WNK2 and acute respiratory distress syndrome: For example, a study on the role of alveolar carbohydrate metabolism during ALI suggested that the functional activity of succinate dehydrogenase (SDH) is inhibited in response to cyclic mechanical stretch, such as occurs during IMV (12), and implicated mitogen-activated protein kinase activation (48) or increased levels of the competitive SDH inhibitor itaconate (49) in the mechanism of SDH inhibition during ALI (20).