Identify food intolerance & chemical sensitivity
with the Alcat Test
The results from the Alcat Test can help determine which foods and other substances may trigger unhealthy inflammation, and related symptoms. The Alcat Test enables providers to help patients improve chronic health issues through dietary change.
Leukocyte activation test
The Alcat Test is a functional blood test to determine cell-mediated immune reactions directed against
- Additives, sugar replacements, chemicals, pharmaceutical agents
- Medicinal herbs, adaptogens, superfoods
- Biogenic amines
Test options in small, medium or large scale: 500 test substances are available and offered in fexible individual test panels.
The Alcat Test offers a nutrition concept based on laboratory data for the management of patients with inflammation-associated complaints and for health prevention, optimization of health, performance and vitality (sports medicine).
Studies have shown that disorders involving inflammation have improved significantly as a result of dietary changes based on the laboratory results.
The clinical sensitivity, specificity and benefit of the Alcat Test was validated using double-blinded study protocols.
Studies suggest that the Alcat laboratory method can be effectively used for the objective specification of an individual dietary programme and that direct immune cell responses could be a groundbreaking biomarker to determine pro-inflammatory food sensitivity.
patient friendly test results
personal care & attention
Prevention, performance, weight
Health conscious individuals, athletes, pregnant women,… Studies suggest that the Alcat dietary changes protect from unhealthy inflammation and thus, have a positive effect on body, mind and spirit – and helps in weight loss or management.
Chronic inflammation & disease
Nutrition as an important element of your treatment protocol: Wage symptoms and chronic inflammatory diseases that may be associated with silent inflammation, a chronically activated innate immune system, or its dysfunction. (See clinical application)
Elevated inflammation marker
Regardless of clinically manifest diseases, the Alcat Test is useful even for single and/or multiple elevated inflammation levels in order to prevent a potential disease process and promote the balance of the organism. (see inflammation & biomarkers)
The Alcat Test is used for prevention (and performance optimization, reducing internal stress factors) as well as a complementary tool for optimizing therapy for disorders that correlate with a chronically activated or malfunctioning innate immune system. The effects of inflammation may be subtle at first, but their long-term impact can be severe.
Diarrhea/constipation, bloating, irritable bowel syndrome (IBS), gastritis, ulcerative colitis, Crohn’s disease, gastric reflux, malabsorption
Metabolic, cardiovascular, endocrine disorders
Obesity, diabetes, metabolic syndrome, inability to lose weight, weight loss, arteriosclerosis, thyroid diseases, infertility, irregular menstruation
Eczema, psoriasis, rashes, keratosis pilaris, urticaria, acne
Stiff or sore joints, arthritis, tendonitis, non-specific muscle pains
Asthma, chronic cough, wheezing / bronchoconstriction, sinusitis
Immune system and other comorbidities
Weakened viral immunity, allergies, autoimmune diseases, heart problems, tumors
Neurological and psychological disorders
Migraines, headaches, memory problems, Alzheimer’s, chronic fatigue, mood swings, depression (related to the neuroendocrine immune system), ADHD, neuropathy, autism, schizophrenia
Periodontitis, inflammation of gums and/or bleeding
Table: Examples of biomarkers in localized (e.g. intestine) and/or systemic inflammation, innate immune activation, and cellular bioenergetic imbalance
Regardless of clinically-manifested diseases, the Alcat Test may also be useful in controlling and monitoring the diet if single or multiple markers are elevated.
- Localized microinflammation (e.g. intestine), systemic inflammation
- Activation of the innate immune system (e.g. degranulation)
- Cellular bioenergetic imbalance (e.g. mitochondrial dysfunction): Reduced mitochondrial energy efficiency or a lack of stress resistance can also be associated with a weakened immune system.
A targeted diet change may be a meaningsful preventive step or counteract possible effects on health and wellbeing.
Differentiation from allergy
There are different types of reactions to food. The terms “allergy”, “intolerance” or “sensitivity /intolerance” are often used interchangeably or improperly. The following clarification provides an overview of basic definitions and classifications.
The Alcat Test detects cell-mediated food sensitivity or intolerance.
The symptoms of sensitivity, hypersensitivity or intolerance can occur hours or maybe even, in some cases, a few days after consumption.
These are inflammatory processes with a wide range of noticeable effects: Digestive problems, such as diarrhoea, constipation, flatulence, bloating, headaches, migraines, fatigue, skin problems, arthritis, problems with focus and attention, severe mood swings and many more.
The inflammation, caused by the direct cellular defence, is often more subtle and underlying without the cause being identified – in contrast to IgE-mediated classical allergies. Those affected can usually tolerate small amounts of the food in case of sensitivity.
Thus, the Alcat Test can be classified as a food sensitivity test – a test procedure to assess the innate immune cell reaction with regard to the immune tolerance of a specific food.
A classical food allergy (type 1 or immediate type) is an immune reaction mediated by IgE antibodies (immunoglobulin E) and usually occurs IMMEDIATELY and very severely, and is in some cases life-threatening.
Even tiny amounts can trigger the reaction. The immune system attacks a certain protein as if it were a harmful pathogen. Symptoms can vary and include tingling in the mouth, hives, rashes, immediate vomiting, wheezing, oedema – swelling of parts of the body such as the throat, tongue and face. If the allergic reaction is very severe and life-threatening, it is called anaphylaxis.
Once a type 1 allergy has been diagnosed, it is very important to strictly avoid such food, often for a lifetime!
The word “intolerance” is used to describe symptoms caused by an enzyme deficiency. This is not an immune reaction, but a metabolic disorder.
The best known are lactose intolerance and fructose malabsorption.
In fact, it is not an immune response but the result of insufficient production of digestive enzymes necessary to break down certain food components. For example, in lactose intolerance, the enzyme lactase is not produced in sufficient quantities to digest the milk sugar (lactose). Consequently, the milk cannot be “digested”.
The Alcat Test is a leukocyte activation test
The leukocytes of a patient’s whole blood sample are confronted with individual foods/additives in vitro, the target are the immune responses of the non-specific cellular primary defence.
