2 -Microglobulin, a small protein localized in serum and on cell surfaces, can adopt specific aggregating conformations that generate amyloid in tissues and joints as a complication to long-term hemodialysis. We characterize a proteolytic variant of  2 -microglobulin (cleaved after Lys 58 ) that as a trimmed form (Lys 58 is removed) can be demonstrated in the circulation in patients with chronic disease. An unexpected electrophoretic heterogeneity of these two cleaved variants was demonstrated by capillary electrophoresis under physiological conditions. Each separated into a fast and a slow component while appearing homogeneous, except for a fraction of oxidized species detected by other techniques. The two components had different binding affinities for heparin and for the amyloid-specific dye Congo red, and the equilibrium between the two forms was dependent on solvent conditions. Together with analysis of the differences in circular dichroism, the results suggest that  2 -microglobulin cleaved after Lys 58 readily adopts two equilibrium conformations under native conditions. In the cleaved and trimmed  2 -microglobulin that appears in vivo, the less populated conformation is characterized by an increased affinity for Congo red. These observations may help elucidate why  2 -microglobulin polymerizes as amyloid in chronic hemodialysis and facilitate the search for means to inhibit this process.1 is a small protein (M r 11,729) localized in the circulation and on cell surfaces, where it constitutes the nonpolymorphic light chain of the class I major histocompatibility complex (1).  2 m can be cleaved C-terminally to Lys 58 (Lys 58 - 2 m) by activated complement component C1s. In serum, the exposed Lys 58 residue of this cleaved molecule is subsequently removed by a carboxypeptidase B-like activity. This generates a cleaved and trimmed  2 m variant called desLys 58 - 2 m ( 2 -microglobulin cleaved C-terminally to Ser 57 and lacking Lys 58 ) (2). Wild-type  2 m is a one-chain protein belonging to the immunoglobulin superfamily characterized by two antiparallel -sheets connected by an internal disulfide bridge in a -sandwich topology without helical structures (3, 4). The Lys 58 - 2 m and des-Lys 58 - 2 m variants are disulfide-linked two-chain heterodimers (Fig. 1). des-Lys 58 - 2 m has been demonstrated in sera from patients in hemodialysis treatment (5) and in patients with malignancies and autoimmune and immunodeficiency diseases (2, 6, 7), but, to our knowledge, analyses of the conformational structure of the cleaved variants have not previously been published. In chronic renal failure, plasma concentrations of  2 m may increase 10 -70 times despite dialysis, and within 2 years after the onset of dialysis, about 20% of patients suffer from complications due to the formation of insoluble deposits of  2 m ( 2 m amyloid) in tissues and joints (8). The events leading to the formation of amyloid in this and other chronic diseases such as Alzheimer's disease are still largely unknown (9). There a...