DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for hyperemesis gravidarum — screening already-approved drugs against its 8-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleHyperemesis gravidarum maps to a 8-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 hyperemesis gravidarum 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
progesterone receptor (PGR) — PGR 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 14beta,17alphadrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 1SQN · 1.451 Å · ligand (14beta,17alpha)-17-ethynyl-17-hydroxyestr-4-en-3-one (NDR). Experimental structure, not a prediction.
What the evidence adds up to
Hyperemesis gravidarum is a complex condition with a multifactorial aetiology characterised by severe intractable nausea and vomiting. Despite a high prevalence, studies exploring underlying causes and treatments are limited. The exact mechanism remains unclear, but an interaction of genetic, biological and psychological factors is plausible; an endocrine trigger linked to ovarian and placental hormones has been proposed but requires further clarification. A 2019 study of 35 women with hyperemesis gravidarum and 35 healthy pregnant controls found no statistically significant difference between groups for serum levels of YKL-40 (an inflammatory marker) or ischaemia-modified albumin (an oxidative marker), though median YKL-40 was numerically higher in the hyperemesis group. The authors concluded that larger studies are needed to assess these markers for predicting or monitoring the condition.
Regarding treatment, a 2011 review found no evidence that any antiemetic class is superior to another in terms of effectiveness. Use of type-3 serotonin receptor antagonists was increasing, but convincing data demonstrating their superiority over other antiemetics were lacking. A 2002 German case report described a 33-year-old primigravida at 15 weeks with extreme treatment-resistant hyperemesis gravidarum who had lost 12 kg over 11 weeks despite conventional therapy and had requested termination of pregnancy. After treatment with mirtazapine (an atypical antidepressant with antiemetic properties via postsynaptic 5HT3 receptor blockade), nausea and vomiting stabilised, oral intake became possible, and she was discharged symptom-free after two weeks; symptoms had not recurred by follow-up at 25 weeks. The authors noted that mirtazapine could be a treatment option in individual cases after careful risk-benefit assessment.
A 2007 prospective study of 27 patients managed as day cases at a single UK hospital reported that all were discharged within 24 hours with no readmissions, and an 88% satisfaction rate was recorded via questionnaire. The authors recommended day-case management. A 2014 literature review reiterated the limited research on aetiology and treatment. What remains missing are adequately powered randomised controlled trials comparing antiemetic classes, validated biomarkers for diagnosis or treatment monitoring, and prospective studies that stratify patients by severity, gestational age, and prior treatment failure to identify which interventions, if any, are effective for the most refractory cases.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
International Journal of Women s Health · 2014 · 124 citations · open access
Hyperemesis gravidarum: current perspectives
AbstractAbstract: Hyperemesis gravidarum is a complex condition with a multifactorial etiology characterized by severe intractable nausea and vomiting. Despite a high prevalence, studies exploring underlying etiology and treatments are limited. We performed a literature review, focusing on articles published over the last 10 years, to examine current perspectives and recent developments in hyperemesis gravidarum. Keywords: hyperemesis gravidarum, nausea, vomiting in pregnancy, pregnancy, antiemetics, adverse pregnancy outcomes
Pulsed steroid therapy is an effective treatment for intractable hyperemesis gravidarum
AbstractOBJECTIVE: Intractable hyperemesis gravidarum remains a serious cause of morbidity among pregnant women. If not controlled, hyperemesis gravidarum can lead to severe disability, electrolyte and acid base imbalance, and even various organ system dysfunctions. From the successful use of steroids for chemotherapy-induced emesis, corticosteroids might prove useful in hyperemesis gravidarum. The purpose of this study was to compare the efficacy of pulsed hydrocortisone therapy with that of metoclopramide for the management of intractable hyperemesis gravidarum. DESIGN: Prospective, double-blind study. SETTING: Intensive care unit of Ain Shams University Maternity Hospital. PATIENTS: Forty patients aged 19-34 yrs having a normal appearing intrauterine pregnancy, of < or =16 wks gestation, admitted to the intensive care unit with intractable hyperemesis meeting the study criteria. INTERVENTIONS: Patients were randomly assigned to receive either intravenous hydrocortisone 300 mg as a daily dose or intravenous metoclopramide 10 mg 3 times daily. After 3 days the hydrocortisone was tapered completely during the course of 1 wk, whereas the metoclopramide was continued without change for 1 wk. Patients were followed up daily during the therapy course and for 2 wks following intensive care unit discharge. MEASUREMENTS AND MAIN RESULTS: There was a significant reduction in vomiting episodes in the hydrocortisone group compared with the metoclopramide group (p < .0001). Within-patient analyses showed a significant reduction in mean vomiting episodes in the hydrocortisone group within the first 3 days (p < .0001). No patients from the hydrocortisone group but six of the patients receiving metoclopramide were readmitted for intractable vomiting within 1 wk from discharge. Five of them showed improvement on intravenous hydrocortisone therapy. CONCLUSIONS: A short course of hydrocortisone is an effective treatment for intractable hyperemesis gravidarum.
