Familial amyotrophic lateral sclerosis (fALS) caused by mutations in copper-zinc superoxide dismutase (SOD1) is characterized by the presence of SOD1-rich inclusions in spinal cords. Similar inclusions observed in fALS transgenic mice have a fibrillar appearance suggestive of amyloid structure. Metal-free apo-SOD1 is a relatively stable protein and has been shown to form amyloid fibers in vitro only when it has been subjected to severely destabilizing conditions, such as low pH or reduction of its disulfide bonds. Here, by contrast, we show that a small amount of disulfide-reduced apo-SOD1 can rapidly initiate fibrillation of this exceptionally stable and highly structured protein under mild, physiologically accessible conditions, thus providing an unusual demonstration of a specific, physiologically relevant form of a protein acting as an initiating agent for the fibrillation of another form of the same protein. We also show that, once initiated, elongation can proceed via recruitment of either apo-or partially metallated disulfideintact SOD1 and that the presence of copper, but not zinc, ions inhibits fibrillation. Our findings provide a rare glimpse into the specific changes in a protein that can lead to nucleation and into the ability of amyloid nuclei to recruit diverse forms of the same protein into fibrils.amyloid ͉ amyotrophic lateral sclerosis ͉ neurodegeneration ͉ protein aggregation T he antioxidant metalloprotein copper-zinc superoxide dismutase (SOD1) is a 153-residue, -rich, homodimeric protein that is abundantly present in the cytoplasm. Each subunit of the mature form contains a copper ion, a zinc ion, and a disulfide bond (1). In vitro studies have shown that the presence of the metal cofactors, copper and zinc, protect the disulfide bond from reduction, suggesting a possible explanation for the persistence of the disulfide bond in the reducing environment of the cytoplasm (2). More than 100 mutations in SOD1 have been linked to the familial form of amyotrophic lateral sclerosis (fALS), a fatal neurodegenerative disease caused by selective death of motor neurons. Neuronal death is attributed to a toxic gain of function by mutant SOD1, but the exact mechanism of toxicity is unknown. Mutations in SOD1 that have been identified in fALS patients occur in 74 positions that are well dispersed over the length of this 153-residue polypeptide (3).Proteinaceous aggregates have been found in the spinal cords of ALS patients, and immunomicroscopy has confirmed that the protein inclusions present in the spinal cords of SOD1-fALS patients are rich in SOD1 (4, 5). Transgenic mice expressing human SOD1 mutants that cause fALS share many symptoms with their human counterparts, including progressive motor neuron degeneration and the presence of detergent-resistant, SOD1-rich aggregates in their spinal cords (6, 7). These aggregates have recently been shown to consist primarily of full-length, unmodified SOD1 (6). The visible proteinaceous inclusions have a fibrillar appearance and bind thioflavin S, suggesting a...