# Patent

## Title
Modulation of C-reactive protein expression

## Abstract

Compounds, compositions and methods are provided for modulating the expression of C-reactive protein. The compositions comprise oligonucleotides, targeted to nucleic acid encoding C-reactive protein. Methods of using these compounds for modulation of C-reactive protein expression and for diagnosis and treatment of disease associated with expression of C-reactive protein are provided.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application claims the benefit of priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Nos. 60/475,272, filed Jun. 2, 2003, and 60/540,042, filed Jan. 28, 2004.


BACKGROUND OF THE INVENTION
The present invention provides compositions and methods for modulating the expression of C-reactive protein.
C-reactive protein (also known as CRP and PTX1) is an essential human acute-phase reactant produced in the liver in response to a variety of inflammatory cytokines. The protein, first identified in 1930, is highly conserved and considered to be an early indicator of infectious or inflammatory conditions. Plasma C-reactive protein levels increase 1,000-fold in response to infection, ischemia, trauma, burns, and inflammatory conditions. Since the biological half-life of C-reactive protein is not influenced by age, liver or kidney function or pharmacotherapy, it is a reliable biochemical marker for tissue destruction, necrosis and inflammation and its measurement is widely used to monitor various inflammatory states, angina pectoris, vascular insults, end-stage renal disease, rheumatoid arthritis, obesity and atherosclerosis (Arici and Walls, Kidney Int., 2001, 59, 407-414; Gabay and Kushner, N. Engl. J. Med., 1999, 340, 448-454; Highton et al., J. Rheumatol., 1985, 12, 871-875; Hulthe et al., Clin Sci (Colch), 2001, 100, 371-378; Lagrand et al., Circulation, 1999, 100, 6+96-102; Morrow and Ridker, Med. Clin. North Am., 2000, 84, 149-161, ix; Szalai et al., Immunol Res, 1997, 16, 127-136; Westhuyzen and Healy, Ann. Clin. Lab. Sci., 2000, 30, 133-143; Yudkin et al., Atherosclerosis, 2000, 148, 209-214).
Improved methods of quantifying C-reactive protein have led to increased application to clinical medicine including diagnoses of urinary tract infections (Arici and Walls, 2001, cited above), meningitis (Ruuskanen et al., J. Pediatr., 1985, 107, 97-100), neonatal sepsis, erythropoietin resistance (Barany, Nephrol. Dial. Transplant., 2001, 16, 224-227) and occult bacteremia, conditions in which C-reactive protein is usually elevated.
Structurally, C-reactive protein is a member of the pentraxin family of proteins, which are characterized by a cyclic pentameric structure and radial symmetry. The five identical 24-kDa protomers consist of 206 amino acids, and are noncovalently linked (Lei et al., J. Biol. Chem., 1985, 260, 13377-13383; Szalai et al., 1997, cited above). The genomic DNA sequence for human C-reactive protein has been reported by Lei et al. 1985, cited above, as have mutant forms of the protein (International Patent Publication No. WO 96/06624) and methods to deliver materials into cells using the mutant protein as a carrier (International Patent Publication No. WO 00/11207). Polypeptides corresponding to amino acids 174-185 of C-reactive protein having immunomodulatory activity are disclosed and claimed U.S. Pat. No. 5,783,179. Peptides corresponding to positions 62-71 of human C-reactive protein have also been studied for their ability to inhibit the activity of human leukocyte elastase and/or cathepsin G for the treatment of inflammatory conditions and these are disclosed in International Patent Publication No. WO 99/00418.
C-reactive protein binds to a broad range of cellular substances such as phosphocholine, fibronectin, chromatin, histones, and ribonucleoprotein in a calcium-dependent manner (Szalai et al., 1997, cited above). It is a ligand for specific receptors on phagocytic leukocytes, mediates activation reactions on monocytes and macrophages, and activates complement (Szalai et al., 1997, cited above).
The function of C-reactive protein is related to its role in the innate immune system. Similar to immunoglobulin(Ig) G, it activates complement, binds to Fc receptors and acts as an opsonin for various pathogens. Interaction of C-reactive protein with Fc receptors leads to the generation of proinflammatory cytokines that enhance the inflammatory response. Unlike IgG, which specifically recognizes distinct antigenic epitopes, C-reactive protein recognizes altered self and foreign molecules based on pattern recognition. C-reactive protein is therefore thought to act as a surveillance molecule for altered self and certain pathogens. This recognition provides early defense and leads to a proinflammatory signal and activation of the humoral, adaptive immune system. Thus, the C-reactive protein molecule has both a recognition function and an effector function.
The pharmacological modulation of C-reactive protein activity and/or its expression is therefore an appropriate point of therapeutic intervention in pathological conditions.
Strategies aimed at modulating C-reactive protein function by targeting protein levels have involved the use of antibodies, peptides and molecules that inhibit HMG-CoA reductase.
In a recent trial, it was demonstrated that lovastatin, an inhibitor of the enzyme HMG-CoA reductase, is an effective agent in reducing the risk of acute coronary events in participants with elevated C-reactive protein levels but no hyperlipidemia; the use of lovastatin resulted in a 14.8 percent reduction in median C-reactive protein levels after one year whereas no change was observed in the placebo group (Ridker et al., N. Engl. J. Med., 2001, 344, 1959-1965). Another statin, cerivastatin, has also been demonstrated to lower C-reactive protein levels in patients with hypercholesterolemia (Ridker et al., Circulation, 2001, 103, 1191-1193.).
However, there are currently no known therapeutic agents that effectively inhibit C-reactive protein levels and function. Consequently, there remains a long felt need for agents capable of effectively and selectively inhibiting C-reactive protein.
SUMMARY OF THE INVENTION
The present invention provides compositions and methods for modulating C-reactive protein expression.
The present invention is directed to compounds, especially nucleic acid and nucleic acid-like oligomers, which are targeted to a nucleic acid encoding C-reactive protein, and which modulate the expression of C-reactive protein. In particular, this invention relates to compounds, particularly oligonucleotide compounds, which, in preferred embodiments, hybridize with nucleic acid molecules encoding C-reactive protein. Such compounds are shown herein to modulate the expression of C-reactive protein.
Antisense technology is emerging as an effective means for reducing the expression of specific gene products and is uniquely useful in a number of therapeutic, diagnostic, and research applications for the modulation of C-reactive protein expression.
Pharmaceutical and other compositions comprising the compounds of the invention are also provided. Further provided are methods of screening for modulators of C-reactive protein and methods of modulating the expression of C-reactive protein in cells, tissues or animals comprising contacting said cells, tissues or animals with one or more of the compounds or compositions of the invention. In these methods, the cells or tissues may be contacted in vivo. Alternatively, the cells or tissues may be contacted ex vivo.
Methods of treating an animal, particularly a human, suspected of having or being prone to a disease or condition associated with expression of C-reactive protein are also set forth herein. Such methods comprise administering a therapeutically or prophylactically effective amount of one or more of the compounds or compositions of the invention to the person in need of treatment.
In one aspect, the invention provides the use of a compound or composition of the invention in the manufacture of a medicament for the treatment of any and all conditions disclosed herein.


DETAILED DESCRIPTION OF THE INVENTION
A. Overview of the Invention
The present invention employs compounds, preferably oligonucleotides and similar species for use in modulating the function or effect of nucleic acid molecules encoding C-reactive protein. This is accomplished by providing oligonucleotides that specifically hybridize with one or more nucleic acid molecules encoding C-reactive protein. As used herein, the terms “target nucleic acid” and “nucleic acid molecule encoding C-reactive protein” have been used for convenience to encompass DNA encoding C-reactive protein, RNA (including pre-mRNA and mRNA or portions thereof) transcribed from such DNA, and also cDNA derived from such RNA. The hybridization of a compound of this invention with its target nucleic acid is generally referred to as “antisense”. Consequently, the preferred mechanism believed to be included in the practice of some preferred embodiments of the invention is referred to herein as “antisense inhibition.” Such antisense inhibition is typically based upon hydrogen bonding-based hybridization of oligonucleotide strands or segments such that at least one strand or segment is cleaved, degraded, or otherwise rendered inoperable. In this regard, it is presently preferred to target specific nucleic acid molecules and their functions for such antisense inhibition.
The functions of DNA to be interfered with can include replication and transcription. Replication and transcription, for example, can be from an endogenous cellular template, a vector, a plasmid construct or otherwise. The functions of RNA to be interfered with can include functions such as translocation of the RNA to a site of protein translation, translocation of the RNA to sites within the cell which are distant from the site of RNA synthesis, translation of protein from the RNA, splicing of the RNA to yield one or more RNA species, and catalytic activity or complex formation involving the RNA which may be engaged in or facilitated by the RNA. One preferred result of such interference with target nucleic acid function is modulation of the expression of C-reactive protein. In the context of the present invention, “modulation” and “modulation of expression” mean either an increase (stimulation) or a decrease (inhibition) in the amount or levels of a nucleic acid molecule encoding the gene, e.g., DNA or RNA. Inhibition is often the preferred form of modulation of expression and mRNA is often a preferred target nucleic acid.
In the context of this invention, “hybridization” means the pairing of complementary strands of oligomeric compounds. In the present invention, the preferred mechanism of pairing involves hydrogen bonding, which may be Watson-Crick, Hoogsteen or reversed Hoogsteen hydrogen bonding, between complementary nucleoside or nucleotide bases (nucleobases) of the strands of oligomeric compounds. For example, adenine and thymine are complementary nucleobases that pair through the formation of hydrogen bonds. Hybridization can occur under varying circumstances.
An antisense compound is specifically hybridizable when binding of the compound to the target nucleic acid interferes with the normal function of the target nucleic acid to cause a loss of activity, and there is a sufficient degree of complementarity to avoid non-specific binding of the antisense compound to non-target nucleic acid sequences under conditions in which specific binding is desired, i.e., under physiological conditions in the case of in vivo assays or therapeutic treatment, and under conditions in which assays are performed in the case of in vitro assays.
In the present invention the phrase “stringent hybridization conditions” or “stringent conditions” refers to conditions under which a compound of the invention will hybridize to its target sequence, but to a minimal number of other sequences. Stringent conditions are sequence-dependent and will be different in different circumstances and in the context of this invention, “stringent conditions” under which oligomeric compounds hybridize to a target sequence are determined by the nature and composition of the oligomeric compounds and the assays in which they are being investigated.
“Complementary,” as used herein, refers to the capacity for precise pairing between two nucleobases of an oligomeric compound. For example, if a nucleobase at a certain position of an oligonucleotide (an oligomeric compound), is capable of hydrogen bonding with a nucleobase at a certain position of a target nucleic acid, said target nucleic acid being a DNA, RNA, or oligonucleotide molecule, then the position of hydrogen bonding between the oligonucleotide and the target nucleic acid is considered to be a complementary position. The oligonucleotide and the further DNA, RNA, or oligonucleotide molecule are complementary to each other when a sufficient number of complementary positions in each molecule are occupied by nucleobases that can hydrogen bond with each other. Thus, “specifically hybridizable” and “complementary” are terms that are used to indicate a sufficient degree of precise pairing or complementarity over a sufficient number of nucleobases such that stable and specific binding occurs between the oligonucleotide and a target nucleic acid.
It is understood in the art that the sequence of an antisense compound can be, but need not be, 100% complementary to that of its target nucleic acid to be specifically hybridizable. Moreover, an oligonucleotide may hybridize over one or more segments such that intervening or adjacent segments are not involved in the hybridization event (e.g., a loop structure or hairpin structure). It is preferred that the antisense compounds of the present invention comprise at least 70%, or at least 75%, or at least 80%, or at least 85% sequence complementarity to a target region within the target nucleic acid, more preferably that they comprise at least 90% sequence complementarity and even more preferably comprise at least 95% or at least 99% sequence complementarity to the target region within the target nucleic acid sequence to which they are targeted. For example, an antisense compound in which 18 of 20 nucleobases of the antisense compound are complementary to a target region, and would therefore specifically hybridize, would represent 90 percent complementarity. In this example, the remaining noncomplementary nucleobases may be clustered or interspersed with complementary nucleobases and need not be contiguous to each other or to complementary nucleobases. As such, an antisense compound which is 18 nucleobases in length having 4 (four) noncomplementary nucleobases which are flanked by two regions of complete complementarity with the target nucleic acid would have 77.8% overall complementarity with the target nucleic acid and would thus fall within the scope of the present invention. Percent complementarity of an antisense compound with a region of a target nucleic acid can be determined routinely using BLAST programs (basic local alignment search tools) and PowerBLAST programs known in the art (Altschul et al., J. Mol. Biol., 1990, 215, 403-410; Zhang and Madden, Genome Res., 1997, 7, 649-656).
Percent homology, sequence identity or complementarity, can be determined by, for example, the Gap program (Wisconsin Sequence Analysis Package, Version 8 for Unix, Genetics Computer Group, University Research Park, Madison Wis.), using default settings, which uses the algorithm of Smith and Waterman (Adv. Appl. Math., 1981, 2, 482-489). In some embodiments, homology, sequence identity or complementarity, between the oligomeric and target is between about 50% to about 60%. In some embodiments, homology, sequence identity or complementarity, is between about 60% to about 70%. In some embodiments, homology, sequence identity or complementarity, is between about 70% and about 80%. In further embodiments, homology, sequence identity or complementarity, is between about 80% and about 90%. In further embodiments, homology, sequence identity or complementarity, is about 90%, about 92%, about 94%, about 95%, about 96%, about 97%, about 98%, about 99%, or about 100%.
B. Compounds of the Invention
According to the present invention, compounds include antisense oligomeric compounds, antisense oligonucleotides, siRNAs, external guide sequence (EGS) oligonucleotides, alternate splicers and other short oligomeric compounds that hybridize to at least a portion of the target nucleic acid. As such, these compounds may be introduced in the form of single-stranded, double-stranded, circular or hairpin oligomeric compounds and may contain structural elements such as internal or terminal bulges or loops. Once introduced to a system, the compounds of the invention may elicit the action of one or more enzymes or structural proteins to effect modification of the target nucleic acid.
One non-limiting example of such an enzyme is RNAse H, a cellular endonuclease which cleaves the RNA strand of an RNA:DNA duplex. It is known in the art that single-stranded antisense compounds that are “DNA-like” elicit RNAse H. Activation of RNase H, therefore, results in cleavage of the RNA target, thereby greatly enhancing the efficiency of oligonucleotide-mediated inhibition of gene expression. Similar roles have been postulated for other ribonucleases such as those in the RNase III and ribonuclease L family of enzymes.
While one form of antisense compound is a single-stranded antisense oligonucleotide, in many species the introduction of double-stranded structures, such as double-stranded RNA (dsRNA) molecules, induces potent and specific antisense-mediated reduction of the function of a gene or its associated gene products. This phenomenon occurs in both plants and animals and is believed to have an evolutionary connection to viral defense and transposon silencing.
The first evidence that dsRNA could lead to gene silencing in animals came in 1995 from work in the nematode, Caenorhabditis elegans (Guo and Kempheus, Cell, 1995, 81, 611-620). The primary interference effects of dsRNA are posttranscriptional (Montgomery et al., Proc. Natl. Acad. Sci. USA, 1998, 95, 15502-15507). The posttranscriptional antisense mechanism defined in Caenorhabditis elegans resulting from exposure to double-stranded RNA (dsRNA) has since been designated RNA interference (RNAi). This term has been generalized to mean antisense-mediated gene silencing involving the introduction of dsRNA leading to the sequence-specific reduction of endogenous targeted mRNA levels (Fire et al., Nature, 1998, 391, 806-811). Recently, the single-stranded RNA oligomers of antisense polarity of the dsRNAs have been reported to be the potent inducers of RNAi (Tijsterman et al., Science, 2002, 295, 694-697).
In the context of this invention, the term “oligomeric compound” refers to a polymer or oligomer comprising a plurality of monomeric units. In the context of this invention, the term “oligonucleotide” refers to an oligomer or polymer of ribonucleic acid (RNA) or deoxyribonucleic acid (DNA) or mimetics, chimeras, analogs and homologs thereof. This term includes oligonucleotides composed of naturally occurring nucleobases, sugars and covalent internucleoside (backbone) linkages as well as oligonucleotides having non-naturally occurring portions which function similarly. Such modified or substituted oligonucleotides are often preferred over native forms because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for a target nucleic acid and increased stability in the presence of nucleases.
The oligonucleotides of the present invention also include modified oligonucleotides in which a different base is present at one or more of the nucleotide positions in the oligonucleotide. For example, if the first nucleotide is an adenosine, modified oligonucleotides may be produced which contain thymidine, guanosine or cytidine at this position. This may be done at any of the positions of the oligonucleotide. These oligonucleotides are then tested using the methods described herein to determine their ability to inhibit expression of C-reactive protein mRNA.
While oligonucleotides are a preferred form of the compounds of this invention, the present invention comprehends other families of compounds as well, including but not limited to oligonucleotide analogs and mimetics such as those described herein.
The compounds in accordance with this invention comprise from about 8 to about 80 nucleobases (i.e. from about 8 to about 80 linked nucleosides). One of ordinary skill in the art will appreciate that the invention embodies compounds of 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, or 80 nucleobases in length.
In one embodiment, the compounds of the invention are 12 to 50 nucleobases in length. One having ordinary skill in the art will appreciate that this embodies compounds of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50 nucleobases in length.
In another embodiment, the compounds of the invention are 15 to 30 nucleobases in length. One having ordinary skill in the art will appreciate that this embodies compounds of 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleobases in length.
In another embodiment, the compounds of the invention are oligonucleotides from about 12 to about 50 nucleobases. Further embodiments are those comprising from about 15 to about 30 nucleobases.
In another embodiment, the antisense compounds comprise at least 8 contiguous nucleobases of an antisense compound disclosed herein.
Antisense compounds 8-80 nucleobases in length comprising a stretch of at least eight (8) consecutive nucleobases selected from within the illustrative antisense compounds are considered to be suitable antisense compounds as well.
Exemplary antisense compounds include oligonucleotide sequences that comprise at least the 8 consecutive nucleobases from the 5′-terminus of one of the illustrative preferred antisense compounds (the remaining nucleobases being a consecutive stretch of the same oligonucleotide beginning immediately upstream of the 5′-terminus of the antisense compound which is specifically hybridizable to the target nucleic acid and continuing until the oligonucleotide contains about 8 to about 80 nucleobases). Similarly preferred antisense compounds are represented by oligonucleotide sequences that comprise at least the 8 consecutive nucleobases from the 3′-terminus of one of the illustrative preferred antisense compounds (the remaining nucleobases being a consecutive stretch of the same oligonucleotide beginning immediately downstream of the 3′-terminus of the antisense compound which is specifically hybridizable to the target nucleic acid and continuing until the oligonucleotide contains about 8 to about 80 nucleobases). Exemplary compounds of this invention may be found identified in the Examples and listed in Tables 1, 2 and 3. One having skill in the art armed with the preferred antisense compounds illustrated herein will be able, without undue experimentation, to identify further preferred antisense compounds.
C. Targets of the Invention
“Targeting” an antisense compound to a particular nucleic acid molecule, in the context of this invention, can be a multistep process. The process usually begins with the identification of a target nucleic acid whose function is to be modulated. This target nucleic acid may be, for example, a cellular gene (or mRNA transcribed from the gene) whose expression is associated with a particular disorder or disease state, or a nucleic acid molecule from an infectious agent. In the present invention, the target nucleic acid encodes C-reactive protein.
The targeting process usually also includes determination of at least one target region, segment, or site within the target nucleic acid for the antisense interaction to occur such that the desired effect, e.g., modulation of expression, will result. Within the context of the present invention, the term “region” is defined as a portion of the target nucleic acid having at least one identifiable structure, function, or characteristic. Within regions of target nucleic acids are segments. “Segments” are defined as smaller or sub-portions of regions within a target nucleic acid. “Sites,” as used in the present invention, are defined as positions within a target nucleic acid.
Since, as is known in the art, the translation initiation codon is typically 5′-AUG (in transcribed mRNA molecules; 5′-ATG in the corresponding DNA molecule), the translation initiation codon is also referred to as the “AUG codon,” the “start codon” or the “AUG start codon”. A minority of genes, having translation initiation codons with the RNA sequence 5′-GUG, 5′-UUG or 5′-CUG, and 5′-AUA, 5′-ACG and 5′-CUG have been shown to function in vivo. Thus, the terms “translation initiation codon” and “start codon” can encompass many codon sequences, even though the initiator amino acid in each instance is typically methionine (in eukaryotes) or formylmethionine (in prokaryotes). It is also known in the art that eukaryotic and prokaryotic genes may have two or more alternative start codons, any one of which may be preferentially utilized for translation initiation in a particular cell type or tissue, or under a particular set of conditions. In the context of the invention, “start codon” and “translation initiation codon” refer to the codon or codons that are used in vivo to initiate translation of an mRNA transcribed from a gene encoding C-reactive protein, regardless of the sequence(s) of such codons. It is also known in the art that a translation termination codon (or “stop codon”) of a gene may have one of three sequences, i.e., 5′-UAA, 5′-UAG and 5′-UGA (the corresponding DNA sequences are 5′-TAA, 5′-TAG and 5′-TGA, respectively).
The terms “start codon region” and “translation initiation codon region” refer to a portion of such an mRNA or gene that encompasses from about 25 to about 50 contiguous nucleotides in either direction (i.e., 5′ or 3′) from a translation initiation codon. Similarly, the terms “stop codon region” and “translation termination codon region” refer to a portion of such an mRNA or gene that encompasses from about 25 to about 50 contiguous nucleotides in either direction (i.e., 5′ or 3′) from a translation termination codon. Consequently, the “start codon region” (or “translation initiation codon region”) and the “stop codon region” (or “translation termination codon region”) are all regions of a molecule encoding C-reactive protein that may be targeted effectively with the antisense compounds of the present invention.
The open reading frame (ORF) or “coding region,” which is known in the art to refer to the region between the translation initiation codon and the translation termination codon, is also a region of the molecule encoding C-reactive protein that may be targeted effectively. Within the context of the present invention, a preferred region is the intragenic region encompassing the translation initiation or termination codon of the open reading frame (ORF) of a gene.
Other target regions of molecules encoding C-reactive protein include the 5′ untranslated region (5′ UTR), known in the art to refer to the portion of an mRNA in the 5′ direction from the translation initiation codon, and thus including nucleotides between the 5′ cap site and the translation initiation codon of an mRNA (or corresponding nucleotides on the gene), and the 3′ untranslated region (3′ UTR), known in the art to refer to the portion of an mRNA in the 3′ direction from the translation termination codon, and thus including nucleotides between the translation termination codon and 3′ end of an mRNA (or corresponding nucleotides on the gene). The 5′ cap site of an mRNA comprises an N7-methylated guanosine residue joined to the 5′-most residue of the mRNA via a 5′-5′ triphosphate linkage. The 5′ cap region of an mRNA is considered to include the 5′ cap structure itself as well as the first 50 nucleotides adjacent to the cap site. It is also preferred to target the 5′ cap region of a molecule encoding C-reactive protein.
Accordingly, the present invention provides antisense compounds that target a portion of nucleotides 1-2480 as set forth in SEQ ID NO: 4. In another embodiment, the antisense compounds target at least an 8 nucleobase portion of nucleotides 1-570, comprising the 5′ UTR as set forth in SEQ ID NO: 4. In another embodiment the antisense compounds target at least an 8 nucleobase portion of nucleotides 1183-2480 comprising the 3′ UTR as set forth in SEQ ID NO: 4. In another embodiment, the antisense compounds target at least an 8 nucleobase portion of nucleotides 571-1182 comprising the coding region as set forth in SEQ ID NO: 4. In still other embodiments, the antisense compounds target at least an 8 nucleobase portion of a “preferred target segment” (as defined herein) as set forth in Table 4.
Although some eukaryotic mRNA transcripts are directly translated, many contain one or more regions, known as “introns,” which are excised from a transcript before it is translated. The remaining (and therefore translated) regions are known as “exons” and are spliced together to form a continuous mRNA sequence, resulting in exon-exon junctions at the sites where exons are joined. Targeting exon-exon junctions can be useful in situations where the overproduction of a normal splice product is implicated in disease, or where the overproduction of an aberrant splice product is implicated in disease. Targeting splice sites, i.e., intron-exon junctions or exon-intron junctions, may also be particularly useful in situations where aberrant splicing is implicated in disease, or where an overproduction of a particular splice product is implicated in disease. Aberrant fusion junctions due to rearrangements or deletions are also preferred target sites. mRNA transcripts produced via the process of splicing of two (or more) mRNAs from different gene sources, known as “fusion transcripts, are also suitable target sites. Introns can be effectively targeted using antisense compounds targeted to, for example, DNA or pre-mRNA.
Alternative RNA transcripts can be produced from the same genomic region of DNA. These alternative transcripts are generally known as “variants”. More specifically, “pre-mRNA variants” are transcripts produced from the same genomic DNA that differ from other transcripts produced from the same genomic DNA in either their start or stop position and contain both intronic and exonic sequence.
Upon excision of one or more exon or intron regions, or portions thereof during splicing, pre-mRNA variants produce smaller “mRNA variants”. Consequently, mRNA variants are processed pre-mRNA variants and each unique pre-mRNA variant must always produce a unique mRNA variant as a result of splicing. These mRNA variants are also known as “alternative splice variants”. If no splicing of the pre-mRNA variant occurs then the pre-mRNA variant is identical to the mRNA variant.
Variants can be produced through the use of alternative signals to start or stop transcription. Pre-mRNAs and mRNAs can possess more than one start codon or stop codon. Variants that originate from a pre-mRNA or mRNA that use alternative start codons are known as “alternative start variants” of that pre-mRNA or mRNA. Those transcripts that use an alternative stop codon are known as “alternative stop variants” of that pre-mRNA or mRNA. One specific type of alternative stop variant is the “polyA variant” in which the multiple transcripts produced result from the alternative selection of one of the “polyA stop signals” by the transcription machinery, thereby producing transcripts that terminate at unique polyA sites. Within the context of the invention, the types of variants described herein are also preferred target nucleic acids.
The locations on the target C-reactive protein nucleic acid to which the preferred antisense compounds hybridize are hereinbelow referred to as “preferred target segments.” As used herein the term “preferred target segment” is defined as at least an 8-nucleobase portion of a target region of a molecule encoding C-reactive protein to which an active antisense compound is targeted. While not wishing to be bound by theory, it is presently believed that these target segments represent portions of the target nucleic acid that are accessible for hybridization.
While the specific sequences of certain preferred C-reactive protein target segments are set forth herein, one of skill in the art will recognize that these serve to illustrate and describe particular embodiments within the scope of the present invention. Additional preferred target segments may be identified by one having ordinary skill in view of this specification.
Target segments 8-80 nucleobases in length comprising a stretch of at least eight (8) consecutive nucleobases selected from within the illustrative preferred target segments of C-reactive protein are considered to be suitable for targeting as well.
Target segments can include DNA or RNA sequences that comprise at least the 8 consecutive nucleobases from the 5′-terminus of one of the illustrative preferred target segments (the remaining nucleobases being a consecutive stretch of the same DNA or RNA beginning immediately upstream of the 5′-terminus of the target segment and continuing until the DNA or RNA contains about 8 to about 80 nucleobases). Similarly preferred target segments are represented by DNA or RNA sequences that comprise at least the 8 consecutive nucleobases from the 3′-terminus of one of the illustrative preferred target segments (the remaining nucleobases being a consecutive stretch of the same DNA or RNA beginning immediately downstream of the 3′-terminus of the target segment and continuing until the DNA or RNA contains about 8 to about 80 nucleobases). One having skill in the art armed with the preferred target segments illustrated herein will be able, without undue experimentation, to identify further preferred target segments.
Once one or more target regions, segments or sites have been identified, antisense compounds are chosen which are sufficiently complementary to the target, i.e., hybridize sufficiently well and with sufficient specificity, to give the desired effect.
In one embodiment, the oligomeric antisense compounds can be targeted to regions of a target nucleobase sequence, such as those disclosed herein. All regions of a nucleobase sequence to which an oligomeric antisense compound can be targeted, wherein the regions are greater than or equal to 8 and less than or equal to 80 nucleobases, are described as follows:
Let R(n, n+m−1) be a region from a target nucleobase sequence, where “n” is the 5′-most nucleobase position of the region, where “n+m−1” is the 3′-most nucleobase position of the region and where “m” is the length of the region. A set “S(m)”, of regions of length “m” is defined as the regions where n ranges from 1 to L−m+1, where L is the length of the target nucleobase sequence and L>m. A set, “A”, of all regions can be constructed as a union of the sets of regions for each length from where m is greater than or equal to 8 and is less than or equal to 80.
This set of regions can be represented using the following mathematical notation:




  
    
      
        A
        =
        
          
            ⋃
            m
          
          ⁢
          
            S
            ⁡
            
              (
              m
              )
            
          
        
      
    
    
      where
    
    
      
        
          m
          ∈
          N
        
        |
        
          8
          ≤
          m
          ≤
          80
        
      
    
  




and

S(m)={Rn,n+m−1|nε{1,2,3, . . . , L−m+1}}

where the mathematical operator | indicates “such that”,
where the mathematical operator ε indicates “a member of a set” (e.g. yεZ indicates that element y is a member of set Z),
where x is a variable,
where N indicates all natural numbers, defined as positive integers,
and where the mathematical operator ∪ indicates “the union of sets”.
For example, the set of regions for m equal to 8, 9 and 80 can be constructed in the following manner. The set of regions, each 8 nucleobases in length, S(m=8), in a target nucleobase sequence 100 nucleobases in length (L=100), beginning at position 1 (n=1) of the target nucleobase sequence, can be created using the following expression:

S(8)={R1,8|nε{1,2,3, . . . ,93}}

and describes the set of regions comprising nucleobases 1-8, 2-9,3-10, 4-11, 5-12, 6-13, 7-14, 8-15, 9-16, 10-17, 11-18, 12-19, 13-20, 14-21, 15-22, 16-23, 17-24, 18-25, 19-26, 20-27, 21-28, 22-29, 23-30, 24-31, 25-32, 26-33, 27-34, 28-35, 29-36, 30-37, 31-38, 32-39, 33-40, 34-41, 35-42, 36-43, 37-44, 38-45, 39-46, 40-47, 41-48, 42-49, 43-50, 44-51, 45-52, 46-53, 47-54, 48-55, 49-56, 50-57, 51-58, 52-59, 53-60, 54-61, 55-62, 56-63, 57-64, 58-65, 59-66, 60-67, 61-68, 62-69, 63-70, 64-71, 65-72, 66-73, 67-74, 68-75, 69-76, 70-77, 71-78, 72-79, 73-80, 74-81, 75-82, 76-83, 77-84, 78-85, 79-86, 80-87, 81-88, 82-89, 83-90, 84-91, 85-92, 86-93, 87-94, 88-95, 89-96, 90-97, 91-98, 92-99, 93-100.

An additional set for regions 20 nucleobases in length, in a target sequence 100 nucleobases in length, beginning at position 1 of the target nucleobase sequence, can be described using the following expression:

S(20)={R1,20|nε{1,2,3, . . . ,81}}

and describes the set of regions comprising nucleobases 1-20, 2-21, 3-22, 4-23, 5-24, 6-25, 7-26, 8-27, 9-28, 10-29, 11-30, 12-31, 13-32, 14-33, 15-34, 16-35, 17-36, 18-37, 19-38, 20-39, 21-40, 22-41, 23-42, 24-43, 25-44, 26-45, 27-46, 28-47, 29-48, 30-49, 31-50, 32-51, 33-52, 34-53, 35-54, 36-55, 37-56, 38-57, 39-58, 40-59, 41-60, 42-61, 43-62, 44-63, 45-64, 46-65, 47-66, 48-67, 49-68, 50-69, 51-70, 52-71, 53-72, 54-73, 55-74, 56-75, 57-76, 58-77, 59-78, 60-79, 61-80, 62-81, 63-82, 64-83, 65-84, 66-85, 67-86, 68-87, 69-88, 70-89, 71-90, 72-91, 73-92, 74-93, 75-94, 76-95, 77-96, 78-97, 79-98, 80-99, 81-100.

An additional set for regions 80 nucleobases in length, in a target sequence 100 nucleobases in length, beginning at position 1 of the target nucleobase sequence, can be described using the following expression:

S(80)={R1,80|nε{1,2,3, . . . ,21}}

and describes the set of regions comprising nucleobases 1-80, 2-81, 3-82, 4-83, 5-84, 6-85, 7-86, 8-87, 9-88, 10-89, 11-90, 12-91, 13-92, 14-93, 15-94, 16-95, 17-96, 18-97, 19-98, 20-99, 21-100.

Thus, in this example, A would include regions 1-8,2-9, 3-10 . . . 93-100, 1-20, 2-21, 3-22 . . . 81-100, 1-80, 2-81, 3-82 . . . 21-100.
The union of these aforementioned example sets and other sets for lengths from 10 to 19 and 21 to 79 can be described using the mathematical expression:




  A
  =
  
    
      ⋃
      m
    
    ⁢
    
      S
      ⁡
      
        (
        m
        )
      
    
  




where ∪ represents the union of the sets obtained by combining all members of all sets.

