d-ROMs Test

-The d-ROMs Test is the only test currently available for the overall assessment of the pro-oxidant component of oxidative stress-

The d-ROMs Test is a photometric test that allows to determine in a biological sample the concentration of Reactive Oxygen Metabolites and in particular of hydroperoxides (ROOH). The hydroperoxides are generated in the cells from the oxidative action of reactive oxygen species (ROS) on several biochemical substrata (lipids, amino acids, peptides, proteins, nucleotides, etc.). The concentration of ROMs is expressed in Unit CARR from the surname of the author (Carratelli) who invented, patented and developed the d-ROMs Test.


Hydroperoxides contained in a biological sample are put under the conditions provided by the Fenton reaction to generate in vitro hydroperoxyl radicals and alkoxy radicals. Basically an aliquot of serum is diluted in a buffer solution with acid pH and under these conditions, the ionic iron previously linked to serum protein becomes free, catalyzing, in vitro, the resolution of hydroperoxides, which are initially present in the blood sample, in hydroperoxyl radicals and alkoxy radicals.
Then, in this solution is added a substance (Cromogen) that has the ability to change colour when oxidised; intensity of color of the complex will be directly correlated with the level of hydroperoxides initially present in the analyzed sample.

Reference Values

The availability of a precise and reliable methodology allowed to establish the reference levels of the d-ROMs in the normal population. It was possible to demonstrate, on a sample of about 5,000 clinically healthy subjects that test values in the population fall under a Gaussian distribution peaking between 250 and 300 U CARR, that is considered the reference value of the test. Obviously, values above this range, after a borderline range (301-320 U CARR) indicate a progressively increasing level of oxidative stress.

d-ROMs (U.Carr) Oxidative stress
250 - 300 Normal range
300 - 320 Border-line condition
321 - 340 Low level of oxidative stress
341 - 400 Medium level of oxidative stress
401 - 500 High level of oxidative stress
> 500 Very high level of oxidative stress

Relevant uses

There is no field of medicine in which the d-ROMs Test has not demonstrated its usefulness in the human field, from neuropsychiatry to cardio-angiology, from bronchopneumology to gastroenterology, from liver medicine to nephrology, from metabolic diseases to endocrinology, from dietetics to sports medicine, aesthetic medicine and so on (for all scientific references updated request the Reference Book).

Some interest areas and applications of d-ROMs Test
Area Examples
Neuropsychiatry Alzheimer disease, Amyotrophic lateral sclerosis
Ophthalmology Senile maculopathy
Otorinolaringoiatry Ménière’s disease
Cardio-angiology Carotid stenosis, ischemic heart disease, Hypertension, Peripheral vascular disease, Venous insufficiency
Gastroenterology Gastrointestinal diseases (Crohn’s disease)
Hepatology Alcoholic liver disease
Nephrology Emodialysis
Hematology Myelodysplastic syndromes
Diabetology Diabetes
Andrology Male infertility
Obstetrics Pregnancy
Neonatology Phototherapy
Genetic disorders Down syndrome
Rheumatology Rheumatoid arthritis
Virology HIV
Oncology Lymphoma, leukemia, radiotherapy e chemiotherapy

Increasing evidences in the last 15 years have documented the usefulness of Panel Carratelli in Animal studies and Veterinary Medicine where up to now about 230 academic papers have documented the scientific value of this highly innovative diagnostic approach in either the basic research or clinical practice, with the involvement of about 500 different researchers worldwide.
According to the available scientific literature, Panel Carratelli proven particularly suitable to evaluate oxidative stress in order to understand the behaviour of Animals and their relationships with environment as well as the basis of Human diseases like metabolic disorders, cancer and so on, by using animal models.
In particular, this panel has been used in order to assess meat quality, health status, hormone-therapy effects and antioxidant efficacy of supplementations in several animal species, like chickens, guinea pigs, rabbits, pigs, cows/calves, and horses. Interestingly, dairy cows, in which an increased free radicals production may be really critical in the periparturient period even in physiological conditions, d-ROMs Test was shown an important tool in evaluating oxidative status.

Strong points

  • d-ROMs Test is the only test currently available for the overall assessment of the pro-oxidant component of oxidative stress
  • d-ROMs Test is a highly accurate and reliable test, which has successfully passed the outcome of sophisticated control procedures, the assessment and the validation of international research organizations (University, National Research Council), and it si proven by numerous reviewed scientific publications in international scientific literature
  • To perform d-ROMs Test is required a simple instrument (a photometer thermostated and a centrifuge) commonly available from any laboratory analysis. Moreover, it can also be performed with a dedicated instrument (FREE Carpe Diem and FREE DUO)
  • d-ROMs Test has all the advantages of a mono test
  • d-ROMs Test, performed with the dedicated instrument, requires minimal manual skill, with considerable reduction of error
  • d-ROMs Test is not significantly influenced by the presence of other substances normally present in the blood that have antioxidant activity
  • d-ROMs Test is a test suitable for use in the prevention and monitoring of conditions related to oxidative stress

Experimental confirmation

The experimental confirmation of the above reactions was obtained by integrating some electrochemical data with results obtained in parallel by spectrophotometry and spectroscopy of electron spin resonance (ESR), the “golden standard” for detecting the presence of radicals and their identification in a sample.

