DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for appendicitis — screening already-approved drugs against its 31-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleAppendicitis maps to a 31-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 appendicitis 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
activin A receptor type 2A (ACVR2A) — ACVR2A 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 {4-[(5-cyclopropyl-1h-pyrazol-3-yldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 3SOC · 1.95 Å · ligand [4-({4-[(5-CYCLOPROPYL-1H-PYRAZOL-3-YL)AMINO]QUINAZOLIN-2-YL}IMINO)CYCLOHEXA-2,5-DIEN-1-YL]ACETONITRILE (GVD). Experimental structure, not a prediction.
What the evidence adds up to
The diagnosis of appendicitis remains difficult because no single clinical finding, laboratory test, or imaging tool is 100% specific and sensitive. A 2025 retrospective analysis of 109 patients found that sex and age were not significantly associated with the diagnosis, and radiating pain made appendicitis significantly less likely than localized pain (relative risk 0.0918, 95% CI 0.039–0.217). Duration of symptoms also did not significantly influence the diagnosis. Higher ALVARADO scores were associated with operative treatment: patients who had an appendicectomy had a mean score of 7.56 (SD 1.91) versus 4.92 (SD 1.56) for those managed conservatively (p < 0.001). A 2001 study using immunofluorohistochemistry found that about 50% of appendices classified as histologically normal from patients with a clinical diagnosis of appendicitis nonetheless showed strong expression of inflammatory mediators (cyclooxygenase 1 and 2, prostaglandin E2, inducible nitric oxide synthase, and major histocompatibility complex class II) in the mucosa, while none of the negative control specimens did. This suggests a subgroup of molecular inflammation that routine histology misses.
In a 2023 retrospective study of 80 patients with uncomplicated acute appendicitis during the COVID-19 pandemic, 40 received medical treatment and 40 had direct surgery. Of the 40 medically treated patients, 8 (20%) later required an operation due to recurrence. The mean hospital stay was 2 days (range 1–3) for the medical group, and the mean follow-up was 285 days. White blood cell count was significantly higher in the surgical group (p = 0.004), and length of hospital stay was longer in the non-surgical group (p < 0.001). Post-operative complication rates were similar whether patients had appendectomy directly or after recurrence (p = 1.000). Predictors of requiring surgery after medical treatment were red cell distribution width and increased appendix diameter on computed tomography (p < 0.05). The authors concluded that medical treatment is an effective alternative, and that surgery after recurrence does not carry increased complication risk compared to direct surgery.
A 2025 study from the Dioïla Reference Health Center in Mali reviewed 221 patients operated on for acute appendicitis, representing 16.9% of all surgical procedures and 67.4% of digestive surgical emergencies. Mean age was 28.4 years, with a male predominance (62.4%, sex ratio 1.7). Appendicitis was simple in 70.1% and complicated in 29.9%. Complicated forms were linked to delay in consultation (p = 0.01). Appendectomy was performed in 99.1% of patients; the appendix was completely necrotic in two. Overall postoperative morbidity was 6.3%, and mortality was zero. Mean hospital stay was 3.1 days. The incidence of appendicitis peaks between 12 and 18 years of age, and it is one of the most frequent causes of litigation for missed diagnosis in children and young people.
What is still missing is a reliable, rapid diagnostic test that can distinguish molecular inflammation from true clinical appendicitis, and prospective trials large enough to stratify patients by inflammatory markers, imaging findings, and risk scores to determine who can safely avoid surgery. The initiating signal for all forms of clinical appendicitis remains unknown.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
PubMed · 2001 · 38 citations
Evidence of an inflammatory pathologic condition in "normal" appendices following emergency appendectomy.
AbstractBACKGROUND: Appendices removed from patients with suspected appendicitis often appear normal on histologic examination. OBJECTIVE: To study appendix specimens for the expression of inflammatory markers as an indicator of presence of an inflammatory response in this subgroup of patients. METHODS: Cyclooxygenase 1 and 2, prostaglandin E(2), inducible nitric oxide synthase, and major histocompatibility complex class II were investigated by immunofluorohistochemistry using confocal laser microscopy in 15 acutely inflamed appendix specimens, 39 histologically classified "normal" appendices, and 11 negative control specimens. RESULTS: Strong expressions of all the inflammatory mediators were found in the mucosa of inflamed appendices, in approximately 50% of histologically normal appendices from patients with a clinical diagnosis of appendicitis, and in none of the normal control specimens. CONCLUSION: This study confirms the existence of a subgroup of appendicitis within the so-called histologically normal appendices in which evidence of an inflammatory pathologic condition is only obvious at a molecular level. The initiating signal for this and all other forms of clinical appendicitis still remains elusive.
AJN American Journal of Nursing · 2008 · 4 citations
Is It Appendicitis?
AbstractIn Brief Presentation can be enigmatic. The diagnosis of appendicitis is difficult, in part because patients present at various points during the progression of the condition. Moreover, there is currently no single clinical finding, laboratory test, or diagnostic tool that is 100% specific and sensitive.
Turkish Journal of Trauma and Emergency Surgery · 2023 · 2 citations · open access
Management of uncomplicated acute appendicitis during the COVID-19 pandemic: Appendectomy or non-surgical treatment?
