The i3-very low density lipoproteins (,B-VLDL) that accumulate in type III hyperlipoproteinemic subjects can be divided into two fractions (fraction I and fraction II), which differ in size, lipid composition, and the type of apolipoprotein B (apo-B) present in the particles. The apo-B48-containing particles (fraction I) are of intestinal origin, while apo-B100-containing particles (fraction II) are derived from the liver. Both The f3-VLDL include two distinct subclasses of lipoproteins (4, 5), which can be isolated by agarose chromatography; they are referred to as fraction I and fraction II. Fraction I consists of large particles (700-800 A in diameter) containing apolipoprotein E (apo-E) and a low molecular weight form of apo-B referred to as B48. The fraction I 8-VLDL appear to be of intestinal origin, and it is reasonable to assume that their accumulation reflects the impaired catabolism of chylomicron remnants (4). The second fraction (fraction II) consists of smaller, cholesterol-rich particles (""400 A in diameter), which contain apo-E and a high molecular weight form of apo-B referred to as B100. Since apo-B100 appears to be made exclusively by the liver (6); these particles probably represent remnants of cholesterol-rich VLDL of hepatic origin (4).A primary defect at least partly responsible for the development of type III hyperlipoproteinemia is the presence of an abnormal form of apo-E (most commonly apo-E2) in the )3-VLDL and other lipoproteins of affected subjects (for review see refs. 2 and 7). Apolipoprotein E occurs in the plasma in three major forms (2, 7-9); apo-E3 is the most prevalent form of the apolipoprotein, whereas the other two major forms, referred to as apo-E2 and apo-E4, represent genetic variants that differ from apo-E3 by single amino acid substitutions (10-12). An important role for apo-E in lipoprotein metabolism is to mediate the interaction of lipoproteins with specific cell surface receptors (13, 14), including both the low density lipoprotein (LDL) apo-B,E receptors of extrahepatic and hepatic tissues and the unique apo-E receptor of the liver (13,15,16). Apolipoproteins E3 and E4 possess normal receptor binding activity. However, the apo-E2 variants all display defective receptor binding (12,17). Recent studies have localized the receptor binding domain of apo-E to the vicinity of amino acid residues 140-160 (18, 19).The defective binding of apo-E2-containing lipoproteins to hepatic and extrahepatic receptors represents at least one mechanism responsible for the accumulation of the j3-VLDL in the plasma of affected subjects (for review see refs. 1 and 2). Population studies have indicated that about 1% of the population is homozygous for the E2 allele (16); however, many of these individuals do not manifest gross hyperlipoproteinemia-although they all display dysbetalipoproteinemia with the presence of ,-VLDL in their plasma (20,21). Therefore, it is necessary to postulate that other factors modulate the effects of the apo-E2 defect on lipoprotein metabolism. Chai...