Lipid transfer inhibitor protein (LTIP) is a physiologic regulator of cholesteryl ester transfer protein (CETP) function. We previously reported that LTIP activity is localized to LDL, consistent with its greater inhibitory activity on this lipoprotein. With a recently described immunoassay for LTIP, we investigated whether LTIP mass is similarly distributed. Plasma fractionated by gel filtration chromatography revealed two LTIP protein peaks, one coeluting with LDL, and another of ?470 kDa. The 470 kDa LTIP complex had a density of 1.134 g/ml, indicating ?50% lipid content, and contained apolipoprotein A-I. By mass spectrometry, partially purified 470 kDa LTIP also contains apolipoproteins C-II, D, E, J, and paraoxonase 1. Unlike LDL-associated LTIP, the 470 kDa LTIP complex does not inhibit CETP activity. In normolipidemic subjects, ?25% of LTIP is in the LDLassociated, active form. In hypercholesterolemia, this increases to 50%, suggesting that lipoprotein composition may influence the status of LTIP activity. Incubation (37°C) of normolipidemic plasma increased active, LDL-associated LTIP up to 3-fold at the expense of the inactive pool. Paraoxon inhibited this shift by 50%. Overall, these studies show that LTIP activity is controlled by its reversible incorporation into an inactive complex. This may provide for short-term fine-tuning of lipoprotein remodeling mediated by CETP.-He, Y., D. J. Greene, M. Kinter, and R. E. Morton. In plasma, cholesteryl ester transfer protein (CETP) mediates the net transfer of cholesteryl ester (CE) from LDL and HDL to VLDL in return for triglyceride (TG) (1, 2). This remodeling of lipoprotein composition alters the metabolism of lipoproteins and ultimately influences both the quality and quantity of lipoproteins in plasma (3-5). Physiologically, CETP may be regulated by at least two proteins. Apolipoprotein C-I, which resides primarily on HDL, has been reported to inhibit CETP in vitro, and studies with transgenic animals have demonstrated its ability to suppress CETP activity in vivo (6, 7). Its mode of action is via modification of the surface charge of HDL, resulting in weakened CETP-HDL interactions and thus suppression of lipid transfer events with HDL (8). A second regulatory protein is lipid transfer inhibitor protein (LTIP), also known as apolipoprotein F (9). Although the mechanism of inhibition of CETP by LTIP has not been firmly established, it also appears to function by disrupting the interaction of CETP with its substrate (10). However, the effects of LTIP on lipid transfer events are quite distinct from that of apolipoprotein C-I. Unlike apolipoprotein C-I, LTIP activity is associated with LDL (11). The addition of exogenous LTIP to native plasma reduces the participation of LDL in lipid transfer events but leads to a dose-dependent increase in the efflux of CE from HDL to VLDL. This enhanced CETP activity on HDL results in HDL particles that are markedly better substrates for lecithin:cholesterol acyltransferase (11). We have proposed that this increa...