A common feature of many metabolic pathways is their control by retinoid X receptor (RXR) heterodimers. Dysregulation of such metabolic pathways can lead to the development of atherosclerosis, a disease influenced by both systemic and local factors. Here we analyzed the effects of activation of RXR and some of its heterodimers in apolipoprotein E ؊͞؊ mice, a well established animal model of atherosclerosis. An RXR agonist drastically reduced the development of atherosclerosis. In addition, a ligand for the peroxisome proliferator-activated receptor (PPAR)␥ and a dual agonist of both PPAR␣ and PPAR␥ had moderate inhibitory effects. Both RXR and liver X receptor (LXR) agonists induced ATP-binding cassette protein 1 (ABC-1) expression and stimulated ABC-1-mediated cholesterol efflux from macrophages from wild-type, but not from LXR␣ and  double ؊͞؊, mice. Hence, activation of ABC-1-mediated cholesterol efflux by the RXR͞LXR heterodimer might contribute to the beneficial effects of rexinoids on atherosclerosis and warrant further evaluation of RXR͞LXR agonists in prevention and treatment of atherosclerosis. R etinoid X receptors (RXRs) are ubiquitously expressed nuclear receptors that heterodimerize with a number of other receptors (e.g., thyroid hormone receptor, vitamin D receptor, retinoic acid receptors, etc.; refs. 1 and 2). The elucidation of RXRs biological activity has advanced significantly through the characterization of rexinoids, high-affinity selective synthetic ligands for RXRs (1, 2). The use of rexinoids led to the demonstration that RXRs are active and permissive signaling molecules in heterodimers with the farnesol X receptor (FXR) [or bile acid receptor (BAR)], the liver X receptors (LXRs), and the peroxisome proliferatoractivated receptors (PPARs). The simultaneous activation of several permissive heterodimers underlies in part RXRs pleiotropic functions, affecting numerous receptor signaling pathways, and ranges from the control of cell proliferation, differentiation, and apoptosis (3) to the regulation of glucose and lipid metabolism (4). This pivotal role of the various permissive RXR heterodimers is in fact an emerging theme in multiple metabolic pathways. Heterodimers between RXR and PPAR␥, PPAR␣, LXR␣, and FXR͞BAR respectively inf luence glucose, triglyceride, cholesterol, and bile acid homeostasis. Dysregulation of these homeostatic control pathways can result in common metabolic disorders such as obesity, type 2 diabetes, and hyperlipidemia, which are often complicated by the development of atherosclerosis.In view of the potential implication of RXRs in various metabolic pathways implicated in atherosclerosis, we studied whether modulating the activity of these receptors or of some of their heterodimers affects the development of atherosclerosis in apolipoprotein (apo)E-deficient mice. We demonstrate here that the administration of rexinoids significantly attenuates atherosclerosis development, and we show that this effect might be linked to the activation of reverse cholesterol transpor...