DeCure's autonomous Dermatology AI scientist is researching a drug-repurposing hypothesis for chronic idiopathic urticaria — screening already-approved drugs against its 4-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleChronic idiopathic urticaria maps to a 4-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 chronic idiopathic urticaria 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
Bruton tyrosine kinase (BTK) — BTK 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 7h-pyrrolo[2,3-d]pyrimidin-4-yldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 6VXQ · 1.4 Å · ligand N-{[4-(7H-pyrrolo[2,3-d]pyrimidin-4-yl)phenyl]methyl}benzamide (RQS). Experimental structure, not a prediction.
What the evidence adds up to
In a 2003 review, chronic idiopathic urticaria was divided into at least two subgroups. Autoimmune chronic urticaria, due to autoantibodies against the high-affinity IgE receptor or IgE itself, accounted for 30–50% of patients previously labelled as having chronic idiopathic urticaria. These patients also had an increased frequency of antithyroid autoantibodies. The remaining 50% remained truly idiopathic, though some may still have an autoimmune basis that evades current detection. Convenient routine diagnostic tests for the autoimmune subset were not available.
A 2008 open study enrolled 22 patients with chronic urticaria unresponsive to conventional antihistamines and corticosteroids. Biopsies of urticaria lesions were classified into three histologic patterns, and patients were assigned to dapsone plus antihistamines, colchicine or dapsone alone, or montelukast. After 12 weeks, 4 patients in the dapsone-plus-antihistamine group, 8 in the colchicine-or-dapsone group, and 7 in the montelukast group had complete control of urticaria. One patient in the colchicine-or-dapsone group and two in the montelukast group did not respond. Two years after discontinuation, 16 patients remained free of urticaria. The study was open-label and small.
A 2013 review of 52 randomised controlled trials of pharmacological treatment for chronic autoimmune or idiopathic urticaria found that 75% of trials lasted less than 8 weeks, 71% had no follow-up after treatment discontinuation, and only 8% had clear blinding with centralised randomisation. The primary outcome was specified in 63% of articles, and 15 different scores were used. Among 12 studies with a non-significant primary outcome, 10 used a “spin” strategy to present the experimental treatment as beneficial despite the lack of statistical significance. The review concluded that studies should focus on clinically relevant and reproducible primary outcomes, long-term follow-up, limited use of placebo, and avoiding spin.
A 2006 diagnostic and therapeutic protocol for chronic urticaria was derived from a literature review with cost-effective evaluation, but the authors acknowledged that much remains to be clarified on pathogenetic mechanisms and aetiological factors. A 2018 article noted that treating the cause is the most desirable option but is not applicable in the majority of patients, in whom urticaria is idiopathic. Symptomatic treatment remains the most frequent form of management, and chronic urticaria can persist from six weeks to over twenty years. What is still missing are reliable routine diagnostic tests for the autoimmune subset, long-term randomised trial data with standardised outcomes, and a clear understanding of the underlying mechanisms in the majority of patients.
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 Allergy and Clinical Immunology · 2003 · 144 citations
Chronic idiopathic urticaria
AbstractPURPOSE OF REVIEW: Chronic idiopathic urticaria has long been a demoralizing disease, baffling allergists and dermatologists alike, to the detriment of the patient. Recent findings, however, have shed light on causation in many, though not all, of these patients. The purpose of this review is to bring the reader up to date on the current position regarding aetiology and pathogenesis and the strength of the evidence. The review also seeks to point up rational approaches to diagnosis and treatment in the light of these developments. RECENT FINDINGS: Chronic idiopathic urticaria encompasses at least two subgroups. One of these is the now well-established entity of autoimmune chronic urticaria, due to autoantibodies against either the high-affinity IgE receptor Fc epsilon R1 or, less commonly, IgE. These patients, who co-segregate with chronic idiopathic urticaria patients having an increased frequency of antithyroid autoantibodies, represent 30-50% of the patients previously designated as having chronic idiopathic urticaria. Convenient routine diagnostic tests for this subset remain elusive. The remaining 50% of patients with chronic idiopathic urticaria remain truly 'idiopathic', although the condition in some may have an autoimmune basis, autoantibodies having eluded current techniques for detection. Selected patients with autoimmune urticaria may benefit from immunotherapy. SUMMARY: It is now known that in 30-50% of patients with chronic idiopathic urticaria, the condition has an autoimmune basis, although confirmation of the diagnosis in these patients is not straightforward. In selected patients, attempts to establish this diagnosis are worthwhile since there are important therapeutic implications.
Journal of Dermatological Treatment · 2008 · 43 citations
Urticaria unresponsive to antihistaminic treatment: An open study of therapeutic options based on histopathologic features
AbstractBACKGROUND: The non- or low-sedating H1 receptor antagonists represent the basic therapy for urticaria. OBJECTIVE: To test an alternative approach to patients unresponsive to conventional treatment. MATERIALS AND METHODS: A total of 22 patients with chronic urticaria unresponsive to conventional antihistamine treatment were enrolled for this study. They had uncontrolled urticaria even using multiple combinations of antihistamines on maximum doses and corticosteroids in short cycles (prednisone 20-40 mg, per os once a day, 3-7 days per month). Cutaneous biopsies of the urticaria lesions were taken. These findings were classified as: (I) a mixture of perivascular dermal inflammatory infiltrate composed of lymphocytes, monocytes and neutrophils and/or eosinophils; (II) inflammatory infiltrate composed chiefly of neutrophils; and (III) inflammatory infiltrate composed mainly of eosinophils. According to histology, the patients were submitted to one of the following therapeutic schemes: class A - antihistamine treatment plus dapsone; class B - colchicine or dapsone; class C - montelukast. RESULTS: Four patients in class A, 08 in class B and seven in class C displayed complete control of urticaria after 12 weeks of treatment; one patient in class B and two in class C did not respond to treatment. Two years after discontinuation, 16 patients are still free of urticaria. CONCLUSIONS: This study suggests an alternative approach for treating unresponsive chronic urticaria.
