# Patent

## Title
Compositions and their uses directed to huntingtin

## Abstract

Disclosed herein are compounds, compositions and methods for modulating the expression of huntingtin in a cell, tissue or animal. Further provided are methods of slowing or preventing Huntington's Disease (HD) progression using an antisense compound targeted to huntingtin. Additionally provided are methods of delaying or preventing the onset of Huntington's Disease (HD) in an individual susceptible to Huntington's Disease (HD). Also provided are uses of disclosed compounds and compositions in the manufacture of a medicament for treatment of diseases and disorders.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation of U.S. application Ser. No. 13/090,146, filed Apr. 19, 2011, which is a divisional of U.S. application Ser. No. 11/627,916, filed Jan. 26, 2007, now U.S. Pat. No. 7,951,934, issued May 31, 2011, which claims priority under 35 USC 119(e) to U.S. provisional application Ser. No. 60/762,954, filed Jan. 26, 2006, and U.S. Provisional Application Ser. No. 60/836,290, filed Aug. 7, 2006, each of which are incorporated herein by reference in their entirety


SEQUENCE LISTING
The present application is being filed along with a Sequence Listing in electronic format. The Sequence Listing is provided as a file entitled RTS0838USC1SEQ.txt, created on Jan. 16, 2013 which is 575 Kb in size. The information in the electronic format of the sequence listing is incorporated herein by reference in its entirety.
GENBANK® numbers and their submission dates are also incorporated herein by reference.
BACKGROUND OF THE INVENTION
Huntington's disease (HD) is a neurodegenerative disorder caused by the mutation of the huntingtin gene. Alteration of this widely expressed single gene results in a progressive, neurodegenerative disorder with a large number of characteristic symptoms. Huntington's Disease (HD) is an autosomal dominant disorder, with an onset generally in mid-life, although cases of onset from childhood to over 70 years of age have been documented. An earlier age of onset is associated with paternal inheritance, with 70% of juvenile cases being inherited through the father. Symptoms have an emotional, motor and cognitive component. Chorea is a characteristic feature of the motor disorder and is defined as excessive spontaneous movements which are irregularly timed, randomly distributed and abrupt. It can vary from being barely perceptible to severe. Other frequently observed abnormalities include dystonia, rigidity, bradykinesia, ocularmotor dysfunction and tremor. Voluntary movement disorders include fine motor incoordination, dysathria, and dysphagia. Emotional disorders commonly include depression and irritability, and cognitive component comprises subcortical dementia (Mangiarini et al., 1996. Cell 87:493-506). Changes in HD brains are widespread and include neuronal loss and gliosis, particularly in the cortex and striatum (Vonsattel and DiFiglia. 1998. J. Neuropathol. Exp. Neurol., 57:369-384).
The HD mutation is a CAG expansion that results in the expansion of a poly-glutamine tract in the huntingtin protein, a 350 kDa protein of unknown function (Huntington Disease Collaborative Research Group, 1993. Cell. 72:971-83). The normal and expanded HD allele size have been found to be CAG6-37 and CAG35-121 repeats, respectively. Longer repeat sequences are associated with earlier disease onset. The mechanism by which the expansion results in pathology is unknown. However, the absence of an HD phenotype in individuals deleted for one copy of huntingtin, or increased severity of disease in those homozygous for the expansion suggests that the mutation does not result in a loss of function (Trottier et al., 1995, Nature Med., 10:104-110). Transcriptional deregulation and loss of function of transcriptional coactivator proteins have been implicated in HD pathogenesis. Mutant huntingtin has been shown specifically to disrupt activator-dependent transcription in the early stages of HD pathogenesis (Dunah et al., 2002. Science 296:2238-2243). Gene profiling of human blood has identified 322 mRNAs that show significantly altered expression in HD blood samples as compared to normal or presymptomatic individuals. Expression of marker genes was similarly substantially altered in post-mortem brain samples from HD caudate, suggesting that upregulation of genes in blood samples reflects disease mechanisms found in brain. Monitoring of gene expression may provide a sensitive and quantitative method to monitor disease progression, especially in the early stages of disease in both animal models and human patients (Borovecki et al., 2005, Proc. Natl. Acad. Sci. USA 102:11023-11028).
Identification of the gene has allowed for the development of animal models of the disease, including transgenic mice carrying mutated human or mouse forms of the gene. Models include mice carrying a fragment of the human gene, typically the first one or two exons, which contains the glutamine expansion, in addition to the undisrupted wild-type, endogenous, mouse gene; mice carrying the full length human huntingtin with an expanded glutamine repeat region, again with the endogenous mouse gene; and mice with pathogenic CAG repeats inserted into the CAG repeat region. All of the models have at least some shared features with the human disease. These mice have allowed for the testing of a number of different therapeutic agents for the prevention, amelioration and treatment of HD (see, e.g., Hersch and Ferrante, 2004. NeuroRx. 1:298-306) using a number of endpoints. The compounds are believed to function by a number of different mechanisms including transcription inhibition, caspace inhibition, histone deacetylase inhibition, antioxidant, huntingtin inhibition/antioxidant, biogenergetic/antioxidant, antiexcitotoxic, and antiapoptotic.
A number of authors have reported that the repression of the mutant huntingtin transgene in animal models of HD reduces the symptoms associated with the disease, (see e.g. Diaz-Hernandez et al., (2005. J. Neurosci. 25:9773-81; incorporated herein by reference). Wang et al., (2005. Nuerosci. Res. 53:241-9; incorporated herein by reference) report that small interfering RNAs (siRNAs) directed against the huntingtin gene in the mouse model R6/2 inhibited transgenic huntingtin expression and significantly prolonged longevity, improved motor function and slowed loss of body weight.
Machida et al., (2006. Biochem. Biophys. Res. Commun. 343:190-7; incorporated herein by reference), report that recombinant adeno-associated virus (rAAV)-mediated delivery of RNA interference (RNAi) into the striatum of a HD mouse model ameliorated neuropathological abnormalities associated with HD, such as insoluable protein accumulation and down-regulation of DARPP-32 expression. Importantly, the authors state that neuronal aggregates in the striatum were reduced after RNAi transduction in the animals compared to those at the time point of RNAi transduction.
Harper et al., (2005. PNAS 102:5820-25; incorporated herein by reference), found that RNAi directed to huntingtin reduced huntingtin mRNA and protein expression in cell culture and a HD mouse model. The authors report that huntingtin gene silencing improved behavioral and neuropathological abnormalities associated with HD.
Rodrigues-Lebron et al., (2005. Mol. Ther. 12:618-33; incorporated herein by reference), report that a recombinant adeno-associated viral serotype 5 (rAAV5) gene transfer of RNAi to suppress the levels of striatal mutant huntingtin in the R6/1 HD transgenic mouse resulted in reduced levels of huntingtin mRNA and protein. The reduction in huntingtin was concomitant with a reduction in the size and number of neuronal intranuclear inclusions and other markers of HD, and resulted in delayed onset of the rear paw clasping phenotype exhibited by the R6/1 mice.
Nguyen et al., (2005. PNAS, 102:11840-45; incorporated herein by reference), used the metal-binding compound clioquinol to treat PC12 cells expressing the mutant huntingtin gene and found reduced accumulation of mutant protein. Treating the HD mouse model R6/2 with clioquinol resulted in improved behavioral and pathologic phenotypes, including decreased huntingtin aggregate accumulation, decreased striatal atrophy, improved rotarod performance, reduction of weight loss, normalization of blood glucose and insulin levels, and extension of lifespan, supporting the conclusion that reduction in mutant huntingtin protein is therapeutic for HD.
Based on these and other studies, one of skill in the art recognizes that reducing the expression of the mutant huntingtin gene will be therapeutic for HD.
SUMMARY OF THE INVENTION
One embodiment of the invention is an antisense oligonucleotide 12 to 35 nucleotides in length comprising at least 12 consecutive nucleotides of a nucleotide sequence selected from the group consisting of SEQ ID NOs 46-357. In a preferred embodiment, the nucleotide sequence is selected from the group consisting of SEQ ID NOs: 50, 93, 100, 105, 110, 125, 137, 345, 346, and 353. In a further embodiment, the antisense oligonucleotide has at least 95% or 100% complementarity to SEQ ID NO: 4. In a further embodiment, the antisense oligonucleotide has at least one modified internucleoside linkage, sugar moiety, or nucleobase. In a further embodiment, the antisense oligonucleotide comprises a chimeric oligonucleotide having a gap segment positioned between 5′ and 3′ wing segments, and in some embodiments, the gap segment of the chimeric oligonucleotide is comprised of 2′-deoxynucleotides and the wing segments are comprised of nucleotides having modified sugar moieties. Is still other embodiments, the modified sugar moiety is 2′-OMe or a bicyclic nucleic acid. In a preferred embodiment, the gap segment of the chimeric oligonucleotide consists of ten 2′-deoxynucleotides and each wing segment consists of five 2′-O-methoxyethyl-modified nucleotides, and in a more preferred embodiment said antisense oligonucleotide is 20 nucleotides in length.
In another embodiment each internucleoside linkage of the antisense oligonucleotide is a phosphorothioate internucleoside linkage.
In another embodiment each cytosine of the antisense oligonucleotide is a 5-methylcytosine.
In another embodiment, the antisense oligonucleotide is 17 to 25 nucleotides in length. In another embodiment, the antisense oligonucleotide is 19 to 23 nucleotides in length. In another embodiment the antisense oligonucleotide is 20 nucleotides in length.
Another embodiment of the invention is a pharmaceutical composition comprising any of the antisense oligonucleotide described herein and a pharmaceutically acceptable diluent.
Another embodiment is a method of treating an individual at risk of suffering from or currently suffering from Huntington's Disease (HD) comprising administering to the individual a therapeutically effective amount of a pharmaceutical composition comprising an antisense compound 12 to 35 nucleobases in length having at least 90% complementarity to nucleotides 1650-1704, 1807-1874, 3183-3228, 4010-4087, 4265-4288, 4553-4608, 5781-5820, and 6793-6796 of SEQ ID NO: 4, where the administration treats the individual. In some embodiments, the administering comprises intrathecal delivery, intracerebroventricular delivery, or intraparenchymall delivery. In some embodiments, the administering comprises administration into the cerebrospinal fluid of the individual by intrathecal infusion. In some embodiments, the treatment comprises improvement in one or more indicators of HD. In some embodiments, the treatment comprises increasing the survival time of the individual. In some embodiments, the treatment comprises delaying the onset of HD. In some embodiments, the antisense compound has at least at least 95%, or 100%, complementarity to nucleotides 1650-1704, 1807-1874, 3183-3228, 4010-4087, 4265-4288, 4553-4608, 5781-5820, and 6793-6796 of SEQ ID NO: 4.
In some embodiments, the antisense compound is an antisense oligonucleotide. In some embodiments, the antisense oligonucleotide has at least one modified internucleoside linkage, sugar moiety, or nucleobase. In some embodiments, the oligonucleotide comprises a chimeric oligonucleotide having a gap segment positioned between 5′ and 3′ wing segments. In some embodiments, the gap segment of the chimeric oligonucleotide is comprised of 2′-deoxynucleotides and the wing segments are comprised of nucleotides having modified sugar moieties. In some embodiments, the modified sugar moiety is 2′-OMe or a bicyclic nucleic acid. In some embodiments, the gap segment of the chimeric oligonucleotide consists of ten 2′-deoxynucleotides and each wing segment consists of five 2′-O-methoxyethyl-modified nucleotides. In some embodiments, each internucleoside linkage is a phosphorothioate internucleoside linkage. In some embodiments, each cytosine is a 5-methylcytosine. In some embodiments, the compound comprises 17 to 25 nucleotides, in others 19 to 23 nucleotides, in others, 20 nucleotides.
In some embodiments, the method further comprises selecting an individual suffering from HD. In some embodiments, the method further comprises selecting an individual susceptible to HD.
Another embodiment is a method of treating an individual at risk of suffering from or currently suffering from Huntington's Disease (HD) comprising administering to the individual a therapeutically effective amount of a pharmaceutical composition comprising an antisense oligonucleotide 12 to 35 nucleotides in length comprising at least 12 consecutive nucleotides of a nucleotide sequence selected from the group consisting of SEQ ID NOs 46-357. In some embodiments, the nucleotide sequence is selected from the group consisting of SEQ ID NOs: 50, 93, 100, 105, 110, 125, 137, 345, 346, and 353.
Another embodiment is the use of any of the antisense compounds or oligonucleotides disclosed herein in the manufacture of a medicament for treatment of HD. One embodiment is use of an antisense oligonucleotide 12 to 35 nucleotides in length comprising at least 12 consecutive nucleotides of a nucleotide sequence selected from the group consisting of SEQ ID NOs 46-357 in the preparation of a medicament for treating HD. Another embodiment is the use of an antisense oligonucleotide 12 to 35 nucleotides in length comprising at least 12 consecutive nucleotides of a nucleotide sequence selected from the group consisting of SEQ ID NOs: 50, 93, 100, 105, 110, 125, 137, 345, 346, and 353 in the preparation of a medicament for treating HD. In a further embodiment, the treatment of HD is the slowing of HD progression in an individual suffering from HD. In a further embodiment, the treatment of HD is preventing the onset of HD in an individual susceptible to HD. In a further embodiment, the treatment of HD comprises increasing survival time of the individual.


