{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:04:21Z","timestamp":1793412261459,"version":"4.5.0"},"reference-count":197,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Villous cytotrophoblast (vCTB) is a precursor cell population that supports the development of syncytiotrophoblast (vSTB), the high surface area barrier epithelium of the placental villus, and the primary interface between maternal and fetal\u00a0tissue. In light of increasing evidence that the placenta can adapt to changing maternal environments or, under stress, can trigger maternal disease, we consider what properties of these cells empower them to exert a controlling influence on pregnancy progression and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE AND RATIONALE<\/jats:title>\n                    <jats:p>How are cytotrophoblast proliferation and differentiation regulated in the human placental villus to allow for the increasing demands of the fetal\u00a0and environmental challenges and stresses that may arise during pregnancy?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SEARCH METHODS<\/jats:title>\n                    <jats:p>PubMed was interrogated using relevant keywords and word roots combining trophoblast, villus\/villous, syncytio\/syncytium, placenta, stem, transcription factor (and the individual genes), signalling, apoptosis, autophagy (and the respective genes) from 1960 to the present. Since removal of trophoblast from its tissue environment is known to fundamentally change cell growth and differentiation kinetics, research that relied exclusively on cell culture has not been the main focus of this review, though it is mentioned where appropriate. Work on non-human placenta is not systematically covered, though mention is made where relevant hypotheses have emerged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OUTCOMES<\/jats:title>\n                    <jats:p>The synthesis of data from the literature has led to a new hypothesis for vCTB dynamics. We propose that a reversible transition can occur from a reserve population in G0 to a mitotically active state. Cells from the in-cycle population can then differentiate irreversibly to intermediate cells that leave the cycle and turn on genes that confer the capacity to fuse with the overlying vSTB as well as other functions associated with syncytial barrier and transport function. We speculate that alterations in the rate of entry to the cell cycle, or return of cells in the mitotic fraction to G0, can occur in response to environmental challenge. We also review evidence on the life cycle of trophoblast from the time that fusion occurs, and point to gaps in knowledge of how large quantities of fetal DNA arrive in maternal circulation. We critique historical methodology and make a case for research to re-address questions about trophoblast lifecycle and dynamics in normal pregnancy and the common diseases of pre-eclampsia and fetal growth restriction, where altered trophoblast kinetics have long been postulated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS<\/jats:title>\n                    <jats:p>The hypothesis requires experimental testing, moving research away from currently accepted methodology towards a new standard that includes representative cell and tissue sampling, assessment of cell cycle and differentiation parameters, and robust classification of cell subpopulations in villous trophoblast, with due attention to gestational age, maternal and fetal phenotype, disease and outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humupd\/dmab015","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T23:20:49Z","timestamp":1620688849000},"page":"904-922","source":"Crossref","is-referenced-by-count":66,"title":["Cell dynamics in human villous trophoblast"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8777-9261","authenticated-orcid":false,"given":"John D","family":"Aplin","sequence":"first","affiliation":[{"name":"Maternal and Fetal Health, University of Manchester, Manchester Academic Health Sciences Centre, St Mary\u2019s Hospital, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn J P","family":"Jones","sequence":"additional","affiliation":[{"name":"Maternal and Fetal Health, University of Manchester, Manchester Academic Health Sciences Centre, St Mary\u2019s Hospital, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"2021082406004383700_dmab015-B1","doi-asserted-by":"crossref","first-page":"3191","DOI":"10.1101\/gad.853700","article-title":"Placental cell fates are regulated in vivo by HIF-mediated hypoxia responses","volume":"14","author":"Adelman","year":"2000","journal-title":"Genes Dev"},{"key":"2021082406004383700_dmab015-B2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1002\/pd.1700","article-title":"Free fetal DNA in maternal plasma in anembryonic pregnancies: confirmation that the origin is the trophoblast","volume":"27","author":"Alberry","year":"2007","journal-title":"Prenat Diagn"},{"key":"2021082406004383700_dmab015-B3","doi-asserted-by":"crossref","first-page":"2742","DOI":"10.1038\/s41598-019-39426-5","article-title":"Trophoblast-specific expression of Hif-1alpha results in preeclampsia-like symptoms and fetal growth restriction","volume":"9","author":"Albers","year":"2019","journal-title":"Sci Rep"},{"key":"2021082406004383700_dmab015-B4","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0143-4004(05)80261-9","article-title":"Expression of integrin alpha 6 beta 4 in human trophoblast and its loss from extravillous cells","volume":"14","author":"Aplin","year":"1993","journal-title":"Placenta"},{"key":"2021082406004383700_dmab015-B5","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1387\/ijdb.082759ja","article-title":"Developmental cell biology of human villous trophoblast: current research problems","volume":"54","author":"Aplin","year":"2010","journal-title":"Int J Dev Biol"},{"key":"2021082406004383700_dmab015-B6","doi-asserted-by":"crossref","first-page":"441","DOI":"10.3109\/9780203091500.030","volume-title":"The Endometrium","author":"Aplin","year":"2008"},{"key":"2021082406004383700_dmab015-B7","volume-title":"Development of the Human Placental Villus. 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