DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for acute chest syndrome — screening already-approved drugs against its 3-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleAcute chest syndrome maps to a 3-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
No approved-drug candidate for acute chest syndrome is corroborated in the literature DeepSearch retrieved. Some conditions are managed with non-pharmacological care — a device, surgery or physical therapy — rather than a medicine; that may be the case here, or the literature we found may simply be too sparse yet to support a drug-repurposing angle.
Molecular view
3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) — HMGCR is one of the genes genetically linked to this disease in Open Targets — shown as context, not as a drug target we're pursuing: no approved-drug candidate for this disease is yet corroborated in the literature we found.
Loading structure…
helix sheet coadrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 1DQA · 2.0 Å · ligand COENZYME A (COA). Experimental structure, not a prediction.
What the evidence adds up to
Acute chest syndrome occurred in 42% of adult Afro-Caribbean patients with sickle cell disease in a 12-year retrospective cohort study on Curaçao. Among 81 episodes in 53 patients, those with HbSS were more prone to recurrences than those with HbSC (odds ratio 2.96, P = .09), though the risk and incidence of a first episode did not differ significantly between genotypes. Abnormal chest sounds were found in 91% of cases at diagnosis, but 48% had normal chest roentgenograms at that time, with radiologic abnormalities developing after a mean delay of 5.4 days. Mortality was 6% and mean hospital stay was 20 days; neither was influenced by transfusions or anticoagulation. All five non-surviving patients were women with HbSS who had more previous admissions for sickle cell disease and acute chest syndrome.
A separate review from 2000 states that acute chest syndrome is the leading cause of mortality in sickle cell disease, that children tend to have milder infectious disease while adults often have more severe disease with pulmonary fat embolism, and that a high white blood cell count and falling haemoglobin are associated. It reports that hydroxyurea has been shown to decrease the incidence of acute chest syndrome. Another review from 2002 describes treatment as primarily supportive, including hydration, analgesia, supplemental oxygen, antibiotics, blood transfusion, and mechanical ventilation.
One abstract from 2015 concerns an accelerated diagnostic protocol for acute chest pain in a general chest pain centre, not sickle cell disease. In that study of 585 low-to-moderate risk patients, the accelerated protocol was associated with fewer readmissions for chest pain (3% vs 9%) and fewer acute coronary syndromes (0.3% vs 3.2%) over 90 days, with similar cost per patient. This abstract does not address sickle cell disease or acute chest syndrome in that context.
What is still missing are prospective trials testing specific interventions for acute chest syndrome in sickle cell disease, adequately powered to detect differences in mortality or length of stay. The existing evidence is observational or review-based, with no randomised controlled data showing that any drug beyond hydroxyurea (for prevention) alters the course of an acute episode. Patient stratification by genotype, severity of prior disease, and presence of pulmonary fat embolism remains unvalidated in a treatment trial. Funding for such trials is lacking.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Archives of Internal Medicine · 1994 · 31 citations
Acute chest syndrome in adult Afro-Caribbean patients with sickle cell disease. Analysis of 81 episodes among 53 patients
AbstractBACKGROUND: To evaluate the frequency, presentation, and course of the acute chest syndrome (ACS) in adult Afro-Caribbean patients with sickle cell disease (SCD). PATIENTS AND METHODS: Retrospective cohort study during a 12-year period in patients with SCD at least 14 years of age, discharged with a diagnosis of ACS from the only hospital on the Caribbean island of Curaçao, where 109 patients with SCD (62 HbSS, 47 HbSC) were observed. RESULTS: Eighty-one episodes of ACS occurred (57 in 34 patients with HbSS and 24 in 19 patients with HbSC). The risk (odds ratio, 1.80; P = .13) and incidence (7.6 vs 4.2 per 100 patient-years; P > .2) of ACS did not differ between patients with HbSS and HbSC, but recurrent ACS affected patients with HbSS more (odds ratio, 2.96; P = .09). Abnormal chest sounds (mainly bilateral crepitations) were found in 91% of cases at diagnosis, but 48% had normal chest roentgenograms at that time and had delayed development (5.4 +/- 3.4 days) of radiologic abnormalities. Patients with HbSS and HbSC had similar clinical presentations. Mortality (6%) and hospital stay (20 days) were not influenced by the use of transfusions or anticoagulation. All five nonsurviving female patients with HbSS had had more previous admissions for SCD and ACS. CONCLUSIONS: Acute chest syndrome occurs in 42% of adult Afro-Caribbean patients with SCD; patients with HbSS are more prone to recurrences. Delayed development of radiologic infiltrates is common. Interventions apart from supportive care do not influence the course of ACS. Fatal ACS occurs in patients with a more severe form of SCD.
AbstractAcute chest syndrome is an acute pulmonary illness in patients with sickle cell disease. It is a common problem, causing significant morbidity and mortality. Many factors may cause this syndrome. Treatment is primarily supportive. Therapy includes hydration, analgesia, supplemental oxygen, antibiotics, blood transfusion and mechanical ventilation. Early detection and aggressive management may limit its severity and prevent its complications. This article reviews the current information for its definition, frequency, pathogenesis, clinical features, complications, investigations, management and prevention. Recent advances in management of acute and recurrent attacks will be discussed.
Clinical Outcomes and Cost Effectiveness of Accelerated Diagnostic Protocol in a Chest Pain Center Compared with Routine Care of Patients with Chest Pain
AbstractAIMS: The aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. METHODS AND RESULTS: Hospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (p<0.001). During hospitalization, 298 accelerated diagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (p<0.001). Throughout the 90-day follow-up, diagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (p<0.001). Ultimately, most patients in both groups had non-invasive imaging testing. Accelerated diagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), p<0.01], and acute coronary syndromes [1 (0.3%) vs. 9 (3.2%), p<0.01], during the follow-up period. The accelerated diagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14-0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)]. CONCLUSION: An accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources.
Journal of Intensive Care Medicine · 2000 · 5 citations
Acute Chest Syndrome in Sickle Cell Disease: Pathophysiology and Management
AbstractAcute chest syndrome (ACS) is defined as the development of a new pulmonary infiltrate and respiratory symptoms in a patient with sickle cell disease (SCD). One of the most serious complications of SCD, ACS is the leading cause of mortality in patients with SCD. ACS is age dependent, with children having milder disease that often is infectious. Adults often have more severe disease, with pulmonary fat embolism secondary to preceding long bone infarction frequently as a contributing factor. Rapid diagnosis and a high index of suspicion are crucial since this syndrome may have a high mortality rate. A high white blood cell count and a felling hemoglobin tend to be associated with this illness. Patients are often febrile, but may not have positive blood or sputum cultures. Appropriate therapy includes judicious fluids, close attention to respiratory care, antibiotics, and transfusion therapy. Use of the drug, hydroxyurea, has been shown to decrease the incidence of ACS. Patients with repeated episodes are at risk for the development of chronic lung disease and pulmonary hypertension. New treatment strategies such as inhibitors of cytokines and pulmonary vasodilators such as nitric oxide may reduce the high mortality of ACS.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
