Under certain conditions, the prion protein (PrP) undergoes a conformational change from the normal cellular isoform, PrP C , to PrP Sc , an infectious isoform capable of causing neurodegenerative diseases in many mammals. Conversion can be triggered by low pH, and in vivo this appears to take place in an endocytic pathway and͞or caveolae-like domains. It has thus far been impossible to characterize the conformational change at high resolution by experimental methods. Therefore, to investigate the effect of acidic pH on PrP conformation, we have performed 10-ns molecular dynamics simulations of PrP C in water at neutral and low pH. The core of the protein is well maintained at neutral pH. At low pH, however, the protein is more dynamic, and the sheet-like structure increases both by lengthening of the native -sheet and by addition of a portion of the N terminus to widen the sheet by another two strands. The side chain of Met-129, a polymorphic codon in humans associated with variant Creutzfeldt-Jakob disease, pulls the N terminus into the sheet. Neutralization of Asp-178 at low pH removes interactions that inhibit conversion, which is consistent with the Asp-178 -Asn mutation causing human prion diseases. P rP C is a glycosylated, glycosylphosphatidylinositol-anchored component of the extracellular surface of neurons that appears to play a role in signal transduction (1). PrP Sc , the misfolded isoform, is a -sheet-rich, protease-resistant protein that causes fatal neurodegenerative diseases of the central nervous system in humans and other mammals (2, 3). Clinically, these diseases can exhibit sporadic, inherited, or infectious presentations. Neuropathologically, spongiform degeneration with astrocytic gliosis and extracellular deposits rich in the prion protein (PrP) are observed (4). Inherited disease maps exclusively to mutations in the PrP. Infectious disease is transmitted by PrP Sc , which is chemically indistinguishable from PrP C (5); however, their secondary, tertiary, and quaternary structures differ (6-10). PrP C is monomeric, whereas PrP Sc adopts a multimeric arrangement. Fourier transform infrared and CD spectroscopy studies indicate that PrP C is highly helical (42%), with little -sheet structure (3%) (8). In contrast, PrP Sc contains a large amount of -structure (43%) and less helical structure (30%). These results and others suggest that a conversion of ␣-helices to -sheets is an essential feature in the formation of PrP Sc from PrP C .Recombinant forms of human and murine PrP C undergo a pH-dependent conformational change in the region of pH 4.4-6, with a loss of helix and gain of -structure (11, 12). In vivo, conversion of PrP C 3 PrP Sc is a posttranslational process that appears to occur in an endocytic pathway (7,13,14). Caveolaelike domains have also been implicated in the conversion of wild-type protein (15, 16), and they appear to be acidic (17). Lower pH accelerates conversion in a cell-free conversion assay (10). Thus low pH may play a role in facilitating the conformational cha...