Host Response to Infection by Direct Analysis of Leukocyte Single Cell-type Gene Expression/transcript Abundance, Direct LS-TA

NCT ID: NCT06838780

Last Updated: 2025-03-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

192 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-01-01

Study Completion Date

2026-01-01

Brief Summary

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Febrile illness is a common condition, particularly among young patients and it is crucial to have an early triage of patients according to various aetiologies to enable appropriate treatment. Most diagnostic tests are targeted towards the detection of pathogens while other assays are mostly related to serum proteins. Blood cells transcriptome has been explored to differentiate bacterial and viral infections.

Here, we propose to develop a rapid test using the host responses in terms of gene expressions of single-cell populations of peripheral leukocytes (monocytes and granulocytes) to differentiate three major categories of infections that are bacterial, viral, and tuberculosis.

The assay is called Direct leukocyte single cell-type transcript abundance (TA) assay (DIRECT LS-TA) as it can directly determine the gene expression of a specified single cell-type (e.g. monocytes and granulocytes) among various leukocyte cell populations directly in a peripheral blood sample. Such results signify the nature of host response and can be used to indicate the type of infection (viral, bacterial or active tuberculosis).

Detailed Description

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DIRECT LS-TA is a ratio-based biomarker (RBB) for blood gene expression analysis which can be performed in commonly available equipments (e.g. qPCR or digital PCR machines). Using the ratio of TA of prior defined numerator gene and denominator gene, this RBB can quantify gene expression of the specified constitutional single cell-type (e.g. monocytes and granulocytes) inside a cell-mixture sample of Whole blood.

DIRECT LS-TA was a method pioneered by the PI \[Tang 2017, https://patents.google.com/patent/US9589099B2/\]. And it has been developed for quantification of early B cell response after vaccination \[DOI: 10.3390/genes12070971\].

Recently, the method is used to develop host response biomarkers after infection to differentiate the type of pathogens (such as viral, bacterial or active tuberculosis). Numerator and denominator genes have been identified by using public gene expression datasets for monocytes and granulocytes. Diagnostic performance was good using these public data.

Therefore, these RBBs will be applied in these retrospective samples to evaluate and compare their diagnostic (triage) performance of febrile patients into different pathogen etiologies.

Conditions

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Gene Expression Gene Expression Profiling Infection Viral Diseases Bacterial Infections Active Tuberculosis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Vaccination Controls

Up to 200 adult samples collected as the baseline of this study will be used to establish the reference ranges of the ratio-based biomarkers by quantitative PCR or digital PCR.

No intervention

Intervention Type OTHER

No intervention for this retrospective study

Bacterial infection samples

A retrospective sample of adult patients with positive bacterial blood culture.

No intervention

Intervention Type OTHER

No intervention for this retrospective study

Tuberculosis samples

A retrospective sample of adult patients who were diagnosed to have active tuberculosis disease.

No intervention

Intervention Type OTHER

No intervention for this retrospective study

Interventions

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No intervention

No intervention for this retrospective study

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Bacterial infection sample: positive isolation of organism in blood culture (Bacterial infection sample group)
* Clinical diagnosed active TB (Tuberculosis infection group)

Exclusion Criteria

* End stage renal failure
* Pregnancy
* Infections for which long term antibiotic treatment is strongly recommended (including infective endocarditis, osteoarticular infections, cerebral or hepatic or lung abscesses, tuberculosis or nontuberculous mycobacterial infections)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Chinese University of Hong Kong

OTHER

Sponsor Role lead

Responsible Party

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Nelson Tang

Principle investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Dept of Chemical Pathology, Chinese University of Hong Kong

Hong Kong, , Hong Kong

Site Status

Countries

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Hong Kong

References

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Tang NLS, Kwan TK, Huang D, Ma SL, Leung KS. Direct single cell-type gene expression analysis in peripheral blood: novel ratio-based gene expression biomarkers using 2 novel monocyte reference genes (PSAP and CTSS) for detection of bacterial infection. Hum Mol Genet. 2025 Aug 21;34(17):1458-1470. doi: 10.1093/hmg/ddaf103.

Reference Type BACKGROUND
PMID: 40581066 (View on PubMed)

Huang D, Liu AYN, Leung KS, Tang NLS. Direct Measurement of B Lymphocyte Gene Expression Biomarkers in Peripheral Blood Transcriptomics Enables Early Prediction of Vaccine Seroconversion. Genes (Basel). 2021 Jun 25;12(7):971. doi: 10.3390/genes12070971.

Reference Type BACKGROUND
PMID: 34202032 (View on PubMed)

Huang B, Huang J, Chiang NH, Chen Z, Lui G, Ling L, Kwan MYW, Wong JSC, Mak PQ, Ling JWH, Lam ICS, Ng RWY, Wang X, Gao R, Hui DS, Ma SL, Chan PKS, Tang NLS. Interferon response and profiling of interferon response genes in peripheral blood of vaccine-naive COVID-19 patients. Front Immunol. 2024 Jan 10;14:1315602. doi: 10.3389/fimmu.2023.1315602. eCollection 2023.

Reference Type BACKGROUND
PMID: 38268924 (View on PubMed)

Related Links

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https://patents.google.com/patent/US9589099B2/

Patent about the model to obtain single cell-type gene expression in peripheral blood

https://patents.google.com/patent/GB2629711A/en

Patent about the model to obtain single cell-type gene expression in peripheral blood

Other Identifiers

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Direct LS-TA retrospective

Identifier Type: -

Identifier Source: org_study_id

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