In vitro diagnostic tests
for allergic disease

MRT Laboratories, Inc. provides a broad range of in vitro diagnostic tests performed on human serum to confirm the diagnosis of allergic disease

  • Allergen specific IgE testing
  • Allergen specific IgG4* testing
  • Total IgE testing
  • Regional allergen panels
  • Inventory of more than 1000 allergens
  • Quantitative test results
  • Testing that provides low-end sensitivity, specificity, and reproducibility
  • Specimens retained for 3-4 months to allow for any additional testing that may be required

*This test is not available for specimens collected in New York

Alternatives to skin testing

Skin testing methodologies, in vivo allergy testing, include the following types:

  • Skin Prick Test
  • Intradermal (Subcutaneous) Test
  • Challenge (Provocation) – limited to certain allergens

In vivo allergy testing measures the processes and reactions of allergic responses “within the body.” Skin Prick Testing suffers from variability, a (rare) risk of anaphylaxis, the need to stop allergy medications before testing, difficulty to read in certain skins and typically, a level of patient discomfort.

In vitro allergy testing, or testing for allergy sensitization through a blood sample from the patient and measuring specific sensitizations in an artificial environment (the test tube), allowing a testing alternative for patients, providing quantifiable results for the patients’ care team to evaluate.

Advantages of in vitro Allergy Testing

In vitro testing offers greater patient comfort during the diagnostic process; patients on anti-histamines do not have to discontinue their medication and quantitative results facilitate transition into immunotherapy at ideal levels, saving time and reducing potential for adverse reactions to immunotherapy

Other advantages include:

  • One blood draw
  • Not dependent on skin conditions
  • Potentially fewer office visits to make a diagnosis
    • Lowering costs
  • Not dependent on technique used by person performing the skin test
  • Enables managed care organizations to standardize diagnostic process
  • Additional benefits
    • Lowers immunotherapy costs
    • Reduces emergency room visits
    • Helps patients to avoid allergenic triggers of acute asthmatic episodes
    • Reduces office visits
In Vitro Allergy Testing Details

In vitro testing for specific IgE’s can be used with greater confidence than skin prick testing in the exclusion of the presence of IgE mediated allergy. The skin test may provoke reactions in many patients on a non-specific basis by triggering mast cell release of mediators without a specific IgE reaction. This will lead to false positive results and might commit the clinician to initiate a potentially unneeded course of immunotherapy.

A positive result is reported in a quantified manner, the result allows the clinician to select an initial concentration of antigens for immunotherapy which is least likely to provoke an adverse reaction in a patient and most likely to be at a level that will result in an alteration of the patient’s immunological response and alleviation of symptoms.

Adverse reactions to foods may be mediated by the IgE mechanism. Immunoassay can identify foods that are causing such reactions.

These tests can be performed on sera of patients who are concurrently taking antihistamines or steroids. Testing of children or patients with eczema or other skin disorders is facilitated by in vitro testing of the patients’ serum rather than in vivo skin testing.

The possibility of severe allergic reactions occurring during in vivo skin testing with allergen extracts is avoided by simply drawing a serum sample by venipuncture.

Custom Panels

MRT Laboratories, Inc. inventories more than 1000 allergens.

Providing physicians with the flexibility to create patient centric custom allergy panels. The results are received in a timely fashion with the assurance of best in class reliability and quality of results.

 View our full list of allergens


REGION 1

States included:
Connecticut Delaware Maine New Maryland
Massachusetts New Hampshire New Jersey New York
Pennsylvania Rhode Island Vermont
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Bermuda Grass Birch, White Cat Hair
English Plantain Hormodendrum (Cladosporium) June(Kentucky Bluegrass) Mite, D-Farinae
Mite, D-Pteronyssinus Oak, White Ragweed, Short



REGION 2

States included:
Alabama

Georgia

Kentucky

Louisiana

Mississippi

N. Carolina

N. Florida

S. Carolina

Tennessee

Virginia

W. Virginia

Arkansas

 
Mini-Screen includes:
Total IgE, plus: 13 allergens
Alternaria

Bermuda Grass

Birch, White

Cat Hair

English Plantain

Hormodendrum (Cladosporium)

June (Kentucky Bluegrass)

Marsh Elder

Mite, D Farinae

Mite, D Pteronyssinus

Oak, White

Pecan Pollen

Ragweed, Short


 REGION 3

States included:
Illinois Indiana Iowa Michigan
Minnesota Missouri Ohio Wisconsin
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Cat Hair Elm, American Hormodendrum (Cladosporium)
June (Kentucky Bluegrass) Oak, White Marsh Elder Mite, D Farinae
Mite, D Pteronyssinus Ragweed, Short Timothy Grass



