Lipoproteins originating from axon and myelin breakdown in injured peripheral nerves are believed to supply cholesterol to regenerating axons. We have used compartmented cultures of rat sympathetic neurons to investigate the utilization of lipids from lipoproteins for axon elongation. Lipids and proteins from human low density lipoproteins (LDL) and high density lipoproteins (HDL) were taken up by distal axons and transported to cell bodies, whereas cell bodies/proximal axons internalized these components from only LDL, not HDL. Consistent with these observations, the impairment of axonal growth, induced by inhibition of cholesterol synthesis, was reversed when LDL or HDL were added to distal axons or when LDL, but not HDL, were added to cell bodies. LDL receptors (LDLRs) and LR7/8B (apoER2) were present in cell bodies/proximal axons and distal axons, with LDLRs being more abundant in the former. Inhibition of cholesterol biosynthesis increased LDLR expression in cell bodies/proximal axons but not distal axons. LR11 (SorLA) was restricted to cell bodies/proximal axons and was undetectable in distal axons. Neither the LDL receptor-related protein nor the HDL receptor, SR-B1, was detected in sympathetic neurons. These studies demonstrate for the first time that lipids are taken up from lipoproteins by sympathetic neurons for use in axonal regeneration.Axonal elongation requires the expansion of axonal membranes by addition of new membrane materials (proteins and lipids) to the growing axon. In sheep (1) and rats (2, 3) the brain and peripheral nerves synthesize all the cholesterol needed for development without requiring cholesterol from circulating lipoproteins. Moreover, after birth, cholesterol used for myelin production is made locally (4). In contrast, fetal liver supplies about 50% of the cholesterol needed for development of heart, lung, and kidney (3). Surprisingly, during peripheral nerve regeneration, cholesterol synthesis in the nerve is down-regulated (5), yet serum-derived cholesterol does not contribute significantly to myelin synthesis or axonal regeneration (6, 7).Instead, cholesterol from degenerating axons and myelin is proposed to be retained within the nerve and re-utilized via a lipoprotein-mediated process (8), although cholesterol uptake by neurons was not directly demonstrated. The presence of endoneural lipoproteins in regenerating, but not non-injured, nerves is well documented. These lipoproteins contain apolipoprotein (apo) 1 E and apoAI but not apoB (9 -11). After peripheral nerve injury, apoE synthesis by resident macrophages increases greatly, and apoE accumulates within the nerve (12-14) supporting the concept that apoE is involved in re-utilization of lipids from degenerating nerves for axonal regeneration and myelin production.The receptors involved in lipoprotein uptake by axons and Schwann cells have not been fully characterized, nor has the uptake and utilization of lipids from lipoproteins for axonal regeneration been directly demonstrated. The low density lipoprotein receptor...