Many of the patients who come to the Center have three symptoms in common: headache, fatigue, and joint/muscle pain. If one or more of these symptoms are found during the history and physical examination, allergy or sensitivity to food is suspected. Other symptoms or complaints may include gas, bloating, diarrhea, irritable bowel syndrome, etc. As part of the biochemical examination, the cytotoxic food sensitivity test is ordered.

In 1956, Black¹ introduced the cytotoxic food test. It was later refined and modified by Bryant and Bryant in 1960² Although the original Bryant test measured the reactivity of WBCs to food allergens, in 1971 they modified the test to also include the reactions of RBCs and platelets.³ In the test, the response between sensitized cells and specific food allergens is thought to be a combination of a type IV cell mediated, delayed-type immune reaction with involvement of a type I immediate hypersensitivity response.⁴ If a food "allergy", symptoms appear very quickly, if a food "sensitivity", symptoms appear later. It is postulated that food allergens remain in the G.I. tract and cause a set of symptoms from there, or that they leave the gut, enter the circulation, and eventually arrive at the target cell where they may combine with specific antibody receptors of RBCs, WBCs and platelets.⁵

The cytotoxic test has been performed at the BioCenter Laboratory almost 19 years. One of the authors (SN) was originally trained on the technique in the Bryant laboratory and has 24 years experience with the procedure. She performs most all the cytotoxic tests at the Center. The test used

at the Center has been described previously.⁵ Basically, 10 mL of venous blood is drawn (fasting) into a tube containing 1.0 mL of acid citrate dextroxse anticoagulant and gently mixed. The blood is transferred to a plastic tube and centrifuged at 1500 RPMs for 20 minutes. One drop of the buffy coat and RBC suspension is placed on prepared slides containing purified antigen in a petroleum jelly ring. The basic panel contains 20 antigens; the standard panel contains 90 antigens; and the supplemental panel contains 90 additional antigens. One ring contains no antigen and is used as the control. The rings are covered with a glass cover slip, incubated for 2 hours and then read under a light microscope at 400 power. Ten fields are viewed and representative Polaroid™ photomicrographs taken. The results are reported as negative (same as the control), Plus 1, plus 2, plus 3 and plus 4.⁶

Patients with positive results are counseled by a physician to eliminate these foods from their diet for a period of time. Patients are also cautioned that symptoms may become worse during the first 3 to 4 days of food elimination. One interesting finding from patients who follow the advice to restrict sensitive foods is that the majority report they lose weight.

Table 1 shows cytotoxic data from patients randomly selected from our files who had the standard panel of 90 antigens performed. The cytotoxic test was ordered by the physicians after the history and physical examination indicated the possibility of foods allergies. Although 100 patient charts were pulled, only 90 had the complete standard panel and could be used. The top 15 reactive antigens are shown.