Objectives-Increasing HDL levels is a potential strategy for the treatment of atherosclerosis. Methods and Results-ITX5061, a molecule initially characterized as a p38 MAPK inhibitor, increased HDL-C levels by 20% in a human population of hypertriglyceridemic subjects with low HDL levels. ITX5061 also moderately increased apoA-I but did not affect VLDL/LDL cholesterol or plasma triglyceride concentrations. ITX5061 increased HDL-C in WT and human apoA-I transgenic mice, and kinetic experiments showed that ITX5061 decreased the fractional catabolic rate of HDL-CE and reduced its hepatic uptake. In transfected cells, ITX5061 inhibited SR-BI-dependent uptake of HDL-CE. Moreover, ITX5061 failed to increase HDL-C levels in SR-BI Ϫ/Ϫ mice. To assess effects on atherosclerosis, ITX5061 was given to atherogenic diet-fed Ldlr ϩ/Ϫ mice with or without CETP expression for 18 weeks. In both the control and CETP-expressing groups, ITX5061-treated mice displayed reductions of early atherosclerotic lesions in the aortic arch Ϫ40%, PϽ0.05), and a nonsignificant trend to reduced lesion area in the proximal aorta. Conclusions-Our data indicate that ITX5061 increases HDL-C levels by inhibition of SR-BI activity. This suggests that pharmacological inhibition of SR-BI has the potential to raise HDL-C and apoA-I levels without adverse effects on VLDL/LDL cholesterol levels in humans. Key Words: scavenger receptor B-I Ⅲ high-density lipoproteins Ⅲ inhibitors Ⅲ p38 MAPK Ⅲ atherosclerosis P lasma high-density lipoprotein (HDL) levels are inversely correlated with atherosclerotic cardiovascular disease, and raising HDL levels by lifestyle changes or pharmacological interventions is an emerging strategy that might help to reduce the residual burden of disease in patients treated with low-density lipoprotein (LDL)-lowering approaches. 1,2 Whereas increasing synthesis or infusion of apolipoprotein A-I (apoA-I) or HDL reduces atherosclerosis in animals and humans, it is not clear that all approaches to raising HDL will reduce atherosclerosis.The scavenger receptor B-I (SR-BI) is a major factor regulating HDL catabolism. SR-BI binds HDL and mediates the selective uptake of HDL-cholesteryl ester (CE) in the liver and steroidogenic tissues. 3 Although the role of SR-BI in HDL metabolism in mice and rats has been clearly shown, much less information is available on the function of SR-BI in humans. Primary human hepatocytes do demonstrate selective uptake of HDL-CE, 4 but the quantitative importance of this pathway has not been shown. In humans, cholesteryl ester transfer protein (CETP), a factor lacking in mice and rats, plays a major role in HDL-CE catabolism. In the present study, we demonstrate that ITX5061, a molecule initially characterized as a p38 mitogen-activated protein kinase (MAPK) inhibitor, caused an increase in HDL cholesterol (HDL-C) and apoA-I levels in humans. Studies in mice and cultured cells indicated that ITX5061 is an inhibitor of the SR-BI activity. Interestingly, ITX5061 did not cause increases in very-low-density lipopr...