The mechanism by which granulocyte-macrophage colony-stimulating factor (GM-CSF) lowers plasma cholesterol levels is not well understood. We tested recombinant human GM-CSF (rhGM-CSF) on plasma cholesterol and triglycerides in rabbits and attempted to determine the mechanisms of the cholesterol-lowering effect. rhGM-CSF (20 /ig • kg" 1 • d" 1 ) was administered to normal and cholesterol-fed rabbits for 2 weeks and to Watanabe heritable hyperlipidemic (WHHL) rabbits for 1 week. The administration of rhGM-CSF markedly lowered cholesterol and triglycerides, an effect that persisted in normal and cholesterol-fed rabbits even after termination of treatment. The cholesterol-lowering effect of rhGM-CSF was also observed in WHHL rabbits. rhGM-CSF was capable of stimulating granulocyte-macrophage colony formation in vitro in rabbits with an effect comparable to that H uman granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulates the proliferation and maturation of myeloid and monocytic lineages in vitro and in vivo. 1 -2 This substance has been used clinically to treat patients with hematologic and oncologic disorders. 3 ' 4 Besides the effects of GM-CSF on hematopoietic cells, various other actions unrelated to hematopoiesis have been reported, 5 including decreases in plasma cholesterol levels in patients who were receiving human GM-CSF for hematologic disorders. 68 These observations suggest that this molecule might play an important role in lipid metabolism.Another molecule, macrophage colony-stimulating factor (M-CSF), reduces the levels of cholesterol in humans and rabbits in vivo. 911 The mechanisms by which M-CSF lowers plasma cholesterol levels have A preliminary report of this work was presented at the 66th Scientific Sessions of the American Heart Association, Atlanta, Ga, November 8-11, 1993 (Circulation. 1993 been extensively studied. 10 -1214 The levels of mRNA for low-density lipoprotein (LDL) receptor are increased in spleen and bone marrow cells of normal rabbits, but the levels in liver are not changed after M-CSF treatment. 10 M-CSF stimulates the secretion of lipoprotein lipase and apolipoprotein (apo) E from macrophages 12 and also promotes the uptake and degradation of acetylated LDL, cholesterol esterification, and cholesterol efflux in macrophages. 13 M-CSF also increases net hydrolysis of cholesteryl ester in monocyte-derived macrophages. 14 Both GM-CSF and M-CSF enhance the proliferation and maturation of monocyte/macrophage lineage and have a wide variety of biological effects on various types of cells. 2 -5 -15 To test the hypothesis that the modes of actions of the two molecules on plasma lipid content might be mediated by pathways other than activating macrophages, we administered recombinant human GM-CSF (rhGM-CSF) to normal, cholesterol-fed, and Watanabe heritable hyperlipidemic (WHHL) rabbits to analyze the effect of GM-CSF on the metabolism of lipoproteins. In this article we describe a dramatic decrease in plasma cholesterol and fat levels in rabbits treated with ...