The liver X receptors (LXRs) a and b are responsible for the transcriptional regulation of a number of genes involved in cholesterol efflux from cells and therefore may be molecular targets for the treatment of cardiovascular disease. However, the effects of LXR ligands on cholesterol turnover in cells has not been examined comprehensively. In this study, cellular cholesterol handling (e.g., synthesis, catabolism, influx, and efflux) was examined using a stable isotope labeling study and a two-compartment modeling scheme. In HepG2 cells, the incorporation of 13 C into cholesterol from [1-13 C]acetate was analyzed by mass isotopomer distribution analysis in conjunction with nonsteady state, multicompartment kinetic analysis to calculate the cholesterol fluxes. Incubation with synthetic, nonsteroidal LXR agonists (GW3965, T0901317, and SB742881) increased cholesterol synthesis (z10-fold), decreased cellular cholesterol influx (71-82%), and increased cellular cholesterol efflux (1.7-to 1.9-fold) by 96 h. As a consequence of these altered cholesterol fluxes, cellular cholesterol decreased (36-39%) by 96 h. The increased cellular cholesterol turnover was associated with increased expression of the LXR-activated genes ABCA1, ABCG1, FAS, and sterol-regulatory element binding protein 1c.In summary, the mathematical model presented allows time-dependent calculations of cellular cholesterol fluxes. These data demonstrate that all of the cellular cholesterol fluxes were altered by LXR activation and that the increase in cholesterol synthesis did not compensate for the increased cellular cholesterol efflux, resulting in a net cellular cholesterol loss.-Aravindhan, K., C. L. Webb, M. Jaye, A. Ghosh, R. N. Willette, N. J. Di Nardo, and B .M. Jucker. The liver X receptor (LXR) is an oxysterol-sensing nuclear receptor responsible for transcriptional regulation of a number of genes involved in reverse cholesterol transport and therefore may be a molecular target for the treatment of cardiovascular disease (1-3). LXR is a member of the nuclear receptor family that regulates cellular cholesterol efflux (4) and whole body cholesterol excretion (5) and is endogenously activated by various oxysterols (6), including 24(S),25-epoxycholesterol and 22(R)-hydroxycholesterol, an intermediate in steroid hormone production (7, 8). Additionally, synthetic LXR agonists that potently upregulate macrophage ABCA1 expression have been shown to be antiatherogenic in genetic mouse models of atherosclerosis (9, 10).Cellular cholesterol metabolism and handling has been examined in terms of its synthesis by measuring the fraction of newly synthesized cholesterol (11,12), in terms of catabolism by measuring levels of bile acids through biochemical assays or HPLC (13,14), in terms of influx by measuring the radioactivity of absorbed [ 3 H]cholesteryl oleate (15, 16), and in terms of efflux by measuring specific radioactivity in labeled cells (17)(18)(19)(20). However, prior methods address only the unidirectional flow of cholesterol and are not ...