DETAILED DESCRIPTION OF THE INVENTION
Overview
Huntington's Disease (HD) is a progressive, neurodegenerative disease caused by mutation of a widely expressed, single gene, huntingtin. The mutation is an expansion of a CAG repeat region, wherein a larger expansion results in greater severity of the disease and an earlier age of onset. The mutation results in a variety of motor, emotional and cognitive symptoms, and results in the formation of huntingtin aggregates in brain. The absence of a phenotype for a single gene deletion, and an increase in disease severity in individuals carrying two mutated copies of the huntingtin gene suggests that the mutation does not result in a loss of function.
Antisense technology provides a mechanism for the development of therapeutic agents for a variety of diseases, including Huntington's Disease. The principle behind antisense technology is that an antisense compound, which hybridizes to a target nucleic acid, modulates gene expression activities such as transcription or translation. This sequence specificity makes antisense compounds extremely attractive as tools for target validation and gene functionalization, as well as therapeutics to selectively modulate the expression of genes involved in disease.
The present invention is directed to antisense compounds, especially nucleic acid and nucleic acid-like oligomers, which are targeted to a nucleic acid encoding huntingtin, and which modulate the expression of huntingtin. In a preferred embodiment, the antisense compound is targeted to human huntingtin (SEQ ID NOs 1-5 and 45). Pharmaceutical and other compositions comprising the compounds of the invention are also provided. Further provided are methods of slowing HD progression, and methods of ameliorating or delaying the onset of HD symptoms. Such methods employ antisense compounds which modulate the expression of huntingtin.
Therapeutics
Provided herein are methods for treating an individual suffering from Huntington's Disease (HD). Treatment encompasses slowing of disease progression in an individual suffering from Huntington's Disease (HD) as well as delaying the onset of HD in an individual susceptible to HD. In some embodiments, such treatment methods comprise the administration to the cerebrospinal fluid of the individual a therapeutically effective amount of a pharmaceutical composition comprising an antisense compound or oligonucleotide targeted to huntingtin. Such treatment methods further comprise increasing the survival time of an individual suffering from HD, or increasing the survival time of an individual susceptible to HD. Slowing of disease progression is indicated by a lack of measurable change in, or an improvement of, one or more indicators of HD, including molecular markers or symptoms of the disease. The delaying of the onset of HD is indicated by a lack of clinical presentation of indicators of HD.
The present invention employs antisense compounds, particularly antisense oligonucleotides, for use in modulating the function of nucleic acid molecules encoding huntingtin, ultimately modulating the amount of huntingtin protein produced. A suitable form of modulation is inhibition of nucleic acid molecules encoding huntingtin, which is evidenced by a reduction in the levels of nucleic acids encoding huntingtin. Accordingly, disclosed herein are antisense compounds, including antisense oligonucleotides, for use in inhibiting the expression of nucleic acid molecules encoding huntingtin, i.e. reducing the levels of nucleic acid molecules encoding huntingtin. As used herein, the terms “target nucleic acid” and “nucleic acid molecule encoding huntingtin” have been used for convenience to encompass DNA encoding huntingtin, RNA (including pre-mRNA and mRNA or portions thereof) transcribed from such DNA, and also cDNA derived from such RNA. Antisense oligonucleotides which hybridize to and modulate the expression of one or more nucleic acids encoding huntingtin are considered to be “targeted to huntingtin.” Antisense oligonucleotides of the present invention do not necessarily distinguish between wild-type huntingtin target nucleic acids and mutant huntingtin target nucleic acids. It is clinically desirable to reduce the levels of mutant huntingtin target nucleic acids, without introducing adverse effects due to reduction of the levels of wild-type huntingtin target nucleic acids.
In one embodiment, antisense oligonucleotides at least 90% complementary to exon 30 of SEQ ID NO: 4, which encompasses nucleotides 4010-4087 of SEQ ID NO: 4. Thus, antisense oligonucleotides are at least 90% complementary to nucleotides 4010-4087 of SEQ ID NO: 4. This embodiment includes antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 99, 100, 101, or 102.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 4028-4146 of SEQ ID NO: 4. In one embodiment, the antisense oligonucleotides include those comprising a sequence selected from SEQ ID NOs: 99, 100, 101, 102, or 103.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 4538-4615 of SEQ ID NO: 4. This embodiment includes antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 109, 110, 111, or 112.
In another embodiment, antisense oligonucleotides are at least 90% complementary to exon 34 of SEQ ID NO: 4, which encompasses nucleotides 4553-4608 of SEQ ID NO: 4. Thus, in this embodiment, the antisense oligonucleotides are at least 90% complementary to nucleotides 4553-4608 of SEQ ID NO: 4. This embodiment includes antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 110 or 112.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 5781-5820 of SEQ ID NO: 4. In one embodiment, the antisense oligonucleotides comprise a sequence selected from SEQ ID NOs: 123, 124, or 125.
In another embodiment, antisense oligonucleotides are at least 90% complementary to exon 42 of SEQ ID NO: 4, which encompasses nucleotides 5722-5863 of SEQ ID NO: 4. Thus, in one embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 5722-5863 of SEQ ID NO: 4. In one embodiment, antisense oligonucleotides comprise a sequence selected from SEQ ID NOs: 123, 124, or 125.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 6763-6796 of SEQ ID NO: 4. In one embodiment, the antisense oligonucleotides comprise a sequence selected from SEQ ID NOs: 136, 137, or 138.
In another embodiment, antisense oligonucleotides are at least 90% complementary to a region comprising both exon 48 of SEQ ID NO: 4, which encompasses nucleotides 6560-6773 of SEQ ID NO: 4, and exon 49 of SEQ ID NO: 4, which encompasses nucleotides 6774-6919 of SEQ ID NO: 4. Accordingly, antisense oligonucleotides are at least 90% complementary to nucleotides 6560-6919 of SEQ ID NO: 4. In one embodiment, antisense oligonucleotides comprise a sequence selected from SEQ ID NOs: 134, 135, 136, 137, 138, or 151.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 3183-3253 of SEQ ID NO: 4. In one embodiment, antisense oligonucleotides comprise a sequence selected from SEQ ID NOs: 90, 91, 92, 93, and 94. In a further embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 3183-3228 of SEQ ID NO: 4. This aspect encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 90, 91, 92, or 93.
In another embodiment, antisense oligonucleotides are at least 90% complementary to a region comprising both exon 23 of SEQ ID NO: 4, which encompasses nucleotides 3019-3211 of SEQ ID NO:4, and exon 24 of SEQ ID NO: 4, which encompasses nucleotides 3212-3288 of SEQ ID NO: 4. Thus, in one embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 3091-3288 of SEQ ID NO: 4. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 90, 91, 92, 93, or 94.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 4265-4288 of SEQ ID NO: 4. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 104 or 105.
In another embodiment, antisense oligonucleotides are at least 90% complementary to exon 31 of SEQ ID NO: 4, which encompasses nucleotides 4088-4311 of SEQ ID NO: 4. Thus, in this embodiment, the antisense oligonucleotides are at least 90% complementary to nucleotides 4088-4311 of SEQ ID NO: 4. This embodiment encompasses the antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 103, 104, or 105.
In another embodiment, the antisense oligonucleotides are at least 90% complementary to nucleotides 1607-1704 of SEQ ID NO: 45. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 342, 343, 344, 345, 346, 347, 348, or 349. In one aspect, antisense oligonucleotides are at least 90% complementary to nucleotides 1650-1704 of SEQ ID NO: 45. This aspect encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 345, 346, 347, 348, or 349.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 1807-1874 of SEQ ID NO: 45. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 351, 352, 353, 354, 355, 356, or 357.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 985-1580 of SEQ ID NO: 45. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 329, 330, 331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341, 47, 48, 49, 50, 51, 52, 53, or 54.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 1079-1459 of SEQ ID NO: 45, which comprises a plurality of CAG repeats. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 48, 49, 50, 51, 52, or 53.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 1055-1477 of SEQ ID NO: 45. This region comprises a plurality of CAG repeats. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 338, 48, 49, 50, 51, 52, or 53.
In another embodiment, antisense oligonucleotides are at least 90% complementary to nucleotides 1019-1542 of SEQ ID NO: 45. This embodiment encompasses antisense oligonucleotides comprising a sequence selected from SEQ ID NOs: 331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341, 48, 49, 50, 51, 52, 53, or 54.
In further embodiments, antisense oligonucleotides are at least 95% complementary to a nucleotide region recited herein. In additional embodiments, antisense oligonucleotides are at least 96%, 97%, 98%, 99% or 100% complementary to a nucleotide region recited herein.
As used herein, an “individual suffering from Huntington's Disease (HD)” is an individual who has received from a health professional, such as a physician, a diagnosis of HD. Relevant diagnostic tests are well known in the art and are understood to include, without limitation, genetic testing to determine the presence of a mutation in the huntingtin gene, neurological examination, and brain imaging. Genetic testing for mutations in the huntingtin gene is a particularly accurate diagnostic test for the presence of HD.
An “individual susceptible to Huntington's Disease (HD)” is understood to include an individual who, based on genetic testing and/or family history, is likely to develop HD. Genetic testing for mutations in the huntingtin gene is a particularly accurate diagnostic test for susceptibility to HD. Indicators of HD may also be employed in the identification of an individual susceptible to HD.
In order for antisense inhibition of huntingtin to have a clinically desirable effect, it is beneficial to deliver an antisense oligonucleotide targeted to huntingtin to the central nervous system (CNS) of an individual, and in particular to the regions of the CNS affected by HD. As the blood-brain barrier is generally impermeable to antisense oligonucleotides administered systemically, a preferred method of providing antisense oligonucleotides targeted to huntingtin to the tissues of the CNS is via administration of the antisense oligonucleotides directly into the cerebrospinal fluid (CSF). Means of the delivery to the CSF and brain include intrathecal (IT), intracerebroventricular (ICV), and intraparenchymal administration. IT or ICV administration may be achieved through the use of surgically implanted pumps that infuse a therapeutic agent into the cerebrospinal fluid. Intraparenchymal delivery may be achieved by the surgical placement of a catheter into the brain. As used herein, “delivery to the CSF” and “administration to the CSF” encompass the IT infusion or ICV infusion of antisense oligonucleotides targeted to huntingtin through the use of an infusion pump. In some embodiments, IT infusion is a suitable means for delivery to the CSF. In other embodiments, the antisense oligonucleotide is continuously infused into the CSF for the entire course of treatment; such administration is referred to as “continuous infusion” or, in the case of IT infusion, “continuous IT infusion.” Also contemplated is continuous intraparenchymal infusion using a pump.
In some embodiments, an infusion pump such as, for example, the Medtronic SyncroMed® II pump, is employed to deliver antisense oligonucleotides targeted to huntingtin to the CNS. The SyncroMed® II pump is surgically implanted according the procedures set forth by the manufacturer. The pump contains a reservoir for retaining a drug solution, which is pumped at a programmed dose into a catheter that is surgically implanted. For intrathecal administration of a drug, the catheter is surgically intrathecally implanted. In the context of the methods provided herein, the drug is the pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin.
As used herein, a “pharmaceutical composition comprising an antisense oligonucleotide” refers to a composition comprising an antisense oligonucleotide targeted to huntingtin in a pharmaceutically acceptable diluent. By way of example, a suitable pharmaceutically acceptable diluent is phosphate-buffered saline. As provided herein, an ISIS Number represents the nonadecasodium salt of the antisense oligonucleotide having the provided nucleobase sequence, where nucleosides 1 to 5 and 16 to 20 have 2′-O-methoxyethyl sugar moieties, nucleosides 6 to 15 are 2′-deoxynucleotides, each internucleoside linkage is a phosphorothioate linkage, and each cytosine is a 5-methylcytosine.
As used herein, a “therapeutically effective amount” is an amount of a compound that provides a therapeutic benefit to an individual. For example, a therapeutically effective amount of an antisense compound targeted to huntingtin, such as an antisense oligonucleotide, is an amount that slows, or prevents the progression of HD, or prevents or delays the onset of HD. In one embodiment, a therapeutically effective amount of an antisense oligonucleotide that will result in an improvement to, or prevents or slows the worsening of, one or more indicators or symptoms of HD, such as those described herein. In some embodiments, a therapeutically effective amount of an antisense oligonucleotide targeted to huntingtin ranges from 8 mg to 12 mg of antisense oligonucleotide. In other embodiments, a therapeutically effect amount of an antisense oligonucleotide targeted to huntingtin is 10 mg. As used herein, “treating” a patient with HD includes administering a therapeutically effective amount of a compound of the invention.
As used herein, “slowing disease progression” means the prevention of, or delay in, a clinically undesirable change in one or more clinical parameters in an individual suffering from HD, such as those described herein. It is well within the abilities of a physician to identify a slowing of disease progression in an individual suffering from HD, using one or more of the disease assessment tests described herein. Additionally, it is understood that a physician may administer to the individual diagnostic tests other than those described herein to assess the rate of disease progression in an individual suffering from HD.
As used herein, “delaying the onset of HD” means delaying undesirable changes in one or more indicators of HD that were previously negative for HD. A physician may use family history of HD to determine an approximate age of HD onset in an individual susceptible to HD to determine if onset of HD is delayed.
As used herein, “indicators of HD,” are parameters employed by a medical professional, such as a physician, to diagnose or measure the progression of HD, and include, without limitation, genetic testing, hearing, eye movements, strength, coordination, chorea (rapid, jerky, involuntary movements), sensation, reflexes, balance, movement, mental status, dementia, personality disorder, family history, weight loss, and degeneration of the caudate nucleus. Degeneration of the caudate nucleus is assessed via brain imaging techniques such as magnetic resonance imaging (MRI) or computed tomography (CT) scan.
As used herein, an “improvement in an indicator of HD” refers to the absence of an undesirable change, or the presence of a desirable change, in one or more indicators of HD. In one embodiment, an improvement in an indicator of HD is evidenced by the absence of a measurable change in one or more indicators of HD. In another embodiment, an improvement in an indicator of HD is evidenced by a desirable change in one or more indicators of HD.
A slowing of disease progression may further comprise an increase in survival time in an individual suffering from HD. An “increase in survival time” is understood to mean increasing the survival of an individual suffering from HD, relative to an approximate survival time based upon HD progression and/or family history of HD. A physician can use one or more of the disease assessment tests described herein to predict an approximate survival time of an individual suffering from HD. A physician may additionally use the family history of an individual suffering from HD to predict survival time.
