AI Drug Discovery for Pharma and Biotech

Drug discovery

22

drugs

With orphan designations

Overview

Ornithine transcarbamylase deficiency (OTCD) is an X-linked urea cycle disorder caused by mutations in the OTC gene, leading to impaired ammonia detoxification. Accumulated ammonia causes neurotoxicity, presenting as lethargy, vomiting, seizures, or coma, with severity ranging from neonatal hyperammonemic crisis to late-onset episodic encephalopathy. Diagnosis involves elevated plasma ammonia, low citrulline, genetic testing, and urine orotic acid analysis [1][6][9]. Management combines protein restriction, nitrogen scavengers (e.g., sodium phenylbutyrate), arginine/citrulline supplementation, and emergent hemodialysis for acute crises [5][10]. Liver transplantation remains the only curative option [3][15].

Population

  • Prevalence: Estimated 1:14,000–1:77,000 [1][8][9]; neonatal-onset predominantly affects males, while 10–40% of heterozygous females develop symptoms due to skewed X-inactivation [6][16].

  • Mortality: ~43–50% in untreated neonatal-onset cases [1][16]; 11-year survival rates: 35% for early-onset vs. 87% for late-onset hyperammonemia [4].

Burden

  • Neurological: Intellectual disability, developmental delays, or metabolic stroke in 20–50% of survivors [1][7][16].

  • Systemic: Chronic liver dysfunction, coagulopathy, and risk of acute liver failure during decompensation [6][15].

  • Quality of life: Lifelong dietary/medication adherence, recurrent hospitalizations, and high economic burden [4][14].

Therapies

  • Acute: Hemodialysis (for氨 >500 µmol/L), IV sodium benzoate/phenylacetate, and arginine [5][10].

  • Chronic: Protein-restricted diet, oral scavengers (glycerol phenylbutyrate), citrulline/arginine supplementation [5][12].

  • Curative: Liver transplantation (prevents recurrent crises but requires lifelong immunosuppression) [3][15].

Categories: rare genetic diseases, rare inborn errors of metabolism, rare neurological diseases

Research Papers

369 drug discovery papers related to Ornithine transcarbamylase deficiency, with 3 first-in-class and 5 next-in-class early-stage therapies forecasted to outperform the average preclinical success rate. Recent publications:

369 drug discovery papers related to Ornithine transcarbamylase deficiency, with 3 first-in-class and 5 next-in-class early-stage therapies forecasted to outperform the average preclinical success rate. Recent publications:

2026-07-10 | Functional Editing of the OTC locus by Targeted Integration with Phenotype Correction and Restoration of Physiological Patterns of Expression.

Here we report highly efficient functional repair of the ornithine transcarbamylase (OTC) locus in mutant mouse and human hepatocytes in vivo using a dual AAV system delivering CRISPR-Cas9 editing reagents and a promoterless donor for targeted integration. The approach was mutation agnostic and targeted intronic sequences to prevent inadvertent inactivation of hypomorphic alleles. Notably, in a murine model, we corrected the metabolic defect and simultaneously achieved liver-wide restoration of physiological metabolic zonation of Otc expression by capturing native cis-acting regulatory elements. The effectiveness of this approach was confirmed using a universally configured therapeutic cassette in patient-derived primary human hepatocytes in vivo. These data provide a powerful template to guide further optimization of this approach and, given the high editing efficacy required for phenotypic effect in OTC deficiency, have broader relevance to other liver disease phenotypes.

