REF-VALUE Study: Establishment of Reference Values for Biomarkers in Healthy Adults

Summary

Circulating biomarkers play a central role in translational research and precision medicine, particularly for the diagnosis, prognostic, monitoring of inflammatory or infectious diseases and patient stratification. Advances in analytical technologies enable standardised, sensitive and multiplexed assays, but their application remains limited by the lack of reliable reference values derived from well-characterised healthy populations. Indeed, the available data are often heterogeneous and difficult to transfer between platforms.

In this context, the establishment of institutional reference cohorts appears essential for the correct interpretation of immunological parameters-which could be strongly influenced by demographic and clinical factors-and for defining relevant cut-off values when identifying new biomarkers of interest. This issue is particularly critical in the field of viral respiratory infections, where current diagnostic approaches still have several limitations.

Circulating biomarkers play a central role in translational research and precision medicine, particularly for the diagnosis, prognostic, monitoring of inflammatory or infectious diseases and patient stratification. Advances in analytical technologies enable standardised, sensitive and multiplexed assays, but their application remains limited by the lack of reliable reference values derived from well-characterised healthy populations. Indeed, the available data are often heterogeneous and difficult to transfer between platforms.

In this context, the establishment of institutional reference cohorts appears essential for the correct interpretation of immunological parameters-which could be strongly influenced by demographic and clinical factors-and for defining relevant cut-off values when identifying new biomarkers of interest. This issue is particularly critical in the field of viral respiratory infections, where current diagnostic approaches still have several limitations.

Diagnosis is usually based on PCR tests targeting the DNA or RNA of pathogens, requiring a virus-specific test. In practice, only a few viruses (SARS-CoV-2, RSV, influenza) are tested for as a first-line investigation, whilst many other agents may be involved. As a comprehensive approach is difficult to achieve, viral infections often remain under-reported.

Furthermore, the detection of a virus by PCR may indicate either an active infection or residual traces of a past infection. Although viral load can aid interpretation, it does not always allow for a definitive conclusion, making it difficult to distinguish between ongoing viral replication and the persistence of genetic material. It is therefore necessary to have additional markers associated with active infection.

In this context, analysing the host response represents a promising alternative. Viruses induce, in particular, the production of type I interferons (IFN-I), the measurement of which could point the diagnosis towards a viral origin and reflect ongoing infectious activity. However, the interpretation of these biomarkers requires robust reference standards, taking into account their variability across individuals and contexts.

Several studies illustrate the value of such approaches, such as the REFIPA study (NCT07239830), conducted in subjects over 80 years of age, which aims to characterise the immune response, particularly IFN-I, in the context of immunosenescence. This type of study highlights the need for well-phenotyped healthy ? control populations according to age groups and clinical contexts.

Finally, beyond the creation of reference databases, the development of biobanks appears essential. This would enable the establishment of harmonised and directly usable reference values, thereby facilitating translational, basic and pre-clinical research projects, as well as the identification and validation of new biomarkers.

Conditions

• Uninfected Healthy Adult Subjects

Interventions

BIOLOGICAL

Biological Sampling

The procedures specifically carried out for the study are as follows: * 1 nasopharyngeal swab for baseline measurement of the nasal IFN score and to detect the presence of infection * Venous blood sample collection: * 1 x 2.5 mL PAXgene tube for baseline measurement of the blood IFN score * 1 x 4 mL dry tube (serum) to quantify anti-IFN antibody levels * 1 x 4 mL heparinized tube to assess non-specific functional immunity. * 1 x 2 mL EDTA tube for quantification of circulating leukocyte populations via complete blood count (CBC) * 1 x 2 mL EDTA tube for quantification of the main circulating lymphocyte subpopulations via immunophenotyping * 2 x 10 mL EDTA tubes and 1 x 4 mL EDTA tube for collection of PBMCs and plasma for biobanking A total of 38.5 mL of venous blood will be collected for the study during a single visit. This volume complies with regulations for subjects weighing at least 50 kg (eligibility criterion).

Sponsors & Collaborators

• Hospices Civils de Lyon

  lead OTHER

Principal Investigators

• Sophie TROUILLET-ASSANT · Laboratoire Commun de Recherche, Hôpital Lyon Sud, Hospices Civils de Lyon, France

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-08-01

Primary Completion

2027-08-01

Completion

2027-08-01