Antisense compounds targeted to huntingtin can be used to modulate the expression of huntingtin in an animal, such as a human, including humans suffering from, or susceptible to, HD. In one embodiment, the antisense compounds effectively inhibit the levels or function of huntingtin RNA. Because reduction in huntingtin mRNA levels can lead to alteration in huntingtin protein products of expression as well, such resultant alterations can also be measured. Antisense compounds of the present invention that effectively inhibit the level or function of huntingtin RNA or protein products of expression are considered an active antisense compound. In one embodiment, the antisense compounds of the invention inhibit the expression of huntingtin causing a reduction of RNA 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%.
The reduction of the expression of huntingtin can be measured in a bodily fluid, tissue or organ of the animal. Methods of obtaining samples for analysis, such as body fluids or tissues, and methods of preparation of the samples to allow for analysis are well known to those skilled in the art. Methods for analysis of RNA and protein levels are discussed above and are well known to those skilled in the art. The effects of treatment using the compounds of the invention can be assessed by measuring biomarkers associated with the target gene expression in the aforementioned fluids, tissues or organs, collected from an animal contacted with one or more compounds of the invention, by routine clinical methods known in the art. Biomarkers of huntingtin include but are not limited to the accumulation of huntingtin positive neuronal inclusions, loss of certain neuronal tissue, etc.
In addition, a subject's systemic response to treatment can be assessed by monitoring clinically relevant measures that include but are not limited to: 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.
Methods whereby bodily fluids, organs or tissues are contacted with an effective amount of one or more of the antisense compounds or compositions of the invention are also contemplated. Bodily fluids, organs or tissues can be contacted with one or more of the compounds of the invention resulting in modulation of huntingtin expression in the cells of bodily fluids, organs or tissues. An effective amount can be determined by monitoring the modulatory effect of the antisense compound or compounds or compositions on target nucleic acids or their products by methods routine to the skilled artisan. Further contemplated are ex vivo methods of treatment whereby cells or tissues are isolated from a subject, contacted with an effective amount of the antisense compound or compounds or compositions and reintroduced into the subject by routine methods known to those skilled in the art.
In one embodiment, provided are uses of a compound of an isolated double stranded RNA oligonucleotide in the manufacture of a medicament for inhibiting huntingtin expression or overexpression. Thus, provided herein is the use of an isolated double stranded RNA oligonucleotide targeted to huntingtin in the manufacture of a medicament for the treatment of a disease or disorder by means of the method described above.
Pharmaceutical Compositions
Antisense compounds targeted to huntingtin can be utilized in pharmaceutical compositions by adding an effective amount of a compound to a suitable pharmaceutically acceptable diluent or carrier. Acceptable carriers and dilutents are well known to those skilled in the art. Selection of a dilutent or carrier is based on a number of factors, including, but not limited to, the solubility of the compound and the route of administration. Such considerations are well understood by those skilled in the art. In one aspect, the antisense compounds of the present invention inhibit the expression of huntingtin.
Antisense compounds targeted to huntingtin can also be used in the manufacture of a medicament for the treatment of diseases and disorders related to huntingtin expression. In one embodiment, the disease or disorder is Huntington's Disease.
The antisense compounds of the present invention comprise any pharmaceutically acceptable salts, esters, or salts of such esters, or any other functional chemical equivalent which, upon administration to an animal including a human, is capable of providing (directly or indirectly) the biologically active metabolite or residue thereof. Accordingly, for example, the disclosure is also drawn to prodrugs and pharmaceutically acceptable salts of the oligomeric compounds of the present invention, pharmaceutically acceptable salts of such prodrugs, and other bioequivalents.
The term “prodrug” indicates a therapeutic agent that is prepared in an inactive or less active form that is converted to an active form (i.e., drug) within the body or cells thereof by the action of endogenous enzymes or other chemicals and/or conditions. In particular, prodrug versions of the oligonucleotides of the invention are prepared as SATE ((S-acetyl-2-thioethyl)phosphate) derivatives according to the methods disclosed in WO 93/24510 or WO 94/26764.
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. Sodium salts of antisense oligonucleotides are useful and are well accepted for therapeutic administration to humans. In another embodiment, sodium salts of dsRNA compounds are also provided.
Formulations
The oligomeric 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 U.S. Pat. No. 5,595,756.
The present invention also includes pharmaceutical compositions and formulations which 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 but not limited to 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. Sites of administration are known to those skilled in the art. Oligonucleotides with at least one 2′-O-methoxyethyl modification are believed to be useful for oral administration.
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.
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.
Oral compositions for administration of non-parenteral oligomeric compounds can 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. Such oral oligomeric compound compositions can be referred to as “mucosal penetration enhancers.”
Oligomeric compounds, such as oligonucleotides, 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. Oral formulations for oligonucleotides and their preparation are described in detail in U.S. application Ser. No. 09/108,673 (filed Jul. 1, 1998), Ser. No. 09/315,298 (filed May 20, 1999) and Ser. No. 10/071,822, filed Feb. 8, 2002, which are herein incorporated by reference.
In one embodiment, oral oligomeric compound compositions comprise at least one member of the group consisting of surfactants, fatty acids, bile salts, chelating agents, and non-chelating surfactants. Such formulations are well known to those skilled in the art.
A “pharmaceutical carrier” or “excipient” can be a pharmaceutically acceptable solvent, suspending agent or any other pharmacologically inert vehicle for delivering one or more nucleic acids to an animal and are known in the art. 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.
Oral oligomeric compositions may additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels.
One of skill in the art will recognize that formulations are routinely designed according to their intended route of administration.
Combinations
Compositions of the invention can contain two or more oligomeric compounds. In another related embodiment, compositions of the present invention can 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 present invention can contain two or more antisense compounds targeted to different regions of the same nucleic acid target. Two or more combined compounds may be used together or sequentially.
Compounds
The term “oligomeric compound” refers to a polymeric structure capable of hybridizing to a region of a nucleic acid molecule. This term includes oligonucleotides, oligonucleosides, oligonucleotide analogs, oligonucleotide mimetics and chimeric combinations of these. Oligomeric compounds are routinely prepared linearly but can be joined or otherwise prepared to be circular. Moreover, branched structures are known in the art. An “antisense compound” or “antisense oligomeric compound” refers to an oligomeric compound that is at least partially complementary to the region of a nucleic acid molecule to which it hybridizes and which modulates (increases or decreases) its expression. Consequently, while all antisense compounds can be said to be oligomeric compounds, not all oligomeric compounds are antisense compounds. Nonlimiting examples of oligomeric compounds include primers, probes, antisense compounds, antisense oligonucleotides, external guide sequence (EGS) oligonucleotides, alternate splicers, and siRNAs. As such, these compounds can be introduced in the form of single-stranded, double-stranded, circular, branched or hairpins and can contain structural elements such as internal or terminal bulges or loops. Oligomeric double-stranded compounds can be two strands hybridized to form double-stranded compounds or a single strand with sufficient self complementarity to allow for hybridization and formation of a fully or partially double-stranded compound. The compounds of the instant invention are non-catalytic.
An “antisense oligonucleotide” is an antisense compound that is a nucleic acid-based oligomer, but does not include siRNA duplexes. In a preferred embodiment, and in any of the embodiments disclosed herein, the “antisense oligonucleotide” can be a single-stranded nucleic acid molecule. An antisense oligonucleotide can be chemically modified.
Antisense compounds comprise from about 12 to about 35 linked nucleotides. This embodies antisense 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, or 35 nucleotides in length.
In one embodiment, the antisense compounds are 15 to 30 linked nucleotides in length, as exemplified above.
In one embodiment, the antisense compounds are 17 to 25 linked nucleotides in length, as exemplified herein.
In one embodiment, the antisense compounds are 19, 20, 21, 22, 23, or 24 linked nucleotides in length, or alternatively the oligomeric compounds range from 19 to 24 linked nucleotides in length.
In one embodiment, the antisense compounds are 21, 22, 23, or 24 linked nucleotides in length, or alternatively the oligomeric compounds range from 21 to 24 linked nucleotides in length.
In one embodiment, the antisense compounds are 20 linked nucleotides in length.
In one embodiment of the invention, double-stranded antisense compounds encompass short interfering RNAs (siRNAs). As used herein, the term “siRNA” is defined as a double-stranded compound having a first and second strand, each strand having a central portion and two independent terminal portions. The central portion of the first strand is complementary to the central portion of the second strand, allowing hybridization of the strands. The terminal portions are independently, optionally complementary. The ends of the strands may be modified by the addition of one or more natural or modified nucleobases to form an overhang. In one nonlimiting example, the first strand of the siRNA is antisense to the target nucleic acid, while the second strand is complementary to the first strand. Once the antisense strand is designed to target a particular nucleic acid target, the sense strand of the siRNA can then be designed and synthesized as the complement of the antisense strand and either strand may contain modifications or additions to either terminus. For example, in one embodiment, both strands of the siRNA duplex would be complementary over the central nucleobases, each having overhangs at one or both termini. It is possible for one end of a duplex to be blunt and the other to have overhanging nucleobases. In one embodiment, the number of overhanging nucleobases is from 1 to 6 on the 3′ end of each strand of the duplex. In another embodiment, the number of overhanging nucleobases is from 1 to 6 on the 3′ end of only one strand of the duplex. In a further embodiment, the number of overhanging nucleobases is from 1 to 6 on one or both 5′ ends of the duplexed strands. In another embodiment, the number of overhanging nucleobases is zero.
In one embodiment of the invention, double-stranded antisense compounds are canonical siRNAs. As used herein, the term “canonical siRNA” is defined as a double-stranded oligomeric compound having a first strand and a second strand each strand being 21 nucleobases in length with the strands being complementary over 19 nucleobases and having on each 3′ termini of each strand a deoxy thymidine dimer (dTdT) which in the double-stranded compound acts as a 3′ overhang.
Each strand of the siRNA duplex may be from about 12 to about 35 nucleobases. In a preferred embodiment, each strand of the siRNA duplex is about 17 to about 25 nucleobases. The central complementary portion may be from about 12 to about 35 nucleobases in length. In a preferred embodiment, the central complimentary portion is about 17 to about 25 nucleobases in length. It is understood that each the strand of the siRNA duplex and the central complementary portion may be about 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or 35 nucleobases in length. The terminal portions can be from 1 to 6 nucleobases. It is understood that the terminal portions can be about 1, 2, 3, 4, 5, or 6 nucleobases in length. The siRNAs may also have no terminal portions. The two strands of an siRNA can be linked internally leaving free 3′ or 5′ termini, or can be linked to form a continuous hairpin structure or loop. The hairpin structure may contain an overhang on either the 5′ or 3′ terminus producing an extension of single-stranded character.
In another embodiment, the double-stranded antisense compounds are blunt-ended siRNAs. As used herein the term “blunt-ended siRNA” is defined as an siRNA having no terminal overhangs. That is, at least one end of the double-stranded compound is blunt. siRNAs, whether canonical or blunt, act to elicit dsRNAse enzymes and trigger the recruitment or activation of the RNAi antisense mechanism. In a further embodiment, single-stranded RNAi (ssRNAi) compounds that act via the RNAi antisense mechanism are contemplated.
Further modifications can be made to the double-stranded compounds and may include conjugate groups attached to one of the termini, selected nucleobase positions, sugar positions or to one of the internucleoside linkages. Alternatively, the two strands can be linked via a non-nucleic acid moiety or linker group. When formed from only one strand, the compounds can take the form of a self-complementary hairpin-type molecule that doubles back on itself to form a duplex. Thus, the compounds can be fully or partially double-stranded. When formed from two strands, or a single strand that takes the form of a self-complementary hairpin-type molecule doubled back on itself to form a duplex, the two strands (or duplex-forming regions of a single strand) are complementary when they base pair in Watson-Crick fashion.
The antisense compounds in accordance with this invention may comprise a complementary antisense compound from about 12 to about 35 nucleobases (i.e. from about 12 to about 35 linked nucleosides). In other words, a single-stranded antisense compound of the invention comprises from about 12 to about 35 nucleobases, and a double-stranded antisense compound of the invention (such as a siRNA, for example) comprises two strands, each of which is from about 12 to about 35 nucleobases. Contained within the antisense compounds of the invention (whether single or double stranded and on at least one strand) are antisense portions. The “antisense portion” is that part of the antisense compound that is designed to work by one of the aforementioned antisense mechanisms. One of ordinary skill in the art will appreciate that this comprehends antisense portions of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or 35 nucleobases.
In one embodiment, the antisense compounds of the invention have antisense portions of 12 to 35 nucleobases. It is understood that the antisense portion may be about 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or 35 nucleobases in length.
Antisense compounds 12 to 35 nucleobases in length comprising a stretch of at least 8, preferably at least 12, more preferably at least 17 consecutive nucleobases selected from within the illustrative antisense compounds are considered to be suitable antisense compounds as well. Also contemplated are antisense compounds 12 to 35 nucleobases in length comprising a stretch of at least 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, or 19 nucleobases selected from within the illustrative antisense compounds are considered to be suitable antisense compounds as well.
Antisense compounds of the invention include antisense compound sequences that comprise at least the 8 (or 9-19) consecutive nucleobases from the 5′-terminus of one of the illustrative antisense compounds (the remaining nucleobases being a consecutive stretch of the same antisense beginning immediately upstream of the 5′-terminus of the antisense compound which is specifically hybridizable to the target nucleic acid and continuing until the antisense contains about 12 to 35 nucleobases). Other antisense compounds are represented by antisense compound sequences that comprise at least the 8 (or 9-19) consecutive nucleobases from the 3′-terminus of one of the illustrative 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 antisense compound contains about 12 to about 35 nucleobases). It is also understood that antisense compounds may be represented by antisense compound sequences that comprise at least 8 (or 9-19) consecutive nucleobases from an internal portion of the sequence of an illustrative compound, and may extend in either or both directions until the antisense contains about 12 to about 35 nucleobases.
