Oxidative Stress

In all living organisms and, in particular, in humans, there is a delicate balance between the production and elimination of so-called free radicals by our antioxidant defence systems.
In physiological conditions, living beings have endogenous defence systems that protect structural and functional biomolecules from attack by free radicals. These defence systems react with reactive species before they can attack the biological structures, lessening their potential damaging action.
If this "antioxidant barrier" is absent, the free radicals will quickly react with the biomolecules that are essential for life, such as DNA, lipids and proteins, causing severe cell damage and even death of the cells themselves.
The alteration of this balance, indicated as oxidative stress, causes cellular lesions which, if severe and continued over time, lead to an acceleration in the ageing process and the onset of a large number of diseases.

How does oxidative stress clinically appear?

Since it is essentially a biochemical condition, oxidative stress does not have any subjective or objectives symptoms.
It therefore remains undiscovered, with inevitable damage to the patient, until the doctor suspects its presence and decides to have the patient undergo specific tests, such as the d-ROMs test and the PAT test.

What is the FRAS4 Evolvo?

FRAS 4 Evolvo is a new integrated analytical system consisting of a photometer with a built-in centrifuge designed to perform a global assessment oxidative stress with the d-ROMs test and the PAT test, on a small sample of finger prick capillary blood, as well as the SAT test for determining the antioxidant power of the saliva.
The initials FRAS stand for Free Radical Analytical System.

What is the d-ROMs test?

The d-ROMs test is a photometric test that is done in analytical laboratories using an analytical instrument called a photometer. For outpatient and routine testing, it is proposed in conjunction with the FRAS system, which, besides having an optical reader, also has a built-in centrifuge to separate the liquid part of the blood from the blood cells.

On which kind of biological sample can the d-ROMs test be performed?

The d-ROMs test can be performed on samples of whole blood (generally finger prick capillary blood, but also from venous blood), serum, heparinized plasma and on certain extracellular fluids.

What is the evidence in favour of the proposed reaction mechanism for the d-ROMs test? In other words, what technique was used to validate the test?

Evidence that the d-ROMs test is a reliable method that can effectively determine the amount of hydroperoxides circulating in the blood was provided by the CNR (Italian National Research Council).
Alberti and collaborators (CNR Bologna) demonstrated that the results obtained by ESR (Electron Spin Resonance), considered the gold standard for the in vitro study of free radicals, can exactly superimpose the resulte obtained with the d-ROMs test.
Hundreds of researchers have subsequently verified the validity of the d-ROMs test.

Do different d-ROMs test values correspond to different levels of oxidative stress?

Yes, they follow a precise scale of values:

  • d-ROMs test
    REFERENCES values
  • 250-300Optimal value
  • 300-320Border line condition
  • 321-340Low level of oxidative stress
  • 341-400Medium level of oxidative stress
  • 401-500High level of oxidative stress
  • >500Very high level of oxidative stress
  • Unit of measure: U. Carr
    1 U. Carr=0.08 mg HO/dl

Can the d-ROMs test be considered a "predictive" test of disease?

Yes. It can predict cardiovascular diseases, for example.
A recent study conducted by the National Research Committee in Pisa unequivocally demonstrated that patients with high values from the d-ROMs test, monitored for 2 consecutive years, had a higher rate of cardiovascular morbidity and mortality with respect to those whose test values were normal.
The d-ROMs test is also an important predictive indicator in the treatment of hepatitis C virus.
The d-ROMs test has also been proven to be very useful in the monitoring dysmetabolic diseases (dyslipidemia, obesity, diabetes, menopause, dysthyroidism), ageing, lung diseases, dialysis, inflammatory diseases, infectious diseases, periodontitis, in oncology, sports medicine, occupational medicine, andrology, etc.

What is the PAT test?

The PAT, (Plasma Antioxidant Test) is a photometric test, that is done using an analytical instrument called a photometer to determine the antioxidant power of plasma. For outpatient and routine testing, it is proposed in conjunction with the FRAS system, which, besides having an optical reader, also has a built-in centrifuge to separate the liquid part of the blood from the blood cells.
The PAT is based on the "in vitro" application of a phenomeno that may be observed in nature, i.e. the formation of rust. The same mechanism occurs in living beings which, unlike metal, are able to defend themselves against the aggression of reactive oxygen species using their own antioxidant system. These substances are nothing other than the antioxidants (eand in particular water soluble antioxidants) in the biological sample being tested.

What does the PAT test measure?

The PAT test essentially determines the concentration of the water-soluble antioxidants in the blood that are able to reduce ferric ions to ferrous ions.
The PAT is an innovative test based on the reaction used in the FRAP and BAP tests, but has been specifically improved with regard to:

  1. the processing time: 1 minute
  2. precision: the interference from the phosphates in blood has been eliminated so that the true amount of antioxidants can be determined
  3. cost: lower

The test is extremely sensitive to changes. The PAT test has not been not designed to provide information on the concentration of an individual antioxidant as this would be of very little clinical value, but instead to determine the total antioxidant reserve.
The PAT test is patented.

Do different PAT test values correspond to how compromised the plasma antioxidant barrier is?

Yes, they follow a precise scale of values.

What is the SAT test?

Exposure to physical agents (hot, cold, dry-mouth, ...), chemical agents (acidity, cigarette smoke, spirits, ...) and biological agents (bacterial pathogens) and/or a reduced amount of salivary and/or tissue antioxidants can alter the oxidation-reduction balance and lead to OXIDATIVE STRESS in the oral cavity's ecosystem.
The SAT test (Saliva Antioxidant Test) is the new reliable, repeatable and precise test that determines the oxidative stress of saliva, to evaluate the health of the oral cavity in just one minute.
The SAT test can:

  1. precisely identify the antioxidant power of the saliva
  2. discover who needs antioxidants
  3. modulate the correct dosage of antioxidants
  4. check the result and thus the effectiveness of the antioxidants
  5. decide on the duration of the treatment

The test is patented.

What does the SAT test measure?

Antioxidants (AOs) are the first line of defence against potentially damaging attacks by exogenous agents such as reactive species (RS) and especially reactive oxygen species (ROS).
When antioxidant capacity is poor the oral cavity is not sufficiently protected from the aggression of cariogenic bacteria. On the other hand, when the antioxidant reserve is abundant this indicates that there is an ongoing reactive or inflammatory process.
The initial stages of the onset of disease are often asymptomatic. The symptoms, however, can be easily detected through the correlation with plasma antioxidants which are derived from the vascular permeability that results from an inflammation (gingivitis, cavities, periodontitis, etc.).
Simply, quick testing (1 minute) and low cost are the key features of the SAT test, which is designed for the prevention and control of diseases in the oral cavity, or to monitor the effectiveness of outpatient and/or therapeutic treatment.

Do different SAT test values correspond to how compromised the plasma antioxidant barrier is?

Yes, they follow a precise scale of values.

  • SAT test
  • <1000Deficient
  • 1000 1500Optimal values
  • 1500 2000Normal values
  • 2000 2500Border line low values
  • > 2500Possible ongoing inflammatory processes
  • Unit of measure: milliequivalents/L of vitamin C