- Certification
- CLIA-certified
- High complexity · Philadelphia, PA
- Collection
- In-office or mobile phlebotomy
- All US states except New York
- Delivery
- Secure access
- Confidential clinical reports
Six readings from 38 pathways,
each placed against a reference group.
The Inflammation Compass is a whole-blood RNA sequencing test for general wellness use. Gene expression is summarized into 38 pathways, 21 for Activation and 17 for Resolution. A statistical model with fixed weights combines them into six readings, and the immune cell mix is estimated from the same data by deconvolution. There is no overall score.
Each reading is a principal component of the pathway scores within one phase. Five show a level and one shows a balance between two sets of pathways. The readings are statistical summaries, not six separate body functions, and a pathway can contribute to more than one. Each name describes what the weighted pathways are associated with.
Activation starts a response
- Activation Level
- The fast, built-in alarm: signals that raise fever and call in immune cells.
- Targeted Defense
- Signals that show a threat to T cells and power up cells that kill targets.
- Where the Fast Response Is Working
- Mainly in the blood, or moving cells out into tissue. This reading is a balance between two sets of pathways, not a level.
Resolution ends it
- Resolution Level
- Early feedback and calming signals that keep a response from running on.
- Regulatory Cells & Repair Signals
- Regulatory T cells and repair signals that hold a response down over time.
- Clean-up & Rebuilding
- Spent immune cells are cleared away and the body shifts toward repair.
Where a result sits, and when it has moved
Each reading and pathway is placed against a reference group, people whose blood was collected, sequenced and analyzed the same way. The reference range is the middle 80 percent of that group, so about 2 in 10 of the group sit outside any one range. Values are on the reference scale, where 1 is the usual spread between people in the group, and each result is marked within, at the edge, below or above.
From the second sample on, each reading is marked as moved or about the same. A reading is marked as moved only when the shift is larger than the usual difference between two samples taken close together. The margin for “at the edge” and the threshold for “moved” are provisional and printed on the report. The reference group is still accruing, so ranges are recalculated as it grows, and the report names the group used.
What the report holds
- Your Bearing
- Where each of the six readings sits in this sample, against its reference range.
- Your Course
- How far each reading has moved since the previous sample, marked as moved or about the same.
- Your Map
- Activation Level against Resolution Level across every sample, with the reference group drawn as the galaxy.
- Pathways
- All 38 pathway results with plain and technical names, and the pathway behind any reading outside its range.
- Immune cell mix
- The estimated share of each immune cell family, deconvolved from the same sequencing data.
- Method and clinician pages
- A method page, and a two-page clinician summary with pathway-level values, technical names, reference ranges and change since earlier samples, to read beside the clinical picture. It is a wellness report and is not intended to guide medical decisions.
Incretin therapies lower inflammatory markers,
partly apart from weight loss.
The studies below report anti-inflammatory changes before substantial weight loss, with some effects partly independent of it. Most measured hs-CRP, one protein, so they show that inflammation changed but not which parts of the inflammation system changed.
Trial data on incretin therapy and inflammatory markers
Randomized controlled trials and meta-analyses across semaglutide, tirzepatide and exenatide.