Open article ↗



2026-04-23 | Profiling and Targeting of Regulatory RNAs to Upregulate Gene Expression

Abstract Transcription of long noncoding RNAs (lncRNAs), including enhancer RNAs (eRNAs) and promoter-associated RNAs (paRNAs), collectively termed regulatory RNAs (regRNAs), is a hallmark of active gene expression, yet it remains unknown whether regRNAs can be targeted to selectively enhance transcription in cis . We developed regRNA Capture-seq, a high-throughput method to profile regRNAs, and applied it to primary human hepatocytes, annotating thousands of regRNAs at ∼2,000 enhancers and promoters. Using this approach, we interrogated a genetically validated enhancer of the ornithine transcarbamylase ( OTC ) gene, mutations of which cause OTC deficiency (OTCD), the most common urea cycle disorder. Antisense oligonucleotides (ASOs) targeting enhancer-derived regRNAs led to dose-dependent upregulation of OTC in hepatocytes. Mechanistically, ASOs altered regRNA structure, elevated regRNA levels, displaced transcriptional repressors, and increased H3K27 acetylation at the targeted enhancer. This work establishes a potential therapeutic strategy for addressing haploinsufficiency and highlights regRNAs as actionable targets for ASO-mediated upregulation of gene expression.

Open article ↗



2026-04-03 | Enzyme Structure and Substrate Binding: From Atomic Mechanisms to Therapeutic Drug Development

This comprehensive technical whitepaper explores the intricate relationship between enzyme structure, substrate binding mechanisms, and catalytic efficiency, highlighting their profound implications for drug discovery and industrial biotechnology. The article begins by detailing the four hierarchical levels of enzyme architecture, explaining how covalent and non-covalent forces stabilize these structures to create highly specific active sites. It critically evaluates molecular recognition models, transitioning from the classical lock-and-key hypothesis to the more dynamic induced-fit and conformational selection models, which better account for the structural flexibility required during the catalytic cycle. A significant portion of the text is dedicated to advanced methodologies used to interrogate enzyme function. Experimental techniques such as X-ray crystallography, cryo-electron microscopy, and nuclear magnetic resonance spectroscopy are discussed alongside cutting-edge computational approaches, including molecular docking, molecular dynamics simulations, and machine learning frameworks. These tools enable researchers to visualize transition states, map complex energy landscapes, and predict kinetic parameters like the Michaelis constant and turnover number. The article also emphasizes the critical role of non-protein cofactors and the surprising impact of distal mutations, residues located far from the active site that significantly enhance catalytic efficiency through allosteric networks and structural dynamics. Practical applications are heavily featured, particularly rational drug design strategies aimed at overcoming drug resistance through multi-target-directed ligands, allosteric inhibitors, and structure-based optimization. Case studies on isovaleric acidemia and ornithine transcarbamylase deficiency illustrate how disease-associated mutations disrupt enzyme stability and function, underscoring the necessity of integrating multi-omics data with structural kinetics. Ultimately, the integration of AI-driven predictive models and high-throughput experimental validation is presented as a transformative paradigm for engineering robust biocatalysts and developing targeted therapeutics. Source: https://www.enzymestudy.com/posts/enzyme-structure-and-substrate-binding-from-atomic-mechanisms-to-therapeutic-drug-development

Open article ↗



2026-07-10 | Functional Editing of the OTC locus by Targeted Integration with Phenotype Correction and Restoration of Physiological Patterns of Expression.

Here we report highly efficient functional repair of the ornithine transcarbamylase (OTC) locus in mutant mouse and human hepatocytes in vivo using a dual AAV system delivering CRISPR-Cas9 editing reagents and a promoterless donor for targeted integration. The approach was mutation agnostic and targeted intronic sequences to prevent inadvertent inactivation of hypomorphic alleles. Notably, in a murine model, we corrected the metabolic defect and simultaneously achieved liver-wide restoration of physiological metabolic zonation of Otc expression by capturing native cis-acting regulatory elements. The effectiveness of this approach was confirmed using a universally configured therapeutic cassette in patient-derived primary human hepatocytes in vivo. These data provide a powerful template to guide further optimization of this approach and, given the high editing efficacy required for phenotypic effect in OTC deficiency, have broader relevance to other liver disease phenotypes.

