Department of Paediatrics, University of Oxford, Oxford, UK.
Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.
EMBO Mol Med. 2021 Apr 9;13(4):e13243. doi: 10.15252/emmm.202013243. Epub 2021 Apr 6.
Nucleic acid-based therapeutics that regulate gene expression have been developed towards clinical use at a steady pace for several decades, but in recent years the field has been accelerating. To date, there are 11 marketed products based on antisense oligonucleotides, aptamers and small interfering RNAs, and many others are in the pipeline for both academia and industry. A major technology trigger for this development has been progress in oligonucleotide chemistry to improve the drug properties and reduce cost of goods, but the main hurdle for the application to a wider range of disorders is delivery to target tissues. The adoption of delivery technologies, such as conjugates or nanoparticles, has been a game changer for many therapeutic indications, but many others are still awaiting their eureka moment. Here, we cover the variety of methods developed to deliver nucleic acid-based therapeutics across biological barriers and the model systems used to test them. We discuss important safety considerations and regulatory requirements for synthetic oligonucleotide chemistries and the hurdles for translating laboratory breakthroughs to the clinic. Recent advances in the delivery of nucleic acid-based therapeutics and in the development of model systems, as well as safety considerations and regulatory requirements for synthetic oligonucleotide chemistries are discussed in this review on oligonucleotide-based therapeutics.
几十年来,基于核酸的治疗药物一直在稳步发展,用于调节基因表达,并推向临床应用,但近年来该领域发展迅速。迄今为止,已有 11 种基于反义寡核苷酸、适体和小干扰 RNA 的上市产品,学术界和工业界还有许多其他产品正在研发中。这种发展的一个主要技术触发因素是寡核苷酸化学的进步,以改善药物特性和降低制造成本,但将其应用于更广泛的疾病的主要障碍是递送到靶组织。对于许多治疗适应症,采用递药技术(如缀合物或纳米颗粒)是一个重大的突破,但仍有许多适应症在等待着他们的突破时刻。在这里,我们介绍了开发用于跨越生物屏障的核酸治疗药物的各种方法以及用于测试这些方法的模型系统。我们讨论了合成寡核苷酸化学的重要安全性考虑因素和监管要求,以及将实验室突破转化为临床应用的障碍。本文综述了核酸治疗药物,讨论了核酸治疗药物的最新进展、模型系统的开发、以及合成寡核苷酸化学的安全性考虑因素和监管要求。