DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for birdshot chorioretinopathy — screening already-approved drugs against its 1-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleBirdshot chorioretinopathy maps to a 1-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 birdshot chorioretinopathy 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
endoplasmic reticulum aminopeptidase 2 (ERAP2) — ERAP2 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 2~{s}drag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 7PFS · 2.7 Å · ligand [(2~{S})-3-[[(2~{S})-1-azanyl-4-methyl-1-oxidanylidene-pentan-2-yl]amino]-2-[(3,5-diphenylphenyl)methyl]-3-oxidanylidene-propyl]-[(1~{R})-1-azanyl-3-phenyl-propyl]phosphinic acid (7OO). Experimental structure, not a prediction.
What the evidence adds up to
Birdshot chorioretinopathy is the disease with the strongest known link to a human leukocyte antigen class I allele, specifically HLA-A29. The most frequent subtype in Caucasians and in patients with the disease is HLA-A*2902, but the condition has also been observed in a few HLA-A*2901 Caucasian patients. It remains absent or extremely rare in Asia, where HLA-A*2901 is the most prevalent subtype. A 2015 case report documented the first HLA-A29–positive birdshot chorioretinopathy in an African American patient, a 51-year-old woman whose ethnicity may have contributed to a 10-year delay in diagnosis. That workup was negative for sarcoid, tuberculosis, and syphilis.
Various therapeutic regimens have been tested, and most studies confirm that corticosteroids alone are not a sustainable treatment. A 1990 case report described a 40-year-old woman treated with steroids and nonsteroidal anti-inflammatory drugs; both appeared to have a beneficial effect, but the authors noted that given the slow progressive course with spontaneous remissions and exacerbations, it is extremely difficult to evaluate the success of different forms of therapy. A 2017 case report described a patient treated successfully with steroids and immunosuppressive agents, including a dexamethasone intravitreal implant and a biologic response modifier. A 2020 series of three clinical cases recommended early use of immunomodulatory drugs with close monitoring and individualised treatment to achieve the best anatomical and functional results.
The disease affects visual acuity, colour vision, contrast sensitivity, and visual field; pigmentation of birdshot spots could be a marker of disease severity. Periodic retinal electrophysiological testing plays a significant role in diagnosis and monitoring, according to a 2023 review of literature from 1988 to 2022. The disease remains of unknown cause, and many management decisions are still empirical. There is no consensus on the best treatment option or its total duration. What is still missing are prospective, controlled trials large enough to account for the disease’s variable natural history, spontaneous remissions, and exacerbations, as well as validated biomarkers to stratify patients by severity or treatment response.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Current Opinion in Ophthalmology · 2006 · 24 citations
Birdshot chorioretinopathy
AbstractPURPOSE OF REVIEW: Birdshot chorioretinopathy is the disease with the strongest link to a human leukocyte antigen class I allele. Current research aims at understanding its immunogenetic mechanisms, focusing on the A29 allele, its subtypes, and on other loci of the human leukocyte antigen region. Research criteria can be applied to define birdshot chorioretinopathy. Its heterogeneous presentations and its multiple consequences on visual function are being delineated. RECENT FINDINGS: HLA-A*2902 is the most frequent subtype in Caucasians and in patients with birdshot chorioretinopathy. The condition has also been observed, however, in a few HLA-A*2901 Caucasian patients, but remains absent or extremely rare in Asia where HLA-A*2901 is the most prevalent subtype. Birdshot chorioretinopathy affects visual acuity, color vision, contrast sensitivity or visual field and pigmentation of birdshot spots could be a marker of disease severity. Electroretinography has been used to monitor the course of the disease; abnormalities may be due to altered outer retinal function or to inner retinal dysfunction. Various therapeutic regimens have been tested and most studies confirm that corticosteroids alone are not a sustainable treatment for patients with birdshot chorioretinopathy. SUMMARY: Progress has been made in understanding the spectrum of manifestations of birdshot chorioretinopathy. The disease remains of unknown cause and many decisions regarding the management of patients are still empirical.