One having skill in the art armed with the antisense compounds illustrated herein will be able, without undue experimentation, to identify further antisense compounds.
Chemical 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 (sometimes referred to as a “nucleobase” or simply a “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 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. 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
Oligomeric compounds may comprise modified internucleoside linkages, e.g. non-naturally occurring internucleoside linkages. As defined in this specification, oligonucleotides having modified internucleoside linkages include internucleoside linkages that retain a phosphorus atom and internucleoside linkages that do not have a phosphorus atom. 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.
Oligomeric compounds, including antisense compounds and antisense oligonucleotides, can have one or more modified internucleoside linkages. Modified oligonucleotide backbones containing a phosphorus atom therein include, for example, phosphorothioates, chiral phosphorothioates, phosphorodithioates, phosphotriesters, aminoalkyl-phosphotriesters, methyl and other alkyl phosphonates including 3′-alkylene phosphonates, 5′-alkylene phosphonates and chiral phosphonates, phosphinates, phosphoramidates including 3′-amino phosphoramidate and aminoalkylphosphoramidates, thionophosphoramidates, thionoalkyl-phosphonates, thionoalkylphosphotriesters, phosphonoacetate and thiophosphonoacetate (see Sheehan et al., Nucleic Acids Research, 2003, 31(14), 4109-4118 and Dellinger et al., J. Am. Chem. Soc., 2003, 125, 940-950), selenophosphates and boranophosphates having normal 3′-5′ linkages, 2′-5′ linked analogs of these, and those having inverted polarity wherein one or more internucleoside linkages is a 3′ to 3′, 5′ to 5′ or 2′ to 2′ linkage. Oligonucleotides having inverted polarity comprise a single 3′ to 3′ linkage at the 3′-most internucleotide linkage, i.e., a single inverted nucleoside residue which 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.
N3′-P5′-phosphoramidates have been reported to exhibit both a high affinity towards a complementary RNA strand and nuclease resistance (Gryaznov et al., J. Am. Chem. Soc., 1994, 116, 3143-3144). N3′-P5′-phosphoramidates have been studied with some success in vivo to specifically down regulate the expression of the c-myc gene (Skorski et al., Proc. Natl. Acad. Sci., 1997, 94, 3966-3971; and Faira et al., Nat. Biotechnol., 2001, 19, 40-44).
In some embodiments, oligomeric compounds may have one or more phosphorothioate and/or heteroatom internucleoside linkages, 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 internucleoside linkage is represented as —O—P(═O)(OH)—O—CH2—).
Some 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.
Modified Sugars
Oligomeric compounds may also contain one or more substituted sugar moieties. Suitable compounds can 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. Also suitable 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 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, poly-alkylamino, 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. One modification includes 2′-methoxyethoxy (2′-O—CH2CH2OCH3, also known as 2′-O-(2-methoxyethyl) or 2′-MOE) (Martin et al., Helv. Chim. Acta, 1995, 78, 486-504), i.e., an alkoxyalkoxy group. A further modification includes 2′-dimethylaminooxyethoxy, i.e., a O(CH2)2ON(CH3)2 group, also known as 2′-DMAOE, as described in examples herein below, and 2′-dimethylaminoethoxyethoxy (also known in the art as 2′-O-dimethyl-amino-ethoxy-ethyl or 2′-DMAEOE), i.e., 2′-O—(CH2)2—O—(CH2)2—N(CH3)2, also described in examples herein below.
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. One 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. Antisense compounds 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; 5,700,920; and, U.S. Pat. No. 6,147,200.
A further modification includes bicyclic sugar moieties referred to as “bicyclic nucleic acids” or “BNAs” in which the 2′-hydroxyl group of the ribosyl sugar ring is linked to the 4′ carbon atom of the sugar ring to form the bicyclic sugar moiety (reviewed in Elayadi et al., Curr. Opinion Invens. Drugs, 2001, 2, 558-561; Braasch et al., Chem. Biol., 2001, 8 1-7; and Orum et al., Curr. Opinion Mol. Ther., 2001, 3, 239-243; see also U.S. Pat. Nos. 6,268,490 and 6,670,461). The linkage can be a methylene (—CH2—) group bridging the 2′ oxygen atom and the 4′ carbon atom, or can be an ethylene group. The alpha-L isomer of the bicyclic nucleic acid moiety wherein the linkage is a methylene group is an additional modified sugar moiety. Another bicyclic sugar moiety that has been prepared and studied has the bridge going from the 3′-hydroxyl group via a single methylene group to the 4′ carbon atom of the sugar ring thereby forming a 3′-C,4′-C-oxymethylene linkage (see U.S. Pat. No. 6,043,060).
Oligonucleotide Mimetics
Another group of oligomeric compounds includes oligonucleotide mimetics. The term “mimetic” as it is applied to oligonucleotides includes oligomeric compounds wherein the furanose ring or the furanose ring and the internucleotide linkage are replaced with novel groups, replacement of only the furanose ring is also referred to in the art as being a sugar surrogate. The heterocyclic base moiety or a modified heterocyclic base moiety is maintained for hybridization with an appropriate target nucleic acid. Oligonucleotide mimetics include peptide nucleic acid (PNA) compounds (Nielsen et al., Science, 1991, 254, 1497-1500), morpholino-based compounds (see, for example, U.S. Pat. No. 5,034,506), cyclohexene nucleic acids (CeNA). In CeNA oligonucleotides (Wang et al., J. Am. Chem. Soc., 2000, 122, 8595-8602), and phosphonomonoester nucleic acids.
Modified and Alternate Nucleobases
Oligomeric compounds can also include nucleobase (often referred to in the art as heterocyclic base or 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). A “substitution” is the replacement of an unmodified or natural base with another unmodified or natural base. “Modified” nucleobases mean 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. Certain nucleobase modifications increase 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 suitable base substitutions, even more particularly when combined with 2′-O-methoxyethyl sugar modifications. It is understood in the art that modification of the base does not entail such chemical modifications as to produce substitutions in a nucleic acid sequence.
Oligomeric compounds of the present invention can also include polycyclic heterocyclic compounds in place of one or more of the naturally-occurring heterocyclic base moieties. A number of tricyclic heterocyclic compounds have been previously reported. These compounds are routinely used in antisense applications to increase the binding properties of the modified strand to a target strand. The most studied modifications are targeted to guanosines hence they have been termed G-clamps or cytidine analogs.
Conjugates
Oligomeric compounds may be chemically linked to one or more moieties or conjugates which enhance the oligomeric compound properties such as activity, cellular distribution or cellular uptake. 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. Additional conjugate groups include cholesterols, lipids, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes. Groups that enhance the pharmaco-dynamic 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.
Oligomeric compounds can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of an oligomeric compound 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. These terminal modifications protect the oligomeric compounds having terminal nucleic acid molecules from exonuclease degradation, and can improve delivery and/or localization within a cell. The cap can be present at either the 5′-terminus (5′-cap) or at the 3′-terminus (3′-cap) or can be present on both termini of a single strand, or one or more termini of both strands of a double-stranded compound. This cap structure is not to be confused with the inverted methylguanosine “5′cap” present at the 5′ end of native mRNA molecules.
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 siRNA constructs, the 5′ end (5′ cap) is commonly but not limited to 5′-hydroxyl or 5′-phosphate.
Particularly suitable 3′-cap structures 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).
Chimeric Compounds
It is not necessary for all positions in a given oligomeric compound to be uniformly modified, and in fact more than one of the aforementioned modifications may be incorporated in a single compound or even within a single nucleoside within an oligomeric compound.
The present invention also includes oligomeric compounds which are chimeric compounds. “Chimeric” oligomeric compounds or “chimeras,” in the context of this invention, are single- or double-stranded oligomeric compounds, such as oligonucleotides, which contain two or more chemically distinct regions, each comprising at least one monomer unit, i.e., a nucleotide in the case of an oligonucleotide compound. Chimeric antisense oligonucleotides are one form of oligomeric compound. These oligonucleotides typically contain at least one region which is modified so as to confer upon the oligonucleotide increased resistance to nuclease degradation, increased cellular uptake, alteration of charge, increased stability and/or increased binding affinity for the target nucleic acid. An additional region of the oligonucleotide may serve as a substrate for RNAses or other enzymes. 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 when bound by a DNA-like oligomeric compound, 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 RNase III or RNAseL which cleaves both cellular and viral RNA. Cleavage products of the RNA target can be routinely detected by gel electrophoresis and, if necessary, associated nucleic acid hybridization techniques known in the art.
Chimeric oligomeric compounds of the invention can be formed as composite structures of two or more oligonucleotides, modified oligonucleotides, oligonucleosides, oligonucleotide mimetics, or regions or portions thereof. Such compounds have also been referred to in the art as hybrids or gapmers. 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 U.S. Pat. No. 5,700,922.
A “gapmer” is defined as an oligomeric compound, generally an oligonucleotide, having a 2′-deoxyoligonucleotide region flanked by non-deoxyoligonucleotide segments. The central region is referred to as the “gap.” The flanking segments are referred to as “wings.” While not wishing to be bound by theory, the gap of the gapmer presents a substrate recognizable by RNase H when bound to the RNA target whereas the wings do not provide such a substrate but can confer other properties such as contributing to duplex stability or advantageous pharmacokinetic effects. Each wing can be one or more non-deoxyoligonucleotide monomers (if one of the wings has zero non-deoxyoligonucleotide monomers, a “hemimer” is described). In one embodiment, the gapmer is a ten deoxynucleotide gap flanked by five non-deoxynucleotide wings. This is referred to as a 5-10-5 gapmer. Other configurations are readily recognized by those skilled in the art. In one embodiment the wings comprise 2′-MOE modified nucleotides. In another embodiment the gapmer has a phosphorothioate backbone. In another embodiment the gapmer has 2′-MOE wings and a phosphorothioate backbone. Other suitable modifications are readily recognizable by those skilled in the art.
Oligomer Synthesis
Oligomerization of modified and unmodified nucleosides can be routinely performed according to literature procedures for DNA (Protocols for Oligonucleotides and Analogs, Ed. Agrawal (1993), Humana Press) and/or RNA (Scaringe, Methods (2001), 23, 206-217. Gait et al., Applications of Chemically synthesized RNA in RNA: Protein Interactions, Ed. Smith (1998), 1-36. Gallo et al., Tetrahedron (2001), 57, 5707-5713).
Oligomeric compounds can 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.
Oligonucleotide Synthesis
Oligomeric compounds and phosphoramidites are made by methods well known to those skilled in the art. Oligomerization of modified and unmodified nucleosides is performed according to literature procedures for DNA like compounds (Protocols for Oligonucleotides and Analogs, Ed. Agrawal (1993), Humana Press) and/or RNA like compounds (Scaringe, Methods (2001), 23, 206-217. Gait et al., Applications of Chemically synthesized RNA in RNA:Protein Interactions, Ed. Smith (1998), 1-36. Gallo et al., Tetrahedron (2001), 57, 5707-5713) synthesis as appropriate. Alternatively, oligomers may be purchased from various oligonucleotide synthesis companies such as, for example, Dharmacon Research Inc., (Lafayette, Colo.).
Irrespective of the particular protocol used, the oligomeric 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 (including solution phase synthesis).
Methods of isolation and analysis of oligonucleotides are well known in the art. A 96-well plate format is particularly useful for the synthesis, isolation and analysis of oligonucleotides for small scale applications.
Hybridization
“Hybridization” means the pairing of complementary strands of oligomeric compounds. While not limited to a particular mechanism, the most common 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 which pair through the formation of hydrogen bonds. Hybridization can occur under varying circumstances.
An oligomeric compound is specifically hybridizable when there is a sufficient degree of complementarity to avoid non-specific binding of the oligomeric 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.
“Stringent hybridization conditions” or “stringent conditions” refer to conditions under which an oligomeric compound 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 “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.
Complementarity
“Complementarity,” as used herein, refers to the capacity for precise pairing between two nucleobases on one or two oligomeric compound strands. For example, if a nucleobase at a certain position of an antisense compound is capable of hydrogen bonding with a nucleobase at a certain position of a target nucleic acid, then the position of hydrogen bonding between the oligonucleotide and the target nucleic acid is considered to be a complementary position. The oligomeric compound and the further DNA or RNA are complementary to each other when a sufficient number of complementary positions in each molecule are occupied by nucleobases which can hydrogen bond with each other. Thus, “specifically hybridizable” and “complementary” are terms which 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 oligomeric compound and a target nucleic acid.
As used herein, an antisense oligonucleotide is “fully complementary” to a target nucleic acid when each nucleobase of the antisense oligonucleotide is capable of undergoing precise base pairing with an equal number of nucleobases in the target nucleic acid. It is understood in the art that the sequence of the antisense oligonucleotide need not be fully complementary to that of its target nucleic acid to be active in inhibiting the activity of the target nucleic acid. In some embodiments there are “non-complementary” positions, also known as “mismatches”, between the antisense oligonucleotide and the target nucleic acid, and such non-complementary positions may be tolerated between an antisense oligonucleotide and the target nucleic acid provided that the antisense oligonucleotide remains specifically hybridizable to the target nucleic acid. For example, as demonstrated herein, 387916, having one non-complementary nucleobases with respect to mouse huntingtin, is capable of reducing mouse huntingtin mRNA levels in vitro and in vivo. A “non-complementary nucleobase” means a nucleobase of an antisense oligonucleotide that is unable to undergo precise base pairing with a nucleobase at a corresponding position in a target nucleic acid. As used herein, the terms “non-complementary” and “mismatch” are interchangeable. In some embodiments antisense oligonucleotides having no more than three non-complementary nucleobases with respect to a nucleic acid encoding huntingtin are considered “complementary” to a nucleic acid encoding huntingtin. In other embodiments, antisense oligonucleotides contain no more than two non-complementary nucleobases with respect to a nucleic acid encoding huntingtin. In further embodiments, antisense oligonucleotides contain no more than one non-complementary nucleobase with respect to a nucleic acid encoding huntingtin.
The location of a non-complementary nucleobase may be at the 5′ end or 3′ end of the antisense oligonucleotide. Alternatively, the non-complementary nucleobase may be at an internal position in the antisense oligonucleotide. When two or more non-complementary nucleobases are present, they may be contiguous (i.e. linked) or non-contiguous.
In other embodiments of the invention, the antisense oligonucleotides comprise at least 90% sequence complementarity to a huntingtin target nucleic acid. In further embodiments of the invention, the antisense oligonucleotides comprise at least 95% sequence complementarity to a huntingtin target nucleic acid. In further embodiments of the invention, the antisense oligonucleotides comprise at least 96%, 97%, 98% or 99% sequence complementarity to a huntingtin target nucleic acid.
Examples of oligonucleotides having mismatches or less than 100% sequence complementarity are shown in Table 1 below where the mismatch is designated by the letter X in the sequence.










