DeCure's autonomous Respiratory AI scientist is researching a drug-repurposing hypothesis for bronchiolitis obliterans — 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 moduleBronchiolitis obliterans 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 bronchiolitis obliterans 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.
What the evidence adds up to
Bronchiolitis obliterans is a rare and severe chronic lung disease that can follow bone marrow or lung transplantation, infection, toxic inhalation, or connective tissue disease; its pathology, pathogenesis, and best treatment remain under investigation. In a 2018 review, the authors state that these areas are still the subject of ongoing research.
A 2008 study of 20 children with post-infectious bronchiolitis obliterans (mean age 11.4 years, 70% boys) found reduced functional capacity. Eleven of the 20 patients had peak oxygen uptake below 84% of predicted on cardiopulmonary exercise testing. Mean distance walked in the six-minute walk test was 77% of predicted (512 metres). Peak oxygen uptake correlated with forced vital capacity in litres (r = 0.90), with FEV1 in litres (r = 0.86), and inversely with residual volume/total lung capacity ratio (r = -0.71 for absolute values, r = -0.63 for percentage predicted). The authors note the six-minute walk test could be an alternative where cardiopulmonary exercise testing is not available.
A 2023 review of anti-inflammatory therapy options for bronchiolitis obliterans in children describes the disease as a non-reversible chronic obstructive lung disease with respiratory insufficiency and disability. The authors state that management and efficient therapy algorithms remain a burning issue, and that risk of side effects from systemic corticosteroids necessitates a search for alternative therapies. They present information on combined use of inhaled corticosteroids, azithromycin, montelukast, and N-acetylcysteine, but do not report efficacy data from any trial.
A 2019 retrospective review of 102 patients with post-infectious bronchiolitis obliterans (68.6% male, mean age at diagnosis 34.3 months) reported that before diagnosis 34.3% had required intensive care. Persistent cough (90.2%), wheezing (96.1%), and shortness of breath (91.2%) were the most frequent findings. Treatments included inhaled corticosteroids (92.2%), six months of azithromycin (69.6%), and six months of oral steroid (61.8%). Eleven patients (10.8%) needed oxygen and ten (9.8%) required bilevel positive airway pressure support. Among 49 patients with pre- and post-treatment CT scans, the mean modified Bhalla score fell from 9.1 to 6.8 after treatment. Pre-treatment mosaicism and peribronchial thickening were present in all patients; post-treatment, mosaicism persisted in 93.9% and peribronchial thickening in 100%. Bronchiectasis decreased from 67.3% to 51%, atelectasis from 91.8% to 65.3%, hyperinflation from 81.6% to 69.4%, and air trapping from 98% to 87.8%. The authors present these as sociodemographic and clinical features and response to long-term steroid and azithromycin treatment, but the study is retrospective and uncontrolled.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Pediatric Pulmonology · 2018 · 91 citations
Post‐infectious bronchiolitis obliterans
AbstractBronchiolitis obliterans is a rare and severe chronic lung disease resulting from a lower respiratory tract lesion. It may occur after a bone marrow or lung transplantation, infectious diseases, or less frequently after inhaling toxic substances or after connective tissue diseases. Pathology, pathogenesis, and molecular biology, as well as the best treatment of bronchiolitis obliterans, remain the subject of ongoing research. This review discusses our current knowledge of different areas of bronchiolitis obliterans associated with infectious lesions.
Functional capacity assessment in children and adolescents with post-infectious bronchiolitis obliterans
AbstractOBJECTIVE: To assess functional capacity during exercise in children and adolescents with post-infectious bronchiolitis obliterans (PIBO). METHODS: 20 children with PIBO, aged 8-16 years old, and in follow-up at an outpatient clinic carried out cardiopulmonary exercise testing (CPET), a 6-minute walk test (6MWT) and pulmonary function tests (PFT), according to American Thoracic Society (ATS), European Respiratory Society (ERS) and American College of Chest Physicians (ACCP) guidelines. Results were expressed as percentages of predicted reference values: Armstrong's for CPET, Geiger's for 6MWT, Knudson's for spirometry, and Zapletal's for plethysmography. RESULTS: Mean age (+/- SD) was 11.4+/-2.2 years; 70% were boys; mean weight: 36.8+/-12.3 kg; mean height: 143.8+/-15.2 cm. When compared to reference values, PFT detected lower airflows (spirometry) and higher volumes (plethysmography). Eleven patients had reduced peak VO2 values in CPET (< 84% predicted). The mean distance walked (6MWT) was 77.0+/-15.7% of predicted (512+/-102 m). Peak VO2 was not correlated with 6MWT, but it was correlated with FVC (L) (r = 0.90/p = 0.00), with FEV1 (L) (r = 0.86/p = 0.00) and with RV/TLC, both in absolute values (r = -0.71/p = 0.02) and as percentages of predicted values (r = -0.63/p = 0.00). CONCLUSIONS: The majority of these post-infectious bronchiolitis obliterans patients exhibited reduced functional capacity, exhibited during both CPET and the 6MWT. Due to its greater feasibility, 6MWT could be an alternative where CPET is not available.