HLA-A29–POSITIVE BIRDSHOT CHORIORETINOPATHY IN AN AFRICAN AMERICAN PATIENT
AbstractIn Brief Purpose: To report the first documented case of HLA-A29–positive birdshot chorioretinopathy in an African American patient. Methods: A 51-year-old African American woman presented with a 10-year history of photopsia, progressive decrease in visual acuity, metamorphopsia, and new nyctalopia. Both fundi showed evidence of periphlebitis, arterial attenuation, macular edema, and diffuse chorioretinal atrophy. Results: Fluorescein angiography revealed diffuse vascular leakage, and indocyanine green showed evenly distributed and symmetrical hypofluorescent spots, which were difficult to appreciate on fundoscopy. Workup revealed a positive HLA-A29 and was negative for sarcoid, tuberculosis, and syphilis. Conclusion: Birdshot chorioretinopathy overwhelmingly affects non-Hispanic Caucasians, but there have been rare reported cases in other ethnicities including Hispanics and African Americans. This patient's ethnicity may have contributed to the 10-year delay in diagnosis. To our knowledge, this is the first documented HLA-A29 positive case of birdshot chorioretinopathy in an African American. HLA-A29 may be a useful supportive test in cases with classic clinical presentation in non-Caucasian patients to enable the correct diagnose in a timely manner. The article demonstrates the first documented case of HLA-A29–positive birdshot chorioretinopathy in an African American patient. As such, this article should be of interest to a broad readership including those interested in uveitis, birdshot chorioretinopathy, and implications of race.
Klinische Monatsblätter für Augenheilkunde · 1990 · 3 citations
Birdshot-Retinochorioideopathie: Systemische Therapie mit Corticosteroiden und nichtsteroidalen Antiphlogistika
AbstractThe symptoms and clinical course of a case of birdshot chorioretinopathy are described. The patient was a 40-year-old woman. The condition can be treated with two types of medication, i.e., steroids and nonsteroidal anti-inflammatory drugs. Both appear to have a beneficial effect. Overall, however, the prognosis for this rare disease of unknown etiology remains uncertain. Given the slow progressive course, with spontaneous remissions and exacerbations, it is extremely difficult to evaluate the success of different forms of therapy.
The Pan-American Journal of Ophthalmology · 2020 · 2 citations · open access
Birdshot chorioretinopathy: Importance of early diagnosis and therapeutic individualization
AbstractIntroduction: Birdshot chorioretinopathy (BCR) is a bilateral and recurrent posterior uveitis with an uncertain natural history and visual prognosis. Currently, there is no consensus on the best treatment option and its total duration.Clinical Cases: We present a series of three clinical cases of patients with BCR diagnosed in different stages of the disease, which demonstrates the clinical spectrum of this pathology and their treatment with different immunomodulatory drugs.Conclusion: As shown in our series of cases, the early use of immunomodulatory drugs is recommended with a close monitoring and individualized treatment to achieve the best anatomical and functional results.
The Importance of Retinal Electrophysiology in Birdshot Chorioretinopathy
AbstractBirdshot chorioretinopathy is a rare disease of probable autoimmune origin. Periodic retinal electrophysiological testing plays a significant role in the diagnosis and monitoring of this disease. This article reviews the literature available in pubmed from1988–2022 on Birdshot chorioretinopathy, with a focus on retinal electrophysiological studies.
Revista de Medicina da UFC · 2017 · 0 citations · open access
Birdshot Chorioretinopathy treated with dexamethasone intravitreal implant and a biologic response modifier: a successful management
AbstractBirdshot chorioretinopathy is an organ-specific, potentially blinding chronic of bilateral inflammation of the posterior eye segment. It is seen mainly in persons who have the HLA-A29 haplotype. The diagnosis remains clinical and is based in his hallmark, which is the presence of multiples white dots throughout the fundus, resembling a shotgun pattern. The immune mechanisms involved in its pathogenesis remains unclear and the long-term outcome is guarded. However, the use of immunosuppressive agents and newer therapies demonstrated control of the inflammation and is a hope mainly in refractory cases. We report a case of Birdshot chorioretinopathy treated successfully with steroids and immunosuppressive agents.
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.