TABLE 1






SEQ




Isis
ID




No.
NO:
Sequence (5′ to 3′)
X is







387902
105
CGCCTGCACCATGTTCCTCA




358
CGXCTGCACCATGTTCCTCA
A or T



359
CGCCXGCACCATGTTCCTCA
C or G



360
CGCCTGCACCAXGTTCCTCA
C or G



361
CGCCTGCACCATGTTCXTCA
A or T


 


388816
345
GCCGTAGCCTGGGACCCGCC




362
GCXGTAGCCTGGGACCCGCC
A or T



363
GCCGTAGCXTGGGXCCCGCC
C or G



364
GCCGTAGCCTGGGACCCXCC
A or T



365
GCCGTAGCCTGGGACCCGCX
A or T


 


387916
125
TCTCTATTGCACATTCCAAG




366
TCXCTATTGCACATTCCAAG
C or G



367
TCTCTATXGCACATTCCAAG
C or G



368
TCTCTATTGCAXATTCCAAG
A or T



369
TCTCTATTGCACATTCXAAG
A or T









Identity

Oligomeric compounds, or a portion thereof, may have a defined percent identity to a SEQ ID NO, or a compound having a specific Isis number. This identity may be over the entire length of the oligomeric compound, or in a portion of the oligomeric compound (e.g., nucleobases 1-20 of a 27-mer may be compared to a 20-mer to determine percent identity of the oligomeric compound to the SEQ ID NO.). It is understood by those skilled in the art that an oligonucleotide need not have an identical sequence to those described herein to function similarly to the oligonucleotides described herein. Shortened (i.e., deleted, and therefore non-identical) versions of oligonucleotides taught herein, or non-identical (i.e., one base replaced with another) versions of the oligonucleotides taught herein fall within the scope of the invention. Percent identity is calculated according to the number of bases that are identical to the SEQ ID NO or compound to which it is being compared. The non-identical bases may be adjacent to each other, dispersed through out the oligonucleotide, or both.
For example, a 16-mer having the same sequence as nucleobases 2-17 of a 20-mer is 80% identical to the 20-mer. Alternatively, a 20-mer containing four nucleobases not identical to the 20-mer is also 80% identical to the 20-mer. A 14-mer having the same sequence as nucleobases 1-14 of an 18-mer is 78% identical to the 18-mer. Such calculations are well within the ability of those skilled in the art.
The percent identity is based on the percent of nucleobases in the original sequence present in a portion of the modified sequence. Therefore, a 30 nucleobase oligonucleotide comprising the full sequence of a 20 nucleobase SEQ ID NO would have a portion of 100% identity with the 20 nucleobase SEQ ID NO while further comprising an additional 10 nucleobase portion. In the context of the invention, the full length of the modified sequence may constitute a single portion.
It is well known by those skilled in the art that it is possible to increase or decrease the length of an antisense oligonucleotide and/or introduce mismatch bases without eliminating activity. For example, in Woolf et al. (Proc. Natl. Acad. Sci. USA 89:7305-7309. 1992, incorporated herein by reference), a series of oligomers 13-25 nucleobases in length were tested for their ability to induce cleavage of a target RNA in an oocyte injection model. Oligonucleotides 25 nucleobases in length with 8 or 11 mismatch bases near the ends of the oligonucleotide were able to direct specific cleavage of the target mRNA, albeit to a lesser extent than the oligonucleotide that contained no mismatches. Similarly, target specific cleavage was achieved using a 13 nucleobase oligomer, including those with 1 or 3 mismatches. Maher and Dolnick (Nuc. Acid. Res. 16:3341-3358.1988, incorporated herein by reference) tested a series of tandem 14 nucleobase oligonucleotides, and a 28 and 42 nucleobase oligonucleotide comprised of the sequence of two or three of the tandem oligonucleotides, respectively, for their ability to arrest translation of human DHFR in a rabbit reticulocyte assay. Each of the three 14 nucleobase oligonucleotides alone were able to inhibit translation, albeit at a more modest level, than the 28 or 42 nucleobase oligonucleotide. Interestingly, a mixture of the tandem 14 nucleobase oligonucleotides was as effective at inhibiting translation as the 28 nucleobase oligonucleotide targeted to the same region.
Target Nucleic Acids
“Targeting” an oligomeric compound to a particular target nucleic acid molecule can be a multistep process. The process usually begins with the identification of a target nucleic acid whose expression is to be modulated. As used herein, the terms “target nucleic acid” and “nucleic acid encoding huntingtin” encompass DNA encoding huntingtin, RNA (including pre-mRNA and mRNA) transcribed from such DNA, and also cDNA derived from such RNA. For example, the target nucleic acid can be 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. As disclosed herein, the target nucleic acid encodes huntingtin.
Target Regions, Segments, and Sites
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. “Region” is defined as a portion of the target nucleic acid having at least one identifiable structure, function, or characteristic. Target regions include, but are not limited to, contiguous nucleotide sequences, translation initiation and termination regions, coding regions, open reading frames, introns, exons, 3′-untranslated regions (3′-UTR), and 5′-untranslated regions (5′-UTR). Within regions of target nucleic acids are target segments. As used herein, a “target segment” means a sequence of a huntingtin target nucleic acid to which one or more antisense oligonucleotides are complementary. The term “5′ target site” is defined as the 5′-most nucleobase of a target segment to which an antisense oligonucleotide is complementary. Likewise, a “3′ target site” is defined as the 3′-most nucleobase of a target segment to which an antisense oligonucleotide is complementary.
Variants
It is also known in the art that 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. Variants can result in mRNA variants including, but not limited to, those with alternate splice junctions, or alternate initiation and termination codons. Variants in genomic and mRNA sequences can result in disease. Oligonucleotides to such variants are within the scope of the instant invention.
Target Names and Synonyms
In accordance with the present invention are compositions and methods for modulating the expression of genes which are presented in Table 2. Listed in Table 2 are the gene target names, as well as GENBANK® accession numbers used to design oligomeric compounds targeted to each gene.







TABLE 2







Gene Target Names and Sequences









Species
Genbank #
SEQ ID NO












Human
AB209506.1
1


Human
BE378835.1
2


Human
L12392.1
3


Human
NM_002111.5
4


Human
nucleotides 462000 to 634000 of
5



NT_006081.17


Mouse
AK042204.1
6


Mouse
AK049546.1
7


Mouse
L23312.1
8


Mouse
L23313.1
9


Mouse
NM_010414.1
10


Mouse
nucleotides 2036000 to 2190000 of
11



NT_039302.4


Mouse
NM_010414.1 (mouse short form) *
44


Human
cut from genomic ad Sac1 and EcoR1 sites
45



surrounding exon 1, expanded CAG to



results in 130 gln in this region





* NM_010414.1 (mouse short form) extended with mouse genomic sequence to create transcript orthologous to human long form (NM_002111.5). Much of this extension is supported by mouse ESTs but the most 3′ end is supported only by homology to the human mRNA






Modulation of Target Expression

Modulation of expression of a target nucleic acid can be achieved through alteration of any number of nucleic acid (DNA or RNA) functions. “Modulation” means a perturbation of function, for example, either an increase (stimulation or induction) or a decrease (inhibition or reduction) in expression. As another example, modulation of expression can include perturbing splice site selection of pre-mRNA processing. “Expression” includes all the functions by which a gene's coded information is converted into structures present and operating in a cell. These structures include the products of transcription and translation. “Modulation of expression” means the perturbation of such functions. The functions of DNA to be modulated 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 modulated can include translocation functions, which include, but are not limited to, 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, and translation of protein from the RNA. RNA processing functions that can be modulated include, but are not limited to, splicing of the RNA to yield one or more RNA species, capping of the RNA, 3′ maturation of the RNA and catalytic activity or complex formation involving the RNA which may be engaged in or facilitated by the RNA. Modulation of expression can result in the increased level of one or more nucleic acid species or the decreased level of one or more nucleic acid species, either temporally or by net steady state level. One result of such interference with target nucleic acid function is modulation of the expression of HUNTINGTINα. Thus, in one embodiment modulation of expression can mean increase or decrease in target RNA or protein levels. In another embodiment modulation of expression can mean an increase or decrease of one or more RNA splice products, or a change in the ratio of two or more splice products.
Cultured Cells
The effect of oligomeric compounds of the present invention 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. The effect of oligomeric compounds of the present invention on target nucleic acid expression can be routinely determined using, for example, PCR or Northern blot analysis. Cell lines are derived from both normal tissues and cell types and from cells associated with various disorders (e.g. hyperproliferative disorders). Cell lines derived from multiple tissues and species can be obtained from American Type Culture Collection (ATCC, Manassas, Va.) and are well known to those skilled in the art. Primary cells, or those cells which are isolated from an animal and not subjected to continuous culture, can be prepared according to methods known in the art or obtained from various commercial suppliers. Additionally, primary cells include those obtained from donor human subjects in a clinical setting (i.e. blood donors, surgical patients).
Cells isolated from Huntington's Disease (HD) patients are also used to test the effects of antisense compounds targeted to huntingtin. In such cells, the mutant huntingtin gene may be present in a heterozygous or homozygous form. Such cells are available from National Institute of General Medical Sciences (NIGMS) Human Genetic Cell Repository, examples of which include fibroblasts having repository number GMO4281 or GMO4478. Cells from Huntington's Disease (HD) patients are cultured according to procedures recommended by the supplier.
The pharmacological effects of antisense inhibition of huntingtin can be assessed in cell lines isolated from neuronal cells expressing either wild-type or mutant forms of the huntingtin gene. The mutant forms of huntingtin are associated with particular phenotypes, and the effects on these phenotypes are evaluated following antisense inhibition of huntingtin. An example of such cells are striatal cells established from HdhQ111 knock-in mice, which bear 111 CAG repeats inserted into the mouse huntingtin locus. Establishment of striatal cell lines isolated from HdhQ111 mice has been described by Trettel et al. (Human Mol. Genet., 2000, 9, 2799-2809). Striatal cell lines established from mice bearing a wild-type huntingtin gene are used for comparison studies.
Assaying Modulation of Expression
Modulation of huntingtin expression can be assayed in a variety of ways known in the art. Huntingtin mRNA levels can be quantitated by, e.g., Northern blot analysis, competitive polymerase chain reaction (PCR), or real-time PCR. RNA analysis can be performed on total cellular RNA or poly(A)+ mRNA by methods known in the art. Methods of RNA isolation are taught in, for example, Ausubel, F. M. et al., Current Protocols in Molecular Biology, Volume 1, pp. 4.1.1-4.2.9 and 4.5.1-4.5.3, John Wiley & Sons, Inc., 1993.
Northern blot analysis is routine in the art and is taught in, for example, Ausubel, F. M. et al., Current Protocols in Molecular Biology, Volume 1, pp. 4.2.1-4.2.9, John Wiley & Sons, Inc., 1996. Real-time quantitative (PCR) can be conveniently accomplished using the commercially available ABI PRISMTM 7700 Sequence Detection System, available from PE-Applied Biosystems, Foster City, Calif. and used according to manufacturer's instructions. The method of analysis of modulation of RNA levels is not a limitation of the instant invention.
Levels of a protein encoded by huntingtin can be quantitated in a variety of ways well known in the art, such as immunoprecipitation, Western blot analysis (immunoblotting), ELISA or fluorescence-activated cell sorting (FACS). Antibodies directed to a protein encoded by huntingtin can be identified and obtained from a variety of sources, such as the MSRS catalog of antibodies (Aerie Corporation, Birmingham, Mich.).
Validated Target Segments
The locations on the target nucleic acid to which active oligomeric compounds hybridize are hereinbelow referred to as “validated target segments.” In one embodiment, a validated target segment includes at least an 8-nucleobase portion of a target region. In another embodiment, a validated target segment includes at least a 12-nucleobase portion of a target region to which an active oligomeric 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 which are accessible for hybridization.
Target segments can include DNA or RNA sequences that comprise at least the 8, or at least the 12, consecutive nucleobases from the 5′-terminus of a validated target segment (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 12 to about 35 nucleobases). Similarly validated target segments are represented by DNA or RNA sequences that comprise at least the 8, or at least the 12 consecutive nucleobases from the 3′-terminus of a validated target segment (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 12 to about 35 nucleobases). It is also understood that a validated oligomeric target segment can be represented by DNA or RNA sequences that comprise at least 8, or at least the 12, consecutive nucleobases from an internal portion of the sequence of a validated target segment, and can extend in either or both directions until the oligonucleotide contains about 12 to about 35 nucleobases.
Screening for Modulator Compounds
In another embodiment, the validated target segments identified herein can be employed in a screen for additional compounds that modulate the expression of huntingtin. “Modulators” are those compounds that modulate the expression of huntingtin and which comprise at least an 8-nucleobase portion which is complementary to a validated target segment. The screening method comprises the steps of contacting a validated target segment of a nucleic acid molecule encoding huntingtin with one or more candidate modulators, and selecting for one or more candidate modulators which perturb the expression of a nucleic acid molecule encoding huntingtin. Once it is shown that the candidate modulator or modulators are capable of modulating the expression of a nucleic acid molecule encoding huntingtin, the modulator can then be employed in further investigative studies of the function of huntingtin, or for use as a research, diagnostic, or therapeutic agent. The validated target segments can also be combined with a second strand as disclosed herein to form stabilized double-stranded (duplexed) oligonucleotides for use as a research, diagnostic, or therapeutic agent.
In Vivo Testing of Antisense Compounds Targeted to Huntingtin
Antisense compounds targeted to huntingtin are tested in experimental animal models. In one embodiment, the antisense compounds are targeted to the human huntingtin gene alone. Such antisense compounds have, for example, less than four mismatches to human huntingtin and four or more mismatches to non-human huntingtin. In another embodiment, antisense compounds are targeted to both human and non-human huntingtin. Such antisense compounds have, for example, less than four mismatches to human huntingtin and less than four mismatches to non-human huntingtin.
Normal Animals
Normal, wild-type animals may be used to perform toxicity studies of antisense oligonucleotides targeted to huntingtin. The antisense compounds are administered systemically (e.g. via intraperitoneal injection) at doses of 25, 50, 75, or 100 mg/kg. Animals are monitored for any clinical changes, including changes in body weight. Serum is collected periodically, for example every week or every two weeks, during the dosing period and subjected to analysis using a clinical analyzer to detect any changes in serum chemistry profiles. At the end of the study, the animals are sacrificed. Blood is collected and analyzed for white blood cell count, platelet count, and serum chemistry. The weights of major organs are determined, and histological analyses are performed on spleen, liver, kidney and pancreas.
Huntington's Disease Models
Antisense compounds targeted to huntingtin may be tested in experimental non-human models of Huntington's Disease (HD). Several non-human models have been developed and characterized.
The R6/2 transgenic mouse model has integrated into its genome 1 kilobase of the human huntingtin gene, including the 5′-UTR exon 1 and the first 262 basepairs of intron 1 (Mangiarin L. et al., Cell, 1996, 87, 493-506). This transgene has 144 CAG repeats. The transgene encodes for approximately 3% of the N-terminal region of the huntingtin protein, expression of which is driven by the human huntingtin promoter. Expression levels of this truncated version of human huntingtin protein are approximately 75% of the endogenous mouse huntingtin protein levels. The R6/2 transgenic mice exhibit symptoms of human Huntington's Disease (HD) and brain dysfunction.
The YAC128 transgenic mice harbor a yeast artificial chromosome (YAC) carrying the entire huntingtin gene, including the promoter region and 128 CAG repeats (Hodgson J. G. et al., Human Mol. Genet., 1998, 5, 1875). This YAC expresses all but exon 1 of the human gene. These transgenic mice do not express endogenous mouse huntingtin.
The endogenous mouse huntingtin gene of the Q111 mice has 111 CAG repeats inserted into exon 1 of the gene (Wheeler V. C. et al., Human Mol. Genet., 8, 115-122).
In the Q150 transgenic mice, the CAG repeat in exon 1 of the wild-type mouse huntingtin gene is replaced with 150 CAG repeats (Li C. H. et al., Human Mol. Genet., 2001, 10, 137).
Antisense compounds targeted to huntingtin are administered to the non-human experimental model, for example to transgenic mice that are used as models of Huntington's Disease (HD).
Antisense compounds may be administered directly into the central nervous system of the experimental animal, for example through intracerebroventricular (ICV), intrathecal (IT) or intraparenchymal administration. Dosages of antisense compounds administered may be 25, 50, 75, or 100 ug/day, and administration may be accomplished through continuous infusion using a surgically implanted osmotic pump (e.g. an Alzet mini-pump). 0.25, 0.5, or 1 uL/hour. Each dosage is administered to groups of 4 to 6 animals. Control groups of animals may receive saline infusion, or infusion of an antisense compound having a sequence not targeted to any known gene.
Animals are treated for several weeks, for example 1, 2, 4, or 8 weeks. Animals are monitored for any clinical changes, including changes in body weight. At the end of the treatment period, animals are sacrificed. The brains are dissected into three regions: forebrain, basal ganglion, and cerebellum. Brain regions undergo histological assessment, including hemotoxylin/eosin staining, GFAP staining (to assess glial cell activation) and FluoroJ staining (to assess neurodegenerative changes). Huntingtin mRNA levels are measured by real-time PCR, and huntingtin protein levels are measured by immunoblotting (western blotting).
The duration of action of antisense compounds targeting huntingtin may also be evaluated. For such analyses, animals are dosed for 2, 4, 6, or 8 weeks with antisense compounds targeting huntingtin. At the end of the dosing period, the osmotic pumps are removed and animals are sacrificed 0, 1, 2, 4, 6, or 8 weeks following dosing termination. The brains are dissected into three regions: forebrain, basal ganglion, and cerebellum. Brain regions undergo histological assessment, including hemotoxylin/eosin staining, GFAP staining (to assess glial cell activation) and FluoroJ staining (to assess neurodegenerative changes). Huntingtin mRNA levels are measured by real-time PCR, and huntingtin protein levels are measured by immunoblotting (western blotting).
Kits, Research Reagents, and Diagnostics
The oligomeric compounds of the present invention can be utilized for diagnostics, research reagents and kits. Furthermore, antisense compounds, which are able to inhibit gene expression with 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 oligomeric compounds of the present invention, either alone or in combination with other compounds or therapeutics, can be 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 one nonlimiting example, expression patterns within cells or tissues treated with one or more compounds or compositions of the present invention are compared to control cells or tissues not treated with 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 which affect expression patterns. By way of example, gene expression patterns may be identified by microarray analysis.
Nonlimiting Disclosure and Incorporation by Reference
While certain compounds, compositions and methods of the present invention have been described with specificity in accordance with certain embodiments, the following examples serve only to illustrate the compounds of 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.
Example 1
Antisense Inhibition of Huntingtin in Culture Cells
The effect of oligomeric compounds on target nucleic acid expression was tested in cultured cells, for example A549 cells or HD patient fibroblasts for compounds targeted to human huntingtin, and in b.END cells for compounds targeted to mouse huntingtin.
When cells reached 65-75% confluency, the transfection reagent LIPOFECTIN® was used to introduce oligonucleotide into cells. Other methods of transfection are well known to those skilled in the art. The method of screening is not a limitation of the instant invention.
Oligonucleotide was mixed with LIPOFECTIN® Invitrogen Life Technologies, Carlsbad, Calif.) in OPTI-MEM®-1 reduced serum medium (Invitrogen Life Technologies, Carlsbad, Calif.) to achieve the desired concentration of oligonucleotide and a LIPOFECTIN® concentration of 2.5 or 3 μg/mL per 100 nM oligonucleotide. This transfection mixture was incubated at room temperature for approximately 0.5 hours. For cells grown in 96-well plates, wells were washed once with 100 μL OPTI-MEM®-1 and then treated with 130 μL of the transfection mixture. Cells are treated and data were obtained in duplicate or triplicate. After approximately 4-7 hours of treatment at 37° C., the medium containing the transfection mixture was replaced with fresh culture medium. Cells were harvested 16-24 hours after oligonucleotide treatment.
For culture chambers other than 96-well plates, the cells may be treated similarly, using appropriate volumes of medium and oligonucleotide.
Example 2
Real-Time Quantitative PCR Analysis of Huntingtin mRNA Levels
Quantitation of huntingtin mRNA levels was accomplished by real-time quantitative PCR using the ABI PRISM® 7600, 7700, or 7900 Sequence Detection System (PE-Applied Biosystems, Foster City, Calif.) according to manufacturer's instructions.
After isolation from cells or tissues, RNA was subjected to sequential reverse transcriptase (RT) reaction and real-time PCR, both of which are performed in the same well. RT and PCR reagents were obtained from Invitrogen Life Technologies (Carlsbad, Calif.). RT, real-time PCR was carried out in the same 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).
Gene target quantities obtained by RT, real-time PCR were normalized using either the expression level of GAPDH, a gene whose expression is constant, or by quantifying total RNA using RIBOGREEN® (Molecular Probes, Inc. Eugene, Oreg.). GAPDH expression was quantified by RT, real-time PCR, by being run simultaneously with the target, multiplexing, or separately. Total RNA was quantified using RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc. Eugene, Oreg.) according to the manufacturer's instructions.
Probes and primers for use in real-time PCR were designed to hybridize to target-specific sequences. The primers and probes and the target nucleic acid sequences to which they hybridize are presented in Table 3. The target-specific PCR probes have FAM covalently linked to the 5′ end and TAMRA or MGB covalently linked to the 3′ end, where FAM is the fluorescent dye and TAMRA or MGB is the quencher dye.







