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<span>Receptors</span> </div> </a> <ul id="toc-Receptors-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Function" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Function"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Function</span> </div> </a> <button aria-controls="toc-Function-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Function subsection</span> </button> <ul id="toc-Function-sublist" class="vector-toc-list"> <li id="toc-Parasite_hypothesis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Parasite_hypothesis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Parasite hypothesis</span> </div> </a> <ul id="toc-Parasite_hypothesis-sublist" class="vector-toc-list"> </ul> </li> <li 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<label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Immunoglobulin E</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another 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Available in 27 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-27" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">27 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%BA%D9%84%D9%88%D8%A8%D9%8A%D9%88%D9%84%D9%8A%D9%86_%D9%85%D9%86%D8%A7%D8%B9%D9%8A_%D9%87%D9%80" title="غلوبيولين مناعي هـ – Arabic" lang="ar" hreflang="ar" data-title="غلوبيولين مناعي هـ" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Immunoglobulina_E" title="Immunoglobulina E – Catalan" lang="ca" hreflang="ca" data-title="Immunoglobulina E" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Imunoglobulin_E" title="Imunoglobulin E – Czech" lang="cs" hreflang="cs" data-title="Imunoglobulin E" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Immunoglobulin_E" title="Immunoglobulin E – Danish" lang="da" hreflang="da" data-title="Immunoglobulin E" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Immunglobulin_E" title="Immunglobulin E – German" lang="de" hreflang="de" data-title="Immunglobulin E" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%91%CE%BD%CE%BF%CF%83%CE%BF%CF%83%CF%86%CE%B1%CE%B9%CF%81%CE%AF%CE%BD%CE%B7_%CE%95" title="Ανοσοσφαιρίνη Ε – Greek" lang="el" hreflang="el" data-title="Ανοσοσφαιρίνη Ε" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Inmunoglobulina_E" title="Inmunoglobulina E – Spanish" lang="es" hreflang="es" data-title="Inmunoglobulina E" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/E_immunoglobulina" title="E immunoglobulina – Basque" lang="eu" hreflang="eu" data-title="E immunoglobulina" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%DB%8C%D9%85%D9%88%D9%86%D9%88%DA%AF%D9%84%D9%88%D8%A8%D9%88%D9%84%DB%8C%D9%86_%D8%A6%DB%8C" title="ایمونوگلوبولین ئی – Persian" lang="fa" hreflang="fa" data-title="ایمونوگلوبولین ئی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Immunoglobuline_E" title="Immunoglobuline E – French" lang="fr" hreflang="fr" data-title="Immunoglobuline E" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Inmunoglobulina_E" title="Inmunoglobulina E – Galician" lang="gl" hreflang="gl" data-title="Inmunoglobulina E" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%A9%B4%EC%97%AD%EA%B8%80%EB%A1%9C%EB%B6%88%EB%A6%B0_E" title="면역글로불린 E – Korean" lang="ko" hreflang="ko" data-title="면역글로불린 E" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Antibodi_E" title="Antibodi E – Indonesian" lang="id" hreflang="id" data-title="Antibodi E" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/IgE" title="IgE – Italian" lang="it" hreflang="it" data-title="IgE" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%98%D0%B3%D0%B5" title="Иге – Kazakh" lang="kk" hreflang="kk" data-title="Иге" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%87%E0%B4%AE%E0%B5%8D%E0%B4%AE%E0%B5%8D%E0%B4%AF%E0%B5%82%E0%B4%A3%E0%B5%8B%E0%B4%97%E0%B5%8D%E0%B4%B2%E0%B5%8B%E0%B4%AC%E0%B5%81%E0%B4%B2%E0%B4%BF%E0%B5%BB_%E0%B4%87" title="ഇമ്മ്യൂണോഗ്ലോബുലിൻ ഇ – Malayalam" lang="ml" hreflang="ml" data-title="ഇമ്മ്യൂണോഗ്ലോബുലിൻ ഇ" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E5%85%8D%E7%96%AB%E3%82%B0%E3%83%AD%E3%83%96%E3%83%AA%E3%83%B3E" title="免疫グロブリンE – Japanese" lang="ja" hreflang="ja" data-title="免疫グロブリンE" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Immunoglobulin_E" title="Immunoglobulin E – Uzbek" lang="uz" hreflang="uz" data-title="Immunoglobulin E" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Immunoglobuliny_E" title="Immunoglobuliny E – Polish" lang="pl" hreflang="pl" data-title="Immunoglobuliny E" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Imunoglobulina_E" title="Imunoglobulina E – Portuguese" lang="pt" hreflang="pt" data-title="Imunoglobulina E" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru badge-Q17559452 badge-recommendedarticle mw-list-item" title="recommended article"><a href="https://ru.wikipedia.org/wiki/%D0%98%D0%BC%D0%BC%D1%83%D0%BD%D0%BE%D0%B3%D0%BB%D0%BE%D0%B1%D1%83%D0%BB%D0%B8%D0%BD%D1%8B_E" title="Иммуноглобулины E – Russian" lang="ru" hreflang="ru" data-title="Иммуноглобулины E" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Imunoglobulin_E" title="Imunoglobulin E – Serbian" lang="sr" hreflang="sr" data-title="Imunoglobulin E" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Immunoglobuliini_E" title="Immunoglobuliini E – Finnish" lang="fi" hreflang="fi" data-title="Immunoglobuliini E" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Immunglobulin_E" title="Immunglobulin E – Swedish" lang="sv" hreflang="sv" data-title="Immunglobulin E" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%86%D0%BC%D1%83%D0%BD%D0%BE%D0%B3%D0%BB%D0%BE%D0%B1%D1%83%D0%BB%D1%96%D0%BD_E" title="Імуноглобулін E – Ukrainian" lang="uk" hreflang="uk" data-title="Імуноглобулін E" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Globulin_mi%E1%BB%85n_d%E1%BB%8Bch_E" title="Globulin miễn dịch E – Vietnamese" lang="vi" hreflang="vi" 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div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"IgE" redirects here. For the virtual currency company, see <a href="/wiki/IGE" title="IGE">IGE</a>. For other uses, see <a href="/wiki/Ige_(disambiguation)" class="mw-redirect mw-disambig" title="Ige (disambiguation)">Ige</a>.</div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:IgE.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9d/IgE.jpg/500px-IgE.jpg" decoding="async" width="400" height="176" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9d/IgE.jpg/600px-IgE.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9d/IgE.jpg/800px-IgE.jpg 2x" data-file-width="902" data-file-height="398" /></a><figcaption>The structure of the IgE antibody</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Mast_cells.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/ce/Mast_cells.jpg/220px-Mast_cells.jpg" decoding="async" width="220" height="395" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/ce/Mast_cells.jpg/330px-Mast_cells.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/ce/Mast_cells.jpg/440px-Mast_cells.jpg 2x" data-file-width="634" data-file-height="1138" /></a><figcaption>The role of mast cells in the development of allergy.</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Allergy_degranulation_processes_01.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/Allergy_degranulation_processes_01.svg/220px-Allergy_degranulation_processes_01.svg.png" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/36/Allergy_degranulation_processes_01.svg/330px-Allergy_degranulation_processes_01.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/36/Allergy_degranulation_processes_01.svg/440px-Allergy_degranulation_processes_01.svg.png 2x" data-file-width="1600" data-file-height="1200" /></a><figcaption>Degranulation processes 1: antigen; 2: IgE antibody; 3: FcεRI receptor; 4: preformed mediators (histamine, proteases, chemokines, heparin); 5: granules; 6: mast cell; 7: newly formed mediators (prostaglandins, leukotrienes, thromboxanes, PAF)</figcaption></figure> <p><b>Immunoglobulin E</b> (<b>IgE</b>) is a type of <a href="/wiki/Antibody" title="Antibody">antibody</a> (or <a href="/wiki/Immunoglobulin" class="mw-redirect" title="Immunoglobulin">immunoglobulin</a> (Ig) "<a href="/wiki/Protein_isoform" title="Protein isoform">isoform</a>") that has been found only in <a href="/wiki/Mammal" title="Mammal">mammals</a>. IgE is synthesised by <a href="/wiki/Plasma_cell" title="Plasma cell">plasma cells</a>. Monomers of IgE consist of two heavy chains (ε chain) and two light chains, with the ε chain containing four Ig-like constant domains (Cε1–Cε4).<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> IgE is thought to be an important part of the <a href="/wiki/Immune_response" title="Immune response">immune response</a> against infection by certain <a href="/wiki/Parasitic_worm" title="Parasitic worm">parasitic worms</a>, including <i><a href="/wiki/Schistosoma_mansoni" title="Schistosoma mansoni">Schistosoma mansoni</a></i>, <i><a href="/wiki/Trichinella_spiralis" title="Trichinella spiralis">Trichinella spiralis</a></i>,<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> and <i><a href="/wiki/Fasciola_hepatica" title="Fasciola hepatica">Fasciola hepatica</a></i>.