Study Design and Quality of Reporting of Randomized Controlled Trials of Chronic Idiopathic or Autoimmune Urticaria: Review
AbstractBACKGROUND: The recommended first-line therapy of chronic urticaria is second-generation antihistamines, but the modalities of treatment remains unclear. Numerous recommendations with heterogeneous conclusions have been published. We wondered whether such heterogeneous conclusions were linked to the quality of published studies and their reporting. OBJECTIVE: To review the study design and quality of reporting of randomized control trials investigating pharmacological treatment of autoimmune or idiopathic chronic urticaria. METHODOLOGY/PRINCIPAL FINDINGS: MEDLINE and EMBASE were searched for pharmacological randomized controlled trials involving patients with chronic autoimmune or idiopathic urticaria, with the main outcome being treatment efficacy. Data were collected on general characteristics of the studies, internal validity, studied treatments, design of the trial, outcome measures and "spin" strategy in interpreting results. Spin was defined as use of specific reporting strategies to highlight that the experimental treatment is beneficial, despite statistically nonsignificant results. We evaluated 52 articles that met our criteria. Patients were reported as blinded in 42 articles (81%) and the outcome assessor was blinded in 37 (71%). A placebo was the only comparator in 13 (25%) studies. The study duration was <8 weeks in 39 articles (75%), with no follow-up after discontinuation of treatment in 37 (71%). In 4 articles (8%), blinding was clear because they described blinding of the outcome assessor, the treatment was not recognizable (identical or double-dummy) or had no major secondary effects, and computed randomization was centralized. The primary outcome was specified in 33 articles (63%) and was a score in 31. In total, 15 different scores were used. A spin strategy was used for 10 of 12 studies with a nonsignificant primary outcome. CONCLUSION: For establishing guidelines in treatment of chronic urticaria, studies should focus on choosing clinically relevant and reproducible primary outcomes, long-term follow-up, limited use of placebo and avoiding spin strategies.
Anais Brasileiros de Dermatologia · 2025 · 10 citations · open access
Chronic spontaneous urticaria: update on pathogenesis and therapeutic implications
AbstractBACKGROUND: The understanding of chronic spontaneous urticaria pathogenesis has been increasing recently. The central role of mast cells is being reinforced, but multiple cells, pathways, and mediators are involved in a complex interrelationship. Modern therapies for its management reflect the need to encompass different mechanisms and promise to alter the course of urticaria and the long journey of those with refractory disease. Continuous updating of these aspects is necessary to optimize patient care. OBJECTIVES: To review concepts and advances in the pathogenesis of chronic spontaneous urticaria, in addition to contextualizing promising drug options for its management. METHOD: A narrative review was conducted between 1977 and 2024, including relevant articles published in the scientific literature, indexed in the PubMed system. RESULTS: A total of 25,732 articles were found. Inclusion criteria were determined by the authors' decision regarding their level of importance for furthering knowledge in the areas of pathogenesis and treatment of chronic spontaneous urticaria, with preference given to meta-analyses, systematic reviews, and randomized trials. Regarding therapeutics, 138 articles from the last 15 years were prioritized, in addition to records on ClinicalTrials.gov, and the drugs could be in the clinical trial phase. Immunobiologicals and small molecules hold promise for future treatment regimens for chronic spontaneous urticaria. STUDY LIMITATIONS: Narrative reviews do not provide statistical value to the results and outcomes studied. CONCLUSION: A review of the pathogenesis of chronic spontaneous urticaria was conducted, contextualizing these aspects with promising drug options for its treatment, particularly immunobiologicals and small molecules.
International Journal of Immunopathology and Pharmacology · 2006 · 5 citations
Diagnostic and Therapeutic <i>Iter</i> in Chronic Urticaria Patients
AbstractWe describe a diagnostic and therapeutic protocol for the management of chronic urticaria. It is derived from an extensive review of current literature, with a cost-effective evaluation of laboratory investigations and therapeutic approaches. Our protocol may not represent a cornerstone for chronic urticaria: much has in fact to be clarified on pathogenetic mechanisms and aetiological factors. Nevertheless, its application should be able, in our opinion, to identify what is useful or not in the everyday management of chronic urticaria patients.
The International Annals of Medicine · 2018 · 0 citations · open access
Pharmacotherapy of Adult Patient with Chronic Urticaria Associated with Gastritis
AbstractChronic urticaria is a challenge both for the patient and the physician. It may seem as a trivial disease, but significantly undermines the patients' quality of life. Due to the constant or constantly relapsing tormenting itch and changes in the appearance, it has a negative impact on the social life and mental state of the patients that limit their working lives. The aim of treatment is to achieve complete symptom relief. However, it can take quite a long time to achieve complete remission. Treating the cause is the most desirable option, but it is, unfortunately, not applicable in the majority of patients, in which urticaria is idiopathic. In all cases, unless contraindicated, symptomatic relief should be offered while searching for the underlying cause. Symptomatic treatment is currently the most frequent form of management.
Health related quality of life is increasingly being recognized as a primary outcome in clinical trials, population studies and public health. In treatment the patient's well-being should be a central focus as CU can persist over an extended duration from six weeks to over twenty years.
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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