Bacterial invasion triggers sensitive, specific molecular alarms that result in the mobilization of host defenses designed to recognize and eliminate invading bacteria and their remnants. The major inducer of host responses to Gram-negative bacteria (GNB) 1 is endotoxin, i.e. lipopolysaccharide, LPS, the unique glycolipid that comprises the bulk of the outer leaflet of the GNB outer membrane (1). These amphipathic molecules are composed of a unique, conserved hydrophobic moiety, the lipid A region, that is a disaccharide of N-acetylglucosamine substituted with saturated fatty acids and attached to a highly charged acidic carbohydrate region of varying size and composition (1, 2). The chemical structure of endotoxin promotes the formation of highly ordered, but potentially malleable aggregated state(s). Interaction with host endotoxin-binding proteins alters the physical presentation of endotoxin and its ability to activate cell responses (2-5). The cumulative work of many laboratories has implicated lipopolysaccharide-binding protein (LBP), CD14, Toll-like receptor 4, and MD-2 as key factors in cell activation by LPS (3, 6 -13). LBP facilitates delivery of LPS to both membrane-bound, GPI-linked (mCD14) and soluble CD14 (sCD14) (14 -19). Through interaction with CD14, LPS activates cells via a transmembrane receptor capable of promoting signal transduction. This recognition/response cascade includes the Toll-like receptor family of proteins, most notably Toll-like receptor 4, that serve as the primary mediator of endotoxin signaling (20, 21).The host also utilizes defense mechanisms that blunt endotoxin-triggered inflammatory responses by eliminating viable GNB and by neutralizing endotoxin. One potent host protein that blocks LPS activity is bactericidal/permeability increasing protein (BPI), a basic protein residing in azurophilic granules of polymorphonuclear (PMN) leukocytes and in the extracellular fluid of PMN-rich inflammatory exudates (22). BPI efficiently neutralizes LPS and is also potently cytotoxic and opsonic, especially toward GNB (22)(23)(24)(25). Although the functional properties of LBP and BPI differ markedly, they share 45% amino acid identity, are encoded within the same region of chromosome 20, and belong to a family of lipid-binding proteins that include phospholipid transfer protein and cholesteryl ester transfer protein (26 -30). The three-dimensional crystal structure for BPI reveals an unusual "hinged" two-domain boomerang-like molecular structure. The extensive sequence homology between LBP and BPI predicts a nearly superimposable threedimensional structure for LBP (30) suggesting that despite their different bioactivities, BPI and LBP have a similar organization of structure and function.In support of this view, studies on the interaction of LBP and BPI with LPS have demonstrated that the NH 2 -terminal domain of each protein is responsible for binding LPS (28,(31)(32)(33)(34). In BPI, both affinity for LPS and antibacterial activity are concentrated in this portion of the protein (31-...