TABLE 3







Gene target-specific primers and


probes for use in real-time PCR












Target






SEQ


SEQ



ID
Sequence

ID


Species
NO
Description
Sequence (5′ to 3′)
NO





Human
 4
Forward
CTCCGTCCGGTAGACATGCT
38




Primer




 


Human
 4
Reverse
GGAAATCAGAACCCTCAAAATGG
39




Primer




 


Human
 4
Probe
TGAGCACTGTTCAACTGTGGATATCGGGA
40


 


Mouse
10
Forward
CAGAGCTGGTCAACCGTATCC
41




Primer




 


Mouse
10
Reverse
GGCTTAAACAGGGAGCCAAAA
42




Primer




 


Mouse
10
Probe
ACTTCATGATGAGCTCGGAGTTCAAC
43









Example 3
Antisense Inhibition of the Huntingtin Gene
Human Huntingtin
Antisense oligonucleotides were designed to target different regions of the human huntingtin gene, using published sequences cited in Table 2. The sequences and corresponding SEQ ID NOs are shown in Table 4. All compounds in Table 4 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of 10 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′) by five-nucleotide “wings”. The wings are composed of 2′-O-(2-methoxyethyl) nucleotides, also known as 2′-MOE nucleotides. The internucleoside (backbone) linkages are phosphorothioate throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
The antisense oligonucleotides were analyzed for their effect on huntingtin mRNA levels in A549 cells by quantitative real-time PCR as described in other examples herein. The data presented in Table 4 represent percent inhibition of huntingtin mRNA levels relative to untreated cells. Data are averages from experiments in which cultured cells were treated with the disclosed antisense oligonucleotides,
If the huntingtin mRNA level in antisense oligonucleotide-treated cells was equal to or higher than in control cells, percent inhibition is expressed as zero inhibition. If present, “N.D.” indicates “not determined.” The target regions to which these antisense oligonucleotides are inhibitory are herein referred to as “validated target segments.”







TABLE 4







Inhibition of huntingtin mRNA levels by chimeric


oligonucleotides having 2′-MOE wings and deoxy gap













Target
5′






SEQ
Target

%
SEQ


ISIS #
ID NO
Site
Sequence (5′ to 3′)
Inhib
ID NO















388224
4
33
CAGGTAAAAGCAGAACCTGA
0
46


 


387865
4
155
GCCTTCATCAGCTTTTCCAG
65
47


 


388829
4
193
GCTGCTGCTGCTGCTGGAAG
46
48


 


388830
4
194
TGCTGCTGCTGCTGCTGCTG
46
49


 


388833
4
195
CTGCTGCTGTTGCTGCTGCT
62
50


 


388831
4
195
CTGCTGCTGCTGCTGCTGCT
56
51


 


388832
4
196
GCTGCTGCTGCTGCTGCTGC
36
52


 


388834
4
198
TGGCGGCTGCTGCTGCTGCT
62
53


 


388835
4
259
GCGGCGGCGGCGGTGGCGGC
52
54


 


387866
4
432
ATGATTCACACGGTCTTTCT
76
55


 


387867
4
489
AAATTCTGGAGAATTTCTGA
31
56


 


387868
4
497
AGTTTCTGAAATTCTGGAGA
58
57


 


387869
4
608
GAATCCATCAAAGCTTTGAT
53
58


 


387870
4
621
CCTTGGAAGATTAGAATCCA
45
59


 


387871
4
709
GAGCCAGCTCAGCAAACCTC
65
60


 


387872
4
718
GAACCAGGTGAGCCAGCTCA
37
61


 


387873
4
749
TTCACCAGGTAAGGCCTGCA
33
62


 


387874
4
821
ACAGCTGCAGCCAAGGTCTC
60
63


 


387875
4
845
CCAAAAGAAGCCATAATTTT
63
64


 


387876
4
876
AACCTTAATTTCATTGTCAT
75
65


 


388225
4
1000
GTAGCCAACTATAGAAATAT
53
66


 


388226
4
1005
ATTTAGTAGCCAACTATAGA
26
67


 


387877
4
1170
AGAGACTTCCATTTCTTTCC
81
68


 


387878
4
1176
AGAAGGAGAGACTTCCATTT
41
69


 


387879
4
1184
TGCTCTGCAGAAGGAGAGAC
46
70


 


387880
4
1201
CATAAACCTGGACAAGCTGC
79
71


 


387881
4
1208
GTCAGTTCATAAACCTGGAC
72
72


 


387882
4
1241
ACATTGTGGTCTTGGTGCTG
51
73


 


387883
4
1460
AAGAGCACTTTGCCTTTTTG
66
74


 


388227
4
1596
TGCTGACCCTGGAGTGGAAA
78
75


 


388228
4
1666
TGGCCAGATCCACTGAGTCC
30
76


 


387884
4
1775
TCATTCAGGTCCATGGCAGG
61
77


 


387885
4
1782
GGTCCCATCATTCAGGTCCA
68
78


 


387886
4
1876
CTAACACAATTTCAGAACTG
73
79


 


388229
4
1990
TGGAAGAGTTCCTGAAGGCC
29
80


 


388230
4
2022
GTTTTTCAATAAATGTGCCT
58
81


 


388231
4
2034
GCAGTGACTCATGTTTTTCA
60
82


 


388232
4
2039
TGCCTGCAGTGACTCATGTT
37
83


 


388233
4
2346
GTCAAGAGGAACTTTATAGA
55
84


 


387887
4
2400
ATCGATGTAGTTCAAGATGT
29
85


 


387888
4
2447
GTCCCACAGAGAATGGCAGT
73
86


 


388234
4
2677
TGATCAGCTGCAGTCCTAAC
1
87


 


387889
4
2820
TGTATAATGATGAGCCCCTC
76
88


 


387890
4
2971
GATCAGCTTGTCCTTGGTCA
81
89


 


388235
4
3183
TCTGGTGGTTGATGTGATTA
63
90


 


388236
4
3190
TGAGTGCTCTGGTGGTTGAT
26
91


 


387891
4
3203
CAGCATCCAAATGTGAGTGC
82
92


 


387892
4
3209
GCTTCACAGCATCCAAATGT
89
93


 


388237
4
3234
GAAGGCAGTGGAAAGAAGAC
62
94


 


387893
4
3641
AGAGAAGGCAAGGCTGCCTT
60
95


 


387894
4
3649
GGTTTGTTAGAGAAGGCAAG
63
96


 


387895
4
3851
ACATCATGCAGTTTGAGGTA
68
97


 


387896
4
3860
GCTTTCAGGACATCATGCAG
51
98


 


387897
4
4028
AAGCAGGATTTCAGGTATCC
78
99


 


387898
4
4036
CTCGACTAAAGCAGGATTTC
90
100


 


387899
4
4055
ACAGTTGCCATCATTGGTTC
67
101


 


388238
4
4069
ATTGTTGAACACAAACAGTT
50
102


 


387900
4
4127
TTGGAAGATAAGCCATCAAA
82
103


 


387901
4
4265
TGCACCATGTTCCTCAGGCT
79
104


 


387902
4
4269
CGCCTGCACCATGTTCCTCA
90
105


 


387903
4
4380
AATAGCATTCTTATCTGCAC
84
106


 


387904
4
4392
AATGTGATTATGAATAGCAT
64
107


 


388239
4
4458
TAACTGCACACATGTTGTAG
54
108


 


387905
4
4538
AACACCTGATCTGAATCCAG
78
109


 


388240
4
4558
GTTTCAATACAAAGCCAATA
78
110


 


387906
4
4586
AACTGGCCCACTTCAATGTA
78
111


 


387907
4
4596
TGATTCCCTGAACTGGCCCA
77
112


 


387908
4
4682
TTAGGAATTCCAATGATCTG
76
113


 


387909
4
4688
ATGATTTTAGGAATTCCAAT
77
114


 


387910
4
4715
CTGGCCATGATGCCATCACA
86
115


 


387911
4
4724
TTCCTTCCACTGGCCATGAT
77
116


 


387912
4
4805
GCATCAGCTTTATTTGTTCC
70
117


 


388241
4
4856
CTCAGTAACATTGACACCAC
71
118


 


388242
4
4868
TACTGGATGAGTCTCAGTAA
49
119


 


387913
4
4875
CTGATGGTACTGGATGAGTC
59
120


 


387914
4
4913
TGGCACTGCTGCAGGACAAG
71
121


 


387915
4
5219
TCCTGAATACGAGAAAGAAC
86
122


 


388243
4
5781
TTTGGCTGCCAAGTCAGAAT
52
123


 


388244
4
5787
TCCAAGTTTGGCTGCCAAGT
48
124


 


387916
4
5801
TCTCTATTGCACATTCCAAG
91
125


 


387917
4
5850
CTGACAGACATAATCACAGA
61
126


 


387918
4
5911
TGATCAGATCTTGAATGTGA
41
127


 


387919
4
6005
CGAGACTGAATTGCCTGGAT
59
128


 


387920
4
6296
GAATAGAGCCTTTGGTGTCT
56
129


 


388245
4
6333
GTCTTGCATGGTGGAGAGAC
39
130


 


387921
4
6466
AATCTGACCTGGTCCAACAC
65
131


 


387922
4
6476
AGCAGTGCAGAATCTGACCT
53
132


 


387923
4
6488
TCTGCACCTTCCAGCAGTGC
62
133


 


