is complicated by high oxygen concentration in the field environment which interferes with the small signal produced from the chemical agents. The matter is further complicated by the precautionary field practice of overpacking recovered munitions with vermiculite in larger steel multiple round containers (MRCs), which places additional oxygen-rich material in contact with the munition while further attenuating an already weak signal emitted from the munition center. This work reports quantitative results from realistic field measurements of CG and CK simulants in mock 4.2-inch (11 cm) mortar rounds overpacked with vermiculite in a large MRC. Results obtained with the AP technique are compared to those obtained with the traditional PGNAA approach for both overpacked- and bare-munition measurements. The AP technique is shown to provide a much more confident discrimination between the two chemicals, particularly for the more challenging field-relevant overpacked measurements, where a significant gain in sensitivity to all the key elements (chlorine, carbon, nitrogen and oxygen) is achieved.

An effective fluorescent probe for detection of phosgene based on naphthalimide dyes in liquid and gaseous phases.

A fluorescent probe was developed for the detection of phosgene based on 1,8-naphthalimide, of which o-diaminobenzene was used as the recognition moiety. The probe does not fluoresce due to nonradiative decay. The probe reacts rapidly with phosgene via an intramolecular cyclization reaction, which induces large fluorescence due to increased rigidity in the resulting molecule and a low detection limit (0.23 nM). This probe has excellent selectivity for phosgene against competing interference analytes and, in the form of probe-loaded test paper, is an extremely sensitive method for phosgene sensing in the gas phase below 1 ppm concentrations.

Pentoxifylline inhibits phosgene-induced lung injury via improving hypoxia.

Inhalation of high concentrations of phosgene often causes pulmonary edema, which obstructs the airway and causes tissue hypoxia. There is currently no specific antidote. This study was performed to investigate the effect behind pentoxifylline (PTX) treatment for phosgene-induced lung injury in rat models. Rats were exposed to phosgene. The protein levels of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), and occludin proteins in lung tissue were determined. The effect of both prophylactic and therapeutic administration of PTX (50 mg/kg and 100 mg/kg) was evaluated. The lung permeability index and HIF-1α protein level increased, the arterial blood oxygenation index (PaO2/FIO2 ratio) and occludin protein level decreased significantly 6 h after phosgene exposure (P < 0.05). PTX exerted protective effects by HIF-1α-VEGF-occludin signaling pathway to some extent. Moreover, prophylactic, but not therapeutic administration of PTX (100 mg/kg), exhibited a significant protective effect. Pretreatment with PTX protected against phosgene-induced lung injury, possibly by inhibiting differential expression of HIF-1α, VEGF, and occludin.

Synthesis mechanism of dimethylhexane-1,6-dicarbamate from 1,6-hexamethylenediamine, urea and methanol: A molecular scale study based on density functional theory.

This work provides a molecular scale insight into non-phosgene synthesis based on the reaction of dimethylhexane-1,6-dicarbamate from 1,6-hexamethylenediamine, urea and methanol with computational electronic method. By exploring almost all possible reaction modes and comparing the effective barrier of each channel, this work analyzes the optimal reaction mechanism for both non-catalytic and self-catalytic systems. The mechanism without catalysis has a high effective free energy barrier (FEB) of 47.0 kcal mol-1. As for self-catalytic system, after sorting out the reaction pathway network, an effective FEB of 24.6 kcal mol-1 is confirmed which corresponds to dissociation of urea.

Chronic Low-dose Exposure to Highly Toxic Gas Phosgene and Its Effect on Peak Expiratory Flow Rate.

Introduction: Phosgene is a highly toxic gas causing irritation of the airways and eyes though at high dose exposure. The effect on airways can be assessed by peak expiratory flow rate (PEFR) which is a cheaper, simple, and easy to perform test under field conditions and routine monitoring. Thus, this study is undertaken to understand the effect of chronic low-dose phosgene exposure on PEFR and the associated factors. Methods: This study included 287 workers of phosgene production and captive units. After recording the demographic, occupational, and clinical history on a questionnaire, every participant was subjected to clinical examination, chest radiography, and measurement of PEFR using Spirovit SP-10. Results: The mean age and mean duration of the job of participants was 42.8 ± 10.4 years and 18.9 ± 9.6 years, respectively. The PEFR was significantly reduced with increasing age, increasing duration in the job, and those having direct exposure. Conclusion: PEFR is affected by chronic low-dose exposure to phosgene.

Evaluation of the Content of Aquaporin-5 and Epithelial Sodium Channel in the Lungs of Rats during the Development of Toxic Pulmonary Edema Caused by Intoxication with Acylating Pulmonotoxicants.

We studied the content of aquaporin-5 (AQP5) and epithelial sodium channel (ENaC) in rat lungs during the development of toxic pulmonary edema (TPE) caused by intoxication with phosgene and perfluoroisobutylene (1.5 LC50). The lung body weight index (LBI) was calculated and histological examination of the lung tissues was performed. Localization and expression of AQP5 and ENaC were determined by immunohistochemistry. Intoxication led to a significant (p<0.05) increase in LBI and histological changes typical of TPE 1 and 3 h after the exposure. In 1 and 3 h after phosgene intoxication, the AQP5 and ENaC content significantly (p<0.05) increased in comparison with the control. Similar changes in the AQP5 and ENaC content were observed 1 and 3 h after exposure to perfluoroisobutylene. It was hypothesized that AQP5 plays an important role in the formation of TPE caused by intoxication with acylating pulmonotoxicants. An increase in the content of ENaC can be considered as a compensatory reaction of the body aimed at clearance of the alveolar fluid.