Expert Opinion on Pharmacotherapy · 2011 · 32 citations
Hyperemesis gravidarum: pathogenesis and the use of antiemetic agents
AbstractINTRODUCTION: Nausea and vomiting in pregnancy remains the most common cause of hospitalization in the first half of pregnancy. Although the exact cause is largely unknown, an interaction of genetic, biological and psychological factors is plausible. An endocrine trigger for hyperemesis has been linked with both ovarian and placental hormones, but this association requires further clarification. The use of type-3 serotonin receptor antagonists is increasing but as yet there are no convincing data to demonstrate their superiority over the other antiemetics. AREAS COVERED: A computerized search was conducted using PubMed, Embase, Cinahl, Lilacs, ISI Web of Science, the Cochrane Central Register of Controlled Trials (all from inception or 1960 to October 2010), and Research Registries of ongoing trials. The key words used were nausea, vomiting, emesis, hyperemesis gravidarum, morning sickness, pregnancy, pregnancy complications, treatment, efficacy, effectiveness, antiemetics, safety and teratogenesis. EXPERT OPINION: The precise mechanism underlying hyperemesis gravidarum remains unclear, but appears to be multifactorial. As yet there is no evidence that any antiemetic class is superior to another with respect to effectiveness.
Geburtshilfe und Frauenheilkunde · 2002 · 20 citations
Mirtazapin (Remergil®): Behandlungsoption bei therapieresistenter Hyperemesis gravidarum? - ein Fallbericht
AbstractHyperemesis gravidarum ist eine Erkrankung, die zu Gewichtsverlust, Dehydration, Elektrolytverschiebungen und im Extremfall zu schweren Organschäden führen kann, wenn keine suffiziente Therapie erfolgt. Wir berichten über eine 33-jährige erstgravide Frau in der 15. Schwangerschaftswoche mit extremer therapieresistenter Hyperemesis gravidarum. Eine somatische oder psychische Ursache der Hyperemesis war nicht zur eruieren. Nachdem die Patientin seit 11 Wochen unter der Symptomatik gelitten und trotz aller konventionellen Therapieversuche insgesamt 12 kg Gewicht verloren hatte, bat sie verzweifelt um einen Schwangerschaftsabbruch, um ihren Zustand zu beenden, obwohl es sich primär um ein Wunschkind gehandelt hatte. Ohne Hoffnung auf Erfolg stimmte sie einem Therapieversuch mit Mirtazapin zu, über dessen antiemetische Wirkung bereits Fallberichte existieren. Unter der Behandlung mit Mirtazapin i. v., später oral, stagnierten Übelkeit und Erbrechen nach kurzer Zeit, so dass ein Kostaufbau möglich wurde. Die Fortsetzung der Schwangerschaft stand damit für die Patientin nicht mehr in Frage. Nach 2 Wochen wurde sie in beschwerdefreiem Zustand entlassen. Die Behandlung mit Mirtazapin konnte nach weiteren 4 Wochen beendet werden. Beschwerden waren bis zur Nachbefragung in der 25. SSW nicht mehr aufgetreten. Mirtazapin ist ein atypisches Antidepressivum und hat sowohl noradrenerge als auch spezifisch serotonerge Wirkung (NaSSA). Die antiemetische Wirkung wird über die postsynaptische Blockade der 5HT 3 -Rezeptoren vermittelt. Unter sorgfältiger Nutzen-Risiko-Abwägung kann Mirtazapin damit im Einzelfall eine Therapieoption bei therapieresistenter Hyperemesis gravidarum sein.
Journal of Obstetrics and Gynaecology · 2007 · 12 citations
Day-case management of hyperemesis gravidarum: Feasibility and clinical efficacy
AbstractDay-case management of hyperemesis gravidarum was introduced at the Whipps Cross University Hospital in September 2003. A prospective study of patients managed as day cases between September and December 2003 was undertaken. A total of 27 cases were managed as day cases in accordance with set criteria. All were discharged within 24 h of admission. There were no re-admissions. Patient satisfaction, assessed using a questionnaire, revealed an 88% satisfaction rate. Day-case management of hyperemesis gravidarum should be encouraged. The benefits to the patient are considerable.
Medical Archives · 2019 · 4 citations · open access
Comparison of Serum Ykl-40 and Ischemia Modified Albulmin Levels Between Pregnant Women with Hyperemesis Gravidarum and Normal Pregnant Women Ykl-40 and Ima Levels in Hyperemesis Gravidarum
AbstractINTRODUCTION: The etiopathogenesis of HG is still unclear. AIM: The aim of this study was to investigate the levels of YKL-40 protein as an inflammatory marker and evaluate the levels of IMA as an oxidative marker in hyperemesis gravidarum women. MATERIALS AND METHODS: Totally 35 patients with hyperemesis gravidarum and 35 healthy pregnants were included in the study. Singleton pregnancies between 6+0 week and 13+6 weeks of gestation, with normal fetal anatomy were included in the study. Complete blood count, complete urine analyze, biochemical tests and thyroid function tests were done. RESULTS: There was no significant difference between groups for demographical features (age, gravidity, gestational age, body mass index). Also, there was no statistically significant difference between groups for IMA levels (p>0.05). The median level of YKL-40 was higher in pregnants with hyperemesis gravidarum than normal pregnants but the difference was not statistically significance (p>0.05). CONCLUSION: Further comprehensive studies with more number of patients are needed to show the efficacy of YKL-40 and IMA levels for predicting hyperemesis gravidarum and even monitoring of the treatment.
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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