This article is available online at http://www.jlr.org of elevated LDL-C levels and, ultimately, coronary heart disease are the statins (3). Although these drugs have proven to be potent and effi cacious, a signifi cant percentage of high-risk patients are unable to attain their ATP-III recommended LDL-C goals for several reasons, including ineffectiveness or intolerance to statins alone or in combination with other dyslipidemia agents (4, 5). These factors have led to a continued search for new drugs with unique mechanisms of action that lower plasma LDL-C levels.Two proteins involved in the formation of apoB-containing lipoprotein particles that have recently received considerable attention as potential therapeutic targets are apolipoprotein B (apoB) and microsomal triglyceride transfer protein (MTP) (6-8). Both are essential for the assembly and secretion of the apoB-containing lipoproteins (i.e., VLDL) synthesized in the liver and chylomicrons produced by enterocytes of the small intestine. In the liver, apoB100 is the main structural protein component of VLDL and LDL particles.Extensive biochemical studies indicate that apoB protein is primarily regulated at the post-transcriptional level (9). Initially, nascent apoB protein is transferred through the ER membrane and into the ER lumen. In the absence of suffi cient lipid or functional MTP, apoB fails to be lipidated and undergoes retrograde translocation into the cytosol, where it is ubiquitinated and degraded. However, in the presence of suffi cient lipid, apoB is lipidated in an MTP-dependent, two-step process, leading to the formation and secretion of a mature VLDL particle (10). VLDL then enters the circulation and is acted upon by lipolytic and lipid transfer enzymes that convert triglycerides TG-rich Abstract Therapeutic agents that suppress apolipoprotein B (apoB) and microsomal triglyceride transfer protein (MTP) levels/activity are being developed in the clinic to benefi t patients who are unable to reach target LDL-C levels with maximally tolerated lipid-lowering drugs. To compare and contrast the metabolic consequences of reducing these targets, murine-specifi c apoB or MTP antisense oligonucleotides (ASOs) were administered to chow-fed and high fatfed C57BL/6 or to chow-fed and Western diet-fed LDLr ؊ / ؊ mice for periods ranging from 2 to 12 weeks, and detailed analyses of various factors affecting fatty acid metabolism were performed. Administration of these drugs signifi cantly reduced target hepatic mRNA and protein, leading to similar reductions in hepatic VLDL/triglyceride secretion. MTP ASO treatment consistently led to increases in hepatic triglyceride accumulation and biomarkers of hepatotoxicity relative to apoB ASO due in part to enhanced expression of peroxisome proliferator activated receptor ␥ target genes and the inability to reduce hepatic fatty acid synthesis. Thus, although both drugs effectively lowered LDL-C levels in mice, the apoB ASO produced a more positive liver safety profi le.