| Trial and citation | Design and population | Inflammatory findings | Evidence |
|---|---|---|---|
|
SELECT hs-CRP analysis1 Plutzky et al., Circulation 2026 | Semaglutide 2.4 mg vs placebo, n=17,604, established CVD, up to 208 wks | hs-CRP −37.8% at wk 104; early reduction of −12% at wk 4 and −19% at wk 8; reductions observed even in patients with minimal or no weight loss | Established (prespecified secondary) |
|
Exenatide PBMC RCT2 Chaudhuri et al., JCEM 2012 | Exenatide 10 mcg BID vs saline, n=24, type 2 diabetes, 12 wks | Mononuclear cell TLR2, TLR4, TNF-α, and IL-1β mRNA along with NF-κB activity reduced by 16–31% with no weight loss | Established (mechanistic human RCT) |
|
STEP 1, 2, 3 exploratory5 Verma et al., EClinicalMedicine 2023 | Semaglutide 2.4 mg vs placebo, 68 wks, overweight/obesity with & without T2D | hs-CRP −44%, −39%, −48% vs placebo; reductions correlated with weight, waist, and HOMA-IR declines | Established (pooled RCTs) |
|
STEP-HFpEF6 Kosiborod et al., NEJM 2023 | Semaglutide vs placebo, n=529, heart failure with preserved ejection fraction | CRP −43.5% vs −7.3% for placebo; symptom reduction and improved 6-minute walk distance | Established (phase 3 RCT) |
|
Tirzepatide
cardiometabolic8,11 Wilson et al., DOM 2022; Masson et al., REMD 2025 | Phase 2b post hoc (n=316) and 8-study systematic meta-analysis | Meta-analysis: hs-CRP −33% and IL-6 −18% vs placebo. Phase 2 post hoc: ICAM-1 (adhesion molecule) and YKL-40 reduced; IL-6 unchanged | Established (phase 2/3 and meta-analysis) |
|
SURMOUNT-OSA mediation7 Malhotra et al., Nat Med 2026 | Tirzepatide vs placebo, OSA with obesity, 52 wks | Post hoc mediation analysis attributed part of the hs-CRP reduction to improvement in OSA metrics, independent of weight change | Emerging (mediation analysis) |
A meta-analysis of randomized trials found GLP-1 receptor agonists improve biomarkers of inflammation and oxidative stress.9
Three questions prescribers ask
about whole-blood RNA.
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Why read inflammation if my patient is already losing weight?
Inflammatory markers and weight can move apart. In SELECT, hs-CRP fell 12% by week 4 and 19% by week 8, when weight loss was 1.4% and 2.8%, and fell even in patients with minimal or no weight loss.1 In a 12-week randomized trial of exenatide, mononuclear-cell NF-κB binding and TLR expression fell 16–31% with no weight loss.2
Weight doesn’t show which parts of the inflammation system changed. Repeat samples show which of the six readings moved and by how much. They don’t show why a reading moved, or whether a therapy is working.
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What does blood RNA measure if leukocytes lack GLP-1 receptors?
Human peripheral leukocytes express virtually no GLP-1R (GLP1R transcripts are undetectable in PBMCs).12 The Inflammation Compass doesn’t measure drug binding. In mouse models, GLP-1 receptor agonists suppress systemic TNF-α responses through central neuronal GLP-1Rs rather than immune-cell receptors, acting via α-adrenergic and opioid receptor signaling.3,4
Weight loss is also thought to reduce adipose-derived TNF-α/IL-6 signaling and gut-derived endotoxin exposure. Circulating leukocytes take up these systemic cues, which is why their transcription can change.
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Why whole-blood RNA instead of hs-CRP alone?
hs-CRP is an IL-6–driven acute-phase protein made in the liver, with a 19-hour half-life, 30–50% biological variability and large swings with intercurrent infection or strenuous exercise. It shows that an acute-phase response is under way, but not which pathways are involved.
Whole-blood RNA sequencing reads gene expression in circulating immune cells across Activation and Resolution pathways, reports resolution pathways directly, and estimates the immune cell mix from the same sample, so a change in cell composition can be read apart from a change in cell activity. It complements hs-CRP and doesn’t replace it.
From venous draw to six readings,
in one CLIA-certified laboratory.
Every sample is processed under high-complexity testing protocols at our laboratory in Philadelphia, PA (CLIA ID # 39D2229561).
- PAXgene® Blood RNA collection
- Venous blood is drawn into PAXgene tubes whose reagents lyse cells and inactivate RNases on contact, holding the transcriptomic state at venipuncture and preventing ex vivo gene induction during ambient transport.10
- Library preparation and sequencing
- Total RNA undergoes DNA digestion, globin mRNA and ribosomal RNA depletion, and ERCC spike-in control addition. Stranded libraries are sequenced at ∼30 million paired-end reads (2×150 bp) on Illumina NovaSeq instruments.
- Alignment and quality control
- Quality-filtered reads are aligned with STAR to the human GRCh38 reference build, quantified with featureCounts and normalized to transcripts per million (TPM). A sample that fails a quality gate is re-processed or re-collected and never reported.