The mathematical expressions described herein define all possible target regions in a target nucleobase sequence of any length L, where the region is of length m, and where m is greater than or equal to 8 and less than or equal to 80 nucleobases and, and where m is less than L, and where n is less than L−m+1.
In one embodiment, the oligonucleotide compounds of this invention are 100% complementary to these sequences or to small sequences found within each of the above listed sequences. In another embodiment the oligonucleotide compounds have from at least 3 or 5 mismatches per 20 consecutive nucleobases in individual nucleobase positions to these target regions. Still other compounds of the invention are targeted to overlapping regions of the above-identified portions of the C-reactive protein sequence.
D. Screening and Target Validation
In a further embodiment, the “preferred target segments” identified herein may be employed in a screen for additional compounds that modulate the expression of C-reactive protein. “Modulators” are those compounds that decrease or increase the expression of a nucleic acid molecule encoding C-reactive protein and which comprise at least an 8-nucleobase portion that is complementary to a preferred target segment. The screening method comprises the steps of contacting a preferred target segment of a nucleic acid molecule encoding C-reactive protein with one or more candidate modulators, and selecting for one or more candidate modulators which decrease or increase the expression of a nucleic acid molecule encoding C-reactive protein. Once it is shown that the candidate modulator or modulators are capable of modulating (e.g. either decreasing or increasing) the expression of a nucleic acid molecule encoding C-reactive protein, the modulator may then be employed in further investigative studies of the function of C-reactive protein, or for use as a research, diagnostic, or therapeutic agent in accordance with the present invention.
The preferred target segments of the present invention may be also be combined with their respective complementary antisense compounds of the present invention to form stabilized double-stranded (duplexed) oligonucleotides.
Such double stranded oligonucleotide moieties have been shown in the art to modulate target expression and regulate translation as well as RNA processsing via an antisense mechanism. Moreover, the double-stranded moieties may be subject to chemical modifications (Fire et al., Nature, 1998, 391, 806-811; Timmons and Fire, Nature 1998, 395, 854; Timmons et al., Gene, 2001, 263, 103-112; Tabara et al., Science, 1998, 282, 430-431; Montgomery et al., Proc. Natl. Acad. Sci. USA, 1998, 95, 15502-15507; Tuschl et al., Genes Dev., 1999, 13, 3191-3197; Elbashir et al., Nature, 2001, 411, 494-498; Elbashir et al., Genes Dev. 2001, 15, 188-200). For example, such double-stranded moieties have been shown to inhibit the target by the classical hybridization of antisense strand of the duplex to the target, thereby triggering enzymatic degradation of the target (Tijsterman et al., Science, 2002, 295, 694-697).
The compounds of the present invention can also be applied in the areas of drug discovery and target validation. The present invention comprehends the use of the compounds and preferred target segments identified herein in drug discovery efforts to elucidate relationships that exist between C-reactive protein and a disease state, phenotype, or condition. These methods include detecting or modulating C-reactive protein comprising contacting a sample, tissue, cell, or organism with the compounds of the present invention, measuring the nucleic acid or protein level of C-reactive protein and/or a related phenotypic or chemical endpoint at some time after treatment, and optionally comparing the measured value to a non-treated sample or sample treated with a further compound of the invention. These methods can also be performed in parallel or in combination with other experiments to determine the function of unknown genes for the process of target validation or to determine the validity of a particular gene product as a target for treatment or prevention of a particular disease, condition, or phenotype.
E. Kits, Research Reagents, Diagnostics, and Therapeutics
The compounds of the present invention are utilized for diagnostics, therapeutics, prophylaxis and as research reagents and kits. Furthermore, antisense oligonucleotides, which are able to inhibit gene expression with exquisite specificity, are often used by those of ordinary skill to elucidate the function of particular genes or to distinguish between functions of various members of a biological pathway.
For use in kits and diagnostics, the compounds of the present invention, either alone or in combination with other compounds or therapeutics, are used as tools in differential and/or combinatorial analyses to elucidate expression patterns of a portion or the entire complement of genes expressed within cells and tissues.
As used herein the term “biological system” or “system” is defined as any organism, cell, cell culture or tissue that expresses, or is made competant to express products of the gene encoding C-reactive protein. These include, but are not limited to, humans, transgenic animals, cells, cell cultures, tissues, xenografts, transplants and combinations thereof.
As one nonlimiting example, expression patterns within cells or tissues treated with one or more antisense compounds are compared to control cells or tissues not treated with antisense compounds and the patterns produced are analyzed for differential levels of gene expression as they pertain, for example, to disease association, signaling pathway, cellular localization, expression level, size, structure or function of the genes examined. These analyses can be performed on stimulated or unstimulated cells and in the presence or absence of other compounds that affect expression patterns.
Examples of methods of gene expression analysis known in the art include DNA arrays or microarrays (Brazma and Vilo, FEBS Lett., 2000, 480, 17-24; Celis, et al., FEBS Lett., 2000, 480, 2-16), SAGE (serial analysis of gene expression)(Madden, et al., Drug Discov. Today, 2000, 5, 415-425), READS (restriction enzyme amplification of digested cDNAs) (Prashar and Weissman, Methods Enzymol., 1999, 303, 258-72), TOGA (total gene expression analysis) (Sutcliffe, et al., Proc. Natl. Acad. Sci. U.S.A., 2000, 97, 1976-81), protein arrays and proteomics (Celis, et al., FEBS Lett., 2000, 480, 2-16; Jungblut, et al., Electrophoresis, 1999, 20, 2100-10), expressed sequence tag (EST) sequencing (Celis, et al., FEBS Lett., 2000, 480, 2-16; Larsson, et al., J. Biotechnol., 2000, 80, 143-57), subtractive RNA fingerprinting (SuRF) (Fuchs, et al., Anal. Biochem., 2000, 286, 91-98; Larson, et al., Cytometry, 2000, 41, 203-208), subtractive cloning, differential display (DD) (Jurecic and Belmont, Curr. Opin. Microbiol., 2000, 3, 316-21), comparative genomic hybridization (Carulli, et al., J. Cell Biochem. Suppl., 1998, 31, 286-96), FISH (fluorescent in situ hybridization) techniques (Going and Gusterson, Eur. J. Cancer, 1999, 35, 1895-904) and mass spectrometry methods (To, Comb. Chem. High Throughput Screen, 2000, 3, 235-41).
The compounds of the invention are useful for research and diagnostics, because these compounds hybridize to nucleic acids encoding C-reactive protein. Primers and probes are useful in methods requiring the specific detection of nucleic acid molecules encoding C-reactive protein and in the amplification of said nucleic acid molecules for detection or for use in further studies of C-reactive protein. Hybridization of the primers and probes disclosed herein with a nucleic acid encoding C-reactive protein can be detected by means known in the art. Such means may include conjugation of an enzyme to the primers and probes, radiolabelling of the primers and probes or any other suitable detection means. Kits using such detection means for detecting the level of C-reactive protein in a sample may also be prepared.
The invention further provides for the use of a compound or composition of the invention in the manufacture of a medicament for the treatment of any and all conditions disclosed herein.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, neurological conditions including obstructive sleep apnea, Alzheimer's disease, ALS, Parkinson's disease, various ataxias, and macular degeneration.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, metabolic conditions including obesity, metabolic syndrome, and diabetes.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, cardiovascular conditions including sudden cardiac death, coronary artery disease (CAD), unstable angina, stroke, elective stent placement, angioplasty, atherosclerosis, post percutaneous transluminal angioplasty (PTCA), post peripheral vascular disease, post myocardial infarction (MI), cardiac transplantation, hypertension, mitral valve commissurotomy, thrombosis, deep vein thrombus, end-stage renal disease (ESRD), renal dialysis, complement activation, congestive heart failure, systemic vasculitis, and cardiopulmonary bypass
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, women's health conditions including premenstrual syndrome (PMS) and dysmenorhhoea.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, inflammatory diseases including gingivitis, inflammatory bowel disease, ulcerative colitis, rheumatoid arthritis, osteoarthritis, and axial spondyloarthritis.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, infectious diseases including HIV-associated rheumatic disorders and bacterial infection.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, pulmonary conditions including asthma and chronic obstructive pulmonary disease.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, musculoskeletal conditions including lower back pain, intense physical exercise, endurance training, and age-related disorders.
Antisense compounds of the invention are provided for the treatment of, or use in the manufacture of a medicament for the treatment of, cancers including pulmonary cancer and colon cancer.
Among diagnostic uses is the measurement of C-reactive protein levels in patients to identify those who may benefit from a treatment stategy aimed at attenuation of inflammation. Such patients suitable for diagnosis include patients with coronary artery stenting, e.g., to diagnose tendencies for myocardial infarction or patients with ESRD or other symptoms related to renal disorders, e.g., hypertension, duresis, renal failure.
The specificity and sensitivity of antisense are also harnessed by those of skill in the art for therapeutic uses. Antisense compounds have been employed as therapeutic moieties in the treatment of disease states in animals, including humans. Antisense oligonucleotide drugs, including ribozymes, have been safely and effectively administered to humans and numerous clinical trials are presently underway. It is thus established that antisense compounds can be useful therapeutic modalities that can be configured to be useful in treatment regimes for the treatment of cells, tissues and animals, especially humans.
For therapeutics, an animal, preferably a human, suspected of having a disease or disorder that can be treated by modulating the expression of C-reactive protein is treated by administering antisense compounds in accordance with this invention. For example, in one non-limiting embodiment, the methods comprise the step of administering to the animal in need of treatment, a therapeutically effective amount of a C-reactive protein inhibitor. The C-reactive protein inhibitors of the present invention effectively inhibit the activity of the C-reactive protein or inhibit the expression of the C-reactive protein. For example, such a compound or composition that reduces levels of C-reactive protein is useful to prevent morbidity and mortality for subjects with acute coronary syndrome. Such a composition is useful for reducing inflammation mediated by C-reactive protein in a subject, e.g., to treat or prevent or reduce the progression of, atherosclerosis; to treat or prevent or reduce the progression of, acute vascular damage at atherosclerotic plaque sites or in coronary arteries; or to treat or prevent or reduce the progression of, damage caused by inflammation associated with myocardial infarctions or renal inflammation. Still other therapeutic or prophylactic methods using the C-reactive protein inhibitory compounds of this invention include to treat patients with coronary artery stenting; or to treat patients with ESRD or other renal diseases or related inflammatory disorders.
In one embodiment, the activity or expression of C-reactive protein in an animal is inhibited by about 10%. Preferably, the activity or expression of C-reactive protein in an animal is inhibited by about 30%. More preferably, the activity or expression of C-reactive protein in an animal is inhibited by 50% or more. Thus, the oligomeric compounds modulate expression of C-reactive protein mRNA by at least 10%, by at least 20%, by at least 25%, by at least 30%, by at least 40%, by at least 50%, by at least 60%, by at least 70%, by at least 75%, by at least 80%, by at least 85%, by at least 90%, by at least 95%, by at least 98%, by at least 99%, or by 100%.
For example, the reduction of the expression of C-reactive protein may be measured in serum, adipose tissue, liver or any other body fluid, tissue or organ of the animal. Preferably, the cells contained within said fluids, tissues or organs being analyzed contain a nucleic acid molecule encoding C-reactive protein and/or C-reactive protein itself.
The compounds of the invention can be utilized in pharmaceutical compositions by adding an effective amount of a compound to a suitable pharmaceutically acceptable diluent or carrier. Use of the compounds and methods of the invention may also be useful prophylactically.
F. Modifications
As is known in the art, a nucleoside is a base-sugar combination. The base portion of the nucleoside is normally a heterocyclic base. The two most common classes of such heterocyclic bases are the purines and the pyrimidines. Nucleotides are nucleosides that further include a phosphate group covalently linked to the sugar portion of the nucleoside. For those nucleosides that include a pentofuranosyl sugar, the phosphate group can be linked to either the 2′, 3′ or 5′ hydroxyl moiety of the sugar. In forming oligonucleotides, the phosphate groups covalently link adjacent nucleosides to one another to form a linear polymeric compound. In turn, the respective ends of this linear polymeric compound can be further joined to form a circular compound, however, linear compounds are generally preferred. In addition, linear compounds may have internal nucleobase complementarity and may therefore fold in a manner as to produce a fully or partially double-stranded compound. Within oligonucleotides, the phosphate groups are commonly referred to as forming the internucleoside backbone of the oligonucleotide. The normal linkage or backbone of RNA and DNA is a 3′ to 5′ phosphodiester linkage.
Modified Internucleoside Linkages (Backbones)
Specific examples of preferred antisense compounds useful in this invention include oligonucleotides containing modified backbones or non-natural internucleoside linkages. As defined in this specification, oligonucleotides having modified backbones include those that retain a phosphorus atom in the backbone and those that do not have a phosphorus atom in the backbone. For the purposes of this specification, and as sometimes referenced in the art, modified oligonucleotides that do not have a phosphorus atom in their internucleoside backbone can also be considered to be oligonucleosides.
Preferred modified oligonucleotide backbones containing a phosphorus atom therein include, for example, phosphorothioates, chiral phosphorothioates, phosphorodithioates, phosphotriesters, aminoalkylphosphotriesters, methyl and other alkyl phosphonates including 3′-alkylene phosphonates, 5′-alkylene phosphonates and chiral phosphonates, phosphinates, phosphoramidates including 3′-amino phosphoramidate and aminoalkylphosphoramidates, thionophosphoramidates, thionoalkylphosphonates, thionoalkylphosphotriesters, selenophosphates and boranophosphates having normal 3′-5′ linkages, 2′-5′ linked analogs of these, and those having inverted polarity wherein one or more internucleotide linkages is a 3′ to 3′, 5′ to 5′ or 2′ to 2′ linkage. Preferred oligonucleotides having inverted polarity comprise a single 3′ to 3′ linkage at the 3′-most internucleotide linkage i.e. a single inverted nucleoside residue that may be abasic (the nucleobase is missing or has a hydroxyl group in place thereof). Various salts, mixed salts and free acid forms are also included.
Representative United States patents that teach the preparation of the above phosphorus-containing linkages include, but are not limited to, U.S. Pat. Nos. 3,687,808; 4,469,863; 4,476,301; 5,023,243; 5,177,196; 5,188,897; 5,264,423; 5,276,019; 5,278,302; 5,286,717; 5,321,131; 5,399,676; 5,405,939; 5,453,496; 5,455,233; 5,466,677; 5,476,925; 5,519,126; 5,536,821; 5,541,306; 5,550,111; 5,563,253; 5,571,799; 5,587,361; 5,194,599; 5,565,555; 5,527,899; 5,721,218; 5,672,697 and 5,625,050, certain of which are commonly owned with this application, and each of which is herein incorporated by reference.
Preferred modified oligonucleotide backbones that do not include a phosphorus atom therein have backbones that are formed by short chain alkyl or cycloalkyl internucleoside linkages, mixed heteroatom and alkyl or cycloalkyl internucleoside linkages, or one or more short chain heteroatomic or heterocyclic internucleoside linkages. These include those having morpholino linkages (formed in part from the sugar portion of a nucleoside); siloxane backbones; sulfide, sulfoxide and sulfone backbones; formacetyl and thioformacetyl backbones; methylene formacetyl and thioformacetyl backbones; riboacetyl backbones; alkene containing backbones; sulfamate backbones; methyleneimino and methylenehydrazino backbones; sulfonate and sulfonamide backbones; amide backbones; and others having mixed N, O, S and CH2 component parts.
Representative United States patents that teach the preparation of the above oligonucleosides include, but are not limited to, U.S. Pat. Nos. 5,034,506; 5,166,315; 5,185,444; 5,214,134; 5,216,141; 5,235,033; 5,264,562; 5,264,564; 5,405,938; 5,434,257; 5,466,677; 5,470,967; 5,489,677; 5,541,307; 5,561,225; 5,596,086; 5,602,240; 5,610,289; 5,602,240; 5,608,046; 5,610,289; 5,618,704; 5,623,070; 5,663,312; 5,633,360; 5,677,437; 5,792,608; 5,646,269 and 5,677,439, certain of which are commonly owned with this application, and each of which is herein incorporated by reference.
Modified Sugar and Internucleoside Linkages-Mimetics
In other preferred oligonucleotide mimetics, both the sugar and the internucleoside linkage (i.e. the backbone), of the nucleotide units are replaced with novel groups. The nucleobase units are maintained for hybridization with an appropriate target nucleic acid. One such compound, an oligonucleotide mimetic that has been shown to have excellent hybridization properties, is referred to as a peptide nucleic acid (PNA). In PNA compounds, the sugar-backbone of an oligonucleotide is replaced with an amide containing backbone, in particular an aminoethylglycine backbone. The nucleobases are retained and are bound directly or indirectly to aza nitrogen atoms of the amide portion of the backbone. Representative United States patents that teach the preparation of PNA compounds include, but are not limited to, U.S. Pat. Nos. 5,539,082; 5,714,331; and 5,719,262, each of which is herein incorporated by reference. Further teaching of PNA compounds can be found in Nielsen et al., Science, 1991, 254, 1497-1500.
Further embodiments of the invention are oligonucleotides with phosphorothioate backbones and oligonucleosides with heteroatom backbones, and in particular —CH2—NH—O—CH2—, —CH2—N(CH3)—O—CH2— [known as a methylene (methylimino) or MMI backbone], —CH2—O—N(CH3)—CH2—, —CH2—N (CH3)—N(CH3)—CH2— and —O—N(CH3)—CH2—CH2— [wherein the native phosphodiester backbone is represented as —O—P—O—CH2—] of the above referenced U.S. Pat. No. 5,489,677, and the amide backbones of the above referenced U.S. Pat. No. 5,602,240. Also preferred are oligonucleotides having morpholino backbone structures of the above-referenced U.S. Pat. No. 5,034,506.
Modified Sugars
Modified oligonucleotides may also contain one or more substituted sugar moieties. Preferred oligonucleotides comprise one of the following at the 2′ position: OH; F; O-, S-, or N-alkyl; O-, S-, or N-alkenyl; O-, S- or N-alkynyl; or O-alkyl-O-alkyl, wherein the alkyl, alkenyl and alkynyl may be substituted or unsubstituted C1 to C10 alkyl or C2 to C10 alkenyl and alkynyl. Particularly preferred are O[(CH2)nO]mCH3, O(CH2)nOCH3, O(CH2)nNH2, O(CH2)nCH3, O(CH2)nONH2, and O(CH2)nON[(CH2)nCH3]2, where n and m are from 1 to about 10. Other preferred oligonucleotides comprise one of the following at the 2′ position: C1 to C10 lower alkyl, substituted lower alkyl, alkenyl, alkynyl, alkaryl, aralkyl, O-alkaryl or O-aralkyl, SH, SCH3, OCN, Cl, Br, CN, CF3, OCF3, SOCH3, SO2CH3, ONO2, NO2, N3, NH2, heterocycloalkyl, heterocycloalkaryl, aminoalkylamino, polyalkylamino, substituted silyl, an RNA cleaving group, a reporter group, an intercalator, a group for improving the pharmacokinetic properties of an oligonucleotide, or a group for improving the pharmacodynamic properties of an oligonucleotide, and other substituents having similar properties. A preferred modification includes 2′-O-methoxyethyl (2′-O—CH2CH2OCH3, also known as 2′-O-(2-methoxyethyl) or 2′-methoxyethoxy or 2′-MOE) (Martin et al., Helv. Chim. Acta, 1995, 78, 486-504) i.e., an alkoxyalkoxy group. A further preferred modification includes 2′-dimethylaminooxyethoxy, i.e., a O(CH2)2ON(CH3)2 group, also known as 2′-DMAOE, as described in examples hereinbelow, and 2′-dimethylaminoethoxyethoxy (also known in the art as 2′-O-dimethyl-amino-ethoxy-ethyl or 2′-DMAEOE), i.e., 2′-O—CH2—O—CH2—N(CH3)2, also described in examples hereinbelow.
Other modifications include 2′-methoxy (2′-O—CH3), 2′-aminopropoxy (2′-OCH2CH2CH2NH2), 2′-allyl (2′-CH2—CH═CH2), 2-O-allyl (2′-O—CH2—CH═CH2) and 2′-fluoro (2′-F). The 2′-modification may be in the arabino (up) position or ribo (down) position. A preferred 2′-arabino modification is 2′-F. Similar modifications may also be made at other positions on the oligonucleotide, particularly the 3′ position of the sugar on the 3′ terminal nucleotide or in 2′-5′ linked oligonucleotides and the 5′ position of 5′ terminal nucleotide. Oligonucleotides may also have sugar mimetics such as cyclobutyl moieties in place of the pentofuranosyl sugar. Representative United States patents that teach the preparation of such modified sugar structures include, but are not limited to, U.S. Pat. Nos. 4,981,957; 5,118,800; 5,319,080; 5,359,044; 5,393,878; 5,446,137; 5,466,786; 5,514,785; 5,519,134; 5,567,811; 5,576,427; 5,591,722; 5,597,909; 5,610,300; 5,627,053; 5,639,873; 5,646,265; 5,658,873; 5,670,633; 5,792,747; and 5,700,920, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference in its entirety.
A further modification of the sugar includes Locked Nucleic Acids (LNAs) in which the 2′-hydroxyl group is linked to the 3′ or 4′ carbon atom of the sugar ring, thereby forming a bicyclic sugar moiety. The linkage is preferably a methylene (—CH2—)n group bridging the 2′ oxygen atom and the 4′ carbon atom wherein n is 1 or 2. LNAs and preparation thereof are described in International Patent Publication Nos. WO 98/39352 and WO 99/14226.
Natural and Modified Nucleobases
Oligonucleotides may also include nucleobase (often referred to in the art simply as “base”) modifications or substitutions. As used herein, “unmodified” or “natural” nucleobases include the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C) and uracil (U). Modified nucleobases include other synthetic and natural nucleobases such as 5-methylcytosine (5-me-C), 5-hydroxymethyl cytosine, xanthine, hypoxanthine, 2-aminoadenine, 6-methyl and other alkyl derivatives of adenine and guanine, 2-propyl and other alkyl derivatives of adenine and guanine, 2-thiouracil, 2-thiothymine and 2-thiocytosine, 5-halouracil and cytosine, 5-propynyl (—C≡C—CH3) uracil and cytosine and other alkynyl derivatives of pyrimidine bases, 6-azo uracil, cytosine and thymine, 5-uracil (pseudouracil), 4-thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioalkyl, 8-hydroxyl and other 8-substituted adenines and guanines, 5-halo particularly 5-bromo, 5-trifluoromethyl and other 5-substituted uracils and cytosines, 7-methylguanine and 7-methyladenine, 2-F-adenine, 2-amino-adenine, 8-azaguanine and 8-azaadenine, 7-deazaguanine and 7-deazaadenine and 3-deazaguanine and 3-deazaadenine. Further modified nucleobases include tricyclic pyrimidines such as phenoxazine cytidine(1H-pyrimido[5,4-b][1,4]benzoxazin-2(3H)-one), phenothiazine cytidine (1H-pyrimido[5,4-b][1,4]benzothiazin-2(3H)-one), G-clamps such as a substituted phenoxazine cytidine (e.g. 9-(2-aminoethoxy)-H-pyrimido[5,4-b][1,4]benzoxazin-2(3H)-one), carbazole cytidine (2H-pyrimido[4,5-b]indol-2-one), pyridoindole cytidine (H-pyrido[3′,2′:4,5]pyrrolo[2,3-d]pyrimidin-2-one). Modified nucleobases may also include those in which the purine or pyrimidine base is replaced with other heterocycles, for example 7-deaza-adenine, 7-deazaguanosine, 2-aminopyridine and 2-pyridone. Further nucleobases include those disclosed in U.S. Pat. No. 3,687,808, those disclosed in The Concise Encyclopedia Of Polymer Science And Engineering, pages 858-859, Kroschwitz, J. I., ed. John Wiley & Sons, 1990, those disclosed by Englisch et al., Angewandte Chemie, International Edition, 1991, 30, 613, and those disclosed by Sanghvi, Y. S., Chapter 15, Antisense Research and Applications, pages 289-302, Crooke, S. T. and Lebleu, B., ed., CRC Press, 1993. Certain of these nucleobases are particularly useful for increasing the binding affinity of the compounds of the invention. These include 5-substituted pyrimidines, 6-azapyrimidines and N-2, N-6 and O-6 substituted purines, including 2-aminopropyladenine, 5-propynyluracil and 5-propynylcytosine. 5-methylcytosine substitutions have been shown to increase nucleic acid duplex stability by 0.6-1.2° C. and are presently preferred base substitutions, even more particularly when combined with 2′-O-methoxyethyl sugar modifications.
Representative United States patents that teach the preparation of certain of the above noted modified nucleobases as well as other modified nucleobases include, but are not limited to, the above noted U.S. Pat. Nos. 3,687,808, as well as U.S. Pat. Nos. 4,845,205; 5,130,302; 5,134,066; 5,175,273; 5,367,066; 5,432,272; 5,457,187; 5,459,255; 5,484,908; 5,502,177; 5,525,711; 5,552,540; 5,587,469; 5,594,121, 5,596,091; 5,614,617; 5,645,985; 5,830,653; 5,763,588; 6,005,096; and 5,681,941, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference, and U.S. Pat. No. 5,750,692, which is commonly owned with the instant application and also herein incorporated by reference.
Conjugates
Another modification of the oligonucleotides of the invention involves chemically linking to the oligonucleotide one or more moieties or conjugates that enhance the activity, cellular distribution or cellular uptake of the oligonucleotide. These moieties or conjugates can include conjugate groups covalently bound to functional groups such as primary or secondary hydroxyl groups. Conjugate groups of the invention include intercalators, reporter molecules, polyamines, polyamides, polyethylene glycols, polyethers, groups that enhance the pharmacodynamic properties of oligomers, and groups that enhance the pharmacokinetic properties of oligomers. Typical conjugate groups include cholesterols, lipids, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes. Groups that enhance the pharmacodynamic properties, in the context of this invention, include groups that improve uptake, enhance resistance to degradation, and/or strengthen sequence-specific hybridization with the target nucleic acid. Groups that enhance the pharmacokinetic properties, in the context of this invention, include groups that improve uptake, distribution, metabolism or excretion of the compounds of the present invention. Representative conjugate groups are disclosed in International Patent Application PCT/US92/09196, filed Oct. 23, 1992, and U.S. Pat. No. 6,287,860, the entire disclosure of which are incorporated herein by reference. Conjugate moieties include but are not limited to lipid moieties such as a cholesterol moiety, cholic acid, a thioether, e.g., hexyl-S-tritylthiol, a thiocholesterol, an aliphatic chain, e.g., dodecandiol or undecyl residues, a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethyl-ammonium 1,2-di-O-hexadecyl-rac-glycero-3-H-phosphonate, a polyamine or a polyethylene glycol chain, or adamantane acetic acid, a palmityl moiety, or an octadecylamine or hexylamino-carbonyl-oxycholesterol moiety. Oligonucleotides of the invention may also be conjugated to active drug substances, for example, aspirin, warfarin, phenylbutazone, ibuprofen, suprofen, fenbufen, ketoprofen, (S)-(+)-pranoprofen, carprofen, dansylsarcosine, 2,3,5-triiodobenzoic acid, flufenamic acid, folinic acid, a benzothiadiazide, chlorothiazide, a diazepine, indomethicin, a barbiturate, a cephalosporin, a sulfa drug, an antidiabetic, an antibacterial or an antibiotic. Oligonucleotide-drug conjugates and their preparation are described in U.S. patent application Ser. No. 09/334,130 (filed Jun. 15, 1999), which is incorporated herein by reference in its entirety.
Representative United States patents that teach the preparation of such oligonucleotide conjugates include, but are not limited to, U.S. Pat. Nos. 4,828,979; 4,948,882; 5,218,105; 5,525,465; 5,541,313; 5,545,730; 5,552,538; 5,578,717, 5,580,731; 5,580,731; 5,591,584; 5,109,124; 5,118,802; 5,138,045; 5,414,077; 5,486,603; 5,512,439; 5,578,718; 5,608,046; 4,587,044; 4,605,735; 4,667,025; 4,762,779; 4,789,737; 4,824,941; 4,835,263; 4,876,335; 4,904,582; 4,958,013; 5,082,830; 5,112,963; 5,214,136; 5,082,830; 5,112,963; 5,214,136; 5,245,022; 5,254,469; 5,258,506; 5,262,536; 5,272,250; 5,292,873; 5,317,098; 5,371,241, 5,391,723; 5,416,203, 5,451,463; 5,510,475; 5,512,667; 5,514,785; 5,565,552; 5,567,810; 5,574,142; 5,585,481; 5,587,371; 5,595,726; 5,597,696; 5,599,923; 5,599,928 and 5,688,941, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference.
Oligomeric compounds used in the compositions of the present invention can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of oligomeric compounds to enhance properties such as for example nuclease stability. Included in stabilizing groups are cap structures. By “cap structure or terminal cap moiety” is meant chemical modifications, which have been incorporated at either terminus of oligonucleotides (see for example International Patent Publication No. WO 97/26270, incorporated by reference herein). These terminal modifications protect the oligomeric compounds having terminal nucleic acid molecules from exonuclease degradation, and can help in delivery and/or localization within a cell. The cap can be present at the 5′-terminus (5′-cap) or at the 3′-terminus (3′-cap) or can be present on both termini. In non-limiting examples, the 5′-cap includes inverted abasic residue (moiety), 4′,5′-methylene nucleotide; 1-(beta-D-erythrofuranosyl) nucleotide, 4′-thio nucleotide, carbocyclic nucleotide; 1,5-anhydrohexitol nucleotide; L-nucleotides; alpha-nucleotides; modified base nucleotide; phosphorodithioate linkage; threo-pentofuranosyl nucleotide; acyclic 3′,4′-seco nucleotide; acyclic 3,4-dihydroxybutyl nucleotide; acyclic 3,5-dihydroxypentyl nucleotide, 3′-3′-inverted nucleotide moiety; 3′-3′-inverted abasic moiety; 3′-2′-inverted nucleotide moiety; 3′-2′-inverted abasic moiety; 1,4-butanediol phosphate; 3′-phosphoramidate; hexylphosphate; aminohexyl phosphate; 3′-phosphate; 3′-phosphorothioate; phosphorodithioate; or bridging or non-bridging methylphosphonate moiety (for more details see Wincott et al., International PCT publication No. WO 97/26270, incorporated by reference herein).
Particularly preferred 3′-cap structures of the present invention include, for example 4′,5′-methylene nucleotide; 1-(beta-D-erythrofuranosyl) nucleotide; 4′-thio nucleotide, carbocyclic nucleotide; 5′-amino-alkyl phosphate; 1,3-diamino-2-propyl phosphate, 3-aminopropyl phosphate; 6-aminohexyl phosphate; 1,2-aminododecyl phosphate; hydroxypropyl phosphate; 1,5-anhydrohexitol nucleotide; L-nucleotide; alpha-nucleotide; modified base nucleotide; phosphorodithioate; threo-pentofuranosyl nucleotide; acyclic 3′,4′-seco nucleotide; 3,4-dihydroxybutyl nucleotide; 3,5-dihydroxypentyl nucleotide, 5′-5′-inverted nucleotide moiety; 5′-5′-inverted abasic moiety; 5′-phosphoramidate; 5′-phosphorothioate; 1,4-butanediol phosphate; 5′-amino; bridging and/or non-bridging 5′-phosphoramidate, phosphorothioate and/or phosphorodithioate, bridging or non bridging methylphosphonate and 5′-mercapto moieties (for more details see Beaucage and Tyer, 1993, Tetrahedron 49, 1925; incorporated by reference herein).
Further 3′ and 5′-stabilizing groups that can be used to cap one or both ends of an oligomeric compound to impart nuclease stability include those disclosed in WO 03/004602 published on Jan. 16, 2003.
Chimeric Compounds
It is not necessary for all positions in a given compound to be uniformly modified, and in fact more than one of the aforementioned modifications may be incorporated in a single compound or even at a single nucleoside within an oligonucleotide.
The present invention also includes antisense compounds that are chimeric compounds. “Chimeric” antisense compounds or “chimeras,” in the context of this invention, are antisense compounds, particularly oligonucleotides, which contain two or more chemically distinct regions, each made up of at least one monomer unit, i.e., a nucleotide in the case of an oligonucleotide compound. These oligonucleotides typically contain at least one region wherein the oligonucleotide is modified so as to confer upon the oligonucleotide increased resistance to nuclease degradation, increased cellular uptake, increased stability and/or increased binding affinity for the target nucleic acid. An additional region of the oligonucleotide may serve as a substrate for enzymes capable of cleaving RNA:DNA or RNA:RNA hybrids. By way of example, RNAse H is a cellular endonuclease which cleaves the RNA strand of an RNA:DNA duplex. Activation of RNase H, therefore, results in cleavage of the RNA target, thereby greatly enhancing the efficiency of oligonucleotide-mediated inhibition of gene expression. The cleavage of RNA:RNA hybrids can, in like fashion, be accomplished through the actions of endoribonucleases, such as RNAseL which cleaves both cellular and viral RNA. Cleavage of the RNA target can be routinely detected by gel electrophoresis and, if necessary, associated nucleic acid hybridization techniques known in the art.
Preferred chimeric oligonucleotides are those disclosed in the Examples herein. Particularly preferred chimeric oligonucleotides are those referred to as ISIS 133726, ISIS 133719, ISIS 140177, ISIS 104183, ISIS 140180, ISIS 133731, ISIS 140187, ISIS 133712, ISIS 140194, ISIS 133730, and ISIS 133729.
Chimeric antisense compounds of the invention may be formed as composite structures of two or more oligonucleotides, modified oligonucleotides, oligonucleosides and/or oligonucleotide mimetics as described above. Chimeric antisense compounds can be of several different types. These include a first type wherein the “gap” segment of linked nucleosides is positioned between 5′ and 31 “wing” segments of linked nucleosides and a second “open end” type wherein the “gap” segment is located at either the 3′ or the 5′ terminus of the oligomeric compound. Oligonucleotides of the first type are also known in the art as “gapmers” or gapped oligonucleotides. Oligonucleotides of the second type are also known in the art as “hemimers” or “wingmers”. Such compounds have also been referred to in the art as hybrids. In a gapmer that is 20 nucleotides in length, a gap or wing can be 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 or 18 nucleotides in length. In one embodiment, a 20-nucleotide gapmer is comprised of a gap 8 nucleotides in length, flanked on both the 5′ and 3′ sides by wings 6 nucleotides in length. In another embodiment, a 20-nucleotide gapmer is comprised of a gap 10 nucleotides in length, flanked on both the 5′ and 3′ sides by wings 5 nucleotides in length. In another embodiment, a 20-nucleotide gapmer is comprised of a gap 12 nucleotides in length flanked on both the 5′ and 3′ sides by wings 4 nucleotides in length. In a further embodiment, a 20-nucleotide gapmer is comprised of a gap 14 nucleotides in length flanked on both the 5′ and 3′ sides by wings 3 nucleotides in length. In another embodiment, a 20-nucleotide gapmer is comprised of a gap 16 nucleotides in length flanked on both the 5′ and 3′ sides by wings 2 nucleotides in length. In a further embodiment, a 20-nucleotide gapmer is comprised of a gap 18 nucleotides in length flanked on both the 5′ and 3′ ends by wings 1 nucleotide in length. Alternatively, the wings are of different lengths, for example, a 20-nucleotide gapmer may be comprised of a gap 10 nucleotides in length, flanked by a 6-nucleotide wing on one side (5′ or 3′) and a 4-nucleotide wing on the other side (5′ or 3′).
In a hemimer, an “open end” chimeric antisense compound, 20 nucleotides in length, a gap segment, located at either the 5′ or 3′ terminus of the oligomeric compound, can be 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 or 19 nucleotides in length. For example, a 20-nucleotide hemimer can have a gap segment of 10 nucleotides at the 5′ end and a second segment of 10 nucleotides at the 3′ end. Alternatively, a 20-nucleotide hemimer can have a gap segment of 10 nucleotides at the 3′ end and a second segment of 10 nucleotides at the 5′ end.
Representative United States patents that teach the preparation of such hybrid structures include, but are not limited to, U.S. Pat. Nos. 5,013,830; 5,149,797; 5,220,007; 5,256,775; 5,366,878; 5,403,711; 5,491,133; 5,565,350; 5,623,065; 5,652,355; 5,652,356; and 5,700,922, certain of which are commonly owned with the instant application, and each of which is herein incorporated by reference in its entirety.
G. Formulations
The compounds of the invention may also be admixed, encapsulated, conjugated or otherwise associated with other molecules, molecule structures or mixtures of compounds, as for example, liposomes, receptor-targeted molecules, oral, rectal, topical or other formulations, for assisting in uptake, distribution and/or absorption. Representative United States patents that teach the preparation of such uptake, distribution and/or absorption-assisting formulations include, but are not limited to, U.S. Pat. Nos. 5,108,921; 5,354,844; 5,416,016; 5,459,127; 5,521,291; 5,543,158; 5,547,932; 5,583,020; 5,591,721; 4,426,330; 4,534,899; 5,013,556; 5,108,921; 5,213,804; 5,227,170; 5,264,221; 5,356,633; 5,395,619; 5,416,016; 5,417,978; 5,462,854; 5,469,854; 5,512,295; 5,527,528; 5,534,259; 5,543,152; 5,556,948; 5,580,575; and 5,595,756, each of which is herein incorporated by reference.
The antisense compounds of the invention encompass any pharmaceutically acceptable salts, esters, or salts of such esters, or any other compound which, upon administration to an animal, including a human, is capable of providing (directly or indirectly) the biologically active metabolite or residue thereof.
The term “pharmaceutically acceptable salts” refers to physiologically and pharmaceutically acceptable salts of the compounds of the invention: i.e., salts that retain the desired biological activity of the parent compound and do not impart undesired toxicological effects thereto. For oligonucleotides, preferred examples of pharmaceutically acceptable salts and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.
The present invention also includes pharmaceutical compositions and formulations that include the antisense compounds of the invention. The pharmaceutical compositions of the present invention may be administered in a number of ways depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be topical (including ophthalmic and to mucous membranes including vaginal and rectal delivery), pulmonary, e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal), oral or parenteral. Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, e.g., intrathecal or intraventricular, administration. Oligonucleotides with at least one 2′-O-methoxyethyl modification are believed to be particularly useful for oral administration. Pharmaceutical compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids and powders. Conventional pharmaceutical carriers, aqueous, powder or oily bases, thickeners and the like may be necessary or desirable. Coated condoms, gloves and the like may also be useful.
The pharmaceutical formulations of the present invention, which may conveniently be presented in unit dosage form, may be prepared according to conventional techniques well known in the pharmaceutical industry. Such techniques include the step of bringing into association the active ingredients with the pharmaceutical carrier(s) or excipient(s). In general, the formulations are prepared by uniformly and intimately bringing into association the active ingredients with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product.
The compositions of the present invention may be formulated into any of many possible dosage forms such as, but not limited to, tablets, capsules, gel capsules, liquid syrups, soft gels, suppositories, and enemas. The compositions of the present invention may also be formulated as suspensions in aqueous, non-aqueous or mixed media. Aqueous suspensions may further contain substances that increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol and/or dextran. The suspension may also contain stabilizers.
Pharmaceutical compositions of the present invention include, but are not limited to, solutions, emulsions, foams and liposome-containing formulations. The pharmaceutical compositions and formulations of the present invention may comprise one or more penetration enhancers, carriers, excipients or other active or inactive ingredients.
Emulsions are typically heterogenous systems of one liquid dispersed in another in the form of droplets usually exceeding 0.1 μm in diameter. Emulsions may contain additional components in addition to the dispersed phases, and the active drug that may be present as a solution in either the aqueous phase, oily phase or itself as a separate phase. Microemulsions are included as an embodiment of the present invention. Emulsions and their uses are well known in the art and are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.
Formulations of the present invention include liposomal formulations. As used in the present invention, the term “liposome” means a vesicle composed of amphiphilic lipids arranged in a spherical bilayer or bilayers. Liposomes are unilamellar or multilamellar vesicles which have a membrane formed from a lipophilic material and an aqueous interior that contains the composition to be delivered. Cationic liposomes are positively charged liposomes, which are believed to interact with negatively charged DNA molecules to form a stable complex. Liposomes that are pH-sensitive or negatively-charged are believed to entrap DNA rather than complex with it. Both cationic and noncationic liposomes have been used to deliver DNA to cells.
Liposomes also include “sterically stabilized” liposomes, a term which, as used herein, refers to liposomes comprising one or more specialized lipids. When incorporated into liposomes, these specialized lipids result in enhanced circulation lifetimes relative to liposomes lacking such specialized lipids. Examples of sterically stabilized liposomes are those in which part of the vesicle-forming lipid portion of the liposome comprises one or more glycolipids or is derivatized with one or more hydrophilic polymers, such as a polyethylene glycol (PEG) moiety. Liposomes and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.
The pharmaceutical formulations and compositions of the present invention may also include surfactants. The use of surfactants in drug products, formulations and in emulsions is well known in the art. Surfactants and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.
In one embodiment, the present invention employs various penetration enhancers to effect the efficient delivery of nucleic acids, particularly oligonucleotides. In addition to aiding the diffusion of non-lipophilic drugs across cell membranes, penetration enhancers also enhance the permeability of lipophilic drugs. Penetration enhancers may be classified as belonging to one of five broad categories, i.e., surfactants, fatty acids, bile salts, chelating agents, and non-chelating non-surfactants. Penetration enhancers and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety.
One of skill in the art will recognize that formulations are routinely designed according to their intended use, i.e. route of administration.
Preferred formulations for topical administration include those in which the oligonucleotides of the invention are in admixture with a topical delivery agent such as lipids, liposomes, fatty acids, fatty acid esters, steroids, chelating agents and surfactants. Preferred lipids and liposomes include neutral (e.g. dioleoylphosphatidyl DOPE ethanolamine, dimyristoylphosphatidyl choline DMPC, distearolyphosphatidyl choline) negative (e.g. dimyristoylphosphatidyl glycerol DMPG) and cationic (e.g. dioleoyltetramethylaminopropyl DOTAP and dioleoylphosphatidyl ethanolamine DOTMA).
For topical or other administration, oligonucleotides of the invention may be encapsulated within liposomes or may form complexes thereto, in particular to cationic liposomes. Alternatively, oligonucleotides may be complexed to lipids, in particular to cationic lipids. Preferred fatty acids and esters, pharmaceutically acceptable salts thereof, and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety. Topical formulations are described in detail in U.S. patent application Ser. No. 09/315,298 filed on May 20, 1999, which is incorporated herein by reference in its entirety.
Compositions and formulations for oral administration include powders or granules, microparticulates, nanoparticulates, suspensions or solutions in water or non-aqueous media, capsules, gel capsules, sachets, tablets or minitablets. Thickeners, flavoring agents, diluents, emulsifiers, dispersing aids or binders may be desirable. Preferred oral formulations are those in which oligonucleotides of the invention are administered in conjunction with one or more penetration enhancers surfactants and chelators. Preferred surfactants include fatty acids and/or esters or salts thereof, bile acids and/or salts thereof. Preferred bile acids/salts and fatty acids and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety. Also preferred are combinations of penetration enhancers, for example, fatty acids/salts in combination with bile acids/salts. A particularly preferred combination is the sodium salt of lauric acid, capric acid and UDCA. Further penetration enhancers include polyoxyethylene-9-lauryl ether, polyoxyethylene-20-cetyl ether. Oligonucleotides of the invention may be delivered orally, in granular form including sprayed dried particles, or complexed to form micro or nanoparticles. Oligonucleotide complexing agents and their uses are further described in U.S. Pat. No. 6,287,860, which is incorporated herein in its entirety. Oral formulations for oligonucleotides and their preparation are described in detail in U.S. Patent Publication No. 2003/0040497 (Feb. 27, 2003) and its parent applications; U.S. Patent Publication No. 2003/0027780 (Feb. 6, 2003) and its parent applications; and U.S. patent application Ser. No. 10/071,822, filed Feb. 8, 2002, each of which is incorporated herein by reference in their entirety.