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> IgE is also utilized during immune defense against certain <a href="/wiki/Protozoa" title="Protozoa">protozoan</a> <a href="/wiki/Parasite" class="mw-redirect" title="Parasite">parasites</a> such as <i><a href="/wiki/Plasmodium_falciparum" title="Plasmodium falciparum">Plasmodium falciparum</a></i>.<sup id="cite_ref-duarte_5-0" class="reference"><a href="#cite_note-duarte-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> IgE may have evolved as a defense to protect against venoms.<sup id="cite_ref-:1_6-0" class="reference"><a href="#cite_note-:1-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:2_7-0" class="reference"><a href="#cite_note-:2-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_8-0" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>IgE also has an essential role in <a href="/wiki/Type_I_hypersensitivity" title="Type I hypersensitivity">type I hypersensitivity</a>,<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> which manifests in various allergic diseases, such as allergic <a href="/wiki/Asthma" title="Asthma">asthma</a>, most types of <a href="/wiki/Sinusitis" title="Sinusitis">sinusitis</a>, <a href="/wiki/Allergic_rhinitis" title="Allergic rhinitis">allergic rhinitis</a>, food allergies, and specific types of <a href="/wiki/Chronic_urticaria" class="mw-redirect" title="Chronic urticaria">chronic urticaria</a> and <a href="/wiki/Atopic_dermatitis" title="Atopic dermatitis">atopic dermatitis</a>. IgE also plays a pivotal role in responses to allergens, such as <a href="/wiki/Anaphylactic" class="mw-redirect" title="Anaphylactic">anaphylactic</a> reactions to drugs, bee stings, and antigen preparations used in desensitization <a href="/wiki/Immunotherapy" title="Immunotherapy">immunotherapy</a>. </p><p>IgE is typically the least abundant isotype: <a href="/wiki/Blood_serum" class="mw-redirect" title="Blood serum">blood serum</a> IgE levels in a non-<a href="/wiki/Atopic" class="mw-redirect" title="Atopic">atopic</a> individual are less than 0.0001% of the total Ig concentration,<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> compared to 75% for the <a href="/wiki/Immunoglobulin_G" title="Immunoglobulin G">IgGs</a> at 10 mg/ml. Despite this, it is capable of triggering <a href="/wiki/Anaphylaxis" title="Anaphylaxis">anaphylaxis</a>, one of the most rapid and severe immunological reactions.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Discovery">Discovery</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=1" title="Edit section: Discovery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>IgE was simultaneously discovered in 1966 and 1967 by two independent groups:<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> by <a href="/wiki/Teruko_Ishizaka" title="Teruko Ishizaka">Teruko Ishizaka</a> and her husband <a href="/wiki/Kimishige_Ishizaka" title="Kimishige Ishizaka">Kimishige Ishizaka</a> at the Children's Asthma Research Institute and Hospital in <a href="/wiki/Denver" title="Denver">Denver</a>, <a href="/wiki/Colorado" title="Colorado">Colorado</a>,<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> and by <a href="/wiki/Gunnar_Johansson_(biochemist)" class="mw-redirect" title="Gunnar Johansson (biochemist)">Gunnar Johansson</a> and <a href="/w/index.php?title=Hans_Bennich&action=edit&redlink=1" class="new" title="Hans Bennich (page does not exist)">Hans Bennich</a><span class="noprint" style="font-size:85%; font-style: normal;"> [<a href="https://sv.wikipedia.org/wiki/Hans_Bennich" class="extiw" title="sv:Hans Bennich">sv</a>]</span> in <a href="/wiki/Uppsala" title="Uppsala">Uppsala</a>, <a href="/wiki/Sweden" title="Sweden">Sweden</a>.<sup id="cite_ref-pmid4168094_14-0" class="reference"><a href="#cite_note-pmid4168094-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Their joint paper was published in April 1969.<sup id="cite_ref-Joint_paper_1969_15-0" class="reference"><a href="#cite_note-Joint_paper_1969-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Receptors">Receptors</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=2" title="Edit section: Receptors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>IgE primes the IgE-mediated allergic response by binding to <a href="/wiki/Fc_receptor" title="Fc receptor">Fc receptors</a> found on the surface of <a href="/wiki/Mast_cell" title="Mast cell">mast cells</a> and <a href="/wiki/Basophil" title="Basophil">basophils</a>. Fc receptors are also found on <a href="/wiki/Eosinophil" title="Eosinophil">eosinophils</a>, <a href="/wiki/Monocyte" title="Monocyte">monocytes</a>, <a href="/wiki/Macrophage" title="Macrophage">macrophages</a> and <a href="/wiki/Platelet" title="Platelet">platelets</a> in humans. There are two types of Fcε receptors:<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2023)">citation needed</span></a></i>]</sup> </p> <ul><li><a href="/wiki/Fc%CE%B5RI" class="mw-redirect" title="FcεRI">FcεRI</a> (type I Fcε receptor), the high-affinity IgE receptor</li> <li><a href="/wiki/Fc%CE%B5RII" class="mw-redirect" title="FcεRII">FcεRII</a> (type II Fcε receptor), also known as CD23, the low-affinity IgE receptor</li></ul> <p>IgE can upregulate the expression of both types of Fcε receptors. FcεRI is expressed on mast cells, basophils, and the antigen-presenting <a href="/wiki/Dendritic_cell" title="Dendritic cell">dendritic cells</a> in both mice and humans. Binding of <a href="/wiki/Antigen" title="Antigen">antigens</a> to IgE already bound by the FcεRI on mast cells causes cross-linking of the bound IgE and the aggregation of the underlying FcεRI, leading to <a href="/wiki/Degranulation" title="Degranulation">degranulation</a> (the release of mediators) and the secretion of several types of type 2 <a href="/wiki/Cytokine" title="Cytokine">cytokines</a> like <a href="/wiki/Interleukin" title="Interleukin">interleukin</a> <a href="/wiki/Interleukin_3" title="Interleukin 3">(IL)-3</a> and <a href="/wiki/Stem_cell_factor" title="Stem cell factor">stem cell factor</a> (SCF), which both help the mast cells survive and accumulate in tissue, and <a href="/wiki/Interleukin_4" title="Interleukin 4">IL-4</a>, <a href="/wiki/Interleukin_5" title="Interleukin 5">IL-5</a>, <a href="/wiki/Interleukin_13" title="Interleukin 13">IL-13</a>, and <a href="/wiki/Interleukin_33" title="Interleukin 33">IL-33</a>, which in turn activate group 2-innate lymphoid cells (<a href="/wiki/ILC2" title="ILC2">ILC2</a> or natural helper cells). Basophils share a common haemopoietic progenitor with mast cells; upon the cross-linking of their surface bound IgE by antigens, also release type 2 cytokines, including IL-4 and IL-13, and other inflammatory mediators. The low-affinity receptor (FcεRII) is always expressed on <a href="/wiki/B_cell" title="B cell">B cells</a>; but IL-4 can induce its expression on the surfaces of macrophages, eosinophils, platelets, and some <a href="/wiki/T_cell" title="T cell">T cells</a>.<sup id="cite_ref-pmid12070780_16-0" class="reference"><a href="#cite_note-pmid12070780-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid11677096_17-0" class="reference"><a href="#cite_note-pmid11677096-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Function">Function</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=3" title="Edit section: Function"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Parasite_hypothesis">Parasite hypothesis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=4" title="Edit section: Parasite hypothesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The IgE isotype has co-evolved with basophils and mast cells in the defence against parasites like helminths (like Schistosoma) but may be also effective in bacterial infections.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Epidemiological research shows that IgE level is increased when infected by <i>Schistosoma mansoni</i>,<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> <i><a href="/wiki/Necator_americanus" title="Necator americanus">Necator americanus</a></i>,<sup id="cite_ref-pmid7761110_20-0" class="reference"><a href="#cite_note-pmid7761110-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Nematode" title="Nematode">nematodes</a><sup id="cite_ref-pmid15961339_21-0" class="reference"><a href="#cite_note-pmid15961339-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> in humans. It is most likely beneficial in removal of hookworms from the lung.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="speculative (March 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Toxin_hypothesis_of_allergic_disease">Toxin hypothesis of allergic disease</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=5" title="Edit section: Toxin hypothesis of allergic disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 1981 <a href="/wiki/Margie_Profet" title="Margie Profet">Margie Profet</a> suggested that allergic reactions have evolved as a last line of defense to protect against <a href="/wiki/Venom" title="Venom">venoms</a>.<sup id="cite_ref-:1_6-1" class="reference"><a href="#cite_note-:1-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Although controversial at the time, new work supports some of Profet's thoughts on the adaptive role of allergies as a defense against noxious toxins.