The discovery of methods suitable for the conversion in vitro of native proteins into amyloid fibrils has shed light on the molecular basis of amyloidosis and has provided fundamental tools for drug discovery. We have studied the capacity of a small library of tetracycline analogues to modulate the formation or destructuration of 2-microglobulin fibrils. The inhibition of fibrillogenesis of the wild type protein was first established in the presence of 20% trifluoroethanol and confirmed under a more physiologic environment including heparin and collagen. The latter conditions were also used to study the highly amyloidogenic variant, P32G. The NMR analysis showed that doxycycline inhibits 2-microglobulin self-association and stabilizes the native-like species through fast exchange interactions involving specific regions of the protein.Cell viability assays demonstrated that the drug abolishes the natural cytotoxic activity of soluble 2-microglobulin, further strengthening a possible in vivo therapeutic exploitation of this drug. Doxycycline can disassemble preformed fibrils, but the IC 50 is 5-fold higher than that necessary for the inhibition of fibrillogenesis. Fibril destructuration is a dynamic and timedependent process characterized by the early formation of cytotoxic protein aggregates that, in a few hours, convert into non-toxic insoluble material. The efficacy of doxycycline as a drug against dialysis-related amyloidosis would benefit from the ability of the drug to accumulate just in the skeletal system where amyloid is formed. In these tissues, the doxycycline concentration reaches values several folds higher than those resulting in inhibition of amyloidogenesis and amyloid destructuration in vitro.Amyloidosis associated with long term hemodialysis results from the deposition of full-length 2-microglobulin (2-m) 2 and its N-terminal truncated species ⌬N62m in target tissues (1, 2). Although all peripheral organs (but not the brain) can be potentially affected (3), the muscle-skeletal tissues are the preferential target always involved in this type of amyloidosis. Despite significant progress achieved in the hemodialysis techniques, including the increased biocompatibility and the active removal of circulating 2-m, the onset of this amyloidosis can be delayed but not avoided in dialysis-related amyloidosis patients (4). New therapeutic approaches, targeting the process of protein aggregation and promoting fibril solubilization (5), are under investigation for the treatment of different types of amyloid diseases. Up until now, different classes of structurally unrelated compounds have been investigated for their ability to interfere with protein self-aggregation and to weaken the intermolecular interactions that stabilize the fibrillar structure of the aggregates (6). Over 10 years ago, iododoxorubicin was serendipitously discovered as the prototype of a class of compounds able to inhibit protein aggregation (7), but this compound was subsequently abandoned for its toxicity. The resemblance of the ...