Natural Product: NPC276377

Natural Product IDNPC276377
Common Name
?
The InCHIKey will be temporarily assigned as the "Common Name" if no IUPAC name or alternative short name is available.
Kaempferol 3-O-Alpha-L-Arabinopyranosyl-7-O-Alpha-L-Rhamnopyranoside
IUPAC Name 5-hydroxy-2-(4-hydroxyphenyl)-7-[(2S,3R,4R,5R,6S)-3,4,5-trihydroxy-6-methyloxan-2-yl]oxy-3-[(2S,3R,4S,5S)-3,4,5-trihydroxyoxan-2-yl]oxychromen-4-one
Synonyms
Synthetic Gene Cluster n.a.
ChEMBL Identifier CHEMBL1929026
PubChem CID 57401109
Chemical Classification
  • CHEMONTID:0000000 [Organic compounds]
    • [CHEMONTID:0000261] Phenylpropanoids and polyketides
      • [CHEMONTID:0000334] Flavonoids
        • [CHEMONTID:0001111] Flavonoid glycosides
          • [CHEMONTID:0001583] Flavonoid O-glycosides
            • [CHEMONTID:0003533] Flavonoid-7-O-glycosides

The Chemical Classification was calculated by Classyfire, a software for chemical taxonomy calculation. Reference: DOI:10.1186/s13321-016-0174-y.

  Chemical Representations

Standard InCHIKey DQBVFTJNUYZVQL-CLFUFSEMSA-N
Standard InCHI InChI=1S/C26H28O14/c1-9-17(30)20(33)22(35)26(37-9)38-12-6-13(28)16-15(7-12)39-23(10-2-4-11(27)5-3-10)24(19(16)32)40-25-21(34)18(31)14(29)8-36-25/h2-7,9,14,17-18,20-22,25-31,33-35H,8H2,1H3/t9-,14-,17-,18-,20+,21+,22+,25-,26-/m0/s1
SMILES C[C@H]1[C@@H]([C@H]([C@H]([C@@H](O1)Oc1cc(c2c(c1)oc(c1ccc(cc1)O)c(c2=O)O[C@H]1[C@@H]([C@H]([C@H](CO1)O)O)O)O)O)O)O

  Calculated Properties

Physi-Chem Properties

Molecular Weight:   564.15 Volume:   517.441
?
Van der Waals volume.
Dense:   1.09 LogP:   1.419
?
The logarithm of the n-octanol/water distribution coefficients.
logD7.4:   1.676
?
The logarithm of the n-octanol/water distribution coefficient at pH=7.4.
LogS:   -2.548
?
The logarithm of aqueous solubility value.
Rotatable Bonds:   5.0 Rigid Bonds:   30.0
TPSA:   228.97
?
Topological Polar Surface Area.
H-Bond Acceptor:   14.0
H-Bond Donor:   8.0 Rings:   5.0
Heavy Atoms:   14.0

MedChem Properties

QED Drug-Likeness Score:   0.184 GASA:   1.0
?
GASA represents the probability of being difficult to synthesize, ranging from 0 to 1.
Synthetic Accessibility Score:   4.602 Fsp3:   0.423
MCE-18:   116.838
?
MCE-18 stands for medicinal chemistry evolution.MCE-18≥45 is considered a suitable value.
Lipinski Rule-of-5:   Accepted
Pfizer Rule:   Rejected GSK Rule:   Accepted
Golden Triangle Rule:   Accepted BMS Rule:   0
Chelating Alert:   0 PAINS Alert:   0
Colloidal aggregators:   0.635 Fluc inhibitor:   0.28
?
The fluc inhibitor value is the probability of being fLuc inhibitors, within the range of 0 to 1.
Blue fluorescence:   0.902
?
The blue fluorescence value is the probability of being blue fluorescence, within the range of 0 to 1
Green fluorescence:   0.796
?
The green fluorescence value is the probability of being green fluorescence, within the range of 0 to 1
Reactive compounds:   0.077 Promiscuous compounds:   0.514

ADMET Properties (ADMETlab3.0)

