DeCure's autonomous Rare AI scientist is researching a drug-repurposing hypothesis for proctitis — screening already-approved drugs against its 13-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleProctitis maps to a 13-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
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Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Structures already discussed alongside proctitis in the retrieved literature, rendered from public PubChem SMILES. Which drugs appear here reflects the evidence found, not a ranked prediction.
Molecular view
Crystal structure of human Biliverdin IX-beta reductase B — Olsalazine has a real, experimentally solved structure in complex with this target (PDB 7ERA, 1.35 Å). This is the drug's own deposited structure, not a prediction, and confirms it is a structurally characterised molecule rather than an untested guess.
Loading structure…
helix sheet jbcdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 7ERA · 1.35 Å · ligand Olsalazine (JBC). Experimental structure, not a prediction.
What the evidence adds up to
In a 1980 double-blind trial of 45 patients with idiopathic proctitis, suppositories of 5-aminosalicylic acid (5-ASA) produced complete clinical remission with normal rectal mucosa on sigmoidoscopy in 60% of patients, compared with 13% for sulphapyridine and 27% for placebo. Twelve patients were included twice; in eight of these, 5-ASA given on one occasion produced clinical remission in every patient, whereas only one of those eight remitted on other therapy. The authors concluded that 5-ASA is the active therapeutic moiety of sulphasalazine.
A 1998 single-blind trial randomised 58 patients with active ulcerative proctitis (≤15 cm) to oral mesalazine 800 mg three times daily or mesalazine suppositories 400 mg three times daily for four weeks. Mean disease activity index scores at baseline, two, and four weeks were 7.7, 2.59, and 1.48 for suppositories, and 7.42, 5.72, and 3.48 for tablets (P < 0.001). Histologic remission was also significantly greater with suppositories at both time points (P < 0.01). A 1990 multicentre double-blind trial of 94 patients with mild to moderate distal proctosigmoiditis (<20 cm) found clinical remission at four weeks in 39% of placebo patients, 69% of those receiving 1 g mesalazine daily, and 74% of those receiving 1.5 g daily. No serious side effects were reported. A 1997 trial of 242 patients with active idiopathic proctitis compared mesalazine 1 g suppositories once daily with hydrocortisone acetate foam 100 mg once daily for 14–21 days. Mesalazine was significantly more effective on rectal blood loss (P = 0.002) and mucus (P = 0.02), and on the reduction in endoscopy score (P = 0.02), with no significant difference in histology or tolerance.
A 1988 crossover study of 41 patients with mild or moderately severe left-sided colitis or proctitis compared olsalazine 1.5 g/day with sulphasalazine 3 g/day. Therapeutic efficacy was similar, but adverse effects occurred in 12 patients on sulphasalazine and 4 on olsalazine (P < 0.05). A 2021 case report describes a 57-year-old woman with ulcerative proctitis who developed mesalazine-related hypersensitivity pneumonitis; symptoms improved after drug discontinuation and corticosteroid therapy. The authors note that unexplained respiratory symptoms during mesalazine treatment should prompt consideration of this rare entity. A 2015 abstract states that proctitis with proximal disease extension is a poor prognostic indicator and that such patients are more vulnerable to failure of medical therapy and more likely to require colectomy. A 1979 review notes that sulphasalazine and corticosteroids are the mainstay of treatment for proctocolitis, and that an oral preparation of sodium cromoglycate (Nalcrom) was developed in the hope of benefiting patients who relapse frequently or are intolerant of sulphasalazine.
What is still missing: no trial has established optimal dosing or duration for mesalazine suppositories beyond four weeks, and the comparative effectiveness of olsalazine versus mesalazine in proctitis specifically has not been tested in a dedicated trial. The 2021 case report highlights a rare but serious adverse effect of mesalazine that remains poorly characterised in incidence. Patient stratification by risk of proximal disease extension or by histologic markers such as basal plasmacytosis has not been prospectively validated to guide treatment selection.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Gut · 1980 · 322 citations · open access
Effect of sulphapyridine, 5-aminosalicylic acid, and placebo in patients with idiopathic proctitis: a study to determine the active therapeutic moiety of sulphasalazine.