- Within-sample pathway scoring
- Each pathway is scored relative to the overall gene activity in the same sample, which makes the result robust to library depth differences and run-to-run technical variation. The fixed-weight model then summarizes the 38 pathway scores as six readings.
- Immune cell mix and comparison
- The share of each immune cell family is estimated from the same data by deconvolution. Each result is placed against the reference group and, from the second sample on, against the patient’s own earlier samples, processed on the same versioned pipeline.
What is done, under way and planned,
stated exactly.
Some of the validation work is finished, some is under way and some is planned. We keep this status current.
- IRB approval to enroll participants
- Done
- Per-sample quality gates for RNA integrity, read depth, mapping rate, spike-in linearity and contamination
- In place
- Reference group
- Accruing
- Pipeline check against public blood transcriptome datasets
- Sign-off pending
- Within-person and pre-analytical variability study
- Planned
- Samples from known inflammatory conditions, through biobank partners
- Planned
What it
can't tell you.
The measurement is RNA in whole blood at a single time point. Reading names are an inference about what those signals are associated with, readings are model summaries, and a pathway can feed several. Blood shows some parts of the inflammation system only partly, and it can’t show where in the body inflammation is taking place, or what caused a result or a change. The immune cell mix is an estimate made from RNA and doesn’t replace a blood count. Results vary with time of day, recent activity, illness, sleep, stress and hydration.
By construction, about 20 percent of the reference group falls outside any one reference range, and with six readings and 38 pathways most people will have some results outside a range. A result outside a range is not a clinical finding, and persistence across samples carries more weight than one result.
The Inflammation Compass is a laboratory-developed test with a general wellness intended use, run in a CLIA-certified laboratory licensed for high-complexity testing. It is not FDA cleared or approved, and it does not diagnose, rule out or predict any disease. It is a wellness report and is not intended to guide medical decisions.
Offering it in your practice,
with the laboratory work handled.
We run the molecular testing and deliver the reports. You decide how the results fit the care you provide.
- Collection in the office or at home
- Draw in your practice with our collection kits and return by prepaid mailer, or book mobile phlebotomy at the patient’s home in all US states except New York.
- Tracked from draw to result
- Every sample is tracked from collection through result delivery. Barcode-verified accessioning and auditable processing records keep every result traceable.
- Secure clinical results and reporting
- Secure, confidential access to longitudinal member tracking. Review current results, compare against prior panels, and evaluate trends across your member cohort. Receive clear, comprehensive clinical reports for direct consultation with your members.
- Revenue opportunity
- Offering Inflammation Compass testing can add a cash-pay revenue stream to your practice. Individual tests and recurring orders support baseline and follow-up monitoring alongside the care you already provide.
How a partnership runs
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1. Onboard
Practice setup and protocol alignment. We configure your account, establish preferred panel configurations, define collection protocols, and establish secure access for your practice. Typical onboarding completes in under one week.
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2. Order
Coordinate orders directly with our clinical accessioning team or integrate via API. Choose individual tests or a subscription for each member.
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3. Collect
Specimens are drawn at your practice using our collection kits, or at home by our mobile phlebotomy network for telehealth and remote members, then shipped to our laboratory in pre-labeled transport packaging.
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4. Report
Results delivered securely with automated notification as soon as sequencing and QC complete. Longitudinal tracking shows trends across sequential panels, making member consultations straightforward and objective.
Practice models
- Weight-management practices
- Members on Ozempic, Wegovy, Mounjaro or Zepbound can give a baseline sample and follow-up samples around dose changes, maintenance or a taper. In-office collection fits routine visits, and recurring orders add cash-pay revenue.
- Telehealth platforms
- Members receive a pre-labeled collection kit, a mobile phlebotomist performs the venous draw at home, and the stabilized sample ships to our laboratory. Results are delivered securely to your practice for virtual consultations, with no in-person visit required.
- Longevity and preventive-care practices
- Pair routine clinical labs with whole-blood gene expression, so members can see where each of their six readings sits against its reference range and what moves across samples.
Talk with us about offering it in your practice.
Schedule a partnership call to discuss integration, pricing, and how Inflammation Compass testing can fit your practice model.
Sources and further reading
References
Trials, mechanistic studies and methods literature cited on this page.