ADMET: Absorption

Caco-2 Permeability:   -6.391 MDCK Permeability:   -5.073
Pgp-inhibitor:   0.0 Pgp-substrate:   0.908
PAMPA:   1.0
?
The experimental data for Peff was logarithmically transformed (logPeff). Molecules with log Peff values below 2.0 were classified as low-permeability (Category 0), while those with log Peff values exceeding 2.5 were classified as high-permeability (Category 1).
Human Intestinal Absorption (HIA):   0.532
20% Bioavailability (F20%):   0.212 30% Bioavailability (F30%):   0.992
50% Bioavailability (F50%):   0.999

ADMET: Distribution

Blood-Brain-Barrier Penetration (BBB):   0.0 MRP1:   0.053
Plasma Protein Binding (PPB):   84.54% Volume Distribution (VD):   -0.017
Fu: 15.248%
?
The fraction unbound in plasms.
OATP1B1 inhibitor:   0.996
OATP1B3 inhibitor:   1.0 BCRP inhibitor:   0.665
BSEP inhibitor:   0.002

ADMET: Metabolism

CYP1A2-inhibitor:   0.001 CYP1A2-substrate:   0.0
CYP2C19-inhibitor:   0.0 CYP2C19-substrate:   0.0
CYP2C9-inhibitor:   0.0 CYP2C9-substrate:   0.0
CYP2D6-inhibitor:   0.0 CYP2D6-substrate:   0.003
CYP3A4-inhibitor:   0.0 CYP3A4-substrate:   0.986
CYP2B6-substrate:   0.0 CYP2C8-inhibitor:   0.992
HLM stability:   0.228
?
Human liver microsomal (HLM) stability. Category 0: stable+ (HLM > 30 min); Category 1: unstable- (HLM ≤ 30 min). The output value is the probability of human liver microsomal instability, where a value closer to 1 indicates a higher likelihood of instability.

ADMET: Excretion

Clearance (CL):  1.945 Half-life (T1/2):  4.613

ADMET: Toxicity

hERG Blockers:  0.02 hERG Blockers (10um):  0.172
Human Hepatotoxicity (H-HT):  0.741 Drug-induced Liver Injury (DILI):  0.992
AMES Toxicity:  0.93 Rat Oral Acute Toxicity:  0.026
Maximum Recommended Daily Dose:  0.034 Skin Sensitization:  0.999
Carcinogencity:  0.056 Eye Corrosion:  0.0
Eye Irritation:  0.454 Respiratory Toxicity:  0.036
Drug-induced Neurotoxicity:  0.004 Ototoxicity:  0.872
Hematotoxicity:  0.151 Drug-induced Nephrotoxicity:  0.662
Genotoxicity:  0.944 RPMI-8226 Immunitoxicity:  0.205
A549 Cytotoxicity:  0.889 Hek293 Cytotoxicity:  0.682
BCF:   0.474
?
Bioconcentration factors are used for considering secondary poisoning potential and assessing risks to human health via the food chain. The unit is -log10[(mg/L)/(1000*MW)].
IGC50:   3.066
?
48 hour Tetrahymena pyriformis IGC50. The unit of IGC50 is -log10[(mg/L)/(1000*MW)].
LC50DM:   4.536
?
48 hour Daphnia magna LC50. The unit of LC50DM is -log10[(mg/L)/(1000*MW)].
LC50FM:   3.663
?
96 hour fathead minnow LC50. The unit of LC50FM is -log10[(mg/L)/(1000*MW)].