Very different from IgE-mediated allergy!
Granulocytes form the predominant immune cell population in human blood, accounting for 60-85% of circulating leukocytes. A key characteristic of innate cell defence is that it acts against a wide range of exo- and endogenous molecules. The cells can directly identify danger molecules, e.g. proteins, fats, carbohydrates, active and vital substances, additives, toxins, etc., which may not be recognised by antibodies (specific immunity).
An over-activation of the immune system (through foods, chemicals, additives etc.) can lead to chronic inflammation and tissue damage. All leukocyte reaction types are associated with characteristic changes in cell volume / number, which are measured in the Alcat Test by using precise impedance flow cytometry.
The aim of Alcat eating recommendations is to promote the immune balance and to prevent an over-activation of the immune system and associated consequences.
Meet the “GALT”
70-80% of the immune system is in the gut
The Gut-Associated Lymphatic Tissue, GALT is part of the lymphatic system in the intestine. Due to its large surface area, the intestine is of particular importance for the immune system.
Cell reactions and intolerances may be facilitated by increased permeability of the zonula occludens, the paracellular barrier of the intestine that controls the flow of molecules across the epithelium, leading to increased contact between immune cells and food.
Possible causes: Repeated antibiotic treatment, stress, gastrointestinal infections, inflammatory bowel diseases, additives, alcohol consumption, medication, etc. are factors that could contribute to a “leaky gut”.
A central key role of the innate immune system is to make decisions between “dangerous/non-dangerous”.
Granulocytes respond directly against exogenous and endogenous factors that are perceived as dangerous.
“Fire spots” and inflammation cascades are initiated and maintained by the cell defence (silent inflammation) and may influence the metabolism, the nervous, hormonal, vascular and immune systems and consequently also the psyche.
Nutrition influences the interaction of the immune system and microbial flora both positively and negatively. The unburdening (= strengthening /supporting) of the immune system from dietary inflammation triggers may be an important factor for the success of therapies that should not to be underestimated.
Pathomechanismus: Molecular processes associated with granulocyte activation
(A) Trigger recognition via receptors
The immune system may be divided functionally into an unspecific (innate) and a specific (acquired) defence, which consists of both cellular and humoral (soluble) components. Both defence systems are closely linked and work in synergy.
The non-specific defence, already functioning to a large extent at birth and therefore also known as innate immune system, is directed against frequently occurring surface structures of exogenous factors (e.g. pathogens), which are called PAMPs = pathogen associated molecular patterns. In connection with chronic inflammatory diseases, however, the DAMPs = danger/damage associated molecular patterns are the subject of intensive current research. These include internal molecules such as for example cell debris, DNA adducts, or heat shock proteins etc. but also food particles or molecules, UV, stress, and many others.
Both PAMPs and DAMPs activate granulocytes, macrophages or dendritic cells via pattern recognition receptors (PRR) – specific surface receptors – such as TLR, NOD-like receptors and others.
(B) Flattening of the cell
The activation of immune cells (here neutrophilic granulocytes) leads to certain characteristic changes in size, shape and volume.
As a result, the immune cells flatten and the cell nucleus membrane begins to disintegrate. At this stage, cell-to-cell communication is active. If cells of the non-specific immune system recognise PAMPs or DAMPs, they are phagocyted and destroyed. At the same time, messenger agents are released which can attract further immune cells, trigger an inflammatory reaction or activate the specific defence by recruiting lymphocytes.
(C) Volume increase of the cell
Loss of segmentation of the cell nucleus; The granules (with pro-inflammatory mediators)
dissolve and the nuclear plasma mixes with the cytoplasm.
Degranulation or NET-formation (neutrophil extracellular traps); Cellburst (after 2 hours) results in degranulation and the release of reactive oxygen species (ROS), pro-inflammatory cytokines and NET (neutrophil extracellular traps) formation.
Granulocytes can expel so-called extracellular traps (ET), extracellular fibres of granule proteins and chromatin, so that pathogens or internal danger molecules can be bound and eliminated.
The formation of ETs by neutrophil/eosinophil granulocytes or mast cells is an important mechanism of innate immune defence. During ET, the immune cell bursts and releases its toxic contents. A special “trap” is created, consisting of decondensed chromatin fibres containing a mixture of antimicrobial mediators from the granules including released pro-inflammatory DNA and reactive oxygen molecules. NETs can rapidly disarm and immobilize pathogens until they can be removed by macrophages.
For the first time, a team of researchers at Yale University has identified elevated cell-free DNA (cfDNA) supernatants associated with food reactions, which may be indicative of NETs. Further research related to NETs associated with food sensitivity is under current investigation.
How it works
How are morphological cell changes identified
during Alcat testing?
The gold standard for identifying food sensitivity/intolerance is oral provocation. According to this, only an immunological blood test can meet the gold standard, which measures the effect of foods and food related substances on exactly those immune parameters that are responsible for the biological effector function.
A cell activation test that detects leukocytes when confronted with food extracts would meet the requirements and reliably identify potentially harmful substances (measurable cellular changes in neutrophil granulocytes). In this way, the various complex immune mechanisms involved in an intolerance reaction could be determined in their overall effect on the blood cells.
On the page “Science” you will find more information on the measuring technique, quality and precision of impedance flow cytometry.
Fig.: Intracellular & extracellular killing mechanisms of polymorphnuclear (PMN) cells (here: neutrophil). C illustrates NETs (extracellular traps) – an external “killing environment” is created, in which the intracellular antimicrobial mediators, granules and reactive oxygen species (ROS) neutralize the “danger“.
Measurement method (impedance-flowcytometry)
Electrical impedance flow cytometry (blood cell analysis) is used as the traditional standard method for counting cells – also known as the Coulter principle. The principle is used in almost every haematological analyser. It involves passing whole blood between two electrodes through an opening that is so narrow that only one cell can pass through at a time. With the help of hydrodynamic focusing, the cells are sent through the opening cell by cell.
