Improving TB meningitis diagnosis and treatment response with metagenomics and host genes in a multinational trial
Official title: Reimagining the IMAGINE-TBM trial: Using metagenomics and host transcriptomics to improve our ability to diagnose tuberculous meningitis and assess response to treatment in a randomized clinical trial
Funded at University of California, San Francisco · NIH-11406305 · Data updated 2026-11-12
A large study will use advanced genetic analysis of pathogens and the patient’s own immune signals to better diagnose tuberculous meningitis and track how people respond to treatment.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | University of California, San Francisco NIH-funded |
| Lab location | 1 site (San Francisco, United States) |
| Project start | September 3, 2025 |
| Project end | July 31, 2030 |
| Funding year | 2026 |
| Award (this year) | $737,954 |
| NIH project number | 5R01NS134054-02 |
| Project ID | NIH-11406305 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with suspected or confirmed tuberculous meningitis enrolled in the ACTG IMAGINE-TBM trial or similar TBM populations in LMIC settings.
✕Less likely to help
Patients not diagnosed with TB meningitis or those not eligible for the ancillary analyses may not benefit from this study.
What this research studies
This project adds an ancillary study to an international TB meningitis trial to analyze metagenomic data from cerebrospinal fluid and host blood/CSF gene expression. Researchers will identify biomarkers that help distinguish TB meningitis from other infections and monitor treatment response over time. The work will be done at multiple sites in LMICs and builds capacity for local researchers through training and infrastructure development. The findings could lead to faster diagnosis and more personalized treatment for TB meningitis patients.
Why it matters
Potential benefit: If successful, patients could receive faster and more accurate diagnosis and better-guided treatment decisions.
How similar studies have gone: Preliminary studies in TB and CNS infections have shown metagenomic and host-response biomarkers hold promise for improving diagnostics and monitoring.
Where this research is happening
-
University of California, San Francisco
San Francisco, United States Active
Researchers
- Principal investigator: Chow, Felicia C. — University of California, San Francisco
- Study coordinator: Chow, Felicia C.
Related research
Other NIH-funded projects on the same topics.
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Personalized Immunomodulatory Therapy for HIV-related Cryptococcal Meningitis
A patient-focused study investigates a personalized treatment approach to improve outcomes for people with HIV who develop cryptococcal meningitis.
-
Improving Diagnostics and Neurocognitive Outcomes in HIV/AIDS-related Meningitis
A study in Uganda aims to use faster, better tests and a new antifungal to help people with HIV who develop meningitis.
-
TB meningitis diagnostic test compare and cost study in sub-Saharan Africa
Researchers are testing a new CSF urine-based test (SILVAMP TB LAM) to improve diagnosis of TB meningitis in people with HIV, to help speed treatment and reduce death in Sub-Saharan Africa.
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Minimally Invasive Sampling to Improve HIV-Associated M meningitis Diagnosis in Africa
A research study is testing easier, less invasive ways to diagnose meningitis in people living with HIV, with a focus on making diagnosis faster and more accurate in Africa and the US.
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Understanding brain injury in kids with tuberculous meningitis (iThemba)
A study in children with TB meningitis in South Africa will look at how inflammation and blood-clotting factors relate to brain injury and infarcts.
-
Serological clues to survival in HIV-related cryptococcal meningitis
This grant looks for antibody signals in the blood that could predict who survives cryptococcal meningitis in people with HIV.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.