Wednesday, April 15, 2009

What is a Mediator Release Test (MRT)?

Happy Tax Day!!!

Hopefully by now everyone either has their taxes done or has filed an extension. Besides dealing with taxes, there are many things going on this month of April: wear orange for ASPCA (Association for the prevention of Cruelty to Animals) to mark “prevent cruelty to animals awareness” month, Easter, Passover, etc. April is also “Irritable Bowel Syndrome (IBS) Awareness” month. Because of that, I’d like to talk about the Mediator Release Test (MRT) I often use in my practice to treat people with IBS, as well as many other food sensitivity related conditions.

Before I get into what the MRT is, let me first explain a little about what food sensitivities are, and how the MRT is useful in treating them. Food sensitivities involve the immune system, but are different from true food allergies. There are 4 main pathways used by our immune system to “fight” antigens (the object causing a reaction). Allergies use the type 1 pathway, involve IgE antibodies, and symptoms manifest within minutes. For this reason, a person often does not even need a test to know that they are allergic to something, their body tells them immediately by causing an outbreak of hives, difficulty breathing, and itchy/watery eyes. Food sensitivities typically involve the type 3 and type 4 pathways, which do not use IgE antibodies, but may use other types of antibodies or cell mediated reactions or complement. Symptoms can take from as little as a few hours to as long as 3 days to manifest and include IBS, migraines, joint pain, skin eruptions, and many more. Because of this, food sensitivities have historically been very difficult to evaluate.

The MRT is a patented blood test developed by Dr. Mark Pasula of Signet Diagnostic, Inc. In actuality, it is 150 separate tests that analyze your blood’s response to 27 different chemicals and 123 different foods. It is currently the most accurate test available on the market, with a sensitivity of 94.5%, a specificity of 91.7%, and split sample reproducibility consistently greater than 90%.

Because MRT is an end-point test, it can determine sensitivities whether type 3 or type 4 pathways are used. When a food sensitivity reaction occurs, mediators such as histamine, cytokines, etc. are released from various immune cells. MRT works by measuring the changes in the ratio of liquid to solids after whole blood is exposed to an antigen and mediators are released. The principle behind MRT is that the total volume of the sample will remain the same (V1 + V2 = V3), but when exposed to an antigen, the volume of solids (V1) and the volume of liquids (V2) will change due to mediator release. ( MRT quantifies the level of reaction into 3 categories: green (least reactive), yellow (moderately reactive), and red (reactive), which allows an individualized diet plan to be developed. Based on these results, a 6-phased diet called the "Lifestyle Eating and Performance" (LEAP) immunocalm diet is implemented.

By following the immunocalm diet, the majority of people with food sensitivities can experience at least a 50% reduction in symptoms, while some people experience complete resolution of symptoms. Next week I’ll talk about my personal experience using MRT to resolve eczema in my hands.

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