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Nu.Q® NETs

Monitoring the immune system to save lives.

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The immune system can be both friend and foe; a potent protective force that sometimes overreacts, damaging the body’s own cells and tissues in the process. We are working to develop tests that will identify people at high risk of poor outcomes caused by an immune system overreaction to COVID-19 and other infections.

The immune system is comprised of many different types of white blood cell with different functions. The most abundant cells are neutrophils, which serve as the first line of defense. When they detect bacteria, viruses, injuries, or other threats these cells produce Neutrophil Extracellular Traps (NETs)—sticky webs made of long strings of nucleosomes that stop the threat from spreading around the body.

Although NETs are an important part of the body’s response to infection, the presence of too many of them in the blood can tip the immune system’s delicate balance between reaction and overreaction.

Elevated levels of NETs are a complicating factor associated with poor patient outcomes in a range of infectious and non-infectious diseases.

Supporting intensive care for COVID-19 and sepsis.

Sepsis—widespread tissue and organ damage triggered by an abnormal immune response to an infection—is an area of particular focus for our research on NETs.

A recent global study estimated that there were 49 million cases and 11 million sepsis-related deaths worldwide in 2017, accounting for approximately 20% of all annual deaths.¹

In severe COVID-19 excessive production of NETs in the lungs, can lead to severe lung impairment or death.

NETs contain nucleosomes; our proprietary Nu.Q® nucleosome assays have been shown to detect NETs in minute quantities. This could enable the stratification of patients with a high level of NETs and allow physicians to rapidly triage these patients, monitor their disease progression and response to treatment.

¹ – accessed 23 Nov 2021

“NETs and NETosis are much more prominent in clinical research currently, driven largely by the COVID-19 pandemic. We are working with academic researchers and leading hospital clinicians to bring Nu.Q® NETs tests to the market as quickly as possible.”

Dr. Jake Micallef, Chief Scientific Officer, Volition

The focus on sepsis due to the COVID-19 pandemic has accelerated our research on NETs

  • COVID-19

    Triage and Monitoring

    In collaboration with other parties, we recently published evidence that the level of circulating NETs, as measured using Nu.Q® NETs assays, correlates with current disease severity and mortality in COVID-19 patients.

    Further, a recent study shows that our NETs-based tests could be used to predict future disease severity and guide treatment selection in patients, on admission. We are also following COVID-19 patients’ NETs levels during their illness and recovery.

  • Sepsis

    Monitoring Sepsis Treatment

    We have obtained proof-of-concept for Nu.Q® NETs as an effective test to monitor response to a novel treatment for sepsis. Our collaborators on this project, Santersus AG, are developing a therapy that takes the patient’s blood outside of their body, removes excess NETs, and recirculates the blood back into the body. Our Nu.Q® NETs assays monitor the level of NETs in the blood and are a key part of the ongoing trials of this exciting potential new therapy.

    Triage and Monitoring

    COVID-19 sepsis is clinically similar to sepsis caused by other infections. We are therefore applying everything we learn from our COVID-19 research to trials of our Nu.Q® NETs tests in other forms of sepsis.

  • Other Conditions

    Inflammation and Vascular Damage

    The levels of NETs that are detected during sepsis are dramatically elevated, but more subtle increases are also seen in non-infectious diseases characterized by inflammation or vascular damage. We are engaged in a number of research collaborations in this area, and recently published findings from a study of NETs-based biomarkers for pregnancy complications.


    There is evidence that cancer cells can use NETs to evade the body’s immune system as they move to new sites through the bloodstream. Nu.Q® NETs tests therefore have significant potential in clinical oncology, for example to monitor for metastatic disease in high-risk individuals, or to provide an early assessment of whether a treatment is working. We are currently investigating multiple potential avenues for clinical test development in this field.