Compositions and formulations for parenteral, intrathecal or intraventricular administration may include sterile aqueous solutions that may also contain buffers, diluents and other suitable additives such as, but not limited to, penetration enhancers, carrier compounds and other pharmaceutically acceptable carriers or excipients.
Oligonucleotides may be formulated for delivery in vivo in an acceptable dosage form, e.g. as parenteral or non-parenteral formulations. Parenteral formulations include intravenous (IV), subcutaneous (SC), intraperitoneal (IP), intravitreal and intramuscular (IM) formulations, as well as formulations for delivery via pulmonary inhalation, intranasal administration, topical administration, etc. Non-parenteral formulations include formulations for delivery via the alimentary canal, e.g. oral administration, rectal administration, intrajejunal instillation, etc. Rectal administration includes administration as an enema or a suppository. Oral administration includes administration as a capsule, a gel capsule, a pill, an elixir, etc.
In some embodiments, an oligonucleotide may be administered to a subject via an oral route of administration. The subject may be an animal or a human (man). An animal subject may be a mammal, such as a mouse, a rat, a dog, a guinea pig, a monkey, a non-human primate, a cat or a pig. Non-human primates include monkeys and chimpanzees. A suitable animal subject may be an experimental animal, such as a mouse, rat, mouse, a rat, a dog, a monkey, a non-human primate, a cat or a pig.
In some embodiments, the subject may be a human. In certain embodiments, the subject may be a human patient in need of therapeutic treatment as discussed in more detail herein. In certain embodiments, the subject may be in need of modulation of expression of one or more genes as discussed in more detail herein. In some particular embodiments, the subject may be in need of inhibition of expression of one or more genes as discussed in more detail herein. In particular embodiments, the subject may be in need of modulation, i.e. inhibition or enhancement, of C-reactive protein in order to obtain therapeutic indications discussed in more detail herein.
In some embodiments, non-parenteral (e.g. oral) oligonucleotide formulations according to the present invention result in enhanced bioavailability of the oligonucleotide. In this context, the term “bioavailability” refers to a measurement of that portion of an administered drug, which reaches the circulatory system (e.g. blood, especially blood plasma) when a particular mode of administration is used to deliver the drug. Enhanced bioavailability refers to a particular mode of administration's ability to deliver oligonucleotide to the peripheral blood plasma of a subject relative to another mode of administration. For example, when a non-parenteral mode of administration (e.g. an oral mode) is used to introduce the drug into a subject, the bioavailability for that mode of administration may be compared to a different mode of administration, e.g. an IV mode of administration. In some embodiments, the area under a compound's blood plasma concentration curve (AUC0) after non-parenteral (e.g. oral, rectal, intrajejunal) administration may be divided by the area under the drug's plasma concentration curve after intravenous (i.v.) administration (AUCiv) to provide a dimensionless quotient (relative bioavailability, RB) that represents fraction of compound absorbed via the non-parenteral route as compared to the IV route. A composition's bioavailability is said to be enhanced in comparison to another composition's bioavailability when the first composition's relative bioavailability (RB1) is greater than the second composition's relative bioavailability (RB2).
In general, bioavailability correlates with therapeutic efficacy when a compound's therapeutic efficacy is related to the blood concentration achieved, even if the drug's ultimate site of action is intracellular (van Berge-Henegouwen et al., Gastroenterol., 1977, 73, 300). Bioavailability studies have been used to determine the degree of intestinal absorption of a drug by measuring the change in peripheral blood levels of the drug after an oral dose (DiSanto, Chapter 76 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, pages 1451-1458).
In general, an oral composition's bioavailability is said to be “enhanced” when its relative bioavailability is greater than the bioavailability of a composition substantially consisting of pure oligonucleotide, i.e. oligonucleotide in the absence of a penetration enhancer.
Organ bioavailability refers to the concentration of compound in an organ. Organ bioavailability may be measured in test subjects by a number of means, such as by whole-body radiography. Organ bioavailability may be modified, e.g. enhanced, by one or more modifications to the oligonucleotide, by use of one or more carrier compounds or excipients, etc. as discussed in more detail herein. In general, an increase in bioavailability will result in an increase in organ bioavailability.
Oral oligonucleotide compositions according to the present invention may comprise one or more “mucosal penetration enhancers,” also known as “absorption enhancers” or simply as “penetration enhancers.” Accordingly, some embodiments of the invention comprise at least one oligonucleotide in combination with at least one penetration enhancer. In general, a penetration enhancer is a substance that facilitates the transport of a drug across mucous membrane(s) associated with the desired mode of administration, e.g. intestinal epithelial membranes. Accordingly it is desirable to select one or more penetration enhancers that facilitate the uptake of an oligonucleotide, without interfering with the activity of the oligonucleotide, and in a such a manner the oligonucleotide can be introduced into the body of an animal without unacceptable side-effects such as toxicity, irritation or allergic response.
Embodiments of the present invention provide compositions comprising one or more pharmaceutically acceptable penetration enhancers, and methods of using such compositions, which result in the improved bioavailability of oligonucleotides administered via non-parenteral modes of administration. Heretofore, certain penetration enhancers have been used to improve the bioavailability of certain drugs. See Muranishi, Crit. Rev. Ther. Drug Carrier Systems, 1990, 7, 1 and Lee et al., Crit. Rev. Ther. Drug Carrier Systems, 1991, 8, 91. It has been found that the uptake and delivery of oligonucleotides, relatively complex molecules which are known to be difficult to administer to animals and man, can be greatly improved even when administered by non-parenteral means through the use of a number of different classes of penetration enhancers.
In some embodiments, compositions for non-parenteral administration include one or more modifications from naturally-occurring oligonucleotides (i.e. full-phosphodiester deoxyribosyl or full-phosphodiester ribosyl oligonucleotides). Such modifications may increase binding affinity, nuclease stability, cell or tissue permeability, tissue distribution, or other biological or pharmacokinetic property. Modifications may be made to the base, the linker, or the sugar, in general, as discussed in more detail herein with regards to oligonucleotide chemistry. In some embodiments of the invention, compositions for administration to a subject, and in particular oral compositions for administration to an animal or human subject, will comprise modified oligonucleotides having one or more modifications for enhancing affinity, stability, tissue distribution, or other biological property.
Suitable modified linkers include phosphorothioate linkers. In some embodiments according to the invention, the oligonucleotide has at least one phosphorothioate linker. Phosphorothioate linkers provide nuclease stability as well as plasma protein binding characteristics to the oligonucleotide. Nuclease stability is useful for increasing the in vivo lifetime of oligonucleotides, while plasma protein binding decreases the rate of first pass clearance of oligonucleotide via renal excretion. In some embodiments according to the present invention, the oligonucleotide has at least two phosphorothioate linkers. In some embodiments, wherein the oligonucleotide has exactly n nucleosides, the oligonucleotide has from one to n-1 phosphorothioate linkages. In some embodiments, wherein the oligonucleotide has exactly n nucleosides, the oligonucleotide has n-1 phosphorothioate linkages. In other embodiments wherein the oligonucleotide has exactly n nucleoside, and n is even, the oligonucleotide has from 1 to n/2 phosphorothioate linkages, or, when n is odd, from 1 to (n−1)/2 phosphorothioate linkages. In some embodiments, the oligonucleotide has alternating phosphodiester (PO) and phosphorothioate (PS) linkages. In other embodiments, the oligonucleotide has at least one stretch of two or more consecutive PO linkages and at least one stretch of two or more PS linkages. In other embodiments, the oligonucleotide has at least two stretches of PO linkages interrupted by at least on PS linkage.
In some embodiments, at least one of the nucleosides is modified on the ribosyl sugar unit by a modification that imparts nuclease stability, binding affinity or some other beneficial biological property to the sugar. In some cases, the sugar modification includes a 2′-modification, e.g. the 2′-OH of the ribosyl sugar is replaced or substituted. Suitable replacements for 2′-OH include 2′-F and 2′-arabino-F. Suitable substitutions for OH include 2′-O-alkyl, e.g. 2-O-methyl, and 2′-O-substituted alkyl, e.g. 2′-O-methoxyethyl, 2′-O-aminopropyl, etc. In some embodiments, the oligonucleotide contains at least one 2′-modification. In some embodiments, the oligonucleotide contains at least 2 2′-modifications. In some embodiments, the oligonucleotide has at least one 2′-modification at each of the termini (i.e. the 3′- and 5′-terminal nucleosides each have the same or different 2′-modifications). In some embodiments, the oligonucleotide has at least two sequential 2′-modifications at each end of the oligonucleotide. In some embodiments, oligonucleotides further comprise at least one deoxynucleoside. In particular embodiments, oligonucleotides comprise a stretch of deoxynucleosides such that the stretch is capable of activating RNase (e.g. RNase H) cleavage of an RNA to which the oligonucleotide is capable of hybridizing. In some embodiments, a stretch of deoxynucleosides capable of activating RNase-mediated cleavage of RNA comprises about 6 to about 16, e.g. about 8 to about 16 consecutive deoxynucleosides. In further embodiments, oligonucleotides are capable of eliciting cleavage by dsRNAse enzymes.
Oral compositions for administration of non-parenteral oligonucleotide compositions of the present invention may be formulated in various dosage forms such as, but not limited to, tablets, capsules, liquid syrups, soft gels, suppositories, and enemas. The term “alimentary delivery” encompasses e.g. oral, rectal, endoscopic and sublingual/buccal administration. A common requirement for these modes of administration is absorption over some portion or all of the alimentary tract and a need for efficient mucosal penetration of the nucleic acid(s) so administered.
Delivery of a drug via the oral mucosa, as in the case of buccal and sublingual administration, has several desirable features, including, in many instances, a more rapid rise in plasma concentration of the drug than via oral delivery (Harvey, Chapter 35 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, page 711).
Endoscopy may be used for drug delivery directly to an interior portion of the alimentary tract. For example, endoscopic retrograde cystopancreatography (ERCP) takes advantage of extended gastroscopy and permits selective access to the biliary tract and the pancreatic duct (Hirahata et al., Gan To Kagaku Ryoho, 1992, 19(10 Suppl.), 1591). Pharmaceutical compositions, including liposomal formulations, can be delivered directly into portions of the alimentary canal, such as, e.g., the duodenum (Somogyi et al., Pharm. Res., 1995, 12, 149) or the gastric submucosa (Akamo et al., Japanese J. Cancer Res., 1994, 85, 652) via endoscopic means. Gastric lavage devices (Inoue et al., Artif. Organs, 1997, 21, 28) and percutaneous endoscopic feeding devices (Pennington et al., Ailment Pharmacol. Ther., 1995, 9, 471) can also be used for direct alimentary delivery of pharmaceutical compositions.
In some embodiments, oligonucleotide formulations may be administered through the anus into the rectum or lower intestine. Rectal suppositories, retention enemas or rectal catheters can be used for this purpose and may be preferred when patient compliance might otherwise be difficult to achieve (e.g., in pediatric and geriatric applications, or when the patient is vomiting or unconscious). Rectal administration can result in more prompt and higher blood levels than the oral route. (Harvey, Chapter 35 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, page 711). Because about 50% of the drug that is absorbed from the rectum will bypass the liver, administration by this route significantly reduces the potential for first-pass metabolism (Benet et al., Chapter 1 In: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Ed., Hardman et al., eds., McGraw-Hill, New York, N.Y., 1996).
One advantageous method of non-parenteral administration oligonucleotide compositions is oral delivery. Some embodiments employ various penetration enhancers in order to effect transport of oligonucleotides and other nucleic acids across mucosal and epithelial membranes. Penetration enhancers may be classified as belonging to one of five broad categories—surfactants, fatty acids, bile salts, chelating agents, and non-chelating non-surfactants (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, p. 92). Accordingly, some embodiments comprise oral oligonucleotide compositions comprising at least one member of the group consisting of surfactants, fatty acids, bile salts, chelating agents, and non-chelating surfactants. Further embodiments comprise oral oligonucleotide comprising at least one fatty acid, e.g. capric or lauric acid, or combinations or salts thereof. Other embodiments comprise methods of enhancing the oral bioavailability of an oligonucleotide, the method comprising co-administering the oligonucleotide and at least one penetration enhancer.
Other excipients that may be added to oral oligonucleotide compositions include surfactants (or “surface-active agents”), which are chemical entities which, when dissolved in an aqueous solution, reduce the surface tension of the solution or the interfacial tension between the aqueous solution and another liquid, with the result that absorption of oligonucleotides through the alimentary mucosa and other epithelial membranes is enhanced. In addition to bile salts and fatty acids, surfactants include, for example, sodium lauryl sulfate, polyoxyethylene-9-lauryl ether and polyoxyethylene-20-cetyl ether (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92); and perfluorohemical emulsions, such as FC-43 (Takahashi et al., J. Pharm. Phamacol., 1988, 40, 252).
Fatty acids and their derivatives which act as penetration enhancers and may be used in compositions of the present invention include, for example, oleic acid, lauric acid, capric acid (n-decanoic acid), myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein (1-monooleoyl-rac-glycerol), dilaurin, caprylic acid, arachidonic acid, glyceryl 1-monocaprate, 1-dodecylazacycloheptan-2-one, acylcarnitines, acylcholines and mono- and di-glycerides thereof and/or physiologically acceptable salts thereof (i.e., oleate, laurate, caprate, myristate, palmitate, stearate, linoleate, etc.) (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1; El-Hariri et al., J. Pharm. Pharmacol., 1992, 44, 651).
In some embodiments, oligonucleotide compositions for oral delivery comprise at least two discrete phases, which phases may comprise particles, capsules, gel-capsules, microspheres, etc. Each phase may contain one or more oligonucleotides, penetration enhancers, surfactants, bioadhesives, effervescent agents, or other adjuvant, excipient or diluent. In some embodiments, one phase comprises at least one oligonucleotide and at lease one penetration enhancer. In some embodiments, a first phase comprises at least one oligonucleotide and at least one penetration enhancer, while a second phase comprises at least one penetration enhancer. In some embodiments, a first phase comprises at least one oligonucleotide and at least one penetration enhancer, while a second phase comprises at least one penetration enhancer and substantially no oligonucleotide. In some embodiments, at least one phase is compounded with at least one degradation retardant, such as a coating or a matrix, which delays release of the contents of that phase. In some embodiments, a first phase comprises at least one oligonucleotide, at least one penetration enhancer, while a second phase comprises at least one penetration enhancer and a release-retardant. In particular embodiments, an oral oligonucleotide comprises a first phase comprising particles containing an oligonucleotide and a penetration enhancer, and a second phase comprising particles coated with a release-retarding agent and containing penetration enhancer.
A variety of bile salts also function as penetration enhancers to facilitate the uptake and bioavailability of drugs. The physiological roles of bile include the facilitation of dispersion and absorption of lipids and fat-soluble vitamins (Brunton, Chapter 38 In: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Ed., Hardman et al., eds., McGraw-Hill, New York, N.Y., 1996, pages 934-935). Various natural bile salts, and their synthetic derivatives, act as penetration enhancers. Thus, the term “bile salt” includes any of the naturally occurring components of bile as well as any of their synthetic derivatives. The bile salts of the invention include, for example, cholic acid (or its pharmaceutically acceptable sodium salt, sodium cholate), dehydrocholic acid (sodium dehydrocholate), deoxycholic acid (sodium deoxycholate), glucholic acid (sodium glucholate), glycholic acid (sodium glycocholate), glycodeoxycholic acid (sodium glycodeoxycholate), taurocholic acid (sodium taurocholate), taurodeoxycholic acid (sodium taurodeoxycholate), chenodeoxycholic acid (CDCA, sodium chenodeoxycholate), ursodeoxycholic acid (UDCA), sodium tauro-24,25-dihydro-fusidate (STDHF), sodium glycodihydrofusidate and polyoxyethylene-9-lauryl ether (POE) (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Swinyard, Chapter 39 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, pages 782-783; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1; Yamamoto et al., J. Pharm. Exp. Ther., 1992, 263, 25; Yamashita et al., J. Pharm. Sci., 1990, 79, 579).
In some embodiments, penetration enhancers useful in some embodiments of present invention are mixtures of penetration enhancing compounds. One such penetration enhancer is a mixture of UDCA (and/or CDCA) with capric and/or lauric acids or salts thereof e.g. sodium. Such mixtures are useful for enhancing the delivery of biologically active substances across mucosal membranes, in particular intestinal mucosa. Other penetration enhancer mixtures comprise about 5-95% of bile acid or salt(s) UDCA and/or CDCA with 5-95% capric and/or lauric acid. Particular penetration enhancers are mixtures of the sodium salts of UDCA, capric acid and lauric acid in a ratio of about 1:2:2 respectively. Anther such penetration enhancer is a mixture of capric and lauric acid (or salts thereof) in a 0.01:1 to 1:0.01 ratio (mole basis). In particular embodiments capric acid and lauric acid are present in molar ratios of e.g. about 0.1:1 to about 1:0.1, in particular about 0.5:1 to about 1:0.5.
Other excipients include chelating agents, i.e. compounds that remove metallic ions from solution by forming complexes therewith, with the result that absorption of oligonucelotides through the alimentary and other mucosa is enhanced. With regards to their use as penetration enhancers in the present invention, chelating agents have the added advantage of also serving as DNase inhibitors, as most characterized DNA nucleases require a divalent metal ion for catalysis and are thus inhibited by chelating agents (Jarrett, J. Chromatogr., 1993, 618, 315). Chelating agents of the invention include, but are not limited to, disodium ethylenediaminetetraacetate (EDTA), citric acid, salicylates (e.g., sodium salicylate, 5-methoxysalicylate and homovanilate), N-acyl derivatives of collagen, laureth-9 and N-amino acyl derivatives of beta-diketones (enamines)(Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1; Buur et al., J. Control Rel., 1990, 14, 43).
As used herein, non-chelating non-surfactant penetration enhancers may be defined as compounds that demonstrate insignificant activity as chelating agents or as surfactants but that nonetheless enhance absorption of oligonucleotides through the alimentary and other mucosal membranes (Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1). This class of penetration enhancers includes, but is not limited to, unsaturated cyclic ureas, 1-alkyl- and 1-alkenylazacyclo-alkanone derivatives (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92); and non-steroidal anti-inflammatory agents such as diclofenac sodium, indomethacin and phenylbutazone (Yamashita et al., J. Pharm. Pharmacol., 1987, 39, 621).
Agents that enhance uptake of oligonucleotides at the cellular level may also be added to the pharmaceutical and other compositions of the present invention. For example, cationic lipids, such as lipofectin (Junichi et al, U.S. Pat. No. 5,705,188), cationic glycerol derivatives, and polycationic molecules, such as polylysine (Lollo et al., PCT Application WO 97/30731), can be used.
Some oral oligonucleotide compositions also incorporate carrier compounds in the formulation. As used herein, “carrier compound” or “carrier” can refer to a nucleic acid, or analog thereof, which may be inert (i.e., does not possess biological activity per se) or may be necessary for transport, recognition or pathway activation or mediation, or is recognized as a nucleic acid by in vivo processes that reduce the bioavailability of a nucleic acid having biological activity by, for example, degrading the biologically active nucleic acid or promoting its removal from circulation. The coadministration of a nucleic acid and a carrier compound, typically with an excess of the latter substance, can result in a substantial reduction of the amount of nucleic acid recovered in the liver, kidney or other extracirculatory reservoirs, presumably due to competition between the carrier compound and the nucleic acid for a common receptor. For example, the recovery of a partially phosphorothioate oligonucleotide in hepatic tissue can be reduced when it is coadministered with polyinosinic acid, dextran sulfate, polycytidic acid or 4-acetamido-4′ isothiocyano-stilbene-2, 2′-disulfonic acid (Miyao et al., Antisense Res. Dev., 1995, 5, 115; Takakura et al., Antisense & Nucl. Acid Drug Dev., 1996, 6, 177).
A “pharmaceutical carrier” or “excipient” may be a pharmaceutically acceptable solvent, suspending agent or any other pharmacologically inert vehicle for delivering one or more nucleic acids to an animal. The excipient may be liquid or solid and is selected, with the planned manner of administration in mind, so as to provide for the desired bulk, consistency, etc., when combined with a nucleic acid and the other components of a given pharmaceutical composition. Typical pharmaceutical carriers include, but are not limited to, binding agents (e.g., pregelatinised maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose, etc.); fillers (e.g., lactose and other sugars, microcrystalline cellulose, pectin, gelatin, calcium sulfate, ethyl cellulose, polyacrylates or calcium hydrogen phosphate, etc.); lubricants (e.g., magnesium stearate, talc, silica, colloidal silicon dioxide, stearic acid, metallic stearates, hydrogenated vegetable oils, corn starch, polyethylene glycols, sodium benzoate, sodium acetate, etc.); disintegrants (e.g., starch, sodium starch glycolate, EXPLOTABTM disintegrating agent); and wetting agents (e.g., sodium lauryl sulphate, etc.).
Oral oligonucleotide compositions may additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels. Thus, for example, the compositions may contain additional, compatible, pharmaceutically-active materials such as, for example, antipuritics, astringents, local anesthetics or anti-inflammatory agents, or may contain additional materials useful in physically formulating various dosage forms of the composition of present invention, such as dyes, flavoring agents, preservatives, antioxidants, opacifiers, thickening agents and stabilizers. However, such materials, when added, should not unduly interfere with the biological activities of the components of the compositions of the present invention.
Certain embodiments of the invention provide pharmaceutical compositions containing one or more oligomeric compounds and one or more other chemotherapeutic agents that function by a non-antisense mechanism. Examples of such chemotherapeutic agents include but are not limited to cancer chemotherapeutic drugs such as daunorubicin, daunomycin, dactinomycin, doxorubicin, epirubicin, idarubicin, esorubicin, bleomycin, mafosfamide, ifosfamide, cytosine ara-binoside, bis-chloroethylnitrosurea, busulfan, mitomycin C, actinomycin D, mithramycin, prednisone, hydroxyprogesterone, testosterone, tamoxifen, dacarbazine, procarbazine, hexamethylmelamine, pentamethylmelamine, mitoxantrone, amsacrine, chlorambucil, methylcyclohexylnitrosurea, nitrogen mustards, melphalan, cyclophosphamide, 6-mercaptopurine, 6-thioguanine, cytarabine, 5-azacytidine, hydroxyurea, deoxycoformycin, 4-hydroxyperoxycyclophosphoramide, 5-fluorouracil (5-FU), 5-fluorodeoxyuridine (5-FUdR), methotrexate (MTX), colchicine, taxol, vincristine, vinblastine, etoposide (VP-16), trimetrexate, irinotecan, topotecan, gemcitabine, teniposide, cisplatin and diethylstilbestrol (DES). When used with the compounds of the invention, such chemotherapeutic agents may be used individually (e.g., 5-FU and oligonucleotide), sequentially (e.g., 5-FU and oligonucleotide for a period of time followed by MTX and oligonucleotide), or in combination with one or more other such chemotherapeutic agents (e.g., 5-FU, MTX and oligonucleotide, or 5-FU, radiotherapy and oligonucleotide). Antiinflammatory drugs, including but not limited to nonsteroidal anti-inflammatory drugs and corticosteroids, and antiviral drugs, including but not limited to ribivirin, vidarabine, acyclovir and ganciclovir, may also be combined in compositions of the invention. Combinations of antisense compounds and other non-antisense drugs are also within the scope of this invention. Two or more combined compounds may be used together or sequentially.
In another related embodiment, compositions of the invention may contain one or more antisense compounds, particularly oligonucleotides, targeted to a first nucleic acid and one or more additional antisense compounds targeted to a second nucleic acid target. Alternatively, compositions of the invention may contain two or more antisense compounds targeted to different regions of the same nucleic acid target. Numerous examples of antisense compounds are known in the art. Two or more combined compounds may be used together or sequentially.
H. Dosing
The formulation of therapeutic compositions and their subsequent administration (dosing) is believed to be within the skill of those in the art. Dosing is dependent on severity and responsiveness of the disease state to be treated, with the course of treatment lasting from several days to several months, or until a cure is effected or a diminution of the disease state is achieved. Optimal dosing schedules can be calculated from measurements of drug accumulation in the body of the patient. Persons of ordinary skill can easily determine optimum dosages, dosing methodologies and repetition rates. Optimum dosages may vary depending on the relative potency of individual oligonucleotides, and can generally be estimated based on EC50s found to be effective in in vitro and in vivo animal models. In general, dosage is from 0.01 μg to 100 g per kg of body weight, from 0.1 μg to 10 g per kg of body weight, from 1.0 μg to 1 g per kg of body weight, from 10.0 μg to 100 mg per kg of body weight, from 100 μg to 10 mg per kg of body weight, or from 1 mg to 5 mg per kg of body weight and may be given once or more daily, weekly, monthly or yearly, or even once every 2 to 20 years. Persons of ordinary skill in the art can easily estimate repetition rates for dosing based on measured residence times and concentrations of the drug in bodily fluids or tissues. Following successful treatment, it may be desirable to have the patient undergo maintenance therapy to prevent the recurrence of the disease state, wherein the oligonucleotide is administered in maintenance doses, ranging from 0.01 μg to 100 g per kg of body weight, once or more daily, to once every 20 years.
The effects of treatments with therapeutic compositions can be assessed following collection of tissues or fluids from a patient or subject receiving said treatments. It is known in the art that a biopsy sample can be procured from certain tissues without resulting in detrimental effects to a patient or subject. In certain embodiments, a tissue and its constituent cells comprise, but are not limited to, blood (e.g., hematopoietic cells, such as human hematopoietic progenitor cells, human hematopoietic stem cells, CD34+ cells CD4+ cells), lymphocytes and other blood lineage cells, bone marrow, breast, cervix, colon, esophagus, lymph node, muscle, peripheral blood, oral mucosa and skin. In other embodiments, a fluid and its constituent cells comprise, but are not limited to, blood, urine, semen, synovial fluid, lymphatic fluid and cerebro-spinal fluid. Tissues or fluids procured from patients can be evaluated for expression levels of the target mRNA or protein. Additionally, the mRNA or protein expression levels of other genes known or suspected to be associated with the specific disease state, condition or phenotype can be assessed. mRNA levels can be measured or evaluated by real-time PCR, Northern blot, in situ hybridization or DNA array analysis. Protein levels can be measured or evaluated by ELISA, immunoblotting, quantitative protein assays, protein activity assays (for example, caspase activity assays) immunohistochemistry or immunocytochemistry.
Furthermore, the effects of treatment can be assessed by measuring biomarkers associated with the disease or condition in the aforementioned tissues and fluids, collected from a patient or subject receiving treatment, by routine clinical methods known in the art. These biomarkers include but are not limited to: glucose, cholesterol, lipoproteins, triglycerides, free fatty acids and other markers of glucose and lipid metabolism; liver transaminases, bilirubin, albumin, blood urea nitrogen, creatine and other markers of kidney and liver function; interleukins, tumor necrosis factors, intracellular adhesion molecules, C-reactive protein and other markers of inflammation; testosterone, estrogen and other hormones; tumor markers; vitamins, minerals and electrolytes.
While the present invention has been described with specificity in accordance with certain of its preferred embodiments, the following examples serve only to illustrate the invention and are not intended to limit the same. Each of the references, GENBANK® accession numbers, and the like recited in the present application is incorporated herein by reference in its entirety.
EXAMPLES
Example 1
Synthesis of Nucleoside Phosphoramidites
The following compounds, including amidites and their intermediates were prepared as described in U.S. Pat. No. 6,426,220 and International Patent Publication No. WO 02/36743; 5′-O-Dimethoxytrityl-thymidine intermediate for 5-methyl dC amidite, 5′-O-Dimethoxytrityl-2′-deoxy-5-methylcytidine intermediate for 5-methyl-dC amidite, 5′-O-Dimethoxytrityl-2′-deoxy-N-4-benzoyl-5-methylcytidine penultimate intermediate for 5-methyl dC amidite, [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-deoxy-N4-benzoyl-5-methylcytidin-3′-O-yl ]-2-cyanoethyl-N,N-diisopropylphosphoramidite (5-methyl dC amidite), 2′-Fluorodeoxyadenosine, 2′-Fluorodeoxyguanosine, 2′-Fluorouridine, 2′-Fluorodeoxycytidine, 2′-O-(2-Methoxyethyl) modified amidites, 2′-O-(2-methoxyethyl)-5-methyluridine intermediate, 5′-O-DMT-2′-O-(2-methoxyethyl)-5-methyluridine penultimate intermediate, [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-5-methyluridin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE T amidite), 5′-O-Dimethoxytrityl-2′-O-(2-methoxyethyl)-5-methylcytidine intermediate, 5′-O-dimethoxytrityl-2′-O-(2-methoxyethyl)-N4-benzoyl-5-methyl-cytidine penultimate intermediate, [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-N4-benzoyl-5-methylcytidin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE 5-Me-C amidite), [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-N6-benzoyladenosin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE A amdite), [5′-O-(4,4′-Dimethoxytriphenylmethyl)-2′-O-(2-methoxyethyl)-N4-isobutyrylguanosin-3′-O-yl]-2-cyanoethyl-N,N-diisopropylphosphoramidite (MOE G amidite), 2′-O-(Aminooxyethyl) nucleoside amidites and 2′-O-(dimethylamino-oxyethyl) nucleoside amidites, 2′-(Dimethylaminooxyethoxy) nucleoside amidites, 5′-O-tert-Butyldiphenylsilyl-O2-2′-anhydro-5-methyluridine, 5′-O-tert-Butyldiphenylsilyl-2′-O-(2-hydroxyethyl)-5-methyluridine, 2′-O-([2-phthalimidoxy)ethyl]-5′-t-butyldiphenylsilyl-5-methyluridine 5′-O-tert-butyldiphenylsilyl-2′-O-[(2-formadoximinooxy) ethyl]-5-methyluridine, 5′-O-tert-Butyldiphenylsilyl-2′-O-[N,N dimethylaminooxyethyl]-5-methyluridine, 2′-O-(dimethylaminooxyethyl)-5-methyluridine, 5′-O-DMT-2′-O-(dimethylaminooxyethyl)-5-methyluridine, 5′-O-DMT-2′-O-(2-N,N-dimethylaminooxyethyl)-5-methyluridine-3′-[(2-cyanoethyl)-N,N-diisopropylphosphoramidite], 2′-(Aminooxyethoxy) nucleoside amidites, N2-isobutyryl-6-O-diphenylcarbamoyl-2′-O-(2-ethylacetyl)-5′-O-(4,4′-dimethoxytrityl) guanosine-3′-[(2-cyanoethyl)-N,N-diisopropylphosphoramidite], 2′-dimethylaminoethoxyethoxy (2′-DMAEOE) nucleoside amidites, 2′-O-[2(2-N,N-dimethylaminoethoxy)ethyl]-5-methyl uridine, 5′-O-dimethoxytrityl-2′-O-[2(2-N,N-dimethylaminoethoxy)-ethyl)]-5-methyl uridine and 5′-O-Dimethoxytrityl-2′-O-[2(2-N,N-dimethylaminoethoxy)-ethyl)]-5-methyl uridine-3′-O-(cyanoethyl-N,N-diisopropyl)phosphoramidite.
Example 2
Oligonucleotide and Oligonucleoside Synthesis
The antisense compounds used in accordance with this invention may be conveniently and routinely made through the well-known technique of solid phase synthesis. Equipment for such synthesis is sold by several vendors including, for example, Applied Biosystems (Foster City, Calif.). Any other means for such synthesis known in the art may additionally or alternatively be employed. It is well known to use similar techniques to prepare oligonucleotides, such as the phosphorothioates and alkylated derivatives.
Oligonucleotides: Unsubstituted and substituted phosphodiester (P═O) oligonucleotides are synthesized on an automated DNA synthesizer (Applied Biosystems model 394) using standard phosphoramidite chemistry with oxidation by iodine.
Phosphorothioates (P═S) are synthesized similar to phosphodiester oligonucleotides with the following exceptions: thiation was effected by utilizing a 10% w/v solution of 3,H-1,2-benzodithiole-3-one 1,1-dioxide in acetonitrile for the oxidation of the phosphite linkages. The thiation reaction step time was increased to 180 seconds and preceded by the normal capping step. After cleavage from the CPG column and deblocking in concentrated ammonium hydroxide at 55° C. (12-16 hours), the oligonucleotides were recovered by precipitating with >3 volumes of ethanol from a 1 M NH4OAc solution. Phosphinate oligonucleotides are prepared as described in U.S. Pat. No. 5,508,270, herein incorporated by reference.
Alkyl phosphonate oligonucleotides are prepared as described in U.S. Pat. No. 4,469,863, herein incorporated by reference.
3′-Deoxy-3′-methylene phosphonate oligonucleotides are prepared as described in U.S. Pat. No. 5,610,289 or 5,625,050, herein incorporated by reference.
Phosphoramidite oligonucleotides are prepared as described in U.S. Pat. Nos. 5,256,775 or U.S. Pat. No. 5,366,878, herein incorporated by reference.
Alkylphosphonothioate oligonucleotides are prepared as described in International Patent Application Nos. PCT/US94/00902 and PCT/US93/06976 (published as WO 94/17093 and WO 94/02499, respectively), herein incorporated by reference.
3′-Deoxy-3′-amino phosphoramidate oligonucleotides are prepared as described in U.S. Pat. No. 5,476,925, herein incorporated by reference.
Phosphotriester oligonucleotides are prepared as described in U.S. Pat. No. 5,023,243, herein incorporated by reference.
Borano phosphate oligonucleotides are prepared as described in U.S. Pat. Nos. 5,130,302 and 5,177,198, both herein incorporated by reference.
Oligonucleosides: Methylenemethylimino linked oligonucleosides, also identified as MMI linked oligonucleosides, methylenedimethylhydrazo linked oligonucleosides, also identified as MDH linked oligonucleosides, and methylenecarbonylamino linked oligonucleosides, also identified as amide-3 linked oligonucleosides, and methyleneaminocarbonyl linked oligonucleosides, also identified as amide-4 linked oligonucleosides, as well as mixed backbone compounds having, for instance, alternating MMI and P═O or P═S linkages are prepared as described in U.S. Pat. Nos. 5,378,825, 5,386,023, 5,489,677, 5,602,240 and 5,610,289, all of which are herein incorporated by reference.
Formacetal and thioformacetal linked oligonucleosides are prepared as described in U.S. Pat. Nos. 5,264,562 and 5,264,564, herein incorporated by reference.
Ethylene oxide linked oligonucleosides are prepared as described in U.S. Pat. No. 5,223,618, herein incorporated by reference.
Example 3
RNA Synthesis
In general, RNA synthesis chemistry is based on the selective incorporation of various protecting groups at strategic intermediary reactions. Although one of ordinary skill in the art will understand the use of protecting groups in organic synthesis, a useful class of protecting groups includes silyl ethers. In particular bulky silyl ethers are used to protect the 5′-hydroxyl in combination with an acid-labile orthoester protecting group on the 2′-hydroxyl. This set of protecting groups is then used with standard solid-phase synthesis technology. It is important to lastly remove the acid labile orthoester protecting group after all other synthetic steps. Moreover, the early use of the silyl protecting groups during synthesis ensures facile removal when desired, without undesired deprotection of 2′ hydroxyl.
Following this procedure for the sequential protection of the 5′-hydroxyl in combination with protection of the 2′-hydroxyl by protecting groups that are differentially removed and are differentially chemically labile, RNA oligonucleotides were synthesized.
RNA oligonucleotides are synthesized in a stepwise fashion. Each nucleotide is added sequentially (3′- to 5′-direction) to a solid support-bound oligonucleotide. The first nucleoside at the 3′-end of the chain is covalently attached to a solid support. The nucleotide precursor, a ribonucleoside phosphoramidite, and activator are added, coupling the second base onto the 5′-end of the first nucleoside. The support is washed and any unreacted 5′-hydroxyl groups are capped with acetic anhydride to yield 5′-acetyl moieties. The linkage is then oxidized to the more stable and ultimately desired P(V) linkage. At the end of the nucleotide addition cycle, the 5′-silyl group is cleaved with fluoride. The cycle is repeated for each subsequent nucleotide.
Following synthesis, the methyl protecting groups on the phosphates are cleaved in 30 minutes utilizing 1 M disodium-2-carbamoyl-2-cyanoethylene-1,1-dithiolate trihydrate (S2Na2) in DMF. The deprotection solution is washed from the solid support-bound oligonucleotide using water. The support is then treated with 40% methylamine in water for 10 minutes at 55° C. This releases the RNA oligonucleotides into solution, deprotects the exocyclic amines, and modifies the 2′-groups. The oligonucleotides can be analyzed by anion exchange HPLC at this stage.
The 2′-orthoester groups are the last protecting groups to be removed. The ethylene glycol monoacetate orthoester protecting group developed by Dharmacon Research, Inc. (Lafayette, Colo.), is one example of a useful orthoester protecting group, which has the following important properties. It is stable to the conditions of nucleoside phosphoramidite synthesis and oligonucleotide synthesis. However, after oligonucleotide synthesis the oligonucleotide is treated with methylamine, which not only cleaves the oligonucleotide from the solid support but also removes the acetyl groups from the orthoesters. The resulting 2-ethyl-hydroxyl substituents on the orthoester are less electron withdrawing than the acetylated precursor. As a result, the modified orthoester becomes more labile to acid-catalyzed hydrolysis. Specifically, the rate of cleavage is approximately 10 times faster after the acetyl groups are removed. Therefore, this orthoester possesses sufficient stability in order to be compatible with oligonucleotide synthesis. Yet, when subsequently modified, this orthoester permits deprotection to be carried out under relatively mild aqueous conditions compatible with the final RNA oligonucleotide product.
Additionally, methods of RNA synthesis are well known in the art (Scaringe, S. A. Ph.D. Thesis, University of Colorado, 1996; Scaringe, S. A., et al., J. Am. Chem. Soc., 1998, 120, 11820-11821; Matteucci, M. D. and Caruthers, M. H. J. Am. Chem. Soc., 1981, 103, 3185-3191; Beaucage, S. L. and Caruthers, M. H. Tetrahedron Lett., 1981, 22, 1859-1862; Dahl, B. J., et al., Acta Chem. Scand,. 1990, 44, 639-641; Reddy, M. P., et al., Tetrahedrom Lett., 1994, 25, 4311-4314; Wincott, F. et al., Nucleic Acids Res., 1995, 23, 2677-2684; Griffin, B. E., et al., Tetrahedron, 1967, 23, 2301-2313; Griffin, B. E., et al., Tetrahedron, 1967, 23, 2315-2331).
RNA antisense compounds (RNA oligonucleotides) of the present invention can be synthesized by the methods herein or purchased from Dharmacon Research, Inc (Lafayette, Colo.). Once synthesized, complementary RNA antisense compounds can then be annealed by methods known in the art to form double stranded (duplexed) antisense compounds. For example, duplexes can be formed by combining 30 μl of each of the complementary strands of RNA oligonucleotides (50 uM RNA oligonucleotide solution) and 15 μl of 5× annealing buffer (100 mM potassium acetate, 30 mM HEPES-KOH pH 7.4, 2 mM magnesium acetate) followed by heating for 1 minute at 90° C., then 1 hour at 37° C. The resulting duplexed antisense compounds can be used in kits, assays, screens, or other methods to investigate the role of a target nucleic acid.
Example 4
Synthesis of Chimeric Oligonucleotides
Chimeric oligonucleotides, oligonucleosides or mixed oligonucleotides/oligonucleosides of the invention can be of several different types. These include a first type wherein the “gap” segment of linked nucleosides is positioned between 5′ and 3′ “wing” segments of linked nucleosides and a second “open end” type wherein the “gap” segment is located at either the 3′ or the 5′ terminus of the oligomeric compound. Oligonucleotides of the first type are also known in the art as “gapmers” or gapped oligonucleotides. Oligonucleotides of the second type are also known in the art as “hemimers” or “wingmers”.
[2′-O-Me]-[2′-deoxy]-[2′-O-Me] Chimeric Phosphorothioate Oligonucleotides
Chimeric oligonucleotides having 2′-O-alkyl phosphorothioate and 2′-deoxy phosphorothioate oligonucleotide segments are synthesized using an Applied Biosystems automated DNA synthesizer Model 394, as above. Oligonucleotides are synthesized using the automated synthesizer and 2′-deoxy-5′-dimethoxytrityl-3′-O-phosphoramidite for the DNA portion and 5′-dimethoxytrityl-2′-O-methyl-3′-O-phosphoramidite for 5′ and 3′ wings. The standard synthesis cycle is modified by incorporating coupling steps with increased reaction times for the 5′-dimethoxytrityl-2′-O-methyl-3′-O-phosphoramidite. The fully protected oligonucleotide is cleaved from the support and deprotected in concentrated ammonia (NH4OH) for 12-16 hours at 55° C. The deprotected oligo is then recovered by an appropriate method (precipitation, column chromatography, volume reduced in vacuo and analyzed spetrophotometrically for yield and for purity by capillary electrophoresis and by mass spectrometry.
[2′-O-(2-Methoxyethyl)]-[2′-deoxy]-[2′-O-(Methoxyethyl)] Chimeric Phosphorothioate Oligonucleotides
[2′-O-(2-methoxyethyl)]-[2′-deoxy]-[-2′-O-(methoxyethyl)] chimeric phosphorothioate oligonucleotides were prepared as per the procedure above for the 2′-O-methyl chimeric oligonucleotide, with the substitution of 2′-O-(methoxyethyl) amidites for the 2′-O-methyl amidites.
[2′-O-(2-Methoxyethyl)Phosphodiester]-[2′-deoxy Phosphorothioate]-[2′-O-(2-Methoxyethyl) Phosphodiester] Chimeric Oligonucleotides
[2′-O-(2-methoxyethyl phosphodiester]-[2′-deoxy phosphorothioate]-[2′-O-(methoxyethyl) phosphodiester] chimeric oligonucleotides are prepared as per the above procedure for the 2′-O-methyl chimeric oligonucleotide with the substitution of 2′-O-(methoxyethyl) amidites for the 2′-O-methyl amidites, oxidation with iodine to generate the phosphodiester internucleotide linkages within the wing portions of the chimeric structures and sulfurization utilizing 3,H-1,2 benzodithiole-3-one 1,1 dioxide (Beaucage Reagent) to generate the phosphorothioate internucleotide linkages for the center gap.
Other chimeric oligonucleotides, chimeric oligonucleosides and mixed chimeric oligonucleotides/oligonucleosides are synthesized according to U.S. Pat. No. 5,623,065, herein incorporated by reference.
Example 5
Design and Screening of Duplexed Antisense Compounds Targeting C-Reactive Protein
In accordance with the present invention, a series of nucleic acid duplexes comprising the antisense compounds of the present invention and their complements can be designed to target C-reactive protein. The nucleobase sequence of the antisense strand of the duplex comprises at least an 8-nucleobase portion of an oligonucleotide in Table 1. The ends of the strands may be modified by the addition of one or more natural or modified nucleobases to form an overhang. The sense strand of the dsRNA is then designed and synthesized as the complement of the antisense strand and may also contain modifications or additions to either terminus. For example, in one embodiment, both strands of the dsRNA duplex are complementary over the central nucleobases, each having overhangs at one or both termini. The antisense and sense strands of the duplex comprise from about 17 to 25 nucleotides, or from about 19 to 23 nucleotides. Alternatively, the antisense and sense strands comprise 20, 21 or 22 nucleotides.
For example, a duplex comprising an antisense strand having the sequence CGAGAGGCGGACGGGACCG (SEQ ID NO: 624) and having a two-nucleobase overhang of deoxythymidine(dT) has the following structure (Antisense SEQ ID NO: 625, Complement SEQ ID NO: 626):




