Disruption of the murine mdr2 gene leads to the complete absence of bi
liary phospholipids. We tested the hypothesis that the increase in bil
iary phospholipid output induced by fibrates is mediated via induction
of the hepatic mdr2 gene and its encoded product, the P-glycoprotein
canalicular flippase. Increased levels of mdr2 mRNA were observed in t
he liver of mice treated with different fibrates: ciprofibrate, 660+/-
155% (as compared with control group); clofibrate, 611+/-77 %; bezafib
rate, 410+/-47 %; fenofibrate, 310+/-52 %; gemfibrozil, 190+/-25 % (P
< 0.05 compared with control group). Induction of expression of the md
r gene family was specific to the mdr2 gene. Two- to three-fold increa
ses in P-glycoprotein immunodetection were evident on the canalicular
plasma-membrane domain of clofibrate- and ciprofibrate-treated mice. B
iliary phospholipid output increased from 4.2+/-1.2 nmol/min per g of
liver in the control group to 8.5+/-0.6, 7.1+/-2.9 and 5.8+/-2.5 in ci
profibrate-, clofibrate- and bezafibrate-treated mice respectively (P
< 0.05 compared with control group). Moreover, a significant correlati
on between biliary phospholipid output and the relative levels of mdr2
mRNA was found (r = 0.86; P < 0.05). In treated animals, bile flow as
well as cholesterol and bile acid outputs remained unchanged. Our fin
dings constitute the first evidence that pharmacological modulation of
biliary lipid secretion mediated by fibrates can be related to the ov
erexpression of a specific liver gene product, the mdr2 P-glycoprotein
, and are consistent with the hypothesis that the mdr2 P-glycoprotein
isoform plays a crucial role in the secretion of biliary phospholipid.