  Species Source

Organism ID Organism Name Taxonomy Level Family SuperKingdom Isolation Part Collection Location Collection Time Reference
NPO23510 Vicia faba Species Fabaceae Eukaryota flowers n.a. n.a. PMID[16180811]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. branch n.a. PMID[22014228]
NPO27656 Lotus edulis Species Fabaceae Eukaryota n.a. branch n.a. PMID[22014228]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. leaf n.a. PMID[22014228]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. PMID[22014228]
NPO27656 Lotus edulis Species Fabaceae Eukaryota n.a. n.a. n.a. PMID[22014228]
NPO27656 Lotus edulis Species Fabaceae Eukaryota n.a. leaf n.a. PMID[22014228]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. PMID[39355945]
NPO27656 Lotus edulis Species Fabaceae Eukaryota n.a. n.a. n.a. Database[COCONUT]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. Database[COCONUT]
NPO23510 Vicia faba Species Fabaceae Eukaryota Flower n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota Fruit n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota Oil n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota Seed n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota Sprout Seedling n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota Stem n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. Database[FooDB]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. Database[HerDing]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. Database[TCMID]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. Database[TCM_Taiwan]
NPO27656 Lotus edulis Species Fabaceae Eukaryota n.a. n.a. n.a. Database[UNPD]
NPO23510 Vicia faba Species Fabaceae Eukaryota n.a. n.a. n.a. Database[UNPD]
NPO528 Dorycnium hirsutum Species Fabaceae Eukaryota n.a. n.a. n.a. Database[UNPD]

Note for Reference:
In addition to directly collecting NP source organism data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated them from below databases:
UNPD: Universal Natural Products Database [PMID: 23638153].
StreptomeDB: a database of streptomycetes natural products [PMID: 33051671].
TM-MC: a database of medicinal materials and chemical compounds in Northeast Asian traditional medicine [PMID: 26156871].
TCM@Taiwan: a Traditional Chinese Medicine database [PMID: 21253603].
TCMID: a Traditional Chinese Medicine database [PMID: 29106634].
TCMSP: The traditional Chinese medicine systems pharmacology database and analysis platform [PMID: 24735618].
HerDing: a herb recommendation system to treat diseases using genes and chemicals [PMID: 26980517].
MetaboLights: a metabolomics database [PMID: 27010336].
FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].



  NP Quantity Composition/Concentration

Organism ID Organism Name Organism Material Preparation Organism Part NP Quantity (Standard) NP Quantity (Minimum) NP Quantity (Maximum) Quantity Unit Reference

Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP quantitative records for specific NP domains (e.g., NPS from foods or herbs) from domain-specific databases. These databases include:
DUKE: Dr. Duke's Phytochemical and Ethnobotanical Databases.
PHENOL EXPLORER: is the first comprehensive database on polyphenol content in foods [PMID: 24103452], its homepage can be accessed at here.
FooDB: a database of constituents, chemistry and biology of food species [www.foodb.ca].



 Biological Activity

Molecular-level activity

Target ID Target Type Target Name Target Organism Activity Type Activity Relation Value Unit Reference
NPT143 Individual protein DNA topoisomerase I Homo sapiens IC50 = 250000.0 nM PMID[22014228]
NPT1044 Individual protein DNA topoisomerase II alpha Homo sapiens IC50 = 330000.0 nM PMID[22014228]

In vitro activity

Target ID Target Type Target Name Target Organism Activity Type Activity Relation Value Unit Reference
NPT2 Others Unspecified n.a. IC50 = 240000.0 nM PMID[22014228]

In vivo activity

Target ID Target Type Target Name Target Organism Activity Type Activity Relation Value Unit Reference





 Experimental ADME

Experiment Model Experiment Tissue ADME Type ADME Relation ADME Value ADME Unit Reference





 Experimental Toxicity

Quantitative toxicity

Experiment Model Experiment Organism Toxicity Type Toxicity Relation Toxicity Value Toxicity Unit Reference

Common Abbreviations:
LC: Lethal Concentration; LD: Lethal Dose; LT:Lethal Time; NOAEL: No-observed-adverse-effect Level; BMDL: Benchmark Dose Lower Confidence Limit; BMD: Benchmark Dose; BMC:Benchmark Concentration; LOAEL: Lowest Observed Adverse Effect Level; RfD:Reference Dose; RfC:Reference Concentration; MRL: Minimal Risk Level; MEG: Maximum Exposure Guideline; PAC: Protective Action Criteria