Why is the impedance method used as measuring technique for the Alcat Test?
Cell changes are detected using specialized automated impedance-flow cytometry, a form of “non-invasive realtime cell monitoring.” The measuring principle of the ROBOCat II device is based on the fact that during the passage of a cell through an electric field, the resistance (as a function of the cells) will change in proportion to the cell’s volume (impedance). The system’s processor will capture the change and express it as a pulse where its amplitude is directly proportional to the cell’s volume. The number and size distribution of the cells is displayed graphically. For relative analysis, the degree of deviation of the measurement to the control curve (baseline/negative control) is determined mathematically using computer algorithms. It is then categorized into four response levels: severe, moderate, mild, or negative.
According to the current state of science, it is used to analyse early cellular responses and is considered superior to other available methods for analysing cellular reactions. The analysis of cell reactions with conventional flow cytometers can miss early adverse cell reactions.
We refer to the work of Prof. M. Cooper, a pioneer in labelfree technology for “continuous non-invasive real-time cell monitoring.” More information on measurement technologies for cells: https://en.wikipedia.org/wiki/Hematology_analyzer
Double-blind studies, validation
Alcat Test primary literature (DBOC, analytical sensitivity/specificity, others)
+++ UPDATE: Publications 2021+++
– B. König et al; Studies of mitochondrial and nuclear DNA released from food allergen-activated neutrophils. Implications for non-IgE food allergy; Allergy Asthma Proc.; 2021 May 1;42(3):e59-e70.doi: 10.2500/aap.2021.42.210021; https://pubmed.ncbi.nlm.nih.gov/33980341/
– F. B. Willis et al; Food Allergen Elimination for Obesity Reduction; a Longitudinal, Case-Control Trial; DOI:10.31488/bjg.1000122; https://britishjournalofgastroenterology.com/food-allergen-elimination-for-obesity
Double-blind studies on the Alcat Test
(1) Ali et al; Efficacy of individualised diets in patients with irritable bowel syndrome: a randomised controlled trial; Yale Scholl of Medicine; BMJ Open Gastroenterol. 2017 Sep 20;4(1):e000164. doi: 10.1136/bmjgast-201 (https://bmjopengastro.bmj.com/content/4/1/e000164 )
(2) Garcia-Martinez, I., Weiss, T.R., Yousaf, M.N. et al. A leukocyte activation test identifies food items which induce release of DNA by innate immune peripheral blood leucocytes. Yale School of Medicine; Nutr Metab (Lond) 15, 26 (2018). https://doi.org/10.1186/s12986-018-0260-4
(3) Lukaszuk I.M, Shokrani M, Ghosh Roy P, Hoppensteadt J, and Josephine Umoren; Effects of Antigen Leukocyte Cellular Activation Test-Based Diet on Inflammation, Body Composition, and Medical Symptoms; Northern Illinois University; Alternative and Complementary Therapies VOL. 24, NO. 5; 11 Oct 2018 https://doi.org/10.1089/act.2018.29183.jml
(4) Buck Willis F, Ram Shanmugam, Sarah A Curran. Food Allergen Eliminations for Obesity Reduction: A Comparison Study with Therapeutic Exercise. University of Texas; Food Sci Nutr Res. 2018; 1(1): 1-6.; https://scivisionpub.com/pdfs/food-allergen-eliminations-for-obesity-reduction-a-comparison-study-with-therapeutic-exercise-580.pdf
(5) Michele Di Stefano, Eugenia Vittoria Pesatori, Giulia Francesca Manfredi, Mara De Amici, Giacomo Grandi, Alessandro Gabriele, Davide Iozzi, Giuseppe Di Fede; Non-Celiac Gluten Sensitivity in patients with severe abdominal pain and bloating: The accuracy of ALCAT 5; University of Pavia; Clin Nutr ESPEN; 2018 Dec;28:127-131. DOI: 10.1016/j.clnesp.2018.08.017 https://www.ncbi.nlm.nih.gov/pubmed/30390869/
(6) Pierluigi Pompei, Iolanda Grappasonni, Stefania Scuri, Fabio Petrelli, Enea Traini, Sacha Sorrentino, Giuseppe Di Fede: A Clinical Evidence of a Correlation Between Insulin Resistance and the ALCAT Food Intolerance Test; University of Camerino; Altern Ther Health Med; 2019 Mar;25(2):22-38. https://www.ncbi.nlm.nih.gov/pubmed/30990791
(7) Pietschmann, N. “Food Intolerance: Immune Activation Through Diet-associated Stimuli in Chronic Disease,” Altern Ther Health Med, vol. 21, no. 4, pp. 42-52, 2015 Jul-Aug 2015
(8) “High Correlation of the Alcat Test Results with Double Blind Challenge (DBC) in Food Sensitivity“; Fell, Brostoff & Pasula, Präsentation der Studiendurchführung und Ergebnisse beim 45. Annual Congress of the American College of Allergy and Immunology, Los Angeles vom 12. – 16. November 1988 und anschließend Veröffentlichung in den Annals of Allergy.
(9) “Alcat a new test for food induced problems in medicine?“ Fell et al., Präsentation der Studiendurchführung und Ergebnisse beim Jahrestreffen der American Academy of Otolaryngic Allergy, Washington DC, 1. Oktober 1988
(10) ”Alcat® – a new cellular test for food sensitivity“; Fell, Brostoff & Soulsby, Präsentation der Studiendurchführung und Ergebnisse beim Jahrestreffen der American In-Vitro Allergy & Immunology Society, August 1990, Toronto, Canada
(11) ”Cellular responses to food in irritable bowel syndrome – an investigation of the Alcat Test“; Fell, Soulsby & Brostoff, Publikation der zusammengefassten Studien-Ergebnisse im Journal of Nutritional Medicine, Vol. 2, Nr. 2, 1991
(12) “Diagnostic Value of Alcat Test in intolerance to food additives compared with double blind placebo controlled (DBPC) oral challenges“ L. Hoj, J Allerg Clin Immun 1 (3); 1996
(13) “Reproducibility of the Alcat Test”; Studie von Dr. Paul Potter an der Universität Kapstadt, Johannesburg, Südafrika 1994.
