Human lecithin:cholesterol acyltransferase (LCAT) 1 is a 416-amino acid glycoprotein circulating in plasma associated with lipids and apolipoproteins in the high density lipoprotein (HDL) fraction (1). LCAT plays a key role in cholesterol homeostasis by mediating the production of most of the cholesteryl esters in human plasma. It has been suggested (2, 3) that LCAT plays an important role in reverse cholesterol transport (RCT) by creating a concentration gradient for the efflux of free cholesterol from peripheral cells to HDL particles and its conversion to cholesteryl esters. The cholesteryl esters are internalized within the lipoprotein core for ultimate transport to the liver for clearance or recycling. Thus, factors affecting the structure, activity, or concentration of LCAT are likely to affect the homeostasis of plasma cholesterol and the RCT process, one of several proposed mechanisms (4) by which HDL may protect against atherosclerosis. Recent investigations (5) suggest that LCAT can act as an antioxidant and prevent the accumulation of oxidized lipid in plasma lipoproteins. In human plasma, LCAT is almost entirely associated with lipoproteins containing apoA-I, its principal physiological activator (6). Francone et al.(1) have shown the presence of LCAT, cholesteryl ester transfer protein, apoD, and a small amount of apoA-I in a complex termed pre- 3 -LpA-I that is involved in the esterification and transfer of cell-derived cholesterol.We have recently found (7) an association between apoE and ␣ 2-macroglobulin (␣ 2 M) in human plasma, when we observed that LCAT and apoE migrate to the same position in twodimensional electrophoretic gels together with ␣ 2 M, in particles 18.5 nm in diameter. This raises the possibility that LCAT circulates in plasma in association with ␣ 2 M. Human ␣ 2 M, the largest known proteinase inhibitor (M r ϭ 720,000), is found at high concentrations (2-5 M) in plasma and in extravascular spaces (8, 9). It plays a pivotal role in the clearance of proteinases from the circulation and in regulating their activity in fibrinolysis, coagulation, and complement activation (10, 11). ␣ 2 M is also a carrier of specific cytokines and various nonproteolytic proteins that include the transforming growth factor TGF-, the platelet-derived growth factor-BB (12), the -amyloid peptide (13), and recently, apolipoprotein E (7).The binding affinities of ␣ 2 M for different non-proteolytic