Apolipoprotein A-V (apoA-V) has a close interrelationship with plasma triglyceride (TG). Since the discovery of the apoA-V gene in 2001, we have learned that single nucleotide polymorphisms in this gene correlate with altered plasma TG levels in humans, while genetically engineered mice manifest unique TG phenotypes. Studies of recombinant apoA-V protein have revealed that it is composed of two independently folded structural domains. The C-terminal domain possesses high lipid binding affinity, while the N-terminal domain adopts a helix bundle molecular architecture. A sequence element with high positive charge character, between residues 185 and 228, functions in binding of apoA-V to heparan sulfate proteoglycans as well as to members of the low-density lipoprotein receptor family and glycosylphosphatidylinositol high-density lipoprotein binding protein1. These interactions may be related to the capacity of this protein to regulate TG levels. ApoA-V is poorly secreted from transfected cultured hepatoma cell lines and is present in plasma at exceedingly low levels. Studies of apoA-V intracellular trafficking revealed an association with cytosolic lipid droplets. Thus, it is conceivable that apoA-V may also modulate TG metabolism within the cell. Much remains to be learned about this fascinating yet confounding member of the class of exchangeable apolipoproteins.-Forte, T. M., X. Shu, and R. O. Ryan. The ins (cell) and outs (plasma) of apolipoprotein A-V. J. Lipid Res. 2009. 50: S150-S155.Supplementary key words apolipoprotein A-V molecular structureExchangeable apolipoproteins that possess a unique structural feature, the amphipathic a-helix, play an essential role in plasma lipoprotein metabolism. Aberrations in the concentration and/or structure of apolipoproteins are frequently associated with dyslipidemias and increased risk for premature coronary artery disease. A new member of the exchangeable apolipoprotein family was discovered by Pennacchio et al. in 2001 (1). These authors carried out a comparative genomics study in the region of the apolipoprotein (apo) gene cluster (APOAI/CIII/AIV ) on human chromosome 11q23. Comparison with the corresponding mouse sequence revealed a conserved region ?30 kb proximal to the gene cluster. This new gene, termed APOAV, encodes a 366 amino acid protein in humans.To evaluate the physiological function of apoA-V, Pennacchio et al.(1) created mice that were deficient in murine apoA-V or that overexpressed human apoA-V. Mice expressing the APOAV transgene showed a 70% decrease in plasma triglyceride (TG) compared with control littermates, while apoA-V deficient mice had a 4-fold elevation in TG concentration. These early observations suggested that apoA-V has a role in regulating TG metabolism.While the discovery of Pennacchio et al. was unfolding, van der Vliet et al. (2), using cDNA subtractive hybridization, discovered a gene that is upregulated in regenerating rat liver. The encoded protein, comprising 367 amino acids, was expressed only in liver and was identif...