DeCure's autonomous Nephrology AI scientist is researching a drug-repurposing hypothesis for stricture or kinking of ureter — screening already-approved drugs against its 18-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleStricture or kinking of ureter maps to a 18-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 stricture or kinking of ureter 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
DENN domain containing 1A (DENND1A) — DENND1A 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 gdpdrag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 6EKK · 1.82 Å · ligand GUANOSINE-5'-DIPHOSPHATE (GDP). Experimental structure, not a prediction.
What the evidence adds up to
A 1997 literature review of endoscopic management of ureteral strictures found that ureteral dilation via an antegrade or retrograde approach can be accomplished in most cases, with success rates varying by stricture etiology, location and length. Endoscopic ureterotomy appeared superior to dilation alone for anastomotic strictures, but the review identified no randomised studies comparing endourological methods. A 2005 retrospective review of 27 ureteroenteric strictures treated endourologically (balloon dilation or endoscopic incision, both with double J stenting) reported that 12 of 21 renal units (57.14%) improved or remained stable after a mean follow-up of 30.2 months. One patient died of septicaemia one day after balloon dilation.
A 2008 study of 18 patients with subtotal ureteral strictures treated with a new retrograde blind endoureterotomy technique using a laser fibre under fluoroscopic control reported a mean operating time of 37 minutes. The procedure was successful in all patients, but 7 of 18 (38.8%) developed re-stenosis, and 5 of those 7 required open surgery. A 2009 series of 8 robot-assisted laparoscopic ureteroneocystostomies in 7 patients with distal ureteral strictures (mean length 2.2 cm) reported a mean operative time of 247 minutes, average blood loss of 109 mL, and mean hospital stay of 2 days. One patient experienced recurrent symptoms with anastomotic narrowing treated by balloon dilation. After a mean follow-up of 18 months, relative renal function improved but did not reach statistical significance (p = 0.26).
No randomised controlled trials comparing any of these techniques exist. Long-term patency data beyond 30 months are scarce, and the 2008 study’s re-stenosis rate of nearly 40% underscores the risk of failure. What is missing are prospective trials with standardised definitions of stricture length, location, and aetiology, adequate sample sizes to allow subgroup analysis, and consistent follow-up protocols that include objective functional imaging. Funding for such trials, rather than further small case series, is needed.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
The Journal of Urology · 1997 · 87 citations
Endoscopic Management of Ureteral Strictures
AbstractPURPOSE: We investigated and defined the role of endourological methods in the treatment of patients with ureteral stricture. MATERIALS AND METHODS: A literature search was performed of the MEDLINE data base from 1978 through August 1996 concerning endoscopic treatment of patients with ureteral strictures. Additional articles from before 1978 were also selectively included. RESULTS: Many endourological methods are available to treat patients with ureteral strictures. Ureteral dilation via an antegrade or retrograde approach may be accomplished in most cases with varying rates of success depending on stricture etiology, location and length. Endoscopic ureterotomy may also lead to long-term patency in select cases and appears to be superior to dilation alone in patients with anastomotic ureteral strictures. However, no randomized studies comparing endourological methods in the treatment of ureteral stricture disease were found. CONCLUSIONS: Significant advances in technique and technology have led to an improved ability to treat ureteral strictures without the need for open surgery in many patients.
Expanding the Horizons: Robot-Assisted Reconstructive Surgery of the Distal Ureter
AbstractOBJECTIVES: To report our single-center experience with robotic ureteroneocystostomy for the treatment of distal ureteral obstruction. METHODS: We performed robot-assisted laparoscopic ureteroneocystostomies between May 2005 and October 2007. We retrospectively collected information on patient demographics, and compared renal scans with furosemide washout and radiographic imaging before and after repair to determine radiographic success. Statistical analysis was performed using statistical software via paired Student's t test analysis. RESULTS: Eight robot-assisted laparoscopic ureteroneocystostomies on seven patients were performed over a 30-month period. The etiology of the ureteric stricture was iatrogenic injury after hysterectomy in three patients, impacted stone in three, and infiltrative endometriosis in one. Mean stricture length was 2.2 cm. Right ureteroneocystostomy was performed in five patients and on the left in one, while one patient had bilateral disease. Mean operative time was 247 minutes (range 120-480), and average blood loss was 109 mL (range 50-200). Mean length of hospital stay was 2 days. All the procedures were completed successfully robotically without open conversion. Of the seven patients, one patient experienced recurrent symptoms. Subsequent imaging confirmed an anastomotic narrowing, which was treated by balloon dilation. There were no intraoperative or postoperative complications. Subsequent (99m)Tc-mercaptoacetyltriglycine scans showed no evidence of obstruction. After a mean follow-up of 18 months (range 5-31), relative renal function of the entire group of patients improved after ureteroneocystostomy, although this did not achieve statistical significance (p = 0.26). CONCLUSIONS: Robotic ureteroneocystostomy is a safe and effective treatment option for the management of distal ureteric stricture disease.
Retrograde Blind Endoureterotomy for Subtotal Ureteral Strictures: A New Technique
AbstractINTRODUCTION: Many causes lead to ureteral strictures. Open procedures require major surgery, for example using the "Boari"-technique. Technical developments in endoscopy provide less invasive treatment modalities for ureteral strictures. These procedures require good visualization and the ability to pass an instrument through the stricture zone. In some cases of subtotal stricture, this cannot be achieved. We introduce a new, minimally invasive surgical technique to overcome this problem. PATIENTS AND METHODS: Eighteen patients with subtotal ureteral strictures included in the studied group were treated according to the technique described below. After radiographic visualization of the impassable area, a glide-wire was inserted through the stenotic portion. Alongside the wire, a 4 French ureteral catheter was advanced up to the renal pelvis and contrast medium was filled into the renal pelvis and ureter. Now a laser fiber was extended through the ureteral catheter. Under direct fluoroscopic control, the laser was slowly pulled through the stenotic zone, until the contrast medium flew freely all along the ureter. To confirm treatment success standard retrograde URS was carried out following blind incision. RESULTS: Eighteen patients with subtotal ureteral strictures in different locations were treated using this technique. Mean operating time was 37 min. The procedure was performed successfully in all patients. Seven out of 18 patients developed re-stenosis (38,8%) and 5 of these 7 patients required open surgery in the following. CONCLUSION: The described technique provides a minimally invasive treatment option for extreme cases of ureteral strictures. In a significant number of patients open surgery can thus be avoided.
AbstractOBJECTIVES: To review the outcomes of the ureteroenteric strictures treated by endourological techniques in our department, and to compare our long-term results with other reported series with similar follow-up and number of patients. METHODS: We retrospectively reviewed 27 ureteroenteric strictures treated from March 1994 to June 2003, with a mean follow-up of 30.2 months (1 day-53 months). 13 cases underwent ballon dilation + permanent double J catheter (3 of them antegrade) 8 patients underwent endoscopical incision + double J catheter (5 of them with Acucise). RESULTS: 12/21 (57,14%) renal units improved and/or remained stable. We emphasize the absence of peroperative complications except 1 case that had a very poor oncological prognosis and died of septicemia 1 day after balloon dilation. CONCLUSIONS: Endourological treatment of ureteroenteric strictures has demonstrated to provide good fuctional results on the short and mid-term in patients that open surgery, although being the treatment of choice, would be too aggressive due to their disease, age, morbid conditions,....
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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