388246
4
6600
ACCAGAAATTTCACTCATCC
50
134


 


388247
4
6606
CTGGCCACCAGAAATTTCAC
21
135


 


388248
4
6763
CAGCATCCCCAAACAGATCA
65
136


 


388249
4
6769
ACAGTGCAGCATCCCCAAAC
72
137


 


388250
4
6777
GGACTGATACAGTGCAGCAT
65
138


 


387924
4
6860
TTCTCAGGAGGAAGGTGCAA
61
139


 


387925
4
6930
CTGCTCATGGATCAAATGCC
78
140


 


388251
4
7177
GTGTGTTTGGATCTACTTCC
67
141


 


388252
4
7199
GCAGTGATATACTTAGGATT
46
142


 


388253
4
7208
TCACAGGCTGCAGTGATATA
29
143


 


388254
4
7312
TGATGTTCCTGAGCAATGGC
51
144


 


388255
4
7383
TCCAAGCTTCCACACCAGTG
67
145


 


387926
4
7489
TGTTGATGCGGTAGATGAAC
29
146


 


387927
4
7556
GTCACCAGGACACCAAGGAG
70
147


 


387928
4
7709
TCCAAGCAGCTTACAGCTGG
69
148


 


388256
4
7816
TTGAAACCATTGCTTGAATC
64
149


 


388257
4
7855
ATGCCTGATATAAATGATGG
52
150


 


387942
4
7932
GTTGATCTGCAGCAGCAGCT
39
151


 


387929
4
7988
GAGTGTATGGACACCTGGCC
49
152


 


387930
4
8005
TGTTCCCCAGCCACACGGAG
85
153


 


387931
4
8363
GTGGCAGGCACCAGGTACTG
65
154


 


388258
4
8655
ATAGTTCTCAATGAGGTAAA
72
155


 


387932
4
8757
ACAGTGGTAAATGATGGAGG
41
156


 


387933
4
8903
ATGCAGGTGAGCATCAGGCC
29
157


 


387934
4
8910
TGTGTACATGCAGGTGAGCA
37
158


 


388259
4
9036
AGGAAAGCCTTTCCTGATCC
31
159


 


387935
4
9149
TATGGCTGCTGGTTGGACAG
57
160


 


387936
4
9240
CAGCATGACCCAGTCCCGGA
63
161


 


387937
4
9243
GGACAGCATGACCCAGTCCC
68
162


 


387938
4
9368
CCCATCCTGCTGATGACATG
69
163


 


387939
4
9407
ACCAGGCAGAAAAGGTTCAC
63
164


 


387940
4
9555
TCAGCAGGTGGTGACCTTGT
64
165


 


388260
4
9714
TCTGCCACATGGCAGAGACA
25
166


 


388261
4
9724
AAAGAGCACTTCTGCCACAT
56
167


 


388262
4
9735
GCCACTGCCACAAAGAGCAC
60
168


 


388263
4
9763
CACCAGGACTGCAGACACTC
65
169


 


388264
4
9785
TGGAAGGCCTCAGGCTCAGC
65
170


 


388265
4
9831
GGACCTGGTCACCCACATGG
22
171


 


388266
4
9863
GGCAACAACCAGCAGGTGAC
54
172


 


388267
4
9871
TGCAACCTGGCAACAACCAG
32
173


 


388268
4
9889
CCCAGATGCAAGAGCAGCTG
65
174


 


388269
4
9921
AACAGCCAGCCTGCAGGAGG
25
175


 


388270
4
9946
TCTACTGCAGGACAGCAGAG
20
176


 


388271
4
9973
TGTTCCCAAAGCCTGCTCAC
43
177


 


388272
4
9982
CCAGGCCAGTGTTCCCAAAG
41
178


 


388273
4
9988
GGAGACCCAGGCCAGTGTTC
44
179


 


388274
4
10047
AGCACAGGCCATGGCATCTG
43
180


 


388275
4
10054
CTGGCCCAGCACAGGCCATG
33
181


 


387941
4
10133
ACTGATATAATTAAATTTTA
0
182


 


388276
4
10274
GGCTATGCCAGTGGCTACAG
29
183


 


388277
4
10329
TGTGAATGCATAAACAGGAA
61
184


 


388278
4
10579
CTAGCAAGGAACAGGAGTGG
15
185


 


388279
4
10639
CCATGGAGCAGCAGGTCCCA
28
186


 


388280
4
10647
GCATGCATCCATGGAGCAGC
31
187


 


388281
4
10726
ACTAACAGTGCCAAGACACC
45
188


 


388282
4
10923
CCATTTTAATGACTTGGCTC
60
189


 


388283
4
11023
AGGAAGCAGAGCCCCTGCCT
48
190


 


388284
4
11150
GGCAGCACCTGCACAGAGTT
57
191


 


388285
4
11225
GCATACAAGTCCACATCTCA
54
192


 


388286
4
11293
CATACAGGCCTGGCAGAGGC
49
193


 


388287
4
11449
AAGAATGGTGATTTTCTTAC
46
194


 


388288
4
11637
TCTAGCCAGGAACAACATCT
47
195


 


388289
4
11646
ATGTAAACATCTAGCCAGGA
24
196


 


388290
4
11854
AATGAGCTCATATTCATCTC
20
197


 


388291
4
12076
GAATGAGCCCTGCCCTGACC
38
198


 


388292
4
12081
GCAATGAATGAGCCCTGCCC
57
199


 


388293
4
12122
AGCTGATATGGAGACCATCT
35
200


 


388294
4
12177
GGTGCTTGCCACAGATTTTT
65
201


 


388295
4
12324
TGCATTGCCAAACAATTCTA
57
202


 


388296
4
12409
TTGGCAGCTGGAAACATCAC
52
203


 


388297
4
12873
TCCAAGTCTACCCTGGCCAG
40
204


 


388298
4
13044
GTTGCCTTCAGTTGTCATGC
34
205


 


388299
4
13050
TTCCAGGTTGCCTTCAGTTG
59
206


 


388300
4
13167
CAGTTACCACCCAGATTGCA
46
207


 


388301
4
13251
GAGACCTGGACAAGGAGGCC
30
208


 


388842
5
3535
TGTAATTACAGAATTTGTAT
60
209


 


388852
5
16048
ACATTCCATGAATTCCATTT
43
210


 


388846
5
17007
GTTAATTTAGAGAAAATTCA
1
211


 


388845
5
24805
CAGAAGCATCCAAACCAGTA
40
212


 


388844
5
31595
CAAGAGGGTTGCATAGAAAC
17
213


 


388848
5
41489
CAAAGTATAAACAGTTTGAG
32
214


 


388839
5
41869
CCCAGTGCAGTTCACATTCA
54
215


 


388859
5
46461
TATTATAAAATACATGTTTC
26
216


 


388856
5
58668
ATTAGAGATTCATCATATTG
46
217


 


388857
5
59960
GGTATGGAAAGGTTCAACAT
58
218


 


388858
5
64678
TGGAAGGTGAGGGACAAAAA
57
219


 


388862
5
71659
AGCAGAAACAAGTATTCCAT
56
220


 


388853
5
86173
CAAATTCACATAGGGTTGGT
60
221


 


388860
5
97067
ACATGAGCAATGAAGGACAG
48
222


 


388840
5
98221
GCAATGTGTGATTTACCACA
67
223


 


388850
5
118154
ACCACATCATAATTTGTCAT
41
224


 


388855
5
120499
ATTATTTAAGAAGTACCCAC
36
225


 


388861
5
121068
TGCCCCAAAAAGTGGAACCA
55
226


 


388847
5
126660
ACATTTCCAAGAGGTTTTGA
48
227


 


388854
5
128596
TCAGCCCCAATTTGTAGCAG
59
228


 


388841
5
140692
GACATAAAGTTTAGAGGTAT
50
229


 


388843
5
142578
GAAGGACCCACAGAGGTTTG
53
230


 


388851
5
146457
TGAAAAGGAAGTGACATCAT
17
231


 


388849
5
165574
CAGTGTCAGGAGAAGCCCAG
46
232


 


388785
45
713
AGGTTCTGCCTCACACAGCA
57
311


 


388786
45
718
CCCGCAGGTTCTGCCTCACA
33
312


 


388787
45
740
AGGGAACCAGCCCGCCCCTG
56
313


 


388788
45
745
TGGCCAGGGAACCAGCCCGC
47
314


 


388789
45
750
ATGGCTGGCCAGGGAACCAG
25
315


 


388790
45
755
TGCCAATGGCTGGCCAGGGA
7
316


 


388791
45
777
GACAGCCCTAGCCTGCGGAC
19
317


 


388792
45
781
GATTGACAGCCCTAGCCTGC
0
318


 


388793
45
785
GCATGATTGACAGCCCTAGC
9
319


 


388794
45
885
ATCTTGGACCCGTCCCGGCA
63
320


 


388795
45
890
CGTCCATCTTGGACCCGTCC
53
321


 


388796
45
896
AGCGGCCGTCCATCTTGGAC
45
322


 


388797
45
902
AACCTGAGCGGCCGTCCATC
54
323


 


388798
45
906
GCAGAACCTGAGCGGCCGTC
62
324


 


388799
45
910
AAAAGCAGAACCTGAGCGGC
56
325


 


388800
45
913
GGTAAAAGCAGAACCTGAGC
36
326


 


388801
45
920
GGCCGCAGGTAAAAGCAGAA
65
327


 


388802
45
926
GCTCTGGGCCGCAGGTAAAA
64
328


 


388803
45
985
AGTCCCCGGAGGCCTCGGGC
56
329


 


388804
45
993
GGCACGGCAGTCCCCGGAGG
57
330


 


388805
45
1019
AGGGTCGCCATGGCGGTCTC
35
331


 


388806
45
1025
TTTTCCAGGGTCGCCATGGC
33
332


 


388807
45
1030
TCAGCTTTTCCAGGGTCGCC
63
333


 


388808
45
1034
TTCATCAGCTTTTCCAGGGT
54
334


 


388809
45
1040
AAGGCCTTCATCAGCTTTTC
48
335


 


388810
45
1045
ACTCGAAGGCCTTCATCAGC
57
336


 


388811
45
1050
GAGGGACTCGAAGGCCTTCA
51
337


 


388812
45
1056
GGACTTGAGGGACTCGAAGG
62
338


 


388836
45
1494
CTGAGGAAGCTGAGGAGGCG
45
339


 


388837
45
1511
TGTGCCTGCGGCGGCGGCTG
61
340


 


388838
45
1523
GGCAGCAGCGGCTGTGCCTG
53
341


 


388813
45
1607
CAAACTCACGGTCGGTGCAG
58
342


 


388814
45
1614
GCGGGCCCAAACTCACGGTC
51
343


 


388815
45
1623
GGAGCTGCAGCGGGCCCAAA
39
344


 


388816
45
1650
GCCGTAGCCTGGGACCCGCC
77
345


 


388817
45
1670
GCAGGGTTACCGCCATCCCC
70
346


 


388818
45
1675
AGGCTGCAGGGTTACCGCCA
66
347


 


388819
45
1680
CCCGCAGGCTGCAGGGTTAC
53
348


 


388820
45
1685
GCCGGCCCGCAGGCTGCAGG
49
349


 


388821
45
1773
AAGGCCTCGCCCCAGGAGGG
46
350


 


388822
45
1807
AGACCCAAGTGAGGGAGCGG
65
351


 


388823
45
1813
AAGGGAAGACCCAAGTGAGG
44
352


 


388824
45
1817
GGACAAGGGAAGACCCAAGT
68
353


 


388825
45
1825
TCGCGAGAGGACAAGGGAAG
24
354


 


388826
45
1830
TCCCCTCGCGAGAGGACAAG
59
355


 


388827
45
1850
GGCCCCAACAAGGCTCTGCC
58
356


 


388828
45
1855
GGACAGGCCCCAACAAGGCT
61
357









Mouse Huntingtin

Antisense oligonucleotides were designed to target different regions of the mouse huntingtin gene, using published sequences cited in Table 2. The sequences and corresponding SEQ ID NOs are shown in Table 5. All compounds in Table 5 are chimeric oligonucleotides (“gapmers”) 20 nucleotides in length, composed of a central “gap” region consisting of 10 2′-deoxynucleotides, which is flanked on both sides (5′ and 3′) by five-nucleotide “wings”. The wings are composed of 2′-O-(2-methoxyethyl) nucleotides, also known as 2′-MOE nucleotides. The internucleoside (backbone) linkages are phosphorothioate throughout the oligonucleotide. All cytidine residues are 5-methylcytidines.
The antisense oligonucleotides were analyzed for their effect on huntingtin mRNA levels in b.END cells by quantitative real-time PCR as described in other examples herein. The data presented in Table 5 represent percent inhibition of huntingtin mRNA levels relative to untreated cells. Data are averages from experiments in which cultured cells were treated with the disclosed antisense oligonucleotides.
If the huntingtin mRNA level in antisense oligonucleotide-treated cells was equal to or higher than in control cells, percent inhibition is expressed as zero inhibition. If present, “N.D.” indicates “not determined.” The target regions to which these antisense oligonucleotides are inhibitory are herein referred to as “validated target segments.”







