DeCure's autonomous AMR AI scientist is researching a drug-repurposing hypothesis for anthrax infection — screening already-approved drugs against its 13-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleAnthrax infection maps to a 13-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
approvedDoxycyclineApproved drug
Structures already discussed alongside anthrax infection in the retrieved literature, rendered from public PubChem SMILES. Which drugs appear here reflects the evidence found, not a ranked prediction.
Molecular view
Crystal structure of Alpha1-antichymotrypsin variant DBS-I1: a drug-binding serpin for doxycycline — Doxycycline has a real, experimentally solved structure in complex with this target (PDB 5OM2, 1.47 Å). This is the drug's own deposited structure, not a prediction, and confirms it is a structurally characterised molecule rather than an untested guess.
Loading structure…
helix sheet dxtdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 5OM2 · 1.47 Å · ligand Doxycycline (DXT). Experimental structure, not a prediction.
What the evidence adds up to
Raxibacumab, a human monoclonal antibody against the protective antigen component of anthrax toxin, improved survival in rabbits and monkeys with symptomatic inhalational anthrax. In therapeutic-intervention studies, survival was 44% (8 of 18) in rabbits given 40 mg per kilogram versus 0% (0 of 18) with placebo (P=0.003), and 64% (9 of 14) in monkeys versus 0% (0 of 12) with placebo (P<0.001). Animals were exposed to aerosolised B. anthracis spores at approximately 200 times the median lethal dose. In 333 healthy human volunteers, a single 40 mg per kilogram intravenous dose had a half-life of 20 to 22 days and produced drug concentrations exceeding levels protective in animals. The drug works by preventing protective antigen from binding to host-cell receptors, blocking toxin entry. Obiltoxaximab, another monoclonal antibody against protective antigen, also showed higher survival rates in New Zealand White rabbits and cynomolgus macaques after anthrax exposure, and was tolerated in healthy humans with a relatively low incidence of adverse events.
For antibiotic treatment, the 2001 CDC recommendations included ciprofloxacin, doxycycline, and penicillin G procaine for prophylaxis, based on monkey efficacy data and pharmacokinetic considerations. Amoxicillin was an option for children and pregnant women exposed to penicillin-susceptible strains, but was not widely recommended as first-line due to lack of FDA approval and uncertain efficacy. The 2024 CDC guidelines for systemic anthrax recommend a combination of a tetracycline (doxycycline or minocycline) with meropenem or a fluoroquinolone. A 2025 study in non-human primates with late-stage systemic anthrax reported high efficacy for doxycycline as monotherapy or in combination with levofloxacin, using a trigger-to-treat design, supporting the current CDC recommendations. These guidelines rely on animal studies because controlled human trials of anthrax treatment are not feasible.
The US anthrax vaccine programme has been described as having critical shortcomings, with calls for direct government production and capacity for preemptive public immunisation. No controlled human efficacy data exist for any anthrax treatment or vaccine, and all therapeutic approvals rest on animal models and human safety and pharmacokinetic studies. What remains missing is the impossibility of conducting a definitive human efficacy trial, reliance on animal rule approvals, and the need for stockpile logistics and distribution plans that can deliver monoclonal antibodies or combination antibiotics rapidly after an aerosol release.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
New England Journal of Medicine · 2009 · 292 citations · open access
Raxibacumab for the Treatment of Inhalational Anthrax
AbstractBACKGROUND: Inhalational anthrax caused by Bacillus anthracis is associated with high mortality primarily due to toxin-mediated injury. Raxibacumab is a human IgG1lambda monoclonal antibody directed against protective antigen, a component of the anthrax toxin. METHODS: We evaluated the efficacy of raxibacumab as a prophylactic agent and after disease onset in a total of four randomized, placebo-controlled studies conducted in rabbits and monkeys. Animals were exposed to an aerosolized target exposure of B. anthracis spores that was approximately 100 times (in the prophylactic studies) and 200 times (in the therapeutic-intervention studies) the median lethal dose. In the therapeutic-intervention studies, animals were monitored for the onset of symptoms. Animals with detectable protective antigen in serum, a significant increase in temperature, or both received a single intravenous bolus of placebo or raxibacumab at a dose of either 20 mg per kilogram of body weight or 40 mg per kilogram. The primary end point was survival at day 14 (in rabbits) or at day 28 (in monkeys). Safety studies were conducted with intravenous raxibacumab (40 mg per kilogram) in 333 healthy human volunteers. RESULTS: In both rabbits and monkeys, the time to detection of protective antigen correlated with the time to bacteremia (r=0.9, P<0.001). In the therapeutic-intervention studies, the survival rate was significantly higher among rabbits that received raxibacumab at a dose of 40 mg per kilogram (44% [8 of 18]) than among rabbits that received placebo (0% [0 of 18]; P=0.003). Raxibacumab treatment also significantly increased survival in monkeys (64% [9 of 14], vs. 0% [0 of 12] with placebo; P<0.001). In human subjects, intravenous raxibacumab at a dose of 40 mg per kilogram had a half-life of 20 to 22 days and provided a maximum concentration of the drug in excess of levels that are protective in animals. Concentrations of raxibacumab provide a surrogate end point that should be predictive of clinical benefit. CONCLUSIONS: A single dose of raxibacumab improved survival in rabbits and monkeys with symptomatic inhalational anthrax. (ClinicalTrials.gov number, NCT00639678.)
