{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:17:26Z","timestamp":1791580646296,"version":"4.3.4"},"reference-count":145,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>\n                    ATP binding cassette (ABC) transporters are active efflux proteins that move substrates against the gradient via hydrolysis of ATP, and regulate fetal metabolic homeostasis and chemical exposure. The maternal-fetal interface represents a barrier for key transporters involved in xenobiotic efflux, reverse cholesterol transport, bile acid handling, metabolism of steroid hormones and immune tolerance. We combine recent data from cryo-electron microscopy-based structure with recent single-cell transcriptomic data and\n                    <jats:italic>ex vivo<\/jats:italic>\n                    studies of placenta pharmacology to explore the underlying mechanism of transporter dysfunction in preeclampsia, intrahepatic cholestasis of pregnancy, preterm birth, gestational diabetes mellitus, intrauterine growth restriction, and early miscarriage. NRF2-dependent antioxidant signaling, HIF-1\u03b1-dependent suppression of BCRP under hypoxia, cytokine-dependent downregulation by TNF-\u03b1 and IL-1\u03b2, and autophagy. Key translation opportunities in clinical pharmacogenomics are highlighted, such as near-term ABCG2 Q141K genotyping for glyburide prescribing in gestational diabetes, and ABCB4 variant profiling for cholestasis risk.\n                  <\/jats:p>","DOI":"10.3389\/fendo.2026.1858727","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:20:59Z","timestamp":1784175659000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Adenosine triphosphate-binding cassette transporters: key players in maintaining fetal health during pregnancy"],"prefix":"10.3389","volume":"17","author":[{"given":"Xian-Hong","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Pediatrics, Medical School, Henan Provincial Research Center of Engineering Technology for Nuclear Protein Medical Detection, Zhengzhou Health College","place":["Zhengzhou, Henan, 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