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Club cell secretory protein (CC16) in gastric fluid at birth and subsequent lung disease in preterm infants

Journal article
Authors C. Hagman
L. J. Bjorklund
Gunnel Hellgren
E. Tufvesson
I. Hansen-Pupp
Published in Pediatric Pulmonology
Volume 53
Issue 10
Pages 1399-1406
ISSN 8755-6863
Publication year 2018
Published at Institute of Biomedicine
Pages 1399-1406
Language en
Keywords CC16 protein, cytokines, human, inflammation, lung diseases, preterm birth, nf-kappa-b, bronchopulmonary dysplasia, premature-infants, inflammatory, cytokines, tracheal aspirate, epithelial-cells, expression, serum, inhibition, patterns, Pediatrics, Respiratory System
Subject categories Clinical Medicine


BackgroundClub cell secretory protein (CC16) probably has a role in protecting the lung from inflammation. AimTo evaluate if low levels of CC16 in gastric fluid at birth, reflecting low levels of CC16 in the lung, would be associated with lung inflammation and respiratory morbidity. MethodsA study of 64 infants with mean gestational age 26.1 weeks. CC16 was analyzed in gastric fluid at birth. CC16, pro-inflammatory cytokines, and MMP-9 were analyzed in tracheal aspirate within 24h from birth. ResultsCC16 in gastric fluid increased with gestational age (P=0.033). Lower concentrations of CC16 in gastric fluid at birth were associated with higher concentrations of IL-1 (P=0.028), TNF- (P=0.034), and MMP-9 (P=0.015) in tracheal aspirate. Infants who needed mechanical ventilation at 24 and 72h of age had lower CC16 in gastric fluid than those not ventilated at these ages (P=0.011 and P=0.024, respectively). Lower CC16 in gastric fluid was associated with higher FiO(2) at 6h (P=0.009), higher PaCO2 at 24h (P=0.03), more ventilator days (P=0.012) and more days with supplemental oxygen (P=0.03). Infants who had either died or were still treated with supplemental oxygen at 36 weeks postmenstrual age had lower CC16 in gastric fluid than infants with none of these outcomes (P=0.049). ConclusionA low CC16 concentration in gastric fluid at birth was associated with increased inflammation in the trachea within the first 24h of life and with more need for respiratory support in the neonatal period.

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