Clinical Issues in the Prophylaxis, Diagnosis, and Treatment of Anthrax
AbstractOn November 18, 2001, a meeting was held at the Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, to discuss the prophylaxis, diagnosis, and treatment of anthrax.Participants included clinicians and health department personnel from areas where anthrax cases were identified, infectious disease experts, representatives of professional societies, and experts from federal agencies.A patient recovering from inhalational anthrax also described her illness.The following is a summary of the presentations and discussion. Prophylaxis 1Ciprofloxacin, doxycycline, and penicillin G procaine have been approved by the Food and Drug Administration (FDA) for prophylaxis of inhalational Bacillus anthracis infection, on the basis of efficacy data in monkeys and pharmacokinetic, pharmacodynamic, and safety considerations (1-3).During the recent bioterrorist attacks, interim CDC recommendations for anthrax prophylaxis include ciprofloxacin or doxycycline; amoxicillin (in three daily doses) is an option for children and pregnant or lactating women exposed to strains susceptible to penicillin (4-6), to avoid potential toxicity of quinolones and tetracyclines.Amoxicillin is not widely recommended as a firstline prophylactic agent, however, because of lack of FDA approval, lack of data regarding efficacy, and uncertainty about the drug's ability to
Infection and Drug Resistance · 2014 · 81 citations · open access
Raxibacumab: potential role in the treatment of inhalational anthrax
AbstractAnthrax is a highly contagious and potentially fatal human disease caused by Bacillus anthracis, an aerobic, Gram-positive, spore-forming rod-shaped bacterium with worldwide distribution as a zoonotic infection in herbivore animals. Bioterrorist attacks with inhalational anthrax have prompted the development of more effective treatments. Antibodies against anthrax toxin have been shown to decrease mortality in animal studies. Raxibacumab is a recombinant human monoclonal antibody developed against inhalational anthrax. The drug received approval after human studies showed its safety and animal studies demonstrated its efficacy for treatment as well as prophylaxis against inhalational anthrax. It works by preventing binding of the protective antigen component of the anthrax toxin to its receptors in host cells, thereby blocking the toxin's deleterious effects. Recently updated therapy guidelines for Bacillus anthracis recommend the use of antitoxin treatment. Raxibacumab is the first monoclonal antitoxin antibody made available that can be used with the antibiotics recommended for treatment of the disease. When exposure is suspected, raxibacumab should be given with anthrax vaccination to augment immunity. Raxibacumab provides additional protection against inhalational anthrax via a mechanism different from that of either antibiotics or active immunization. In combination with currently available and recommended therapies, raxibacumab should reduce the morbidity and mortality of inhalational anthrax.
American Journal of Public Health · 2007 · 29 citations · open access
Anthrax Vaccine and Public Health Policy
AbstractThe Centers for Disease Control and Prevention has classified Bacillus anthracis, the causative organism of anthrax, as a category A potential bioterrorism agent. There are critical shortcomings in the US anthrax vaccine program. Rather than depending on the private sector, the government must assume direct production of anthrax vaccine. The development of a capacity capable of preemptive immunization of the public against anthrax should be considered.
