DeCure's autonomous Respiratory AI scientist is researching a drug-repurposing hypothesis for pulmonary sarcoidosis — screening already-approved drugs against its 4-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease modulePulmonary sarcoidosis maps to a 4-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 pulmonary sarcoidosis 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
inosine monophosphate dehydrogenase 1 (IMPDH1) — IMPDH1 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 cprdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 1JCN · 2.5 Å · ligand 6-CHLOROPURINE RIBOSIDE, 5'-MONOPHOSPHATE (CPR). Experimental structure, not a prediction.
What the evidence adds up to
Lung transplantation for end stage pulmonary sarcoidosis in a series of 12 patients between 1988 and 1997 gave survival of 70% at three years and 56% at five years. Three patients developed obliterative bronchiolitis. Sarcoid granulomas recurred in the donor organ in three patients; in one case this was associated with clinical deterioration that required retransplantation. The authors concluded that medium term results were comparable to transplantation for other indications and that clinically important recurrence was low despite histological recurrence.
A 2018 review reported a mortality rate of 11–14 per 1000 person-years in pulmonary sarcoidosis. It noted that approximately 20–30% of patients present with chronic or progressive lung disease associated with morbidity and mortality. The review stated that no tools exist that can reliably predict which patients will progress to fibrosis, and that conflicting evidence exists on the role of demographic characteristics such as age, sex, and race depending on the population studied.
A 2021 systematic review of outcomes in pulmonary sarcoidosis clinical trials identified 56 unique outcomes from 36 trial registry entries and 82 unique outcomes from six studies on patient perspective. The most frequently reported domain was respiratory, thoracic and mediastinal outcomes. The patient perspective literature identified outcomes in personal circumstances and societal or carer burden domains that were not reported in any of the included trial registrations. The review was the first step toward developing a core outcome set for future research.
A 2025 observational study of 384 pulmonary sarcoidosis patients found that at six months of treatment initiation, 361 patients (94.01%) had responded and 23 (5.9%) had not. At 18 months, 303 patients (78.9%) were in remission, 42 (10.9%) had relapsed, and 39 (10.1%) had refractory disease. Predictors of non-response at six months included loss of weight, female sex, pleural involvement, and longer duration to taper steroids to 10 mg. Predictors of relapse and refractory disease at 18 months included dermatological involvement, pleural involvement, past ATT intake, presence of nodules on CT at baseline, and longer duration to taper steroids to 10 mg. Lung function at baseline was lower in the refractory group, but after 18 months there was no statistically significant difference in lung function between remission, relapse, and refractory groups. What remains missing is a validated risk stratification tool that can prospectively identify which patients will progress to fibrosis, a core outcome set agreed for use across trials, and prospective data on whether the predictors identified in the 2025 study replicate in other populations.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Thorax · 1998 · 49 citations · open access
Medium term results of lung transplantation for end stage pulmonary sarcoidosis
AbstractBACKGROUND: Lung transplantation is an accepted therapeutic option for patients with end stage pulmonary sarcoidosis. However, the medium term outcome of transplantation in this patient group is unknown. METHODS: This study was performed to evaluate our experience with lung transplantation for end stage pulmonary sarcoidosis. Between July 1988 and July 1997 12 patients (nine men) underwent lung transplantation for sarcoidosis at our institution. Ten underwent single lung transplantation and two double lung transplantation. RESULTS: Survival at three and five years was 70% and 56%, respectively. Three patients developed obliterative bronchiolitis at six, 18, and 45 months. One died at the time of retransplantation. Sarcoid granulomas have recurred in the donor organ in three patients. In one the development of granulomas has been associated with clinical deterioration, necessitating retransplantation. Mean (SD) forced expiratory volumes in one second at three and five years were 1.37 (0.67) 1 and 1.34 (0.13) 1, respectively. CONCLUSIONS: Lung transplantation is a viable option for patients with end stage pulmonary sarcoidosis. The medium term results are comparable with patients undergoing lung transplantation for other indications. Despite histological recurrence of sarcoidosis, the risk of clinically important recurrence is low.
Abstract2001 marks the 50th anniversary of the first reports of the successful treatment of sarcoidosis with cortisone1 2 and ACTH.3 In an early report of treatment with corticosteroids, Siltzbach4 highlighted one of the problems of evaluating the results when he wrote:
“The aetiology of sarcoidosis still eludes us, as does the definitive treatment. Part of the difficulty stems from the unpredictability of spontaneous remissions. This accounts for the many transitory successes reported at one time or another with such agents as calcium salts, gold, arsenicals, potassium iodide, chaulmoogra oil, antileprol and tuberculin.”
It is somewhat depressing that no better therapeutic agents than steroids have emerged over the subsequent 50 years, and the sceptic might well conclude that little has changed! While the approach to treatment may have become more rational and the choice of effective agents has increased, it is at best suppressive rather than curative. Happily, as Siltzbach pointed out, in most patients the natural tendency of pulmonary sarcoidosis is towards spontaneous resolution. The therapeutic challenges remain the recognition of those patients in whom remission and resolution are less likely, and determination of the optimum treatment to minimise permanent organ damage.
