Mudde GC, Bheekha R, Bruijnzeel-Koomen CAFM. IgE-mediated antigen presentation. Allergy 1995: 50: 193-199 Atopic allergy afflicts at least 20% of the population in developed countries. It comprises a wide range of IgE-mediated disorders, such as hay fever, asthma, atopic dermatitis (AD), and food allergies. Higher serum IgE concentrations correlate with hyperreactive diseases in which larger parts of skin, mucosa, or both are involved ( Fig. 1) (66). Clearly, there is a direct connection between IgE titers and the distribution of effector cells which bear high-affinity receptors for IgE (Ec,-RI), such as mast cells and basophils. However, the view that these cells are unique in expressing Fc^Rl cannot be sustained since the recent discovery of FCfRI on normal Langerhans' cells (6, 65), on monocytes from atopic patients (36), and on eosinophils in parasitic infections (54). The finding of Fc,-RI in human skin (44) and blood, on cells different from effector cells such as mast cells and basophils, suggests an additional role for IgE in immune responses (38). Moreover, not only can FCjRI be found on antigen-presenting cells (APCs), but also the low-affinity receptor for IgE (Fc^RII or CD23) can be found and induced on many different cell types including APCs (60). Therefore, the data pointing to a role of IgE in antigen focusing are accumulating. In addition, we propose that IgE has a role in allergy expansion by generating allergies to new allergens.