Working Conditions

d-ROMs test can be carried out either heparinized plasma or serum. Serum and heparinized plasma can be used fresh or frozen at -20°C. It can be carried both on dedicated systems (FREE CarpeDiem and FREE DUO) and on standard photometer or automatic analyzers. Working conditions experimentally determined and standardized for the d-ROMs Test are as follows: wavelength 505nm or 546nm, 1 cm optical path, and 37° C temperature.

Clinical studies

The d-ROMs Test has proved valuable in identifying people at risk of oxidative stress related to lifestyle, such as cigarette smoking, alcohol intake, inadequate physical activity and being overweight.
For example heavy smokers, in most cases, have d-ROMs levels significantly higher than those found in non-smokers. Similarly, alcoholics have the d-ROMs values significantly higher than those detected in non-drinkers and for this reason some authors have proposed the d-ROMs Test as a possible marker for alcohol abuse. Physical activity incongruous and obesity is a major risk factor for oxidative stress. In addition to identifying individuals at risk for oxidative stress in relation to lifestyle, the d-ROMs Test has proved extremely beneficial in identifying and quantifying the redox imbalances associated with pathological situations. It is able to document, in particular, that specific therapies implemented to counteract certain morbid conditions associated to oxidative stress may sometimes exhibit itself effects "anti-radicals", which can be synergistically enhanced through a careful antioxidant integration.Today, thanks to the d-ROMs Test, it is possible evaluate the efficacy of antioxidant therapy, based on the capacity of treatment to reduce the levels of hydroperoxides in serum, markers and amplifiers of cellular damage from free radicals. For this peculiarity, confirmed by numerous clinical and experimental studies, the d-ROMs Test is clearly different from other tests currently available for the laboratory evaluation of oxidative stress. In fact, it is the only test able to dose all the hydroperoxides present in a biological sample.

d-ROMs Test in clinical practice

The purposes of the d-ROMs Test are many and they change depending on the type of patients.

Patients and purposes of d-ROMs Test
Patients Example Purposes
Normal subjects, clinically asymptomatic, with no risk factor for OS Any person Identify and prevent the OS and its consequences (aging, diseases)
Normal subjects, clinically asymptomatic, with one or more risk factors for OS Subjects exposed to radiation sources and/or to environmental pollution; subjects overweight or obese, alcoholics, smokers; subjects who perform incongruous physical activity; subjects following an unbalanced diet Identify and prevent the OS and its consequences
Subjects with diseases related with the OS Subjects with: Alzheimer’s disease, Parkinson's disease, stroke, heart attack, hypertension, peripheral vascular disease, chronic obstructive pulmonary disease, celiac disease, Crohn's disease, pancreatitis, hepatitis, HIV, rheumatoid arthritis, chronic kidney disease, diabetes, lipid disorders, Down syndrome, some type of cancers Monitor the OS and prevent its consequences. Monitor the effectiveness of specific therapy on the disease. Monitor the effectiveness of specific therapy and the potential additional antioxidant treatment on SO associated with the present disease
Subjects undergoing special treatments at the risk of OS Patients undergoing drug therapies (anticancer, progestogens,) or doing hemodialysis or transplant organs or in revascularization intervention Identify and prevent the OS and its consequences. Monitors the effectiveness of any measures put in place to prevent the tissue damage from OS

The d-ROMs Test should be done in all healthy subjects periodically, because there is no individual who is not exposed to the risk of producing excessive quantities of reactive oxygen species. The primary purpose of the test, in fact, is to identify and prevent oxidative stress and its undesirable consequences (aging, diseases).
The d-ROMs Test should be carried out systematically on all subjects, apparently healthy from a clinical point of view, if they are exposed to factors that can increase production (radiation, pollutants, smoke, etc.) and/or reduce inactivation of reactive oxygen species (eg. unbalanced diets). The purpose of the test is to identify and prevent oxidative stress and its consequences.
The test should be performed on all patients with diseases that are somehow related to oxidative stress, from senile dementia to Parkinson's disease, from stroke to heart attack, from Crohn's disease to rheumatoid arthritis, from HIV to some neoplasia and so on. In all these cases the purpose of the d-ROMs Test is monitoring oxidative stress, prevent its consequences and track the effectiveness of specific therapy. Moreover it is useful to track the effectiveness of specific therapy in combination with any supplemental antioxidant treatment on oxidative stress associated with the disease.
It is important to underline that in many pathologies mentioned above, the oxidative stress is an additional risk factor and it must be controlled in order to optimize the results of therapy .
Finally, the d-ROMs Test is fundamental for all the subjects that follow therapeutic interventions either pharmacological and surgical that can compromise the oxidative balance. The purpose is to identify and prevent oxidative stress and its consequences, and, in particular, monitor the effectiveness of any measures put in place to prevent the damage of the tissue from oxidative stress.


DIACRON INTERNATIONAL s.r.l is the leader company in research and evaluation of oxidative stress. Our company produces and sells analytical dedicated instruments, kits and accessories for oxidative stress assessment in Human, Veterinary and Agrifood fields.