Categorical toxicity labels

Hepatotoxicity Carcinogenicity Mutagenicity Cardiotoxicity Respiratory Toxicity Eye Irritation Endocrine Disruption
Hepatotoxicity Carcinogenicity Mutagenicity Cardiotoxicity Respiratory Toxicity Eye Irritation Endocrine Disruption

Note for Reference:
In addition to directly collecting NP quantitative data from primary literature (where reference will provided as NCBI PMID or DOI links), NPASS also integrated NP toxicity records from domain-specific databases. These databases include:
ToxValDB: a curated database that compiles quantitative toxicity values for chemicals from diverse public sources to support toxicological research and risk assessment.
TOXRIC: a comprehensive, free-to-access, online database providing toxicological/feature data. The toxicity labels are retrieved from this database. [PMID: 36400569]


  Chemically structural similarity

Similar Active Natural Products in NPASS

Top-200 similar NPs were calculated against the active-NP-set (includes approximately 50,000 NPs with experimentally-derived bioactivity available in NPASS)

Similarity is measured using the Tanimoto coefficient (Tc) , which compares the binary fingerprints of two molecules. Tc is calculated as the intersection divided by the union of '1' bits in the fingerprints, ranging from 0 to 1, with 1 indicating highest similarity.

●  The left chart: Distribution of similarity level between NPC276377 and all remaining natural products in the NPASS database.
●  The right table: Most similar natural products (Tc>=0.5 or Top200).

