Of all the antibody classes, IgE displays a uniquely slow dissociation rate from, and high affinity for, its cell surface receptor FcεRI. The structural basis for these key determinants of IgE's ability to mediate allergic hypersensitivity is now revealed by the 3.4Å resolution crystal structure of human IgE-Fc (consisting of the Cε2, Cε3 and Cε4 domains) bound to the extracellular domains of the FcεRI α-chain. Comparison with free IgE-Fc (reported here at 1.9Å) shows that the antibody, which has a compact, bent structure prior to receptor engagement, becomes even more acutely bent in the complex. Thermodynamic analysis indicates that the interaction is entropically driven, which explains how the non-contacting Cε2 domains, in place of the flexible hinge region of IgG antibodies, contribute together with the conformational changes to IgE's unique binding properties.The global incidence of allergic disease has increased markedly in recent years and continues to rise. Asthma currently affects 22.2 million people in North America and 5.4 million in the UK where the rate of incidence, especially in children, is among the highest in the world 1 . Anaphylactic reactions to foods such as nuts, virtually unknown thirty years ago, are now relatively common. The reason for this increase is debated, but these and other allergic conditions (rhinitis, eczema etc.) are all mediated by IgE, and the viability of AUTHOR CONTRIBUTIONS MDH and AMD carried out the crystallographic analysis of the complex, and BD the crystallographic analysis of IgE-Fc; MDH, JEN, JH, AJB and RJO produced the proteins; SCB and JMM carried out the thermodynamic analysis; EG contributed to the analysis of the conformational changes; HJG, AJB and BJS planned and directed the project; MDH, AMD, JMM and BJS wrote the paper.Accession codes. Atomic coordinates and structure factors have been deposited in the Protein Data Bank with entry codes 2WQR for IgE-Fc and 2Y7Q for the complex. [6][7][8][9] . Particular interest has centered on the role of the Cε2 domains, which were shown to contribute to the slow dissociation rate 10 , by comparing the binding kinetics of the complete IgE-Fc (dimer Cε2-Cε3-Cε4 domains) with a sub-fragment lacking the Cε2 domains, here referred to as Fcε3-4. The Cε2 domains have no counterpart in IgG, all four subclasses of which have in their place hinge regions of various lengths and degrees of flexibility. Europe PMC Funders GroupEarly fluorescence resonance energy transfer (FRET) studies of labelled chimeric IgE indicated a more compact and bent structure than the extended, flexible Y-shaped IgG 11 , and later solution scattering studies of IgE-Fc were consistent with such a structure 12 . The crystal structure of IgE-Fc revealed for the first time the extent and nature of this bend 13 , made possible by the presence of the Cε2 domains. Surprisingly the molecule was found to be so acutely and asymmetrically bent, with the Cε2 domain pair folded back across the Cε3 domains, that one Cε2 domain even contacted the Cε4 domai...

Abs have a paramount place in the treatment of certain, mainly lymphoid, malignancies, although tumors of nonhemopoietic origin have proved more refractory ones. We have previously shown that the efficacy of immunotherapy of solid tumors, in particular ovarian carcinoma, may be improved by the use of IgE Abs in place of the conventional IgG. An IgE Ab (MOv18 IgE) against an ovarian-tumor-specific Ag (folate binding protein), in combination with human PBMC, introduced into ovarian cancer xenograft-bearing mice, greatly exceeded the analogous IgG1 in promoting survival. In this study, we analyzed the mechanisms by which MOv18 IgE may exert its antitumor activities. Monocytes were essential IgE receptor-expressing effector cells that mediated the enhanced survival of tumor-bearing mice by MOv18 IgE and human PBMC. Monocytes mediated MOv18 IgE-dependent ovarian tumor cell killing in vitro by two distinct pathways, cytotoxicity and phagocytosis, acting respectively through the IgE receptors FcεRI and CD23. We also show that human eosinophils were potent effector cells in MOv18 IgE Ab-dependent ovarian tumor cell cytotoxicity in vitro. These results demonstrate that IgE Abs can engage cell surface IgE receptors and activate effector cells against ovarian tumor cells. Our findings offer a framework for an improved immunotherapeutic strategy for combating solid tumors.

Trastuzumab (Herceptin®), a humanized IgG1 antibody raised against the human epidermal growth factor receptor 2 (HER2/neu), is the main antibody in clinical use against breast cancer. Pre-clinical evidence and clinical studies indicate that trastuzumab employs several anti-tumour mechanisms that most likely contribute to enhanced survival of patients with HER2/neu-positive breast carcinomas. New strategies are aimed at improving antibody-based therapeutics like trastuzumab, e.g. by enhancing antibody-mediated effector function mechanisms. Based on our previous findings that a chimaeric ovarian tumour antigen-specific IgE antibody showed greater efficacy in tumour cell killing, compared to the corresponding IgG1 antibody, we have produced an IgE homologue of trastuzumab. Trastuzumab IgE was engineered with the same light- and heavy-chain variable-regions as trastuzumab, but with an epsilon in place of the gamma-1 heavy-chain constant region. We describe the physical characterisation and ligand binding properties of the trastuzumab IgE and elucidate its potential anti-tumour activities in functional assays. Both trastuzumab and trastuzumab IgE can activate monocytic cells to kill tumour cells, but they operate by different mechanisms: trastuzumab functions in antibody-dependent cell-mediated phagocytosis (ADCP), whereas trastuzumab IgE functions in antibody-dependent cell-mediated cytotoxicity (ADCC). Trastuzumab IgE, incubated with mast cells and HER2/neu-expressing tumour cells, triggers mast cell degranulation, recruiting against cancer cells a potent immune response, characteristic of allergic reactions. Finally, in viability assays both antibodies mediate comparable levels of tumour cell growth arrest. These functional characteristics of trastuzumab IgE, some distinct from those of trastuzumab, indicate its potential to complement or improve upon the existing clinical benefits of trastuzumab.