showed that a combination of seed fibrils prepared under acidic conditions and a low concentration of sodium dodecyl sulfate below its critical micelle concentration enabled extensive fibril formation at pH 7.0. Here, we found that repeated self-seeding at pH 7.0 with fibrils formed at the same pH causes a marked acceleration of growth, indicating the maturation of fibrils. The observed maturation can be simulated by assuming the existence of two types of fibrils with different growth rates. Importantly, some mutations of 2-m or the addition of a low concentration of urea, both destabilizing the native conformation, were not enough to extend the fibrils at pH 7.0, and a low concentration of sodium dodecyl sulfate (i.e. 0.5 mM) was essential. Thus, even though the first stage fibrils in patients are unstable and require stabilizing factors to remain at neutral pH, they can adapt to a neutral pH with repeated selfseeding, implying a mechanism of development of amyloid deposition after a long latent period in patients.Amyloidosis results from the deposition of normally soluble proteins into insoluble amyloid fibrils that are long, unbranched, and often twisted fibrillar structures a few nanometers in diameter and predominantly composed of cross--sheets (1-3). Currently, Ͼ20 proteins are known to be associated with human amyloid diseases (1-3). Moreover, various proteins and peptides that are not related to diseases can also form amyloid-like fibrils, implying that the formation of amyloid fibrils is a general property of polypeptides (2, 3). Most of the amyloidogenic proteins studied to date have been shown to unfold or refold (if they are initially unfolded), such that one or more partially unfolded intermediate(s) are produced prior to the formation of amyloid fibrils (2, 3). These structural alterations are often brought about by changes in the solution, such as a switch to low pH (4 -6), high temperature (7, 8), or by the addition of organic solvents (9, 10). However, the mechanism by which native proteins form amyloid fibrils under physiological conditions is still unclear.Among the various amyloidogenic proteins,  2 -microglobulin (2-m), 1 which is responsible for dialysis-related amyloidosis, is a target of extensive study because of its clinical importance and suitable size for examining the relationship between protein folding and amyloid fibril formation (10 -18). Dialysisrelated amyloidosis is a common and serious complication in patients receiving hemodialysis for Ͼ10 years (11, 12). 2-m, a typical immunoglobulin domain made of 99 residues and seven -strands, is present as the non-polymorphic light chain of the class I major histocompatibility complex (MHC-I) (19). As part of its normal catabolic cycle, 2-m dissociates from the MHC-I complex and is transported in serum to the kidneys, where the majority (95%) of it is degraded (12). Renal failure disrupts the clearance of 2-m from the serum and, moreover, the 2-m does not pass through the dialysis membrane, resulting in an increase in the 2-m ...