ABCA1 is a key element of cellular cholesterol homeostasis. ApoE K/O mice fed with high-fat diet were infused with anti-ABCA1 antibody or control IgM. Infusion of anti-ABCA1 antibody led to 72% increase in the area of atherosclerotic plaque in aorta. After 16 weeks on high-fat diet plasma level of high density lipoprotein cholesterol (HDL-C) was reduced in control group, but was unchanged in mice infused with anti-ABCA1 antibody. Total plasma cholesterol level was elevated while the capacity of plasma to support cholesterol efflux ex vivo was reduced after 16 weeks on high-fat diet; the effects were similar in the two groups. We conclude that functional blocking of ABCA1-dependent cholesterol efflux stimulates development of atherosclerosis in apoE K/O mice independently from HDL-C levels. (C) 2011 Elsevier Inc. All rights reserved.