Endoplasmic reticulum (ER) membrane cholesterol is maintained at an optimal concentration of ϳ5 mol % by the net impact of sterol synthesis, modification, and export. Arv1p was first identified in the yeast Saccharomyces cerevisiae as a key component of this homeostasis due to its probable role in intracellular sterol transport. Mammalian ARV1, which can fully complement the yeast lesion, encodes a ubiquitously expressed, resident ER protein. Repeated dosing of specific antisense oligonucleotides to ARV1 produced a marked reduction of ARV1 transcripts in liver, adipose, and to a lesser extent, intestine. This resulted in marked hypercholesterolemia, elevated serum bile acids, and activation of the hepatic farnesoid X receptor (FXR) regulatory pathway. Knockdown of ARV1 in murine liver and HepG2 cells was associated with accumulation of cholesterol in the ER at the expense of the plasma membrane and suppression of sterol regulatory element-binding proteins and their targets. These studies indicate a critical role of mammalian Arv1p in sterol movement from the ER and in the ensuing regulation of hepatic cholesterol and bile acid metabolism.The endoplasmic reticulum (ER) 4 is the pivotal organelle with regard to cholesterol homeostasis. It is here that cholesterol is synthesized via the mevalonate pathway, sensed by the sterol regulatory element-binding protein (SREBP) cleavageactivating protein system, and neutralized by esterification (1-3). In addition, in certain cells, ER cholesterol is secreted in lipoprotein particles or hydroxylated to form bile acids. Consequently, sterol levels in the ER of all eukaryotic cells are strikingly low relative to the plasma membrane (PM) (4). Movement of sterol between these organelles is rapid; the majority of endogenously synthesized cholesterol is transported from the ER to the PM within 10 -20 min by an energy-dependent process (5). Vesicular and nonvesicular cholesterol transport pathways have been described (6, 7); however, the molecular components of these events are surprisingly obscure. The net impact of these processes is striking; any variation around the threshold concentration of ϳ5 mol % results in activation or repression of key regulators of lipid homeostasis, including the master regulators, SREBP-1 and -2 (8).In the yeast Saccharomyces cerevisiae, ARV1 encodes a key component of sterol transport from the ER to the PM and was identified by complementation of yeast mutations that confer viability dependence upon sterol esterification (9). This concept of synthetic lethality was based on the hypothesis that loss of one homeostatic pathway (e.g. sterol esterification) might be tolerated; however, removal of multiple "detoxifying" events would be lethal. Yeast with mutations in ARV1 have striking phenotypes, including an elevated ratio of subcellular sterols relative to the PM and abnormal phospholipid, sphingolipid, and glycosylphosphatidylinositol metabolism (9 -11). The yeast ARV1 gene predicts a 322-residue protein with several transmembrane domains. An ARV1...