Introduction
The Folate Receptor Autoantibody Test (FRAT®) is a blood test used to detect the presence of autoantibodies against folate receptors in the body. These autoantibodies can block or interfere with the transport of folate (a form of Vitamin B9) into cells, particularly across the blood-brain barrier.
Why is the FRAT® test Important?
The test is typically used to identify Folate Receptor Autoimmunity, which can lead to perturbed folate transport resulting in possible cerebral folate deficiency (CFD) and other neurodevelopmental/neuropsychiatric disorders. This condition has been associated with several neurological and developmental disorders, including:
- Autism Spectrum Disorder (ASD)
- Epilepsy
- Speech and motor delays
- Cognitive dysfunction
- Movement disorders
Folate is crucial for DNA synthesis, brain development, and normal nervous system functioning. If autoantibodies block folate transport into the brain, it can result in low folate levels within the cerebrospinal fluid (CSF), even if blood folate levels appear normal.
How Does the Test Work?
The test measures two types of folate receptor autoantibodies:
- Blocking Antibodies:
- These antibodies interfere with the ability of folate to bind to folate receptors, limiting folate transport into cells.
- Binding Antibodies:
- These antibodies attach to folate receptors, leading to an immune response that can damage or impair receptor function.
Test Procedure
- A blood sample is drawn from the patient. Typically, 1ml of serum is needed to run the test.
- The sample is analyzed to determine the presence and levels of the folate receptor autoantibodies.
- Results typically indicate whether the antibodies are:
- Present/Absent
- Specific titer levels for both blocking and binding antibodies
Turn-Around-Time for FRAT®
- Typically, the results for blocking and binding antibodies are reported within 2 weeks. FRAT® measures two distinct types of autoantibodies – blocking and binding.
Clinical Implications
- If folate receptor autoantibodies are detected, high-dose folinic acid supplementation (a stable form of folate) is often recommended.
- Folinic acid can bypass the blocked receptors and help restore folate levels in the brain.
- Studies have shown that folinic acid treatment may improve symptoms in children with autism spectrum disorder and folate receptor autoimmunity.
Who Should Get Tested?
The FRAT® test is often considered for individuals who exhibit:
- Developmental delays
- Signs of cerebral folate deficiency (e.g., irritability, sleep disturbances, motor dysfunction)
- Neurological symptoms with unclear causes
- Autism spectrum disorder (ASD), especially if standard treatments have limited success.
Next Steps After Testing
If the FRAT® test identifies folate receptor autoantibodies, treatment with folinic acid (e.g., leucovorin) under a healthcare provider’s supervision is often pursued. Monitoring and follow-up are essential to assess improvements in symptoms.
As with any diagnostic, therapeutic, or medical condition, a physician’s guidance and supervision is required. FRAT® requires a prescription from a physician. This ensures that proper medical advice and supervision is provided. Please consult your physician for any further information or questions that you may have about FRAT®.
FRAT® is known as a lab developed test (LDT) and is not approved by the FDA for any diagnostic indications. It is run under the auspices of CLIA (Clinical Laboratory Improvement Amendments), which is administered by CMS (Centers for Medicare & Medicaid Services), a federal governing body that ensures that lab and test practices are in compliance with the highest standards.
