Antigen LeukocyteCellular Antibody Test (ALCAT) By: Jennifer Smith
Objectives Purpose of the tool History/ Development of the tool Marketing of the tool Patient selection criteria • What to tell our patients in regards to: Mechanism Safety of use Case studies and testimonials Synopsis of the literature Conclusion
Purpose of the ALCAT The ALCAT is used to identify reactions to over 350 foods, chemicals, and other substances associated with inflammation and chronic symptoms such as migraines, joint pain, fatigue, GI disorders, and asthma.1
History/ Development of ALCAT1 The ALCAT was developed by the American Medical Testing Laboratories and is now marketed by Cell Science Systems in Deerfield Beach, FL • Privately held US based biomedical lab • 20 years in business • FDA Inspected and Registered • CLIA Inspected and Licensed • Robocat II an automated liquid handling system designed to measure blood cells using the electronic principle of particle counting and sizing • Awarded 3 Patents • 20 Labs, 20 Countries, 6 Continents
Marketing of ALCAT1 The procedure was first marketed in 1984 as an in-vitro screening testing for adverse reactions to specific foods, additives, colorings, and chemicals. Since 1986 the original testing methods have been modified The goal is to offer high quality laboratory testing to healthcare professionals and their patients, by using a state of the art technique to provide clients with accurate, timely, and dependable test results along with nutritional support services. Cell Science Systems continues to offer an extensive and growing product lines. Testing is available in the U.S. as well as the U.K., Italy, Denmark, Israel, Thailand, South Africa, Spain, Mexico, Greece, Germany, Singapore, Ukraine, UAE, Saudi Arabia, India and South America including Colombia, Venezuela and Argentina.
Patient Selection Criteria1 People that would benefit from this form of testing includes most individuals that are coming to the office for nutritional counseling • Most patients learn about the ALCAT from a functional medical professional People who have found the allopathic route a dead end People with inflammatory and/or undiagnosed varying symptoms with no certain cause such as • RA • Fibromyalgia • Headaches, Migraines, fatigue • Joint pain • Unable to loose weight • IBS/ IBS like symptoms
What to tell our patients: Mechanism1,2 It is a whole blood test that detects food and chemical sensitivities or intolerances Measures delayed reaction over the course of several hours after exposure The test measure changes in size/volume of white blood cells Pathways include Immune, Non-Immune, Pharmacologic, Toxic Measures the final common pathway of all mechanisms Sensitivities/Intolerances are not IgE mediated An indication of cellular inflammatory/ IgG response
What to tell our patients: Safety of use The testing only requires a blood draw which is a minimally invasive procedure1 • Short term side effects can include temporary discomfort from the needle stick, bruising, and very rarely infection • There are no long term repercussions to testing if the blood draw is performed correctly Theoretically, if the testing is not accurate it may have false positive or false negative results which could impact the patient’s outlook and/or patient care.
What to tell our patients: Case studies and testimonials1 Website testimonials“I went to see Dr. Phillip Arnone at The Balanced Body Center …He requestedthat I take a $583 food allergy test as well as begin a course of chiropracticcare. I have to admit I did so with reservations given the expense (which wasuninsured and had to be paid up front), and a lack of knowledge about thelikely success. Well, the test results came back showing that my body showedreactions to wheat, corn, soy, and rice, four staple foods in the American diet! Ialso showed reactions to a host of other foods that I commonly ate, includinggarlic, ginger, mint, cilantro, grapes, and some citrus. I had to basically relearnhow to eat and where to shop to get workable foods….Three months later, every one of the lingering MS symptoms I had was gone.Gone! No more tingling hands and feet. No more labored breathing. I was evenable to successfully train for and complete the Ramblin Rose triathlon….” Kristin from North Carolina Testimonials
What to tell our patients:Case studies and testimonials One case study3 demonstrates the use of ALCAT in a 38yof with severe facial dermatitis, candida infection, and asthma. She had been given the run-around thought the medical community with all testing indicating that no disease was present. ALCAT results showed reaction with dairy, corn, salmon, apricot, onion, and garlic. Removal of these foods from the diet improved all of her symptoms in 4 weeks and total elimination of symptoms at the 12 week follow-up.