Overhangs can range from 2 to 6 nucleobases and these nucleobases may or may not be complementary to the target nucleic acid. In another embodiment, the duplexes may have an overhang on only one terminus.
In another embodiment, a duplex comprising an antisense strand having the same sequence CGAGAGGCGGACGGGACCG (SEQ ID NO: 624) is prepared with blunt ends (no single stranded overhang) as shown (Antisense SEQ ID NO: 624, Complement SEQ ID NO: 627):




The RNA duplex can be unimolecular or bimolecular; i.e., the two strands can be part of a single molecule or may be separate molecules.
RNA strands of the duplex can be synthesized by methods disclosed herein or purchased from Dharmacon Research Inc., (Lafayette, Colo.). Once synthesized, the complementary strands are annealed. The single strands are aliquoted and diluted to a concentration of 50 μM. Once diluted, 30 μL of each strand is combined with 15 μL of a 5× solution of annealing buffer. The final concentration of said buffer is 100 mM potassium acetate, 30 mM HEPES-KOH pH 7.4, and 2 mM magnesium acetate. The final volume is 75 μL. This solution is incubated for 1 minute at 90° C. and then centrifuged for 15 seconds. The tube is allowed to sit for 1 hour at 37° C. at which time the dsRNA duplexes are used in experimentation. The final concentration of the dsRNA duplex is 20 μM. This solution can be stored frozen (−20° C.) and freeze-thawed up to 5 times.
Once prepared, the duplexed antisense compounds are evaluated for their ability to modulate C-reactive protein expression.
When cells reached 80% confluency, they are treated with duplexed antisense compounds of the invention. For cells grown in 96-well plates, wells are washed once with 200 μL OPTI-MEMTM-1 reduced-serum medium (Gibco BRL) and then treated with 130 μL of OPTI-MEMTM-1 medium containing 12 μg/mL LIPOFECTINTM reagent (Gibco BRL) and the desired duplex antisense compound at a final concentration of 200 nM. After 5 hours of treatment, the medium is replaced with fresh medium. Cells are harvested 16 hours after treatment, at which time RNA is isolated and target reduction measured by RT-PCR.
Example 6
Oligonucleotide Isolation
After cleavage from the controlled pore glass solid support and deblocking in concentrated ammonium hydroxide at 55° C. for 12-16 hours, the oligonucleotides or oligonucleosides are recovered by precipitation out of 1 M NH4OAc with >3 volumes of ethanol. Synthesized oligonucleotides were analyzed by electrospray mass spectroscopy (molecular weight determination) and by capillary gel electrophoresis and judged to be at least 70% full-length material. The relative amounts of phosphorothioate and phosphodiester linkages obtained in the synthesis were determined by the ratio of correct molecular weight relative to the −16 amu product (+/−32+/−48). For some studies oligonucleotides were purified by HPLC, as described by Chiang et al., J. Biol. Chem. 1991, 266, 18162-18171. Results obtained with HPLC-purified material were similar to those obtained with non-HPLC purified material.
Example 7
Oligonucleotide Synthesis—96 Well Plate Format
Oligonucleotides were synthesized via solid phase P(III) phosphoramidite chemistry on an automated synthesizer capable of assembling 96 sequences simultaneously in a 96-well format. Phosphodiester internucleotide linkages were afforded by oxidation with aqueous iodine. Phosphorothioate internucleotide linkages were generated by sulfurization utilizing 3,H-1,2 benzodithiole-3-one 1,1 dioxide (Beaucage Reagent) in anhydrous acetonitrile. Standard base-protected beta-cyanoethyl-diiso-propyl phosphoramidites were purchased from commercial vendors (e.g. PE-Applied Biosystems, Foster City, Calif., or Pharmacia, Piscataway, N.J.). Non-standard nucleosides are synthesized as per standard or patented methods. They are utilized as base protected beta-cyanoethyldiisopropyl phosphoramidites.
Oligonucleotides were cleaved from support and deprotected with concentrated NH4OH at elevated temperature (55-60° C.) for 12-16 hours and the released product then dried in vacuo. The dried product was then re-suspended in sterile water to afford a master plate from which all analytical and test plate samples are then diluted utilizing robotic pipettors.
Example 8
Oligonucleotide Analysis—96-Well Plate Format
The concentration of oligonucleotide in each well was assessed by dilution of samples and UV absorption spectroscopy. The full-length integrity of the individual products was evaluated by capillary electrophoresis (CE) in either the 96-well format (Beckman P/ACETM MDQ apparatus) or, for individually prepared samples, on a commercial CE apparatus (e.g., Beckman P/ACETM 5000, ABI 270 apparatus). Base and backbone composition was confirmed by mass analysis of the compounds utilizing electrospray-mass spectroscopy. All assay test plates were diluted from the master plate using single and multi-channel robotic pipettors. Plates were judged to be acceptable if at least 85% of the compounds on the plate were at least 85% full length.
Example 9
Cell Culture and Oligonucleotide Treatment
The effect of antisense compounds on target nucleic acid expression can be tested in any of a variety of cell types provided that the target nucleic acid is present at measurable levels. This can be routinely determined using, for example, PCR or Northern blot analysis. The following cell types are provided for illustrative purposes, but other cell types can be routinely used, provided that the target is expressed in the cell type chosen. This can be readily determined by methods routine in the art, for example Northern blot analysis, ribonuclease protection assays, or RT-PCR.
T-24 Cells:
The human transitional cell bladder carcinoma cell line T-24 was obtained from the American Type Culture Collection (ATCC) (Manassas, Va.). T-24 cells were routinely cultured in complete McCoy's 5A basal media (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), penicillin 100 units per mL, and streptomycin 100 micrograms per mL (Invitrogen Corporation, Carlsbad, Calif.). Cells were routinely passaged by trypsinization and dilution when they reached 90% confluence. Cells were seeded into 96-well plates (Falcon-Primaria #353872) at a density of 7000 cells/well for use in RT-PCR analysis.
For Northern blotting or other analysis, cells may be seeded onto 100 mm or other standard tissue culture plates and treated similarly, using appropriate volumes of medium and oligonucleotide.
A549 Cells:
The human lung carcinoma cell line A549 was obtained from the American Type Culture Collection (ATCC) (Manassas, Va.). A549 cells were routinely cultured in DMEM basal media (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), penicillin 100 units per mL, and streptomycin 100 micrograms per mL (Invitrogen Corporation, Carlsbad, Calif.). Cells were routinely passaged by trypsinization and dilution when they reached 90% confluence.
NHDF Cells:
Human neonatal dermal fibroblast (NHDF) were obtained from the Clonetics Corporation (Walkersville, Md.). NHDFs were routinely maintained in Fibroblast Growth Medium (Clonetics Corporation, Walkersville, Md.) supplemented as recommended by the supplier. Cells were maintained for up to 10 passages as recommended by the supplier.
HEK Cells:
Human embryonic keratinocytes (HEK) were obtained from the Clonetics Corporation (Walkersville, Md.). HEKs were routinely maintained in Keratinocyte Growth Medium (Clonetics Corporation, Walkersville, Md.) formulated as recommended by the supplier. Cells were routinely maintained for up to 10 passages as recommended by the supplier.
Hep3B Cells:
The human hepatoma cell line Hep3B (Hep3B2.1-7) was obtained from the American Type Culture Collection (ATCC Catalog # HB-8064; Manassas, Va.). This cell line was initially derived from a hepatocellular carcinoma of an 8-yr-old black male. The cells are epithelial in morphology and are tumorigenic in nude mice. These cells can be induced to produce C-reactive protein by addition of media containing 1 μM dexamethasone (Sigma-Catalog #D2915 St. Louis, Mo.), 400 U/ml IL1B (Sigma-Catalog #19401) and 200 U/ml IL6 (Sigma-Catalog#1139), according to the protocol described by Lozanski, et al., (Cytokine, vol. 8, 1996 pp.534-540). Hep3B cells were routinely cultured in Minimum Essential Medium (MEM) with Earle's Balanced Salt Solution, 2 mM L-glutamine, 1.5 g/L sodium bicarbonate, 0.1 mM nonessential amino acids, 1.0 mM sodium pyruvate (ATCC #20-2003, Manassas, Va.) and with 10% heat-inactivated fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.). Cells were routinely passaged by trypsinization and dilution when they reached 90% confluence.
In order to determine antisense oligonucleotide inhibition of induced C-reactive protein, Hep3B cells were plated at a density of 100,000 cells into each well of a 6 well plate (Primaria, Franklin N.J., Catalog# 3846) in MEM supplemented with 10% fetal bovine serum and allowed to attach overnight. The next day, cells were induced to produce C-reactive protein for 24 hours in regular media supplemented with a final concentration of 1 μM dexamethasone, 400 U/ml IL1B and 200 U/ml IL6 as described above. At the end of this induction period, the media was removed and cells treated for 4 hrs with 50-150 nM of antisense oligonucleotide and 3.0-4.5 μg LIPOFECTINTM reagent in MEM alone (minus) serum supplemented with the three cytokines. At the end of the 4-hour drug treatment, the media was removed and fresh MEM containing FCS and cytokines was added to each well and allowed to sit for an additional 20 hrs. RNA was harvested 24 hrs after treatment with oligonucleotide using the QIAGEN® RNeasy (Qiagen Ltd, Valencia, Calif.) procedure and C-reactive protein RNA detected using RT-PCR analysis.
Primary Rat Hepatocytes:
Primary rat hepatocytes were prepared from Sprague-Dawley rats purchased from Charles River Labs (Wilmington, Mass.) and were routinely cultured in DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units per ml penicillin, and 100 micrograms per ml streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were cultured to 80% confluence for use in antisense oligonucleotide transfection experiments.
Primary Rabbit Hepatocytes:
Primary rabbit hepatocytes from New Zealand White rabbits were purchased from InVitro Technologies (Baltimore, Md.) and were routinely cultured in DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units per ml penicillin, and 100 micrograms per ml streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Primary rabbit hepatocytes are purchased and transfected at 100% confluency.
Primary Mouse Hepatocytes:
Primary mouse hepatocytes were prepared from Balb/c mice purchased from Charles River Labs (Wilmington, Mass.) and were routinely cultured in DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units per ml penicillin, and 100 micrograms per ml streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were cultured to 80% confluence for use in antisense oligonucleotide transfection experiments.
Primary Human Hepatocytes:
Pre-plated primary human hepatocytes were purchased from InVitro Technologies (Baltimore, Md.). Cells were cultured in high-glucose DMEM (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units/mL penicillin and 100 μg/mL streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were transfected with oligonucleotide upon receipt from the vendor.
Primary Cynomolgus Monkey Hepatocytes:
Pre-plated primary Cynomolgus monkey hepatocytes were purchased from InVitro Technologies (Baltimore, Md.). Cells were cultured in high-glucose DMEM (Invitrogen Corporation, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Corporation, Carlsbad, Calif.), 100 units/mL penicillin and 100 μg/mL streptomycin (Invitrogen Corporation, Carlsbad, Calif.). Cells were treated with oligonucleotide upon receipt from the vendor.
Treatment with Antisense Compounds:
When cells reached 65-75% confluency, they were treated with oligonucleotide. For cells grown in 96-well plates, wells were washed once with 100 μL OPTI-MEMTM-1 reduced-serum medium or with serum-free DMEM, high glucose (Invitrogen Corporation, Carlsbad, Calif.) and then treated with 130 μL of OPTI-MEMTM-1 medium containing 3.75 μg/mL LIPOFECTINTM reagent (Invitrogen Corporation, Carlsbad, Calif.) and the desired concentration of oligonucleotide. Cells are treated and data are obtained in triplicate. After 4-7 hours of treatment at 37° C., the medium was replaced with fresh medium. Cells were harvested 16-24 hours after oligonucleotide treatment.
The concentration of oligonucleotide used varies from cell line to cell line. To determine the optimal oligonucleotide concentration for a particular cell line, the cells are treated with a positive control oligonucleotide at a range of concentrations. For human cells the positive control oligonucleotide is selected from either ISIS 13920 (TCCGTCATCGCTCCTCAGGG, SEQ ID NO: 1), which is targeted to human H-ras, or ISIS 18078, (GTGCGCGCGAGCCCGAAATC, SEQ ID NO: 2) which is targeted to human Jun-N-terminal kinase-2 (JNK2). Both controls are 2′-O-methoxyethyl gapmers (2′-O-methoxyethyls shown in bold) with a phosphorothioate backbone. For mouse or rat cells the positive control oligonucleotide is ISIS 15770, ATGCATTCTGCCCCCAAGGA, SEQ ID NO: 3, a 2′-O-methoxyethyl gapmer (2′-O-methoxyethyls shown in bold) with a phosphorothioate backbone which is targeted to both mouse and rat c-raf. The concentration of positive control oligonucleotide that results in 80% inhibition of c-H-ras (for ISIS 13920), JNK2 (for ISIS 18078) or c-raf (for ISIS 15770) mRNA is then utilized as the screening concentration for new oligonucleotides in subsequent experiments for that cell line. If 80% inhibition is not achieved, the lowest concentration of positive control oligonucleotide that results in 60% inhibition of c-H-ras, JNK2 or c-raf mRNA is then utilized as the oligonucleotide screening concentration in subsequent experiments for that cell line. If 60% inhibition is not achieved, that particular cell line is deemed as unsuitable for oligonucleotide transfection experiments. The concentrations of antisense oligonucleotides used herein are from 50 nM to 300 nM.
Example 10
Analysis of Oligonucleotide Inhibition of C-Reactive Protein Expression
Antisense modulation of C-reactive protein expression can be assayed in a variety of ways known in the art. For example, C-reactive protein mRNA levels can be quantitated by, e.g., Northern blot analysis, competitive polymerase chain reaction (PCR), or real-time PCR (RT-PCR). Real-time quantitative PCR is presently preferred. RNA analysis can be performed on total cellular RNA or poly(A)+ mRNA. The preferred method of RNA analysis of the present invention is the use of total cellular RNA as described in other examples herein. Methods of RNA isolation are well known in the art. Northern blot analysis is also routine in the art. Real-time quantitative (PCR) can be conveniently accomplished using the commercially available ABI PRISMTM 7600, 7700, or 7900 Sequence Detection System, available from PE-Applied Biosystems, Foster City, Calif. and used according to manufacturer's instructions.
Protein levels of C-reactive protein can be quantitated in a variety of ways well known in the art, such as immunoprecipitation, Western blot analysis (immunoblotting), enzyme-linked immunosorbent assay (ELISA) or fluorescence-activated cell sorting (FACS). Antibodies directed to C-reactive protein can be identified and obtained from a variety of sources, such as the MSRS catalog of antibodies (Aerie Corporation, Birmingham, Mich.), or can be prepared via conventional monoclonal or polyclonal antibody generation methods well known in the art.
Example 11
Design of Phenotypic Assays for the use of C-Reactive Protein Inhibitors
Once C-reactive protein inhibitors have been identified by the methods disclosed herein, the compounds are further investigated in one or more phenotypic assays, each having measurable endpoints predictive of efficacy in the treatment of a particular disease state or condition. Phenotypic assays, kits and reagents for their use are well known to those skilled in the art and are herein used to investigate the role and/or association of C-reactive protein in health and disease. Representative phenotypic assays, which can be purchased from any one of several commercial vendors, include those for determining cell viability, cytotoxicity, proliferation or cell survival (Molecular Probes, Eugene, Oreg.; PerkinElmer, Boston, Mass.), protein-based assays including enzymatic assays (Panvera, LLC, Madison, Wis.; BD Biosciences, Franklin Lakes, N.J.; Oncogene Research Products, San Diego, Calif.), cell regulation, signal transduction, inflammation, oxidative processes and apoptosis (Assay Designs Inc., Ann Arbor, Mich.), triglyceride accumulation (Sigma-Aldrich, St. Louis, Mo.), angiogenesis assays, tube formation assays, cytokine and hormone assays and metabolic assays (Chemicon International Inc., Temecula, Calif.; Amersham Biosciences, Piscataway, N.J.)
In one non-limiting example, cells determined to be appropriate for a particular phenotypic assay (i.e., MCF-7 cells selected for breast cancer studies; adipocytes for obesity studies) are treated with C-reactive protein inhibitors identified from the in vitro studies as well as control compounds at optimal concentrations which are determined by the methods described above. At the end of the treatment period, treated and untreated cells are analyzed by one or more methods specific for the assay to determine phenotypic outcomes and endpoints.
Phenotypic endpoints include changes in cell morphology over time or treatment dose as well as changes in levels of cellular components such as proteins, lipids, nucleic acids, hormones, saccharides or metals. Measurements of cellular status, which include pH, stage of the cell cycle, intake or excretion of biological indicators by the cell, are also endpoints of interest.
Analysis of the genotype of the cell (measurement of the expression of one or more of the genes of the cell) after treatment is also used as an indicator of the efficacy or potency of the C-reactive protein inhibitors. Hallmark genes, or those genes suspected to be associated with a specific disease state, condition, or phenotype, are measured in both treated and untreated cells.
The cells subjected to the phenotypic assays described herein derive from in vitro cultures or from tissues or fluids isolated from living organisms, both human and non-human. In certain embodiments, a tissue and its constituent cells comprise, but are not limited to, blood (e.g., hematopoietic cells, such as human hematopoietic progenitor cells, human hematopoietic stem cells, CD34+cells CD4+cells), lymphocytes and other blood lineage cells, bone marrow, brain, stem cells, blood vessel, liver, lung, bone, breast, cartilage, cervix, colon, cornea, embryonic, endometrium, endothelial, epithelial, esophagus, facia, fibroblast, follicular, ganglion cells, glial cells, goblet cells, kidney, lymph node, muscle, neuron, ovaries, pancreas, peripheral blood, prostate, skin, skin, small intestine, spleen, stomach, testes and fetal tissue. In other embodiments, a fluid and its constituent cells comprise, but are not limited to, blood, urine, synovial fluid, lymphatic fluid and cerebro-spinal fluid. The phenotypic assays may also be performed on tissues treated with C-reactive protein inhibitors ex vivo.
Example 12
RNA Isolation
Poly(A)+ mRNA Isolation
Poly(A)+ mRNA was isolated according to Miura et al., (Clin. Chem., 1996, 42, 1758-1764). Other methods for poly(A)+ mRNA isolation are routine in the art. Briefly, for cells grown on 96-well plates, growth medium was removed from the cells and each well was washed with 200 μL cold PBS. 60 μL lysis buffer (10 mM Tris-HCl, pH 7.6, 1 mM EDTA, 0.5 M NaCl, 0.5% NP-40, 20 mM vanadyl-ribonucleoside complex) was added to each well, the plate was gently agitated and then incubated at room temperature for five minutes. 55 μL of lysate was transferred to Oligo d(T) coated 96-well plates (AGCT Inc., Irvine Calif.). Plates were incubated for 60 minutes at room temperature, washed 3 times with 200 μL of wash buffer (10 mM Tris-HCl pH 7.6, 1 mM EDTA, 0.3 M NaCl). After the final wash, the plate was blotted on paper towels to remove excess wash buffer and then air-dried for 5 minutes. 60 μL of elution buffer (5 mM Tris-HCl pH 7.6), preheated to 70° C., was added to each well, the plate was incubated on a 90° C. hot plate for 5 minutes, and the eluate was then transferred to a fresh 96-well plate.
Cells grown on 100 mm or other standard plates may be treated similarly, using appropriate volumes of all solutions.
Total RNA Isolation
Total RNA was isolated using an RNEASY 96TM kit and buffers purchased from Qiagen Inc. (Valencia, Calif.) following the manufacturer's recommended procedures. Briefly, for cells grown on 96-well plates, growth medium was removed from the cells and each well was washed with 200 μL cold PBS. 150 μL Buffer RLT was added to each well and the plate vigorously agitated for 20 seconds. 150 μL of 70% ethanol was then added to each well and the contents mixed by pipetting three times up and down. The samples were then transferred to the RNEASY 96TM well plate attached to a QIAVACTM manifold fitted with a waste collection tray and attached to a vacuum source. Vacuum was applied for 1 minute. 500 μL of Buffer RW1 was added to each well of the RNEASY 96TM plate and incubated for 15 minutes and the vacuum was again applied for 1 minute. An additional 500 μL of Buffer RW1 was added to each well of the RNEASY 96TM plate and the vacuum was applied for 2 minutes. 1 mL of Buffer RPE was then added to each well of the RNEASY 96TM plate and the vacuum applied for a period of 90 seconds. The Buffer RPE wash was then repeated and the vacuum was applied for an additional 3 minutes. The plate was then removed from the QIAVACTM manifold and blotted dry on paper towels. The plate was then re-attached to the QIAVACTM manifold fitted with a collection tube rack containing 1.2 mL collection tubes. RNA was then eluted by pipetting 140 μL of RNAse free water into each well, incubating 1 minute, and then applying the vacuum for 3 minutes.
The repetitive pipetting and elution steps may be automated using a QIAGEN® BIO-ROBOTTM 9604-(Qiagen, Inc., Valencia Calif.). Essentially, after lysing of the cells on the culture plate, the plate is transferred to the robot deck where the pipetting, DNase treatment and elution steps are carried out.
Example 13
Real-Time Quantitative PCR Analysis of C-Reactive Protein mRNA Levels
Quantitation of C-reactive protein mRNA levels was accomplished by real-time quantitative PCR using the ABI PRISMTM 7600, 7700, or 7900 Sequence Detection System (PE-Applied Biosystems, Foster City, Calif.) according to manufacturer's instructions. This is a closed-tube, non-gel-based, fluorescence detection system which allows high-throughput quantitation of polymerase chain reaction (PCR) products in real-time. As opposed to standard PCR in which amplification products are quantitated after the PCR is completed, products in real-time quantitative PCR are quantitated as they accumulate. This is accomplished by including in the PCR reaction an oligonucleotide probe that anneals specifically between the forward and reverse PCR primers, and contains two fluorescent dyes. A reporter dye (e.g., FAM or JOE, obtained from either PE-Applied Biosystems, Foster City, Calif., Operon Technologies Inc., Alameda, Calif. or Integrated DNA Technologies Inc., Coralville, Iowa) is attached to the 5′ end of the probe and a quencher dye (e.g., TAMRA, obtained from either PE-Applied Biosystems, Foster City, Calif., Operon Technologies Inc., Alameda, Calif. or Integrated DNA Technologies Inc., Coralville, Iowa) is attached to the 3′ end of the probe. When the probe and dyes are intact, reporter dye emission is quenched by the proximity of the 3′ quencher dye. During amplification, annealing of the probe to the target sequence creates a substrate that can be cleaved by the 5′-exonuclease activity of Taq polymerase. During the extension phase of the PCR amplification cycle, cleavage of the probe by Taq polymerase releases the reporter dye from the remainder of the probe (and hence from the quencher moiety) and a sequence-specific fluorescent signal is generated. With each cycle, additional reporter dye molecules are cleaved from their respective probes, and the fluorescence intensity is monitored at regular intervals by laser optics built into the ABI PRISMTM Sequence Detection System. In each assay, a series of parallel reactions containing serial dilutions of mRNA from untreated control samples generates a standard curve that is used to quantitate the percent inhibition after antisense oligonucleotide treatment of test samples.
Prior to quantitative PCR analysis, primer-probe sets specific to the target gene being measured are evaluated for their ability to be “multiplexed” with a GAPDH amplification reaction. In multiplexing, both the target gene and the internal standard gene GAPDH are amplified concurrently in a single sample. In this analysis, mRNA isolated from untreated cells is serially diluted. Each dilution is amplified in the presence of primer-probe sets specific for GAPDH only, target gene only (“single-plexing”), or both (multiplexing). Following PCR amplification, standard curves of GAPDH and target mRNA signal as a function of dilution are generated from both the single-plexed and multiplexed samples. If both the slope and correlation coefficient of the GAPDH and target signals generated from the multiplexed samples fall within 10% of their corresponding values generated from the single-plexed samples, the primer-probe set specific for that target is deemed multiplexable. Other methods of PCR are also known in the art.
Gene target quantities are obtained by reverse-transcriptase, real-time PCR. Prior to the real-time PCR, isolated RNA is subjected to a reverse transcriptase (RT) reaction, for the purpose of generating complementary DNA (cDNA). Reverse transcriptase and real-time PCR reagents were obtained from Invitrogen Corporation, (Carlsbad, Calif.). RT, real-time PCR reactions were carried out by adding 20 μL PCR cocktail (2.5× PCR buffer minus MgCl2, 6.6 mM MgCl2, 375 μM each of dATP, dCTP, dCTP and dGTP, 375 nM each of forward primer and reverse primer, 125 nM of probe, 4 Units RNAse inhibitor, 1.25 Units PLATINUM® Taq, 5 Units MuLV reverse transcriptase, and 2.5×ROX dye) to 96-well plates containing 30 μL total RNA solution (20-200 ng). The RT reaction was carried out by incubation for 30 minutes at 48° C. Following a 10 minute incubation at 95° C. to activate the PLATINUM® Taq, 40 cycles of a two-step PCR protocol were carried out: 95° C. for 15 seconds (denaturation) followed by 60° C. for 1.5 minutes (annealing/extension). This method of obtaining gene target quantities is herein referred to as real-time PCR.
Gene target quantities obtained by real-time PCR are normalized using either the expression level of GAPDH, a gene whose expression is constant, or by quantifying total RNA using RiboGreen reagent (Molecular Probes, Inc. Eugene, Oreg.). GAPDH expression is quantified by real-time PCR by being run simultaneously with the target, multiplexing, or separately. Total RNA is quantified using RiboGreenTM RNA quantification reagent (Molecular Probes, Inc. Eugene, Oreg.). Methods of RNA quantification by RiboGreen reagent are taught in Jones, L. J., et al, (Analytical Biochemistry, 1998, 265, 368-374).
In this assay, 170 μL of RiboGreenTM working reagent (RiboGreenTM reagent diluted 1:350 in 10 mM Tris-HCl, 1 mM EDTA, pH 7.5) is pipetted into a 96-well plate containing 30 μL purified, cellular RNA. The plate is read in a CytoFluor 4000 reader (PE Applied Biosystems) with excitation at 485 nm and emission at 530 nm.
Probes and primers to human C-reactive protein were designed to hybridize to a human C-reactive protein sequence, using published sequence information (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). For human C-reactive protein the PCR primers were: forward primer: TGACCAGCCTCTCTCATGCTT (SEQ ID NO: 5) reverse primer: TCCGACTCTTTGGGAAACACA (SEQ ID NO: 6) and the PCR probe was: FAM-TGTCGAGGAAGGCTT-TAMRA (SEQ ID NO: 7) where FAM is the fluorescent dye and TAMRA is the quencher dye. For human GAPDH the PCR primers were: forward primer: GAAGGTGAAGGTCGGAGTC(SEQ ID NO: 8) reverse primer: GAAGATGGTGATGGGATTTC (SEQ ID NO: 9) and the PCR probe was: 5′ JOE-CAAGCTTCCCGTTCTCAGCC-TAMRA 3′ (SEQ ID NO: 10) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye.
Probes and primers to rat C-reactive protein were designed to hybridize to a rat C-reactive protein sequence, using published sequence information (GENBANK® accession number M83176.1, incorporated herein as SEQ ID NO: 11). For rat C-reactive protein the PCR primers were: forward primer: AAGCACCCCCAATGTCACC (SEQ ID NO: 12) reverse primer: GGGATGGCAGAGCCAATGTA (SEQ ID NO: 13) and the PCR probe was: FAM-TCCTGGATTCAAGCTTCTATGTGCCTTCA-TAMRA (SEQ ID NO: 14) where FAM is the fluorescent reporter dye and TAMRA is the quencher dye. For rat GAPDH the PCR primers were: forward primer: TGTTCTAGAGACAGCCGCATCTT(SEQ ID NO: 15) reverse primer: CACCGACCTTCACCATCTTGT(SEQ ID NO: 16) and the PCR probe was: 5′ JOE-TTGTGCAGTGCCAGCCTCGTCTCA-TAMRA 3′ (SEQ ID NO: 17) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye.
Example 14
Northern Blot Analysis of C-Reactive Protein mRNA Levels
Eighteen hours after antisense treatment, cell monolayers were washed twice with cold PBS and lysed in 1 mL RNAZOLTM reagent (TEL-TEST “B” Inc., Friendswood, Tex.). Total RNA was prepared following manufacturer's recommended protocols. Twenty micrograms of total RNA was fractionated by electrophoresis through 1.2% agarose gels containing 1.1% formaldehyde using a MOPS buffer system (AMRESCO, Inc. Solon, Ohio). RNA was transferred from the gel to HYBONDTM-N+ nylon membranes (Amersham Pharmacia Biotech, Piscataway, N.J.) by overnight capillary transfer using a Northern/Southern Transfer buffer system (TEL-TEST “B” Inc., Friendswood, Tex.). RNA transfer was confirmed by UV visualization. Membranes were fixed by UV cross-linking using a STRATALINKERTM UV Crosslinker 2400 instrument (Stratagene, Inc, La Jolla, Calif.) and then probed using QUICKHYBTM hybridization solution (Stratagene, La Jolla, Calif.) using manufacturer's recommendations for stringent conditions.
To detect human C-reactive protein, a human C-reactive protein specific probe was prepared by PCR using the forward primer TGACCAGCCTCTCTCATGCTT (SEQ ID NO: 5) and the reverse primer TCCGACTCTTTGGGAAACACA (SEQ ID NO: 6). To normalize for variations in loading and transfer efficiency membranes were stripped and probed for human glyceraldehyde-3-phosphate dehydrogenase (GAPDH) RNA (Clontech, Palo Alto, Calif.).
To detect rat C-reactive protein, a rat C-reactive protein specific probe was prepared by PCR using the forward primer TGACCAGCCTCTCTCATGCTT (SEQ ID NO: 12) and the reverse primer TCCGACTCTTTGGGAAACACA (SEQ ID NO: 13). To normalize for variations in loading and transfer efficiency membranes were stripped and probed for rat glyceraldehyde-3-phosphate dehydrogenase (GAPDH) RNA (Clontech, Palo Alto, Calif.).
Hybridized membranes were visualized and quantitated using a PHOSPHORIMAGERTM apparatus and IMAGEQUANTTM Software V3.3 (Molecular Dynamics, Sunnyvale, Calif.). Data was normalized to GAPDH levels in untreated controls.
Example 15
Antisense Inhibition of Human C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap
In accordance with the present invention, a series of antisense compounds was designed to target different regions of the human C-reactive protein RNA, using published sequences (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). The compounds are shown in Table 1. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. All compounds in Table 1 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines. The compounds were analyzed for their effect on human C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Data, shown in Table 1, are averages from three experiments in which cytokine-induced Hep3B cells were treated with 150 nM of the antisense oligonucleotides of the present invention. The positive control for each data point is identified in the table by sequence ID number. If present, “N.D.” indicates “no data”.







