Recent studies have documented the presence of Niemann-Pick C1-Like 1 (NPC1L1) in the small intestine and its capacity to transport cholesterol in mice and rats. The current investigation was undertaken to explore the localization and function of NPC1L1 in human enterocytes. Cell fractionation experiments revealed an NPC1L1 association with apical membrane of the enterocyte in human jejunum. Signal was also detected in lysosomes, endosomes, and mitochondria. Confirmation of cellular NPC1L1 distribution was obtained by immunocytochemistry. Knockdown of NPC1L1 caused a decline in the ability of Caco-2 cells to capture micellar [14 C]free cholesterol. Furthermore, this NPC1L1 suppression resulted in increased and decreased mRNA levels and activity of HMG-CoA reductase, the rate-limiting step in cholesterol synthesis, and of ACAT, the key enzyme in cholesterol esterification, respectively. An increase was also noted in the transcriptional factor sterol-regulatory element binding protein that modulates cholesterol homeostasis. Efforts were devoted to define the impact of NPC1L1 knockdown on other mediators of cholesterol uptake. RT-PCR evidence is presented to show the significant decrease in the levels of scavenger receptor class B type I (SR-BI) with no changes in ABCA1, ABCG5, and cluster determinant 36 in NPC1L1-deficient Caco-2 cells. Together, our data suggest that NPC1L1 contributes to intestinal cholesterol homeostasis and possibly cooperates with SR-BI to mediate cholesterol absorption in humans. Coronary heart disease is the most important clinical manifestation of atherosclerosis and remains the main cause of death in developed societies. Hypercholesterolemia is beyond doubt the most prominent risk factor for the development of atherosclerosis, which is caused by derangements in cholesterol homeostasis (i.e., intestinal uptake, endogenous synthesis and metabolism, transport in lipoprotein particles, and biliary excretion). At present, there are increasing efforts to understand the physiology of intestinal fat transport in view of the positive relationship between cholesterol absorption, plasma cholesterol levels, and coronary heart disease (1-4). Additionally, augmented dietary fat and cholesterol intake have been tightly linked to the increased incidence of other diseases, such as cancer, diabetes, and obesity (5-7).In stark contrast to previous tenets suggesting that cholesterol uptake occurs as a passive diffusion down a concentration gradient, more and more investigators now support protein-mediated cholesterol absorption. Curiously, protein transporters intervening in intestinal cholesterol movement have not yet been ascertained. A few recent studies have proposed scavenger receptor class B type I (SR-BI) as a candidate protein involved in dietary cholesterol transport (8-11). On the other hand, the involvement of SR-BI in cholesterol uptake has been questioned because intestinal cholesterol absorption was shown to be unaffected by deletion of the SR-BI gene in mice (10, 12). Other laboratori...