Prakash Thazha P, Graham Mark J, Yu Jinghua, Carty Rick, Low Audrey, Chappell Alfred, Schmidt Karsten, Zhao Chenguang, Aghajan Mariam, Murray Heather F, Riney Stan, Booten Sheri L, Murray Susan F, Gaus Hans, Crosby Jeff, Lima Walt F, Guo Shuling, Monia Brett P, Swayze Eric E, Seth Punit P
Isis Pharmaceuticals, Inc., 2855 Gazelle Court, Carlsbad, CA 92010, USA.
Isis Pharmaceuticals, Inc., 2855 Gazelle Court, Carlsbad, CA 92010, USA
Nucleic Acids Res. 2014 Jul;42(13):8796-807. doi: 10.1093/nar/gku531. Epub 2014 Jul 3.
Triantennary N-acetyl galactosamine (GalNAc, GN3: ), a high-affinity ligand for the hepatocyte-specific asialoglycoprotein receptor (ASGPR), enhances the potency of second-generation gapmer antisense oligonucleotides (ASOs) 6-10-fold in mouse liver. When combined with next-generation ASO designs comprised of short S-cEt (S-2'-O-Et-2',4'-bridged nucleic acid) gapmer ASOs, ∼ 60-fold enhancement in potency relative to the parent MOE (2'-O-methoxyethyl RNA) ASO was observed. GN3: -conjugated ASOs showed high affinity for mouse ASGPR, which results in enhanced ASO delivery to hepatocytes versus non-parenchymal cells. After internalization into cells, the GN3: -ASO conjugate is metabolized to liberate the parent ASO in the liver. No metabolism of the GN3: -ASO conjugate was detected in plasma suggesting that GN3: acts as a hepatocyte targeting prodrug that is detached from the ASO by metabolism after internalization into the liver. GalNAc conjugation also enhanced potency and duration of the effect of two ASOs targeting human apolipoprotein C-III and human transthyretin (TTR) in transgenic mice. The unconjugated ASOs are currently in late stage clinical trials for the treatment of familial chylomicronemia and TTR-mediated polyneuropathy. The ability to translate these observations in humans offers the potential to improve therapeutic index, reduce cost of therapy and support a monthly dosing schedule for therapeutic suppression of gene expression in the liver using ASOs.
三触角N-乙酰半乳糖胺(GalNAc,GN3:)是肝细胞特异性去唾液酸糖蛋白受体(ASGPR)的高亲和力配体,可使第二代缺口mer反义寡核苷酸(ASO)在小鼠肝脏中的效力提高6至10倍。当与由短链S-cEt(S-2'-O-乙基-2',4'-桥连核酸)缺口mer ASO组成的下一代ASO设计相结合时,相对于亲本MOE(2'-O-甲氧基乙基RNA)ASO,效力提高了约60倍。GN3:缀合的ASO对小鼠ASGPR表现出高亲和力,这导致ASO向肝细胞的递送相对于非实质细胞增强。内化到细胞后,GN3:-ASO缀合物在肝脏中被代谢以释放亲本ASO。在血浆中未检测到GN3:-ASO缀合物的代谢,这表明GN3:作为一种肝细胞靶向前药,在内化到肝脏后通过代谢与ASO分离。GalNAc缀合还增强了两种靶向人载脂蛋白C-III和人转甲状腺素蛋白(TTR)的ASO在转基因小鼠中的效力和作用持续时间。未缀合的ASO目前正处于治疗家族性乳糜微粒血症和TTR介导的多发性神经病的后期临床试验中。将这些观察结果转化为人类应用的能力为提高治疗指数、降低治疗成本以及支持使用ASO对肝脏基因表达进行治疗性抑制的每月给药方案提供了潜力。