TABLE 1







Inhibition of human C-reactive protein mRNA levels by


chimeric phosphorothioate oligonucleotides having


2′-MOE wings and a deoxy gap















TARGET






ISIS

SEQ ID
TARGET

%
SEQ


#
REGION
NO
SITE
SEQUENCE
INHIB
ID NO
















133709
5′UTR
4
16
gcaggtgtcagagcttcggg
77
19


133710
5′UTR
4
71
gcagtaagggagtttgcgcc
71
20


133711
5′UTR
4
181
gcctgaattcactcctttgg
87
21


133712
Start Codon
4
221
agcttctccatggtcacgtc
92
22


133713
Coding
4
281
tggcccttacctgtctggcc
88
23


133714
Intron
4
311
ctcagatcaaaactctccca
30
24


133715
Intron
4
341
ttcatgcagtcttagacccc
N.D.
25


133716
Coding
4
551
gtctgtgagccagaaaaaca
77
26


133717
Coding
4
701
cgagaaaatactgtacccac
82
27


133718
Coding
4
781
gacccacccactgtaaaact
82
28


133719
Coding
4
871
cagaactccacgatccctga
96
29


133720
Coding
4
1091
attaggactgaagggcccgc
86
30


133721
Stop Codon
4
1171
agctggcctcagggccacag
80
31


133722
3′UTR
4
1191
gaggtaccttcaggacccac
89
32


133723
3′UTR
4
1361
cccagaccagacactttacc
88
33


133724
3′UTR
4
1391
tggaccatttcccagcatag
67
34


133725
3′UTR
4
1631
ttctgagactgaagagccct
27
35


133726
3′UTR
4
1671
gcactctggacccaaaccag
96
36


133727
3′UTR
4
1711
caggagacctgggcccagca
85
37


133728
3′UTR
4
1918
cccagaagagccataaaatt
27
38


133729
3′UTR
4
1961
attcacagccccacaaggtt
90
39


133730
3′UTR
4
2161
agaagatgtctcactcccaa
91
40


133731
3′UTR
4
2291
tgtttgtcaatcccttggct
93
41


133732
3′UTR
4
2431
ttctaaagcaactatcagaa
64
42


140167
5′UTR
4
111
gccttagagctacctcctcc
70
43


140168
5′UTR
4
201
ctgctgccagtgatacaagg
69
44


140169
Intron
4
317
ccatacctcagatcaaaact
48
45


140170
Intron
4
451
accccttctccagttacaca
69
46


140171
Coding
4
671
cagttccgtgtagaagtgga
43
47


140172
Coding
4
761
gtatcctatatccttagacc
N.D.
48


140173
Coding
4
821
tggagctactgtgacttcag
82
49


140174
Coding
4
861
cgatccctgaggcggactcc
N.D.
50


140175
Coding
4
901
ctcttcctcaccctgggctt
84
51


140176
Coding
4
921
cagtgtatcccttcttcaga
68
52


140177
Coding
4
951
gccccaagatgatgcttgct
95
53


140178
Coding
4
1031
gtcccacatgttcacatttc
61
54


140179
Coding
4
1111
agtgcccgccagttcaggac
86
55


140180
Coding
4
1141
gtgaacacttcgccttgcac
94
56


140181
3′UTR
4
1341
tccattctcaggcgctgagg
85
57


140182
3′UTR
4
1461
gaaattatctccaagatctg
33
58


140183
3′UTR
4
1551
cagcgcttccttctcagctc
94
59


140184
3′UTR
4
1611
gtgaatgtgggcaatgctcc
58
60


140185
3′UTR
4
1651
acacctgqccagtgtcctga
N.D.
61


140186
3′UTR
4
1771
cctttccagtgtgctttgag
N.D.
62


140187
3′UTR
4
1831
tagtgcttcattttgctctg
93
63


140188
3′UTR
4
1971
tgaagaaaqaattcacagcc
58
64


140189
3′UTR
4
2041
ggctcctctgacaggacacc
86
65


140190
3′UTR
4
2101
gctaggaacacgtaactatc
71
66


140191
3′UTR
4
2121
ggaagactgtagttggtcct
35
67


140192
3′UTR
4
2211
ctactggtggtcccaggttc
77
68


140193
3′UTR
4
2271
cctccacttccagtttggct
77
69


140194
3′UTR
4
2341
ctggttccagacaaggctga
92
70


140195
3′UTR
4
2402
gactcactcaagtaaacagg
71
71


140196
3′UTR
4
2461
ttcaaaggtcatagagaagt
28
72









As shown in Table 1, SEQ ID NOs 19, 20, 21, 22, 23, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 36, 37, 39, 40, 41, 42, 43, 44, 46, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 59, 60, 61, 62, 63, 64, 65, 66, 68, 69, 70 and 71 demonstrated at least 50% inhibition of human C-reactive protein expression in this assay and are therefore preferred. More preferred are SEQ ID NOs 36, 22 and 56. The target regions to which these preferred sequences are complementary are herein referred to as “preferred target segments” and are therefore preferred for targeting by compounds of the present invention. These preferred target segments are shown in Table 4. These sequences are shown to contain thymine (T) but one of skill in the art will appreciate that thymine (T) is generally replaced by uracil (U) in RNA sequences. The sequences represent the reverse complement of the preferred antisense compounds shown in Table 1. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the oligonucleotide binds. Also shown in Table 4 is the species in which each of the preferred target segments was found.
In further embodiment of the present invention, a second series of antisense compounds was designed to target different regions of the human C-reactive protein RNA, using published sequences (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). The compounds are shown in Table 2. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. All compounds in Table 2 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
The compounds were analyzed for their effect on human C-reactive protein mRNA levels by quantitative real-time PCR using a second set of probes and primer designed to hybridize to a human C-reactive protein sequence, using published sequence information (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4). For human C-reactive protein the PCR primers were: forward primer: GCTTCCCCTCTTCCCGAA (SEQ ID NO: 73) reverse primer: TGCGCCACTATGTAAATAATTTTCC (SEQ ID NO: 74) and the PCR probe was: FAM-TCTGACACCTGCCCCAACAAGCAATG-TAMRA (SEQ ID NO: 75) where FAM is the fluorescent dye and TAMRA is the quencher dye. Data, shown in Table 2, are averages from three experiments in which cytokine-induced Hep3B cells were treated with 150 nM of the antisense oligonucleotides of the present invention. The positive control for each datapoint is identified in the table by sequence ID number. If present, “N.D.” indicates “no data”.







TABLE 2







Inhibition of human C-reactive protein mRNA levels by


chimeric phosphorothioate oligonucleotides having


2′-MOE wings and a deoxy gap
















TARGET




CONTROL


ISIS

SEQ ID
TARGET

%
SEQ ID
SEQ ID


#
REGION
NO
SITE
SEQUENCE
INHIB
NO
NO

















140185
3′UTR
4
1651
acacctggccagtgtcctga
37
61
1


140186
3′UTR
4
1771
cctttccagtgtgctttgag
1
62
1


329883
3′UTR
4
10
gtcagagcttcgggaagagg
6
76
1


329884
3′UTR
4
37
tttccaacattgcttgttgg
0
77
1


329885
3′UTR
4
47
tgtaaataattttccaacat
41
78
1


329886
3′UTR
4
57
tgcgccactatgtaaataat
7
79
1


329887
3′UTR
4
67
taagggagtttgcgccacta
40
80
1


329888
3′UTR
4
77
tccaaagcagtaagggagtt
21
81
1


329889
3′UTR
4
87
tggatttatatccaaagcag
N.D.
82



329890
3′UTR
4
94
tcctgcctggatttatatcc
8
83
1


329891
3′UTR
4
107
tagagctacctcctcctgcc
1
84
1


329892
3′UTR
4
122
ccagatctcttgccttagag
70
85
1


329893
3′UTR
4
132
gctagaagtcccagatctct
38
86
1


329894
3′UTR
4
157
gatgtattcggctgaaagtt
29
87
1


329895
3′UTR
4
167
ctttggaaaagatgtattcg
22
88
1


329896
3′UTR
4
191
tgatacaagggcctgaattc
30
89
1


329897
Start codon
4
206
acgtcctgctgccagtgata
44
90
1


329898
Coding
4
226
acaacagcttctccatggtc
43
91
1


329899
Coding
4
231
gaaacacaacagcttctcca
28
92
1


329900
Coding
4
241
tcaagaccaagaaacacaac
0
93
1


329901
Coding
4
251
gagaggctggtcaagaccaa
15
94
1


329902
Coding
4
258
agcatgagagaggctggtca
54
95
1


329903
Coding
4
268
tctggccaaaagcatgagag
48
96
1


329904
Coding
4
278
cccttacctgtctggccaaa
45
97
1


329905
Coding
4
283
ggtggcccttacctgtctgg
12
98
1


329906
Coding
4
318
cccatacctcagatcaaaac
0
99
1


329907
Coding
4
342
gttcatgcagtcttagaccc
21
100
1


329908
Coding
4
347
agactgttcatgcagtctta
N.D.
101



329909
Coding
4
351
tttgagactgttcatgcagt
28
102
1


329910
Coding
4
381
gttctgttcatacagtcttt
16
103
1


329911
Coding
4
386
ccactgttctgttcatacag
0
104
1


329912
Coding
4
391
atgctccactgttctgttca
4
105
1


329913
Coding
4
396
gaaggatgctccactgttct
0
106
1


329914
Coding
4
401
accatgaaggatgctccact
49
107
1


329915
Coding
4
406
cacacaccatgaaggatgct
33
108
1


329916
Coding
4
411
acacacacacaccatgaagg
0
109
1


329917
Coding
4
449
cccttctccagttacacacc
3
110
1


329918
Coding
4
459
acagactgaccccttctcca
19
111
1


329919
Coding
4
469
agattgagaaacagactgac
52
112
1


329920
Coding
4
479
atagaatttaagattgagaa
8
113
1


329921
Coding
4
489
tcacttacgtatagaattta
0
114
1


329922
Coding
4
492
ccctcacttacgtatagaat
40
115
1


329923
Coding
4
499
atctatcccctcacttacgt
23
116
1


329924
Coding
4
510
agatcacacagatctatccc
6
117
1


329925
Coding
4
520
gaggtttctcagatcacaca
0
118
1


329926
Coding
4
530
gcaaatgtgagaggtttctc
4
119
1


329927
Coding
4
557
cgacatgtctgtgagccaga
39
120
1


329928
Coding
4
562
ttcctcgacatgtctgtgag
52
121
1


329929
Coding
4
567
aagccttcctcgacatgtct
81
122
1


329930
Coding
4
596
ggaagtatccgactctttgg
39
123
1


329931
Coding
4
605
ggatacataggaagtatccg
0
124
1


329932
Coding
4
615
gtgctttgagggatacatag
12
125
1


329933
Coding
4
625
ttcgttaacggtgctttgag
0
126
1


329934
Coding
4
635
tttgagaggcttcgttaacg
0
127
1


329935
Coding
4
645
cagtgaaggctttgagaggc
1
128
1


329936
Coding
4
655
tggaggcacacagtgaaggc
69
129
1


329937
Coding
4
660
agaagtggaggcacacagtg
0
130
1


329938
Coding
4
665
cgtgtagaagtggaggcaca
36
131
1


329939
Coding
4
675
aggacagttccgtgtagaag
40
132
1


329940
Coding
4
685
ccacgggtcgaggacagttc
46
133
1


329941
Coding
4
695
aatactgtacccacgggtcg
26
134
1


329942
Coding
4
716
tctcttggtggcatacgaga
55
135
1


329943
Coding
4
726
cattgtcttgtctcttggtg
70
136
1


329944
Coding
4
736
atgagaatctcattgtcttg
58
137
1


329945
Coding
4
746
agaccaaaatatgagaatct
6
138
1


329946
Coding
4
756
ctatatccttagaccaaaat
26
139
1


329947
Coding
4
765
aactgtatcctatatcctta
0
140
1


329948
Coding
4
775
cccactgtaaaactgtatcc
26
141
1


329949
Coding
4
785
ttcagacccacccactgtaa
N.D.
142



329950
Coding
4
796
tcgaataatatttcagaccc
37
143
1


329951
Coding
4
806
ttcaggaacctcgaataata
14
144
1


329952
Coding
4
816
ctactgtgacttcaggaacc
59
145
1


329953
Coding
4
826
tgtactggagctactgtgac
39
146
1


329954
Coding
4
836
tgtacaaatgtgtactggag
60
147
1


329955
Coding
4
846
actcccagcttgtacaaatg
21
148
1


329956
Coding
4
856
cctgaggcggactcccagct
62
149
1


329957
Coding
4
860
gatccctgaggcggactccc
66
150
1


329958
Coding
4
870
agaactccacgatccctgag
30
151
1


329959
Coding
4
880
ccatctacccagaactccac
22
152
1


329960
Coding
4
890
cctgggcttcccatctaccc
34
153
1


329961
Coding
4
900
tcttcctcaccctgggcttc
52
154
1


329962
Coding
4
910
ttcttcagactcttcctcac
38
155
1


329963
Coding
4
920
agtgtatcccttcttcagac
39
156
1


329964
Coding
4
944
gatgatgcttgcttctgccc
55
157
1


329965
Coding
4
964
gaatcctgctcctgccccaa
37
158
1


329966
Coding
4
967
aaggaatcctgctcctgccc
55
159
1


329967
Coding
4
977
gttcccaccgaaggaatcct
26
160
1


329968
Coding
4
987
ttccttcaaagttcccaccg
59
161
1


329969
Coding
4
1000
accagggactggcttccttc
71
162
1


329970
Coding
4
1010
aatgtctcccaccagggact
7
163
1


329971
Coding
4
1020
tcacatttccaatgtctccc
56
164
1


329972
Coding
4
1030
tcccacatgttcacatttcc
49
165
1


329973
Coding
4
1040
cagcacaaagtcccacatgt
66
166
1


329974
Coding
4
1050
catctggtgacagcacaaag
65
167
1


329975
Coding
4
1060
gtgttaatctcatctggtga
47
168
1


329976
Coding
4
1070
aagatagatggtgttaatct
37
169
1


329977
Coding
4
1097
caggacattaggactgaagg
53
170
1


329978
Coding
4
1107
cccgccagttcaggacatta
52
171
1


329979
Coding
4
1117
tacttcagtgcccgccagtt
49
172
1


329980
Coding
4
1127
ttgcacttcatacttcagtg
69
173
1


329981
Coding
4
1137
acacttcgccttgcacttca
54
174
1


329982
Coding
4
1147
ggtttggtgaacacttcgcc
55
175
1


329983
3′UTR
4
1193
gggaggtaccttcaggaccc
48
176
1


329984
3′UTR
4
1235
taccagagacagagacgtgg
62
177
1


329985
3′UTR
4
1245
aagcgggaggtaccagagac
62
178
1


329986
3′UTR
4
1283
gcccagagacagagacgtgg
68
179
1


329987
3′UTR
4
1293
gggaacaaaggcccagagac
59
180
1


329988
3′UTR
4
1326
tgaggagggtggagcaggcc
44
181
1


329989
3′UTR
4
1338
attctcaggcgctgaggagg
44
182
1


329990
3′UTR
4
1348
ctttacctccattctcaggc
74
183
1


329991
3′UTR
4
1358
agaccagacactttacctcc
29
184
1


329992
3′UTR
4
1368
acgagctcccagaccagaca
70
185
1


329993
3′UTR
4
1378
agcatagttaacgagctccc
64
186
1


329994
3′UTR
4
1388
accatttcccagcatagtta
34
187
1


329995
3′UTR
4
1398
attcttttggaccatttccc
35
188
1


329996
3′UTR
4
1408
tcaaattctgattcttttgg
27
189
1


329997
3′UTR
4
1451
ccaagatctgtccaacttga
55
190
1


329998
3′UTR
4
1471
tgtgaggtaagaaattatct
21
191
1


329999
3′UTR
4
1481
ttctcatctatgtgaggtaa
74
192
1


330000
3′UTR
4
1491
ggtgttagttttctcatcta
63
193
1


330001
3′UTR
4
1501
ctcctttctgggtgttagtt
70
194
1


330002
3′UTR
4
1511
aacatcatttctcctttctg
41
195
1


330003
3′UTR
4
1536
agctcttgccttatgagttt
58
196
1


330004
3′UTR
4
1546
cttccttctcagctcttgcc
57
197
1


330005
3′UTR
4
1556
aagatcagcgcttccttctc
69
198
1


330006
3′UTR
4
1566
aattaaatagaagatcagcg
57
199
1


330007
3′UTR
4
1621
gaagagccctgtgaatgtgg
24
200
1


330008
3′UTR
4
1641
agtgtcctgattctgagact
53
201
1


330009
3′UTR
4
1661
cccaaaccagacacctggcc
75
202
1


330010
3′UTR
4
1681
atgatgatgagcactctgga
59
203
1


330011
3′UTR
4
1691
gttctatgacatgatgatga
59
204
1


330012
3′UTR
4
1719
tcccatttcaggagacctgg
60
205
1


330013
3′UTR
4
1729
ttgctgggcttcccatttca
39
206
1


330014
3′UTR
4
1739
ctgcgtggtattgctgggct
64
207
1


330015
3′UTR
4
1749
agtggagggactgcgtggta
60
208
1


330016
3′UTR
4
1761
gtgctttgagaaagtggagg
69
209
1


330017
3′UTR
4
1781
attctaatggcctttccagt
61
210
1


330018
3′UTR
4
1805
aagcagatctgctctgctgg
52
211
1


330019
3′UTR
4
1840
atttatacctagtgcttcat
53
212
1


330020
3′UTR
4
1850
gtaacaacatatttatacct
15
213
1


330021
3′UTR
4
1860
gttcttggcagtaacaacat
74
214
1


330022
3′UTR
4
1870
agtcatttaagttcttggca
67
215
1


330023
3′UTR
4
1923
agtttcccagaagagccata
45
216
1


330024
3′UTR
4
1952
cccacaaggttcgtgtggaa
53
217
1


330025
3′UTR
4
1962
aattcacagccccacaaggt
2
218
1


330026
3′UTR
4
1972
atgaagaaagaattcacagc
29
219
1


330027
3′UTR
4
2003
cttgtggcctgggtatattg
59
220
1


330028
3′UTR
4
2013
cacgtccactcttgtggcct
69
221
1


330029
3′UTR
4
2023
ccctgtggttcacgtccact
63
222
1


330030
3′UTR
4
2033
tgacaggacaccctgtggtt
29
223
1


330031
3′UTR
4
2043
tgggctcctctgacaggaca
66
224
1


330032
3′UTR
4
2043
tcctccagatagggagctgg
N.D.
225



330033
3′UTR
4
2085
tatccaactatcctccagat
31
226
1


330034
3′UTR
4
2095
aacacgtaactatccaacta
27
227
1


330035
3′UTR
4
2105
tcctgctaggaacacgtaac
72
228
1


330036
3′UTR
4
2115
ctgtagttggtcctgctagg
56
229
1


330037
3′UTR
4
2126
ccttgggaagactgtagttg
34
230
1


330038
3′UTR
4
2136
ataactcaatccttgggaag
27
231
1


330039
3′UTR
4
2146
cccaaagtccataactcaat
22
232
1


330040
3′UTR
4
2156
atgtctcactcccaaagtcc
36
233
1


330041
3′UTR
4
2166
cagcaagaagatgtctcact
50
234
1


330042
3′UTR
4
2176
ggaaatccagcagcaagaag
48
235
1


330043
3′UTR
4
2186
ctctcagcttggaaatccag
57
236
1


330044
3′UTR
4
2196
ggttcacgtcctctcagctt
76
237
1


330045
3′UTR
4
2205
gtggtcccaggttcacgtcc
50
238
1


330046
3′UTR
4
2215
atggctactggtggtcccag
N.D.
239



330047
3′UTR
4
2225
ggcaaacaagatggctactg
56
240
1


330048
3′UTR
4
2235
ctctccatgtggcaaacaag
53
241
1


330049
3′UTR
4
2245
ctcacagtctctctccatgt
58
242
1


330050
3′UTR
4
2255
ggcttctgtcctcacagtct
50
243
1


330051
3′UTR
4
2265
cttccagtttggcttctgtc
65
244
1


330052
3′UTR
4
2275
ggctcctccacttccagttt
71
245
1


330053
3′UTR
4
2285
tcaatcccttggctcctcca
53
246
1


330054
3′UTR
4
2295
ctgttgtttgtcaatccctt
61
247
1


330055
3′UTR
4
2305
ggtcaaggctctgttgtttg
30
248
1


330056
3′UTR
4
2315
gactccacgtggtcaaggct
79
249
1


330057
3′UTR
4
2325
ctgattcagagactccacgt
69
250
1


330058
3′UTR
4
2335
ccagacaaggctgattcaga
45
251
1


330059
3′UTR
4
2345
agatctggttccagacaagg
59
252
1


330060
3′UTR
4
2355
gtccaggtgtagatctggtt
53
253
1


330061
3′UTR
4
2365
gacctgggcagtccaggtgt
38
254
1


330062
3′UTR
4
2378
ttattggcttatagacctgg
56
255
1


330063
3′UTR
4
2410
acagcttggactcactcaag
30
256
1


330064
3′UTR
4
2432
cttctaaagcaactatcaga
10
257
1


330065
3′UTR
4
2442
ttagtcacaacttctaaagc
13
258
1


330066
3′UTR
4
2452
catagagaagttagtcacaa
22
259
1









As shown in Table 2, SEQ ID NOs 85, 95, 112, 121, 122, 129, 135, 136, 137, 145, 147, 149, 150, 154, 157, 159, 161, 162, 164, 166, 167, 170, 171, 173, 174, 175, 177, 178, 179, 180, 183, 185, 186, 190, 192, 193, 194, 196, 197, 198, 199, 201, 202, 203, 204, 205, 207, 208, 209, 210, 211, 212, 214, 215, 217, 220, 221, 222, 224, 228, 229, 234, 236, 237, 238, 240, 241, 242, 243, 244, 245, 246, 247, 249, 250, 252, 253 and 255 demonstrated at least 50% inhibition of human C-reactive protein expression in this assay and are therefore preferred. The target regions to which these preferred sequences are complementary are herein referred to as “preferred target segments” and are therefore preferred for targeting by compounds of the present invention. These preferred target segments are shown in Table 4. These sequences are shown to contain thymine (T) but one of skill in the art will appreciate that thymine (T) is generally replaced by uracil (U) in RNA sequences. The sequences represent the reverse complement of the preferred antisense compounds shown in Table 2. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the oligonucleotide binds. Also shown in Table 4 is the species in which each of the preferred target segments was found.
Example 16
Antisense Inhibition of rat C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap.
In accordance with the present invention, a series of antisense compounds was designed to target different regions of the rat C-reactive protein RNA, using published sequences (GENBANK® accession number M83176.1, incorporated herein as SEQ ID NO: 11). The compounds are shown in Table 3. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the compound binds. All compounds in Table 3 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines. The compounds were analyzed for their effect on rat C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Data, shown in Table 3, are averages from three experiments in which primary rat hepatocytes were treated with 150 nM of the antisense oligonucleotides of the present invention. If present, “N.D.” indicates “no data”.







TABLE 3







Inhibition of rat C-reactive protein mRNA levels by


chimeric phosphorothioate oligonucleotides having 2′-MOE


wings and a deoxy gap















TARGET






ISIS

SEQ ID
TARGET

%
SEQ


#
REGION
NO
SITE
SEQUENCE
INHIB
ID NO
















197163
Start Codon
11
1
caccatagtagcttctccat
26
260


197164
Coding
11
21
agcttatcgtgatcagaaga
27
261


197165
Coding
11
41
atgaccaaaagcctgagaga
26
262


197166
Coding
11
61
gcctgtttagacatgtcttc
57
263


197167
Coding
11
81
acactccgggaaatacgaag
47
264


197168
Coding
11
101
ggacacataggcagtagctg
61
265


197169
Coding
11
121
ttctttgactctgcttccag
36
266


197170
Coding
11
141
cagtgaaggcttccagtggc
56
267


197171
Coding
11
161
agcgtgggcatagagacaca
48
268


197172
Coding
11
181
ctgaagcttcggctcacatc
23
269


197173
Coding
11
201
tggtagcgtaagagaagatg
26
270


197174
Coding
11
221
aatctcgttaaagctcgtct
34
271


197175
Coding
11
261
ctgcaatactaaacccttga
38
272


197176
Coding
11
281
cagtatttcaggcccaccta
39
273


197177
Coding
11
301
ggaatttctgaagcactgaa
30
274


197178
Coding
11
320
gatgtgtgttggtacctcag
21
275


197179
Coding
11
411
caatgtagcccttctgcaga
48
276


197180
Coding
11
431
gatgcttgcatttgtcccca
51
277


197181
Coding
11
451
tcctgctcctgccccaagat
19
278


197182
Coding
11
471
caaagccaccgccatacgag
28
279


197183
Coding
11
491
caccaaagactgattcgcgt
14
280


197184
Coding
11
511
ttcacatctccaatgtctcc
35
281


197185
Coding
11
531
atagcacaaagtcccacatg
53
282


197186
Coding
11
551
tgcattgatctgttctggag
37
283


197187
Coding
11
571
aataccctaccaacatagac
47
284


197188
Coding
11
601
agtgcccgccagttcaaaac
40
285


197189
Coding
11
621
caccgtgtgtttcatacttc
31
286


197190
Coding
11
641
ctgcggcttgataaacacat
21
287


197191
Coding
11
661
cagtcagtcaagggccacag
43
288


197192
Coding
11
671
ggactcacaacagtcagtca
35
289









As shown in Table 3, SEQ ID NOs 260, 261, 262, 263, 264, 265, 266, 267, 268, 270, 271, 272, 273, 274, 276, 277, 279, 281, 282, 283, 284, 285, 286, 288 and 289 demonstrated at least 25% inhibition of rat C-reactive protein expression in this experiment and are therefore preferred. The target regions to which these preferred sequences are complementary are herein referred to as “preferred target segments” and are therefore preferred for targeting by compounds of the present invention. These preferred target segments are shown in Table 4. These sequences are shown to contain thymine (T) but one of skill in the art will appreciate that thymine (T) is generally replaced by uracil (U) in RNA sequences. The sequences represent the reverse complement of the preferred antisense compounds shown in Tables 1,2 and 3. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the oligonucleotide binds. Also shown in Table 4 is the species in which each of the preferred target segments was found.







TABLE 4







Sequence and position of preferred target segments


identified in C-reactive protein.














TARGET


REV




SITE
SEQ ID
TARGET

COMP OF

SEQ


ID
NO
SITE
SEQUENCE
SEQ ID
ACTIVE IN
ID NO
















44586
11
16
cccgaagctctgacacctgc
19
H. sapiens
290


44587
11
71
ggcgcaaactcccttactgc
20
H. sapiens
291


44588
11
181
ccaaaggagtgaattcaggc
21
H. sapiens
292


44589
11
221
gacgtgaccatggagaagct
22
H. sapiens
293


44590
11
281
ggccagacaggtaagggcca
23
H. sapiens
294


44592
11
341
ggggtctaagactgcatgaa
25
H. sapiens
295


44593
11
551
tgtttttctggctcacagac
26
H. sapiens
296


44594
11
701
gtgggtacagtattttctcg
27
H. sapiens
297


44595
11
781
agttttacagtgggtgggtc
28
H. sapiens
298


44596
11
871
tcagggatcgtggagttctg
29
H. sapiens
299


44597
11
1091
gcgggcccttcagtcctaat
30
H. sapiens
300


44598
11
1171
ctgtggccctgaggccagct
31
H. sapiens
301


44599
11
1191
gtgggtcctgaaggtacctc
32
H. sapiens
302


44600
11
1361
ggtaaagtgtctggtctggg
33
H. sapiens
303


44601
11
1391
ctatgctgggaaatggtcca
34
H. sapiens
304


44603
11
1671
ctggtttgggtccagagtgc
36
H. sapiens
305


44604
11
1711
tgctgggcccaggtctcctg
37
H. sapiens
306


44606
11
1961
aaccttgtggggctgtgaat
39
H. sapiens
307


44607
11
2161
ttgggagtgagacatcttct
40
H. sapiens
308


44608
11
2291
agccaagggattgacaaaca
41
H. sapiens
309


44609
11
2431
ttctgatagttgctttagaa
42
H. sapiens
310


53590
11
111
ggaggaggtagctctaaggc
43
H. sapiens
311


53589
11
201
ccttgtatcactggcagcag
44
H. sapiens
312


53587
11
451
tgtgtaactggagaaggggt
46
H. sapiens
313


53585
11
761
ggtctaaggatataggatac
48
H. sapiens
314


53584
11
821
ctgaagtcacagtagctcca
49
H. sapiens
315


53583
11
861
ggagtccgcctcagggatcg
50
H. sapiens
316


53582
11
901
aagcccagggtgaggaagag
51
H. sapiens
317


53581
11
921
tctgaagaagggatacactg
52
H. sapiens
318


53580
11
951
agcaagcatcatcttggggc
53
H. sapiens
319


53579
11
1031
gaaatgtgaacatgtgggac
54
H. sapiens
320


53578
11
1111
gtcctgaactggcgggcact
55
H. sapiens
321


53577
11
1141
gtgcaaggcgaagtgttcac
56
H. sapiens
322


53576
11
1341
cctcagcgcctgagaatgga
57
H. sapiens
323


53574
11
1551
gagctgagaaggaagcgctg
59
H. sapiens
324


53573
11
1611
ggagcattgcccacattcac
60
H. sapiens
325


53572
11
1651
tcaggacactggccaggtgt
61
H. sapiens
326


53571
11
1771
ctcaaagcacactggaaagg
62
H. sapiens
327


53570
11
1831
cagagcaaaatgaagcacta
63
H. sapiens
328


53569
11
1971
ggctgtgaattctttcttca
64
H. sapiens
329


53568
11
2041
ggtgtcctgtcagaggagcc
65
H. sapiens
330


53567
11
2101
gatagttacgtgttcctagc
66
H. sapiens
331


53565
11
2211
gaacctgggaccaccagtag
68
H. sapiens
332


53564
11
2271
agccaaactggaagtggagg
69
H. sapiens
333


53563
11
2341
tcagccttgtctggaaccag
70
H. sapiens
334


53562
11
2402
cctgtttacttgagtgagtc
71
H. sapiens
335


246578
11
122
ctctaaggcaagagatctgg
85
H. sapiens
336


246588
11
258
tgaccagcctctctcatgct
95
H. sapiens
337


246605
11
469
gtcagtctgtttctcaatct
112
H. sapiens
338


246614
11
562
ctcacagacatgtcgaggaa
121
H. sapiens
339


246615
11
567
agacatgtcgaggaaggctt
122
H. sapiens
340


246622
11
655
gccttcactgtgtgcctcca
129
H. sapiens
341


246628
11
716
tctcgtatgccaccaagaga
135
H. sapiens
342


246629
11
726
caccaagagacaagacaatg
136
H. sapiens
343


246630
11
736
caagacaatgagattctcat
137
H. sapiens
344


246638
11
816
ggttcctgaagtcacagtag
145
H. sapiens
345


246640
11
836
ctccagtacacatttgtaca
147
H. sapiens
346


246642
11
856
agctgggagtccgcctcagg
149
H. sapiens
347


246643
11
860
gggagtccgcctcagggatc
150
H. sapiens
348


246647
11
900
gaagcccagggtgaggaaga
154
H. sapiens
349


246650
11
944
gggcagaagcaagcatcatc
157
H. sapiens
350


246652
11
967
gggcaggagcaggattcctt
159
H. sapiens
351


246654
11
987
cggtgggaactttgaaggaa
161
H. sapiens
352


246655
11
1000
gaaggaagccagtccctggt
162
H. sapiens
353


246657
11
1020
gggagacattggaaatgtga
164
H. sapiens
354


246659
11
1040
acatgtgggactttgtgctg
166
H. sapiens
355


246660
11
1050
ctttgtgctgtcaccagatg
167
H. sapiens
356


246663
11
1097
ccttcagtcctaatgtcctg
170
H. sapiens
357


246664
11
1107
taatgtcctgaactggcggg
171
H. sapiens
358


246666
11
1127
cactgaagtatgaagtgcaa
173
H. sapiens
359


246667
11
1137
tgaagtgcaaggcgaagtgt
174
H. sapiens
360


246668
11
1147
ggcgaagtgttcaccaaacc
175
H. sapiens
361


246670
11
1235
ccacgtctctgtctctggta
177
H. sapiens
362


246671
11
1245
gtctctggtacctcccgctt
178
H. sapiens
363


246672
11
1283
ccacgtctctgtctctgggc
179
H. sapiens
364


246673
11
1293
gtctctgggcctttgttccc
180
H. sapiens
365


246676
11
1348
gcctgagaatggaggtaaag
183
H. sapiens
366


246678
11
1368
tgtctggtctgggagctcgt
185
H. sapiens
367


246679
11
1378
gggagctcgttaactatgct
186
H. sapiens
368


246683
11
1451
tcaagttggacagatcttgg
190
H. sapiens
369


246685
11
1481
ttacctcacatagatgagaa
192
H. sapiens
370


246686
11
1491
tagatgagaaaactaacacc
193
H. sapiens
371


246687
11
1501
aactaacacccagaaaggag
194
H. sapiens
372


246689
11
1536
aaactcataaggcaagagct
196
H. sapiens
373


246690
11
1546
ggcaagagctgagaaggaag
197
H. sapiens
374


246691
11
1556
gagaaggaagcgctgatctt
198
H. sapiens
375


246692
11
1566
cgctgatcttctatttaatt
199
H. sapiens
376


246694
11
1641
agtctcagaatcaggacact
201
H. sapiens
377


246695
11
1661
ggccaggtgtctggtttggg
202
H. sapiens
378


246696
11
1681
tccagagtgctcatcatcat
203
H. sapiens
379


246697
11
1691
tcatcatcatgtcatagaac
204
H. sapiens
380


246698
11
1719
ccaggtctcctgaaatggga
205
H. sapiens
381


246700
11
1739
agcccagcaataccacgcag
207
H. sapiens
382


246701
11
1749
taccacgcagtccctccact
208
H. sapiens
383


246702
11
1761
cctccactttctcaaagcac
209
H. sapiens
384


246703
11
1781
actggaaaggccattagaat
210
H. sapiens
385


246704
11
1805
ccagcagagcagatctgctt
211
H. sapiens
386


246705
11
1840
atgaagcactaggtataaat
212
H. sapiens
387


246707
11
1860
atgttgttactgccaagaac
214
H. sapiens
388


246708
11
1870
tgccaagaacttaaatgact
215
H. sapiens
389


246710
11
1952
ttccacacgaaccttgtggg
217
H. sapiens
390


246713
11
2003
caatatacccaggccacaag
220
H. sapiens
391


246714
11
2013
aggccacaagagtggacgtg
221
H. sapiens
392


246715
11
2023
agtggacgtgaaccacaggg
222
H. sapiens
393


246717
11
2043
tgtcctgtcagaggagccca
224
H. sapiens
394


246721
11
2105
gttacgtgttcctagcagga
228
H. sapiens
395


246722
11
2115
cctagcaggaccaactacag
229
H. sapiens
396


246727
11
2166
agtgagacatcttcttgctg
234
H. sapiens
397


246729
11
2186
ctggatttccaagctgagag
236
H. sapiens
398


246730
11
2196
aagctgagaggacgtgaacc
237
H. sapiens
399


246731
11
2205
ggacgtgaacctgggaccac
238
H. sapiens
400


246733
11
2225
cagtagccatcttgtttgcc
240
H. sapiens
401


246734
11
2235
cttgtttgccacatggagag
241
H. sapiens
402


246735
11
2245
acatggagagagactgtgag
242
H. sapiens
403


246736
11
2255
agactgtgaggacagaagcc
243
H. sapiens
404


246737
11
2265
gacagaagccaaactggaag
244
H. sapiens
405


246738
11
2275
aaactggaagtggaggagcc
245
H. sapiens
406


246739
11
2285
tggaggagccaagggattga
246
H. sapiens
407


246740
11
2295
aagggattgacaaacaacag
247
H. sapiens
408


246742
11
2315
agccttgaccacgtggagtc
249
H. sapiens
409


246743
11
2325
acgtggagtctctgaatcag
250
H. sapiens
410


246745
11
2345
ccttgtctggaaccagatct
252
H. sapiens
411


246746
11
2355
aaccagatctacacctggac
253
H. sapiens
412


246748
11
2378
ccaggtctataagccaataa
255
H. sapiens
413


115255
252
1
atggagaagctactatggtg
260
R. norvegicus
414


115256
252
21
tcttctgatcacgataagct
261
R. norvegicus
415


115257
252
41
tctctcaggcttttggtcat
262
R. norvegicus
416


115258
252
61
gaagacatgtctaaacaggc
263
R. norvegicus
417


115259
252
81
cttcgtatttcccggagtgt
264
R. norvegicus
418


115260
252
101
cagctactgcctatgtgtcc
265
R. norvegicus
419


115261
252
121
ctggaagcagagtcaaagaa
266
R. norvegicus
420


115262
252
141
gccactggaagccttcactg
267
R. norvegicus
421


115263
252
161
tgtgtctctatgcccacgct
268
R. norvegicus
422


115265
252
201
catcttctcttacgctacca
270
R. norvegicus
423


115266
252
221
agacgagctttaacgagatt
271
R. norvegicus
424


115267
252
261
tcaagggtttagtattgcag
272
R. norvegicus
425


115268
252
281
taggtgggcctgaaatactg
273
R. norvegicus
426


115269
252
301
ttcagtgcttcagaaattcc
274
R. norvegicus
427


115271
252
411
tctgcagaagggctacattg
276
R. norvegicus
428


115272
252
431
tggggacaaatgcaagcatc
277
R. norvegicus
429


115274
252
471
ctcgtatggcggtggctttg
279
R. norvegicus
430


115276
252
511
ggagacattggagatgtgaa
281
R. norvegicus
431


115277
252
531
catgtgggactttgtgctat
282
R. norvegicus
432


115278
252
551
ctccagaacagatcaatgca
283
R. norvegicus
433


115279
252
571
gtctatgttggtagggtatt
284
R. norvegicus
434


115280
252
601
gttttgaactggcgggcact
285
R. norvegicus
435


115281
252
621
gaagtatgaaacacacggtg
286
R. norvegicus
436


115283
252
661
ctgtggcccttgactgactg
288
R. norvegicus
437


115284
252
671
Tgactgactgttgtgagtcc
289
R. norvegicus
438









As these “preferred target segments” have been found by experimentation to be open to, and accessible for, hybridization with the antisense compounds of the present invention, one of skill in the art armed with the knowledge of the present invention will recognize or be able to ascertain, using no more than routine experimentation, further embodiments of the invention that encompass other compounds that specifically hybridize to these preferred target segments and consequently inhibit the expression of C-reactive protein.
According to the present invention, antisense compounds include antisense oligomeric compounds, antisense oligonucleotides, siRNAs, external guide sequence (EGS) oligonucleotides, alternate splicers, and other short oligomeric compounds that hybridize to at least a portion of the target nucleic acid.
Example 17
Western Blot Analysis of C-Reactive Protein Protein Levels
Western blot analysis (immunoblot analysis) is carried out using standard methods. Cells are harvested 16-20 hours after oligonucleotide treatment, washed once with PBS, suspended in Laemmli buffer (100 μl/well), boiled for 5 minutes and loaded on a 16% SDS-PAGE gel. Gels are run for 1.5 hours at 150 V, and transferred to membrane for western blotting. Appropriate primary antibody directed to C-reactive protein is used, with a radiolabeled or fluorescently labeled secondary antibody directed against the primary antibody species. Bands are visualized using a PHOSPHORIMAGERTM instrument (Molecular Dynamics, Sunnyvale Calif.).
Example 18
Antisense Inhibition of Rabbit C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap.
In accordance with the present invention, a series of antisense compounds was designed to target different regions of the rabbit C-reactive protein RNA, using published sequences (GENBANK® accession number M13497.1, incorporated herein as SEQ ID NO: 439). The compounds are shown in Table 5. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the compound binds. All compounds in Table 5 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
The compounds were analyzed for their effect on rabbit C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Probes and primers to rabbit C-reactive protein were designed to hybridize to a rabbit C-reactive protein sequence, using published sequence information (GENBANK® accession number M13497.1, incorporated herein as SEQ ID NO: 439). For rabbit C-reactive protein the PCR primers were: forward primer: GGCGCGAGCTGACATATCA (SEQ ID NO: 440) reverse primer: CTTGGCAGAGCTCAGGGC (SEQ ID NO: 441) and the PCR probe was: FAM-TACGTGGTGAAGTACATGTCAAGCCCCAG-TAMRA (SEQ ID NO: 442) where FAM is the fluorescent reporter dye and TAMRA is the quencher dye. For rabbit GAPDH the PCR primers were: forward primer: TGTTCTAGAGACAGCCGCATCTT(SEQ ID NO: 443) reverse primer: CACCGACCTTCACCATCTTGT(SEQ ID NO: 444) and the PCR probe was: 5′ JOE-TTGTGCAGTGCCAGCCTCGTCTCA-TAMRA 3′ (SEQ ID NO: 445) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye. Data, shown in Table 5, are averages from three experiments in which primary rabbit hepatocytes were treated with 10 nM of the antisense oligonucleotides of the present invention. If present, “N.D.” indicates “no data”.







