ABSTRACT:The glucuronide conjugate of methyl 1-(3,4-dimethoxyphenyl)-3-(3-ethylvaleryl)-4-hydroxy-6,7,8-trimethoxy-2-naphthoate (S-8921; S-8921G) is a 6000-fold more potent inhibitor of an ileal apical sodium-dependent bile acid transporter (SLC10A2) than S-8921 and is responsible for the hypocholesterolemic effect of S-8921 in rats. Because S-8921G is formed in the intestine and liver, the present study investigated the transporters involved in the secretion of S-8921G that govern its exposure to the target site and thereby play an important role in its pharmacological action. Or- Furthermore, the secretion clearance of S-8921G to the mucosal side was also significantly lower in everted jejunum sacs from EHBR (9.18 and 20.8 l/min/g tissue). These results suggest that MRP2 is responsible for the secretion of S-8921G to the intestinal lumen and bile and that OATP1B1 and OATP1B3 account for the hepatic uptake. These transporters deliver S-8921G to the target site of its pharmacological action.Hyperlipidemia, especially hypercholesterolemia, is a major risk factor for atherosclerosis, leading to coronary heart disease. In clinical trials, reducing serum low-density lipoprotein (LDL) cholesterol has been shown to reduce the incidence of coronary heart disease and to reverse atherosclerotic lesions in hypercholesterolemic patients (Shepherd et al., 1995). The hypocholesterolemic agents most commonly used are the HMG-CoA reductase inhibitors (so-called statins).Statins have a potent hypocholesterolemic action and few side effects, resulting in good patient compliance. As alternative pharmacological targets for the hypocholesterolemic effect, there is growing interest in inhibition of the intestinal absorption of cholesterol and bile acids.S-8921 is a novel inhibitor of an ileal apical sodium-dependent bile acid transporter (ASBT/SLC10A2) and inhibits the absorption of bile acids from the ileum. The bile acid pool is tightly regulated; thus, inhibition of bile acid reabsorption via ASBT in the ileum by S-8921 would lead to an increase in the biosynthesis of bile acids from cholesterol. This is partly ascribed to the increase in the uptake of plasma LDL cholesterol through the up-regulation of LDL receptors as a result of partial depletion of hepatic cholesterol (Packard and Shepherd, 1982). In addition, S-8921 up-regulates hepatic LDL receptor expression and cholesterol 7␣-hydroxylase in rabbits (Higaki et al., 1998). These events result in a reduction in the plasma cholesterol.Initially, the reduction in plasma cholesterol by S-8921 was ascribed to the direct inhibition of ASBT by S-8921 following p.o. administration. Later, it became evident that the glucuronide conjugate of S-8921 (S-8921G), rather than S-8921 itself, is responsible for Article, publication date, and citation information can be found at