Obiltoxaximab: Adding to the Treatment Arsenal for <i>Bacillus anthracis</i> Infection
AbstractOBJECTIVE: To review the safety and efficacy of obiltoxaximab, a monoclonal antibody indicated for the treatment of Bacillus anthracis inhalational anthrax in adult and pediatric patients. DATA SOURCES: A MEDLINE (1946 to May, week 1, 2017) and EMBASE (1980 to 2017, week 19) search was performed using the search terms obiltoxaximab OR ETI-204 OR Anthim AND anthrax. STUDY SELECTION AND DATA EXTRACTION: All English-language clinical studies in both animal and human models assessing the safety and efficacy of obiltoxaximab were included. DATA SYNTHESIS: A total of 5 articles have been published on clinical studies examining safety and efficacy of obiltoxaximab. Efficacy studies in 2 animal models, New Zealand White rabbits and cynomolgus macaques, showed higher rates of survival post-anthrax exposure when obiltoxaximab was administered. Safety studies in healthy human volunteers showed that it was tolerated, with a relatively low incidence of adverse events. CONCLUSION: Based on these clinical studies and the implausibility of conducting a trial in infected individuals, obiltoxaximab is a safe and efficacious addition to the anthrax antitoxin armamentarium to protect against and treat inhalational anthrax.
Expert Opinion on Investigational Drugs · 2010 · 7 citations
Raxibacumab for inhalational anthrax: an effective specific therapeutic approach?
AbstractIMPORTANCE OF THE FIELD: Inhalational anthrax is a disease with a high lethality potential and current therapeutic interventions with antibiotics to manage the bacteraemia might not always be fully effective. Blocking the activity of the toxins with raxibacumab, a fully-human mAb directed against the protective antigen of Bacillus anthracis, may serve as an adjunct treatment. The existing ones are aimed at preventing post-exposure bacteraemia but might not be always fully protective. Therefore, more specific 'therapies' are needed and the protective antigen of B. anthracis might be targeted effectively with raxibacumab, which is a blocking human mAb. AREAS COVERED IN THIS PAPER: To discuss the results of experimental and human studies evaluating raxibacumab for inhalational anthrax. WHAT THE READER WILL GAIN: Raxibacumab was efficacious prophylactically after exposure and therapeutically before exposure in rabbit and monkey animal models of inhalational anthrax and exhibited good safety and pharmacokinetic profiles in healthy humans. TAKE HOME MESSAGE: Raxibacumab is a promising prophylactic and therapeutic for inhalational anthrax.
bioRxiv (Cold Spring Harbor Laboratory) · 2025 · 0 citations · open access
Efficacy of Doxycycline as monotherapy or in combination with Levofloxacin in treating late-stage systemic anthrax in non-human primates
AbstractAbstract Bacillus anthracis spores pose a major biosecurity threat, in light of their use in several documented bio-terror attacks and the fact that it was weaponized. The absence of specific and accurate treatment instructions in the 2001 anthrax letter attacks and the poor prognosis of patient receiving noneffective treatment, emphasized the need for reliable guidelines for treating exposed(prophylaxis) or symptomatic populations. The recent 2024 CDC guidelines for treating systemic anthrax recommend a combined treatment of a tetracycline (Minocycline or Doxycycline) with Meropenem or a fluoroquinolone. These recommendations differ from the 2001 or 2015 updates, and in the absence of significant clinical data, rely on animal studies. Previously we demonstrated, based on a rabbit model, that these recommendations are efficient in treating various stages of anthrax, ranging from post exposure prophylaxis, through systemic to involvement of the CNS. Herein we confirm our rabbit results by demonstrating the efficacy of Doxycycline as a monotherapy or in combination with Levofloxacin in treating late-stage systemic anthrax in non-human primates (NHP), in a trigger to treat type of experiment. Our experiments show high efficacy of the mono or combined therapy. Altogether, these results support the CDC guidelines by demonstrating the efficacy of this treatment in a second highly relevant NHP model.
RePEc: Research Papers in Economics · · 0 citations
Ethics in public health research: Anthrax vaccine and public health policy
AbstractThe Centers for Disease Control and Prevention has classified Bacillus anthracis, the causative organism of anthrax, as a category A potential bioterrorism agent. There are critical shortcomings in the US anthrax vaccine program. Rather than depending on the private sector, the government must assume direct production of anthrax vaccine. The development of a capacity capable of preemptive immunization of the public against anthrax should be considered.
Disease module: DeepOracle (Open Targets). Approved indication: ChEMBL drug_indication (max_phase=4). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works, resolved on OpenAlex.
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