Sphingomyelinase (SMase) treatment of control and NPC1 mutant fibroblasts stimulates cholesteryl ester (CE) synthesis. On day 0, hTERT-control and hTERT-NPC1 human fibroblasts were set up in medium A with 10% FCS at either 7 × 104 cells per 60-mm dish (A and B) or 4 × 105 cells per 100-mm dish (C). On day 2, cells were switched to medium A with 5% human lipoprotein-deficient serum (LPDS). (A) Immunoblot analysis of SREBP-2 cleavage. On day 4, the cells were incubated with medium A containing 5% LPDS, 50 μM compactin, 50 μM sodium mevalonate, 0.1% DMSO, and 10 μg/mL ACAT inhibitor Sandoz 58-035. After 30 min at 37 °C, cells received SMase (200 milliunits per milliliter), β-migrating very low density lipoprotein (β-VLDL) (10 μg of protein per milliliter), or 25-hydroxycholesterol (25-HC) (1 μg/mL) as indicated. After 2 h at 37 °C, triplicate dishes were harvested and pooled for preparation of nuclear extract and 100,000 × g membrane fractions, which were analyzed by immunoblotting for SREBP-2. P, precursor form of SREBP-2; N, cleaved nuclear form of SREBP-2. (B) Cholesterol esterification assay. On day 4, each dish received medium A with 5% LPDS, 50 μM compactin, and 50 μM sodium mevalonate in the absence or presence of 200 milliunits per milliliter of SMase. After 1 h at 37 °C, each monolayer was pulse-labeled for 1 h with 0.2 mM sodium [14C]oleate-albumin (32,433 dpm/nmol). Cells were harvested for measurement of cholesteryl [14C]oleate. Each value is the average of duplicate incubations. (C) Analysis of the cholesterol content of purified endoplasmic reticulum (ER) membranes. On day 3, cells from 13 dishes (100 mm) for each condition were switched to medium A containing 5% LPDS, 5 μM compactin, and 50 μM sodium mevalonate. On day 4, cells received the same medium supplemented with 50 μM rather than 5 μM compactin in the absence or presence of 200 milliunits per milliliter of SMase. After 2 h at 37 °C, the cells were harvested, and the ER membranes were purified as described in SI Materials and Methods and Fig. 5. Cholesterol and phospholipids were quantified as described in Fig. 5E. Cholesterol content is expressed as the molar percentage of total lipids (phospholipids + cholesterol). Each bar represents the mean ± SEM from three experiments.