DSANJ Registration Form

RequiredPresenter's Name

RequiredPresenter's Instituition

RequiredPresenter's Division

RequiredPresenter's Title

RequiredE-mail Address

RequiredPhone number *Number with no hyphens

RequiredPresentation (Proposal) Title
*Within 100characters in Japanese

e.g.
Research and Development ofNeurodegenerative Disease Therapies Targeting Gene X

RequiredKeywords related to presentaion

e.g.
CNS disease,ubiquitination,misfolding,DNA methylation,axonal regeneration

RequiredTherapeutics category

• Oncology
• Central Nervous System
• Pain
• Infectious disease
• Metabolic & Endocrine disease
• Cardiovascular disease
• Respiratory disease
• Gastrointestinal disease
• Immunological / Autoimmune disease
• Allergic disease
• Dermatological disease
• Bone / Joint disease
• Ophthalmologic disease
• Urinary / Renal disease
• Reproductive / Women's health
• Hematological disease
• Rare / Orphan disease
• Genetic disorders
• Others

pls. specify

RequiredType of Target

• Enzyme
• G-protein-coupled receptor (GPCR)
• Ion channel
• Transporter
• Nuclear receptor
• Cytokine / Growth factor
• Transcription factor
• Protein-protein interaction (PPI)
• Epigenetic regulator
• MicroRNA / Non-coding RNA
• Cell surface antigen
• Pathway / Network level target
• Unknown / To be identified
• Others

pls. specify

RequiredMode of Action

• Inhibitor
• Activator / Agonist
• Antagonist
• Modulator
• Degrader / PROTAC
• Immune checkpoint modulation
• Gene expression modulation
• Cell death induction
• Epigenetic modification
• Signal pathway modulation
• Reprogramming / Differentiation
• Targeted delivery
• Others

pls. specify

RequiredModality (Molecule type)

• Small molecule
• Medium-sized molecule
• Peptide / Protein
• Antibody
• Nucleic acid therapy
• Gene therapy
• Cell therapy
• Virus-based therapy
• Vaccine
• SaMD / Digital therapeutics
• AI-designed compound / AI drug discovery
• PPI-targeting modality
• Others

pls. specify

Platform Technology
Please check the appropriate box below, if you have your unique technology, method and technique.

• Drug delivery system
• Screening platform
• Assay / Evaluation model
• ADME / Toxicology technology
• In vivo / Animal model
• Formulation / CMC
• Structure-based drug design / SAR
• Antibody engineering platform
• Nucleic acid technology
• Genomic / Transcriptomic analysis
• Biomarker discovery / Diagnostics platform
• AI / In silico / Digital platform
• Cell model / Organoid / Organ-on-chip
• PROTAC / Degrader platform
• Adjuvant technology
• Others

pls. specify

RequiredAttached file *(zip,excel,word,ppt,pdf)

Please select only one file to upload.