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Departments of 1 Pediatrics and 2 Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63110; 3 Departments of Pathology and Pediatrics, University of Texas-Southwestern Medical Center, Dallas, Texas 75235; and 4 Department of Pediatrics, Vanderbilt Children's Hospital, Vanderbilt University, Nashville, Tennessee 37232
The role of
fat metabolism during human pregnancy and in 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 syndrome
called HELLP. We have investigated the developmental expression and
activity of six fatty acid 
-oxidation enzymes at various
gestational-age human placentas. Placental specimens exhibited abundant
expression of all six enzymes, as assessed by immunohistochemical and
immunoblot analyses, with greater staining in syncytiotrophoblasts
compared with 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.
acute fatty liver of pregnancy; mitochondria; hemolysis, elevated liver enzymes, and low platelets syndrome
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