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Dr Vera Stejskal, inventor of MELISA testing, has passed away after a brief period of illness. A pioneer in the field of immunotoxicology, her groundbreaking research into the connection between metal induced inflammation and chronic disease has helped hundreds of patients regain their health. She was born in Prague and fled to Sweden after the 1968 invasion of Czechoslovakia. She started work at the Department of Immunology at the University of Stockholm where she became Associated Professor of Immunology in 1976. She then joined Astra, running its immunotoxicology division where one of her first assignments was to have a final look at a new drug that was being tested: omeprazole. Studies had showed necrotizing vasculitis in the small intestine of some dogs, and the project looked set to be terminated. The group she led was able to prove that the drug had no such side effects and the drug went on to become Losec, the best-selling drug in the world.

As a next project, Dr Stejskal was asked to develop a test for the diagnosis of drug allergy among workers in Astra’s pharmaceutical factories. They had noticed that some workers complained of allergy related symptoms while working in the factories – symptoms that would completely disappear during holidays. Dr Stejskal applied the lymphocyte transformation test, originally developed in the 1960s for evaluating histocompatible class II HLA antigens. She modified it for class II antigen typing and also applied it extensively to detecting type IV allergies to drugs. As of today, Astra is still using this blood test to ensure workers are not exposed to drugs that might be inducing sensitivities.

In 1990 a colleague of Dr Stejskal, dermatologist Dr Margit Forsbeck, asked to try the new test on patients who suspected their symptoms were caused by their dental metal fillings, mainly amalgam. At the time, the only option was patch testing – as a skin test not very reliable for testing metal allergy. Dr Stejskal compared lymphocyte reactions between patients and healthy controls and found to her surprise that patients’ lymphocytes reacted more frequently and strongly to mercury salts than controls’. The results were published in The Journal of Clinical Immunology in 1996 (Mercury-specific lymphocytes: An indication of mercury allergy in man). 

In 1999, Astra and Zeneca group merged to form AstraZeneca. Since there were now three immunotoxicological departments, Dr Stejskal decided to leave the company and pursue the test on her own. Astra was a pharmaceutical rather than a diagnostic company, and had no interest in developing the test further. She patented it under the name MELISA, and acronym for Memory Lymphocyte Immuno Stimulation Assay.

She then devoted her life to the test, and was affiliated with the Karolinska Institute, Stockholm. From 2004 to 2012 she was an associated professor at the Department of Immunology and Microbiology, First Medical faculty at Charles University, Prague, Czech Republic, where she directed research on the pathological role of metals in chronic diseases.

Dr Stejskal and colleagues worked tirelessly to prove the validity of the MELISA, and that its test results were repeatable, reliable and useful. The test promised to open a new field of medicine, investigating the link between chronic disease and an allergy to an everyday metal exposure. The allergies were rare, but for those affected they could be debilitating – yet once their condition was diagnosed, the patient’s health could improve with removal or replacement of allergy causing metals. Dr Stejskal organised conferences to educate and facilitate cooperation between researchers, doctors and dentist, and dentistry especially was a key part of the treatment protocol. Many professional relationships turned into close friendships.

MELISA started to be performed under license by certified laboratories worldwide and university researchers were using the test in their work. In total, Dr Stejskal published more than 100 scientific articles and was frequently a speaker on the subject of immunotoxicity of heavy and transitional metals and the link to the development/aggravation of allergy and autoimmunity. She was also board member of European Academy of Environmental Medicine and scientific member of ESAAM and I-GAP.

Dr Stejskal never planned to retire – for her, her work was her passion in life. She believed rigorous scientific studies would bring a better, healthier world. The MELISA test is her medical legacy, and will now continue without her. She has left us to go on to further discoveries and adventures.