Sepsis: An Overlooked 'Silent Killer'
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. According to data published in The Lancet in 2025, there were approximately 166 million sepsis cases worldwide in 2021, resulting in 21.4 million deaths. Even more concerning, among survivors, 33% die within one year, 40% are readmitted to hospital within 90 days of discharge, and one-sixth experience significant morbidity such as functional limitations.
Early detection of people with infection who are at risk of deteriorating is likely to have a favorable public health impact. However, traditional clinical indicators often fail to accurately identify these high-risk patients at an early stage.
Breakthrough Discovery: The Nu.Q® NETs H3.1 Biomarker
Recently, VolitionRx Limited, a multinational epigenetics company, announced a landmark milestone in the clinical validation of its Nu.Q® NETs H3.1 biomarker in sepsis. The research was published in the authoritative critical care journal Critical Care Medicine and was accompanied by an independent editorial.
The study, titled "H3.1 Nucleosomes to Predict Renal Replacement Therapy and Mortality in Sepsis—A Secondary Analysis of the SISPCT Randomized Control Trial," confirmed the following key findings:
- Independent prediction of 28-day mortality: Nu.Q® NETs H3.1 levels independently predict 28-day mortality risk in patients with sepsis and septic shock.
- Prediction of renal replacement therapy needs: The biomarker can predict whether patients will require renal replacement therapy (RRT), providing a basis for early intervention in acute kidney injury.
- Dose-response relationship: H3.1 levels in septic shock patients are significantly higher than in sepsis patients, with a clear dose-response relationship with acute kidney injury severity.
- Independence from conventional markers: Its risk stratification capability is independent of conventional clinical indicators, offering unique complementary clinical value.
Clinical Significance: From 'Reactive' to 'Proactive' Intervention
Professor Michael Bauer, Chair of the Department of Anesthesiology and Intensive Care Medicine at Jena University Hospital, Germany, and co-author of the paper, stated: "Our study establishes H3.1 nucleosomes as a biomarker delineating organ dysfunction in sepsis, particularly for early mortality and the need for RRT. The clear stratification of risk and independence from conventional markers suggests clinical utility."
Dr. Andrew Retter, Medical Consultant at Volition, commented: "Nu.Q® NETs is a simple, low-cost, accessible test to detect diseases associated with NETosis. Although NETs play a critical role in our normal immune response, elevated levels of NETs can lead to tissue damage and, in severe cases, sepsis, organ failure, and death. Introducing Nu.Q® NETs into hospitals as a treatable, trackable trait could lead to new ways of treating sepsis, improve patient survival, and enhance the quality of life of survivors."
Market Outlook and Commercial Progress
Mr. Remi Rabeuf, VP of Corporate Alliances and Strategic Partnership at Volition, revealed: "We are currently advancing several active commercial discussions with significant players in the diagnostic space, including large markets such as sepsis; the findings from this peer-reviewed paper support this ongoing licensing process."
The total addressable market (TAM) for Nu.Q® NETs in sepsis is estimated at $2.8 billion. The technology has the potential to enable clinicians and researchers to anticipate disease, guide treatment decisions, and monitor patients over time across both acute and chronic conditions.
Future Outlook
The editorial published in Critical Care Medicine concluded: "Ultimately, the clinical value of H3.1 may lie less in its ability to predict outcomes than in its potential to identify a biologically distinct subgroup of patients with NET-mediated organ injury."
As early warning technology for sepsis continues to advance, clinicians will gain wider intervention windows before patient deterioration, significantly improving outcomes for sepsis patients. For readers concerned about their own and their family's health, understanding these cutting-edge medical developments can help make more informed decisions when seeking medical care.
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