(14) “Reproducibility of the Antigen Leukocyte Cellular Antibody Test (Alcat) – Statistical Analysis, Summary Statistics & Scientific Report“, University of the Range Free State in Bloemfontein, Südafrika, Dr. WML Neetling and Dr. AM Kachelhoffer von Januar – April, 1998.
(15) “Parexel Medstat Final Statistical Report – Study of the Alcat Test in 10 subjects”, Dr. Per Fuglerud, Parexel Norwegen, Nov. 1999
(16) Study Comparing Alcat Test Results With Flow Cytometry and Microscop, Dr. Gitte Jensen, NIS Labs (Natural Immune System) Oregon, USA, 2009
Alcat studies – other
(17) ”Evaluation of Alcat Test Results in the Non-IgE Mediated Pathology of the Skin” DeAmici et al., Studiendurchführung und -bericht der Universität von Pavia, Italien. Presented at the 30th Congress of the European Academy of Allergy and Clinical Immunology, 11 – 15 June 2011 – Istanbul, Turkey. (Poster Presentation, Abstract #553)
(18) ”Alcat Test Results in the Treatment of Gastrointestinal Symptoms” Berardi L. et al., Studiendurchführung und -bericht der Universität von Pavia, Italien. Presented at the 30th Congress of the European Academy of Allergy and Clinical Immunology, 11 – 15 June 2011 – Istanbul, Turkey. (Poster Presentation, Abstract #552)
(19) ”Rational management of food intolerance in an elite soccer club” Angelini et al., Journal of the International Society of Sports Nutrition 2011, 8(Suppl 1):36
(20) ”Alcat Test Identifies Food Intolerance in Patients with Gastrointestinal Symptoms” Berardi et al., Report of the XXVIII Congress of the European Academy of Allergy & Clinical Immunology, European Journal of Allergy and Clinical Immunology, Supplement 90, Volume 64, 2009, pg. 490.
(21) “Food Intolerance in Patients with Cutaneous Diseases: Diagnostic Value of the Alcat Test” Berardi et al., Report of the XXVIII Congress of the European Academy of Allergy and Clinical Immunology, European Journal of Allergy and Clinical Immunology, Supplement 90, Volume 64, 2009, pg. 490.
(22) “The Effect of the Alcat Test Diet Therapy for Food Sensitivity in Patients with Obesity” Akmal et al., Middle East Journal of Family Medicine. April 2009 – Vol. 7, Issue 3.
(23) ” IMS Health Economics and Outcomes Research – Influence of Food Intolerance in Migraines: Final Report of Statistical Results” Immunological Center of Cataluna, Version 3, December 28, 2006.
(24) “A Comparison of the Alcat Test for Food Reactions Amongst 2 Population Sub-Groups” Studienpräsentation von Dr. DH Sandberg und Dr. MJ Pasula, 45th Annual Congress of the American College of Allergy and Immunology, Los Angeles, CA: November 12 – 16, 1998, publiziert in den Annals of Allergy.
(25) “The Short Term Efficacy of the Alcat Test of Food Sensitivities to Facilitate Changes in Body Composition and Self-Reported Disease Symptoms: A Randomized Controlled Study” Kaats et al. in Am J of Bariatric Med, Spring 1996: 18 – 23.
(26) “El test Alcat de sensibilidad a los alimentos y su interés en Medicina Estética Cabo-Soler JR. Alcuni Particolari Della Dieta In Medicina Estetica (Comments On Diets In Esthetic Medicine)”. Abstract of 14th Med Day of Esthetical Medicine & Dermatological Survey. Venice, Italy, Sep. 22 – 23, 1995. Published in the proceedings.
(27) “Outcome Study in 353 Consecutive Patients Following The Alcat Diet”, Studie von Dr. Lene Hoj in Kopenhagen, Allergy Clinic Charlottenlund, Dänemark 1998. Non-Published.
(28) “Prevalence of food allergy and intolerance in children based on MAST CLA and Alcat Tests” Buczylko et al., Rocz Akad Med Bialymst. 1995; 40(3):452 – 456.
(29) “Alcat Test Results in the Treatment of Respiratory and Gastrointestinal Symptoms, Arthritis, Skin and Central Nervous System” Mylek et al., Rocz Akad Med Bialymst. 1995; 40(3): 625 – 629.
(30) “Food Intolerance in Patients with Angioedema and Chronic Urticaria. An investigation by RAST and Alcat Test Studie von Dr. Lene Hoj, präsentiert beim XVI European Congress of Allergy and Clinical Immunology”, Madrid, Spanien: June 25 – 30, 1995 und publiziert im European Journal of Allergy and Clinical Immunology – Supplement, No. 26, Vol. 50, 1995.
(31) “Multiple Pathogenic Mechanisms in Food Sensitivity Reaction In-Vitro”. Pasula MJ, Puccio SG, 4th International Symposium on Immunological and Clinical Problems of Food Allergy, Milan, Italy. November 5 – 9, 1989. Abstract Symposium Book, pg. 37.
(32) “Influence of Food antigens on Volumes of Circulating White Blood Cells and Platelets Aggregation Studienpräsentation beim 4. Symposium on Immunological and Clinical Problems of Food Allergy”, Mailand, Italien, 5. – 9. November 1989
(33) “The Alcat Test – A Guide and Barometer in the Therapy of Environmental and Food Sensitivities”. Dr. BA Solomon, Environmental Medicine, Vol. 9, Number 2, 1992:2 – 6
(34) “Pilot Study into the Effect of Naturally Occurring Pharmacoactive Agents on the Alcat Test”. Fell, PJ. American Otolaryngic Allergy Association Annual Meeting, September 27, 1991, Kansas City, MO. Published in the proceedings.
