The prion protein unstructured N-terminal region is a broad-spectrum molecular sensor with diverse and contrasting potential functions.

The physiological function of the prion protein (PrP(C) ) and its conversion into its infectious form (PrP(Sc) ) are central issues to understanding the pathogenesis of prion diseases. The N-terminal moiety of PrP(C) (NH(2) -PrP(C) ) is an unstructured region with the characteristic of interacting with a broad range of partners. These interactions endow PrP(C) with multifunctional and sometimes contrasting capabilities, including neuroprotection and neurotoxicity. Recently, binding of β-sheet rich conformers to NH(2) -PrP(C) demonstrated a probable neurotoxic function for PrP(C) in Alzheimer's disease. NH(2) -PrP(C) also enhances the propagation of prions in vivo and is the target of the most potent antiprion compounds. Another level of complexity is provided by endoproteolysis and release of most of NH(2) -PrP(C) into the extracellular space. Further studies will be necessary to understand how NH(2) -PrP(C) regulates the physiological function of PrP(C) and how it is involved in the corruption of its normal function in diseases.