TABLE 5







Inhibition of rabbit C-reactive protein mRNA levels by


chimeric phosphorothioate oligonucleotides having


2′-MOE wings and a deoxy gap















Target






ISIS

Seq ID
Start

%
SEQ


#
Region
NO
Site
SEQUENCE
Inhib
ID NO
















196123
5′UTR
439
3
cgtctctggctgaaggctca
N.D.
446


196124
5′UTR
439
31
ggctcagaatccactccttt
N.D.
447


196125
5′UTR
439
51
gccaccagtgctaccgagca
N.D.
448


196126
Start Codon
439
71
cttctccatggtcactccct
N.D.
449


196127
Coding
439
131
catgcctgcctggtcagaca
N.D.
450


196128
Coding
439
181
gacacgtaggaattatctga
N.D.
451


196129
Coding
439
201
tctttaactgtgcgttgagg
N.D.
452


196130
Coding
439
241
gtgtagaagtagaggcacac
N.D.
453


196131
Coding
439
261
cacgagtcatggacagatca
N.D.
454


196132
Coding
439
341
actatatcctatgtccttgg
N.D.
455


196133
Coding
439
371
gaatattatttcatctccac
N.D.
456


196134
Coding
439
421
tcccagcttgcacagaggtg
N.D.
457


196135
Coding
439
441
ctgcaatgcctgtgctggac
N.D.
458


196136
Coding
439
461
cttcccatctacccagagct
N.D.
459


196137
Coding
439
491
gcccttcttcagactcttcc
N.D.
460


196138
Coding
439
526
cccagaataatgcttgcctc
N.D.
461


196139
Coding
439
601
atgttcacatttccaatgtc
N.D.
462


196140
Coding
439
621
gtgaaagtgcatagtcccac
N.D.
463


196141
Coding
439
661
ctaaaggtcccaccagcata
N.D.
464


196142
3′UTR
439
771
caagaagcaccttcaggatc
N.D.
465


196143
3′UTR
439
811
ggtccacagccagaagtatg
N.D.
466


196144
3′UTR
439
841
tagcaggcattcagtatatg
N.D.
467


196145
3′UTR
439
921
caatgtagtccacaagatcc
N.D.
468


196146
3′UTR
439
1111
accaatgtcctcttcccagt
N.D.
469


196147
3′UTR
439
1181
gtgaatgtgggcaactacct
N.D.
470


196148
3′UTR
439
1201
ttctgagagtgaatagccct
N.D.
471


196149
3′UTR
439
1221
agtcctagctgatagcctaa
N.D.
472


196150
3′UTR
439
1251
agaatgagcactgtgaactc
N.D.
473


196151
3′UTR
439
1371
gcaagccttctctctaaggc
N.D.
474


196152
3′UTR
439
1411
tgactatacccagatgccac
N.D.
475


196153
3′UTR
439
1561
cctgactcttgtggcctgaa
N.D.
476


196154
3′UTR
439
1581
taggacagcctgagtctcac
N.D.
477


196155
3′UTR
439
1601
gagagatggactactctggt
N.D.
478


196156
3′UTR
439
1621
gcaacatacagccatccatg
N.D.
479


196157
3′UTR
439
1641
gtctgtaattgctcctgcta
N.D.
480


196158
3′UTR
439
1681
acgtcttatccccagagtcc
N.D.
481


196159
3′UTR
439
1751
tggtcaacaagatagctgca
N.D.
482


196160
3′UTR
439
1801
agctctcagctcttccagct
N.D.
483


196161
3′UTR
439
1821
cagattccaccactctgtca
N.D.
484


196162
3′UTR
439
1881
caggaagtccaggtatagat
N.D.
485


196163
3′UTR
439
1901
agctatattagtcacagacc
N.D.
486


196164
3′UTR
439
1951
cctctaatgcaaccatcaga
N.D.
487


196165
3′UTR
439
2011
atggtcagtctgagctcaca
N.D.
488


196166
3′UTR
439
2041
tgccacggactctcccttgc
N.D.
489


196167
3′UTR
439
2071
ccttgcaggagactccagat
N.D.
490


196168
3′UTR
439
2221
tgaccatgacagcagatttg
N.D.
491


196263
3′UTR
439
2
gtctctggctgaaggctcag
N.D.
492


196264
Coding
439
525
ccagaataatgcttgcctct
N.D.
493


280264
5′UTR
439
27
cagaatccactcctttggag
66
494


280265
5′UTR
439
61
gtcactccctgccaccagtg
74
495


280266
Start Codon
439
81
accacagcagcttctccatg
25
496


280267
Coding
439
111
tattagagaagctgaccaag
27
497


280268
Coding
439
141
ccttcttgtgcatgcctgcc
74
498


280269
Coding
439
221
agtgaaggctttgagtggct
25
499


280270
Coding
439
311
gaggatctcgttaaattgtc
50
500


280271
Coding
439
364
atttcatctccacccactga
60
501


280272
Coding
439
411
cacagaggtgagttggatcc
59
502


280273
Coding
439
431
tgtgctggactcccagcttg
63
503


280274
Coding
439
451
acccagagctctgcaatgcc
45
504


280275
Coding
439
495
tgtagcccttcttcagactc
46
505


280276
Coding
439
544
aacgaatcctgatcctgccc
70
506


280277
Coding
439
641
gacggtattaatctcttctg
70
507


280278
3′UTR
439
773
cccaagaagcaccttcagga
92
508


280279
3′UTR
439
851
gctgtttatgtagcaggcat
91
509


280280
3′UTR
439
881
ctctggtgttgaagaaggca
86
510


280281
3′UTR
439
1041
ctaggcgtcaactttctcat
100
511


280282
3′UTR
439
1071
tgacttaaaagtcacttctc
46
512


280283
3′UTR
439
1091
taagtggtgaacctgtcttg
72
513


280284
3′UTR
439
1121
tagacagaagaccaatgtcc
79
514


280285
3′UTR
439
1171
gcaactaccttctactctct
60
515


280286
3′UTR
439
1211
gatagcctaattctgagagt
64
516


280287
3′UTR
439
1291
atcttctatttcagaagact
81
517


280288
3′UTR
439
1312
agaatggcacagtattgctg
72
518


280289
3′UTR
439
1401
cagatgccacttttgcccag
65
519


280290
3′UTR
439
1447
atataagcaagcaaacaccc
86
520


280291
3′UTR
439
1571
tgagtctcaccctgactctt
56
521


280292
3′UTR
439
1611
gccatccatggagagatgga
47
522


280293
3′UTR
439
1631
gctcctgctagcaacataca
85
523


280294
3′UTR
439
1671
cccagagtccacactgaatc
67
524


280295
3′UTR
439
1725
cccaggttcatgccttctaa
92
525


280296
3′UTR
439
1771
cttctccatctccctccaca
58
526


280297
3′UTR
439
1861
ttggttccatgcaaggctga
39
527


280298
3′UTR
439
1891
gtcacagacccaggaagtcc
81
528


280299
3′UTR
439
1919
ttcacccaggtaaccaagag
77
529


280300
3′UTR
439
1961
gatagtcagacctctaatgc
73
530


280301
3′UTR
439
2031
tctcccttgcaaggacagca
57
531


280302
3′UTR
439
2051
gagattagagtgccacggac
68
532


280303
3′UTR
439
2081
cagcaagaatccttgcagga
85
533


280304
3′UTR
439
2124
cccacacgaatgactaattg
75
534


280305
3′UTR
439
2155
gaataagagcattaagaccc
62
535


280306
3′UTR
439
2211
agcagatttgagcttctcaa
22
536


280307
3′UTR
439
2271
gaggagtctgtttctacaac
10
537


280308
3′UTR
439
2281
ccttacctttgaggagtctg
11
538


280309
3′UTR
439
2285
aagcccttacctttgaggag
8
539









As shown in Table 5, SEQ ID NOs 494, 495, 498, 501, 502, 503, 506, 507, 508, 509, 510, 511, 513, 514, 515, 516, 517, 518, 519, 520, 521, 523, 524, 525, 526, 528, 529, 530, 531, 532, 533, 534 and 535 demonstrated at least 25% inhibition of rabbit C-reactive protein expression in this experiment and are therefore preferred.
Example 19
Antisense Inhibition of Human C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies
In a further embodiment of the present invention, five oligonucleotides were selected for additional dose-response studies. Cytokine-induced Hep3B cells were treated with 50, 100 and 150 nM of ISIS 133712, 133719, 133726, 140180 and 140177 and mRNA levels were measured 24 hours after oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.
Results of these studies are shown in Table 6. Data are averages from two experiments and are expressed as percent inhibition of cytokine-induced control.







TABLE 6







Inhibition of cytokine-induced human C-reactive protein mRNA


expression in Hep3B cells 24 hours after oligonucleotide


treatment










% Inhibition




Dose of oligonucleotide











ISIS #
50 nM
100 nM
150 nM
SEQ ID NO














133712
60
84
77
22


133719
0
46
76
29


133726
75
85
92
36


140177
31
45
15
53


140180
26
59
91
56









As shown in Table 6, ISIS 133712, ISIS 133726 and ISIS 140180 were effective at reducing human C-reactive protein mRNA levels in a dose-dependent manner and are therefore preferred compounds of the present invention.
Example 20
Antisense Inhibition of rat C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies
In a further embodiment of the present invention, three oligonucleotides were selected for additional dose-response studies. Rat primary hepatocytes were treated with 50, 150 and 300 nM of ISIS 197181, 197178, 197183 and 197190. Target mRNA levels were measured at 24 hours post oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.
Results of these studies are shown in Table 7. Data are averages from three experiments and are expressed as percent inhibition of control.







TABLE 7







Inhibition of rat C-reactive protein mRNA expression in


primary hepatocytes: dose response









% Inhibition



Dose, nM











ISIS #
SEQ ID NO
50
150
300














197181
278
38
37
37


197178
275
38
56
65


197183
280
9
73
84


197190
287
55
71
85









As shown in Table 7, ISIS 197181, ISIS 197178, ISIS 197183 and ISIS 197190 were effective at reducing rat C-reactive protein mRNA levels in a dose-dependent manner and are therefore preferred compounds of the present invention.
Example 21
Antisense Inhibition of Rat C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: In Vivo Dose Response Studies
In a further embodiment of the present invention, three oligonucleotides were selected for additional in vivo dose response studies. Three-month old male Sprague-Dawley rats received subcutaneous injections of saline or 1, 10 or 25 mg/kg of ISIS 197178 (SEQ ID NO: 275), ISIS 197183 (SEQ ID NO: 280) and ISIS 197190 (SEQ ID NO: 287) twice weekly for 2 weeks. At the end of the treatment period, animals were sacrificed and liver target mRNA levels were measured by real-time PCR as described in other examples herein. Saline treated animals served as a control. Rat liver C-reactive protein mRNA levels were reduced by 5% following a 1 mg/kg dose of 197178 and by 18% following a 10 mg/kg dose of ISIS 197190.
Example 22
Antisense Inhibition of Rabbit C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies
In a further embodiment of the present invention, four oligonucleotides were selected for additional dose-response studies. Rabbit primary hepatocytes were treated with 10, 50 150 and 300 nM of ISIS 280279, 280290, 280298 and 282303. mRNA levels were measured 24 hours after oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.
Results of these studies are shown in Table 8. Data are averages from two experiments and are expressed as percent inhibition of control.







TABLE 8







Inhibition of rabbit C-reactive protein mRNA expression in


rabbit primary hepatocytes: dose response









% Inhibition



Dose of oligonucleotide












ISIS #
SEQ ID NO
10 nM
50 nM
150 nM
300 nM





280279
509
55
53
62
35


280290
520
49
77
84
81


280298
528
55
53
62
36


282303
533
40
76
80
87









As shown in Table 8, ISIS 280303 and ISIS 280290 were effective at reducing C-reactive protein mRNA levels in a dose-dependent manner and are therefore preferred compounds of the present invention.
Example 23
Antisense Inhibition of C-Reactive Protein Expression (ISIS 133726) in Liver Tissue of the Cynomolgus Monkey
In a further embodiment, male Cynomolgus monkeys were treated with ISIS 133726 (SEQ ID NO: 36) and levels of C-reactive protein mRNA were measured in liver tissue.
Male Cynomolgus monkeys were divided into two treatment groups, control animals (n=4; saline treatment only) and treated animals (n=8; treated with ISIS 133726). Animals in the treatment group were dosed subcutaneously twice a week for 4 weeks with 10 mg/kg and 20 mg/kg of ISIS 133726, respectively. Animals in the control group were treated with saline only. Three days later, all animals were sacrificed and livers were taken for analysis of C-reactive protein mRNA. Levels of mRNA were normalized to those of the saline treated animals. In animals treated with 10 mg/kg and 20 mg/kg ISIS 133726, C-reactive protein mRNA levels within liver were reduced by 42% and 69%, respectively.
Levels of the liver enzymes ALT and AST were measured weekly and showed no change, indicating no ongoing toxic effects of the oligonucleotide treatment.
The results of this study demonstrate a significant reduction in liver C-reactive protein mRNA upon treatment with ISIS 133726.
Example 24
Modulation of Mouse C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap.
In accordance with the present invention, a series of antisense compounds was designed to target different regions of the mouse C-reactive protein RNA, using published sequences (GENBANK® accession number NM—007768.1, incorporated herein as SEQ ID NO: 540). The compounds are shown in Table 9. “Target site” indicates the first (5′-most) nucleotide number on the particular target nucleic acid to which the compound binds. All compounds in Table 9 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE)nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
The compounds were analyzed for their effect on mouse C-reactive protein mRNA levels by quantitative real-time PCR as described in other examples herein. Probes and primers to mouse C-reactive protein were designed to hybridize to a mouse C-reactive protein sequence, using published sequence information (GENBANK® accession number NM—007768.1, incorporated herein as SEQ ID NO: 540). For mouse C-reactive protein the PCR primers were: forward primer: TGGATTGATGGGAAACCCAA (SEQ ID NO: 541) reverse primer: GCATCTGGCCCCACAGTG (SEQ ID NO: 542) and the PCR probe was: FAM-TGCGGAAAAGTCTGCACAAGGGC-TAMRA (SEQ ID NO: 543) where FAM is the fluorescent reporter dye and TAMRA is the quencher dye. For mouse GAPDH the PCR primers were: forward primer: GGCAAATTCAACGGCACAGT (SEQ ID NO: 544) reverse primer: GGGTCTCGCTCCTGGAAGAT (SEQ ID NO: 545) and the PCR probe was: 5′ JOE-AAGGCCGAGAATGGGAAGCTTGTCATC-TAMRA 3′ (SEQ ID NO: 546) where JOE is the fluorescent reporter dye and TAMRA is the quencher dye. Data, shown in Table 9, are from an experiment in which primary mouse hepatocytes were treated with 150 nM the antisense oligonucleotides of the present invention. The data are presented as percent expreeion relative to control, untreated cells. If present, “N.D.” indicates “no data”.







TABLE 9







Modulation of mouse C-reactive protein mRNA levels by


chimeric phosphorothioate oligonucleotides having


2′-MOE wings and a deoxy gap
















TARGET







ISIS

SEQ ID
TARGET

%
SEQ


#
REGION
NO
SITE
SEQUENCE
CONTROL
ID NO

















133685
5′UTR
540
21
TTTGTCTGAAAGATCAAGGA
83
547



133686
5′UTR
540
31
AGGACAGTGTTTTGTCTGAA
55
548


133687
start codon
540
71
CTTCTCCATGGCTATGGATG
68
549


133688
start codon
540
81
ACCAGAGTAGCTTCTCCATG
131
550


133689
coding
540
221
AGTAAAGGTGTTCAGTGGCT
84
551


133690
coding
540
301
TTAGAGTTCTTCTTGGTAGC
36
552


133691
coding
540
371
GAATCGTACTTCAGCACCAC
139
553


133692
coding
540
411
CACAGATGTGTGTTGGAGCC
128
554


133693
coding
540
441
CTACAATCCCCGTAGCAGAC
122
555


133694
coding
540
531
CCTGCCCCAAGATGATGCTT
238
556


133695
coding
540
661
CTGAGTGTCCCACCAACATA
183
557


133696
coding
540
711
CATCACCCTGTGCTTTATAG
175
558


133697
stop codon
540
741
GTCAGGACCACAGCTGCGGC
48
559


133698
stop codon
540
761
TTCAGGGTTCACAACAGTAG
67
560


133699
3′UTR
540
781
AATGTAATCCCAGGAGGTGC
44
561


133700
3′UTR
540
891
GTGCTCTAGTGCTGAGGACC
102
562


133701
3′UTR
540
1091
CTCCTTTCTGTGCATCTATT
70
563


133702
3′UTR
540
1261
AGATGATAGGTATTATGCAT
120
564


133703
3′UTR
540
1361
CCAGTGTCCAGTCTTCAACA
52
565


133704
3′UTR
540
1381
GGGCCCTCCTGATAGATTAT
87
566


133705
3′UTR
540
1425
GTAATCAGTGGCTGCTGAGA
46
567


133706
3′UTR
540
1451
ACAGAACCCTATATGAAGAG
94
568


133707
3′UTR
540
1508
AGACCTGCATAATGACACCA
34
569


133708
3′UTR
540
1551
GCACAGTGTAGTCAGTGCTC
50
570


147859
5′UTR
540
1
CAAGGAGTCCTGGAACGCCT
414
571


147860
5′UTR
540
41
CTGGACTAAGAGGACAGTGT
81
572


147861
coding
540
102
AGCTGATCATGATCAGAAGG
435
573


147862
coding
540
191
TGCTTCCAGAGACACATAGG
262
574


147863
coding
540
241
GTGTAGAAATGGAGACACAC
212
575


147864
coding
540
281
ATAAGAGAAGACACTGAAGC
129
576


147865
coding
540
501
CCACAGTGTAGCCCTTGTGC
N.D.
577


147866
coding
540
521
GATGATGCTTGCATCTGGCC
148
578


147867
coding
540
544
TACGAGTCCTGCTCCTGCCC
106
579


147868
coding
540
571
GACTGCTTTGCATCAAAGTC
26
580


147869
coding
540
701
TGCTTTATAGTTCAGTGCCC
72
581


147870
3′UTR
540
801
TAACCCGAGACAAGGGAGAG
95
582


147871
3′UTR
540
841
CAGAACAGACCTACAACATC
89
583


147872
3′UTR
540
861
GAAGTGAAAGGCCATATTCA
91
584


147873
3′UTR
540
931
TAGTGGGATGCTTATGCTGG
275
585


147874
3′UTR
540
1141
AATACAGCACTCAAGATGAC
212
586


147875
3′UTR
540
1181
ATAGGAAAGGATCTGAAGAG
93
587


147876
3′UTR
540
1211
CATCATGAATTTGAGAGAGA
138
588


147877
3′UTR
540
1281
AGGTAGATAGATTGATTGAT
314
589


147878
3′UTR
540
1301
CTGATGAATAGATGATAGAT
228
590


147879
3′UTR
540
1321
GTAATCAGTAAGATGGATGA
381
591


147880
3′UTR
540
1378
CCCTCCTGATAGATTATCCA
38
592


147881
3′UTR
540
1501
CATAATGACACCAATTGACA
101
593


147882
3′UTR
540
1521
GGTTGCCCAAACAAGACCTG
144
594


147883
3′UTR
540
1541
GTCAGTGCTCCATCACTCTA
44
595


147884
3′UTR
540
1561
CTGATTCTGAGCACAGTGTA
233
596









Example 25
Antisense Inhibition of Mouse C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies
In a further embodiment of the present invention, seven oligonucleotides were selected for additional dose-response studies. Primary mouse hepatocytes were treated with 10, 50 150 and 300 nM of ISIS 133688, 133697, 133702, 133708, 147880, 147868, 147883. mRNA levels were measured 24 hours after oligonucleotide treatment as described in other examples herein. Untreated cells served as a control.
Results of these studies are shown in Table 10. Data are averages from three experiments and are expressed as percent inhibition of control.







TABLE 10







Inhibition of mouse C-reactive protein mRNA expression in


mouse primary hepatocytes: dose response









% Inhibition



Dose of oligonucleotide












ISIS #
SEQ ID NO
10 nM
50 nM
150 nM
300 nM





133688
550
59
75
75
67


133697
559
63
63
76
76


133702
564
43
35
45
52


133708
570
72
74
72
72


147868
580
59
59
76
80


147880
592
61
69
82
77


147883
595
90
82
91
70









As demonstrated in Table 10, ISIS 113697 and 147868 inhibited C-reactive protein expression in a dose-dependent manner.
Example 26
Antisense Inhibition of Rabbit C-Reactive Protein In Vivo
In a further embodiment of the present invention, ISIS 280303 (SEQ ID NO: 533) was tested for its effects on C-reactive proteins in rabbits. Male New Zealand white rabbits were fed a normal diet and received subcutaneous injections of 20 mg/kg ISIS 280303 twice per week for a period of three weeks. Saline-injected animals served as a control. Oligonucleotide- and saline-injected groups included 4 animals each. At the end of the treatment period, the animals were sacrificed and the liver was isolated for RNA extraction. C-reactive protein mRNA levels in liver were measured by real-time PCR as described by other examples herein. Relative to the saline control, ISIS 280303 inhibited C-reactive protein mRNA expression by 52%.
Example 27
Rabbit Models for Study of Atherosclerotic Plaque Formation
The Watanabe heritable hyperlipidemic (WHHL) strain of rabbit is used as a model for atherosclerotic plaque formation. New Zealand white rabbits on a high-fat diet are also used as a model of atherosclerotic plaque formation. Treatment of WHHL or high fat fed New Zealand white rabbits with C-reactive protein antisense compounds is used to test their potential as therapeutic or prophylactic treatments for atherosclerotic plaque disease. Rabbits are injected with 5, 10, 29 or 50 mg/kg of antisense oligonucleotides targeted to C-reactive protein. Animals treated with saline alone or a control oligonucleotide serve as controls. Throughout the treatment, serum samples are collected and evaluated for serum lipids, including cholesterol, LDL-cholesterol, VLDL-cholesterol, HDL-cholesterol and triglycerides, by routine clinical analysis. Liver tissue triglyceride content is measured using a Triglyceride GPO Assay (Sigma-Aldrich, St. Louis, Mo.). Liver, kidney, heart, aorta and other tissues are procured and processed for histological analysis using routine procedures. Liver and kidney tissues are examined for evidence of basophilic granules and inflammatory infiltrates. The aorta is stained using routine procedures, with a dye such as Sudan IV, to visualize atherosclerosis. Aorta tissue is also embedded in paraffin and sectioned, using routine histological procedures, and the sections are evaluated for the presence of intimal lesions.
Example 28
A Mouse Model for Atherosclerotic Plaque Formation: Human C-Reactive Protein Transgenic Mice Lacking the LDL Receptor Gene
The LDL receptor is responsible for clearing C-reactive protein-containing LDL particles. Without the LDL receptor, animals cannot effectively clear C-reactive protein-containing LDL particles from the plasma, thus the serum levels of C-reactive protein and LDL cholesterol are markedly elevated. Mice expressing the human C-reactive protein transgene (TgN-hApoB +/+) and mice deficient for the LDL receptor (LDLr −/−) are both used as animal models of atherosclerotic plaque development. When the LDL receptor deficiency genotype is combined with a human C-reactive protein transgenic genotype (TgN-hApoB +/+; LDLr −/−), atherosclerotic plaques develop rapidly. In accordance with the present invention, mice of this genetic background are used to investigate the ability of compounds to prevent atherosclerosis and plaque formation.
Male TgN-hApoB +/+; LDLr −/− mice are treated twice weekly with 10 or 20 mg/kg of C-reactive protein antisense oligonucleotides for 12 weeks. Control groups are treated with saline or control oligonucleotide. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides are measured at 2, 4, 6, 8 and 12 weeks by routine clinical analysis using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). Mouse apolipoprotein mRNA in liver is measured at 12 weeks.
Additionally, a four month study is performed in TgN-hApoB +/+; LDLr −/− mice, with treatment conditions used in the 12 week study. Mice are treated for 4 months with antisense oligonucleotides targeted to C-reactive protein to evaluate the ability of such compounds to prevent atherosclerotic plaque formation. Serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides are measured at 2, 4, 6, 8, 12 and 16 weeks by routine clinical analysis using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). Mouse C-reactive protein mRNA in liver at 16 weeks is measured by real-time PCR. At the end of the 4-month treatment period, additional treated mice are anesthetized and perfused with 10% formalin. The perfused arterial tree is isolated and examined for the presence of atherosclerotic plaques. Sections of the arterial tree are embedded in paraffin and prepared for histological analysis using routine methods.
Example 29
A Mouse Model for Atherosclerotic Plaque Formation: B6.129P-ApoetmlUnc Knockout Mice
B6.129P-ApoEtmlUnc knockout mice (herein referred to as ApoE knockout mice) obtained from The Jackson Laboratory (Bar Harbor, Me.), are homozygous for the ApoetmlUnc mutation and show a marked increase in total plasma cholesterol levels that are unaffected by age or sex. These animals present with fatty streaks in the proximal aorta at 3 months of age. These lesions increase with age and progress to lesions with less lipid but more elongated cells, typical of a more advanced stage of pre-atherosclerotic lesion.
The mutation in these mice resides in the apolipoprotein E (ApoE) gene. The primary role of the ApoE protein is to transport cholesterol and triglycerides throughout the body. It stabilizes lipoprotein structure, binds to the low density lipoprotein receptor (LDLR) and related proteins, and is present in a subclass of HDLs, providing them the ability to bind to LDLR. ApoE is expressed most abundantly in the liver and brain. Female B6.129P-ApoetmlUnc knockout mice (ApoE knockout mice) were used in the following studies to evaluate C-reactive protein antisense oligonucleotides as potential compounds for preventing atherosclerotic plaque formation.
Female ApoE knockout mice range in age from 5 to 7 weeks and are placed on a normal diet for 2 weeks before study initiation. ApoE knockout mice are then fed ad libitum a 60% fat diet, with 0.15% added cholesterol to induce dyslipidemia and obesity. Control animals are maintained on a high-fat diet with no added cholesterol. After overnight fasting, mice from each group are dosed intraperitoneally every three days with 5, 25 or 50 mg/kg of antisense oligonucleotide targeted to C-reactive protein, for a period of six weeks. Control groups consist of animals injected with a control oligonucleotide and animals injected with saline.
During and at the end of the treatment period, glucose levels, cholesterol (total cholesterol, HDL-cholesterol and LDL-cholesterol), triglyceride and liver enzyme levels are measured by routine clinical analysis using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). At study termination and forty-eight hours after the final injections, animals were sacrificed and evaluated for target mRNA levels in liver by real-time PCR. At the end of the treatment period, additional treated mice are anesthetized and perfused with 10% formalin. The perfused arterial tree is isolated and examined for the presence of atherosclerotic plaques. Sections of the arterial tree are embedded in paraffin and prepared for histological analysis using routine methods.
Example 30
Antisense Inhibition of Human C-Reactive Protein mRNA Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Study
In a further embodiment, four oligonucleotides were selected for an additional dose-response study. Cytokine-induced Hep3B cells, cultured as described herein, were treated with 25, 50, 75 and 150 nM of ISIS 329956 (SEQ ID NO: 149), ISIS 330012 (SEQ ID NO: 205), ISIS 330031 (SEQ ID NO: 224) and ISIS 133726 (SEQ ID NO: 36). 24 hours following oligonucleotide treatment, human C-reactive protein mRNA levels were quantitated using real-time PCR as described herein. ISIS 113529 (CTCTTACTGTGCTGTGGACA; incorporated herein as SEQ ID NO: 597) does not target C-reactive protein and served as a control. Cells were treated with 150 and 300 nM of ISIS 113529. ISIS 113529 is a chimeric oligonucleotide (“gapmer”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
Levels of C-reactive protein mRNA expression were also measured in cytokine-induced cells that were not treated with oligonucleotide (induced) and cells that receive neither cytokine nor oligonucleotide treatment (basal).
The results of this dose-response study are shown in Table 11. Data are averages from three experiments. Results were normalized to expression of C-reactive protein mRNA from cytokine-induced cells. Basal C-reactive protein mRNA was 11% of the cytokine-induced expression. Cells treated with 150 and 300 nM of ISIS 113529 expressed C-reactive protein mRNA at 76 and 84% of the cytokine-induced levels, respectively.







TABLE 11







Inhibition of cytokine-induced human C-reactive protein mRNA


expression in Hep3B cells 24 hours after oligonucleotide


treatment










% C-reactive protein mRNA expression




relative to cytokine-induced cells



Dose of oligonucleotide











ISIS #
25 nM
50 nM
75 nM
150 nM





329956
45
41
21
19


330012
48
33
22
12


330031
53
29
21
26


133726
94
51
33
23









These data reveal that ISIS 329956, ISIS 330012, ISIS 330031 and ISIS 133726 inhibited human C-reactive protein expression in cytokine-induced Hep3B cells, in a dose-dependent manner.
Example 31
Antisense Inhibition of Human C-Reactive Protein Secretion by Hep3B Cells: Dose Response Study
In a further embodiment of the present invention, four oligonucleotides were selected for an additional dose-response study to measure the effect of antisense oligonucleotide treatment on the secretion of C-reactive protein from cytokine-induced Hep3B cells. Cytokine-induced Hep3B cells, cultured as described herein, were treated with 150 and 300 nM of ISIS 329956 (SEQ ID NO: 149), ISIS 330012 (SEQ ID NO: 205), ISIS 330031 (SEQ ID NO: 224) and ISIS 133726 (SEQ ID NO: 36). Cells were treated with the control oligonucleotide ISIS 113529 (SEQ ID NO: 597) at 150 and 300 nM. 24 hours following oligonucleotide treatment human C-reactive protein secreted from cytokine-induced Hep3B cells into the culture media was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.). C-reactive protein secretion was also measured in cytokine-induced cells that were not treated with oligonucleotide (induced) and cells that received neither cytokine nor oligonucleotide treatment (basal).
The results of this dose-respose study are shown in Table 12. Data are averages from three experiments. Results were normalized to C-reactive protein levels secreted from cytokine-induced cells. Basal C-reactive protein level in the culture media was 8% of the cytokine-induced level.







TABLE 12







Inhibition of cytokine-induced human C-reactive protein


secretion from Hep3B cells 24 hours after oligonucleotide


treatment










% C-reactive protein




secretion relative to



cytokine-induced cells



Dose of oligonucleotide










150 nM
300 nM













329956
71
65


330012
69
47


330031
78
107


133726
76
55


113529
127
113









These data reveal that ISIS 329956, ISIS 330012 and ISIS 133726 inhibited secretion of C-reactive protein from cytokine-induced Hep3B cells, in a dose-dependent manner. ISIS 330031 inhibited C-reactive protein secretion at the lower dose of oligonucleotide. The control oligonucleotide ISIS 113529 did not inhibit C-reactive protein secretion.
Example 32
Antisense Oligonucleotides Targeted to C-Reactive Protein Having Variable 2′-deoxy Gaps and Variable 2′-MOE Wings
In a further embodiment, antisense oligonucleotides targeted to C-reactive protein were designed using the nucleotide sequences of SEQ ID NOs 36 and 205 and employing various gap and wing segment lengths. The compounds are shown in Table 13. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. All compounds in Table 13 are chimeric oligonucleotides (“gapmers”) ranging from 16 to 20 nucleotides in length. The “gap” region consists of 2′-deoxynucleotides, which is flanked on one or both sides (5′ and 3′ directions) by “wings” composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The length of the 2′-deoxy gap varies from 10 to 18 nucleotides and the length of the 2′-MOE wings varies from 1 to 5 nucleotides. The exact structure of each oligonucleotide is designated in Table 13 as the “configuration”. A designation of 3 ̃14 ̃3, for instance, indicates that the first (5′-most) 3 nucleotides and the last (3′-most) 3 nucleotides are 2′-MOE nucleotides and the 14 nucleotides in the gap are 2′-deoxynucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.








TABLE 13







Antisense oligonucleotides targeted to C-reactive protein



having varying 2′-deoxy gaps and varying 2′-MOE wings
















TARGET







ISIS

SEQ ID
TARGET


SEQ


#
REGION
NO
SITE
SEQUENCE
Configuration
ID NO

















353490
3′UTR
4
1671
GCACTCTGGACCCAAACCAG
4~12~4
36



353491
3′UTR
4
1671
GCACTCTGGACCCAAACCAG
3~14~3
36


353492
3′UTR
4
1671
GCACTCTGGACCCAAACCAG
2~16~2
36


353470
3′UTR
4
1719
TCCCATTTCAGGAGACCTGG
4~12~4
205


353471
3′UTR
4
1719
TCCCATTTCAGGAGACCTGG
3~16~1
205


353472
3′UTR
4
1719
TCCCATTTCAGGAGACCTGG
2~16~2
205


353512
3′UTR
4
1719
TCCCATTTCAGGAGACCTGG
3~14~3
205


353480
3′UTR
4
1719
TCCCATTTCAGGAGACCTG
5~10~4
598


353486
3′UTR
4
1719
CCCATTTCAGGAGACCTGG
4~10~4
599


353499
3′UTR
4
1672
GCACTCTGGACCCAAACCA
5~10~4
600


353502
3′UTR
4
1671
CACTCTGGACCCAAACCAG
4~10~5
601


353481
3′UTR
4
1720
TCCCATTTCAGGAGACCT
5~10~3
602


353483
3′UTR
4
1721
CCCATTTCAGGAGACCTG
4~10~4
603


353487
3′UTR
4
1719
CCATTTCAGGAGACCTGG
3~10~5
604


353500
3′UTR
4
1672
GCACTCTGGACCCAAACC
5~10~3
605


353503
3′UTR
4
1671
ACTCTGGACCCAAACCAG
3~10~5
606


353505
3′UTR
4
1673
CACTCTGGACCCAAACCA
4~10~4
607


353484
3′UTR
4
1722
CCATTTCAGGAGACCT
3~10~3
608


353506
3′UTR
4
1674
ACTCTGGACCCAAACC
3~10~3
609









Additional oligonucleotides were designed, using the nucleotide sequence of SEQ ID Nos 36 and 205 and incorporating uniformly modified nucleotides. ISIS 353489 and ISIS 353473 (sequences incorporated herein as SEQ ID Nos 36 and 205, respectively) hybridize to target sites 1671 and 1719 of SEQ ID NO: 4, respectively. These two compounds are uniformly comprised of 2′-O-methoxyethyl (2′-MOE) nucleotides, with phosphorothioate internucleoside linkages throughout the oligonucleotide. All cytosines are 5-methylcytosines.
A subset of these antisense oligonucleotides was selected for testing in cytokine-induced Hep3B cells. All oligonucleotides tested share the same nucleotide sequence represented herein as SEQ ID NO: 205, and vary with respect to modifications of the sugar moieties. Cells were cultured and induced as described herein, and subsequently treated with 50, 100 and 200 nM of ISIS 353470, ISIS 353512, ISIS 353472, ISIS 353473 and ISIS 330012 for a period of 24 hours. Cytokine-induced cells served as the control to which data were normalized. C-reactive protein mRNA was measured by real-time PCR as described herein. Data, shown in Table 14, represent the average of 3 experiments and are normalized to data from cells receiving cytokine treatment only. For the gapmers, the configuration of each oligonucleotide is indicated in the same manner as described for Table 13. The oligonucleotide uniformly comprised of 2′-MOE nucleotides is indicated by “uniform 2′-MOE”.







