DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for endometriosis of pelvic peritoneum — screening already-approved drugs against its 19-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleEndometriosis of pelvic peritoneum maps to a 19-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 endometriosis of pelvic peritoneum 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
ABO, alpha 1-3-N-acetylgalactosaminyltransferase and alpha 1-3-galactosyltransferase (ABO) — ABO 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 6-deoxy-alpha-l-galactopyranosyldrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 4Y63 · 1.3 Å · ligand octyl 2-O-(6-deoxy-alpha-L-galactopyranosyl)-beta-D-galactopyranoside (BHE). Experimental structure, not a prediction.
What the evidence adds up to
Endometriosis of the pelvic peritoneum affects 6–10% of women of reproductive age and is defined by endometrial tissue outside the uterus, most commonly attached to the pelvic peritoneum. A 2013 review summarises evidence that the peritoneal mesothelium itself plays a key role in the disease. Differential expression of peritoneal mesothelial adhesion factors in women with endometriosis may provide attachment sites for ectopic endometrial cells. Loss of tight junctions in peritoneal mesothelial cells may allow binding or early invasion into the extracellular matrix, and epithelial-to-mesenchymal transition of these cells may increase lesion invasion and fibrotic tissue formation. The peritoneum may also contribute to invasion potential through production of matrix metalloproteinases, and peritoneal immune scavenging function appears lowered, with increased macrophage-derived secretion products linked to cell proliferation, adhesion, and neovascularisation.
A 2021 study reported outcomes of laparoscopic peritoneal stripping in 94 women with symptomatic early-stage endometriosis resistant to medical therapy or impairing fertility. All had suspended hormonal pretreatment for two months. At surgery, 44.7% had stage I and 48.9% stage II disease. Follow-up data were available for 87% of cases. More than three-quarters reported pain relief, attributed in part to post-surgical hormonal therapy. Of the roughly one-third who desired pregnancy after the procedure, 62% became pregnant, most without assisted reproductive therapy. Re-operation was performed in seven women. The authors conclude that consistent excision of altered peritoneum followed by adjuvant hormonal therapy and multimodal concepts yields better outcomes for pregnancy and recurrence rates.
A 2022 commentary notes that new European Society of Human Reproduction and Embryology (ESHRE) guidelines present different directions for diagnosis and treatment from the past, with more precise and applicable recommendations. A separate 2022 case report describes abdominal wall endometriosis associated with clear-cell carcinoma, noting that parietal endometriosis has a reported incidence of 0.03 to 0.4%, most often after caesarean section, and is associated with pelvic endometriosis in only 5 to 15% of cases. Rare malignant transformation, mainly to clear-cell tumours, has been described.
What remains missing is prospective data comparing surgical excision of altered peritoneum against medical therapy alone in a randomised design, particularly for fertility outcomes. The 2021 study is a single-surgeon series without a control group, and the 2013 review highlights mechanisms but not therapeutic targets. No drug is mentioned in these abstracts. The 2022 ESHRE guideline commentary does not specify which pharmacological or surgical strategies are recommended. Patient stratification by lesion phenotype, peritoneal adhesion profile, or immune status is not yet tested in trials.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Human Reproduction Update · 2013 · 178 citations · open access
The role of the peritoneum in the pathogenesis of endometriosis
AbstractBACKGROUND Endometriosis affects 6-10% of women of reproductive age and is associated with chronic pelvic pain, dysmenorrhoea, dyspareunia and infertility. Endometriosis is defined by the presence of endometrial tissue outside the uterus, most commonly attached to the pelvic peritoneum. The endometrium in women with endometriosis is reported to be altered and there is increasing evidence that the phenotype of the pelvic peritoneum may also play a role in the establishment and maintenance of the disease. The aim of this review is to discuss the putative role of the pelvic peritoneum in the pathophysiology of peritoneal endometriosis. METHODS A review was undertaken of the published literature on (i) the anatomy and physiology of the peritoneum and (ii) the potential roles played by peritoneal cells in the establishment and maintenance of peritoneal endometriosis. The current understanding of the biology of peritoneal endometriosis is summarized and the potential interaction of the peritoneum with ectopic endometrial cells in endometriosis is highlighted. RESULTS Several studies indicate that differential expression of peritoneal mesothelial adhesion factors occurs in women with endometriosis, providing potential ectopic endometrial cell attachment sites for the establishment of endometriosis lesions. Changes in the peritoneal mesothelial cell phenotype, including loss of tight junctions, may allow ectopic cells to bind to, or early lesions to invade into, the extracellular matrix. Epithelial-to-mesenchymal transition of peritoneal mesothelial cells may also lead to an increase in lesion invasion and formation of fibrotic tissue in and around the lesion. There is evidence that the peritoneal mesothelium may also play a role in the invasion potential of ectopic cells by production of MMPs increasing local tissue remodelling. Peritoneal immune scavenging function may be lowered in women with endometriosis; for example there is a notable increase in macrophage-derived secretion products in women with endometriosis associated with increases in cell proliferation, cell adhesion and neovascularization. CONCLUSIONS The pelvic peritoneum appears to play a key role in the development and maintenance of endometriosis.
