Placental regulation of fetal nutrient supplyLarqué, Elvira; Ruiz-Palacios, María; Koletzko, BertholdCurrent Opinion in Clinical Nutrition & Metabolic Care: May 2013 - Volume 16 - Issue 3 - p 292–297 doi: 10.1097/MCO.0b013e32835e3674 PAEDIATRICS: Edited by Berthold Koletzko and Raanan Shamir Abstract Author Information Purpose of review Placental nutrient uptake and transfer may have a unique role, as changes in trophoblast nutrient-sensing signaling pathways regulate cell metabolism and may affect the fetal growth and health programming in the offspring. Recent findings The functionality of the placenta could affect the neonatal adiposity and the fetal levels of key nutrients such as long-chain polyunsaturated fatty acids. Insulin, oxygen and amino acid concentrations may regulate the mammalian target of rapamycin (mTOR) nutrient sensor in the human placenta affecting trophoblast metabolism and nutrient delivery. Summary The mechanisms involved in both placental uptake and transfer of macronutrients are reviewed. Fatty acid, cholesterol and amino acid transport across the placenta involves a complex system to ensure nutrient delivery to the growing fetus. The placental glucose transfer is important for fetal macrosomia, but lipid disturbances in both maternal and placental compartments may contribute to neonatal fat accretion. Maternal insulin has little effect on the avidity of glucose transport by the placenta, but may interfere in placental metabolism via mTOR nutrient sensor. mTOR is a positive regulator of the amino acid carriers and constitutes a critical link between maternal nutrient availability and fetal growth, thereby influencing the long-term health of the fetus. aDepartment of Physiology, Faculty of Biology, University of Murcia, Murcia, Spain bDr von Haunersches Kinderspital, Ludwig-Maximilians University, Munich, Germany Correspondence to Elvira Larqué, Department of Physiology, Faculty of Biology, University of Murcia, Campus Espinardo 30100, Murcia, Spain. Tel: +34 868884239; fax: +34 868883963; e-mail: firstname.lastname@example.org Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.