The newly identified apolipoprotein AV (apoAV) gene is a key player in determining plasma triglyceride concentrations. Because hypertriglyceridemia is a major independent risk factor in coronary artery disease, the understanding of the regulation of the expression of this gene is of considerable importance. We presently characterize the structure, the transcription start site, and the promoter of the human apoAV gene. Since the peroxisome proliferator-activated receptor-␣ (PPAR␣) and the farnesoid X-activated receptor (FXR) have been shown to modulate the expression of genes involved in triglyceride metabolism, we evaluated the potential role of these nuclear receptors in the regulation of apoAV transcription. Bile acids and FXR induced the apoAV gene promoter activity. 5-Deletion, mutagenesis, and gel shift analysis identified a heretofore unknown element at positions ؊103/؊84 consisting of an inverted repeat of two consensus receptor-binding hexads separated by 8 nucleotides (IR8), which was required for the response to bile acid-activated FXR. The isolated IR8 element conferred FXR responsiveness on a heterologous promoter. On the other hand, in apoAV-expressing human hepatic Hep3B cells, transfection of PPAR␣ specifically enhanced apoAV promoter activity. By deletion, site-directed mutagenesis, and binding analysis, a PPAR␣ response element located 271 bp upstream of the transcription start site was identified. Finally, treatment with a specific PPAR␣ activator led to a significant induction of apoAV mRNA expression in hepatocytes. The identification of apoAV as a PPAR␣ target gene has major implications with respect to mechanisms whereby pharmacological PPAR␣ agonists may exert their beneficial hypotriglyceridemic actions.Recent epidemiological studies have shown that hypertriglyceridemia is a major independent risk factor for coronary heart disease, which remains as a major cause of mortality in the Western world (1-6). Understanding the factors that control plasma triglyceride levels and the genes that primarily reflect circulating concentrations of triglyceride-rich lipoproteins is thus of major importance and may provide new opportunities for therapeutic intervention in atherogenic dyslipidemia.Pharmacological activation of peroxisome proliferator-activated receptor-␣ (PPAR␣ 1 ; NR1C1) lowers plasma levels of triglyceride-rich lipoproteins markedly (7,8). PPAR␣ is a fatty acid-activated nuclear transcription factor that regulates the expression of genes involved in lipid and energy metabolism (9, 10). PPAR␣ heterodimerizes with the retinoid X receptor ␣ (RXR␣; NR2B1) and binds to specific DNA sequence elements, designated PPREs, which consist of a direct repeat of the hexanucleotide core motif PuGGTCA separated by 1 or 2 nucleotides (DR1 or DR2). PPAR␣ mediates the hypotriglyceridemic effect of fibrates by regulating the transcription of key genes associated with different intra-and extracellular metabolic pathways. Fibrates increase cellular fatty acid transport and uptake, conversion to acyl-CoA deriv...