DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for neonatal abstinence syndrome — screening already-approved drugs against its 7-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleNeonatal abstinence syndrome maps to a 7-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 neonatal abstinence syndrome 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
CD3 gamma subunit of T-cell receptor complex (CD3G) — CD3G 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 y01drag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 8ES8 · 2.65 Å · ligand CHOLESTEROL HEMISUCCINATE (Y01). Experimental structure, not a prediction.
What the evidence adds up to
In a 1983 randomised trial of 153 passively addicted neonates, paregoric and phenobarbital initially appeared equally effective at controlling abstinence signs. However, seven of 62 phenobarbital-treated newborns had abstinence-associated seizures within the first month of life, while none of 49 paregoric-treated neonates did. Forty-two neonates who initially required no pharmacotherapy were born to mothers taking less methadone just before delivery, yet five of those 42 still had seizures within the first 14 days. The authors considered paregoric the treatment of choice and warned that phenobarbital use should be monitored with serum drug levels.
A 2013 review noted that pharmacologic treatments for neonatal abstinence syndrome include methadone, buprenorphine, morphine, and phenobarbital, but stated that their safety and efficacy are not fully recognised. The review identified gaps in the literature regarding both pharmacologic and complementary therapies for neonatal withdrawal. A 2017 abstract reported that neonatal abstinence syndrome occurs in 55% to 94% of newborns whose mothers were addicted to or treated with opioids while pregnant, and noted a lack of clarity and consistency in definition, measurement, and management.
A 2023 quality improvement project in a single neonatal intensive care unit compared the eat, sleep, console (ESC) method with the Finnegan Neonatal Abstinence Scoring System (FNASS). Among infants of 36 weeks or longer gestation with in utero opioid exposure, average length of stay decreased from 25.9 days to 13.7 days, a 47% reduction. Scheduled morphine initiation fell from 58% to 7% (88% reduction), as-needed morphine from 33% to 7% (79% reduction), and adjunctive medication initiation from 17% to 0% (100% reduction). The authors called for further research on long-term neurodevelopmental outcomes.
A 2022 nonsystematic review and opinion suggested that genetic polymorphisms of COMT and OPRM1 genes appear to affect length of stay and need for pharmacotherapy in newborns with prenatal opioid exposure. The authors proposed that future management could include genetic assessment using the genetic addiction risk severity (GARS) test and DNA-directed precision amino-acid enkephalinase inhibition (KB220) therapy as a frontline modality instead of potent opioids. This remains a proposal, not a tested intervention. What is still missing are prospective trials comparing the ESC method against standard pharmacotherapy in multiple centres, long-term neurodevelopmental follow-up data for any non-pharmacologic approach, and any clinical trial evidence for KB220 in neonates.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Archives of Pediatrics and Adolescent Medicine · 1983 · 65 citations
Opiate v CNS Depressant Therapy in Neonatal Drug Abstinence Syndrome
AbstractParegoric and phenobarbital, administered randomly in 153 passively addicted neonates, initially appeared to control neonatal abstinence signs equally well. However, seven of the 62 phenobarbital-treated newborns had abstinence-associated seizures within the first month of life, while none of 49 paregoric-treated neonates had seizures. Forty-two neonates initially requiring no specific pharmacotherapy for abstinence signs were born to mothers taking less methadone hydrochloride just before delivery. Five of those 42 neonates, however, had seizures within the first 14 days of life. Seizure occurrence could not be predicted from analysis of early abstinence patterns. We consider paregoric to be the treatment of choice for the neonatal abstinence syndrome. Phenobarbital use should be monitored with serum drug levels and modification of recommended dosage regimens considered.
AbstractNeonatal Abstinence Syndrome (NAS) occurs in infants exposed to opiates or illicit drugs during pregnancy. It can be severe and cause long hospital stays after birth and with symptoms up to 6 months after birth. Pharmacologic interventions are commonly used as treatment for NAS; however, their safety and efficacy are not fully recognized. Pharmacologic treatments for NAS include medications such as methadone, buprenorphine, morphine, and phenobarbital. Nonpharmacologic interventions and complementary therapies have been documented in neonates. However, there are gaps in the literature regarding use of these therapies for neonatal withdrawal. This article provides an overview of the possible risks, benefits, and outcomes of pharmacologic and complementary therapies in the neonatal population, and illustrates the gaps in knowledge related to their use for neonatal withdrawal.