AbstractSuppositories of sulphapyridine, 5-aminosalicylic acid, and placebo were used in 45 patients with idiopathic proctitis to determine the active part of sulphasalazine. Each patient used one of the suppositories twice daily for four weeks in a double-blind controlled trial. Complete clinical remission with normal rectal mucosa on sigmoidoscopy occurred in 60% of patients given 5-aminosalicylic acid, but in only 13% and 27% of those given sulphapyridine and placebo respectively. Twelve patients were included twice. In eight of these patients 5-aminosalicylic acid was given one time and sulphapyridine (two patients) or placebo (six patients) another time. Clinical remission occurred in each patient with 5-aminosalicylic acid, but in only one patient during other therapy. The results suggest that 5-aminosalicylic acid is the active therapeutic moiety of sulphasalazine.
Diseases of the Colon & Rectum · 1998 · 146 citations
Comparison of oral with rectal mesalazine in the treatment of ulcerative proctitis
AbstractPURPOSE: The aim of our study was to compare the efficacy and safety of oral mesalazine with mesalazine suppositories in patients with active ulcerative proctitis. PATIENTS AND METHODS: A four-week, randomized, single-blind trial was performed in 58 patients with active, histologically confirmed ulcerative proctitis (< or = 15 cm) to evaluate the efficacy and safety of oral 800-mg mesalazine tablets taken three times per day (n = 29) compared with 400 mg of mesalazine suppositories administered three times per day (n = 29). Patients were evaluated at study entry and after two and four weeks. Efficacy evaluations included a disease activity index, which represents a score with four variables: stools frequency, rectal bleeding, mucosal appearance, and physician's assessment of disease severity. Histologic activity was also assessed at study entry and after two and four weeks in accordance with the criteria by Truelove and Richard. Safety assessment included clinical laboratory parameters and adverse event reports. RESULTS: There were no significant differences with regard to baseline comparisons of demographics and severity between the two treatment groups. Improvement in mean disease activity index score was significantly greater with suppositories compared with oral mesalazine, both at two-week and four-week visits (mean disease activity index scores at baseline, two, and four weeks: suppositories = 7.7, 2.59, and 1.48; tablets = 7.42, 5.72, and 3.48, respectively (P < 0.001)). The rate of histologic remission was significantly greater with suppositories compared with tablets both at two and four weeks (P < 0.01). There were no significant differences in adverse events or clinical laboratory results between treatment groups. CONCLUSIONS: Results of this study indicate that treatment with mesalazine suppositories produces earlier and significantly better results than oral mesalazine in the treatment of active ulcerative proctitis.
Scandinavian Journal of Gastroenterology · 1990 · 100 citations
Mesalazine (5-Aminosalicylic Acid) Suppositories in the Treatment of Ulcerative Proctitis or Distal Proctosigmoiditis: A Randomized Controlled Trial
AbstractA multicentre double-blind study was conducted to evaluate the efficacy and tolerability of 1 g or 1.5 g mesalazine daily compared with placebo in 94 patients with mild to moderate distal proctosigmoiditis (less than 20 cm). The study end point was the determination of clinical, endoscopic, and histologic remission rates at 4 weeks. Eleven patients, nine receiving placebo and two receiving 1.5 g mesalazine, withdrew during trial, mostly because of worsening of symptoms. At 4 weeks clinical remission was achieved in 7 of 31 (39%) patients with placebo, in 22 of 32 (69%) patients in the 1 g mesalazine group, and 23 of 31 (74%) patients in the 1.5 g mesalazine group. No serious clinical or biochemical side effect of treatment was reported. Mesalazine suppositories are safe, well tolerated, and very effective in patients with active distal proctosigmoiditis: 500 mg twice daily appears a suitable dose regimen.
