Nu.Q® NETs

Measuring circulating H3.1 nucleosomes to support research into sepsis and other diseases associated with NETosis.

Our Solution

Introducing Nu.Q^® NETs.

Nu.Q^{^®} NETs is a groundbreaking CE-marked diagnostic solution that clinicians can use to detect NETosis. Our assay can be used to identify patients with clinically relevant elevated levels of circulating NETs and enable physicians to rapidly treat these patients.

Overview

Nu.Q^® NETs detects circulating nucleosomes in sepsis and other diseases.

Our Nu.Q^® NETs assay detects diseases associated with NETosis, such as sepsis. It has the potential to help doctors accurately diagnose disease and could also help predict disease severity, measure response to treatment and monitor disease progression.

Sepsis is a life-threatening response to infection that can rapidly progress to organ failure and death. Early diagnosis remains challenging because symptoms often overlap with other inflammatory conditions. There is a growing need for biomarkers that provide additional insight into the host immune response and support patient stratification.

Download Nu.Q^® NETs information sheet

Sepsis Statistics

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Estimated 21.4 million deaths from sepsis worldwide each year.

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Risk of death increases by 7.6% for every hour of treatment delay.

Dr Andrew Retter reviews the clinical and scientific evidence for Nu.Q® NETs

Clinical Evidence

The development of Nu.Q^® NETs has been supported by a growing body of peer-reviewed research spanning mechanistic biology, assay validation, clinical sepsis studies and investigations into other NETosis-associated diseases.

The Clinical Evidence in Sepsis

2021. Cavalier et al.

H3.1 and citrullinated nucleosomes rise with COVID-19 severity.

Two cohorts. BE 93 subjects. DE 82 subjects

Observational Study

Morimont et al.

Nu.Q^® H3.1 separates septic shock from critical COVID-19.

46 septic shock. 22 COVID. 48 controls. BE

Observational Study

Haem Rahimi et al. Annals of Intensive Care

H3.1 peaks at admission in septic shock. Independent predictor of day 5 and 28 mortality.

151 patients. Median 1515 ng per mL day 1. Fr.

Retrospective Analysis

2025. Neumann et al.

Admission H3.1 independently predicts 28- day mortality and 28-day RRT.

971 patients. 33 ICUs. Adj HR 1.80. DE multi-center

Retrospective Analysis

2025. Filippini et al.

H3.1 separates sepsis from non-sepsis. Predicts RRT independent of mortality.

MARS. 1,713 patients. HR 2.00 per log10.

NL multicenter Observational Study

Clinical Evidence in Non-Sepsis Diseases

The Clinical Evidence in Non-Sepsis Diseases

2023, Bouvier et al. Pre-eclampsia

Nucleosomes and free DNA rise in pre-eclampsia. Distinct profile from IUGR.

115 women. 3 groups. Fr.

Park et al. Stroke.

Plasma H3.1 elevated in acute ischemic stroke. Independent risk factor.

89 AIS plus 20 controls. AUC 0.907. Korea.

Navarro et al. Trauma.

H3.1 and citrullinated H3R8 elevated after trauma. Higher in patients who develop VTE.

674 patients. H3.1 830.9 vs 259.2 in VTE. Mayo.

Supporting Evidence

The supporting scientific evidence

2023. Garcia et al.

Critical Care Histone neutralisation reduces vasopressor need, IL-6 and H3.1 in septic sheep.

2023. Cayford et al.

Understanding NETosis Priming and Induction through Nucleosome Changes and Real-Time Monitoring in Isolated Neutrophils and in an Ex-Vivo Model.

2024. Zukas et al.

First whole-blood ex vivo NETosis model. Three physiological triggers required.

384-well throughput.

2024. Atteberry et al.

ATAC-Seq maps chromatin opening during PMA-induced NETosis.

2025. Retter, Singer, Annane et al

The NET effect – NETs as a central component of the dysregulated host response in sepsis.

2025.Cayford et al

Underscores the importance of studying NET formation within a whole blood environment to capture the complexity of neutrophil responses and immune cell interactions.

NETs Evidence Summary

The Nu.Q^® NETs evidence base has evolved from understanding the biology of NETosis to demonstrating clinical utility in large patient cohorts. Together, these studies provide a strong scientific foundation for H3.1 nucleosomes as biomarkers of dysregulated host response in sepsis and other acute inflammatory conditions.

NETs Evidence Summary Slidepdf 0.16MB

Collaboration

Working together.

We are working with teams at several major hospitals across Europe, undertaking studies to test our technology as a diagnostic aid for sepsis, to monitor disease progression and treatment response.

Who: Large-scale study being undertaken in collaboration with Amsterdam UMC, a leading medical center, and led by Dr Lieuwe Bos.

About: A retrospective analysis of 4,000+ samples, prospectively collected from 1,700+ intensive care patients, to assess the potential value of Nu.Q^{^®} NETs assay to diagnose and monitor patients at risk of sepsis. Results presented at ISICEM 2025, peer-reviewed paper published in Critical Care, BMC, Part of Springer Nature

Download the paper

Who: Large scale study undertaken in collaboration with German SepNet Study Group, led by Professor Michael Bauer, Chief Executive Director of the Center for Sepsis Control and Care, Jena University Hospital.

About: A retrospective analysis of 1000 samples, prospectively collected from intensive care patients, to assess the potential value of Nu.Q^{^®} NETs assay to diagnose and monitor patients at risk of sepsis.

Next steps: Results published at ESICM 2024, manuscript submitted for peer review and publication.

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Who: RECORDS study (Rapid recognition of Corticosteroid Resistant or sensitive Sepsis) currently being led by Professor Djillali Annane, France.

About: Our Nu.Q^{^®} NETs assay is being used as part of RHU RECORDS – a 1,500-patient study – to help identify eligible patients for corticosteroid therapy in the management of sepsis, and help establish decision-making thresholds. Nu.Q^{^®} NETs will also be used in conjunction with a point-of-care device to assess critical care requirements.

Next Steps: Interim analysis presented at ISICEM 2025, study due to be completed in 2026.

Who: Mayo Clinic

About: We are working with the Mayo Clinic Research Team, which is analysing reliable biomarkers in trauma patients. They used Nu.Q^® NETs to measure elevated levels of the H3.1 and H3R8 Citrulline nucleosomes early after traumatic injury, especially in those who developed Venous Thromboembolism (“VTE”).

Press Release

Who: Santersus AG

About: We are working with Santersus AG, which is developing “NucleoCapture”, a transformational technology that cleanses blood of NETs as a sepsis treatment. They used Nu.Q^® NETs within an animal study to measure treatment response and have moved to their ﬁrst human trial, with results due shortly.

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Who: Hospice Civil de Lyon, France

About: We worked with Hospices Civil de Lyon to measure nucleosome levels using the Nu.Q^® NETs assay in septic shock patients. The study included 151 septic shock patients and demonstrated an association with mortality.

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testimonial

I believe that using the Nu.Q^{^®} NETs test to measure elevated H3.1 nucleosome levels as a “treatable trait” in sepsis management could be a game changer in modifying a patient's trajectory. Introducing Nu.Q^® NETs into hospitals could lead to new ways of treating sepsis, improve patient survival and the quality of life of survivors.

Professor Djillali Annane
Professor of Medicine at University Paris Saclay-UVSQ

Product Resources

Brochures & Clinical Papers

Introducing Nu.Q^® NETs.