This article is available online at http://www.jlr.org thesis ( 2 ). We showed that ChEH was fully inhibited by therapeutic doses of AEBS ligands, including drugs belonging to different pharmacological classes and widely used nutritional compounds. These compounds include tamoxifen (tam), one of the main drugs used for the fi rstline and long-term hormone therapy of breast cancers; raloxifene, which has been approved for the prevention of osteoporosis ( 3 ); amiodarone, which is widely used for the prevention and the treatment of anti-arrhythmia ( 4 ); trifluoroperazine, an antipsychotic drug used for the treatment of schizophrenia ( 5 ); and the omega-3 fatty acid docosahexaenoic acid, which is widely proposed as dietary supplement with health benefi ts ( 2 ). Extensive knowledge of the mechanism of action of all these molecules is required to prevent toxicity to patients submitted to longterm treatment with such inhibitors of ChEH.AEBS/ChEH ligands, such as tam and raloxifene, were recently shown to induce cell differentiation and death of breast cancer cells through a mechanism involving sterol accumulation and autoxidation ( 6-8 ) leading to the production of 5,6-EC, suggesting that 5,6-EC accumulation is involved in their anticancer and chemopreventitive activity. This is contrary to the initial hypothesis that the biological function of ChEH was to detoxify 5,6-EC. This hypothesis emerged because it was initially postulated that 5,6-EC could, like other chemicals bearing epoxide groups, be potent alkylating substances and, hence, carcinogenic ( 9 ).Abstract We recently established that drugs used for the treatment and the prophylaxis of breast cancers, such as tamoxifen, were potent inhibitors of cholesterol-5,6-epoxide hydrolase (ChEH), which led to the accumulation of 5,6 ␣ -epoxy-cholesterol (5,6 ␣ -EC) and 5,6  -epoxy-cholesterol (5,6  -EC). This could be considered a paradox because epoxides are known as alkylating agents with putative carcinogenic properties. We report here that, as opposed to the carcinogen styrene-oxide, neither of the ECs reacted spontaneously with nucleophiles. Under catalytic conditions, 5,6  -EC remains unreactive whereas 5,6 ␣ -EC gives cholestan-3  ,5 ␣ -diol-6  -substituted compounds. These data showed that 5,6-ECs are stable epoxides and unreactive toward nucleophiles in the absence of a catalyst, which contrasts with the well-known reactivity of aromatic and aliphatic epoxides. These data rule out 5,6-EC acting as spontaneous alkylating agents. In addition, these data support the existence of a stereoselective metabolism of 5,6 ␣ -EC. Cholesterol-5,6-epoxide hydrolase (ChEH; EC 3.3.2.11) catalyzes the stereoselective hydration of cholesterol-5,6-epoxide diastereoisomers (5,6-EC: 5,6 ␣ -EC and 5,6  -EC) into cholestane-3  ,5 ␣ ,6  -triol (CT) ( 1 ). We recently reported the molecular identifi cation of this enzyme and established that ChEH activity was carried out by the microsomal antiestrogen binding site (AEBS), which consists of two subunits: the 3  -hydroxyste...