DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for Myelitis — 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 moduleMyelitis 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 myelitis 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
The 2025 population-wide study from Stockholm County, covering 2008–2018, identified 461 patients with myelitis from 2,321 individuals screened, giving a crude mean incidence of 24.9 cases per million person-years. Idiopathic myelitis had an incidence of 8.0 per million person-years. Partial myelitis accounted for 80% of cases. Poor functional outcome occurred in 11% of the cohort and was independently associated with age over 50 years (odds ratio 4.26), transverse spinal cord lesions (odds ratio 6.85), elevated CSF polymorphonuclear cells (odds ratio 6.09), and elevated CSF/serum albumin ratio (odds ratio 3.17). Median follow-up was 5.4 years. Relapses occurred in 27% of idiopathic myelitis patients and 72% of patients with unspecified demyelinating disease of the CNS. Factors linked to increased relapse rate after idiopathic myelitis included oligoclonal bands (incidence rate ratio 4.47), transverse lesions (incidence rate ratio 2.81), and multifocal spinal cord lesions (incidence rate ratio 2.82). 48% of all myelitis patients received a multiple sclerosis diagnosis during the study period.
A 2014 case report described a 30-year-old man with neuro-Behçet syndrome presenting as recurrent longitudinal extensive transverse myelitis, anti-aquaporin-4 antibody negative. After insufficient response to azathioprine, cyclophosphamide, and corticosteroids, infliximab was started. The patient’s clinical and radiological status remained stationary for three years on infliximab. The authors note that myelitis in neuro-Behçet syndrome can mimic neuromyelitis optica and that anti-tumour necrosis factor agents may be an alternative treatment in severe forms.
The 2021 review emphasises that autoantibody biomarkers and imaging have improved diagnosis of immune-mediated myelopathies, and that timely immunotherapy can help improve symptoms and prevent permanent disability. It states that no patient should be classified as having idiopathic transverse myelitis without a comprehensive evaluation for a specific cause, and that recognising non-inflammatory mimics is crucial because of therapeutic and prognostic implications.
A prospective multicentre observational cohort study of paediatric myelitis, published in 2000, enrolled 90 patients including those with acute flaccid myelitis (AFM) and transverse myelitis (TM). Among 51 AFM patients, two clinical patterns were observed: a grey matter restricted form and a form with concomitant white matter involvement that could explain lower extremity motor deficits from cervical lesions. Improvement with corticosteroids was similar between the AFM and TM cohorts (p=0.97). The authors state that prospective controlled studies of long-term outcomes are needed. A 2024 lecture describing eight clinical cases of myelitis notes the complexity and diversity of manifestations and suggests that analysis of such cases may help develop more effective diagnostic and treatment strategies.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
CONTINUUM Lifelong Learning in Neurology · 2021 · 67 citations
Myelitis and Other Autoimmune Myelopathies
AbstractPURPOSE OF REVIEW: This article provides an update on the clinical diagnosis and management of immune-mediated myelopathies, including the relevance of imaging, ancillary testing with an emphasis on autoantibody biomarkers, recognition of myelitis mimics, and therapeutic approach. RECENT FINDINGS: The imaging characterization of immune-mediated myelopathies and the discovery of neural autoantibodies have been crucial in improving our ability to accurately diagnose myelitis. The identification of autoantibodies directed against specific central nervous system targets has led to major improvements in our understanding of the mechanisms underlying inflammation in myelitis. It has also allowed distinction of these myelopathy etiologies from noninflammatory etiologies of myelopathy and from multiple sclerosis and provided insight into their risk of recurrence, treatment response, and long-term clinical outcomes. Prompt recognition and appropriate testing in the setting of acute and subacute myelopathies is critical as timely administration of immunotherapy can help improve symptoms and prevent permanent neurologic disability. A patient should not be classified as having "idiopathic transverse myelitis" without a comprehensive evaluation for a more specific etiology. Achieving the correct diagnosis and learning to recognize noninflammatory myelitis mimics is crucial as they have therapeutic and prognostic implications. SUMMARY: Identifying the clinical and radiographic features of immune-mediated myelitis and recognizing mimics and pitfalls will help clinicians treat confirmed autoimmune myelitis appropriately.
Journal of Spinal Cord Medicine · 2014 · 33 citations · open access
Recurrent longitudinal extensive transverse myelitis in a neuro-Behçet syndrome treated with infliximab
AbstractBACKGROUND: Spinal cord involvement is not common, but can be seen in neuro-Behçet's syndrome (NBS). The major site of involvement is the cervical spinal cord with the myelitis-like inflammatory lesions continuing more than two segments, and extending to the brainstem. CASE: A 30-year-old male patient who has been followed with a diagnosis of Behçet's syndrome admitted to our neurology department clinically and radiologically suggestive of recurrent and extensive longitudinal myelitis. His anti-aquaporine antibody was negative. Because of insufficient effect of azathioprine, cyclophosphamide, and corticosteroids, infliximab was started. His clinical and radiological status is stationary for 3 years under infliximab treatment. DISCUSSION: Myelitis such as that occurring in our patient may have a similar presentation like neuromyelitis optica (NMO), which should therefore be included in differential diagnosis. Myelitis observed in both NMO and NBS shows spinal cord lesions longer than three or more vertebrae. Anti-aquaporine antibody must be evaluated in all patients presenting with longitudinal myelitis. Anti-tumor necrosis factor agent infliximab might be an alternative treatment in severe form of NBS such as myelitis. CONCLUSION: In our case, successful treatment of recurrent and extensive longitudinal transverse myelitis in NBS with infliximab was demonstrated.
