Maternal smoking and CC-16: implications for lung development and COPD across the lifespan

maternal smoking
Maternal smoking and CC16 are linked to impaired lung development, lung function decline and emphysema progression, increasing lifelong COPD risk.

Maternal smoking, CC16 and lifelong lung development

Early-life CC16 deficiency and COPD risk

Early-life lung function trajectories predict long-term respiratory health, including COPD risk. Club Cell protein 16 (CC16) is a key determinant of lung health, with low levels associated with impaired lung development, reduced lung function, and COPD.

Cigarette smoking lowers CC16, but it is unknown whether maternal smoking leads to persistent CC16 deficiency from early life, thereby disrupting lung development and predisposing to COPD risk and progression.

Reduced CC16, lung function decline and emphysema progression

Maternal smoking was linked to reduced circulating and airway CC16 in COPD patients, controls, and a preclinical murine COPD model.

In human adults, lower CC16 correlated with accelerated lung function decline and emphysema progression, while in children it was associated with obstructive physiology and early small airway impairment.

Maternal smoking and CC16: implications for COPD outcomes

Maternal smoking reduces CC16 levels, disrupting lung development in ways that predispose to lifelong impairment of lung function and worse COPD outcomes.

Defining the mechanisms by which CC16 regulates lung maturation is essential for establishing reliable outcome measures and designing trials aimed at preventing early COPD.

Authors

Joselyn Rojas-Quintero, Rosa Faner, Chia-Ying Chiu, Jeffrey T Kue, Yan Zhang, David Sanz Rubio, Anna S Colborg, Claudia A Jakwerth, Carsten B Schmidt-Weber, Anke-Hilse Maitland-van der Zee, Mahmoud I Abdel-Aziz, Andrea L Pilon, Caroline A Owen, Elizabeth J Plosa, Gregory L Kinney, Sharon Mc-Grath Morrow, Mariana G Gazzaneo, Nilda Cortes Santiago, Krithika Lingappan, Julie G Ledford, Jason Spence, Jennifer M Sucre, Maor Sauler, Thomas D Wu, Alvar Agusti, Aimee Wheelock, Sabine Illi, Erika von Mutius, Russell P Bowler, Bartolome Celli, Steven H Abman, James M Wells, Francesca Polverino.

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Fecha de publicación

 Issue 3, March 2026. Published: 07 October 2025

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