The islet amyloid polypeptide (IAPP) is a hormone, secreted by pancreatic b-cells along with glucagon and insulin. A balanced ratio of insulin and IAPP keeps the glucose metabolism of humans under control.[1] Disturbance of this balance results in type II diabetes mellitus. Most patients diagnosed with type II diabetes have a deposition of extracellular amyloid in the pancreas, and biochemical analysis has revealed that the main component of the amyloid deposit is IAPP. IAPP comprises 37 amino acids and is C-terminally amidated. In addition, cysteines 2 and 7 form a disulfide bond. [2,3] Under physiological conditions, IAPP remains soluble and a random coil structure has been reported by circular dichroism (CD) spectroscopy. [4] However, in the pathological condition of type II diabetes, IAPP adopts a fibrillar structure rich in b-sheets. [5] It is still unclear what triggers the conversion of soluble monomeric IAPP into insoluble amyloid fibrils. Mostly biophysical and mutagenesis approaches have been used to understand IAPP fibril formation in vitro. [6,7] A wealth of information about the role of the amino acid sequence in IAPP fibril formation has been obtained from rat IAPP (rIAPP), which differs in only six amino acid residues but does not form amyloid fibrils.[8] The non-aggregating nature of rIAPP was attributed to three proline residues in region 20-29 in the peptide. One other important difference in IAPP residues in the two species is the presence of arginine at position 18 in rat and histidine in humans. Although the preventive properties of the proline residues in IAPP fibrillation have been well studied, [8] biophysical studies that pinpoint the roles of specific residues in the initiation of IAPP amyloid formation are missing. Various real-time spectroscopic methods have been used to monitor amyloid fibril formation in bulk solution, [9,10] as well as in the presence of membranes, [11,12] but residue-specific information on the native peptide, which can best be obtained by NMR spectroscopy, is so far lacking. In a recent NMR spectroscopic study it was shown that rIAPP forms transient stretches of helical structure in its monomeric form.[13] In another study on human IAPP free acid, it has been indicated that the N terminus has a propensity for a-helical structure formation, but owing to the fast aggregation rate these studies were carried out only on the charged IAPP free acid. [14] In an attempt to study the early stages of glucagon amyloid fibril formation, one-dimensional, correlation and diffusion experiments were carried out by NMR spectroscopy. [15] Other approaches such as the application of high pressure to dissociate the fibril or to stabilize oligomeric structures during amyloid formation have also been shown to provide insight into the fibrillation reaction. [16,17] In this study we elucidated the monomeric structure of fulllength human IAPP (hIAPP, Figure 1) and the role of specific amino acid residues in the initiation of IAPP fibril formation by NMR spectroscopy. IAPP is known to be o...