Similarity Score Similarity Level Natural Product ID
0.9014 High Similarity NPC249281
0.8514 High Similarity NPC46420
0.8375 Intermediate Similarity NPC150164
0.8312 Intermediate Similarity NPC116458
0.8312 Intermediate Similarity NPC246943
0.8049 Intermediate Similarity NPC186816
0.7976 Intermediate Similarity NPC72016
0.7662 Intermediate Similarity NPC297987
0.7564 Intermediate Similarity NPC271692
0.7407 Intermediate Similarity NPC605784
0.7179 Intermediate Similarity NPC111929
0.7179 Intermediate Similarity NPC320283
0.7179 Intermediate Similarity NPC41121
0.716 Intermediate Similarity NPC611303
0.7159 Intermediate Similarity NPC32641
0.7159 Intermediate Similarity NPC256188
0.7159 Intermediate Similarity NPC35119
0.7 Intermediate Similarity NPC158674
0.6962 Remote Similarity NPC331652
0.6875 Remote Similarity NPC108831
0.6875 Remote Similarity NPC182634
0.6795 Remote Similarity NPC54802
0.6795 Remote Similarity NPC197304
0.679 Remote Similarity NPC136042
0.6744 Remote Similarity NPC251417
0.6742 Remote Similarity NPC64425
0.6667 Remote Similarity NPC289667
0.6667 Remote Similarity NPC25523
0.6596 Remote Similarity NPC14187
0.6522 Remote Similarity NPC142142
0.6477 Remote Similarity NPC471079
0.6463 Remote Similarity NPC127546
0.6463 Remote Similarity NPC57625
0.6463 Remote Similarity NPC19709
0.6463 Remote Similarity NPC173637
0.6463 Remote Similarity NPC317489
0.6463 Remote Similarity NPC238376
0.6463 Remote Similarity NPC223424
0.6463 Remote Similarity NPC600591
0.6413 Remote Similarity NPC606657
0.6404 Remote Similarity NPC173582
0.6404 Remote Similarity NPC265885
0.6404 Remote Similarity NPC181465
0.6404 Remote Similarity NPC215710
0.6404 Remote Similarity NPC473438
0.6404 Remote Similarity NPC253788
0.6374 Remote Similarity NPC240306
0.6354 Remote Similarity NPC121703
0.631 Remote Similarity NPC84362
0.631 Remote Similarity NPC27640
0.6235 Remote Similarity NPC59534
0.6222 Remote Similarity NPC44931
0.6098 Remote Similarity NPC276222
0.6098 Remote Similarity NPC274618
0.6098 Remote Similarity NPC118284
0.6098 Remote Similarity NPC608147
0.6071 Remote Similarity NPC77672
0.6071 Remote Similarity NPC133671
0.6071 Remote Similarity NPC135391
0.6071 Remote Similarity NPC78263
0.6071 Remote Similarity NPC250069
0.6023 Remote Similarity NPC223747
0.6 Remote Similarity NPC480441
0.5978 Remote Similarity NPC65563
0.5978 Remote Similarity NPC470949
0.5955 Remote Similarity NPC66087
0.5952 Remote Similarity NPC473043
0.5952 Remote Similarity NPC135599
0.5952 Remote Similarity NPC73855
0.5952 Remote Similarity NPC113968
0.5952 Remote Similarity NPC328940
0.5952 Remote Similarity NPC277174
0.5952 Remote Similarity NPC606877
0.593 Remote Similarity NPC305811
0.593 Remote Similarity NPC24043
0.5914 Remote Similarity NPC473571
0.5914 Remote Similarity NPC110941
0.5889 Remote Similarity NPC265115
0.5882 Remote Similarity NPC39360
0.5882 Remote Similarity NPC29763
0.5882 Remote Similarity NPC210003
0.5882 Remote Similarity NPC348541
0.5876 Remote Similarity NPC221342
0.5876 Remote Similarity NPC476470
0.587 Remote Similarity NPC67326
0.587 Remote Similarity NPC67105
0.5862 Remote Similarity NPC27942
0.5842 Remote Similarity NPC164704
0.5814 Remote Similarity NPC265530
0.5814 Remote Similarity NPC323593
0.5814 Remote Similarity NPC203500
0.5806 Remote Similarity NPC203259
0.5806 Remote Similarity NPC33054
0.5806 Remote Similarity NPC210073
0.5806 Remote Similarity NPC176740
0.5806 Remote Similarity NPC471725
0.5806 Remote Similarity NPC134532
0.5806 Remote Similarity NPC602582
0.5795 Remote Similarity NPC219904
0.5747 Remote Similarity NPC349108
0.5714 Remote Similarity NPC288084
0.5701 Remote Similarity NPC209550
0.5698 Remote Similarity NPC476405
0.567 Remote Similarity NPC486577
0.5625 Remote Similarity NPC470443
0.5625 Remote Similarity NPC483414
0.5625 Remote Similarity NPC483415
0.5618 Remote Similarity NPC159579
0.5607 Remote Similarity NPC470720
0.5604 Remote Similarity NPC476215
0.5604 Remote Similarity NPC190003
0.56 Remote Similarity NPC146679
0.5591 Remote Similarity NPC480466
0.5577 Remote Similarity NPC470716
0.5568 Remote Similarity NPC488080
0.5568 Remote Similarity NPC169977
0.5567 Remote Similarity NPC483416
0.5556 Remote Similarity NPC138990
0.5543 Remote Similarity NPC116864
0.5543 Remote Similarity NPC244776
0.5534 Remote Similarity NPC470715
0.5521 Remote Similarity NPC488074
0.5521 Remote Similarity NPC64051
0.5514 Remote Similarity NPC470717
0.5505 Remote Similarity NPC175429
0.5481 Remote Similarity NPC277532
0.5474 Remote Similarity NPC304741
0.5464 Remote Similarity NPC12013
0.5464 Remote Similarity NPC11432
0.5464 Remote Similarity NPC477613
0.5455 Remote Similarity NPC145038
0.5455 Remote Similarity NPC476472
0.5455 Remote Similarity NPC8573
0.5455 Remote Similarity NPC56077
0.5455 Remote Similarity NPC294815
0.5455 Remote Similarity NPC281131
0.5455 Remote Similarity NPC470447
0.5455 Remote Similarity NPC64305
0.5455 Remote Similarity NPC253662
0.5455 Remote Similarity NPC473073
0.5455 Remote Similarity NPC179950
0.5455 Remote Similarity NPC16194
0.5455 Remote Similarity NPC277205
0.5455 Remote Similarity NPC37919
0.5455 Remote Similarity NPC88789
0.5455 Remote Similarity NPC189142
0.5455 Remote Similarity NPC77660
0.5455 Remote Similarity NPC491374
0.5444 Remote Similarity NPC175107
0.5444 Remote Similarity NPC129217
0.5435 Remote Similarity NPC355481
0.5426 Remote Similarity NPC139320
0.5417 Remote Similarity NPC129264
0.54 Remote Similarity NPC101636
0.54 Remote Similarity NPC298171
0.5392 Remote Similarity NPC203145
0.5368 Remote Similarity NPC470405
0.5368 Remote Similarity NPC39834
0.5368 Remote Similarity NPC163242
0.5368 Remote Similarity NPC272068
0.5368 Remote Similarity NPC227508
0.5361 Remote Similarity NPC470125
0.5361 Remote Similarity NPC126784
0.5361 Remote Similarity NPC241423
0.534 Remote Similarity NPC189564
0.5333 Remote Similarity NPC216496
0.5333 Remote Similarity NPC472459
0.5312 Remote Similarity NPC22062
0.5312 Remote Similarity NPC65003
0.5312 Remote Similarity NPC473634
0.5312 Remote Similarity NPC303913
0.5312 Remote Similarity NPC138811
0.5312 Remote Similarity NPC605592
0.53 Remote Similarity NPC85751
0.53 Remote Similarity NPC76831
0.53 Remote Similarity NPC19240
0.5275 Remote Similarity NPC488071
0.5253 Remote Similarity NPC270448
0.5253 Remote Similarity NPC209296
0.5253 Remote Similarity NPC473327
0.5248 Remote Similarity NPC292929
0.5227 Remote Similarity NPC160515
0.5204 Remote Similarity NPC153755
0.52 Remote Similarity NPC270675
0.52 Remote Similarity NPC195685
0.5196 Remote Similarity NPC602448
0.5169 Remote Similarity NPC261866
0.5165 Remote Similarity NPC599850
0.5158 Remote Similarity NPC480463
0.5158 Remote Similarity NPC278419
0.5158 Remote Similarity NPC179198
0.5155 Remote Similarity NPC156869
0.5152 Remote Similarity NPC65711
0.5149 Remote Similarity NPC80068
0.5146 Remote Similarity NPC470455
0.5146 Remote Similarity NPC214621
0.5146 Remote Similarity NPC34267
0.5114 Remote Similarity NPC67037
0.5114 Remote Similarity NPC255615

