Recently, we generated mice lacking microsomal triglyceride transfer protein (MTP) in the liver (Mttp ⌬/⌬ ) and demonstrated that very low density lipoprotein secretion from hepatocytes was almost completely blocked. The blockade in lipoprotein production was accompanied by mild to moderate hepatic steatosis, but the mice appeared healthy. Although hepatic MTP deficiency appeared to be innocuous, we hypothesized that a blockade in very low density lipoprotein secretion and the accompanying steatosis might increase the sensitivity of Mttp ⌬/⌬ livers to additional hepatic insults. To address this issue, we compared the susceptibility of Mttp
Microsomal triglyceride transfer protein (MTP)1 is critical for the assembly and secretion of apolipoprotein (apo) B-containing lipoproteins, both in the intestine and in the liver (1, 2). A genetic absence of MTP causes abetalipoproteinemia, a disease characterized by intestinal fat malabsorption, a virtual absence of chylomicrons, very low density lipoproteins (VLDL), low density lipoproteins in the plasma, and strikingly low plasma levels of triglycerides and cholesterol. The fact that a deficiency in MTP reduces the plasma levels of atherogenic lipoproteins has attracted the attention of the pharmaceutical industry. Many companies have established MTP programs, with the goal of identifying MTP inhibitors suitable for treating humans with hyperlipidemias (3, 4). Thus far, however, the efficacy and safety of these compounds in humans has not been documented.To investigate the role of MTP in lipoprotein assembly and secretion, we inactivated the MTP gene (Mttp) in mice (5). Heterozygous knockout mice (Mttp ϩ/Ϫ ) manifested slightly reduced levels of lipoprotein secretion, reduced levels of apoB100-containing lipoproteins in the plasma, and slightly increased levels of neutral lipids (triglycerides and cholesterol esters) in the liver. Homozygous knockout mice (Mttp Ϫ/Ϫ ) died during embryonic development. Subsequently, we used Cre/LoxP recombination techniques to produce mice lacking Mttp expression in the liver but not in the intestine (6). Those mice, designated Mttp ⌬/⌬ mice, exhibited strikingly reduced plasma levels of apoB100, sizable reductions in the plasma levels of cholesterol and triglycerides, and mild to moderate steatosis with increased levels of neutral lipids in the liver. The Mttp ⌬/⌬ mice were healthy and grew normally; their plasma transaminase levels were normal, and their livers were free of inflammatory infiltrates (6).The fact that it was possible to eliminate hepatic Mttp expression in a mammalian model without noticeable side effects supported the concept that it might be possible to develop MTP inhibitors to treat hyperlipidemias. Also encouraging were studies by Wetterau et al. (7) that showed that MTP inhibitors could reduce plasma lipoprotein levels in low density lipoprotein receptor-deficient rabbits without causing elevated transaminases or histologic evidence of liver inflammation.In this study, we further investigated the notion that it mig...