“…Permeability to proteins of the epithelial and endothelial layers widely differs, alveolar epithelium being much less permeable than the endothelium (21). The alveolocapillary membrane may face physical, chemical, or biological insults, and the response of the epithelial or endothelial layers may differ depending on insult type (1,17,25,27,32,54). For example, Pseudomonas aeruginosa elastase on the alveolar side produces alveolar epithelium leakiness that manifests as an increase in the clearance of aerosolized albumin, without evidence of edema (1), whereas chronic heart failure due to large cardiac infarcts increases protein fluxes in both directions (11).…”