P-glycoprotein (P-gp) is a membrane-bound efflux pump that actively exports a wide range of compounds from the cell and is associated with the phenomenon of multidrug resistance. However, the role of P-gp in normal physiological processes remains elusive. Using P-gp-deficient fibroblasts, we showed that P-gp was critical for the replication of the intracellular parasite Toxoplasma gondii but was not involved in invasion of host cells by the parasite. Importantly, we found that the protein participated in the transport of host-derived cholesterol to the intracellular parasite. T. gondii replication in P-gp-deficient host cells not only resulted in reduced cholesterol content in the parasite but also altered its sphingolipid metabolism. In addition, we found that different levels of P-gp expression modified the cholesterol metabolism in uninfected fibroblasts. Collectively our findings reveal a key and previously undocumented role of P-gp in hostparasite interaction and suggest a physiological role for P-gp in cholesterol trafficking in mammalian cells.2 is one of the most intensively studied members of the ABC transporter superfamily. With remarkably broad substrate recognition, P-gp drives the ATP-dependent efflux of toxic metabolites and xenobiotics from the cell (1) and is thus a central mediator of drug bioavailability. Importantly, P-gp overexpression following drug treatment is responsible for the multidrug resistance (MDR) phenotype, a major reason for chemotherapy failure not only in cancer cells (2) but also in pathogenic microorganisms (3, 4). Aside from its well known role in drug efflux, P-gp is also expressed at basal levels in many different tissues, yet the normal physiological functions of the protein remain poorly understood.The possibility that physiological levels of host P-gp play a role in host-pathogen interaction, other than mediating drug resistance, has not been investigated so far. We addressed this question using Toxoplasma gondii as a model pathogenic parasite. T. gondii is the causative agent of toxoplasmosis, a potentially fatal disease not only for immunocompromised patients and fetuses but according to recent insights also emerging as a life threatening infection in immunocompetent individuals (5). T. gondii infects virtually all nucleated host cells and resides in a highly specialized vacuole, called the parasitophorous vacuole (PV), which is formed by invaginating the host cell membrane at the time of invasion. The PV is not competent for lysosome fusion, thus avoiding acidification (6), but it is closely associated with host organelles, including lysosomes, mitochondria, and endoplasmic reticulum (reviewed in Ref. 7). Even though the PV does not intersect directly with host vesicular traffic, T. gondii remains dependent on host cells for a number of critical nutrients. Significant progress has been made in our understanding of the mechanisms T. gondii uses to scavenge nutrients from its host, especially in the case of lipid molecules. An important recent example was the identifi...