Neonatal fragment crystallizable receptor
The neonatal fragment crystallizable receptor is a protein that in humans is encoded by the FCGRT gene. It is an IgG Fc receptor which is similar in structure to the MHC class I molecule and also associates with beta-2-microglobulin. In rodents, FcRn was originally identified as the receptor that transports maternal immunoglobulin G from mother to neonatal offspring via mother's milk, leading to its name as the neonatal Fc receptor. In humans, FcRn is present in the placenta where it transports mother's IgG to the growing fetus. FcRn has also been shown to play a role in regulating IgG and serum albumin turnover. Neonatal Fc receptor expression is up-regulated by the proinflammatory cytokine, TNF, and down-regulated by IFN-γ.
Comparative Role of FcRn in Neonatal Immunity Across Species
The function of FcRn in neonatal immunity differs across species. In humans, FcRn in the placenta transfers maternal IgG to the fetus during gestation. In rodents, maternal IgG is delivered postnatally through FcRn-mediated uptake in the neonatal gut. Species like piglets and foals, which lack prenatal IgG transfer due to their placental structure, depend entirely on intestinal FcRn to absorb IgG from colostrum shortly after birth. These species-specific mechanisms reflect evolutionary adaptations in FcRn expression and function across mammals.FcRn Expression Across the Lifespan
FcRn is highly expressed during the neonatal period, particularly in epithelial and endothelial cells, to support passive immunity through maternal IgG transfer and protection from protein degradation. In adulthood, FcRn expression persists in various tissues including the endothelium, intestinal epithelium, kidney podocytes, and antigen-presenting cells, where it continues to regulate IgG and albumin homeostasis. While overall FcRn function remains critical throughout life, some studies suggest that FcRn expression or activity may decline with aging, potentially contributing to altered antibody pharmacokinetics and immune responses in the elderly.Interactions of FcRn with IgG and serum albumin
In addition to binding to IgG, FCGRT has been shown to interact with human serum albumin. FcRn-mediated transcytosis of IgG across epithelial cells is possible because FcRn binds IgG at acidic pH but not at neutral or higher pH. The binding site for FcRn on IgG has been mapped using functional and structural studies, and involves in the interaction of relatively well conserved histidine residues on IgG with acidic residues on FcRn.FcRn-mediated recycling and transcytosis of IgG and serum albumin
FcRn extends the half-life of IgG and serum albumin by reducing lysosomal degradation of these proteins in endothelial cells and bone-marrow derived cells. The clearance rate of IgG and albumin is abnormally short in mice that lack functional FcRn. IgG, serum albumin and other serum proteins are continuously internalized into cells through pinocytosis. Generally, internalized serum proteins are transported from early endosomes to lysosomes, where they are degraded. Following entry into cells, the two most abundant serum proteins, IgG and serum albumin, are bound by FcRn at the slightly acidic pH within early endosomes, sorted and recycled to the cell surface where they are released at the neutral pH of the extracellular environment. In this way, IgG and serum albumin are salvaged to avoid lysosomal degradation. This cellular mechanism provides an explanation for the prolonged in vivo half-lives of IgG and serum albumin and transport of these ligands across cellular barriers. In addition, for cell types bathed in an acidic environment such as the slightly acidic intestinal lumen, cell surface FcRn can bind to IgG, transport bound ligand across intestinal epithelial cells followed by release at the near neutral pH at the basolateral surface.Diverse roles for FcRn in various organs
FcRn is expressed on antigen-presenting leukocytes such as dendritic cells and is also expressed in neutrophils to help clear opsonized bacteria. In the kidneys, FcRn is expressed on epithelial cells called podocytes to prevent IgG and albumin from clogging the glomerular filtration barrier. Current studies are investigating FcRn in the liver because there are relatively low concentrations of both IgG and albumin in liver bile despite high concentrations in the blood. Studies have also shown that FcRn-mediated transcytosis is involved with the trafficking of the HIV-1 virus across genital tract epithelium.Half-life extension of therapeutic proteins
The identification of FcRn as a central regulator of IgG levels led to the engineering of IgG-FcRn interactions to increase in vivo persistence of IgG. For example, the half-life extended complement C5-specific antibody, Ultomiris, has been approved for the treatment of autoimmunity and a half-life extended antibody cocktail with 'YTE' mutations is used for the prophylaxis of SARS-CoV2. Engineering of albumin-FcRn interactions has also generated albumin variants with increased in vivo half-lives. It has also been shown that conjugation of some drugs to the Fc region of IgG or serum albumin to generate fusion proteins significantly increases their half-life.There are several drugs on the market that have Fc portions fused to the effector proteins in order to increase their half-lives through FcRn-mediated recycling. They include: Amevive, Arcalyst, Enbrel, Nplate, Orencia and Nulojix. Enbrel was the first successful IgG Fc-linked soluble receptor therapeutic and works by binding and neutralizing the pro-inflammatory cytokine, TNF-α.