<sup id="cite_ref-:2_7-1" class="reference"><a href="#cite_note-:2-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>In 2013 it emerged that IgE-antibodies play an essential role in acquired resistance to <a href="/wiki/Honey_bee" title="Honey bee">honey bee</a><sup id="cite_ref-:0_8-1" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Russell%27s_viper" title="Russell's viper">Russell's viper</a> venoms.<sup id="cite_ref-:0_8-2" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> The authors concluded that "a small dose of bee venom conferred immunity to a much larger, fatal dose" and "this kind of venom-specific, IgE-associated, adaptive immune response developed, at least in evolutionary terms, to protect the host against potentially toxic amounts of venom, such as would happen if the animal encountered a whole nest of bees, or in the event of a snakebite".<sup id="cite_ref-:0_8-3" class="reference"><a href="#cite_note-:0-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-News_Center_2013_23-0" class="reference"><a href="#cite_note-News_Center_2013-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NatureWorldNews_2013_24-0" class="reference"><a href="#cite_note-NatureWorldNews_2013-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> The major allergen of bee venom (<a href="/wiki/Phospholipase_A2" title="Phospholipase A2">phospholipase A2</a>) induces a <a href="/wiki/Th2" class="mw-redirect" title="Th2">T<sub>h</sub>2</a> immune responses, associated with production of IgE antibodies, which may "increase the resistance of mice to challenge with potentially lethal doses".<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cancer">Cancer</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=6" title="Edit section: Cancer"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although it is not yet well understood, IgE may play an important role in the immune system's recognition of <a href="/wiki/Cancer" title="Cancer">cancer</a>,<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> in which the stimulation of a strong cytotoxic response against cells displaying only small amounts of early cancer markers would be beneficial. If this were the case, anti-IgE treatments such as <a href="/wiki/Omalizumab" title="Omalizumab">omalizumab</a> (for allergies) might have some undesirable side effects. However, a recent study, which was performed based on pooled analysis using comprehensive data from 67 phase I to IV clinical trials of omalizumab in various indications, concluded that a causal relationship between omalizumab therapy and malignancy is unlikely.<sup id="cite_ref-pmid22365654_27-0" class="reference"><a href="#cite_note-pmid22365654-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Role_in_disease">Role in disease</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=7" title="Edit section: Role in disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Atopic" class="mw-redirect" title="Atopic">Atopic</a> individuals can have up to ten times the normal level of IgE in their blood (as do sufferers of <a href="/wiki/Hyper-IgE_syndrome" class="mw-redirect" title="Hyper-IgE syndrome">hyper-IgE syndrome</a>). However, this may not be a requirement for symptoms to occur as has been seen in asthmatics with normal IgE levels in their blood—recent research has shown that IgE production can occur locally in the nasal mucosa.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p><p>IgE that can specifically recognise an <a href="/wiki/Allergen" title="Allergen">allergen</a> (typically this is a protein, such as <a href="/wiki/Dust_mite" class="mw-redirect" title="Dust mite">dust mite</a> <a href="/wiki/Peptidase_1_(mite)" title="Peptidase 1 (mite)">Der p 1</a>, cat <a href="/wiki/Fel_d_1" title="Fel d 1">Fel d 1</a>, grass or <a href="/wiki/Ragweed" title="Ragweed">ragweed</a> pollen, food protein, etc.) has a unique long-lived interaction with its high-affinity <a href="/wiki/Biochemistry" title="Biochemistry">receptor</a> FcεRI so that <a href="/wiki/Basophils" class="mw-redirect" title="Basophils">basophils</a> and <a href="/wiki/Mast_cells" class="mw-redirect" title="Mast cells">mast cells</a>, capable of mediating inflammatory reactions, become "primed", ready to release chemicals like <a href="/wiki/Histamine" title="Histamine">histamine</a>, <a href="/wiki/Leukotriene" title="Leukotriene">leukotrienes</a>, and certain interleukins. These chemicals cause many of the symptoms we associate with allergy, such as airway constriction in <a href="/wiki/Asthma" title="Asthma">asthma</a>, local inflammation in <a href="/wiki/Eczema" class="mw-redirect" title="Eczema">eczema</a>, increased <a href="/wiki/Mucus" title="Mucus">mucus</a> secretion in <a href="/wiki/Allergic_rhinitis" title="Allergic rhinitis">allergic rhinitis</a>, and increased vascular permeability, it is presumed, to allow other immune cells to gain access to tissues, but which can lead to a potentially fatal drop in blood pressure as in <a href="/wiki/Anaphylaxis" title="Anaphylaxis">anaphylaxis</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2020)">citation needed</span></a></i>]</sup> </p><p>IgE is known to be elevated in various autoimmune disorders such as <a href="/wiki/Systemic_lupus_erythematosus" class="mw-redirect" title="Systemic lupus erythematosus">SLE</a>, <a href="/wiki/Rheumatoid_arthritis" title="Rheumatoid arthritis">rheumatoid arthritis</a> (RA), and <a href="/wiki/Psoriasis" title="Psoriasis">psoriasis</a>, and is theorized to be of pathogenetic importance in SLE and RA by eliciting a hypersensitivity reaction.<sup id="cite_ref-Permin_H_Wilk_A_29-0" class="reference"><a href="#cite_note-Permin_H_Wilk_A-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-PMID7741196_30-0" class="reference"><a href="#cite_note-PMID7741196-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>Regulation of IgE levels through control of B cell differentiation to antibody-secreting <a href="/wiki/Plasma_cells" class="mw-redirect" title="Plasma cells">plasma cells</a> is thought to involve the "low-affinity" receptor FcεRII, or <a href="/wiki/CD23" title="CD23">CD23</a>.<sup id="cite_ref-pmid17697638_31-0" class="reference"><a href="#cite_note-pmid17697638-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> <a href="/wiki/CD23" title="CD23">CD23</a> may also allow facilitated antigen presentation, an IgE-dependent mechanism whereby <a href="/wiki/B_cells" class="mw-redirect" title="B cells">B cells</a> expressing <a href="/wiki/CD23" title="CD23">CD23</a> are able to present allergen to (and stimulate) specific <a href="/wiki/T_helper_cells" class="mw-redirect" title="T helper cells">T helper cells</a>, causing the perpetuation of a T<sub>h</sub>2 response, one of the hallmarks of which is the production of more antibodies.<sup id="cite_ref-pmid21377718_32-0" class="reference"><a href="#cite_note-pmid21377718-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Role_in_diagnosis">Role in diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=8" title="Edit section: Role in diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Diagnosis of allergy is most often done by reviewing a person's medical history and finding a positive result for the presence of allergen specific IgE when conducting a skin or blood test.<sup id="cite_ref-pearlspitfalls_33-0" class="reference"><a href="#cite_note-pearlspitfalls-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> Specific IgE testing is the proven test for allergy detection; evidence does not show that indiscriminate IgE testing or testing for immunoglobulin G (IgG) can support allergy diagnosis.<sup id="cite_ref-AAAAIfive_34-0" class="reference"><a href="#cite_note-AAAAIfive-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Drugs_targeting_the_IgE_pathway">Drugs targeting the IgE pathway</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=9" title="Edit section: Drugs targeting the IgE pathway"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Currently, allergic diseases and asthma are usually treated with one or more of the following drugs: (1) <a href="/wiki/Antihistamines" class="mw-redirect" title="Antihistamines">antihistamines</a> and <a href="/wiki/Antileukotriene" title="Antileukotriene">antileukotrienes</a>, which antagonize the inflammatory mediators histamine and leukotrienes, (2) local or systemic (oral or injectable) <a href="/wiki/Corticosteroids" class="mw-redirect" title="Corticosteroids">corticosteroids</a>, which suppress a broad spectrum of inflammatory mechanisms, (3) short or long-acting <a href="/wiki/Bronchodilators" class="mw-redirect" title="Bronchodilators">bronchodilators</a>, which relax smooth muscle of constricted airway in asthma, or (4) <a href="/wiki/Mast_cell_stabilizer" title="Mast cell stabilizer">mast cell stabilizers</a>, which inhibit the <a href="/wiki/Degranulation" title="Degranulation">degranulation</a> of mast cells that is normally triggered by IgE-binding at <a href="/wiki/Fc_receptor#Fc-epsilon_receptors" title="Fc receptor">FcεRI</a>. Long-term uses of systemic corticosteroids are known to cause many serious side effects and are advisable to avoid, if alternative therapies are available.