(35) “Inhibitory Effect of Sodium Cromoglycate on Granulocyte Response to Food Antigens In-Vitro”. Fell PJ, Sandberg DH, Pasula MJ. 47th Annual meeting of the American College of Allergy & Immunology, November 10 – 14, 1990, San Francisco, CA. Publ. in proceedings.
(36) “Gastrointestinal Complaints Related to Diet”, DH Sandberg, International Pediatrics, Vol. 5 No. 1, 1990:23 – 9.
(37) “South African Outcome Study randomisierte Studie an 274 Patienten”, Dr. Jan Geldenhuys, Johannesburg, Südafrika, 1997
(38) “Allergie alimentari. Tecniche diagnostiche a confronto [Food allergy: comparison of diagnostic techniques]”, Mancini S, Fierimonte V, Iacovoni R, Spaini A, Viarani P, Pichi A., Minerva Pediatr. 1995 May;47(5):159-63 [Italian]
(39). “Technical Study Comparing The Alcat Methodology With Activation Of Granulocytes Following Challenge With Zymosan”. Studie von Dr. Cristina Mele der Universität von Rom.
(40) “Autism – a multidisciplinary approach to treatment”, Kotsanis et al. 1994. Diese Studie wurde unter der Leitung von Dr. Constantine A. Kotsanis durchgeführt. Die Ergebnisse wurden auf dem Jahrestreffen der American Academy of Otolaryngic Allergy 1994 präsentiert und stehen auf der Webseite des Kotsianis Instituts zur Verfügung. https://www.kotsanisinstitute.com
(41) “Controversial antigen leucocyte cellular antibody test (Alcat): a non specific inhibitory effect of alpha glycoproteins”, Kedryna & Guminska, Med Sci Monit 1999; 5(2):BR193 – 197.
(42) “Ogni intervento comincia a tavola”, Mele Cristina, Medici Oggi, Maggio 2002: 210 – 213
(43) “Evaluation of the cytotoxic food test and the Alcat (antigen leukocyte cellular antibody test)”. Pol Merkuriusz Lek. 1997 Feb;2(8):154 – 9.
(44) “The Alcat Test: in vitro procedure for determining food sensitivities”, Pasula MJ., Folia Med Cracov. 1993; 34(1 –4):153 –7.
(45) “Pharmacoactive Compounds in Foods – The effect on the Alcat Test in Healthy volunteers and patients suffering from Migraine” Fell PJ, Brostoff J, Pasula M. AAOA News 9:2:29.
Alcat Test primary/secondary literature on Innate Immunity Activation & Diseases
(1) Sollid, L.M. and Jabri, B. “Triggers and drivers of autoimmunity: lessons from coeliac disease,” Nat Rev Immunol, vol. 13, no. 4, pp.294-302, 04 2013.
 Garcia-Martinez, I., Weiss, T.R., Ali, A. and Mehal, W.Z. “The ALCAT Test Predicts the Release of DNA and Myeloperoxidase by Innate Immune Peripheral Blood Leukocytes via a PKC Dependent Pathway,” presented at the he International Congress on Integrative Medicine and Health (ICIMH), Las Vegas, Nevada, USA, 2016.
 Ali, A. et al. “Efficacy of individualised diets in patients with irritable bowel syndrome: a randomised controlled trial.” BMJ Open Gastroenterol, vol. 4, no 1, p. e000164, Sep 2017.
 Kau, A.L., Ahern, P.P., Griffin, N.W., Goodman, A.L. and Gordon, J.I. “Human nutrition, the gut microbiome and the immune system,” Nature, vol. 474, no. 7351, pp. 327-36, Jun 2011.
 Berardi, L., De Amici, M., Vignini, A., Mantegna, G. and Mosca, M. “Alcat Test identifies food intolerance in patients with gastrointestinal symptoms,” presented at the The XXVIII European Academy of Allergy and Clinical Immunology Congress Warsaw, Poland, 2009.
 Pietschmann, N. “Food Intolerance: Immune Activation Through Diet-associated Stimuli in Chronic Disease,” Altern Ther Health Med, vol. 21, no. 4, pp. 42-52, 2015 Jul-Aug 2015.
 Berardi, L., De Amici, M., Vignini, A., Torre, C. and Mosca, M. “Food intolerance in patients with cutaneous diseases: diagnostic value of the alcat test,” Allergy: European Journal of Allergy and Clinical Immunology, vol. 64, p. 490, 2009.
 Buczyłko, K. et al. “Prevalence of food allergy and intolerance in children based on MAST CLA and ALCAT tests,” Rocz Akad Med Bialymst, vol. 40, no. 3, pp. 452-6, 1995.
 Mancini, S., Fierimonte, V., Iacovoni, R., Spaini, A., Viarani, P., and Pichi, A. “[Food allergy: comparison of diagnostic techniques],” inita), Minerva Pediatr, vol. 47, no. 5, pp. 159-63, May 1995.
 Sharma, S. et al. “Association of variants in innate immune genes with asthma and eczema,” Pediatr Allergy Immunol, vol. 23, no. 4, pp. 315-23, Jun 2012.
 Sweeney, C.M., Tobin, A.M. and Kirby, B. “Innate immunity in the pathogenesis of psoriasis,” Arch Dermatol Res, vol. 303, no. 10, pp. 691-705, Dec 2011.
 Mylek, D. “ALCAT Test results in the treatment of respiratory and gastrointestinal symptoms, arthritis, skin and central nervous system,” Rocz Akad Med Bialymst, vol. 40, no. 3, pp. 625-9, 1995.
 Rashtak, S., Snyder, M.R., Pittock, S.J., Wu, T.T., Gandhi, M.J. and Murray, J.A. “Serology of celiac disease in gluten-sensitive ataxia or neuropathy: role of deamidated gliadin antibody,” J Neuroimmunol, vol. 230, no. 1-2, pp. 130-4, Jan 2011.
 Vitte, J., Michel, B.F., Bongrand, P. and Gastaut, J.L. “Oxidative stress level in circulating neutrophils is linked to neurodegenerative diseases,” J Clin Immunol, vol. 24, no. 6, pp. 683-92, Nov 2004.