Synopsis of the literature For the use of the ALCAT • The effect of the ALCAT test diet therapy for food sensitivity in patient’s with obesity4 • Case study • 27 patients • ALCAT was performed • Results indicated intolerances for each patient • Diet recommendations were made • After 12 weeks following the diet • Significant decreases in body weight, total body fat percent and body mass index was seen • The ALCAT and an elimination diet were successful in alleviating many additional symptoms along with providing weight loss.
Synopsis of the literature Cellular responses to food in irritable bowel syndrome- and investigation of the ALCAT test5 • Double-blind study with respect to food challenges • 20 patients • >3yr hx of IBS • Examined to r/o major pathology • Skin testing was performed on all patients only one showed a positive result • ALCAT performed • 2 week elimination diet followed by 6 one week food challenges (3 positive, 3 negative) with randomly assigned foods followed by another 6weeks of exclusion diet. • Subjects were not aware that the elimination diet only contained negative foods. • Diarys were kept through out the process to record problems or reactions that occurred during the challenges. • After 14 weeks the subjects were assessed • Symptoms overall improved, and in 2/3 of subjects improvement was seen in just 2 weeks. • The study found the accuracy of the ALCAT 72% for a positive result and 81% for a negative result. • The study could have been performed better if washout periods were given between the challenges.
Synopsis of the literature The short term efficacy of the ALCAT2 • Randomized Controlled Study • 100 subjects • Filled out a Disease Symptom Inventory at the beginning and end of 4 weeks. • Control group pursued a weight loss program • Experimental was given the ALCAT results and dietary guidance • Experimental group has significant improvements in body composition and self-reported disease symptoms.
Synopsis of the literature Against the use of the ALCAT • Unproven techniques in allergy diagnosis6 • A review of literature on different allergy diagnostic tools • Stated that consensus statements released by allergy societies throughout the world as well as the Worlds Allergy Organization do not recommend the use of this test. • They also report that the testing is “neither economical nor useful for diagnosis”
Conclusions At this time the research is still inconclusive The Allopathic Medical community still stands on the belief that this testing has not been proven to be accurate Many testimonials, professional case studies, and even some recent blinded studies are having positive results. However, it is still difficult to conclude that the ALCAT evaluation is accurate. The only conclusion that can reasonably be made is that positive sensitivity reactions found by the ALCAT, along with the utilization an elimination diet, has seemed to be effected for weight loss, IBS, and relief of many other associated symptoms. More large scale double blind and RCT need to be done to sufficiently evaluate the test’s true sensitivity and specificity. While the testing is rather expensive and results hold no guarantee. If the individual is at the end of their rope so-to-speak then this may be a viable alternative for an additional piece of information to the diagnostic puzzle.
References 1. ALCAT Worldwide. Retrieved on March 9,2010 from: http://www.alcat.com/ 2. Kaats, G.R., Pullin, D., Parker, L.K. (1996) 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. The Bariatrician. Spring; 18-23. 3. Brady, D.M. Clinical rounds in functional and nutritional medicine. Retrieved on March 9,2010 from: http://www.alcat.com/clinical_info/Case_Studies 4. Akmal, M., Khan, S.A., Khan, A.Q. (2009) The effect of the ALCAT test diet therapy for food sensitivity in patient’s with obesity. Middle East Journal of Family Medicine. 7(3). 5. Fell, P.J., Soulsby, S., Brostoff, J. (1991) Cellular responses to food in irritable bowel syndrome- and investigation of the ALCAT test. Journal of Nutritional Medicine. 2; 143-149. 6. University of Zϋrich, Zϋrich Switzerland. (2005). Unproven techniques in allergy diagnosis. Journal of Investigational Allergology and Clinical Immunology. 15(2); 86-90.