CMS (CHRNE) OMIM 608931
In CMS (CHRNE, OMIM 608931), the master switch sits on the ↓ DOWN branch ([F] forced below); the healthy state is the ON well. The forced corrective direction is to raise s toward ON branch (polarity: supply). 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 0.5206, γ 1.4431, spinodal 0.6673). 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 CMS is an R19 double-well emerged from the real proximal-promoter DNA of CHRNE. Its geometry is fixed by measured stiffness γ (never fitted); the numbers below are read directly off that cusp.
- emergent axis
- ↓ DOWN [F]
- healthy branch
- ON
- lesion
- LOF_null
- γ (stiffness)
- 1.4431
- barrier
- 0.5206
- spinodal
- 0.6673
- s_on / s_off
- 1.2013 / -1.2013
- fragility
- 0.36
- corrective polarity
- supply
- forced direction
- raise s toward ON branch
Chemistry feasibility (DIRECTION only [O]). small-molecule recrossing of the fold is geometrically harder (barrier 0.5206 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).
Agents mapped onto the lever
| agent (class) | dir. | status | phase | map |
|---|---|---|---|---|
| cholinergic-transmission augmentation (pyridostigmine, an acetylcholinesterase-acting agent) augmenting endplate signalling deficient downstream of the CHRNE receptor defect Engel 2015 Lancet Neurol 14:461 (congenital myasthenic syndromes: pathogenesis, diagnosis, and treatment); Ohno 1995 Proc Natl Acad Sci U S A 92:758 (congenital myasthenic syndrome caused by prolonged acetylcholine) | increase | established standard of care | 0 | ✓ in use |
Evidence & provenance
| element | grade | basis |
|---|---|---|
| R19 switch & cusp geometry (this page) | [V] verified | emerged from measured promoter γ of CHRNE; deterministic, 2×sha256 identical |
| corrective direction | [F] forced | forced by the cusp sign; falsifiable (see lever falsifiers) |
| mapped agents / leads | [O] open | direction-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).