TABLE 14







Comparison of antisense inhibition by oligonucleotides


targeted to C-reactive protein having varying 2′-deoxy gaps


and varying 2′-MOE wings









% mRNA expression relative to



cytokine-induced control cells



Dose of oligonucleotide











ISIS #
Configuration
50 nM
100 nM
200 nM














353470
4~12~4
37
28
15


353512
3~14~3
20
16
28


353472
2~16~2
74
42
9


353473
Uniform 2′-MOE
117
89
80


330012
5~10~5
55
39
29









Additional oligonucleotides were designed, using the nucleotide sequence of SEQ ID Nos 36 and 205 and employing differing internucleoside linkages in the compound. ISIS 353514 and ISIS 353515 (sequences incorporated herein as SEQ ID Nos 36 and 205, respectively) hybridize to target sites 1671 and 1719 of SEQ ID NO: 4, respectively. These two compounds are chimeric oligonucleotides, having a 14 nucleotide gap segment composed of 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′) by 3 nucleotide wing segments composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside linkages between nucleotides 2 and 3 and between nucleotides 18 and 19 are phosphodiester. All other nucleoside linkages in the compounds are phosphorthioate. All cytosines are 5-methylcytosines.
Additional olignucleotides were designed using the publicly available sequence of human C-reactive protein (incorporated herein as SEQ ID NO: 4). The compounds are shown in Table 15. “Target site” indicates the first (5′-most) nucleotide number on the particular target sequence to which the compound binds. These compounds are hemimers, or “open end” type compounds, 15 nucleotides in length, wherein the “gap” segment is located at either the 3′ or the 5′ terminus of the oligomeric compound and consists of 2′-deoxynucleotides. The remaining segment is composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The exact structure of each oligonucleotide is designated in Table 15 as the “configuration”. A designation of 5 ̃10, for instance, indicates that a 5 nucleotide segment of a first chemical modification is at the 5′ terminus and a 10 nucleotide segment of a second chemical modification is at the 3′ terminus. A designation of 2′-MOE ̃2′-deoxy indicates that the 5′ terminus is comprised of 2′-MOE nucleotides, and the 3′ terminus is comprised of 2′-deoxynucleotides; 2′-MOE nucleotides are further indicated in bold type. Where present, “O” indicates that the internucleoside (backbone) linkages are phosphodiester. All other internucleoside linkages are phosphorothioate (P═S). All cytidine residues are 5-methylcytidines.







TABLE 15







Chimeric hemimers targeted to C-reactive protein
















TARGET







ISIS

SEQ ID
TARGET


SEQ


#
REGION
NO
SITE
SEQUENCE
Configuration
ID NO





353698
3′UTR
4
1720
TCCCAoTTTCAGGAGA
5~10
610








2′-MOE~2′-deoxy



353699
3′UTR
4
1719
TTTCAGGAGAoCCTGG
10~5 
611







2′-deoxy~2′-MOE



353501
3′UTR
4
1672
GCACTCTGGACCCAA
5~10
612







2′-MOE~2′-deoxy



353504
3′UTR
4
1671
CTGGACCCAAACCAG
1~14
613







2′-deoxy~2′-MOE









Example 33
Antisense Inhibition of Human C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies
In a further embodiment, oligonucleotides targeted to human C-reactive protein were selected for additional dose-response studies. Following antisense oligonucleotide treatment, C-reactive protein mRNA and secreted protein were measured in primary human hepatocytes, cultured as described herein and cytokine-induced as described herein for Hep3B cells.
Primary human hepatocytes were treated with 12.5, 25, 50, 100 and 200 nM of ISIS 330012 (SEQ ID NO: 205) and ISIS 133726 (SEQ ID NO: 36). Cytokine-induced cells that did not receive oligonucleotide treatment served as controls to which all data were normalized. ISIS 13650 (TCCCGCCTGTGACATGCATT, SEQ ID NO: 614) and ISIS 113529 (SEQ ID NO: 597), neither of which target C-reactive protein, served as control oligonucleotides. Cells were treated with 100 and 200 nM of ISIS 113529 and ISIS 13650. ISIS 13650 is a chimeric oligonucleotide (“gapmer”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
C-reactive protein mRNA levels were measured after 24 hours of oligonucleotide treatment by real-time PCR as described in other examples herein. Results of these studies are shown in Table 16. Data are averages from three experiments and are expressed as percent mRNA expression relative to data from cytokine-induced cells. Where present, “N.D.” indicates not determined.







TABLE 16







Inhibition of human C-reactive protein mRNA expression in


human primary hepatocytes: 24 hr dose response









% mRNA expression relative to cytokine-



induced control cells



Dose of oligonucleotide













ISIS #
SEQ ID NO
12.5 nM
25 nM
50 nM
100 nM
200 nM





330012
205
42
66
43
45
26


133726
 36
53
73
56
36
34


113529
597
N.D.
N.D.
N.D.
73
97


 13650
614
N.D 
N.D.
N.D.
74
57









As demonstrated in Table 16, doses of 25, 50, 100 and 200 nM of ISIS 330012 and 133726 inhibited C-reactive mRNA expression in a dose-dependent manner following 24 hours of oligonucleotide treatment.
In a further embodiment, in the same experiment presented in Table 16, C-reactive protein secreted into the tissue culture media from the cytokine-induced primary human hepatocytes was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.) following 24 hours of oligonucleotide treatment. Data, shown in Table 17, are averages from three experiments and are expressed as percent protein secreted relative to cytokine-induced controls. Where present, “N.D.” indicates not determined.







TABLE 17







Inhibition of human C-reactive protein secretion in human


primary hepatocytes: 24 hour dose response









% Protein secretion relative to



cytokine-induced control cells



Dose of oligonucleotide













ISIS #
SEQ ID NO
12.5 nM
25 nM
50 nM
100 nM
200 nM





330012
205
85
67
61
66
65


133726
 36
63
67
66
61
68


113529
597
N.D.
N.D.
N.D.
80
80


 13650
614
N.D 
N.D.
N.D.
79
91









As demonstrated in Table 17, ISIS 330012 inhibited C-reactive protein secretion following 24 hours of oligonucleotide treatment.
In a further embodiment, C-reactive protein mRNA levels in cytokine-induced primary human hepatocytes were measured following 48 hours of oligonucleotide treatment. Cells were treated with 12.5, 25, 50, 100 and 200 nM of ISIS 330012 and ISIS 133726. ISIS 13650 and ISIS 113529 served as control oligonucleotides. Cells were treated with 100 and 200 nM of ISIS 113529 and ISIS 13650. Data, shown in Table 18, are averages from three experiments and are expressed as percent mRNA expression relative to cytokine-induced control cells. Where present, “N.D.” indicates not determined.







TABLE 18







Inhibition of human C-reactive mRNA expression in human


primary hepatocytes: 48 hour dose response









% mRNA expression relative to cytokine-



induced control cells



Dose of oligonucleotide













ISIS #
SEQ ID NO
12.5 nM
25 nM
50 nM
100 nM
200 nM





330012
205
73
53
58
 27
19


133726
 36
65
53
39
 34
19


113529
597
N.D.
N.D.
N.D.
116
79


 13650
598
N.D 
N.D.
N.D.
116
85









As demonstrated in Table 18, ISIS 330012 and 133726 inhibited C-reactive mRNA expression in a dose-dependent manner following 48 hours of oligonucleotide treatment.
In a further embodiment, treatment with ISIS 330012 and ISIS 133726 for 48 hours was repeated, and both C-reactive protein mRNA and protein were measured. C-reactive protein was measured by real-time PCR following 48 hours of oligonucleotide treatment. Data, shown in Table 19, are averages from three experiments and are expressed as percent mRNA expression relative to cytokine-induced control cells. Where present, “N.D.” indicates not determined.







TABLE 19







Inhibition of human C-reactive protein mRNA expression in


human primary hepatocytes: 48 hour dose response









% mRNA expression



relative to cytokine-



induced control cells



Dose of oligonucleotide











ISIS #
SEQ ID NO
50
100
200














330012
205
54
36
17


133726
36
72
33
25


113529
597
N.D.
N.D.
112









As demonstrated in Table 19, ISIS 330012 and 133726 inhibited C-reactive mRNA expression in a dose-dependent manner following 48 hours of oligonucleotide treatment.
In a further embodiment, in the same experiment presented in Table 19, C-reactive protein secreted into the tissue culture media from the cytokine-induced primary human hepatocytes was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.) following 48 hours of oligonucleotide treatment. Data, shown in Table 20, are averages from three experiments and are expressed as percent protein secreted relative to cytokine-induced controls. Where present, “N.D.” indicates not determined.







TABLE 20







Inhibition of human C-reactive protein secretion in human


primary hepatocytes: 48 hour dose response









% Protein secretion



relative to cytokine-



induced control cells



Dose of oligonucleotide











ISIS #
SEQ ID NO
50
100
200














330012
205
40
25
18


133726
36
37
18
20


113529
597
N.D.
N.D.
104









As demonstrated in Table 20, ISIS 330012 and 133726 inhibited C-reactive protein expression in a dose-dependent manner following 48 hours of oligonucleotide treatment. At the 200 nM dose, ISIS 133726 and ISIS 330012 were able to lower C-reactive protein mRNA in cytokine-induced cells to levels below basal expression levels, i.e. levels observed in cells not induced with cytokine. Northern and immunoblot analyses also confirmed the reduction in C-reactive protein mRNA and protein expression after 48 hours of oligonucleotide treatment.
Example 34
Sequencing of Cynomolgus Monkey (Macaca fascicularis) C-Reactive Protein mRNA
In accordance with the present invention, a portion of the cynomolgus monkey C-reactive protein mRNA not available in the art was amplified and sequenced. Positions 537 to 2201 of the human C-reactive protein mRNA sequence (GENBANK® accession number M11725.1, incorporated herein as SEQ ID NO: 4) contain the target segment to which ISIS 133726 and ISIS 330012 hybridize. The corresponding segment of Cynomolgus monkey C-reactive protein mRNA was amplified and sequenced, using a series of 8 primer sets designed to the human sequence. Total RNA was purified from Cynomolgus monkey primary hepatocytes (In Vitro Technologies, Gaithersburg, Md.). A reverse transcription was performed to produce cDNA and was followed by approximately 40 rounds of PCR amplification. Following gel purification of the Cynomolgus fragments, the forward and reverse sequencing reactions of each product were performed using the RETROGENTM kit (Invitrogen). This kit was used to create the single-stranded cDNA and provided reagents for AMPLITAQTM PCR reaction. The sequenced products were assembled to largely complete the Cynomolgus monkey C-reactive protein mRNA. This Cynomolgus monkey sequence is incorporated herein as SEQ ID NO: 615 and is 93% homologous to positions 537 to 2201 of the human C-reactive protein mRNA. An additional sequence that shares 97% homology with human C-reactive protein from positions 101-290 is incorporated herein as SEQ ID NO: 616.
Example 35
Antisense Inhibition of Cynomolgus Monkey C-Reactive Protein Expression by Chimeric Phosphorothioate Oligonucleotides Having 2′-MOE Wings and a Deoxy Gap: Dose Response Studies
In a further embodiment, oligonucleotides targeted to human C-reactive protein were selected for additional dose-response studies were tested for their ability to inhibit target mRNA in primary Cynomolgus monkey hepatocytes. Due to the high degree of identity between human and Cynmolgus monkey C-reactive protein, ISIS 133726 (SEQ ID NO: 36) and ISIS 330012 (SEQ ID NO: 205) hybridize to Cynomolgus monkey C-reactive protein with perfect complementarity, at target sites 1147 and 1195 of the Cynomolgus monkey mRNA disclosed herein (SEQ ID NO: 615), respectively. Primary Cynolmolgus monkey hepatocytes were induced with cytokine as described herein for Hep3B cells and were treated with 50, 100 and 200 nM of ISIS 330012 (SEQ ID NO: 205) and ISIS 133726 (SEQ ID NO: 36). ISIS 113529 (SEQ ID NO: 597) served as the control oligonucleotide. Cells were treated with 150 and 300 nM of ISIS 113529.
C-reactive protein mRNA levels were measured following 24 hours of oligonucleotide treatment. Data, shown in Table 21, are averages from three experiments and are expressed as percent mRNA expression relative to cytokine-induced controls. Where present, “N.D.” indicates not determined.







TABLE 21







Inhibition of Cynomolgus monkey C-reactive protein mRNA


expression in human primary hepatocytes: 24 hour dose


response









% mRNA expression relative to



cytokine-induced control cells



Dose of oligonucleotide












ISIS #
SEQ ID NO
25 nM
50 nM
150 nM
300 nM















330012
205
 66
 62
48
13


133726
36
104
111
47
22


113529
597
N.D.
N.D.
130
86









As demonstrated in Table 21, ISIS 330012 (at all doses tested) and ISIS 133726 (at 150 and 300 nM) inhibited C-reactive protein mRNA expression in a dose-dependent manner following 24 hours of oligonucleotide treatment.
In a further embodiment, in the same experiment presented in Table 21, C-reactive protein secreted into the tissue culture media from the cytokine-induced primary Cynomolgus hepatocytes was measured by ELISA using a commercially available kit (ALerCHEK Inc., Portland, Me.) following 24 hours of oligonucleotide treatment. Data, shown in Table 22, are averages from three experiments and are expressed as percent protein secreted relative to cytokine-induced control cells. Where present, “N.D.” indicates not determined.







TABLE 22







Inhibition of Cynomolgus monkey C-reactive protein secretion


in Cynomolgus monkey primary hepatocytes: 24 hour dose


response









% protein secretion



relative to cytokine



induced control cells



Dose of oligonucleotide











ISIS #
SEQ ID NO
50
100
200














330012
205
40
25
18


133726
36
37
18
20


113529
597
N.D.
N.D.
104









As demonstrated in Table 22, ISIS 330012 and 133726 inhibited C-reactive protein secretion in a dose-dependent manner following 48 hours of oligonucleotide treatment.
These data demonstrate that ISIS 133726 and ISIS 330012, while designed to target the human C-reactive protein mRNA, are capable of inhibiting both C-reactive protein mRNA and secreted protein in Cynomolgus monkey primary hepatocytes, and are therefore antisense oligonucleotides that can be used to test the inhibition of Cynomolgus monkey C-reactive protein in vivo.
Example 36
Antisense Inhibition of C-Reactive Protein In Vivo: Cynomolgus Monkeys
Cynomolgus monkeys (male or female) are useful to evaluate antisense oligonucleotides for their potential to lower C-reactive protein mRNA or protein levels, as well as phenotypic endpoints associated with C-reactive protein including, but not limited to cardiovascular indicators, atherosclerosis, lipid diseases, obesity, and plaque formation. One study includes normal and induced hypercholesterolemic monkeys fed diets that are normal or high in lipid and cholesterol. Parameters that are observed during the test period include: total plasma cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, arterial wall cholesterol content, and coronary intimal thickening.
In a further embodiment, Cynomolgus monkeys fed an atherogenic diet develop atherosclerosis with many similarities to atherosclerosis of humans and are used to evaluate the potential of antisense compounds to prevent or ameliorate atherosclerosis. Female Cynomolgus macaques share several similarities in lipoproteins and the cardiovascular system with humans. In addition to these characteristics, there are similarities in reproductive biology. The Cynomolgus female has a 28-day menstrual cycle like that of women. Plasma hormone concentrations have been measured throughout the Cynomolgus menstrual cycle, and the duration of the follicular and luteal phases, as well as plasma estradiol and progesterone concentrations across the cycle, are also remarkably similar to those in women.
Antisense oligonucleotides targeted to C-reactive protein are evaluated for efficacy and toxicity in Cynomolgus monkeys. The oligonucleotides chosen for these studies hybridize to two distinct regions of the 3′ UTR of both human and monkey C-reactive protein mRNA. ISIS 133726 (SEQ ID NO: 36) and ISIS 330012 (SEQ ID NO: 205) are chimeric oligonucleotides with a 5 ̃10 ̃5 configuration, as described herein. ISIS 353512 (SEQ ID NO: 36) and ISIS 353491 (SEQ ID NO: 205) are the same chimeric oligonucleotides, respectively, with a 3 ̃14 ̃3 configuration, as described herein. Cynomolgus monkeys are treated as described in Table 23. Each of the 9 groups presented in Table 23 consists of 5 animals, and the number of males and females in each of these groups is indicated.







TABLE 23







Treatment of Cynomolgus monkeys with oligonucleotides


targeted to C-reactive protein: study design












Group

Number of




#
Treatment
Females/Males
Dose mg/kg
















1
Saline
3/2




2
ISIS 330012
2/3
7



3
ISIS 330012
3/2
20



4
ISIS 133726
2/3
7



5
ISIS 133726
3/2
20



6
ISIS 353512
2/3
7



7
ISIS 353512
3/2
20



8
ISIS 353491
2/3
7



9
ISIS 353491
3/2
20










All animals are dosed via subcutaneous injection on the study days 1, 3, 5, 8, 11, 15, 18, 22, 25 and 29. The first day of dosing is designated Day 1. The animals are evaluated for changes in general appearance and behavior, food consumption and body weight. Blood samples are collected at 1, 2 and 3 week intervals prior to the start of the study, on days 1 and 29 just prior to dosing and at 1, 2, 4 and 24 hours after dosing and on days 8, 15 and 22 just prior to dosing. Blood samples are subjected to clinical pathology evaluations, which include serum chemistry, hematology, coagulation and urinalysis parameters. Serum chemistry parameters analyzed include sodium, potassium, chloride, carbon dioxide, total bilirubin, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), calcium, phosphorus, blood urea nitrogen (BUN), creatinine, total protein, albumin, globulin, albumin/globulin ratio, glucose, cholesterol and triglycerides. Hematology parameters include red blood cell (RBC) counts, white blood cell (WBC) counts, hemoglobin concentration, hematocrit, reticulocyte counts, plasmodium evaluation, mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), platelet counts and blood cell morphology. Coagulation parameters that are evaluated include activated partial thromboplastin time (APTT) and prothromgin time (PT). Urinalysis parameters that are evaluated include color, character, pH, specific gravity, leukocyte esterase, nitrite, urobilinogen, protein, glucose, ketones, bilirubin, occult blood and microscopics. C-reactive protein in serum is measured using an immunochemiluminescence assay (ICMA). All clinical parameters are measured using routine procedures known in the art. Additionally, a toxicokinetic analysis is performed to determine the concentration of C-reactive protein oligonucleotide in serum. Furthermore, serum levels of cytokines and chemokines, including interleukin-1, interleukin-6, interleukin-8, interferon-gamma, tumor necrosis factor-alpha, monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), macrophage inflammatory protein-1β (MIP-1β), and regulated-on-activation, normal T cell expressed and secreted cytokine (RANTES), are measured to determine the extent of any immune or inflammatory response.
On day 30 of the study, 24 hours after the final dose of saline or oligonucleotide, animals are sacrificed. Final body weights are recorded, and a gross necropsy examination is conducted to evaluate the carcass, muscular/skeletal system, all external surfaces and orifices, cranial cavity and external surface of the brain, neck with associated organs and tissues, thoraci, abdominal and pelvic cavities with associated organs and tissues. Urine is collected from the bladder and analyzed as previously described herein. Kidney, liver, lung, heart and spleen weights are recorded. Cardiovascular, digestive, lymphoid/hematopoietic, urogenital and endocrine tissues are collected and preserved in 10% neutral-buffered formalin. Tissues collected from animals treated with saline and 20 mg/kg oligonucleotide, following preservation in 10% neutral-buffered formalin, are embedded in paraffin, sectioned, stained with hematoxylin and eosin and examined for pathological abnormalities. Bone marrow smears are collected for microscopic examination in cases where bone marrow sections reveal changes or abnormalities. A portion of the liver tissue collected, which has not been preserved in formalin, is homogenized in a buffer that inhibits Rnase activity and is evaluated for C-reactive protein mRNA expression by real-time PCR as described herein. The parameters evaluated in this study determine the efficacy and toxicity of antisense oligonucleotides targeted to C-reactive protein.
Example 37
Antisense Oligonucleotides Targeted to Human C-Reactive Protein In Vivo: Lean Mouse Study
In a further embodiment, antisense oligonucleotides targeted to human C-reactive protein were tested for their effects on serum lipids, serum glucose and indicators of toxicity. Male C57Bl/6 mice (Charles River Laboratories, Wilmington, Mass.) were fed a standard rodent diet. Mice were given intraperitoneal injections of 25 and 50 mg/kg of each of the following antisense oligonucleotides: ISIS 133726 (SEQ ID NO: 36), ISIS 329956 (SEQ ID NO: 149), ISIS 330012 (SEQ ID NO: 205) and ISIS 330031 (SEQ ID NO: 224). Each oligonucleotide-treated group consisted of 5 mice. A total of 10 saline-injected animals served as controls. Injections were administered twice weekly for a period of 4 weeks. At the end of the treatment period, mice were sacrificed. Body, liver and spleen weights were recorded and exhibited no significant changes.
Serum was collected for routine clinical analysis of ALT, AST, cholesterol (CHOL), glucose (GLUC), HDL-cholesterol (HDL), LDL-cholesterol (LDL), triglycerides (TRIG) and non-esterified free fatty acids (NEFA). These parameters were measured by routine procedures using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). The data are presented in Table 24.







TABLE 24







Serum chemistry analysis of mice treated with antisense


oligonucleotides targeted to human C-reactive protein









Serum parameters

















Dose
ALT
AST
CHOL
GLUC
HDL
TG
LDL
NEFA


Treatment
mg/kg
IU/L
IU/L
mg/dL
mg/dL
mg/dL
mg/dL
mg/dL
mEq/L



















SALINE

45
86
81
187
63
132
14
1.0


133726
25
36
62
85
172
63
158
16
1.2



50
42
64
73
179
54
139
15
1.4


329956
25
31
57
98
172
77
117
17
1.5



50
37
60
105
176
82
149
18
1.7


330012
25
34
71
89
200
71
123
13
1.5



50
35
59
93
187
75
115
12
1.5


330031
25
36
94
80
194
63
131
14
1.5



50
153
443
150
152
83
131
66
1.6









These data reveal that only the 50 mg/kg dose of ISIS 330031 resulted in a significant increase in the liver transaminases ALT and AST, suggesting a hepatotoxic effect at the highest dose of ISIS 330031. Treatment with ISIS 330031 at 50 mg/kg also resulted in an increase in cholesterol and LDL-cholesterol. A moderate increase in cholesterol was observed in animals treated with ISIS 329956 at 50 mg/kg. Increases in non-esterified free fatty acids were observed in mice treated with all oligonucleotides used in this study.
These data reveal that antisense oligonucleotides targeted to human C-reactive protein effectively inhibited target expression in lean mice, without producing overt toxicities.
Example 38
Antisense Inhibition of C-Reactive Protein In Vivo: Rat Study
In a further embodiment, antisense oligonucleotides targeted to C-reactive protein were tested in an additional animal model. Male Sprague Dawley rats (Charles River Laboratories, Wilmington, Mass.), maintained on a standard rodent diet, received intraperitoneal injections of 75 and 100 mg/kg ISIS 197178 (SEQ ID NO: 275) once per week for a period of 6 weeks. Saline-injected animals served as controls. Each treatment group consisted of 5 animals. At the end of the treatment period, the animals were sacrificed and evaluated for C-reactive protein mRNA and protein expression and liver, as well as C-reactive protein expression in serum. mRNA was measured by real-time PCR as described by other examples herein. Protein was measured by ELISA using a commercially available kit (BD Biosciences, Bedford, Mass.). The data, averaged from the 5 animals in each treatment group, are normalized to results from saline-treated animals and are presented in Table 25.







TABLE 25







Effects of antisense inhibition of C-reactive protein in rats










% control




Dose of ISIS 197178











C-reactive protein:
75 mg/kg
100 mg/kg







mRNA
12
13



protein, serum
15
15



protein, liver
32
33










These data demonstrate that ISIS 197178 markedly decreased liver C-reactive protein mRNA and protein, as well as serum protein. Reduction of serum C-reactive protein levels was confirmed by immunoblot analysis using the rat C-reactive protein antibody from the ELISA kit. These results reveal that reduction in liver C-reactive protein mRNA lowers serum C-reactive protein levels, illustrating an important link between liver C-reactive protein production and serum levels.
Example 39
Specificity of Oligonucleotides Targeted to C-Reactive Protein
In a further embodiment, the specificity of ISIS 330012 to C-reactive protein mRNA was investigated. A BLAST search was conducted to determine whether ISIS 330012 could hybridize to genes other than C-reactive protein. This search revealed several genes with sequences that harbor potential binding sites for ISIS 330012. These genes are shown in Table 26, where the number of mismatches is indicated. All potential ISIS 330012 target sites contain 2-3 mismatched nucleotides with respect to ISIS 330012. Also shown are the Unigene ID accession numbers of sequences, both of which are available through the National Center for Biotechnology Information database. The number of times the binding site is repeated in the gene sequence is indicated in the “count” column in Table 26.







TABLE 26







Gene sequences sharing 2-3 mismatches with C-reactive protein


at the ISIS 330012 binding site











# Mis-

GENBANK ®




matches
Unigene ID
Accession #
Gene Name
Count





2
Hs.256184
NM_001404.1
eukaryotic translation
1





elongation factor 1





gamma


2
Hs.441043
NM_014817.1
importin 11
1


2
Hs.54971
NM_016505.1
putative S1 RNA
1





binding domain





protein


3
Hs.11417
NM_006423.1
Rab acceptor 1
3





(prenylated)


3
Hs.121549
NM_145752.1
CDP-diacylglycerol—
1





inositol





3-phosphatidyl-





transferase





(phosphatidylinositol





synthase)


3
Hs.131842
NM_015255.1
ubiquitin ligase E3
2





alpha-II


3
Hs.135226
NM_001908.1
cathepsin B
1


3
Hs.135805
BC016490.1
skeletrophin
1


3
Hs.180577
NM_002087.1
granulin
1


3
Hs.200063
NM_015401.1
histone deacetylase 7A
1


3
Hs.20157
NM_025197.1
CDK5 regulatory
1





subunit associated





protein 3


3
Hs.248017
NM_014364.1
glyceraldehyde-3-
1





phosphate





dehydrogenase, testis-





specific


3
Hs.274268
NM_145648.1
solute carrier family
1





15, member 4


3
Hs.387667
AF106698.1
peroxisome
1





proliferative activated





receptor, gamma


3
Hs.418167
NM_000477.3
albumin
2









To test whether ISIS 330012 affects the expression of the genes in Table 26, primary human hepatocytes, cultured as described herein, were treated with 200 nM ISIS 330012 for 48 hours. Expression of the genes in Table 26 was measured by real-time PCR as described herein, using primers and probes designed to publicly available sequences. These data revealed that ISIS 330012 did not modulate the expression of any of the genes in Table 26, illustrating that, in primary hepatocytes, ISIS 330012 specifically hybridizes to, and inhibits, C-reactive protein mRNA.
Example 40
Cell Proliferation and Survival in Response to Cells Treated with Oligomeric Compounds Targeted to C-Reactive Protein
Cell cycle regulation is the basis for various cancer therapeutics. Unregulated cell proliferation is a characteristic of cancer cells, thus most current chemotherapy agents target dividing cells, for example, by blocking the synthesis of new DNA required for cell division. However, cells in healthy tissues are also affected by agents that modulate cell proliferation.
In some cases, a cell cycle inhibitor causes apoptosis in cancer cells, but allows normal cells to undergo growth arrest and therefore remain unaffected (Blagosklonny, Bioessays, 1999, 21, 704-709; Chen et al., Cancer Res., 1997, 57, 2013-2019; Evan and Littlewood, Science, 1998, 281, 1317-1322; Lees and Weinberg, Proc. Natl. Acad. Sci. USA, 1999, 96, 4221-4223). An example of sensitization to anti-cancer agents is observed in cells that have reduced or absent expression of the tumor suppressor genes p53 (Bunz et al., Science, 1998, 282, 1497-1501; Bunz et al., J. Clin. Invest., 1999, 104, 263-269; Stewart et al., Cancer Res., 1999, 59, 3831-3837; Wahl et al., Nat. Med., 1996, 2, 72-79). However, cancer cells often escape apoptosis (Lowe and Lin, Carcinogenesis, 2000, 21, 485-495; Reed, Cancer J. Sci. Am., 1998, 4 Suppl 1, S8-14). Further disruption of cell cycle checkpoints in cancer cells can increase sensitivity to chemotherapy while allowing normal cells to take refuge in G1 and remain unaffected. Cell cycle assays are employed to identify genes, such as p53, whose inhibition sensitizes cells to anti-cancer agents.
Cell Cycle Assay
The effect of oligomeric compounds targeted to C-reactive protein were examined in normal human mammary epithelial cells (HMECs) as well as in two breast carcinoma cell lines, MCF7 and T47D. All of the cell lines are obtained from the American Type Culture Collection (Manassas, Va.). The latter two cell lines express similar genes. MCF7 cells express the tumor suppressor p53, while T47D cells are deficient in p53. MCF-7 and HMECs cells are routinely cultured in DMEM low glucose (Invitrogen Life Technologies, Carlsbad, Calif.) supplemented with 10% fetal bovine serum (Invitrogen Life Technologies, Carlsbad, Calif.). T47D cells were cultured in DMEM High glucose media (Invitrogen Life Technologies, Carlsbad, Calif.) supplemented with 10% fetal bovine serum. Cells were routinely passaged by trypsinization and dilution when they reached approximately 90% confluence. Cells were plated in 24-well plates at approximately 50,000-60,000 cells per well for HMEC cells, approximately 140,000 cells per well for MCF-7 and approximately 170,000 cells per well for T47D cells, and allowed to attach to wells overnight.
ISIS 133726 (SEQ ID NO: 36) was used to test the effects of antisense inhibition of C-reactive protein on cell cycle progression. A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) was used a negative control, a compound that does not modulate cell cycle progression. In addition, a positive control for the inhibition of cell proliferation was assayed. The positive control was ISIS 148715 (TTGTCCCAGTCCCAGGCCTC; herein incorporated as SEQ ID NO: 618), which targets human Jagged2 and is known to inhibit cell cycle progression. ISIS 29248 and ISIS 148715 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
Oligonucleotide was mixed with LIPOFECTINTM reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEMTM medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 200 nM of oligonucleotide and 6 μg/mL LIPOFECTINTM reagent. Before adding to cells, the oligonucleotide, LIPOFECTINTM reagent and OPTI-MEMTM medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well containing T47D or MCF7 cells was washed with 150 μl of phosphate-buffered saline. Each well containing HMECs was washed with 150 μL of Hank's balanced salt solution. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEMTM medium/LIPOFECTINTM reagent cocktail. Control cells received LIPOFECTINTM reagent only. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. After 72 hours, routine procedures were used to prepare cells for flow cytometry analysis and cells were stained with propidium iodide to generate a cell cycle profile using a flow cytometer. The cell cycle profile was analyzed with the ModFit program (Verity Software House, Inc., Topsham Me.).
Fragmentation of nuclear DNA is a hallmark of apoptosis and produces an increase in cells with a hypodiploid DNA content, which are categorized as “subG1”. An increase in cells in G1 phase is indicative of a cell cycle arrest prior to entry into S phase; an increase in cells in S phase is indicative of cell cycle arrest during DNA synthsis; and an increase in cells in the G2/M phase is indicative of cell cycle arrest just prior to or during mitosis. Data are expressed as percentage of cells in each phase relative to the cell cycle profile of untreated control cells and are shown in Table 27.







TABLE 27







Cell cycle profile of cells treated with oligomeric compounds


targeted to C-reactive protein















G1
S
G2/M



Treatment
Sub G1
Phase
Phase
Phase


















HMEC
ISIS 133726
135
101
80
111




ISIS 29848
117
99
82
113




ISIS 148715
47
99
88
107



MCF7
ISIS 133726
116
110
83
103




ISIS 29848
130
106
91
98




ISIS 148715
42
109
80
110



T47D
ISIS 133726
349
82
111
130




ISIS 29848
154
86
111
118




ISIS 148715
62
83
116
124










These data reveal that ISIS 133726 did not significantly affect cell cycle progression in HMECs, MCF7 cells or T47D cells.
Caspase Assay
Programmed cell death, or apoptosis, is an important aspect of various biological processes, including normal cell turnover, as well as immune system and embryonic development. Apoptosis involves the activation of caspases, a family of intracellular proteases through which a cascade of events leads to the cleavage of a select set of proteins. The caspase family can be divided into two groups: the initiator caspases, such as caspase-8 and -9, and the executioner caspases, such as caspase-3, -6 and -7, which are activated by the initiator caspases. The caspase family contains at least 14 members, with differing substrate preferences (Thornberry and Lazebnik, Science, 1998, 281, 1312-1316). A caspase assay is utilized to identify genes whose inhibition selectively causes apoptosis in breast carcinoma cell lines, without affecting normal cells, and to identify genes whose inhibition results in cell death in the p53-deficient T47D cells, and not in the MCF7 cells which express p53 (Ross et al., Nat. Genet., 2000, 24, 227-235; Scherf et al., Nat. Genet., 2000, 24, 236-244). The chemotherapeutic drugs taxol, cisplatin, etoposide, gemcitabine, camptothecin, aphidicolin and 5-fluorouracil all have been shown to induce apoptosis in a caspase-dependent manner.
In a further embodiment of the invention, oligomeric compounds targeted to C-reactive protein were examined in normal human mammary epithelial cells (HMECs) as well as in two breast carcinoma cell lines, MCF7 and T47D. HMECs and MCF7 cells express p53, whereas T47D cells do not express this tumor suppressor gene. Cells were cultured as described for the cell cycle assay in 96-well plates with black sides and flat, transparent bottoms (Corning Incorporated, Corning, N.Y.). DMEM media, with and without phenol red, were obtained from Invitrogen Life Technologies (Carlsbad, Calif.). MEGM media, with and without phenol red, were obtained from Cambrex Bioscience (Walkersville, Md.).
ISIS 133726 (SEQ ID NO: 36) was used to test the effects of antisense inhibition of C-reactive protein on caspase-activity. A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; incorporated herein as SEQ ID NO: 617) was used as a negative control, a compound that does not effect caspase activity. As a positive control for caspase activation, an oligonucleotide targeted to human Jagged2 ISIS 148715 (SEQ ID NO: 618) or human Notchl ISIS 226844 (GCCCTCCATGCTGGCACAGG; herein incorporated as SEQ ID NO: 619) was also assayed. Both of these genes are known to induce caspase activity, and subsequently apoptosis, when inhibited. ISIS 29248, ISIS 148715 and ISIS 226844 are all chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
Oligonucleotide was mixed with LIPOFECTINTM reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEMTM medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 200 nM of oligonucleotide and 6 μg/mL LIPOFECTINTM reagent. Before adding to cells, the oligonucleotide, LIPOFECTINTM reagent and OPTI-MEMTM medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline (150 μL Hank's balanced salt solution for HMEC cells). The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEMTM medium/LIPOFECTINTM reagent cocktail. Compounds targeted to C-reactive protein, ISIS 226844 and ISIS 148715 were tested in triplicate, and ISIS 29848 was tested in up to six replicate wells. Untreated control cells received LIPOFECTINTM reagent only. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium without phenol red was added to each well.
Caspase-3 activity was evaluated with a fluorometric HTS Caspase-3 assay (Catalog # HTS02; EMD Biosciences, San Diego, Calif.) that detects cleavage after aspartate residues in the peptide sequence (DEVD). The DEVD substrate is labeled with a fluorescent molecule, which exhibits a blue to green shift in fluorescence upon cleavage by caspase-3. Active caspase-3 in the oligonucleotide treated cells is measured by this assay according to the manufacturer's instructions. 48 hours following oligonucleotide treatment, 50 uL of assay buffer containing 10 μM dithiothreitol was added to each well, followed by addition 20 uL of the caspase-3 fluorescent substrate conjugate. Fluorescence in wells was immediately detected (excitation/emission 400/505 nm) using a fluorescent plate reader (SPECTRAMAXTM GEMINIXSTM reader, Molecular Devices, Sunnyvale, Calif.). The plate was covered and incubated at 37° C. for and additional three hours, after which the fluorescence was again measured (excitation/emission 400/505 nm). The value at time zero was subtracted from the measurement obtained at 3 hours. The measurement obtained from the untreated control cells was designated as 100% activity.
The experiment was replicated in each of the 3 cell types, HMECs, T47D and MCF7 and the results are shown in Table 28. From these data, values for caspase activity above or below 100% are considered to indicate that the compound has the ability to stimulate or inhibit caspase activity, respectively. The data are shown as percent increase in fluorescence relative to untreated control values.







