Ephraim Tsalik, MD, PhD

Adjunct Associate Professor in the Department of Medicine
Member of Duke Center for Applied Genomics and Precision Medicine
Campus mail Box 102359 DUMC, Durham, NC 27710
Phone (919) 684-3114
Email address e.t@duke.edu

My research is focused on understanding the dynamic between host and pathogen so as to discover and develop host-response markers that can diagnose and predict health and disease.  This new and evolving approach to diagnosing illness has the potential to significantly impact individual as well as public health considering the rise of antibiotic resistance.

With any potential infectious disease diagnosis, it is difficult, if not impossible, to determine at the time of presentation what the underlying cause of illness is.  For example, acute respiratory illness is among the most frequent reasons for patients to seek care. These symptoms, such as cough, sore throat, and fever may be due to a bacterial infection, viral infection, both, or a non-infectious condition such as asthma or allergies.  Given the difficulties in making the diagnosis, most patients are inappropriately given antibacterials.  However, each of these etiologies (bacteria, virus, or something else entirely) leaves a fingerprint embedded in the host’s response. We are very interested in finding those fingerprints and exploiting them to generate new approaches to understand, diagnose, and manage disease.

These principles also apply to sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Just as with acute respiratory illness, it is often difficult to identify whether infection is responsible for a patient’s critical illness.  We have embarked on a number of research programs that aim to better identify sepsis; define sepsis subtypes that can be used to guide future clinical research; and to better predict sepsis outcomes.  These efforts have focused on many systems biology modalities including transcriptomics, miRNA, metabolomics, and proteomics.  Consequently, our Data Science team has utilized these highly complex data to develop new statistical methods, furthering both the clinical and statistical research communities.

Synergy between multi-disciplinary experts is crucial to tackle the threats posed by infectious diseases and the rise in antimicrobial resistance. We have successfully assembled a team of clinical scientists, data scientists, laboratorians, clinical research coordinators, among many others. Potential collaborators are encouraged to contact us.

These examples are just a small sampling of the breadth of research Dr. Tsalik and his colleagues conduct.  Please visit https://precisionmedicine.duke.edu/ for more details.

Education and Training

  • Fellowship in Infectious Diseases, Medicine, Duke University School of Medicine, 2008 - 2011
  • Residency, Medicine, Duke University School of Medicine, 2005 - 2008
  • M.D., Columbia University, College of Physicians and Surgeons, 2005
  • Ph.D., Columbia University, College of Physicians and Surgeons, 2003

Publications

Patel, Robin, Christopher R. Polage, Jennifer Dien Bard, Larissa May, Francesca M. Lee, Valeria Fabre, Mary K. Hayden, et al. “Envisioning Future Urinary Tract Infection Diagnostics.” Clin Infect Dis 74, no. 7 (April 9, 2022): 1284–92. https://doi.org/10.1093/cid/ciab749.

PMID
34463708
Full Text

Ko, Emily R., Ricardo Henao, Katherine Frankey, Elizabeth A. Petzold, Pamela D. Isner, Anja K. Jaehne, Nakia Allen, et al. “Prospective Validation of a Rapid Host Gene Expression Test to Discriminate Bacterial From Viral Respiratory Infection.” Jama Netw Open 5, no. 4 (April 1, 2022): e227299. https://doi.org/10.1001/jamanetworkopen.2022.7299.

PMID
35420659
Full Text

Bodkin, Nicholas, Melissa Ross, Micah T. McClain, Emily R. Ko, Christopher W. Woods, Geoffrey S. Ginsburg, Ricardo Henao, and Ephraim L. Tsalik. “Systematic comparison of published host gene expression signatures for bacterial/viral discrimination.” Genome Med 14, no. 1 (February 21, 2022): 18. https://doi.org/10.1186/s13073-022-01025-x.

PMID
35184750
Full Text

Jaffe, Ian S., Anja K. Jaehne, Eugenia Quackenbush, Emily R. Ko, Emanuel P. Rivers, Micah T. McClain, Geoffrey S. Ginsburg, Christopher W. Woods, and Ephraim L. Tsalik. “Comparing the Diagnostic Accuracy of Clinician Judgment to a Novel Host Response Diagnostic for Acute Respiratory Illness.” Open Forum Infect Dis 8, no. 12 (December 2021): ofab564. https://doi.org/10.1093/ofid/ofab564.

PMID
34888402
Full Text

Tsalik, Ephraim L., Ricardo Henao, Jesse L. Montgomery, Jeff W. Nawrocki, Mert Aydin, Emily C. Lydon, Emily R. Ko, et al. “Discriminating Bacterial and Viral Infection Using a Rapid Host Gene Expression Test.” Crit Care Med 49, no. 10 (October 1, 2021): 1651–63. https://doi.org/10.1097/CCM.0000000000005085.

PMID
33938716
Full Text

Grzesiak, Emilia, Brinnae Bent, Micah T. McClain, Christopher W. Woods, Ephraim L. Tsalik, Bradly P. Nicholson, Timothy Veldman, et al. “Assessment of the Feasibility of Using Noninvasive Wearable Biometric Monitoring Sensors to Detect Influenza and the Common Cold Before Symptom Onset.” Jama Netw Open 4, no. 9 (September 1, 2021): e2128534. https://doi.org/10.1001/jamanetworkopen.2021.28534.

PMID
34586364
Full Text

Mahle, Rachael E., Sunil Suchindran, Ricardo Henao, Julie M. Steinbrink, Thomas W. Burke, Micah T. McClain, Geoffrey S. Ginsburg, Christopher W. Woods, and Ephraim L. Tsalik. “Validation of a Host Gene Expression Test for Bacterial/Viral Discrimination in Immunocompromised Hosts.” Clin Infect Dis 73, no. 4 (August 16, 2021): 605–13. https://doi.org/10.1093/cid/ciab043.

PMID
33462581
Full Text

Chambers, Henry F., Scott R. Evans, Robin Patel, Heather R. Cross, Anthony D. Harris, Yohei Doi, Helen W. Boucher, et al. “Antibacterial Resistance Leadership Group 2.0: Back to Business.” Clin Infect Dis 73, no. 4 (August 16, 2021): 730–39. https://doi.org/10.1093/cid/ciab141.

PMID
33588438
Full Text

Steinbrink, Julie M., Rachel A. Myers, Kaiyuan Hua, Melissa D. Johnson, Jessica L. Seidelman, Ephraim L. Tsalik, Ricardo Henao, et al. “The host transcriptional response to Candidemia is dominated by neutrophil activation and heme biosynthesis and supports novel diagnostic approaches.” Genome Med 13, no. 1 (July 5, 2021): 108. https://doi.org/10.1186/s13073-021-00924-9.

PMID
34225776
Full Text

Cawcutt, Kelly A., Robin Patel, Jeff Gerber, Angela M. Caliendo, Sara E. Cosgrove, Elizabeth Dodds Ashley, Piero Garzaro, Melissa Miller, Ebbing Lautenbach, and Ebbing IDSA Research Summit “Leveraging Existing and Novel Diagnostics for Optimizing Outpatient Antibiotic Stewardship in Patients with Respiratory Tract Infections” Group. “Leveraging Existing and Soon-to-Be-Available Novel Diagnostics for Optimizing Outpatient Antibiotic Stewardship in Patients With Respiratory Tract Infections.” Clin Infect Dis 72, no. 12 (June 15, 2021): e1115–21. https://doi.org/10.1093/cid/ciaa1815.

PMID
33277647
Full Text

Pages