The present study evaluates the roles of the multidrug resistance-1 P-glycoprotein, Mdr1a/1b, the bile salt export pump (Bsep), and the multidrug resistance-associated protein-2 (Mrp2) in mediating cholestasis induced by estradiol-17(-D-glucuronide) (E 2 17G). Administration of [ 3 H]E 2 17G (18 nmol/g body weight) gave a similar degree of cholestasis and biliary excretion of E 2 17G-equivalents in wild-type and Mdr1a -/-/1b -/-mice. When expressed in Sf9 cells, Bsepmediated adenosine triphosphate (ATP)-dependent transport of taurocholate (TC, 1 mol/L) in membrane vesicles was 110% ؎ 12.5% and 108% ؎ 17.3% of control in the presence of 10 and 50 mol/L E 2 17G, respectively, whereas in rat canalicular membrane, both E 2 17G and the choleretic estradiol-3--D-glucuronide (E 2 3G) inhibited ATP-dependent transport of TC to the same extent. Infusion of The normal liver canalicular membrane expresses a number of adenosine triphosphate (ATP)-binding cassette (ABC) transporters that mediate the active transport of solutes into the canaliculus and are thereby important for the generation of bile and the biliary excretion of a variety of products of endogenous and exogenous origin. 1 MDR1, or the multidrug resistance-1 P-glycoprotein, which is overexpressed in resistant tumor cells, was the first ATP-binding cassette transporter shown to be constitutively expressed in the canalicular membrane. 2 Although its physiological role in the liver is not understood, it transports a wide variety of hydrophobic chemotherapeutic drugs, such as daunorubicin and taxol, 3 in addition to the endogenous metabolite estradiol-17(-Dglucuronide) (E 2 17G). 4 MDR3/Mdr2 is a phospholipid transporter that translocates phosphatidylcholine from the inner to the outer leaflet of the canalicular membrane from where it is extracted by bile acids and secreted into bile. 5 Mrp2, the liver-specific homologue of the multidrug resistance-associated protein, originally characterized as the canalicular multispecific organic anion transporter, is responsible for the biliary excretion of many glutathione-S-conjugates (e.g., leukotriene C 4 ), glucuronide conjugates (e.g., E 2 17G), and sulfate conjugates. 6,7 Sister-P-glycoprotein, a member of the P-glycoprotein gene family, which is closely related to MDR1 and is highly expressed in liver, 8 has been shown to be the major bile salt export pump (Bsep), which transports bile acids across the canalicular membrane. 9 Bile acids are the most concentrated organic solutes in bile and are considered to be the major driving force for the generation of bile flow. 10 E 2 17G is an endogenous estrogen metabolite that has been shown to decrease bile flow in the rat and bile secretory function in the rhesus monkey. 11 A clear structure-activity relationship for the cholestatic activity of estrogen glucuronides is apparent in that glucuronide conjugates of the estrogen D-ring reversibly induce dose-dependent inhibition of bile flow to yield a family of parallel dose-response curves. In contrast, glucuronide conjug...