Several uncontrolled and controlled studies, as well as common clinical experience, have amply confirmed the suppressive effect of steroids.5-11 In pulmonary sarcoidosis the most common indication for treatment is symptomatic, usually troublesome breathlessness and sometimes cough. Most commonly, prednisolone is started at a dose of 30–40 mg daily with later reduction titrated against symptoms, respiratory function, and radiographic appearance. Once started, treatment is usually continued for at least 1 year but patients may require more prolonged treatment if dose reduction is accompanied by recrudescence of disease activity. Whether or not steroid treatment reduces long term pulmonary damage due to fibrosis has proved difficult to determine. …
Current Opinion in Pulmonary Medicine · 2018 · 15 citations
Why do people die from pulmonary sarcoidosis?
AbstractPURPOSE OF REVIEW: In sarcoidosis, the design and validation of an appropriate risk stratification strategy is hampered by the considerable variability in initial presentation, disease evolution, and outcome. Although spontaneous resolution of the disease is described in a large proportion of patients, approximately 20-30% would present with chronic or progressive lung disease that has been associated with morbidity and mortality. Higher morbidity and mortality can be related to both the disease severity and extent as well as its treatments. We review the utility of integration of clinical, pathological, and radiological features of pulmonary sarcoidosis to detect pulmonary sarcoidosis patient at risk of developing severe, fibrotic lung disease. RECENT FINDINGS: Recently published studies suggested a mortality rate of 11-14 per 1000 person-years. Demographic characteristics such as age, sex, and race may play a role but conflicting evidence are reported depending on the origin of the population. To date, there are no tools that can reliably predict the exact group of pulmonary sarcoidosis patients to progress to fibrosis. Imaging contributes significantly to the diagnosis and management of patients with sarcoidosis as it can provide useful information regarding the discrimination between reversible and irreversible disease, the extent of the parenchymal damage and the presence of possible complications. Symptoms and lung function tests are the rest of the key determinants and their change over time should be considered. SUMMARY: This review concentrates on the definition of advanced pulmonary sarcoidosis and determinants of mortality in the pulmonary sarcoidosis group of patients.
Scout - sarcoidosis outcomes taskforce. A systematic review of outcomes to inform the development of a core outcome set for pulmonary sarcoidosis.
AbstractBACKGROUND: Clinical trials evaluating different management strategies for pulmonary sarcoidosis may measure different outcomes. This heterogeneity in outcomes can lead to waste in research due to the inability to compare and combine data. Core outcome sets (COS) have the potential to address this issue and here we describe a systematic review of outcomes as the first step in the development of a COS for pulmonary sarcoidosis research. METHODS: A search of clinical trial registries for phase II, III and IV trials of pulmonary sarcoidosis was undertaken along with a rapid review of the patient perspective literature. Each study was screened for eligibility and outcomes extracted verbatim from the registry entry or publication then reviewed, grouped and categorised using the COMET taxonomy. RESULTS: 36 trial registry entries and 6 studies on patients' perspective of pulmonary sarcoidosis were included reporting 56 and 82 unique outcomes respectively across 23 domains. The most frequently reported outcome domain was "respiratory, thoracic and mediastinal outcomes". However, the patients' perspective literature identified outcomes in the "personal circumstances" and "societal/carer burden" domains that were not reported in any of the included trial registrations. CONCLUSIONS: Using both clinical trial registry data and published literature on patients' perspective has allowed rapid review of outcomes measured and reported in pulmonary sarcoidosis research. The use of multiple sources has led to the development of a comprehensive list of outcomes that represents the first step in the development of a COS for use in future pulmonary sarcoidosis research.
American Journal of Respiratory and Critical Care Medicine · 2025 · 0 citations
Predictors of Response and Treatment Outcomes in Sarcoidosis
AbstractAbstract Background: The natural history and treatment outcomes of patients with Pulmonary Sarcoidosis are variable. Identifying parameters that can predict treatment outcome may help in prognosis and individualizing therapy for patients with specific disease characteristics. Methods: This was an analytical observational study with prospective and retrospective data analysis from a large Pulmonary Sarcoidosis cohort. Results: The study included 384 patients of Pulmonary Sarcoidosis. Males and females were almost equally distributed. The mean age of onset of disease was 42.75 years. 195 patients had both pulmonary and extra pulmonary involvement. At 6 months of treatment initiation, there were 361 patients (94.01%) who had responded to treatment (Responders) and 23 patients (5.9%) had not responded to therapy (Non-responders). At 18 month of treatment initiation, patients were finally categorized into 3 categories; Remission, Relapse and Refractory disease. There were 303 patients (78.9%), 42 patients (10.9%) and 39 patients (10.1%) in Remission, relapse and refractory disease categories respectively. Loss of weight, female sex, pleural involvement and longer duration to taper steroids to 10 mg were predictors of non-response to treatment at 6 months. Dermatological involvement, Pleural involvement, ATT intake in the past, presence of Nodules on CT at baseline and the longer duration taken to taper the steroids to 10 mg were predictors for disease relapse as well as for refractory disease. Even though the lung function at baseline was low in refractory disease group at baseline, there was no statistically significant difference between remission, relapse and refractory disease groups in lung function after 18 months of treatment. Conclusion: Majority of patients with pulmonary sarcoidosis respond well to treatment. Dermatological involvement, Pleural involvement, ATT intake in the past, presence of Nodules on CT at baseline and the longer duration taken to taper the steroids to 10 mg were predictors for relapse and refractory disease at 18 months of treatment initiation.
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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