Transthyretin (TTR) acts physiologically in the transport of retinol in the circulation. We previously reported the generation and partial characterization of TTR-deficient (TTR ؊ ) mice. TTR ؊ mice have very low circulating levels of retinol and its specific transport protein, retinol-binding protein (RBP). We have examined the biochemical basis for the low plasma retinol-RBP levels. Cultured primary hepatocytes isolated from wild type (WT) and TTR ؊ mice accumulated RBP in their media to an identical degree, suggesting that RBP was being secreted from the hepatocytes at the same rate. In vivo experiments support this conclusion. For the first 11 h after complete nephrectomy, the levels retinol and RBP rose in the circulations of WT and TTR ؊ mice at nearly identical rates. However, human retinol-RBP injected intravenously was more rapidly cleared from the circulation (t1 ⁄2 ؍ 0.5 h for TTR ؊ versus t1 ⁄2 >6 h for WT) and accumulated faster in the kidneys of TTR ؊ compared with WT mice. The rate of infiltration of the retinol-RBP complex from the circulation to tissue interstitial fluids was identical in both strains. Taken together, these data indicate that low circulating retinol-RBP levels in TTR ؊ mice arise from increased renal filtration of the retinol-RBP complex.The predominant retinoid in the fasting circulation is retinol (1, 2). All circulating retinol is bound to its specific plasma transport protein, the 21-kDa retinol-binding protein (RBP) 1 (1, 2). RBP, which is synthesized and secreted primarily by hepatocytes, is the sole specific transport protein for retinol in the circulation (1, 2). The secretion of RBP is strongly stimulated by its association with retinol, which alters the conformation of the protein (1, 2). In blood, RBP is found as a 1:1 protein-protein complex with a 55-kDa serum protein, transthyretin (TTR) (1, 2). Association with TTR is proposed both to facilitate RBP release from its site of synthesis in the endoplasmic reticulum (2) and to prevent renal filtration of RBP (1). Delivery of retinol to cells through the circulation by the RBP-TTR complex is the major pathway through which cells and tissues acquire retinol. It is generally accepted that cells and tissues acquire the retinoic acid they need for regulating gene expression via intracellular oxidation of this retinol to retinoic acid (3).We previously reported the targeted disruption of the mouse gene for TTR (4, 5). Although TTR-deficient (TTR Ϫ ) mice have no immunoreactive TTR, they appear normal and are viable and fertile (4). Yet, these mutant mice show marked biochemical differences when compared with wild type (WT) mice in parameters associated with retinoid transport and metabolism (4, 5). The plasma retinol and RBP levels in TTR Ϫ mice are very low, ϳ5% of those observed in WT mice (4, 5). These retinol levels correspond to those seen in severely vitamin A-deficient animals that are near death (4, 5). Nevertheless, despite these low circulating levels of retinol-RBP, total retinol (retinol ϩ retinyl ester) level...