ALS is a terminal disease of motor neurons that is characterized by accumulation of proteinaceous deposits in affected cells. Pathological deposition of mutated Cu/Zn superoxide dismutase (SOD1) accounts for ∼20% of the familial ALS (fALS) cases. However, understanding the molecular link between mutation and disease has been difficult, given that more than 140 different SOD1 mutants have been observed in fALS patients. In addition, the molecular origin of sporadic ALS (sALS) is unclear. By dissecting the amino acid sequence of SOD1, we identified four short segments with a high propensity for amyloid fibril formation. We find that fALS mutations in these segments do not reduce their propensity to form fibrils. The atomic structures of two fibril-forming segments from the C terminus, 101 impaired nucleation and fibril growth of full-length protein, confirming that these segments participate in aggregate formation. Our hypothesis is that improper protein maturation and incompletely folded states that render these aggregation-prone segments available for interaction offer a common molecular pathway for sALS and fALS.protein aggregation | peptide structure | amyotrophic lateral sclerosis A LS is a progressive neurodegenerative disease that affects motor neurons, often causing death within 2 to 5 years. Ninety percent of ALS cases are sporadic (sALS), and their cause is unknown (1). However, the remaining 10% of ALS cases are inherited familial ALS (fALS), ∼20% of which are linked to mutations in the Cu/Zn superoxide dismutase (SOD1) gene.Mature SOD1 is a 32-kDa homodimeric metalloenzyme, in which each monomer contains a copper ion, zinc ion, and one intrasubunit disulfide bond (2) (Fig. 1A). SOD1 is one of the most abundant proteins in cells, serving to protect organisms against oxidative damage. The loss of protein function does not necessarily lead to disease because SOD1-deficient mice develop mild impairments that are not observed in ALS (3). Instead, the mutated SOD1 seems to have a toxic gain of function that leads to the pathologies of disease. To date, more than 140 dominant disease-related mutations that span nearly the whole protein sequence have been described (http://alsod.iop.kcl.ac.uk/Als/).Several studies suggest sALS and fALS have common mechanisms of pathogenesis associated with accumulation of misfolded SOD1 (4). Evidence to support this has shown that insoluble protein aggregates found in both fALS (5) and sALS (6) patients were SOD1 immunoreactive. Scientists have created transgenic mice that express human SOD1 mutations found in fALS. The mice exhibit behavioral and cellular symptoms similar to human ALS (7), including accumulation of insoluble aggregates (8). In addition, expression in mice of heterozygous wild-type/ mutant SOD1 augments disease symptoms relative to homozygous mutant animals (7), implying that the wild-type protein produced by the allele carrying the normal gene enhances the toxicity of the mutant protein in fALS. It was also shown that transgenic mice overexpressing wild-typ...