Analysis of Anti-Inflammatory Therapy Options for Bronchiolitis Obliterans in Children
AbstractAim: To present the relevant information on the new approaches to the management of obliterating bronchiolitis in children, based on the data generated by foreign researchers. Key Points. Obliterating bronchiolitis is a non-reversible chronic obstructive lung disease associated with respiratory insufficiency, significant deterioration in the quality of life, and steady signs of disability. Despite the fact that this topic is of high interest, the management of patients and efficient therapy algorithms are a burning issue. A risk of side effects from systemic corticosteroids necessitates the search for alternative therapies. This overview presents information on a combined use of inhaled corticosteroids, azithromycin, monteleukast, and N-acetylcysteine. Conclusion. Further development of alternative therapies for chronic obliterating bronchiolitis can help in achieving efficient control of this disease. Keywords: obliterating bronchiolitis, therapy, children.
GP283 Clinical and radiological evaluation of patients with postinfectious bronchiolitis obliterans
Abstract<h3>Introduction</h3> Postinfectious bronchiolitis obliterans is characterized by persistent symptoms and signs of obstructive pulmonary disease following acute bronchial injury. It usually occurs with persistent wheezing and cough as a result of severe viral infections. The aim of this study was to investigate the socio-demographic characteristics, treatment status, and clinical response of our cases of postinfectious bronchiolitis obliterans. <h3>Methods</h3> The records of 102 patients with postinfectious bronchiolitis obliterans who were followed-up in our clinic were retrospectively reviewed. Sociodemographic characteristics, treatments, pre-treatment and post-treatment complaints, pulmonary function tests, clinical status, radiological changes were evaluated. <h3>Results</h3> 68.6% (n = 70) of our patients were male. The mean age of the patients at the time of the study was 88.8 ± 53.5 months, and the age of diagnosis was 34.3 ± 36.4 months. The mean period from the first complaints to the date of diagnosis was 22.8 ± 33.8 months. 59% (57) of the patients had a history of smoking in one of their parents. In 62.7% of the cases, the first lower respiratory tract infection was bronchopneumonia and 36.3% was in the acute bronchiolitis. Before the diagnosis, 35 patients had intensive care hospitalization (34.3%). Persistent cough (90.2%), wheezing (96.1%), shortness of breath (91.2%) and purulant cough (75%) were the most frequent findings. When treatments of the patients were evaluated; inhaled corticosteroids were 92.2%, 6 months azithromycin 69.6%, 6 months oral steroid 61.8%. 11 patients (10.8%) needed oxygen and 10 patients (9.8%) required Bilevel Positive Airway Pressure (BPAP) support. Before and after treatment of 49 patients, lung CTs were evaluated by radiologist and modified Bhalla scores were calculated. Pre-treatment mosaism and peribronchial thickening were detected in all patients. There were bronchiectasis 67.3%, atelectasis 91.8%, hyperinflation 81.6%, air trapping 98% of patients. Post-treatment radiological evaluation revealed mosaism 93.9%, peribronchial thickening 100%, bronchiectasis 51%, atelectasis 65.3%, hyperinflation 69.4%, air trapping 87.8%. The mean Bhalla score was 9.1 ± 4.1 before the treatment and it was found to be 6.8 ± 4.6 after treatment. <h3>Discussion and Conclusion</h3> Postinfectious bronchiolitis obliterans is a rare condition with obstruction findings. It occurs as a result of immune mechanisms after severe lung infection, especially at a young age. In this study, we aimed to present sociodemographic characteristics, clinical features and especially response to long-term sterolid and azithromycin treatment in patients with bronchiolitis obliterans.
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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