Ium emerges either during or soon after the trophoblast passes through the breached uterine epithelium and into the decidualized stromal layer beneath and appears to be responsible for hollowing out regions within the stroma to form order EPZ004777 lacunae (5), which become filled with fluid and cells from maternal blood and uterine glands and presumably provide a source of nutrients for the conceptus (3, 6). By about 12 d of gestation, soon after the blastocyst has sunk below the endometrial surface, strands of cytotrophoblast begin to form and penetrate through the primitive AZD3759 price syncytium to form primary chorionic villi, which are subsequently invaded by extraembryonic mesoderm to form secondary and tertiary villi (villous trees) (2?). The cytotrophoblast cells associated with the villi continue to divide and provide a progenitor cell population for the villous STB, which is the cell layer that covers the outer surface of the villi and forms the definitive interface involved in exchange of gases, nutrients, and excretory materials between the fetal placenta and maternal blood. Villous STB is also the major site for production of placental hormones. Cytotrophoblast cells at the tips of the anchoring villi proliferate and colonize the endometrium, thus expanding the placental bed and simultaneously remodeling maternal spiral arteries. The extent to which extravillous trophoblast becomes multinucleated and whether such cells are the source of islands of giant cells within the endometrium (7)is controversial; an alternative theory is that the latter are remnants of the original primitive syncytium formed during initial trophoblast invasion (2, 3). The extent to which the phenotypes of these different forms of STB resemble each other and whether the underlying processes that lead to cell fusion have features in common remain unclear. Several main cell systems have been used to study STB formation. One has been to culture placental explants, where some of the features of STB formation and turnover can be preserved temporarily, provided the viability of the explant is maintained (8, 9). A second has been to use certain lines of choriocarcinoma cells, for example BeWo, which can be induced to undergo fusion by the addition of agents such as forskolin or dibutyryl cAMP to the culture medium (10, 11). A third approach has been to purify cytotrophoblast populations from whole placentas, usually from term collections, which, when cultured appropriately, fuse and form a multinucleated syncytium exhibiting many of the physiological features expected of STB within 2? d (12). An additional, fourth approach for generating what appears to be STB, is from human pluripotent stem cells, which, in absence of fibroblast growth factor-2 (FGF2) and in a process primed by the presence of the growth factor bone morphogenetic protein-4 (BMP-4), form areas of syncytium within the colonies (13?5). An up-regulation of genes expressed in placental syncytium accompanies this process of progressive differentiation (13, 16). When BMP4 is SignificanceSyncytiotrophoblast (STB) is responsible for nutrient and gas exchange in the human placenta. STB also forms when human embryonic stem cells (ESCs) differentiate to trophoblast. Here we compare ESC-derived STB with cytotrophoblasts isolated from term placentas before and after such cells had fused to form STB. Although both types of STB expressed all common trophoblast marker genes, there were dissimilarities indicative of altered function and.Ium emerges either during or soon after the trophoblast passes through the breached uterine epithelium and into the decidualized stromal layer beneath and appears to be responsible for hollowing out regions within the stroma to form lacunae (5), which become filled with fluid and cells from maternal blood and uterine glands and presumably provide a source of nutrients for the conceptus (3, 6). By about 12 d of gestation, soon after the blastocyst has sunk below the endometrial surface, strands of cytotrophoblast begin to form and penetrate through the primitive syncytium to form primary chorionic villi, which are subsequently invaded by extraembryonic mesoderm to form secondary and tertiary villi (villous trees) (2?). The cytotrophoblast cells associated with the villi continue to divide and provide a progenitor cell population for the villous STB, which is the cell layer that covers the outer surface of the villi and forms the definitive interface involved in exchange of gases, nutrients, and excretory materials between the fetal placenta and maternal blood. Villous STB is also the major site for production of placental hormones. Cytotrophoblast cells at the tips of the anchoring villi proliferate and colonize the endometrium, thus expanding the placental bed and simultaneously remodeling maternal spiral arteries. The extent to which extravillous trophoblast becomes multinucleated and whether such cells are the source of islands of giant cells within the endometrium (7)is controversial; an alternative theory is that the latter are remnants of the original primitive syncytium formed during initial trophoblast invasion (2, 3). The extent to which the phenotypes of these different forms of STB resemble each other and whether the underlying processes that lead to cell fusion have features in common remain unclear. Several main cell systems have been used to study STB formation. One has been to culture placental explants, where some of the features of STB formation and turnover can be preserved temporarily, provided the viability of the explant is maintained (8, 9). A second has been to use certain lines of choriocarcinoma cells, for example BeWo, which can be induced to undergo fusion by the addition of agents such as forskolin or dibutyryl cAMP to the culture medium (10, 11). A third approach has been to purify cytotrophoblast populations from whole placentas, usually from term collections, which, when cultured appropriately, fuse and form a multinucleated syncytium exhibiting many of the physiological features expected of STB within 2? d (12). An additional, fourth approach for generating what appears to be STB, is from human pluripotent stem cells, which, in absence of fibroblast growth factor-2 (FGF2) and in a process primed by the presence of the growth factor bone morphogenetic protein-4 (BMP-4), form areas of syncytium within the colonies (13?5). An up-regulation of genes expressed in placental syncytium accompanies this process of progressive differentiation (13, 16). When BMP4 is SignificanceSyncytiotrophoblast (STB) is responsible for nutrient and gas exchange in the human placenta. STB also forms when human embryonic stem cells (ESCs) differentiate to trophoblast. Here we compare ESC-derived STB with cytotrophoblasts isolated from term placentas before and after such cells had fused to form STB. Although both types of STB expressed all common trophoblast marker genes, there were dissimilarities indicative of altered function and.