In mammalian cells, synthesis of CE from free cholesterol is mainly catalyzed by acyl coenzyme A: cholesterol acyltransferase (ACAT) enzymes, ACAT-1 and ACAT-2 (Figure 2a), of which the latter one is primarily expressed in intestinal mucosal cells in human.21, 22 To test which isoform contributes to the CE accumulation in pancreatic cancers, we first examined the expression level of ACAT-1 and ACAT-2 in matched normal and cancer human pancreatic tissues. This evidence concerns the gene ACAT1 and familial pancreatic carcinoma.