Improving Outcomes in Infants With Neonatal Abstinence Syndrome With the Eat, Sleep, Console Method
AbstractBACKGROUND: Neonatal abstinence syndrome (NAS) is a significant public health concern. A quality improvement project was executed in a neonatal intensive care unit at a large urban hospital. The aim was to address the prolonged hospitalization of infants and exposure to medications to treat NAS. PURPOSE: The goal was to determine whether the eat, sleep, console (ESC) method decreases the length of stay (LOS) and morphine usage when compared with the Finnegan Neonatal Abstinence Scoring System (FNASS). METHODS: The inclusion criteria were 36 weeks' or longer gestation and exposure to opiates in utero. The FNASS method was replaced by the ESC method with a refocus on nonpharmacologic care. Data were collected for 6 months during implementation of the ESC method and compared with the 6 months prior to implementation. RESULTS: The results of the project include: the average LOS decreased from 25.9 days to 13.7 days, a 47% reduction; the rate of scheduled morphine initiation decreased from 58% to 7%, an 88% reduction; as-needed morphine initiation decreased from 33% to 7%, a 79% reduction; and the rate of adjunctive medication initiation decreased from 17% to 0%, a 100% reduction. IMPLICATIONS FOR PRACTICE AND RESEARCH: The outcomes of LOS and rate of morphine usage were significantly improved when using the ESC method when compared with the FNASS at this facility. The results support future implications including expanding the ESC program to the well newborn population at this facility and other similar units. Further research needs to be done on long-term neurodevelopmental outcomes.
Abstract(Abstracted from N Engl J Med 2016;375:2468–2479) Neonatal abstinence syndrome (NAS) is a postnatal opioid withdrawal syndrome occurring in 55% to 94% of newborns whose mothers were addicted to or treated with opioids while pregnant. A lack of clarity and consistency regarding the definition, measurement, and management of the syndrome still exists.
Journal of Personalized Medicine · 2022 · 5 citations · open access
Future Newborns with Opioid-Induced Neonatal Abstinence Syndrome (NAS) Could Be Assessed with the Genetic Addiction Risk Severity (GARS) Test and Potentially Treated Using Precision Amino-Acid Enkephalinase Inhibition Therapy (KB220) as a Frontline Modality Instead of Potent Opioids
AbstractIn this nonsystematic review and opinion, including articles primarily selected from PubMed, we examine the pharmacological and nonpharmacological treatments of neonatal abstinence syndrome (NAS) in order to craft a reasonable opinion to help forge a paradigm shift in the treatment and prevention of primarily opioid-induced NAS. Newborns of individuals who use illicit and licit substances during pregnancy are at risk for withdrawal, also known as NAS. In the US, the reported prevalence of NAS has increased from 4.0 per 1000 hospital births in 2010 to 7.3 per 1000 hospital births in 2017, which is an 82% increase. The management of NAS is varied and involves a combination of nonpharmacologic and pharmacologic therapy. The preferred first-line pharmacological treatment for NAS is opioid therapy, specifically morphine, and the goal is the short-term improvement in NAS symptomatology. Nonpharmacological therapies are individualized and typically focus on general care measures, the newborn-parent/caregiver relationship, the environment, and feeding. When used appropriately, nonpharmacologic therapies can help newborns with NAS avoid or reduce the amount of pharmacologic therapy required and the length of hospitalization. In addition, genetic polymorphisms of the catechol-o-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genes appear to affect the length of stay and the need for pharmacotherapy in newborns with prenatal opioid exposure. Therefore, based on this extensive literature and additional research, this team of coauthors suggests that, in the future, in addition to the current nonpharmacological therapies, patients with opioid-induced NAS should undergo genetic assessment (i.e., the genetic addiction risk severity (GARS) test), which can subsequently be used to guide DNA-directed precision amino-acid enkephalinase inhibition (KB220) therapy as a frontline modality instead of potent opioids.
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.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