 Jyonouchi, H. “Food allergy and autism spectrum disorders: is there a link?,” Curr Allergy Asthma Rep, vol. 9, no. 3, pp. 194-201, May 2009.
 Jyonouchi, H., Geng, L., Streck, D.L. and Toruner, G.A. “Children with autism spectrum disorders (ASD) who exhibit chronic gastrointestinal (GI) symptoms and marked fluctuation of behavioral symptoms exhibit distinct innate immune abnormalities and transcriptional profiles of peripheral blood (PB) monocytes,” J Neuroimmunol, vol. 238, no. 1-2, pp. 73-80, Sep 2011.
 Samaroo, D. et al. “Novel immune response to gluten in individuals with schizophrenia,” Schizophr Res, vol. 118, no. 1-3, pp. 248-55, May 2010.
 Dickerson, F., Stallings, C., Origoni, A., Vaughan, C., Khushalani, S. and Yolken, R. “Markers of gluten sensitivity in acute mania: a longitudinal study,” Psychiatry Res, vol. 196, no. 1, pp. 68-71, Mar 2012.
 Pan, A. et al. “Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review.” JAMA, vol. 306, no 11, pp.1241-9, Sep 2011.
(20) P., Samuel, L.J., Miller, E.R. and Szanton, S.L. “Depression and oxidative stress: results from a meta-analysis of observational studies,” Psychosom Med, vol. 76, no. 1, pp. 12-9, Jan 2014.
 Rybka, J. et al. “Interplay between the pro-oxidant and antioxidant systems and proinflammatory cytokine levels, in relation to iron metabolism and the erythron in epression,” Free Radic Biol Med, vol. 63, pp. 187-94, Oct 2013.
 Liu, T. et al. “A Meta-Analysis of Oxidative Stress Markers in Depression,” PLoS One, vol. 10, no. 10, p. e0138904, 2015.
 Bajpai, A., Verma, A.K., Srivastava, M. and Srivastava, R. “Oxidative stress and major depression,” J Clin Diagn Res, vol. 8, no. 12, pp. CC04-7, Dec 2014.
 Galecki, P. “Oxidative Stress inDepression,” in Systems Biology of Free Radicals and Antioxidants, I. Laher, Ed. Germany: Springer-Verlag Berlin Heidelberg, 2014, pp. 2369-2395.
 Holgate, S.T. “Innate and adaptive immune responses in asthma,” Nat Med, vol. 18, no. 5, pp. 673-83, May 2012.
 Finn, P.W. and Bigby, T.D. “Innate immunity and asthma,” Proc Am Thorac Soc, vol. 6, no. 3, pp. 260-5, May 2009.
 Ghani, A., Mehal, W.Z. and Ali, A. “Food reactivity on the Alcat leukocyte activation test is associated with up-regulation of CD11b on T cells,” vol. 20, N. H. Yale School of Medicine, CT, USA, Ed., ed: The Journal of Alternative and Complementary Medicine, 2014, pp. A35-A36.
 Akmal, M., Khan, S.A. and Khan, A.Q. “The Effect of The ALCAT Test Diet Therapy for Food Sensitivity in Patient’s with Obesity,” MIDDLE EAST JOURNAL OF FAMILY MEDICINE, vol. 7, no. 3, 2009.
 Odegaard, J.I. and A. Chawla, A. Connecting type 1 and type 2 diabetes through innate immunity,” Cold Spring Harb Perspect Med, vol. 2, no. 3, p. a007724, Mar 2012.
 Tremellen, K. and Tunc, O. “Macrophage activity in semen is significantly correlated with sperm quality in infertile men,” Int J Androl, vol. 33, no. 6, pp. 823-31, Dec 2010.
 Bastard, J.P. et al. “Recent advances in the relationship between obesity, inflammation, and insulin resistance,” Eur Cytokine Netw, vol. 17, no. 1, pp. 4-12, Mar 2006.
 Miesel, R., Hartung, R., and Kroeger, H. “Priming of NADPH oxidase by tumor necrosis factor alpha in patients with inflammatory and autoimmune rheumatic diseases,” nflammation, vol. 20, no. 4, pp. 427-38, Aug 1996.
 Fitzpatrick, A.L. et al. “Leukocyte telomere length and cardiovascular disease in the cardiovascular health study,” Am J Epidemiol, vol. 165, no. 1, pp. 14-21, Jan 2007.
 Tlaskalová-Hogenová, H. et al. Involvement of innate immunity in the development of inflammatory and autoimmune diseases,” Ann NY Acad Sci, vol. 1051, pp. 787-98, Jun 2005.
 Li, L. et al. “[Changes of neutrophil myeloperoxidase in coronary circulation among patients with acute coronary syndrome],” (in chi), Zhonghua Xin Xue Guan Bing Za Zhi, vol. 33, no. 12, pp. 1106-8, Dec 2005.
 Lin, W.W. and Karin, M.”A cytokine-mediated link between innate immunity, inflammation, and cancer,” J Clin Invest, vol. 117, no. 5, pp. 1175-83, May 2007.
 Poon, B.Y., Ward, C.A., Cooper, C.B., Giles, W.R., Burns, A.R. and Kubes, P. “alpha(4)-integrin mediates neutrophil-induced free radical injury to cardiac myocytes,” J Cell Biol, vol. 152, no. 5, pp. 857-66, Mar 2001.
 Nascimento, G.G., Leite, F.R., Correa, M.B., Horta, B.L., Peres, M.A. and Demarco, F.F. “Relationship between periodontal disease and obesity: the role of life-course events,” Braz Dent J, vol. 25, no. 2, pp. 87-9, 2014.
 Bostanci, N. et al. “Expression and regulation of the NALP3 inflammasome complex in periodontal diseases,” Clin Exp Immunol, vol. 157, no. 3, pp. 415-22, Sep 2009.
 Geering, B., Stoeckle, C., Conus, S. and Simon, H.U. “Living and dying for inflammation: neutrophils, eosinophils, basophils,” Trends Immunol, vol. 34, no. 8, pp. 398-409, Aug 2013.