Similar Clinical/Approved Drugs

Similarity level is defined by Tanimoto coefficient (Tc) between two molecules.

●  The left chart: Distribution of similarity level between NPC276377 and all drugs/candidates.
●  The right table: Most similar clinical/approved drugs (Tc>=0.5 or Top200).

Similarity Score Similarity Level Drug ID Developmental Stage
0.663 Remote Similarity NPD7251 Phase 2
0.602 Remote Similarity NPD7808 Phase 3
0.5806 Remote Similarity NPD6797 Phase 2
0.5253 Remote Similarity NPD7054 Phase 4
0.505 Remote Similarity NPD7804 Clinical (unspecified phase)

Bioactivity similarity

  Bioactivity similarity

Similar Natural Products in NPASS

Similarity level is defined by Bioactivity similarity was calculated based on bioactivity descriptors of compounds. The bioactivity descriptors were calculated by a recently developed AI algorithm Chemical Checker (CC) [Nature Biotechnology, 38:1087–1096, 2020; Nature Communications, 12:3932, 2021], which evaluated bioactivity similarities at five levels:
A: chemistry similarity;
B: biological targets similarity;
C: networks similarity;
D: cell-based bioactivity similarity;
E: similarity based on clinical data.
Those 5 categories of CC bioactivity descriptors were calculated and then subjected to manifold projection using UMAP algorithm, to project all NPs on a 2-Dimensional space. The current NP was highlighted with a small circle in the 2-D map. Below figures: left-to-right, A-to-E.

A: chemistry similarity
B: biological targets similarity
C: networks similarity
D: cell-based bioactivity similarity
E: similarity based on clinical data