In inflammatory disease states, such as hepatitis and sepsis, cholestasis is a common observation. 1,2 Although it is known that endotoxemia decreases hepatocellular bile acid uptake in vivo, the sequence of events leading to impairment of transport for bile salts is incompletely understood. The role of macrophages as mediators in endotoxemia or exposure of the liver to toxins such as alcohol or D-galactosamine, in particular through the release of proinflammatory cytokines, has been the focus of recent studies. [3][4][5] However, the question of whether macrophages are needed to mediate the cholestatic effect of inflammatory disease has not yet been clearly answered.Plasma membrane transport proteins for biliary solutes at both poles of the hepatocyte have been shown to be affected by endotoxin (lipopolysaccharide [LPS]). [6][7][8][9][10][11][12] On the canalicular membrane, mrp2, the organic anion transporter, is significantly down-regulated after LPS exposure. 8,11 In contrast, the canalicular bile acid transporter (bile salt export pump [BSEP]), is not substantively down-regulated during endotoxemia. 11 Several investigators have focused attention on the response of the sodium-taurocholate-cotransporting polypeptide (ntcp), the dominant transport protein for bile salts on the basolateral plasma membrane in a variety of inflammatory models. The effects of LPS or proinflammatory cytokines on ntcp have been the subject of intense investigation using in vivo models, 9,10,12 perfused rat liver, 6 hepatocyte cell culture, 13,14 and membrane preparations from the rat liver. 9,10 These studies show that ntcp protein expression and messenger RNA (mRNA) levels are down-regulated in the presence of LPS or proinflammatory cytokines. Recent studies provide evidence for hepatocellular alterations in regulatory nuclear transcription factors acting on the ntcp promoter 12 during endotoxemia. However, less information has been gained regarding extracellular mediators of endotoxin-induced cholestasis. It has been postulated but not proven that macrophages are responsible for the processing of LPS and the release of cytokines, which, in turn, adversely affect bile acid transport on the basolateral domain of the hepatocyte. 2 In this study, we show that LPS has a cholestatic effect on a hepatoma cell line only if macrophages are used as mediators. Tumor necrosis factor ␣ (TNF-␣), interleukin 1 (IL-1), and IL-6 were identified as effector cytokines causing diminished bile acid transport across the basolateral membrane and decreased expression of ntcp mRNA. Macrophage release of