Infectious prions containing the pathogenic conformer of the mammalian prion protein (PrP Sc ) can be produced de novo from a mixture of the normal conformer (PrP C ) with RNA and lipid molecules. Recent reconstitution studies indicate that nucleic acids are not required for the propagation of mouse prions in vitro, suggesting the existence of an alternative prion propagation cofactor in brain tissue. However, the identity and functional properties of this unique cofactor are unknown. Here, we show by purification and reconstitution that the molecule responsible for the nucleaseresistant cofactor activity in brain is endogenous phosphatidylethanolamine (PE). Synthetic PE alone facilitates conversion of purified recombinant (rec)PrP substrate into infectious recPrP Sc molecules. Other phospholipids, including phosphatidylcholine, phosphatidylserine, phosphatidylinositol, and phosphatidylglycerol, were unable to facilitate recPrP Sc formation in the absence of RNA. PE facilitated the propagation of PrP Sc molecules derived from all four different animal species tested including mouse, suggesting that unlike RNA, PE is a promiscuous cofactor for PrP Sc formation in vitro. Phospholipase treatment abolished the ability of brain homogenate to reconstitute the propagation of both mouse and hamster PrP Sc molecules. Our results identify a single endogenous cofactor able to facilitate the formation of prions from multiple species in the absence of nucleic acids or other polyanions.PrP | scrapie P rions are mechanistically unique infectious agents that contain a misfolded, membrane-bound, glycoprotein (PrP Sc ) formed by the conformational change of a host-encoded conformer (PrP C ) (1). Conversion of PrP C into PrP Sc is the central event in the formation of infectious prions, but the molecular mechanism underlying conformational change remains poorly understood. In particular, the number and identity of endogenous factors other than PrP required for prion formation has not been determined (2).Cell culture and biochemical studies have implicated several classes of macromolecules such as GAGs, nucleic acids, proteins, and lipids as potential cofactors for prion formation (3). Reconstitution experiments with defined substrates (in which purified PrP molecules are mixed with Prnp 0/0 brain homogenate or purified cofactors that facilitate its conversion to PrP Sc ) have suggested that the conversion mechanism may be relatively simple, requiring only a few components (4, 5). Wild-type hamster prions possessing specific infectivity levels similar to those associated with natural scrapie have been formed de novo by using a defined mixture of purified native PrP C , copurified lipid, and RNA molecules (4), and infectious prions have also been formed de novo from bacterially expressed, recombinant PrP substrate in a reaction facilitated by synthetic 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoglycerol (POPG) and RNA molecules (5, 6). In summary, infectious prions have not yet been produced either with a single cofactor or in the abs...