Open article ↗



2026-04-23 | Profiling and Targeting of Regulatory RNAs to Upregulate Gene Expression

Abstract Transcription of long noncoding RNAs (lncRNAs), including enhancer RNAs (eRNAs) and promoter-associated RNAs (paRNAs), collectively termed regulatory RNAs (regRNAs), is a hallmark of active gene expression, yet it remains unknown whether regRNAs can be targeted to selectively enhance transcription in cis . We developed regRNA Capture-seq, a high-throughput method to profile regRNAs, and applied it to primary human hepatocytes, annotating thousands of regRNAs at ∼2,000 enhancers and promoters. Using this approach, we interrogated a genetically validated enhancer of the ornithine transcarbamylase ( OTC ) gene, mutations of which cause OTC deficiency (OTCD), the most common urea cycle disorder. Antisense oligonucleotides (ASOs) targeting enhancer-derived regRNAs led to dose-dependent upregulation of OTC in hepatocytes. Mechanistically, ASOs altered regRNA structure, elevated regRNA levels, displaced transcriptional repressors, and increased H3K27 acetylation at the targeted enhancer. This work establishes a potential therapeutic strategy for addressing haploinsufficiency and highlights regRNAs as actionable targets for ASO-mediated upregulation of gene expression.

Open article ↗



2026-04-03 | Enzyme Structure and Substrate Binding: From Atomic Mechanisms to Therapeutic Drug Development

This comprehensive technical whitepaper explores the intricate relationship between enzyme structure, substrate binding mechanisms, and catalytic efficiency, highlighting their profound implications for drug discovery and industrial biotechnology. The article begins by detailing the four hierarchical levels of enzyme architecture, explaining how covalent and non-covalent forces stabilize these structures to create highly specific active sites. It critically evaluates molecular recognition models, transitioning from the classical lock-and-key hypothesis to the more dynamic induced-fit and conformational selection models, which better account for the structural flexibility required during the catalytic cycle. A significant portion of the text is dedicated to advanced methodologies used to interrogate enzyme function. Experimental techniques such as X-ray crystallography, cryo-electron microscopy, and nuclear magnetic resonance spectroscopy are discussed alongside cutting-edge computational approaches, including molecular docking, molecular dynamics simulations, and machine learning frameworks. These tools enable researchers to visualize transition states, map complex energy landscapes, and predict kinetic parameters like the Michaelis constant and turnover number. The article also emphasizes the critical role of non-protein cofactors and the surprising impact of distal mutations, residues located far from the active site that significantly enhance catalytic efficiency through allosteric networks and structural dynamics. Practical applications are heavily featured, particularly rational drug design strategies aimed at overcoming drug resistance through multi-target-directed ligands, allosteric inhibitors, and structure-based optimization. Case studies on isovaleric acidemia and ornithine transcarbamylase deficiency illustrate how disease-associated mutations disrupt enzyme stability and function, underscoring the necessity of integrating multi-omics data with structural kinetics. Ultimately, the integration of AI-driven predictive models and high-throughput experimental validation is presented as a transformative paradigm for engineering robust biocatalysts and developing targeted therapeutics. Source: https://www.enzymestudy.com/posts/enzyme-structure-and-substrate-binding-from-atomic-mechanisms-to-therapeutic-drug-development

Open article ↗



Access all drug discovery articles and probability of success in trials forecasts:

Access all drug discovery articles and probability of success in trials forecasts:

Drug Discovery Landscape

22 orphan drug designations for Ornithine transcarbamylase deficiency, including 2 approved therapies.

22 orphan drug designations for Ornithine transcarbamylase deficiency, including 2 approved therapies.

Drug

Therapy type

Regulator

Orphan designation

Approval

Sponsor

adeno-associated viral vector serotype LK03 containing the human ornithine transcarbamylase gene

gene therapies

FDA

2023-08-08

Bloomsbury Genetic Therapies Ltd.

A replication-deficient adeno-associated virus serotype 9 vector containing the ornithine transcarbamylase gene within the transposon and a lipid nanoparticle containing messenger RNA for the transposase

gene therapies

FDA

2023-07-24

Poseida Therapeutics, Inc.