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="Factual statement w/o source (March 2020)">citation needed</span></a></i>]</sup> </p><p>IgE, the IgE synthesis pathway, and the IgE-mediated allergic/inflammatory pathway are all important targets in intervening with the pathological processes of allergy, asthma, and other IgE-mediated diseases. The B lymphocyte differentiation and maturation pathway that eventually generate IgE-secreting plasma cells go through the intermediate steps of IgE-expressing B lymphoblasts and involves the interaction with IgE-expressing memory B cells. <a href="/wiki/Tanox" title="Tanox">Tanox</a>, a biotech company based in Houston, Texas, proposed in 1987 that by targeting membrane-bound IgE (mIgE) on B lymphoblast and memory B cells, those cells can be lysed or down-regulated, thus achieving the inhibition of the production of antigen-specific IgE and hence a shift of immune balance toward non-IgE mechanisms.<sup id="cite_ref-pmid17383539_35-0" class="reference"><a href="#cite_note-pmid17383539-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> Two approaches targeting the IgE pathway were evolved and both are in active development. In the first approach, the <a href="/wiki/Anti-IgE" class="mw-redirect" title="Anti-IgE">anti-IgE</a> antibody drug <a href="/wiki/Omalizumab" title="Omalizumab">omalizumab</a> (trade name <a href="/wiki/Xolair" class="mw-redirect" title="Xolair">Xolair</a>) recognises IgE not bound to its receptors and is used to neutralise or mop-up existing IgE and prevent it from binding to the receptors on mast cells and basophils. Xolair has been approved in many countries for treating severe, persistent allergic asthma. It has also been approved in March 2014 in the European Union<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> and the U. S.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> for treating <a href="/wiki/Chronic_spontaneous_urticaria" title="Chronic spontaneous urticaria">chronic spontaneous urticaria</a>, which cannot be adequately treated with H1-<a href="/wiki/Antihistamines" class="mw-redirect" title="Antihistamines">antihistamines</a>. In the second approach, antibodies specific for a domain of 52 amino acid residues, referred to as CεmX or M1' (M1 prime), present only on human mIgE on B cells and not on free, soluble IgE, have been prepared and are under clinical development for the treatment of allergy and asthma.<sup id="cite_ref-pmid20083663_38-0" class="reference"><a href="#cite_note-pmid20083663-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid20458139_39-0" class="reference"><a href="#cite_note-pmid20458139-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> An anti-M1' humanized antibody, <a href="/wiki/Quilizumab" title="Quilizumab">quilizumab</a>, is in phase IIb clinical trial.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid24990880_41-0" class="reference"><a href="#cite_note-pmid24990880-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>In 2002, researchers at the <a href="/wiki/Randall_Division_of_Cell_and_Molecular_Biophysics" title="Randall Division of Cell and Molecular Biophysics">Randall Division of Cell and Molecular Biophysics</a> determined the structure of IgE.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Understanding of this structure (which is atypical of other isotypes in that it is highly bent and asymmetric) and of the interaction of IgE with receptor FcεRI will enable development of a new generation of allergy drugs that seek to interfere with the IgE-receptor interaction. It may be possible to design treatments cheaper than monoclonal antibodies (for instance, small molecule drugs) that use a similar approach to inhibit binding of IgE to its receptor.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="speculative, not factual (March 2020)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Immunoglobulin_E&action=edit&section=10" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width reflist-columns-2"> <ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20080906211232/http://www.cartage.org.lb/en/themes/Sciences/LifeScience/GeneralBiology/Immunology/Recognition/AntigenRecognition/Antibodystructure/Antibodystructure.htm">"Antibody structure"</a>. 