ACAT1 and hyperinsulinemic hypoglycemia, familial, 4: Similar to effects on T-cell proliferation, deletion of genes or treatments that favor cholesterol accumulation (Lxrβ deficiency [30••], Acat1 deficiency [31••], MβCD-cholesterol [31••], and LDL-c [36]) induce differentiation into these cytotoxic CD8+ T-cells, while a decrease in cholesterol synthesis by Scap deficiency [33•] or treatment with lovastatin [31••] or cholesterol depletion by MβCD [31••] does the opposite.