Guggulsterone is the active ingredient in gugulipid, an organic extract of the Commiphora mukul plant. Gugulipid has been used for nearly 3000 years in Ayurvedic medicine, mainly as a treatment for arthritis. Herbal practitioners currently use gugulipid therapy in conditions as diverse as rheumatism, coronary artery disease, arthritis, hyperlipidemia, acne, and obesity. The active ingredient in gugulipid is guggulsterone, a plant sterol compound recently identified as a pregnane X receptor (PXR; NR1I2) ligand. We show herein that guggulsterone treatment represses the expression of cytochrome P450 2b10 (Cyp2b10) gene expression by inhibiting constitutive androstane receptor (CAR; NR1I3) activity in hepatocytes lacking functional PXR (PXR-knockout). We also show that PXR-CAR cross-talk determines the net activity of guggulsterone treatment toward Cyp2b10 gene expression. Using mammalian two-hybrid assays, we show that treatment with guggulsterone differentially affects protein cofactor recruitment to these two nuclear receptors. These data identify guggulsterone as an inverse agonist of the nuclear receptor CAR. When viewed together with the data showing that PXR and CAR expression is highly variable in different ethnic populations and that CAR expression is under the control of a circadian rhythm, our data provide important insight into the molecular mechanism of interindividual variability of drug metabolism. These data, together with the recent resolution of the crystal structures of PXR and CAR, will likely aid in the rational design of more specific CAR inverse agonists that are currently viewed as potential antiobesity drugs.Gugulipid is an herbal remedy derived from the gum resin of the Commiphora mukul tree. Gugulipid has been used in Ayurvedic medicine mainly to treat arthritis and inflammation. A number of clinical trials performed in India determined that gugulipid treatment produces favorable lipid profiles in patients with high cholesterol Gopal et al., 1986;Nityanand et al., 1989). This finding has led to the widespread import and use of gugulipid extract in humans as a cholesterol-lowering agent sold in nutrition centers without a prescription in western societies. A recent human clinical trial has raised questions regarding the efficacy of gugulipid extract in lowering serum cholesterol (Szapary et al., 2003). Moreover, our laboratory has recently demonstrated that the use of gugulipid induces the expression and activity of drug-metabolizing cytochrome P450 genes through activation of the nuclear receptor protein PXR in cells (Brobst et al., 2004). The notion that gugulipid produces herb-drug interactions in humans is further supported by the results of a small, well controlled study that revealed significantly reduced (P Ͻ 0.01) peak plasma concentrations of either diltiazem or propranololin in volunteer patients cofed 1 g of gugulipid in comparison with those that received one of these drugs in combination with a placebo (Dalvi et al., 1994).The active ingredients in gugulipid are the ket...