REGION 4

States included:
Nebraska North
Dakota
South Dakota
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Cat Hair Elm, American Hormodendrum (Cladosporium)
June (Kentucky Bluegrass) Oak, White Marsh Elder Mite, D Farinae
Mite, D Pteronyssinus Ragweed, Short Timothy Grass


 
REGION 5

States included:
Kansas Oklahoma Texas
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Bermuda Grass Cat Hair Elm, American
False Ragweed Hormodendrum (Cladosporium) Johnson Grass Oak, White
Mite, D Farinae Mite, D Pteronyssinus Ragweed, Short


 REGION 6

States included:
Arizona Colorado New Mexico Utah
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Bermuda Grass Cat Hair Elm, American
False Ragweed Hormodendrum (Cladosporium) Kochia Oak, White
Mite, D Farinae Mite, D Pteronyssinus Rye Grass


 REGION 7

States included:
Idaho Montana Wyoming
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Cat Hair Elm, American Hormodendrum (Cladosporium)
June (Kentucky Bluegrass) Kochia Oak, White Mite, D Farinae
Mite, D Pteronyssinus Rye Grass Western Ragweed


 REGION 8

States included:
Alaska Oregon Washington
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Bermuda Grass Birch, White Cat Hair
False Ragweed Hormodendrum (Cladosporium) June (Kentucky Bluegrass) Kochia
Maple, Box Elder Mite, D Farinae Mite, D Pteronyssinus


 REGION 9

States included:
California Nevada
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Bermuda Grass Cat Hair Elm, American
English Plantain Hormodendrum (Cladosporium) June (Kentucky Bluegrass) Kochia
Oak, White Mite, D Farinae Mite, D Pteronyssinus


 REGION 10

States included:
Southern Florida
 
Mini-Screen includes:
Total IgE, plus: 11 allergens
Alternaria Australian Pine Bahia Grass Bermuda Grass
Cat Hair Hormodendrum (Cladosporium) Oak, Live Marsh Elder
Mite, D Farinae Mite, D Pteronyssinus Ragweed, Short
adverse reactions to foods – allergen specific IGG4

Update on the Value of Allergen Specific IgG4 Testing in Patients with Adverse Reactions to Foods

Reactions can vary from mild food intolerance to a severe anaphylactic response often of the type found in patients with elevated levels of allergen specific IgE antibody.

General information about IgG4 use:

Many studies have been carried out to establish the clinical role and usefulness of IgG4 testing. It is well known that the IgG4 measurement has been a useful indicator for the effect of hyposensitization therapy. IgG4 seems to play the role of blocking antibody in allergen immunotherapy. In contrast, in food induced allergy reactions IgG4 may have a provocative role. High levels of IgG4 antibodies to foods have been observed in atopic eczema patients as well as in patients with asthma, celiac disease, chronic rhinitis, irritable bowel syndrome.

Since IgG4 antibodies may be associated with delayed reaction to foods, it has been suggested that IgG4 testing may assist in confirming food sensitivity in IgE negative patients.

MRT Laboratories Inc. has identified that the rate of positive results is highest for dairy foods, eggs and high fiber foods, such as legumes, grains, banana, and pineapple. The allergen specific IgG4 assay may be ordered for individual allergens as well as suggested and/or custom panels.

Specimen requirement: 1 ml serum is sufficient for 90 tests.

Suggested Food Panel (20)
Almond Milk
Banana Oat
Beef Orange
Bean, kidney Peanut
Bean, kidney Pork
Casein Potato
Cheese, cheddar Soybean
Corn Tomato
Egg, whole Walnut
Gluten Wheat

Depending on exposure, fish and shellfish may be added to the suggested panel. Custom Panel requests are dependent on the individual patient’s diet.

The interpretation of a positive test result by the practitioner should always be correlated with the history, physical and clinical symptoms of the patient.

Case Study

A 62 year old woman with swelling of the lips and tongue after ingestion of banana. This patient’s reaction was so severe that the treating physician initially ordered testing for IgE antibody to banana, expecting to confirm that her reaction must be due to an elevated measurement of IgE similar to scores seen in his peanut sensitive patients. To his amazement, the patient had no detectable levels of IgE reactivity to banana!

MRT Laboratories, Inc. then performed an allergen specific IgG4 assay for banana. The result was surprising. She had extremely high levels of banana IgG4. The result was well above the 10 ug/ml that has been reported by others with adverse reactions to milk and other food intolerances. Our lab has observed similar antibody responses in food sensitive patients; i.e. low allergen specific IgE and high allergen specific IgG4.

Laboratory data suggests that levels above 10 ug/ml represent an extraordinary immune response to the specific food antigen.

** This test is not available for specimens collected in New York **