Members of the pappalysin family of metzincin metalloproteinases, pregnancy-associated plasma protein-A (PAPP-A, pappalysin-1) and PAPP-A2 (pappalysin-2), regulate the bioavailability of insulin-like growth factors (IGFs) by specific proteolytic inactivation of IGF-binding proteins (IGFBPs). PAPP-A cleaves IGFBP-4 and IGFBP-5, whereas PAPP-A2 cleaves only IGFBP-5. The pappalysins contain three Lin12-Notch repeat (LNR1-3) modules, previously considered unique to the Notch receptor family in which they function to regulate receptor cleavage. In contrast to the Notch receptor where three LNR modules are tandemly arranged, LNR3 is separated by more than 1000 residues from LNR1-2 in the pappalysin sequence. Each of the three LNR modules of PAPP-A is required for proteolysis of IGFBP-4, but not IGFBP-5. However, we here find that a C-terminal truncated variant of PAPP-A, which lacks LNR3 and therefore activity against IGFBP-4, cleaves IGFBP-4 when co-expressed with a PAPP-A variant, which is mutated in the active site. This suggests that LNR3 from the inactive subunit interacts in trans with LNR1-2 of the truncated PAPP-A subunit to form a functional trimeric LNR unit. We also show that formation of such a functional LNR unit depends on dimerization, as dissociation of a mutated non-covalent PAPP-A dimer results in reduced activity against IGFBP-4, but not IGFBP-5. Using PAPP-A/PAPP-A2 chimeras, we demonstrate that PAPP-A2 LNR1-2, but not LNR3, are functionally conserved with respect to IGFBP proteolysis. Additionally, we find that a sequence stretch C-terminal to LNR3 and single residues (Asp 1521 , Arg 1529 , and Asp 1530 ) within this are required for LNR functionality.The metalloproteinase pregnancy-associated plasma protein-A (PAPP-A, pappalysin-1, EC 3.4.24.79) 2 is secreted as a disulfide-linked 400-kDa homodimer (1) that cleaves insulinlike growth factor binding proteins (IGFBP)-4 (2) and IGFBP-5 (3). Through this proteolytic activity, PAPP-A causes the release of active IGF and thereby regulates its bioavailability in several biological systems. In particular, the role of PAPP-A has been studied in ovarian follicular development (4), implantation (5), fetal development (6 -8), wound healing (9), and atherosclerosis (10, 11). PAPP-A is the founding member of the pappalysin family (12, 13) within the metzincin superfamily of metalloproteinases (14, 15), also including its only known homologue, PAPP-A2, which cleaves IGFBP-5, but not IGFBP-4 (16). The 1558 3 -residue PAPP-A2 shares 46% of its residues with the 1547-residue PAPP-A (17), and they display the same domain organization with a laminin G-like domain and a proteolytic domain in the N-terminal part (18), a central region of ϳ500 residues with unknown domain composition, and a C-terminal part with five complement control protein (CCP) modules that mediate cell surface adhesion of 20). The pappalysins also contain three Lin12-Notch repeat (LNR) modules, previously considered unique to the Notch receptor family. But in contrast to the Notch receptors, which...