Human plasma contains two forms of phospholipid transfer protein (PLTP), one catalytically active [highactivity PLTP (HA-PLTP)] and the other a low-activity (LA-PLTP) form. We present here a PLTP ELISA that allows not only for accurate measurement of PLTP concentration in plasma but also of the distribution of both LA-and HA-PLTP. To achieve similar immunoreactivity of the two PLTP forms, a denaturing sample pretreatment with 0.5% SDS was required. Distribution of LA-and HA-PLTP in plasma was assessed using size-exclusion chromatography, Heparin-Sepharose chromatography, anti-PLTP immunoaffinity chromatography, and dextran sulfate-CaCl 2 precipitation. All four methods demonstrated that ف 60% of plasma PLTP represents LA-PLTP and 40% represents HA-PLTP. According to the modified ELISA, the total serum PLTP concentration in a random Finnish population sample (n ؍ 80) was 5.81 ؎ 1.33 mg/l (mean ؎ SD) (range, 2.78-10.06 mg/l) and the mean activity was 5.84 ؎ 1.39 mol/ml/h (range, 3.21-11.15 mol/ml/h).To quantitate both forms of PLTP in sera from this sample, we combined dextran sulfate-CaCl 2 precipitation with the modified PLTP ELISA. Other in vitro functions demonstrated are proteolysis of apolipoprotein A-I (apoA-I) (3), HDL interconversion (4, 5), and the stimulation of LCAT and cholesteryl ester transfer protein activity (6).Studies in genetically manipulated mice with altered PLTP expression have advanced our understanding of the metabolic functions of PLTP (7-16). PLTP has three major functions in HDL metabolism: it transfers surface remnants from VLDL to HDL during lipolysis (7), it increases the catabolism of HDL and the generation of pre- -HDL, and it stimulates cellular cholesterol/PL efflux (9-12). PLTP has also been shown to play a role in the secretion of apoB-containing lipoproteins (15,17,18).Although the in vitro role of PLTP in gene-targeted animal models has been studied intensively, the physiological role of PLTP in human lipid metabolism is far from resolved. To obtain information about the role of PLTP in human metabolism, one approach has been to assess PLTP activity under different physiological conditions (19)(20)(21)(22). Moreover, to gain a more complete understanding of the metabolic role of PLTP, its mass in plasma should also be recorded (23-26). To date, three different methods to assay plasma PLTP mass have been reported, with conflicting results (23-25). A possible reason for the discrepancies may be differences in the immunoreactivity of the antibodies used, as reported by Murdoch et al. (27), and the presence of two forms of PLTP in the circulation (28, 29). The two forms, one catalytically active [high-activity PLTP (HA-PLTP)] and the other low-activity (LA-PLTP), are associated with distinct macromolecular complexes of different size and eventually display different immunochemical reactivities. The observation that PLTP mass and activity in human plasma do not correlate (24, 25) further suggests differences in the reactivity of antibodies to HAAbbreviations: HA-PLT...