Scandinavian Journal of Gastroenterology · 1988 · 26 citations
Treatment of Ulcerative Colitis with Olsalazine and Sulphasalazine: Efficacy and Side-Effects
AbstractThe effects of olsalazine were studied mainly in patients with ulcerative colitis who were intolerant to sulphasalazine, and for relapse prevention. A crossover design with sulphasalazine, 3 g/day, and olsalazine, 1.5 g/day, was applied to compare the side-effects of each drug and to evaluate their therapeutic efficacy. A total of 41 patients with mild or moderately severe left-sided colitis or proctitis were assigned to a randomized treatment schedule. Olsalazine and sulphasalazine were similar in their therapeutic efficacy. Twelve patients complained of adverse effects while on sulphasalazine and 4 patients during olsalazine treatment (p less than 0.05). It is concluded that olsalazine is a safe and effective drug for the treatment of mild or moderately severe ulcerative colitis, and is comparable to sulphasalazine, though with reduced side-effects.
Efficacy and tolerance of mesalazine suppositories vs. hydrocortisone foam in proctitis
AbstractBACKGROUND: Topical treatments with steroids or mesalazine are the most effective treatments for idiopathic proctitis. AIM: To compare the efficacy and tolerance of mesalazine suppositories vs. hydrocortisone acetate foam in the treatment of acute proctitis. PATIENTS AND METHODS: 242 patients with active idiopathic proctitis were randomized to receive once daily either one Pentasa suppository (mesalazine 1 g) or 100 mg hydrocortisone (Colofoam) for 14-21 days (until remission). Disease activity and tolerance of the treatments were assessed using a daily questionnaire, by physician assessment, and endoscopy score. RESULTS: Both treatments induced a significant reduction in disease activity. Mesalazine suppositories were significantly more effective than hydrocortisone on rectal blood loss (P = 0.002) and mucus (P = 0.02) parameters, and on the degree of the decrease in endoscopy score (P = 0.02). No significant difference was observed between treatments concerning histology or tolerance. CONCLUSION: Mesalazine suppositories were as well-tolerated as hydrocortisone foam, but were more effective for some parameters of disease activity.
European Journal of Case Reports in Internal Medicine · 2021 · 4 citations · open access
Mesalazine-induced Hypersensitivity Pneumonitis
AbstractA 57-year-old woman with Crohn's disease (ulcerative proctitis) treated with mesalazine (5-ASA) developed worsening respiratory distress and cough. The lack of response to antibiotics and the results of bronchoalveolar lavage led to the diagnosis of mesalazine-related hypersensitivity pneumonitis, an infrequent entity. Symptoms improved after discontinuation of mesalazine and the administration of corticosteroid therapy. The authors discuss the diagnosis and management of this rare condition. LEARNING POINTS: A diagnosis of mesalazine-related hypersensitivity pneumonitis should be considered when unexplained respiratory symptoms develop during treatment with mesalazine.It is important to distinguish pulmonary manifestations in patients with inflammatory bowel disease secondary to drug-related toxicity from the disease process itself.Amelioration of symptoms and improvement in imaging and lung function seem to occur only upon abrupt discontinuation of the drug; severe symptoms such as respiratory failure may justify corticosteroid therapy.
Journal of Crohn s and Colitis · 2015 · 1 citations · open access
P215. Correlation of histological activity and basal plasmacytosis with mucosal healing in ulcerative colitis patients
AbstractThese patients are more vulnerable to failure of medical therapy and more likely to require colectomy than patients with extensive disease at diagnosis. Hence, proctitis with proximal disease extension is a poor prognostic indicator and greater understanding of the biology of this phenomenon might facilitate disease modifying treatments strategies.
Drug and Therapeutics Bulletin · 1979 · 1 citations
Sodium cromoglycate for use in the gut (nalcrom)
AbstractSulphasalazine (Salazopyrin) and corticosteroids are the mainstay of drug treatment for proctocolitis (ulcerative colitis and proctitis). Sulphasalazine is particularly effective in maintaining the disease in remission, and corticosteroids in treating the acute attack. Nevertheless some patients with proctocolitis have frequent relapses or have symptoms which do not respond to these or other medical treatment, and occasional patients are hypersensitive to or intolerant of sulphasalazine. An oral preparation of sodium cromoglycate (SCG; Nalcrom - Fisons) has been developed in the hope that it would benefit some of these patients. It has also been tried in the treatment of food allergies.
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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