Adeno-associated virus serotype rh79 containing the human OTC gene, adeno-associated virus serotype rh79 encoding a meganuclease for targeted editing of the human PCSK9 gene

gene therapies

EMA

2022-12-09

Pharma Gateway AB

non-replicating recombinant adeno-associated virus serotype rh79 (AAVrh.79) vectors: AAVrh79.TBG.M2PCSK9.WPRE.bGH and AAVrh79.hHDR.TBG.hOTCco.bGH

gene therapies

FDA

2022-09-01

iECURE, Inc.

mRNA encoding modified human ornithine transcarbamylase

RNAs

EMA

2022-07-18

Arcturus Therapeutics Europe B.V.

L-Citrulline

small molecules

FDA

2020-11-03

Orpha Labs, AG

Ornithine transcarbamylase messenger RNA

gene therapies

FDA

2019-06-26

Arcturus Therapeutics, Inc.

Sodium benzoate, sodium phenylacetate

small molecules

EMA

2019-04-24

Dipharma B.V.

Codon-optimised human ornithine transcarbamylase mRNA complexed with lipid-based nanoparticles

RNAs

EMA

2018-06-27

Transcrip Ireland Limited

Nanoparticle suspension containing biosynthetic codon-optimized human ornithine transcarbamylase messenger RNA

RNAs

FDA

2018-03-28

Translate Bio, Inc.

Modified messenger ribonucleic acid encoding human ornithine transcarbamylase enzyme encapsulated into lipid nanoparticles

RNAs

EMA

2017-04-20

PhaseRx Ireland, Ltd

Adeno-associated viral vector serotype LK03 encoding human ornithine transcarbamylase

gene therapies

EMA

2017-03-20

UCL Research Limited

mRNA encoding human ornithine transcarbamylase

RNAs

FDA

2016-11-23

PhaseRx, Inc.

Sodium benzoate

small molecules

EMA

2016-07-14

Lucane Pharma SA

Adeno-associated viral vector serotype 8 encoding human ornithine transcarbamylase

gene therapies

EMA

2016-03-21

Ultragenyx Germany GmbH

recombinant adeno-associated virus serotype AAV8 vector encoding human ornithine transcarbamylase

gene therapies

FDA

2015-12-29

Dimension Therapeutics

Sodium phenylbutyrate [Pheburane]

small molecules

EMA

2012-02-09

Lucane Pharma

Heterologous human adult liver-derived stem cells

cell therapies

EMA

2011-09-27

Unicyte S.R.L.

Glyceryl tri-(4-phenylbutyrate) [Ravicti]

small molecules

EMA

2010-06-10

2015-12-01

Immedica Pharma AB

Heterologous human adult liver derived stem cells

cell therapies

EMA

2008-02-04

Cellaion

Human heterologous liver cells (for infusion)

gene therapies

EMA

2007-09-14

Promethera Biosciences

Benzoate and phenylacetate [Ucephan]

small molecules

FDA

1986-01-21

1987-12-23

ImmunexImmunex

Explority AI logo

228 Park Ave S,
New York, USA.

At Explority, we build first-of-its-kind AI to bring clarity to the earliest and riskiest stages of pharmaceutical research by forecasting which therapies are most likely to succeed. Explority AI web and mobile applications are properties of the Explority AI Inc., a company registered in the United States (File No. 10320493).
For all questions: support@explority.ai

Copyright © 2026 Explority AI Inc.

Explority AI logo

228 Park Ave S,
New York, USA.

At Explority, we build first-of-its-kind AI to bring clarity to the earliest and riskiest stages of pharmaceutical research by forecasting which therapies are most likely to succeed. Explority AI web and mobile applications are properties of the Explority AI Inc., a company registered in the United States (File No. 10320493).
For all questions: support@explority.ai

Copyright © 2026 Explority AI Inc.

Explority AI logo

228 Park Ave S,
New York, USA.

At Explority, we build first-of-its-kind AI to bring clarity to the earliest and riskiest stages of pharmaceutical research by forecasting which therapies are most likely to succeed. Explority AI web and mobile applications are properties of the Explority AI Inc., a company registered in the United States (File No. 10320493).
For all questions: support@explority.ai

Copyright © 2026 Explority AI Inc.