The pathogenesis of transmissible encephalopathies is associated with the c
onversion of the cellular prion protein, PrPC, into a conformationally alte
red oligomeric form, PrPSc. Here we report the crystal structure of the hum
an prion protein in dimer form at 2 Angstrom resolution. The dimer results
from the three-dimensional swapping of the C-terminal helix 3 and rearrange
ment of the disulfide bond. An interchain two-stranded antiparallel beta -s
heet is formed at the dimer interface by residues that are located in helix
2 in the monomeric NMR structures. Familial prion disease mutations map to
the regions directly involved in helix swapping. This crystal structure su
ggests that oligomerization through 3D domain-swapping may constitute an im
portant step on the pathway of the PrPC --> PrPSc conversion.