This article is available online at http://www.jlr.org bile ( 1 ). Phospholipid secretion into bile is important for the protection of the canalicular membrane against the strong detergent action of bile salts, which aid in absorption of cholesterol from food. Dysfunction of ABCB4 results in a lack of phospholipids and surplus of bile salts in primary bile, and this compositional imbalance causes damage to biliary canaliculi followed by chronic and progressive liver disease, such as intrahepatic cholestasis and lowphospholipid-associated cholelithiasis syndrome ( 2-5 ). ABCB4 shares quite high (86%) amino-acid sequence similarity ( 6 ) with multidrug resistance protein 1 (ABCB1), an ATP-dependent multidrug exporter ( 7 ). We have demonstrated that ABCB4 also functions as an ATP-dependent exporter by showing that PC and cholesterol are exported from cultured cells expressing the wild-type human ABCB4, but not from cells expressing an ATP-hydrolysis-defi cient mutant of ABCB4, when bile salts are present in the medium ( 8 ).ABCA1 exports excess cellular cholesterol and PC to the extracellular lipid acceptor apoA-I to generate HDL and plays a major role in cholesterol homeostasis and HDL metabolism. ABCG1, another member of the ABC proteins, is also involved in these processes. ABCG1 exports cholesterol and SM when HDL, but not apoA-I, is added to the medium as the lipid acceptor ( 9 ). We have shown that the decrease in cellular SM content in the plasma membrane reduces cholesterol export by ABCG1, and that the function of ABCG1 is dependent on SM ( 10, 11 ). By contrast, reduced Abstract ABCB4, which is specifi cally expressed on the canalicular membrane of hepatocytes, exports phosphatidylcholine (PC) into bile. Because SM depletion increases cellular PC content and stimulates PC and cholesterol effl ux by ABCA1, a key transporter involved in generation of HDL, we predicted that SM depletion also stimulates PC effl ux through ABCB4. To test this prediction, we compared the lipid effl ux activity of ABCB4 and ABCA1 under SM depletion induced by two different types of inhibitors for SM synthesis, myriocin and ( 1R,3S )-N -(3-hydroxy-1-hydroxymethyl-3-phenylpropyl) dodecanamide, in human embryonic kidney 293 and baby hamster kidney cells. Unexpectedly, SM depletion exerted opposite effects on ABCB4 and ABCA1, suppressing PC effl ux through ABCB4 while stimulating effl ux through ABCA1. Both ABCB4 and ABCA1 were recovered from Triton-X-100-soluble membranes, but ABCB4 was mainly recovered from CHAPS-insoluble SM-rich membranes, whereas ABCA1 was recovered from CHAPS-soluble membranes. These results suggest that a SM-rich membrane environment is required for ABCB4 to function. ABCB4 must have evolved to exert its maximum activity in the SM-rich membrane environment of the canalicular membrane, where it transports PC as the physiological substrate. Press, January 19, 2015 DOI 10.1194 ABCB4 exports phosphatidylcholine in a sphingomyelindependent manner Abbreviations: BHK, baby hamster kidney; CERT, ceramide transfer ...