Editorial
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 14, 2006; 12(46): 7397-7404
Published online Dec 14, 2006. doi: 10.3748/wjg.v12.i46.7397
Acute fatty liver of pregnancy: An update on pathogenesis and clinical implications
Jamal A Ibdah
Jamal A Ibdah, Division of Gastroenterology, School of Medicine, University of Missouri at Columbia, One Hospital Drive, Columbia, Missouri 65212, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Jamal A. Ibdah MD, PhD, Division of Gastroenterology, School of Medicine, University of Missouri at Columbia, One Hospital Drive, Columbia, Missouri 65212, United States. ibdahj@health.missouri.edu
Telephone: +1-573-8820482 Fax: +1-573-884-4595
Received: August 1, 2006
Revised: August 15, 2006
Accepted: August 22, 2006
Published online: December 14, 2006
Abstract

Acute fatty liver of pregnancy (AFLP) is a serious maternal illness occurring in the third trimester of pregnancy with significant perinatal and maternal mortality. Till recently, it has been considered a mysterious illness. In this editorial, we review the recent advances in understanding the pathogenesis of AFLP and discuss the studies documenting a fetal-maternal interaction with a causative association between carrying a fetus with a defect in mitochondrial fatty acid oxidation and development of AFLP. Further, we discuss the impact of these recent advances on the offspring born to women who develop AFLP, such that screening for a genetic defect can be life saving to the newborn and would allow genetic counseling in subsequent pregnancies. The molecular basis and underlying mechanism for this unique fetal-maternal interaction causing maternal liver disease is discussed.

Keywords: Acute fatty liver of pregnancy; HELLP syndr-ome; Mitochondrial Trifunctional Protein; Mitochondrial fatty acid oxidation