TABLE 28







Effects of antisense inhibition of C-reactive protein on


apoptosis in the caspase assay













Percent relative to



Cell Type
Treatment
untreated control















HMEC
ISIS 133726
148




ISIS 29848
275




ISIS 148715
1006



MCF7
ISIS 133726
77




ISIS 29848
103




ISIS 226844
199



T47D
ISIS 133726
125




ISIS 29848
154




ISIS 148715
380










From these data it is evident that inhibition of C-reactive protein expression by ISIS 133726 resulted in an inhibition of apoptosis in MCF7 cells, as compared to untreated control cells controls. These data indicate that this oligomeric compound is a candidate agent with applications in the treatment of conditions in which inhibition of apoptosis is desirable, for example, in neurodegenerative disorders.
Example 41
Assay for Inhibition of Angiogenesis Using Oligomeric Compounds Targeted to C-Reactive Protein
Angiogenesis is the growth of new blood vessels (veins and arteries) by endothelial cells. This process is important in the development of a number of human diseases, and is believed to be particularly important in regulating the growth of solid tumors. Without new vessel formation it is believed that tumors will not grow beyond a few millimeters in size. In addition to their use as anti-cancer agents, inhibitors of angiogenesis have potential for the treatment of diabetic retinopathy, cardiovascular disease, rheumatoid arthritis and psoriasis (Carmeliet and Jain, Nature, 2000, 407, 249-257; Freedman and Isner, J. Mol. Cell. Cardiol., 2001, 33, 379-393; Jackson et al., Faseb J., 1997, 11, 457-465; Saaristo et al., Oncogene, 2000, 19, 6122-6129; Weber and De Bandt, Joint Bone Spine, 2000, 67, 366-383; Yoshida et al., Histol. Histopathol., 1999, 14, 1287-1294).
Endothelial Tube Formation Assay as a Measure of Angiogenesis
Angiogenesis is stimulated by numerous factors that promote interaction of endothelial cells with each other and with extracellular matrix molecules, resulting in the formation of capillary tubes. This morphogenic process is necessary for the delivery of oxygen to nearby tissues and plays an essential role in embryonic development, wound healing, and tumor growth (Carmeliet and Jain, Nature, 2000, 407, 249-257). Moreover, this process can be reproduced in a tissue culture assay that evaluated the formation of tube-like structures by endothelial cells. There are several different variations of the assay that use different matrices, such as collagen I (Kanayasu et al., Lipids, 1991, 26, 271-276), Matrigel (Yamagishi et al., J. Biol. Chem., 1997, 272, 8723-8730) and fibrin (Bach et al., Exp. Cell Res., 1998, 238, 324-334), as growth substrates for the cells. In this assay, HUVECs are plated on a matrix derived from the Engelbreth-Holm-Swarm mouse tumor, which is very similar to Matrigel (Kleinman et al., Biochemistry, 1986, 25, 312-318; Madri and Pratt, J. Histochem. Cytochem., 1986, 34, 85-91). Untreated HUVECs form tube-like structures when grown on this substrate. Loss of tube formation in vitro has been correlated with the inhibition of angiogenesis in vivo (Carmeliet and Jain, Nature, 2000, 407, 249-257; Zhang et al., Cancer Res., 2002, 62, 2034-2042), which supports the use of in vitro tube formation as an endpoint for angiogenesis.
In a further embodiment, primary human umbilical vein endothelial cells (HuVECs) were used to measure the effects of oligomeric compounds targeted to C-reactive protein on tube formation activity. HuVECs were routinely cultured in EBM (Clonetics Corporation, Walkersville, Md.) supplemented with SingleQuots supplements (Clonetics Corporation, Walkersville, Md.). Cells were routinely passaged by trypsinization and dilution when they reached approximately 90% confluence and were maintained for up to 15 passages. HuVECs are plated at approximately 3000 cells/well in 96-well plates. One day later, cells are transfected with antisense oligonucleotides. The tube formation assay is performed using an in vitro Angiogenesis Assay Kit (Chemicon International, Temecula, Calif.).
ISIS 133726 (SEQ ID NO: 36) was used to test the effects of inhibition of C-reactive protein on endothelial tube formation. A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) served as a negative control, a compound that does not affect tube formation. ISIS 196103 (AGCCCATTGCTGGACATGCA, incorporated herein as SEQ ID NO: 620) which is targeted to integrin-β3 and is known to inhibit endothelial tube formation, was used as a positive control Oligonucleotide was mixed with LIPOFECTINTM reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEMTM medium (Invitrogen Life Technologies, Carlsbad, Calif.) to achieve a final concentration of 75 nM of oligonucleotide and 2.25 μg/mL LIPOFECTINTM reagent. Before adding to cells, the oligonucleotide, LIPOFECTINTM reagent and OPTI-MEMTM medium were mixed thoroughly and incubated for 0.5 hrs. Untreated control cells received LIPOFECTINTM reagent only. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEMTM medium/LIPOFECTINTM reagent cocktail. ISIS 133726 and ISIS 196103 were tested in triplicate, and ISIS 29848 was tested in up to six replicates. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. Fifty hours after transfection, cells are transferred to 96-well plates coated with ECMa-trixTM (Chemicon Inter-national). Under these conditions, untreated HUVECs form tube-like structures. After an overnight incubation at 37° C., treated and untreated cells are inspected by light microscopy. Individual wells are assigned discrete scores from 1 to 5 depending on the extent of tube formation. A score of 1 refers to a well with no tube formation while a score of 5 is given to wells where all cells are forming an extensive tubular network. Results are expressed as percent tube formation relative to untreated control samples. Treatment with ISIS 133726, ISIS 29848 and ISIS 196103 resulted in 81%, 100% and 51% tube formation, respectively. These results illustrate that ISIS 133726 inhibited tube formation and is thus a candidate agent with applications in the treatment of conditions where the inhibition of angiogenesis is desirable, for example, in the treatment of cancer, diabetic retinopathy, cardiovascular disease, rheumatoid arthritis and psoriasis.
Matrix Metalloproteinase Activity
During angiogenesis, endothelial cells must degrade the extracellular matrix (ECM) and thus secrete matrix metalloproteinases (MMPs) in order to accomplish this degradation. MMPs are a family of zinc-dependent endopeptidases that fall into eight distinct classes: five are secreted and three are membrane-type MMPs (MT-MMPs) (Egeblad and Werb, J. Cell Science, 2002, 2, 161-174). MMPs exert their effects by cleaving a diverse group of substrates, which include not only structural components of the extracellular matrix, but also growth-factor-binding proteins, growth-factor pre-cursors, receptor tyrosine-kinases, cell-adhesion molecules and other proteinases (Xu et al., J. Cell Biol., 2002, 154, 1069-1080).
In a further embodiment, the antisense inhibition of apolipoprotein B was evaluated for effects on MMP activity in the media above human umbilical-vein endothelial cells (HUVECs). MMP activity was measured using the EnzChek Gelatinase/Collagenase Assay Kit (Molecular Probes, Eugene, Oreg.). HUVECs are cultured as described for the tube formation assay. HUVECs are plated at approximately 4000 cells per well in 96-well plates and transfected one day later.
HUVECs were treated with ISIS 133726 (SEQ ID NO: 36) to inhibit C-reactive protein expression. An oligonucleotide with a randomized sequence, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) served as a negative control, or a treatment not expected to affect MMP activity. ISIS 25237 (GCCCATTGCTGGACATGC, SEQ ID NO: 621) targets integrin beta 3 and was used as a positive control for the inhibition of MMP activity. ISIS 25237 is a chimeric oligonucleotide (“gapmers”) 18 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by four-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotides. All cytidine residues are 5-methylcytidines.
Cells were treated as described for the tube formation assay, with 75 nM of oligonucleotide and 2.25 μg/mL LIPOFECTINTM reagent. ISIS 133726 and ISIS 25237 were tested in triplicate, and the ISIS 29848 was tested in up to six replicates. The plates were incubated for approximately 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. Approximately 50 hours after transfection, a p-aminophenylmercuric acetate (APMA, Sigma-Aldrich, St. Louis, Mo.) solution is added to each well of a Corning-Costar 96-well clear bottom plate (VWR International, Brisbane, Calif.). The APMA solution is used to promote cleavage of inactive MMP precursor proteins. Media above the HUVECs is then transferred to the wells in the 96-well plate. After 30 minutes, the quenched, fluorogenic MMP cleavage substrate is added, and baseline fluorescence is read immediately at 485 nm excitation/530 nm emission. Following an overnight incubation at 37° C. in the dark, plates are read again to determine the amount of fluorescence, which corresponds to MMP activity. Total protein from HUVEC lysates is used to normalize the readings, and MMP activites are expressed as a percent relative to MMP activity from untreated control cells that did not receive oligonucleotide treatment. MMP activities were 78%, 82% and 58% in the culture media from cells treated with ISIS 133726, ISIS 29848 and ISIS 25237. These data reveal that ISIS 133726 did not inhibit MMP activity.
Example 42
Adipocyte Assay of Oligomeric Compounds Targeted to C-Reactive Protein
Insulin is an essential signaling molecule throughout the body, but its major target organs are the liver, skeletal muscle and adipose tissue. Insulin is the primary modulator of glucose homeostasis and helps maintain a balance of peripheral glucose utilization and hepatic glucose production. The reduced ability of normal circulating concentrations of insulin to maintain glucose homeostasis manifests in insulin resistance which is often associated with diabetes, central obesity, hypertension, polycystic ovarian syndrom, dyslipidemia and atherosclerosis (Saltiel, Cell, 2001, 104, 517-529; Saltiel and Kahn, Nature, 2001, 414, 799-806).
Response of Undifferentiated Adipocytes to Insulin
Insulin promotes the differentiation of preadipocytes into adipocytes. The condition of obesity, which results in increases in fat cell number, occurs even in insulin-resistant states in which glucose transport is impaired due to the antilipolytic effect of insulin. Inhibition of triglyceride breakdown requires much lower insulin concentrations than stimulation of glucose transport, resulting in maintenance or expansion of adipose stores (Kitamura et al., Mol. Cell. Biol., 1999, 19, 6286-6296; Kitamura et al., Mol. Cell. Biol., 1998, 18, 3708-3717).
One of the hallmarks of cellular differentiation is the upregulation of gene expression. During adipocyte differentiation, the gene expression patterns in adipocytes change considerably. Some genes known to be upregulated during adipocyte differentiation include hormone-sensitive lipase (HSL), adipocyte lipid binding protein (aP2), glucose transporter 4 (Glut4), and peroxisome proliferator-activated receptor gamma (PPAR-γ). Insulin signaling is improved by compounds that bind and inactivate PPAR-γ, a key regulator of adipocyte differentiation (Olefsky, J. Clin. Invest., 2000, 106, 467-472). Insulin induces the translocation of GLUT4 to the adipocyte cell surface, where it transports glucose into the cell, an activity necessary for triglyceride synthesis. In all forms of obesity and diabetes, a major factor contributing to the impaired insulin-stimulated glucose transport in adipocytes is the downregulation of GLUT4. Insulin also induces hormone sensitive lipase (HSL), which is the predominant lipase in adipocytes that functions to promote fatty acid synthesis and lipogenesis (Fredrikson et al., J. Biol. Chem., 1981, 256, 6311-6320). Adipocyte fatty acid binding protein (aP2) belongs to a multi-gene family of fatty acid and retinoid transport proteins. aP2 is postulated to serve as a lipid shuttle, solubilizing hydrophobic fatty acids and delivering them to the appropriate metabolic system for utilization (Fu et al., J. Lipid Res., 2000, 41, 2017-2023; Pelton et al., Biochem. Biophys. Res. Commun., 1999, 261, 456-458). Together, these genes play important roles in the uptake of glucose and the metabolism and utilization of fats.
Leptin secretion and an increase in triglyceride content are also well-established markers of adipocyte differentiation. While it serves as a marker for differentiated adipocytes, leptin also regulates glucose homeostasis through mechanisms (autocrine, paracrine, endocrine and neural) independent of the adipocyte's role in energy storage and release. As adipocytes differentiate, insulin increases triglyceride accumulation by both promoting triglyceride synthesis and inhibiting triglyceride breakdown (Spiegelman and Flier, Cell, 2001, 104, 531-543). As triglyceride accumulation correlates tightly with cell size and cell number, it is an excellent indicator of differentiated adipocytes.
The effect of antisense inhibition of C-reactive protein by on the expression of markers of cellular differentiation was examined in preadipocytes. Human white preadipocytes (Zen-Bio Inc., Research Triangle Park, N.C.) were grown in preadipocyte media (ZenBio Inc., Research Triangle Park, N.C.). One day before transfection, 96-well plates were seeded with approximately 3000 cells/well.
A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) was used a negative control, a compound that does not modulate adipocyte differentiation. Tumor necrosis factor-alpha (TNF-α), which inhibits adipocyte differentiation, was used as a positive control for the inhibition of adipocyte differentiation as evaluated by leptin secretion. For all other parameters measured, ISIS 105990 (AGCAAAAGATCAATCCGTTA, incorporated herein as SEQ ID NO: 622), an inhibitor of PPAR-y, served as a positive control for the inhibition of adipocyte differentiation. ISIS 29848 and ISIS 105990 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
Oligonucleotide was mixed with LIPOFECTINTM reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEMTM medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 250 nM of oligonucleotide and 7.5 μg/mL LIPOFECTINTM reagent. Before adding to cells, the oligonucleotide, LIPOFECTINTM reagent and OPTI-MEMTM medium were mixed thoroughly and incubated for 0.5 hrs. Untreated control cells received LIPOFECTINTM reagent only. The medium was removed from the plates and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEMTM medium/LIPOFECTINTM reagent cocktail. ISIS 133726 and ISIS 105990 were tested in triplicate, ISIS 29848 was tested in up to six replicate wells. The plates were incubated for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. 100 μl of full growth medium was added to each well. After the cells have reached confluence (approximately three days), they were exposed for three days to differentiation media (Zen-Bio, Inc.) containing a PPAR-γ agonist, IBMX, dexamethasone, and insulin. Cells were then fed adipocyte media (Zen-Bio, Inc.), which was replaced at 2 to 3 day intervals.
Leptin secretion into the media in which adipocytes are cultured was measured by protein ELISA. On day nine post-transfection, 96-well plates were coated with a monoclonal antibody to human leptin (R&D Systems, Minneapolis, Minn.) and left at 4° C. overnight. The plates were blocked with bovine serum albumin (BSA), and a dilution of the treated adipocyte media was incubated in the plate at room temperature for 2 hours. After washing to remove unbound components, a second monoclonal antibody to human leptin (conjugated with biotin) was added. The plate was then incubated with strepavidin-conjugated horseradish peroxidase (HRP) and enzyme levels were determined by incubation with 3, 3′, 5,5′-tetramethlybenzidine, which turns blue when cleaved by HRP. The OD450 was read for each well, where the dye absorbance is proportional to the leptin concentration in the cell lysate. Results, shown in Table 29, are expressed as a percent control relative to untreated control samples. With respect to leptin secretion, values above or below 100% are considered to indicate that the compound has the ability to stimulate or inhibit leptin secretion, respectively.
The triglyceride accumulation assay measures the synthesis of triglyceride by adipocytes. Triglyceride accumulation was measured using the InfinityTM Triglyceride reagent kit (Sigma-Aldrich, St. Louis, Mo.). On day nine post-transfection, cells were washed and lysed at room temperature, and the triglyceride assay reagent was added. Triglyceride accumulation was measured based on the amount of glycerol liberated from triglycerides by the enzyme lipoprotein lipase. Liberated glycerol is phosphorylated by glycerol kinase, and hydrogen peroxide is generated during the oxidation of glycerol-1-phosphate to dihydroxyacetone phosphate by glycerol phosphate oxidase. Horseradish peroxidase (HRP) uses H2O2 to oxidize 4-aminoantipyrine and 3,5 dichloro-2-hydroxybenzene sulfonate to produce a red-colored dye. Dye absorbance, which is proportional to the concentration of glycerol, was measured at 515 nm using an UV spectrophotometer. Glycerol concentration was calculated from a standard curve for each assay, and data were normalized to total cellular protein as determined by a Bradford assay (Bio-Rad Laboratories, Hercules, Calif.). Results, shown in Table 29, are expressed as a percent control relative to untreated control samples. From these data, values for triglyceride (TRIG) accumulation above or below 100% are considered to indicate that the compound has the ability to stimulate or inhibit triglyceride accumulation, respectively.
Expression of the four hallmark genes, HSL, aP2, Glut4, and PPARγ, was also measured in adipocytes transfected with compounds of the invention. Cells were lysed on day nine post-transfection, in a guanadinium-containing buffer and total RNA is harvested. The amount of total RNA in each sample was determined using a Ribogreen Assay (Invitrogen Life Technologies, Carlsbad, Calif.). Real-time PCR was performed on the total RNA using primer/probe sets for the adipocyte differentiation hallmark genes Glut4, HSL, aP2, and PPAR-γ. mRNA levels, shown in Table 29, are expressed as percent control relative to the untreated control values. With respect to the four adipocyte differentiation hallmark genes, values above or below 100% are considered to indicate that the compound has the ability to stimulate adipocyte differentiation, or inhibit it, respectively.







TABLE 29







Effects of antisense inhibition of Tudor-SN on adipocyte


differentiation













Treatment
Leptin
TRIG
aP2
Glut4
HSL
PPARγ





ISIS 133726
85
67
93
63
99
77


ISIS 29848
94
76
87
70
87
72


ISIS 105990
N.D.
38
55
53
55
38


TNF-α
27
N.D.
N.D.
N.D.
N.D.
N.D.









ISIS 133726 reduced the expression levels leptin, triglycerides and GLUT4, suggesting that this antisense oligonucleotide is a candidate agent for applications where inhibition of adipocytes differentiation is desirable, for example, obesity, hyperlipidemia, atherosclerosis, atherogenesis, diabetes, hypertension, or other metabolic diseases, as well as having potential applications in the maintenance of the pluripotent phenotype of stem or precursor cells.
Example 43
Inflammation Assays Using Oligomeric Compounds Targeted to C-Reactive Protein
Inflammation assays are designed to identify genes that regulate the activation and effector phases of the adaptive immune response. During the activation phase, T lymphocytes (also known as T-cells) receiving signals from the appropriate antigens undergo clonal expansion, secrete cytokines, and upregulate their receptors for soluble growth factors, cytokines and co-stimulatory molecules (Cantrell, Annu. Rev. Immunol., 1996, 14, 259-274). These changes drive T-cell differentiation and effector function. In the effecotr phase, response to cytokines by non-immune effector cells controls the production of inflammatory mediators that can do extensive damage to host tissues. The cells of the adaptive immune systems, their products, as well as their interactions with various enzyme cascades involved in inflammation (e.g., the complement, clotting, fibrinolytic and kinin cascades) represent potential points for intervention in inflammatory disease. The inflammation assay presented here measures hallmarks of the activation phase of the immune response.
Dendritic cells treated with antisense compounds are used to identify regulators of dendritic cell-mediated T-cell costimulation. The level of interleukin-2 (IL-2) production by T-cells, a critical consequence of T-cell activation (DeSilva et al., J. Immunol., 1991, 147, 3261-3267; Salomon and Bluestone, Annu. Rev. Immunol., 2001, 19, 225-252), is used as an endpoint for T-cell activation. T lymphocytes are important immunoregulatory cells that mediate pathological inflammatory responses. Optimal activation of T lymphocytes requires both primary antigen recognition events as well as secondary or costimulatory signals from antigen presenting cells (APC). Dendritic cells are the most efficient APCs known and are principally responsible for antigen presentation to T-cells, expression of high levels of costimulatory molecules during infection and disease, and the induction and maintenance of immunological memory (Banchereau and Steinman, Nature, 1998, 392, 245-252). While a number of costimulatory ligand-receptor pairs have been shown to influence T-cell activation, a principal signal is delivered by engagement of CD28 on T-cells by CD80 (B7-1) and CD86 (B7-2) on APCs (Boussiotis et al., Curr. Opin. Immunol., 1994, 6, 797-807; Lenschow et al., Annu. Rev. Immunol., 1996, 14, 233-258). Inhibition of T-cell co-stimulation by APCs holds promise for novel and more specific strategies of immune suppression. In addition, blocking costimulatory signals may lead to the development of long-term immunological anergy (unresponsiveness or tolerance) that would offer utility for promoting transplantation or dampening autoimmunity. T-cell anergy is the direct consequence of failure of T-cells to produce the growth factor IL-2 (DeSilva et al., J. Immunol., 1991, 147, 3261-3267; Salomon and Bluestone, Annu. Rev. Immunol., 2001, 19, 225-252).
Dendritic Cell Cytokine Production as a Measure of the Activation Phase of the Immune Response
In a further embodiment of the present invention, the effect of ISIS 133726 (SEQ ID NO: 36) was examined on the dendritic cell-mediated costimulation of T-cells. Dendritic cells (DCs, Clonetics Corp., San Diego, Calif.) were plated at approximately 6500 cells/well on anti-CD3 (UCHT1, Pharmingen-BD, San Diego, Calif.) coated 96-well plates in 500 U/mL granulocyte macrophase-colony stimulation factor (GM-CSF) and interleukin-4 (IL-4). DCs were treated with antisense compounds 24 hours after plating.
A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617) served as a negative control, a compound that does not affect dendritic cell-mediated T-cell costimulation. ISIS 113131 (CGTGTGTCTGTGCTAGTCCC, incorporated herein as SEQ ID NO: 623), an inhibitor of CD86, served as a positive control for the inhibition of dendritic cell-mediated T-cell costimulation. ISIS 29848 and ISIS 113131 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
Oligonucleotide was mixed with LIPOFECTINTM reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEMTM medium (Invitrogen Life Technologies, Carlsbad, Calif.) to acheive a final concentration of 200 nM of oligonucleotide and 6 μg/mL LIPOFECTINTM reagent. Before adding to cells, the oligonucleotide, LIPOFECTINTM reagent and OPTI-MEMTM medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the cells and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEMTM medium/LIPOFECTINTM reagent cocktail. Untreated control cells received LIPOFECTINTM reagent only. ISIS 133726 and the positive control were tested in triplicate, and the negative control oligonucleotide was tested in up to six replicates. The plates were incubated with oligonucleotide for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. Fresh growth media plus cytokines was added and DC culture was continued for an additional 48 hours. DCs are then co-cultured with Jurkat T-cells in RPMI medium (Invitrogen Life Technologies, Carlsbad, Calif.) supplemented with 10% heat-inactivated fetal bovine serum (Sigma Chemical Company, St. Louis, Mo.). Culture supernatants are collected 24 hours later and assayed for IL-2 levels (IL-2 DUOSETTM kit, R&D Systems, Minneapolis, Minn.), which are expressed as a percent relative to untreated control samples. A value greater than 100% indicates an induction of the inflammatory response, whereas a value less than 100% demonstrates a reduction in the inflammatory response.
The culture supernatant of cells treated with ISIS 133726, ISIS 29848 and ISIS 113131 contained IL-2 at 84%, 83% and 55% of the IL-2 concentration found in culture supernatant from untreated control cells, respectively. These results indicate that ISIS 133726 did not inhibit T-cell co-stimulation.
Cytokine Signaling as a Measure of the Effector Phase of the Inflammatory Response
The cytokine signaling assay is designed to identify genes that regulate inflammatory responses of non-immune effector cells (initially endothelial cells) to both IL-1β and TNF-α (Heyninck et al., J Cell Biol, 1999, 145, 1471-1482; Zetoune et al., Cytokine, 2001, 15, 282-298). Response to cytokine stimulation is monitored by tracking the expression levels of four genes: A20, intracellular adhesion molecule 1 (ICAM-1), interleukin-9 (IL-8) and macrophage-inflammatory protein 2 (MIP2α). As described below, these genes regulate numerous parameters of the inflammatory response. Antisense oligonucleotides are used to identify genes that alter the cellular response to these cytokines.
A20 is a zinc-finger protein that limits the transcription of pro-inflammatory genes by blocking TRAF2-stimulated NK-KB signaling. Studies in mice show that TNF-α dramatically increases A20 expression in mice, and that A20 expression is crucial for their survival (Lee et al., Science, 2000, 289, 2350-2354).
ICAM-1 is an adhesion molecule expressed at low levels on resting endothelial cells that is markedly up-regulated in response to inflammatory mediators like tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interferon-γ (IFN-γ) (Springer, Nature, 1990, 346, 425-434). ICAM-1 expression serves to attract circulating leukocytes into the inflammatory site.
IL-8 is a member of the chemokine gene superfamily, members of which promote the pro-inflammatory phenotype of macrophages, vascular smooth muscle cells and endothelial cells (Koch et al., Science, 1992, 258, 1798-1801). IL-8 has been known as one of the major inducible chemokines with the ability to attract neutrophils to the site of inflammation. More recently, IL-8 has been implicated as a major mediator of acute neutrophil-mediated inflammation, and is therefore a potential anti-inflammatory target (Mukaida et al., Cytokine Growth Factor Rev, 1998, 9, 9-23).
MIP2α, another chemokine known to play a central role in leukocyte extravasation, has more recently been shown to be involved in acute inflammation (Lukacs et al., Chem Immunol, 1999, 72, 102-120). MIP2α is expressed in response to microbial infection, to injection of lipopolysaccharides (LPS), and to stimulation of cells with pro-inflammatory mediators such as IL-1β and TNF-α (Kopydlowski et al., J Immunol, 1999, 163, 1537-1544). Endothelial cells are one of several cell types that are sources of MIP2α (Rudner et al., J Immunol, 2000, 164, 6576-6582).
The effect of ISIS 133726 targeted to C-reactive protein was examined in human umbilical vascular endothelial cells (HUVECs) (ATCC, Manassus, Va.). HUVECs are cultured according to the supplier's recommendations. HUVECs are plated in a 96 well plate at a seeding density of approximately 3000 cells per well and are treated with antisense compounds 24 hours later.
A randomized control oligonucleotide, ISIS 29848 (NNNNNNNNNNNNNNNNNNNN; where N is A,T,C or G; herein incorporated as SEQ ID NO: 617), was used as a negative control, a compound that does not affect cytokine signaling. ISIS 29848 is chimeric oligonucleotide (“gapmer”) 20 nucleotides in length, composed of a central “gap” region consisting of ten 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′ directions) by five-nucleotide “wings”. The wings are composed of 2′-O-methoxyethyl (2′-MOE) nucleotides. The internucleoside (backbone) linkages are phosphorothioate (P═S) throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
Oligonucleotide was mixed with LIPOFECTINTM reagent (Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEMTM medium (Invitrogen Life Technologies, Carlsbad, Calif.) to achieve a final concentration of 75 nM of oligonucleotide and 2.25 μg/mL LIPOFECTINTM reagent. Before adding to cells, the oligonucleotide, LIPOFECTINTM reagent and OPTI-MEMTM medium were mixed thoroughly and incubated for 0.5 hrs. The medium was removed from the cells and the plates were tapped on sterile gauze. Each well was washed in 150 μl of phosphate-buffered saline. The wash buffer in each well was replaced with 100 μL of the oligonucleotide/OPTI-MEMTM medium/LIPOFECTINTM reagent cocktail. Untreated control cells received LIPOFECTINTM reagent only. ISIS 133726 was tested in triplicate, and ISIS 29848 was tested in up to six replicate wells. The plates were incubated with oligonucleotide for 4 hours at 37° C., after which the medium was removed and the plate was tapped on sterile gauze. Fresh growth media plus cytokines was added and DC culture was continued for an additional 46 hours, after which HUVECS were stimulated with 0.1 ng/mL of IL-1β or 1 ng/mL TNF-α for 2 hours. Total RNA is harvested 48 hours post-transfection, and real time PCR is performed using primer/probe sets to detect A20, ICAM-1, IL-8 and MIP2a mRNA expression. Expression levels of each gene, shown in Table 30, are normalized to total RNA and values are expressed as a percent relative to untreated control samples. A value greater than 100% indicates an induction of the inflammatory response, whereas a value less than 100% demonstrates a reduction in the inflammatory response.







TABLE 30







Effects of antisense inhibition of C-reactive protein on the


inflammatory response










+IL-1β
+TNF α













Treatment
A20
ICAM-1
IL-8
MIP2α
IL-8
MIP2α
















ISIS 133726
95
64
77
58
130
77


ISIS 29848
101
89
96
86
84
71









ISIS 133726 inhibited the expression of ICAM-1, IL-8 and MIP2α in response to IL-1β stimulation, and therefore is a candidate agent for the treatment of conditions in which inhibition or reduction of the inflammatory response is desirable, for example, in conditions such as rheumatoid arthritis, asthma and inflammatory bowel diseases. Conversely, ISIS 133726 stimulated the response of IL-8 in the presence of TNF-α, suggesting that in this stimulatory pathway, inhibition of C-reactive protein can stimulate an immune response, and is a candidate agent for the treatment of conditions in which stimulation of the immune response is desirable, for example, in conditions characterized by immunodeficiency.
Example 44
Antisense Oligonucleotides Targeted to Mouse C-Reactive Protein In Vivo: Lean Mouse Study
In a further embodiment, antisense oligonucleotides targeted to mouse C-reactive protein were tested for their effects on target expression, serum lipids, serum glucose and indicators of toxicity. Male C57Bl/6 mice (Charles River Laboratories, Wilmington, Mass.) were fed a standard rodent diet. Mice were given intraperitoneal injections of 50 mg/kg of each of ISIS 147868 (SEQ ID NO: 580) and ISIS 147880 (SEQ ID NO: 592). Each oligonucleotide-treated group consisted of 5 mice. A total of 5 saline-injected animals served as controls. Injections were administered twice weekly for a period of 2 weeks. At the end of the treatment period, mice were sacrificed. No significant changes were observed in body weights, which were recorded weekly, nor in liver and spleen weights recorded at necropsy.
C-reactive protein mRNA expression in liver was measured by real-time PCR, as described by other examples herein. ISIS 147868 and ISIS 147880, at a 50 mg/kg dose, resulted in 48% and 5% reductions in mouse C-reactive protein mRNA, respectively.
Serum was collected for routine clinical analysis of ALT, AST, cholesterol (CHOL), glucose (GLUC), HDL-cholesterol (HDL), LDL-cholesterol (LDL) and triglycerides (TRIG). These parameters were measured by routine procedures using an Olympus Clinical Analyzer (Olympus America Inc., Melville, N.Y.). The data are presented in Table 31.







TABLE 31







Serum chemistry analysis of mice treated with antisense


oligonucleotides targeted to mouse C-reactive protein









Serum parameters
















Dose



HDL
LDL
TG
GLUC



mg/
ALT
AST
CHOL
mg/
mg/
mg/
mg/


Treatment
kg
IU/L
IU/L
mg/dL
dL
dL
dL
dL





SALINE

27
62
80
61
11
102
243


147868
50
25
56
82
61
12
113
214


147880
50
43
72
96
73
13
125
228









These data reveal that treatment with ISIS 147868 or ISIS 147880 did not result in changes in the serum parameters measured. Together, these results illustrate that ISIS 147868 reduced C-reactive protein mRNA expression in vivo without causing toxicity. ISIS 147880 did not cause toxicity in mice.

## Claims

1. An antisense compound 15 to 30 nucleobases in length targeted to a nucleic acid molecule encoding C-reactive protein, wherein said compound comprises a 15 nucleobase portion having at least 90% complementarity to at least a 15 nucleobase portion of nucleotides 1719 to 1738 of SEQ ID NO. 4.

2. The antisense compound of claim 1, wherein said antisense compound has a nucleobase sequence that is at least 95% complementary to at least a 15 nucleobase portion of nucleotides 1719-1738 of SEQ ID NO: 4.

3. The antisense compound of claim 1, wherein said antisense compound has a nucleobase sequence that is 100% complementary to at least a 15 nucleobase portion of nucleotides 1719-1738 of SEQ ID NO: 4.

4. The antisense compound of claim 1, wherein said antisense compound comprises an antisense oligonucleotide.

5. The antisense compound of claim 4, wherein said antisense compound comprises a chimeric oligonucleotide.

6. The antisense compound of claim 1, wherein said antisense compound comprises at least one modified internucleoside linkage, modified sugar moiety, or modified nucleobase.

7. The antisense compound of claim 1, wherein said antisense compound comprises at least one 2′-O-methoxyethyl sugar moiety.

8. The antisense compound of claim 1, wherein said antisense compound comprises at least one phosphorothioate internucleoside linkage.

9. The antisense compound of claim 1, wherein said antisense compound comprises at least one 5-methylcytosine.

10. The antisense compound of claim 5, wherein said chimeric oligonucleotide comprises a 2′-deoxynucleotide segment positioned between wing segments, each wing segment having two to five nucleotides comprising modified sugar moieties, wherein each internucleoside linkage of said chimeric oligonucleotide is a phosphorothioate internucleoside linkage and wherein all cytidine residues are 5-methylcytidines.

11. The antisense compound of claim 1, wherein said antisense compound is single-stranded.

12. An antisense compound 20 nucleobases in length targeted to a nucleic acid molecule encoding C-reactive protein, comprising:
at least 16 consecutive nucleotides of SEQ ID NO: 205;
a 5′ terminus having two to four 2′-O-methoxyethyl nucleotides;
a 3′ terminus having two to four 2′-O-methoxyethyl nucleotides; and
a 2′-deoxynucleotide portion twelve to sixteen nucleotides in length disposed between said 5′ terminus and said 3′ terminus.

13. The antisense compound of claim 12, wherein all internucleoside linkages are phosphorothioate.

14. The antisense compound of claim 12, wherein all cytidine residues are 5-methylcytidines.

15. The antisense compound of claim 12, wherein each terminus is two nucleotides in length and said 2′-deoxynucleotide portion is sixteen nucleobases in length.

16. The antisense compound of claim 12, wherein each terminus is three nucleotides in length and said 2′-deoxynucleotide portion is fourteen nucleobases in length.

17. The antisense compound of claim 12, wherein each terminus is four nucleotides in length and said 2′-deoxynucleotide portion is twelve nucleobases in length.

18. The antisense compound of claim 12, wherein said antisense compound has a nucleobase sequence consisting of SEQ ID NO: 205.

19. A method of treating an animal having a disease or condition treatable by reducing C-reactive protein comprising administering to said animal a therapeutically or prophylactically effective amount of the compound of claim 1 so that expression of C-reactive protein is inhibited.

20. The method of claim 19, wherein said disease or condition is selected from the group consisting of: coronary artery disease, unstable angina, stroke, atherosclerosis, myocardial infarction, thrombosis, obesity, metabolic syndrome, diabetes, hyperlipidemia, acute coronary syndrome, and coronary artery stenting.

21. The method according to claim 19 wherein said animal is a human.

22. The method according to claim 19, wherein said disease or condition is selected from the group consisting of: coronary artery disease, unstable angina, atherosclerosis, myocardial infarction, hyperlipidemia, and coronary artery stenting.

23. The method according to claim 19, wherein said disease or condition is coronary artery disease.

24. The method according to claim 19, wherein said disease or condition is unstable angina.

25. The method according to claim 19, wherein said disease or condition is atherosclerosis.

26. The method according to claim 19, wherein said disease or condition is myocardial infarction.

27. The method according to claim 19, wherein said disease or condition is hyperlipidemia.

28. The method according to claim 19, wherein said disease or condition is coronary artery stenting.

29. The method according to claim 19, wherein said disease or condition is stroke.

30. The method according to claim 19, wherein said disease or condition is thrombosis.

31. The method according to claim 19, wherein said disease or condition is obesity.

32. The method according to claim 19, wherein said disease or condition is metabolic syndrome.

33. The method according to claim 19, wherein said disease or condition is diabetes.

34. The method according to claim 19, wherein said disease or condition is acute coronary syndrome.

35. The antisense compound of claim 1, wherein said antisense compound comprises at least one bicyclic nucleic acid sugar moiety.

36. The antisense compound of claim 12, wherein said antisense compound comprises an antisense oligonucleotide.

37. An antisense oligonucleotide consisting the nucleobase sequence of SEQ ID NO: 205, having a 2′-deoxynucleotide portion fourteen nucleotides in length positioned between a 5′ terminus and a 3′ terminus, wherein said 5′ terminus has three 2′-O-methoxyethylnucleotides, wherein said 3′terminus has three 2′-O-methoxyethylnucleotides, wherein each internucleoside linkage is a phosphorothioate internucleoside linkage, and wherein each cytosine is a 5-methylcytosine.

38. The antisense oligonucleotide of claim 37, wherein the antisense oligonucleotide is in a pharmaceutically acceptable salt form.

39. A composition comprising the antisense oligonucleotide of claim 38 and a pharmaceutically acceptable carrier or excipient.

40. The antisense oligonucleotide of claim 38, wherein the salt is a sodium salt.

41. The method of claim 19 wherein said antisense oligonucleotide consists of the nucleobase sequence of SEQ ID NO: 205, having a 2′-deoxynucleotide portion fourteen nucleotides in length positioned between a 5′ terminus and a 3′ terminus, wherein said 5′ terminus has three 2′-O-methoxyethylnucleotides, wherein said 3′ terminus has three 2′-O-methoxyethylnucleotides, wherein each internucleoside linkage is a phosphorothioate internucleoside linkage, and wherein each cytosine is a 5-methylcytosine.

42. The method of claim 41 wherein said antisense oligonucleotide is in a pharmaceutically acceptable salt form.