AbstractBACKGROUND: This study aims to compare medical treatment and appendectomy in patients diagnosed with uncomplicated acute appendicitis during the COVID-19 pandemic. METHODS: Retrospectively analyzed were the data of 80 patients who received medical or surgical treatment for uncomplicated acute appendicitis between March 15, 2020, and August 31, 2020. The demographic characteristics of the patients, length of hospital stay, physical examination and radiology findings, laboratory results, and any complications were recorded. Patients were divided into two groups depending on the mode of treatment, as surgical and non-surgical. RESULTS: Forty patients were given medical treatment and 40 patients were directly operated on for appendicitis. Of the 40 patients who received medical treatment, 8 (20%) ended up requiring an operation due to recurrence. The mean duration of hospitalization was 2 days (range: 1-3), and the mean follow-up duration was 285.35±65.66 days (range: 101-379). The white blood cell count was significantly higher in the surgical group (p=0.004), and the length of hospital stay was longer in the non-surgical group (p<0.001). The prevalence of post-operative complications was similar for patients who underwent appendectomy directly on admission or after recurrence (p=1.000). Among the patients who received medical treatment, the most important predictors of requiring surgery were the red cell distribution width and increased appendix diameter in computed tomography (p<0.05). CONCLUSION: Medical treatment is an effective alternative in patients with uncomplicated appendicitis. Even in the case of a recurrence in follow-up, surgery due to a potential recurrence is not associated with an increased rate of complication compared to direct surgery.
Gastroenterology Review · 2025 · 1 citations · open access
The role of clinical, laboratory, and imaging findings in the diagnosis of appendicitis: a retrospective analysis
AbstractIntroduction: Appendicitis represents a prevalent surgical emergency globally, posing a significant risk of severe complications.These complications encompass a spectrum of conditions, including ileus, peritonitis, abscess formation, and, in extreme cases, mortality.Aim: The present study aims to assess the association of existing risk scores for the diagnosis of acute appendicitis and patient characteristics with the diagnosis of acute appendicitis, the odds of operative vs non-operative management, and postoperative outcomes.Material and methods: In total, 109 patients assessed for acute appendicitis were included in this study.Results: Sex (p = 0.99, OR = 1.01, 95% CI: 0.87-1.17)and age (p = 0.23, OR = 1.01, 95% CI: 0.98-1.04)were not found to be significantly associated with the diagnosis of appendicitis.Patients with radiating pain were significantly less likely to be diagnosed with appendicitis compared to those with localized pain (p = 4.05 10 -6 , RR = 0.0918, 95% CI: 0.039-0.217).The duration of symptoms did not significantly influence the diagnosis (p = 0.12, RR = 1.04, 95% CI: 0.98-1.11).Increased ALVARADO scores were significantly associated with operative treatment, with patients receiving an appendicectomy having a mean score of 7.56 (SD 1.91) and patients undergoing conservative management having a mean score of 4.92 (SD 1.56) (p-value < 0.001).Conclusions: The results of this study highlight the importance of clinical presentation, physical examination findings, and specific laboratory markers in the diagnosis of appendicitis.While demographic factors and certain biomarkers did not show significant associations, the combination of clinical and laboratory data can aid in accurate diagnosis and timely intervention.
AbstractThe incidence of appendicitis has its peak between 12 and 18 years of age. It is one of the commonest, and familiar, emergency surgical conditions in this age group, but it appears to be difficult to diagnose, since it is one of the most frequent causes of litigation on the basis of ‘missed diagnosis’. This paper explores why appendicitis should pose such difficulties to clinicians.
SAS Journal of Surgery · 2025 · 0 citations · open access
Epidemio-Clinical and Therapeutic Aspects of Acute Appendicitis at the Dioila Reference Health Center
AbstractObjective: To assess the epidemiological, clinical and therapeutic aspects of appendicitis at the Dioïla Reference Health Center. Methods: This was a retrospective study conducted in the surgery department of the Dioïla Reference Health Center. The records of patients admitted for acute appendicitis during the period from July 1, 2019 to December 31, 2023 were collected. Patients operated on for simple and complicated acute appendicitis were included in the study. Results: We collected the records of 221 patients operated on for acute appendicitis. They represented 16.9% of surgical procedures (n = 1301) and 67.4% (n = 328) of digestive surgical emergencies. The mean age was 28.4 ± 15.4 years. There was a male predominance (62.4%, n = 138) with a sex ratio of 1.7. Appendicitis was simple in 155 patients (70.1%) and complicated in 66 patients (29.9%). The occurrence of complicated forms was linked to a delay in consultation (p = 0.01). Appendectomy was performed in 219 patients (99.1%), the appendix was completely necrotic in 2 patients. The overall postoperative morbidity of appendicitis was 6.3% (n = 14). Mortality was zero. The average length of hospitalization was 3.1 ± 1.1 days. Conclusion: Acute appendicitis is common in Dioïla. Delay in consultation is associated with complicated forms. Laparotomy remains the only surgical approach in our department. Postoperative morbidity is high in complicated appendicitis and mortality is zero.
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.
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