Multidrug resistance continues to be a major impediment to successful chemotherapy in cancer patients. One cause of multidrug resistance is enhanced expression of the mdr1 gene, but the precise factors and physiological conditions controlling mdr1 expression are not entirely known. To gain a better understanding of mdr1 transcriptional regulation, we created a unique mouse model that allows noninvasive bioimaging of mdr1 gene expression in vivo and in real time. The model uses a firefly luciferase ( fLUC) gene inserted by homologous recombination into the murine mdr1a genetic locus. The inserted fLUC gene is preceded by a neo expression cassette flanked by loxP sites, so that Cre-mediated recombination is required to configure the fLUC gene directly under the control of the endogenous mdr1a promoter. We now demonstrate that the mdr1a.fLUC knock-in is a faithful reporter for mdr1a expression in naive animals, in which fLUC mRNA levels and luminescence intensities accurately parallel endogenous mdr1a mRNA expression. We also demonstrate xenobiotic-inducible regulation of mdr1a.fLUC expression in real time, in parallel with endogenous mdr1a expression, resulting in a more detailed understanding of the kinetics of mdr1a gene induction. This mouse model demonstrates the feasibility of using bioimaging coupled with Cre/loxP conditional knock-in to monitor regulated gene expression in vivo. It represents a unique tool with which to study the magnitude and kinetics of mdr1a induction under a variety of physiologic, pharmacologic, genetic, and environmental conditions. bioimaging ͉ conditional knock-in ͉ gene regulation ͉ MDR1 ͉ multidrug resistance T he human MDR1 gene encodes P-glycoprotein (Pgp), which functions as a transmembrane drug transporter and mediates the efflux of drugs from cells, thus conferring multidrug resistance on cancer cells and tumors that over-express it (1, 2). In addition, basal expression of MDR1 in organs such as liver, kidney, and colon, because of their involvement in drug excretion and absorption, affects the pharmacokinetics of drug uptake and excretion for agents that are substrates for Pgp transport (3-6). The mechanism of MDR1 regulation in tumors or in normal, nonmalignant tissue, particularly in response to xenobiotics and other environmental and physiologic stimuli, is not fully understood. The tumor-suppressor p53 has been implicated as a possible transactivator of MDR1 expression in tumors (7-9), although this association remains controversial (see ref. 10). In addition, nuclear receptors such as SXR and constitutive androstane receptor (CAR) have been suggested as possible master regulators of xenobiotic-and druginducible expression of MDR1, and of other genes involved in drug metabolism in organs such as the liver, kidney, and colon (11,12). One recent report implicates the transcription factor FOXO3a in doxorubicin-mediated induction of MDR1 in the K562 human leukemia cell line (13).Our limited understanding of MDR1 gene regulation in vivo is partly a result of the difficulty in...