{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:28:29Z","timestamp":1789759709660,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T00:00:00Z","timestamp":1531180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Royal Physiographic Society in Lund"},{"name":"The Sk\u00e5ne Council Foundation for Research and Development"},{"name":"The Foundation De Blindas V\u00e4nner"},{"name":"The Linn\u00e9a and Josef Carlsson Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Club cell secretory protein (CC16) probably has a role in protecting the lung from inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A study of 64 infants with mean gestational age 26.1 weeks. CC16 was analyzed in gastric fluid at birth. CC16, pro\u2010inflammatory cytokines, and MMP\u20109 were analyzed in tracheal aspirate within 24\u2009h from birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CC16 in gastric fluid increased with gestational age (<jats:italic>P<\/jats:italic>\u2009=\u20090.033). Lower concentrations of CC16 in gastric fluid at birth were associated with higher concentrations of IL\u20101\u03b2 (<jats:italic>P<\/jats:italic>\u2009=\u20090.028), TNF\u2010\u03b1 (<jats:italic>P<\/jats:italic>\u2009=\u20090.034), and MMP\u20109 (<jats:italic>P<\/jats:italic>\u2009=\u20090.015) in tracheal aspirate. Infants who needed mechanical ventilation at 24 and 72\u2009h of age had lower CC16 in gastric fluid than those not ventilated at these ages (<jats:italic>P<\/jats:italic>\u2009=\u20090.011 and <jats:italic>P<\/jats:italic>\u2009=\u20090.024, respectively). Lower CC16 in gastric fluid was associated with higher FiO<jats:sub>2<\/jats:sub> at 6\u2009h (<jats:italic>P<\/jats:italic>\u2009=\u20090.009), higher PaCO<jats:sub>2<\/jats:sub> at 24\u2009h (<jats:italic>P<\/jats:italic>\u2009=\u20090.03), more ventilator days (<jats:italic>P<\/jats:italic>\u2009=\u20090.012) and more days with supplemental oxygen (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). 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 (<jats:italic>P<\/jats:italic>\u2009=\u20090.049).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A low CC16 concentration in gastric fluid at birth was associated with increased inflammation in the trachea within the first 24\u2009h of life and with more need for respiratory support in the neonatal period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24128","type":"journal-article","created":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T06:53:53Z","timestamp":1531292033000},"page":"1399-1406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Club cell secretory protein (CC16) in gastric fluid at birth and subsequent lung disease in preterm infants"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8346-6417","authenticated-orcid":false,"given":"Cecilia","family":"Hagman","sequence":"first","affiliation":[{"name":"Lund University, Sk\u00e5ne University Hospital Department of Clinical Sciences Lund, Pediatrics Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars J.","family":"Bj\u00f6rklund","sequence":"additional","affiliation":[{"name":"Lund University, Sk\u00e5ne University Hospital Department of Clinical Sciences Lund, Pediatrics Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnel","family":"Hellgren","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Tufvesson","sequence":"additional","affiliation":[{"name":"Lund University, Faculty of Medicine, Department of Clinical Sciences Lund Respiratory Medicine and Allergology Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Hansen\u2010Pupp","sequence":"additional","affiliation":[{"name":"Lund University, Sk\u00e5ne University Hospital Department of Clinical Sciences Lund, Pediatrics Lund 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