Journal of Lipid Research Volume 52, 2011 345export. Of major importance are transport mechanisms that promote the effl ux of excess cholesterol to extracellular acceptors, i.e., macrophage reverse cholesterol transport (RCT). The removal of excess cholesterol is critical in the vessel wall, where macrophage uptake of lipoproteinderived lipid can lead to a pathological cholesterol load in the absence of suffi cient removal systems. On the basis of studies in mice, two members of the ATP binding cassette (ABC) superfamily of transmembrane transporters, ABCA1 and ABCG1, play critical roles in preventing cholesterol accumulation in macrophages. In mice, combined defi ciency of ABCA1 and ABCG1 in macrophages leads to impaired cellular cholesterol effl ux in vitro and a massive increase in macrophage lipid accumulation in vivo ( 1-3 ). However, the role of ABCG1 in cholesterol effl ux in human monocyte-derived macrophages has recently been questioned ( 4 ). Accumulating evidence suggests that ABCA1 and ABCG1 act through distinct, yet synergistic, mechanisms to promote macrophage RCT. Whereas lipid-poor apolipoproteins serve as extracellular acceptors for ABCA1-mediated phospholipid (PL) and cholesterol effl ux, ABCG1 appears to promote effl ux by redistributing intracellular cholesterol to plasma membrane domains accessible for removal by HDL, but not lipid-poor apolipoprotein A-I (apoA-I) ( 5 ). ABCA1 and ABCG1 may act sequentially to mediate effl ux, such that nascent HDL generated through the lipidation of lipid-poor/free apoA-I by ABCA1 in turn serves as a substrate for cellular cholesterol export through ABCG1 ( 6, 7 Macrophages possess a number of mechanisms to regulate the balance between cholesterol uptake/synthesis and