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1 Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
2 Departments of Pathology and Pediatrics, University of Texas-Southwestern Medical Center, Dallas, TX, USA
3 Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
4 Department of Pediatrics and Vanderbilt Children's Hospital, Vanderbilt University, Nashville, TN, USA
* To whom correspondence should be addressed. E-mail: pshekhawat{at}mail.mcg.edu.
The role of fat metabolism during human pregnancy, placental growth and function is poorly understood. Mitochondrial fatty acid oxidation disorders in an affected fetus are associated with maternal diseases of pregnancy, including preeclampsia, acute fatty liver of pregnancy, and the Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome. We have investigated the developmental expression and activity of six fatty acid 
-oxidation enzymes at various gestational age human placentae. Placental specimens exhibited abundant expression of all six enzymes, as assessed by immunohistochemical and immunoblot analyses, with greater staining in syncytiotrophoblasts as compared to other placental cell types. -oxidation enzyme activities in placental tissues were higher early in gestation and lower near term.
Trophoblast cells in culture oxidized tritium-labeled palmitate and myristate in substantial amounts, indicating that the human placenta utilizes fatty acids as a significant metabolic fuel. Thus human placenta derives energy from fatty acid oxidation, providing a potential explanation for the association of fetal fatty acid oxidation disorders with maternal liver diseases in pregnancy.
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