Molecular associations between sphingomyelin and cholesterol provide a molecular basis for the colocalization of these lipids in plasma membrane microdomains (lipid rafts) and for the inhibitory effect of sphingomyelin on the intestinal absorption of cholesterol. Using surface pressure measurements at the air-water interface, we showed that sphingosine, the common sphingoid backbone of most sphingolipids, formed condensed lipid complexes with cholesterol. Structure-activity relationship studies with long-chain analogs of sphingosine, together with molecular mechanics simulations, were consistent with a specific interaction between sphingosine and the ␣ face of cholesterol. The uptake of micellar cholesterol and the effect of sphingosine on cholesterol absorption were studied with two human model intestinal epithelial cell lines, Caco-2 and HT-29-D4. Realtime PCR quantifications of the putative cholesterol transporter Niemann-Pick C1 like 1 (NPC1L1) mRNA revealed that, in these cell lines, the activity of cholesterol transport correlated with the level of NPC1L1 expression. In both cell lines, sphingosine induced a dose-dependent decrease of cholesterol absorption. Yet the effect of sphingosine was more dramatic in Caco-2 cells, which also displayed the highest expression of NPC1L1 mRNA. Altogether, these data suggested that sphingosine interacts specifically with cholesterol and inhibits the intestinal NPC1L1-dependent transport of micellar cholesterol. It has been known for several years that cholesterol interacts with sphingomyelin (1-3) and that this interaction is of high biological significance for two main reasons. i ) The formation of ordered lipid domains in the plasma membrane of eukaryotic cells is, at least in part, driven by lipid-lipid interactions (4, 5). Among them, the molecular association between sphingomyelin and cholesterol is an important parameter that controls the segregation of both lipids into cholesterol-enriched microdomains usually referred to as lipid rafts (6). These microdomains of the plasma membrane are involved in key cellular functions, such as the control of signal transduction pathways, and they are used as landing platforms and ports of entry by many pathogens or toxins (7)(8)(9). ii ) On the other hand, the formation of cholesterol-sphingomyelin molecular complexes in the intestinal lumen explains the mutual inhibitory effects of cholesterol and sphingomyelin on their intestinal absorption (10). Indeed, it was recently demonstrated that sphingomyelin decreased the absorption of cholesterol by affecting the thermodynamic activity (i.e., the active concentration) of cholesterol monomers in the small intestine (11). The process of intestinal sphingomyelin absorption is complex. A part of sphingomyelin can be directly absorbed by the intestinal epithelium, but this phosphorylated sphingolipid is also cleaved by intestinal sphingomyelinases, giving rise to ceramide and phosphorylcholine (12, 13). Ceramide is poorly absorbed and is further hydrolyzed into fatty acid and ...