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epitope">Conformational</a></li></ul></li> <li><a href="/wiki/Mimotope" title="Mimotope">Mimotope</a></li></ul> <ul><li><a href="/wiki/Antigen_presentation" title="Antigen presentation">Antigen presentation</a>/<a href="/wiki/Antigen-presenting_cell" title="Antigen-presenting cell">professional APCs</a>: <a href="/wiki/Dendritic_cell" title="Dendritic cell">Dendritic cell</a></li> <li><a href="/wiki/Macrophage" title="Macrophage">Macrophage</a></li> <li><a href="/wiki/B_cell" title="B cell">B cell</a></li> <li><a href="/wiki/Immunogen" title="Immunogen">Immunogen</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Antibodies</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antibody" title="Antibody">Antibody</a> <ul><li><a href="/wiki/Monoclonal_antibody" title="Monoclonal antibody">Monoclonal antibodies</a></li> <li><a href="/wiki/Polyclonal_antibodies" title="Polyclonal antibodies">Polyclonal antibodies</a></li> <li><a href="/wiki/Autoantibody" title="Autoantibody">Autoantibody</a></li> <li><a href="/wiki/Microantibody" title="Microantibody">Microantibody</a></li></ul></li> <li><a href="/wiki/Polyclonal_B_cell_response" title="Polyclonal B cell response">Polyclonal B cell response</a></li> <li><a href="/wiki/Allotype_(immunology)" title="Allotype (immunology)">Allotype</a></li> <li><a href="/wiki/Isotype_(immunology)" title="Isotype (immunology)">Isotype</a></li> <li><a href="/wiki/Idiotype" title="Idiotype">Idiotype</a></li></ul> <ul><li><a href="/wiki/Immune_complex" title="Immune complex">Immune complex</a></li> <li><a href="/wiki/Paratope" title="Paratope">Paratope</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Immunity vs.<br /> tolerance</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Action: <a href="/wiki/Immunity_(medical)" class="mw-redirect" title="Immunity (medical)">Immunity</a></li> <li><a href="/wiki/Autoimmunity" title="Autoimmunity">Autoimmunity</a></li> <li><a href="/wiki/Alloimmunity" title="Alloimmunity">Alloimmunity</a></li> <li><a href="/wiki/Allergy" title="Allergy">Allergy</a></li> <li><a href="/wiki/Hypersensitivity" title="Hypersensitivity">Hypersensitivity</a></li> <li><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></li> <li><a href="/wiki/Cross-reactivity" title="Cross-reactivity">Cross-reactivity</a></li> <li><a href="/wiki/Co-stimulation" title="Co-stimulation">Co-stimulation</a></li></ul> <ul><li>Inaction: <a href="/wiki/Immune_tolerance" title="Immune tolerance">Tolerance</a> <ul><li><a href="/wiki/Central_tolerance" title="Central tolerance">Central</a></li> <li><a href="/wiki/Peripheral_tolerance" title="Peripheral tolerance">Peripheral</a></li> <li><a href="/wiki/Clonal_anergy" title="Clonal anergy">Clonal anergy</a></li> <li><a href="/wiki/Clonal_deletion" title="Clonal deletion">Clonal deletion</a></li> <li><a href="/wiki/Immune_tolerance_in_pregnancy" title="Immune tolerance in pregnancy">Tolerance in pregnancy</a></li></ul></li> <li><a href="/wiki/Immunodeficiency" title="Immunodeficiency">Immunodeficiency</a></li> <li><a href="/wiki/Immune_privilege" title="Immune privilege">Immune privilege</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immunogenetics" title="Immunogenetics">Immunogenetics</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Affinity_maturation" title="Affinity maturation">Affinity maturation</a> <ul><li><a href="/wiki/Somatic_hypermutation" title="Somatic hypermutation">Somatic hypermutation</a></li> <li><a href="/wiki/Clonal_selection" title="Clonal selection">Clonal selection</a></li></ul></li> <li><a href="/wiki/V(D)J_recombination" title="V(D)J recombination">V(D)J recombination</a></li> <li><a href="/wiki/Junctional_diversity" title="Junctional diversity">Junctional diversity</a></li> <li><a href="/wiki/Immunoglobulin_class_switching" title="Immunoglobulin class switching">Immunoglobulin class switching</a></li> <li><a href="/wiki/Major_histocompatibility_complex" title="Major histocompatibility complex">MHC</a>/<a href="/wiki/Human_leukocyte_antigen" title="Human leukocyte antigen">HLA</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lymphocyte" title="Lymphocyte">Lymphocytes</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cell-mediated_immunity" title="Cell-mediated immunity">Cellular</a> <ul><li><a href="/wiki/T_cell" title="T cell">T cell</a></li></ul></li> <li><a href="/wiki/Humoral_immunity" title="Humoral immunity">Humoral</a> <ul><li><a href="/wiki/B_cell" title="B cell">B cell</a></li></ul></li> <li><a href="/wiki/Natural_killer_cell" title="Natural killer cell">NK cell</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Substances</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cytokine" title="Cytokine">Cytokines</a></li> <li><a href="/wiki/Opsonin" title="Opsonin">Opsonin</a></li> <li><a href="/wiki/Cytolysin" title="Cytolysin">Cytolysin</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Antibodies39" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse 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