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Gogate A, Belcourt J, Shah M, Wang AZ, Frankel A, Kolmel H, Chalon M, Stephen P, Kolli A, Tawfik SM, Jin J, Bahal R, Rasmussen TP, Manautou JE, Zhong XB. Targeting the Liver with Nucleic Acid Therapeutics for the Treatment of Systemic Diseases of Liver Origin. Pharmacol Rev 2023; 76:49-89. [PMID: 37696583 PMCID: PMC10753797 DOI: 10.1124/pharmrev.123.000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
Systemic diseases of liver origin (SDLO) are complex diseases in multiple organ systems, such as cardiovascular, musculoskeletal, endocrine, renal, respiratory, and sensory organ systems, caused by irregular liver metabolism and production of functional factors. Examples of such diseases discussed in this article include primary hyperoxaluria, familial hypercholesterolemia, acute hepatic porphyria, hereditary transthyretin amyloidosis, hemophilia, atherosclerotic cardiovascular diseases, α-1 antitrypsin deficiency-associated liver disease, and complement-mediated diseases. Nucleic acid therapeutics use nucleic acids and related compounds as therapeutic agents to alter gene expression for therapeutic purposes. The two most promising, fastest-growing classes of nucleic acid therapeutics are antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs). For each listed SDLO disease, this article discusses epidemiology, symptoms, genetic causes, current treatment options, and advantages and disadvantages of nucleic acid therapeutics by either ASO or siRNA drugs approved or under development. Furthermore, challenges and future perspectives on adverse drug reactions and toxicity of ASO and siRNA drugs for the treatment of SDLO diseases are also discussed. In summary, this review article will highlight the clinical advantages of nucleic acid therapeutics in targeting the liver for the treatment of SDLO diseases. SIGNIFICANCE STATEMENT: Systemic diseases of liver origin (SDLO) contain rare and common complex diseases caused by irregular functions of the liver. Nucleic acid therapeutics have shown promising clinical advantages to treat SDLO. This article aims to provide the most updated information on targeting the liver with antisense oligonucleotides and small interfering RNA drugs. The generated knowledge may stimulate further investigations in this growing field of new therapeutic entities for the treatment of SDLO, which currently have no or limited options for treatment.
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Affiliation(s)
- Anagha Gogate
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Jordyn Belcourt
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Milan Shah
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Alicia Zongxun Wang
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Alexis Frankel
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Holly Kolmel
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Matthew Chalon
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Prajith Stephen
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Aarush Kolli
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Sherouk M Tawfik
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Jing Jin
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Raman Bahal
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Theodore P Rasmussen
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - José E Manautou
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
| | - Xiao-Bo Zhong
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Connecticut, Storrs, Connecticut
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Pollak AJ, Zhao L, Vickers TA, Huggins IJ, Liang XH, Crooke ST. Insights into innate immune activation via PS-ASO-protein-TLR9 interactions. Nucleic Acids Res 2022; 50:8107-8126. [PMID: 35848907 PMCID: PMC9371907 DOI: 10.1093/nar/gkac618] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/14/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
Non-CpG PS-ASOs can activate the innate immune system, leading to undesired outcomes. This response can vary—in part—as a function of 2′modifications and sequence. Here we investigated the molecular steps involved in the varied effects of PS-ASOs on the innate immune system. We found that pro-inflammatory PS-ASOs require TLR9 signaling based on the experimental systems used. However, the innate immunity of PS-ASOs does not correlate with their binding affinity with TLR9. Furthermore, the innate immune responses of pro-inflammatory PS-ASOs were reduced by coincubation with non-inflammatory PS-ASOs, suggesting that both pro-inflammatory and non-inflammatory PS-ASOs can interact with TLR9. We show that the kinetics of the PS-ASO innate immune responses can vary, which we speculate may be due to the existence of alternative PS-ASO binding sites on TLR9, leading to full, partial, or no activation of the pathway. In addition, we found that several extracellular proteins, including HMGB1, S100A8 and HRG, enhance the innate immune responses of PS-ASOs. Reduction of the binding affinity by reducing the PS content of PS-ASOs decreased innate immune responses, suggesting that PS-ASO–protein complexes may be sensed by TLR9. These findings thus provide critical information concerning how PS-ASOs can interact with and activate TLR9.
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Affiliation(s)
| | - Luyi Zhao
- Ionis Pharmaceuticals, Inc. Carlsbad, CA 92010, USA
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Smith RA, Miller TM, Yamanaka K, Monia BP, Condon TP, Hung G, Lobsiger CS, Ward CM, McAlonis-Downes M, Wei H, Wancewicz EV, Bennett CF, Cleveland DW. Antisense oligonucleotide therapy for neurodegenerative disease. J Clin Invest 2006; 116:2290-6. [PMID: 16878173 PMCID: PMC1518790 DOI: 10.1172/jci25424] [Citation(s) in RCA: 379] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Accepted: 06/06/2006] [Indexed: 01/04/2023] Open
Abstract
Neurotoxicity from accumulation of misfolded/mutant proteins is thought to drive pathogenesis in neurodegenerative diseases. Since decreasing levels of proteins responsible for such accumulations is likely to ameliorate disease, a therapeutic strategy has been developed to downregulate almost any gene in the CNS. Modified antisense oligonucleotides, continuously infused intraventricularly, have been demonstrated to distribute widely throughout the CNS of rodents and primates, including the regions affected in the major neurodegenerative diseases. Using this route of administration, we found that antisense oligonucleotides to superoxide dismutase 1 (SOD1), one of the most abundant brain proteins, reduced both SOD1 protein and mRNA levels throughout the brain and spinal cord. Treatment initiated near onset significantly slowed disease progression in a model of amyotrophic lateral sclerosis (ALS) caused by a mutation in SOD1. This suggests that direct delivery of antisense oligonucleotides could be an effective, dosage-regulatable means of treating neurodegenerative diseases, including ALS, where appropriate target proteins are known.
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Affiliation(s)
- Richard A. Smith
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Timothy M. Miller
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Koji Yamanaka
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Brett P. Monia
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Thomas P. Condon
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Gene Hung
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Christian S. Lobsiger
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Chris M. Ward
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Melissa McAlonis-Downes
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Hongbing Wei
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Ed V. Wancewicz
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - C. Frank Bennett
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
| | - Don W. Cleveland
- Ludwig Institute for Cancer Research, University of California, San Diego, La Jolla, California, USA.
The Scripps Research Institute, La Jolla, California, USA.
Center for Neurologic Study, La Jolla, California, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.
Isis Pharmaceuticals, Carlsbad, California, USA
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