Nucleotide insertions in the ferritin light chain (FTL) polypeptide gene cause hereditary ferritinopathy, a neurodegenerative disease characterized by abnormal accumulation of ferritin and iron in the central nervous system. Here we describe for the first time the protein structure and iron storage function of the FTL mutant p.Phe167SerfsX26 (MT-FTL), which has a C terminus altered in sequence and extended in length. MT-FTL polypeptides assembled spontaneously into soluble, spherical 24-mers that were ultrastructurally indistinguishable from those of the wild type. Far-UV CD showed a decrease in ␣-helical content, and 8-anilino-1-naphthalenesulfonate fluorescence revealed the appearance of hydrophobic binding sites. Near-UV CD and proteolysis studies suggested little or no structural alteration outside of the C-terminal region. In contrast to wild type, MT-FTL homopolymers precipitated at much lower iron loading, had a diminished capacity to incorporate iron, and were less thermostable. However, precipitation was significantly reversed by addition of iron chelators both in vitro and in vivo. Our results reveal substantial protein conformational changes localized at the 4-fold pore of MT-FTL homopolymers and imply that the C terminus of the MT-FTL polypeptide plays an important role in ferritin solubility, stability, and iron management. We propose that the protrusion of some portion of the C terminus above the spherical shell allows it to cross-link with other mutant polypeptides through iron bridging, leading to enhanced mutant precipitation by iron. Our data suggest that hereditary ferritinopathy pathogenesis is likely to result from a combination of reduction in iron storage function and enhanced toxicity associated with iron-induced ferritin aggregates.Iron is an essential element needed for vital processes such as neuronal development, myelination, synthesis, and catabolism of neurotransmitters and electron transport, as well as heme and iron-sulfur cluster synthesis (1). Iron that is not utilized immediately in the cell is stored in ferritin. However, when iron is improperly regulated, it is potentially toxic leading to cell death. Mammalian ferritin is a large, iron-storage heteropolymer composed of two conformationally equivalent subunit types, light (FTL) 2 and heavy (FTH1) polypeptides, which are expressed in most kinds of cells (2-5). A single ferritin protein is composed of 24 self-assembled polypeptide subunits related by 4-, 3-, and 2-fold symmetry axes with one polypeptide per asymmetric unit. Each polypeptide subunit consists of a bundle of four parallel ␣-helices (A-D), a long extended loop (connecting helices B and C), and a C terminus with a short ␣-helix (E), which is involved in important stabilizing interactions around the 4-fold symmetry axes (2, 6, 7). Although both types of polypeptide subunits share a high degree of conformational similarity, they have diverse functional roles. The FTH1 subunit has a potent ferroxidase activity that catalyzes the oxidation of ferrous iron, whereas the F...