Lipid metabolism: Edited by Jeffrey S. CohnTransintestinal cholesterol effluxvan der Velde, Astrid Ea; Brufau, Gemmab; Groen, Albert Kb,cAuthor Information aAcademic Medical Center, AMC Liver Center, Amsterdam, The Netherlands bDepartment of Pediatrics, The Netherlands cDepartment of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands Correspondence to Professor Dr Albert K. Groen, Departments of Pediatrics/Laboratory Medicine, Room Y2-145, University Medical Center Groningen, Hanzeplein 1 9713GZ Groningen, The Netherlands E-mail: [email protected]. Current Opinion in Lipidology: June 2010 - Volume 21 - Issue 3 - p 167-171 doi: 10.1097/MOL.0b013e3283395e45 Buy Metrics Abstract Purpose of review Regulation of cholesterol homeostasis is a complex interplay of a multitude of metabolic pathways situated in different organs. The liver plays a central role and has received most attention of the research community. In this review, we discuss recent progress in the understanding of the emerging role of the intestine in cholesterol transport. Recent findings In recent years, insight in the transport systems that mediate intestinal cholesterol excretion has deepened considerably. Evidence is emerging that the proximal part of the small intestine is able to secrete cholesterol actively, a pathway called transintestinal cholesterol efflux (TICE). In mice, TICE accounts for up to 70% of fecal neutral sterol excretion. Summary The small intestine plays a significant role in the regulation of body cholesterol homeostasis. Active processes control both absorption and excretion of the sterol and the pathways involved are being elucidated. TICE might provide an attractive target for therapy aiming at reduction of atherosclerosis. © 2010 Lippincott Williams & Wilkins, Inc.