(41)Jensen, G. “Study Comparing Alcat Test Results With Flow Cytometry and Microscop.” Oregon USA: NIS Labs (Natural Immune System) 2009.
 Mehal, W.Z. “CELLS ON FIRE,” Sci Am, vol. 312, no. 6, pp. 44-9, Jun 2015.
 Hou, W. et al. “Strange attractors: DAMPs and autophagy link tumor cell death and immunity,” Cell Death Dis, vol. 4, p. e966, Dec 2013.
 Ueki, S., Melo, R.C., Ghiran, I., Spencer, L.A., Dvorak, A.M. and Weller, P.F. “Eosinophil extracellular DNA trap cell death mediates lytic release of free secretion-competent eosinophil granules in humans,” Blood, vol. 121, no. 11, pp. 2074-83, Mar 2013.
 Garcia-Martinez, I., et al., A leukocyte activation test identifies food items which induce release of DNA by innate immune peripheral blood leucocytes. Nutr Metab (Lond), 2018. 15: p. 26.
(46) Willis, F.B. et al. Food Allergen Eliminations for Obesity Reduction: A Comparison Study with Therapeutic Exercise, et. al, Editor. 2018: Food Sci Nutr Res.
 Di Stefano, M., et al., Non-Celiac Gluten Sensitivity in patients with severe abdominal pain and bloating: The accuracy of ALCAT 5. ClinNutr ESPEN, 2018. 28: p. 127-131.
 Lukaszuk, J.M., Effects of Antigen Leukocyte Cellular Activation Test-Based Diet on Inflammation, Body Composition, and Medical Symptoms, e. al, Editor. 2018: Alternative and Complementary Therapies.
 Pompei, P., et al., A Clinical Evidence of a Correlation Between Insulin Resistance and the ALCAT Food Intolerance Test. Altern Ther Health Med, 2019. 25(2): p. 22-38.
(50) Sapone, A. et al. “Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity,” BMC Med, vol. 9, p. 23, Mar 2011.
 Schuppan, D., Junker, Y. and Barisani, D. “Celiac disease: from pathogenesis to novel therapies,” Gastroenterology, vol. 137, no. 6, pp. 1912-33, Dec 2009.
 Fasano, A., Sapone, A., Zevallos, V. and Schuppan, D. “Nonceliac gluten sensitivity,” Gastroenterology, vol. 148, no. 6, pp. 1195-204, May 2015
 Boyce, J.A. et al. “Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel,” J Allergy Clin Immunol, vol. 126, no. 6 Suppl, pp. S1- 58, Dec 2010.
 Ellis, A. and Linaker, B. “Non-coeliac gluten sensitivity?” The Lancet, vol. 311, no. 8078 pp. 1358-1359, 1978.
 Di Stefano, M., et al., Non-Celiac Gluten Sensitivity in patients with severe abdominal pain and bloating: The accuracy of ALCAT 5. Clin Nutr ESPEN, 2018. 28: p. 127-131.
Mode of action & basic research on Innate Immunity & Inflammation
(1) Garcia-Martinez, I., Weiss, T.R., Yousaf, M.N. et al. A leukocyte activation test identifies food items which induce release of DNA by innate immune peripheral blood leucocytes. Yale School of Medicine; Nutr Metab (Lond) 15, 26 (2018).
(2) Rosales, C. and Uribe-Querol, E. Phagocytosis: A Fundamental Process in Immunity. Biomed Res Int, 2017. 2017: p. 9042851.
 Geering, B., et al. Living and dying for inflammation: neutrophils, eosinophils, basophils. Trends Immunol, 2013. 34(8): p. 398-409.
 Rosenberg, H.F., J.C. Masterson, and G.T. Furuta. Eosinophils, probiotics, and the microbiome. J Leukoc Biol, 2016. 100(5): p. 881-888.
 Nicholls, S.J. and S.L. Hazen. Myeloperoxidase and cardiovascular disease. Arterioscler Thromb Vasc Biol, 2005. 25(6): p. 1102-11.
 Brinkmann, V., et al.. Neutrophil extracellular traps kill bacteria. Science, 2004. 303(5663): p. 1532-5.
 Wartha, F., et al. Neutrophil extracellular traps: casting the NET over pathogenesis. Curr Opin Microbiol, 2007. 10(1): p. 52-6.
 Lögters, T., et al. The clinical value of neutrophil extracellular traps. Med Microbiol Immunol, 2009. 198(4): p. 211-9.
 Medina, E. Neutrophil extracellular traps: a strategic tactic to defeat pathogens with potential consequences for the host. J Innate Immun, 2009. 1(3): p. 176-80.
 Branzk, N. and V. Papayannopoulos. Molecular mechanisms regulating NETosis in infection and disease. Semin Immunopathol, 2013. 35(4): p. 513-30.
 Hahn, S., et al. Modulation of neutrophil NETosis: interplay between infectious agents and underlying host physiology. Semin Immunopathol, 2013. 35(4): p. 439-53.
 Saffarzadeh, M. and K.T. Preissner. Fighting against the dark side of neutrophil extracellular traps in disease: manoeuvres for host protection. Curr Opin Hematol, 2013. 20(1): p. 3-9.
 Yipp, B.G. and P. Kubes. NETosis: how vital is it? Blood, 2013. 122(16): p. 2784-94.
 Zawrotniak, M. and M. Rapala-Kozik. Neutrophil extracellular traps (NETs) – formation and implications. Acta Biochim Pol, 2013. 60(3): p. 277-84.
 Manda, A., et al. Neutrophil extracellular traps in physiology and pathology. Cent Eur J Immunol, 2014. 39(1): p. 116-21.
 Pinegin, B., N. Vorobjeva, and V. Pinegin. Neutrophil extracellular traps and their role in the development of chronic inflammation and autoimmunity. Autoimmun Rev, 2015. 14(7): p. 633-40.
