Structure of a factor VIII C2 domain-immunoglobulin G4kappa Fab complex: identification of an inhibitory antibody epitope on the surface of factor VIII.
Primary Citation of Related Structures:   1IQD
PubMed Abstract: 
The development of an immune response to infused factor VIII is a complication affecting many patients with hemophilia A. Inhibitor antibodies bind to antigenic determinants on the factor VIII molecule and block its procoagulant activity. A patient-derived inhibitory immunoglobulin G4kappa antibody (BO2C11) produced by an immortalized memory B-lymphocyte cell line interferes with the binding of factor VIII to phospholipid surfaces and to von Willebrand factor ...
The development of an immune response to infused factor VIII is a complication affecting many patients with hemophilia A. Inhibitor antibodies bind to antigenic determinants on the factor VIII molecule and block its procoagulant activity. A patient-derived inhibitory immunoglobulin G4kappa antibody (BO2C11) produced by an immortalized memory B-lymphocyte cell line interferes with the binding of factor VIII to phospholipid surfaces and to von Willebrand factor. The structure of a Fab fragment derived from this antibody complexed with the factor VIII C2 domain was determined at 2.0 A resolution. The Fab interacts with solvent-exposed basic and hydrophobic side chains that form a membrane-association surface of factor VIII. This atomic resolution structure suggests a variety of amino acid substitutions in the C2 domain of factor VIII that might prevent the binding of anti-C2 inhibitor antibodies without significantly compromising the procoagulant functions of factor VIII.
Related Citations: 
Structure of the C2 domain of human factor VIII at 1.5 A resolution Pratt, K.P., Shen, B.W., Takeshima, K., Davie, E.W., Fujikawa, K., Stoddard, B.L. (1999) Nature 402: 439
Hemophilic factor VIII C1- and C2-domain missense mutations and their modeling to the 1.5-angstrom human C2-domain crystal structure Liu, M.L., Shen, B.W., Nakaya, S., Pratt, K.P., Fujikawa, K., Davie, E.W., Stoddard, B.L., Thompson, A.R. (2000) Blood 96: 979
Organizational Affiliation: 
Graduate Program in Biomolecular Structure and Design, University of Washington, and Division of Basic Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.