Abstract<h3>Background</h3> Since 2014, the USA has documented three outbreaks of acute flaccid myelitis (AFM). Unique features and treatment responses of this myelitis variant have not been prospectively studied. This study prospectively measured outcomes in paediatric myelitis patients relative to treatments. <h3>Methods</h3> This was a prospective, multicentre, non-randomised, observational cohort study. The study duration was 5 years and the length of follow-up was 1 year. This study collected data from children and families in North America. Patients were enrolled at academic centres with expertise in myelitis or online via a web portal. Paediatric patients diagnosed with myelitis were eligible for enrolment in the study within 6 months of onset of symptoms. Patients were characterised as transverse myelitis (TM) or the AFM variant based on clinical and radiographic findings. <h3>Results</h3> The cohort of 90 patients included patients with AFM and TM. Of the 51 patients with AFM there was evidence of two clinically relevant patterns. This included a grey matter restricted form of AFM and a cohort with concomitant white matter that could explain lower extremity motor deficits in patients with lesions restricted to the cervical spine. The improvement in deficits with the use of corticosteroids was similar to what was observed in the TM cohort (p=0.97). <h3>Conclusions</h3> Clinicians should consider on a case by case basis the approach to therapy for AFM patients. Prospective controlled studies of long-term outcomes would be useful in this growing patient population.
Incidence, Etiology, and Long-Term Outcome of Acute Myelitis in Stockholm County, Sweden
AbstractBACKGROUND AND OBJECTIVES: Myelitis is a relatively common clinical entity for neurologists, with diverse underlying causes. The aim of this study was to describe the incidence of myelitis, its causes, clinical presentation, and factors predicting functional outcomes and relapses. METHODS: Using the Swedish National Patient Registry, we identified all adult patients in Stockholm County between 2008 and 2018 using International Classification of Diseases, 10th Edition (ICD-10) codes likely to include myelitis. We collected medical records and classified patients using a modification of the 2002 Transverse Myelitis Consortium Group criteria. Long-term follow-up data were collected for patients not diagnosed with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder as a result of the initial myelitis. RESULTS: We identified 2,321 individuals, of whom 461 were patients with myelitis. The crude mean incidence of all-cause myelitis was 24.9 (95% CI 16.7-33.9) cases per million person-years, of which idiopathic myelitis had an incidence of 8.0 (95% CI 3.8-12.1) cases per million person-years. Partial myelitis was found in 80% of patients. Poor functional outcome was found in 11% of the cohort and correlated, in a multivariate logistic model, with age older than 50 years (OR 4.26, 95% CI 1.75-10.40), transverse spinal cord lesions (odds ratio [OR] 6.85, 95% CI 2.68-17.52), elevated CSF count of polymorphonuclear cells (OR 6.09, 95% CI 1.56-23.72), and elevated CSF/serum albumin ratio (OR 3.17, 95% CI 1.23-8.17). The median follow-up time was 5.4 years. Relapses occurred in 27% of patients with idiopathic myelitis and 72% of patients with unspecified demyelinating disease of the CNS. An increased relapse rate after idiopathic myelitis was found to be associated, in a multivariate model, with the presence of oligoclonal bands (incidence rate ratio [IRR] 4.47, 95% CI 1.70-11.73), transverse spinal cord lesions (IRR 2.81, 95% CI 1.11-7.12), and multifocal spinal cord lesions (IRR 2.82, 95% CI 1.03-7.69). Around half (48%) of all patients with myelitis received MS diagnosis during the study period. DISCUSSION: This large population-wide study describes a relatively high incidence of myelitis and low risk of relapses after idiopathic myelitis. A complete diagnostic workup of myelitis, including MRI of the entire CNS and collection of CSF, is essential in evaluating underlying causes and prognosis.
Russian Journal of Child Neurology · 2024 · 0 citations · open access
Clinical polymorphism of myelitis in neurologic practice. Lecture with description of clinical cases
AbstractAmong rather rare but extremely interesting and important conditions, myelitis stands apart due to its complexity and diversity of clinical manifestations. In this article, in addition to the well-known data on this group of diseases, we present the results of the analysis of eight cases of myelitis, which may serve as a starting point for the development of more effective and streamlined strategies in diagnosis and treatment. It may also contribute to deeper understanding of difficult cases in neurological practice.
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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