Acute intermittent porphyria OMIM 176000

In Acute intermittent porphyria OMIM 176000 (HMBS, OMIM 176000), the master switch sits on the ↑ UP branch ([F] forced below); the healthy state is the ON well. The forced corrective direction is to raise s toward ON branch (polarity: clear). Classification: ✓ Recovers an existing standard. Direction only — no dose, no efficacy magnitude.

The disease maps to an R19 double-well whose corrective lever is read straight off the cusp (barrier 0.5012, γ 1.4159, spinodal 0.6485). The corrective direction is forced [F]; the agent names below are direction-concordant labels at grade [O] (no dose, no efficacy or safety magnitude). This is a research hypothesis offered to experts, not medical advice.

The emergence switch

The switch for Acute intermittent porphyria OMIM 176000 is an R19 double-well emerged from the real proximal-promoter DNA of HMBS. Its geometry is fixed by measured stiffness γ (never fitted); the numbers below are read directly off that cusp.

emergent axis
↑ UP [F]
healthy branch
ON
lesion
LOF_null
γ (stiffness)
1.4159
barrier
0.5012
spinodal
0.6485
s_on / s_off
1.1899 / -1.1899
fragility
0.45
corrective polarity
clear
forced direction
raise s toward ON branch

Chemistry feasibility (DIRECTION only [O]). small-molecule recrossing of the fold is geometrically harder (barrier 0.5012 at neutral drive; lower barrier = smaller drive to supply). [O] -- no affinity/potency/dose/efficacy asserted.

The derived corrective lever

The cusp forces a corrective direction: raise s toward ON branch. This is the load-bearing output of the framework — it is [F] forced, and it is falsifiable. 2 lever families are derived; the lead is h-restore (drive modulator).

h-restore (drive modulator)sign: decreasegeometric rank 0.45
Mechanism. remove / oppose the drive (clear the accumulating load that pins the disease branch)
Applies to. allele-agnostic (downstream/environmental tilt)
favoured when the switch is fragile -- a small drive shift recrosses the fold
Falsifier. If clearing/opposing the accumulating ALAS1 does NOT relieve the disease branch in a HMBS model, the h-restore(clear) lever is refuted for this axis.
gamma-restore (stabiliser / chaperone)sign: Nonegeometric rank 0.00
Mechanism. N/A
Applies to. none (honest exclusion)
EXCLUDED: null allele -- no product to stiffen
Falsifier. If a folding-stabiliser/chaperone does NOT re-deepen the healthy well for a residual HMBS allele (no rescue that a null allele lacks), the gamma-restore lever is refuted; null alleles are excluded by construction.

Agents mapped onto the lever

✓ Agreement with established practice. The corrective direction derived here (raise s toward ON branch) independently matches an agent already in clinical use for this disease: ALAS1-knockdown siRNA (givosiran); hemin / heme arginate (ALAS1 feedback repression). The geometry recovered known medicine — this is a validation signal for the logic, not a new treatment claim by this kit.
Existing agents whose known action is direction-concordant with the derived lever (status as pinned in the corpus; no dose, no efficacy magnitude).
agent (class)dir.statusphasemap
ALAS1-knockdown siRNA (givosiran)
Balwani 2020 NEJM 382:2289 (ENVISION, givosiran); givosiran FDA 2019
decreaseapproved4✓ in use
hemin / heme arginate (ALAS1 feedback repression)
Anderson 2006 (hematin in acute porphyria)
decreaseapproved4✓ in use
HMBS restoration (liver transplantation; HMBS gene therapy investigational)
Dowman 2012 (liver transplant in AIP); D'Avola 2016 (AAV-HMBS phase I)
decreaseclinical3◇ in trials
⚠ Mechanism-direction only — do not self-administer; no dose (unvalidated; set by a physician / national authority); not an approved use.

Direction-only candidate leads (corpus join)

Each lead is surfaced only because its known mechanism points the same way as the derived lever, and each comes with a source and a falsifier. None is a treatment.

givosiran✓ recovered standarddir: decrease · approved
Class. ALAS1-directed siRNA (substrate-precursor lowering)
Mechanism. An siRNA that knocks down hepatic ALAS1, the rate-limiting upstream enzyme, lowering the neurotoxic porphyrin precursors (ALA / PBG) that accumulate when HMBS is deficient. Direction: decrease / clear the precursor build-up downstream of the HMBS lesion. Engaged node: ALAS1 (the agent acts upstream, not on HMBS itself). Allele scope: agnostic -- reduces precursor flux regardless of the HMBS variant. Mapped to acute intermittent porphyria. An approved agent; the geometry's clear direction recovers it.
✓ This is a rediscovery. Givosiran is approved for acute hepatic porphyria and lowers the precursors driving AIP attacks; the clear direction recovered the approved agent.
Safety (qualitative; no magnitude). siRNA class; hepatic and renal monitoring and injection-reaction signals noted on label (qualitative; no magnitude)
Falsifier. If givosiran (a pathway decrease agent) clearing/opposing the accumulating load does NOT relieve the UP [F] disease branch in a HMBS model, the h-restore(clear) direction is refuted for givosiran here.
Source: Givosiran (Givlaari) label; Balwani 2020 NEJM 382:2289
⚠ Mechanism-direction only — do not self-administer; no dose (unvalidated; set by a physician / national authority); not an approved use.

Evidence & provenance

What is reproduced vs. cited for this page.
elementgradebasis
R19 switch & cusp geometry (this page)[V] verifiedemerged from measured promoter γ of HMBS; deterministic, 2×sha256 identical
corrective direction[F] forcedforced by the cusp sign; falsifiable (see lever falsifiers)
mapped agents / leads[O] opendirection-concordance only; corpus-pinned (2026-06-21); no dose, no efficacy/safety magnitude

Reading the agent column. VALIDATION SIGNAL -- the agent is already approved / established standard for this disease, so the direction logic recovered known clinical practice. Not a new claim by this kit. GENUINE HYPOTHESIS -- no approved indication for this disease; the direction match is a direction-only, untested [O] lead. Basis field grades the evidence (investigational here / in a related condition / off-label / speculative).