 Gupta, S. and M.J. Kaplan. The role of neutrophils and NETosis in autoimmune and renal diseases. Nat Rev Nephrol, 2016. 12(7): p.402-13
 Castanheira, F.V.S. and P. Kubes. Neutrophils and NETs in modulating acute and chronic inflammation. Blood, 2019. 133(20): p. 2178-2185.
 Lacy, P. Mechanisms of degranulation in neutrophils. Allergy Asthma Clin Immunol, 2006. 2(3): p. 98-108.
 Jorch, S.K. and P. Kubes. An emerging role for neutrophil extracellular traps in noninfectious disease. Nat Med, 2017. 23(3): p. 279-287.
 Delgado-Rizo, V., et al. Neutrophil Extracellular Traps and Its Implications in Inflammation: An Overview. Front Immunol, 2017. 8: p. 81.
 Masuda, S., et al. NETosis markers: Quest for specific, objective, and quantitative markers. Clin Chim Acta, 2016. 459: p. 89-93.
 Yang, H., et al. New Insights into Neutrophil Extracellular Traps: Mechanisms of Formation and Role in Inflammation. Front Immunol, 2016. 7: p. 302.
 McEwen, B.J. Eosinophils: a review. Vet Res Commun, 1992. 16(1): p. 11-44.
 Muniz, V.S., R. Baptista-Dos-Reis and J.S. Neves. Functional extracellular eosinophil granules: a bomb caught in a trap. Int Arch Allergy Immunol, 2013. 162(4): p. 276-82.
 Ueki, S., et al. Eosinophil extracellular DNA trap cell death mediates lytic release of free secretion-competent eosinophil granules in humans. Blood, 2013. 121(11): p. 2074-83.
 Falcone, F.H., D.I. Pritchard, and B.F. Gibbs. Do basophils play a role in immunity against parasites? Trends Parasitol, 2001. 17(3): p. 126-9.
 Bianchi, M.E. DAMPs, PAMPs and alarmins: all we need to know about danger. J Leukoc Biol, 2007. 81(1): p. 1-5.
 Fink, S.L. and B.T. Cookson. Apoptosis, pyroptosis, and necrosis: mechanistic description of dead and dying eukaryotic cells. Infect Immun, 2005. 73(4): p. 1907-16.
 van Schaarenburg, R.A., et al. C1q Deficiency and Neuropsychiatric Systemic Lupus Erythematosus. Front Immunol, 2016. 7: p. 647.
 Amarante-Mendes, G.P., et al. Pattern Recognition Receptors and the Host Cell Death Molecular Machinery. Front Immunol, 2018. 9: p. 2379.
 Krug, S.M., J.D. Schulzke, and M. Fromm. Tight junction, selective permeability, and related diseases. Semin Cell Dev Biol, 2014. 36: p.166-76
Webinars, publications, lectures, research, news, symptom center, and more
Cell Science Systems offers a wide range of educational materials for both healthcare professionals and patients. Click on the button to open in a new window the education homepage of Cell Science Systems, Corp. (https://cellsciencesystems.com/education/news/).
Is the Alcat Test a food allergy test?
The Alcat Test is NOT a food allergy test. It is designed to test for sensitivities, which have a delayed reaction. Although in common parlance, the terms have been used interchangeably, food allergy and food sensitivity are quite different from one another.
The Alcat Test detects sensitivities and NOT allergies. You should still avoid all items to which you have a known allergy.
Is the Alcat Test a IgG Test?
No. In contrast to IgE, the mediator of classical allergies, primarily type 1, there is currently no evidence that antigen-specific IgG is also an indicator of hypersensitivity of the body to food.
Evidence from multiple studies suggest that elevated IgG levels, especially IgG4, are physiologically natural and an indicator of contact with a substance. However, previous exposure to a food should not be confused with an active inflammatory defence process.
In the context of the corona virus, for example, antibody tests are used to evaluate whether a person has been exposed to the virus and has developed protection.
Is the Alcat Test ea cytotoxic test?
- The Alcat Test is a leukocyte activation test, which identifies cell responses of mainly innate immune cells while stimulated with individual foods or chemical substances.
- Alcat Test is not a “cytotoxic food test”. The innate immune system can mediate toxic reactions. However, the pro-inflammatory granulocyte response (first line defence) are broader in scope and can also activate immunological or metabolic immune pathways.
Is the Alcat Test validated?
The gold standard for identifying food sensitivity is oral provocation. Accordingly, only an
immunological blood test can approach the gold standard, which measures the effect of food substances on precisely those immune parameters that are responsible for the biological effector function. The validation of an in vitro test, such as is the Alcat Test, is divided into an a) analytical and b) clinical validation.
Some of the Alcat Test studies are equivalent to a clinical validation for the diagnosis of sensitivity to foods, additives, and other substances. The analytical validation results both from clinical studies and, in particular, from the authorisations, certificates and patents.
About 45 studies or observational applications are currently available for the Alcat Test, including double-blind studies from independent institutions such as Yale University, Baylor Medical College, Northern Illinois University, Pavia University, University of Camerino and others.
Why use the impedance method?
The measurement technique for the Alcat Test is a specific combination of flow cytometry and impedance methodology. According to the current state of science, it is used to analyze early cellular responses, and is superior to all other available methods for the analysis of cellular responses. Analysis of cellular responses by conventional flow cytometers can miss early adverse cellular responses. We refer to the work of Prof. M. Cooper, a pioneer in labelfree technology for “continuous non-invasive real-time cell monitoring.” (Label-Free Technologies for Drug Discovery, Wiley-Blackwell; Label-free Biosensors: Techniques and Applications. Cambridge University Press).
Allergy test positive /Alcat Test negative – how?
Yes, this is possible! It can be regarded as a sign for the high clinical specificity of the Alcat Test.
A classical allergy is usually mediated by the specific immune system via the formation of IgE antibodies. The Alcat Test, on the other hand, reflects the reaction of the innate immune system.
Thus, very different immune paths are activated and therefore, a patient with a confirmed classical allergy to a certain food must avoid this substance even though he/she may have tested negative in the Alcat Test.