Population studies have shown an inverse relationship between plasma HDL levels and the risk for atherosclerotic disease, implying that factors associated with HDL metabolism are cardioprotective. HDL and its major protein, apolipoprotein A-I (apoA-I), are thought to protect against atherosclerosis by several diverse mechanisms, including removing excess cholesterol from arterial macrophages, reducing infl ammation, and inhibiting lipoprotein oxidation ( 1 ). There is strong evidence that the infl ammatory milieu of atherosclerotic tissue can promote oxidation of HDL apolipoproteins and impair their cardioprotective activities ( 2 ).One oxidative pathway in the human artery wall involves myeloperoxidase (MPO), a phagocyte heme protein that colocalizes with arterial macrophages ( 3, 4 ). MPO uses hydrogen peroxide (H 2 O 2 ) and chloride to generate hypochlorous acid (HOCl), a powerful chlorinating oxidant ( 5 ). MPO also uses H 2 O 2 and nitrite (NO 2 Ϫ ) to generate reactive species that nitrate proteins ( 6, 7 ). HDL isolated from human atherosclerotic lesions contains high levels of 3-chlorotyrosine and 3-nitrotyrosine ( 8-10 ). In mouse models of acute infl ammation, generation of both of these oxidized amino acids is markedly impaired when the mice are defi cient in MPO ( 7, 11 ). Moreover, levels of 3-chlorotyrosine and 3-nitrotyrosine are markedly higher in HDL isolated from plasma of subjects with established coronary artery disease than in HDL from healthy subjects ( 8-10 ). These fi ndings indicate that MPO targets HDL for oxidation in humans and support the concept that reactions Abstract A key cardioprotective effect of high-density lipoprotein involves the interaction of its major protein, apolipoprotein A-I (apoA-I) with ATP-binding cassette transporter A1 (ABCA1), a macrophage cholesterol exporter. ApoA-I is thought to remove cholesterol from macrophages by a cascade of events. First it binds directly to ABCA1, activating signaling pathways, and then it binds to and solubilizes lipid domains generated by ABCA1. HDL isolated from human atherosclerotic lesions and blood of subjects with established coronary artery disease contains elevated levels of 3-chlorotyrosine and 3-nitrotyrosine, two characteristic products of myeloperoxidase (MPO), a heme protein secreted by macrophages. Here we show that chlorination (but not nitration) of apoA-I by the MPO pathway impairs its ability to interact directly with ABCA1, to activate the Janus kinase 2 signaling pathway, and to promote effl ux of cellular cholesterol. In contrast, oxidation of apoA-I has little effect on its ability to stabilize ABCA1 protein or to solubilize phospholipids. Our results indicate that chlorination of apoA-I by the MPO pathway selectively inhibits two critical early events in cholesterol effl ux: (1) the binding of apoA-I to ABCA1 and (2) the activation of a key signaling pathway. Therefore, oxidation of apoA-I in the artery wall by MPO-generated chlorinating intermediates may contribute to atherogenesis by impairing cholesterol ef...