The relationship between various amyloidoses and chaperones is gathering attention. In patients with dialysis-related amyloidosis, ␣ 2 -macroglobulin (␣2M), an extracellular chaperone, forms a complex with  2 -microglobulin (2-m), a major component of amyloid fibrils, but the molecular mechanisms and biological implications of the complex formation remain unclear. Here, we found that ␣2M substoichiometrically inhibited the 2-m fibril formation at a neutral pH in the presence of SDS, a model for anionic lipids. Binding analysis showed that the binding affinity between ␣2M and 2-m in the presence of SDS was higher than that in the absence of SDS. Importantly, SDS dissociated tetrameric ␣2M into dimers with increased surface hydrophobicity. Western blot analysis revealed that both tetrameric and dimeric ␣2M interacted with SDS-denatured 2-m. At a physiologically relevant acidic pH and in the presence of heparin, ␣2M was also dissociated into dimers, and both tetrameric and dimeric ␣2M interacted with 2-m, resulting in the inhibition of fibril growth reaction. These results suggest that under conditions where native 2-m is denatured, tetrameric ␣2M is also converted to dimeric form with exposed hydrophobic surfaces to favor the hydrophobic interaction with denatured 2-m, thus dimeric ␣2M as well as tetrameric ␣2M may play an important role in controlling 2-m amyloid fibril formation.A number of proteins and peptides can misfold into -sheetrich structures, called amyloid fibrils (1). The deposition of amyloid fibrils in intra-and extracellular spaces is responsible for more than 40 serious diseases, including Alzheimer and Parkinson diseases and dialysis-related amyloidosis (DRA) 2 (1).  2 -Microglobulin (2-m) is a major structural component of amyloid fibrils in DRA, a common and serious complication in long term hemodialysis patients (2). The formation of 2-m amyloid fibrils is thought to be induced by partial unfolding of 2-m (3, 4). Several groups have established conditions under which 2-m amyloid fibril formation occurs at a neutral pH (5-11). We found that 2-m amyloid fibrils are formed at a neutral pH in the presence of SDS (11). SDS below its critical micelle concentration unfolds the compact structure of 2-m to an amyloidogenic conformer and stabilizes the extended amyloid fibrils. SDS is an anionic detergent that mimics some characteristics of biological membranes and is considered to be a good model for anionic lipids. We recently reported that some lysophospholipids, especially lysophosphatidic acid as well as nonesterified fatty acids induce the extension of 2-m amyloid fibrils at a neutral pH by partially unfolding the compact structure of 2-m to an amyloidogenic conformer as well as by stabilizing the extended fibrils (6, 8). Although many groups have proposed the mechanisms by which 2-m amyloid fibrils are formed under physiological conditions, the biological machineries to inhibit the formation and deposition of 2-m amyloid fibrils are poorly understood (12).␣ 2 -Macroglobulin (...