Archives of Gynecology and Obstetrics · 2021 · 37 citations · open access
When and how should peritoneal endometriosis be operated on in order to improve fertility rates and symptoms? The experience and outcomes of nearly 100 cases
AbstractPURPOSE: To analyze the follow-up results of patients suffering from symptomatic early-stage endometriosis after a consistent laparoscopic peritoneal stripping of the altered peritoneum (peritoneal endometriosis and surrounding inflamed tissue) was performed. This type of endometriosis is resistant to medical therapy and/or impairs fertility. METHODS: Using our prospectively maintained database, we were able to identify all symptomatic women with the suspicion of only peritoneal endometriosis who underwent laparoscopy at our endometriosis center over a period of 5 years. All procedures were carried out in a standardized fashion by one single surgeon, who is highly experienced in minimal invasive surgery, and included a suspended hormonal pretreatment for 2 months. Postoperative outcomes including complications, fertility and recurrence rates were analysed. RESULTS: Laparoscopic peritonectomy was performed on 94 women. Follow-up data were available in 87% of these cases. At the time of surgery, almost all patients tested showed signs of stage I or II endometriosis (44.7 and 48.9%, respectively). More than three-quarters of the women reported pain relief, inter alia, due to the post-surgical hormonal therapy. About one-third of the patients wanted to have children after the procedure. 62% of them became pregnant and the majority did so without the need for assisted reproductive therapy. In seven women a re-operation was performed. CONCLUSION: According to our data, a consistent excision of altered peritoneum followed by adjuvant hormonal therapy and multimodal concepts results in better outcomes for the patient, particularly in regards to pregnancy and recurrence rates.
Daehan saengsik uihak hoeji/Clinical and experimental reproductive medicine · 2022 · 24 citations · open access
Commentary on the new 2022 European Society of Human Reproduction and Embryology (ESHRE) endometriosis guidelines
AbstractEndometriosis is a prevalent benign illness defined by the presence of endometrial glands and stroma outside of the uterine cavity, primarily on the ovary, pelvic peritoneum, and rectovaginal septum, resulting in a variety of symptoms, including dysmenorrhea and infertility. Traditionally, prolonged medical therapy has been needed in most cases since a conservative approach to surgery has usually been taken, especially in young women. In 2022, new European Society of Human Reproduction and Embryology (ESHRE) guidelines were published that present different directions for diagnosis and treatment from the past. Furthermore, the guidelines for the diagnosis and management of endometriosis are more precise and applicable than in previous editions. Thus, referring to the representative changes in the new guidelines and important updates will be beneficial for the diagnosis and management of endometriosis. This paper provides a brief overview of these developments.
Gynecology and Minimally Invasive Therapy · 2014 · 20 citations · open access
Visible and occult microscopic lesions of endometriosis
AbstractEndometriosis is a multifactorial disease mostly affecting women of reproductive age and is associated with chronic pelvic pain and infertility. Even after 300 years, most of the literature claims that pathogenesis and/or pathophysiology of endometriosis is still elusive. Recurrence of pain and lesion continues to occur after effective medical or surgical therapies. Once generated within the pelvis due to retrograde entry of menstrual debris, peritoneal endometriotic lesions time-dependently change their color appearance resulting from certain biochemical change within lesions. A variable pattern of endometriotic lesions within the pelvis can be detected by laparoscopy as visible peritoneal endometriosis. It is generally believed that besides ovarian steroid hormones, the growth of endometriosis can be regulated by the innate immune system in the pelvic microenvironment by their interaction with endometrial cells and immune cells. Even with the careful eyes of an expert surgeon, we may sometimes miss detecting peritoneal lesion within the peritoneal cavity or deep into the peritoneum. In such a case, random collection of normal peritoneum may carry the possibility to identify some hidden endometriotic lesions by microscopy and these lesions can be named as occult (invisible) microscopic endometriosis (OME). Here, we discuss the color appearance of peritoneal lesions and activity of these lesions by analysis of a panel of activity markers. Finally we discuss our recent findings on OME, their biological and clinical significance, and try to make a possible link in the origin between visible endometriosis and OME.
Journal of Clinical and Medical Images Case Reports · 2022 · 0 citations
Surgery of abdominal wall endometriosis associated with clear-cell carcinoma: Case report and review
AbstractThe peritoneum is a rare location for endometriosis, with a reported incidence of parietal endometriosis of approximately 0.03 to 0.4%. It most often occurs in the aftermath of a caesarean section and is associated with pelvic endometriosis in only 5 to 15% of cases. Rare cases of malignant transformation have been described, mainly in the form of clear-cell tumours.
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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