TABLE 5







Inhibition of mouse huntingtin mRNA levels by chimeric


oligonucleotides having 2′-MOE wings and deoxy gap













Target







SEQ
Target

%
SEQ


ISIS #
ID NO
Site
Sequence (5′ to 3′)
Inhib
ID NO















387869
8
517
GAATCCATCAAAGCTTTGAT
46
58


 


387884
8
1684
TCATTCAGGTCCATGGCAGG
54
77


 


387913
8
4787
CTGATGGTACTGGATGAGTC
32
120


 


387865
10
177
GCCTTCATCAGCTTTTCCAG
35
47


 


387866
10
394
ATGATTCACACGGTCTTTCT
38
55


 


387867
10
451
AAATTCTGGAGAATTTCTGA
22
56


 


387868
10
459
AGTTTCTGAAATTCTGGAGA
39
57


 


387870
10
583
CCTTGGAAGATTAGAATCCA
41
59


 


387871
10
671
GAGCCAGCTCAGCAAACCTC
34
60


 


387872
10
680
GAACCAGGTGAGCCAGCTCA
23
61


 


387874
10
783
ACAGCTGCAGCCAAGGTCTC
52
63


 


387875
10
807
CCAAAAGAAGCCATAATTTT
19
64


 


387876
10
838
AACCTTAATTTCATTGTCAT
42
65


 


387877
10
1132
AGAGACTTCCATTTCTTTCC
51
68


 


387878
10
1138
AGAAGGAGAGACTTCCATTT
24
69


 


387879
10
1146
TGCTCTGCAGAAGGAGAGAC
17
70


 


387880
10
1163
CATAAACCTGGACAAGCTGC
34
71


 


387882
10
1203
ACATTGTGGTCTTGGTGCTG
70
73


 


387883
10
1422
AAGAGCACTTTGCCTTTTTG
52
74


 


387885
10
1744
GGTCCCATCATTCAGGTCCA
44
78


 


387887
10
2365
ATCGATGTAGTTCAAGATGT
39
85


 


387888
10
2412
GTCCCACAGAGAATGGCAGT
31
86


 


387889
10
2785
TGTATAATGATGAGCCCCTC
48
88


 


387890
10
2936
GATCAGCTTGTCCTTGGTCA
55
89


 


387891
10
3168
CAGCATCCAAATGTGAGTGC
52
92


 


387892
10
3174
GCTTCACAGCATCCAAATGT
46
93


 


387893
10
3606
AGAGAAGGCAAGGCTGCCTT
46
95


 


387894
10
3614
GGTTTGTTAGAGAAGGCAAG
43
96


 


387895
10
3816
ACATCATGCAGTTTGAGGTA
57
97


 


387896
10
3825
GCTTTCAGGACATCATGCAG
38
98


 


387897
10
3993
AAGCAGGATTTCAGGTATCC
60
99


 


387898
10
4001
CTCGACTAAAGCAGGATTTC
48
100


 


387899
10
4020
ACAGTTGCCATCATTGGTTC
35
101


 


387900
10
4092
TTGGAAGATAAGCCATCAAA
41
103


 


387901
10
4230
TGCACCATGTTCCTCAGGCT
64
104


 


387902
10
4234
CGCCTGCACCATGTTCCTCA
47
105


 


387903
10
4345
AATAGCATTCTTATCTGCAC
46
106


 


387904
10
4357
AATGTGATTATGAATAGCAT
25
107


 


387905
10
4503
AACACCTGATCTGAATCCAG
29
109


 


387906
10
4551
AACTGGCCCACTTCAATGTA
64
111


 


387908
10
4647
TTAGGAATTCCAATGATCTG
74
113


 


387909
10
4653
ATGATTTTAGGAATTCCAAT
28
114


 


387910
10
4680
CTGGCCATGATGCCATCACA
27
115


 


387911
10
4689
TTCCTTCCACTGGCCATGAT
38
116


 


387912
10
4770
GCATCAGCTTTATTTGTTCC
45
117


 


387914
10
4878
TGGCACTGCTGCAGGACAAG
73
121


 


387915
10
5184
TCCTGAATACGAGAAAGAAC
8
122


 


387916
10
5763
TCTCTATTGCACATTCCAAG
59
125


 


387917
10
5812
CTGACAGACATAATCACAGA
55
126


 


387918
10
5873
TGATCAGATCTTGAATGTGA
69
127


 


387919
10
5967
CGAGACTGAATTGCCTGGAT
73
128


 


387920
10
6258
GAATAGAGCCTTTGGTGTCT
53
129


 


387921
10
6428
AATCTGACCTGGTCCAACAC
4
131


 


387922
10
6438
AGCAGTGCAGAATCTGACCT
16
132


 


387924
10
6822
TTCTCAGGAGGAAGGTGCAA
26
139


 


387925
10
6892
CTGCTCATGGATCAAATGCC
43
140


 


387926
10
7445
TGTTGATGCGGTAGATGAAC
8
146


 


387927
10
7512
GTCACCAGGACACCAAGGAG
47
147


 


387928
10
7665
TCCAAGCAGCTTACAGCTGG
31
148


 


387942
10
7888
GTTGATCTGCAGCAGCAGCT
54
151


 


387930
10
7961
TGTTCCCCAGCCACACGGAG
53
153


 


387931
10
8319
GTGGCAGGCACCAGGTACTG
62
154


 


387932
10
8713
ACAGTGGTAAATGATGGAGG
51
156


 


387933
10
8859
ATGCAGGTGAGCATCAGGCC
64
157


 


387934
10
8866
TGTGTACATGCAGGTGAGCA
45
158


 


387935
10
9105
TATGGCTGCTGGTTGGACAG
43
160


 


387936
10
9196
CAGCATGACCCAGTCCCGGA
53
161


 


387937
10
9199
GGACAGCATGACCCAGTCCC
34
162


 


387938
10
9324
CCCATCCTGCTGATGACATG
41
163


 


387939
10
9363
ACCAGGCAGAAAAGGTTCAC
28
164


 


387940
10
9511
TCAGCAGGTGGTGACCTTGT
54
165


 


387941
10
10042
ACTGATATAATTAAATTTTA
3
182


 


387873
11
39021
TTCACCAGGTAAGGCCTGCA
28
62


 


387881
11
46216
GTCAGTTCATAAACCTGGAC
57
72


 


387886
11
52829
CTAACACAATTTCAGAACTG
25
79


 


388535
11
64098
GATAAAACACCTTGTTAATG
0
233


 


388536
11
74028
GGAGCAGTACCTTATAGTTG
0
234


 


388467
11
85701
ATAGCTGCTGCACACAGACA
37
235


 


387907
11
90911
TGATTCCCTGAACTGGCCCA
77
112


 


388534
11
90914
GCATCAGTACCTGAACTGGC
18
236


 


388532
11
116664
GAGTGGTTGGCTAATGTTGA
26
237


 


387923
11
119259
TCTGCACCTTCCAGCAGTGC
25
133


 


387929
11
138172
GAGTGTATGGACACCTGGCC
64
152


 


388533
11
142848
CAGTTTTGTCCTGGATACAA
0
238


 


388459
44
962
GGAGCCAGTTGTAGAAGTAC
4
239


 


388460
44
1284
CCTGGTGTGGTCAGTGCTTG
39
240


 


388461
44
1306
CAGAGTGAGCTGCCCAAGCC
18
241


 


388462
44
1317
TCTTCTTGAACCAGAGTGAG
29
242


 


388463
44
1948
GTTTCTGAAAACATCTGAGA
13
243


 


388464
44
1998
CTATGGCCCATTCTTTCCAA
33
244


 


388465
44
2642
TAAGCAGTTGTAATCCCAAG
7
245


 


388466
44
3690
GGACTCATTGGAGTAGAAGC
34
246


 


388468
44
5944
AAGACCACTAGCTGCAGAAT
29
247


 


388469
44
6735
TGGTATGATGTGGTATCACC
53
248


 


388470
44
6855
GTCATTACCACAAACTTCAC
20
249


 


388471
44
7145
GACTGAGGTTTTGTATATCT
19
250


 


388472
44
7269
ACAATGTTCTTCAGCACAGC
24
251


 


388473
44
8515
CAGCAGATAGTCACTAACAA
20
252


 


388474
44
9228
ACTGGAGTTCTTTGTGTGAA
25
253


 


388475
44
9519
GGCACTACTCAGCAGGTGGT
49
254


 


388476
44
9532
CTTTTGTCCCACAGGCACTA
20
255


 


388477
44
9630
CTTGACACAAGTGGAAGCCT
15
256


 


388478
44
9676
GCATAGCCCTCATTGCAAAG
40
257


 


388479
44
9691
TAGTGCATGTTCCCTGCATA
45
258


 


388480
44
9701
AACCCCAACATAGTGCATGT
16
259


 


388481
44
9770
AAGACAAACACCTGGTCAAC
13
260


 


388482
44
9855
AACCATCTGGCAAGAGCTAG
23
261


 


388483
44
9924
TGTGGCAGGTATGCCTACTG
14
262


 


388484
44
9932
GACACTGGTGTGGCAGGTAT
36
263


 


388485
44
10102
CTTGCCAAGTCACACACTTT
19
264


 


388486
44
10135
ACTTCCATAAACTTTGTCAC
7
265


 


388487
44
10181
GACTGAGTAGCTACAGGAGA
40
266


 


388488
44
10275
TGCTGGCTTAATGGAATGCA
34
267


 


388489
44
10315
GGATTCTCACACAGGCAGTC
39
268


 


388490
44
10330
GTTAGGCCACAGGCAGGATT
30
269


 


388491
44
10348
CAGTTTTTCAGTTCCTCAGT
51
270


 


388492
44
10370
TTATAACTCTAACAGTGGAA
24
271


 


388493
44
10460
CTAGGAGAGTGCATCAACAC
38
272


 


388494
44
10480
TTTCTACCCAGGCTGAGAGA
30
273


 


388495
44
10550
CTACAGTGCAGGTCAGCCAC
42
274


 


388496
44
10582
CATCCACAATGGTCAGCTGG
30
275


 


388497
44
10616
CCCAACCATGCAGAAGATAC
17
276


 


388498
44
10634
GGTCAGCACTTCTCAGGTCC
50
277


 


388499
44
10950
TTAACATGACCTGGTTACTC
27
278


 


388500
44
10988
CCCAAACCAAGCCAGGAAAT
19
279


 


388501
44
11020
CTTGGTCATATAGTCAAACA
43
280


 


388502
44
11140
TAATCACAGGCTGCAAGCTC
28
281


 


388503
44
11170
AAGCAATCCATGGACTGAAG
52
282


 


388504
44
11211
GTCATGATGGAAAGATAGAG
35
283


 


388505
44
11240
AACCTTGCATCCCAGCAGCA
12
284


 


388506
44
11300
GGCAGATAGGAGGAGAGTCA
19
285


 


388507
44
11407
GGTGAATTTCTTTCATTAAA
53
286


 


388508
44
11525
TTGGACCAACCTCAGAGTGT
45
287


 


388509
44
11560
GTAATCAGGCCTGCACCATG
41
288


 


388510
44
11575
CATCTACCATGAGGAGTAAT
15
289


 


388511
44
11611
AATGGCTCTAGATTTTATAT
33
290


 


388512
44
11678
TTCTGATCACACTAAACAAG
31
291


 


388513
44
11750
CTAGGTTGTGGCACCCATGA
47
292


 


388514
44
11766
GTACCCAGGTGCATCTCTAG
52
293


 


388515
44
11890
TGTATGTGGCAGTTGCAAGA
51
294


 


388516
44
11940
ACTTTTAAAAATTGAGTCCC
17
295


 


388517
44
12054
TTAAATAAAGCTTGGAAATC
8
296


 


388518
44
12132
TGACAGTACCACCATGGAAA
27
297


 


388519
44
12176
GTGCATTGCCAAAAGTTCTA
41
298


 


388520
44
12248
AAGTCACCTACATGTCAAGG
22
299


 


388521
44
12262
ACTTGGCAGTGGCTAAGTCA
21
300


 


388522
44
12377
GTTAGGATTGGTCCCTTCCC
18
301


 


388523
44
12527
GACCAATTCTGCAGCCCCAC
28
302


 


388524
44
12648
CCATGATCCTAGTGCTCAAT
42
303


 


388525
44
12696
CCACATACCAATCCCTGGAG
38
304


 


388526
44
12726
CCAGCATCAGCAGCTCAGTG
40
305


 


388527
44
12756
TTTCCCAACCATGATATCCT
7
306


 


388528
44
12846
CCCTGAACCTTGATATCATC
2
307


 


388529
44
12971
TGCAGATAGGTCTCTGCCAC
16
308


 


388530
44
13020
TACAGCAGCAAGGCTTGGAC
29
309


 


388531
44
13100
GGAAATGGACAGCCAGGTCT
44
310





Isis numbers 387865-387942 are targeted to both human and mouse huntingtin.






Example 4
Antisense Inhibition of Human Huntingtin in A549 Cells
Several antisense oligonucleotides were selected for additional testing in A549 cells. Cells in multi-well plates were treated with various amounts of the selected antisense oligonucleotides, as indicated in the following table (n=6 treatments per antisense oligonucleotide). Following the end of the treatment period, RNA was isolated from the cells, and human huntingtin mRNA levels in each individual cell culture well were measured by quantitative, real-time PCR. The data presented in the following table (Table 6) represent the average percent inhibition for each antisense oligonucleotide (n=6 treatments), relative to untreated cells. Control oligonucleotides, having randomized nucleotide sequences not targeted to any known gene, were also tested.







TABLE 6







Dose response inhibition of human huntingtin in A549 cells













Isis No.
6.25 nM
12.5 nM
25 nM
50 nM
100 nM
200 nM
















387892
97
91
77
68
45
28


387898
85
86
69
47
35
21


387902
91
104
67
47
23
9


387916
88
100
100
51
32
19


388227
86
92
114
80
69
58


388240
117
126
83
65
24
22


388249
101
100
106
54
35
24


388816
101
132
77
59
38
26


388817
92
97
84
69
50
30


388824
78
87
85
69
41
27


388833
81
82
68
65
47
41


Control #1
115
102
96
77
71
57









These results demonstrate that the antisense oligonucleotides targeted to huntingtin reduced huntingtin mRNA levels in A549 cells. The control oligonucleotides were not able to effectively inhibit huntingtin mRNA levels, particularly at lower doses. The target regions to which these inhibitory antisense oligonucleotides are complementary are herein referred to as “validated target segments.”
Example 5
Antisense Inhibition of Human Huntingtin in HD Patient Cells
GMO4281
Several antisense oligonucleotides were selected for additional testing in GMO4281 fibroblasts, which originated from an HD patient. Cells in multi-well plates were treated with various amounts of the selected antisense oligonucleotides, as indicated in the following table (n=6 treatments per antisense oligonucleotide). Control oligonucleotides, having randomized nucleotide sequences not targeted to any known gene, were also tested.
Following the end of the treatment period, RNA was isolated from the cells, and human huntingtin mRNA levels in each individual cell culture well were measured by quantitative, real-time PCR. The data presented in the following table represent the average huntingtin mRNA level (n=6), relative to untreated cells, i.e. the data are expressed as percentage of control cell huntingtin mRNA levels. Percent control less than 100 indicates a reduction in huntingtin mRNA levels, whereas percent control greater than 100 indicates an increase in huntingtin mRNA levels. Percent inhibition can be calculated by subtracting the percentage of control from 100.







TABLE 7







Dose response inhibition of human huntingtin in GMO4281 fibroblasts









Oligonucleotide Treatment Concentration














9.375




300.0


Isis #
nM
18.75 nM
37.5 nM
75.0 nM
150.0 nM
nM
















387892
77
55
47
33
22
21


387898
77
61
49
25
17
13


387902
87
58
52
27
17
13


387916
104
75
50
25
14
12


388240
81
74
57
26
17
16


388249
96
74
55
32
18
14


388816
86
61
48
26
14
12


388817
84
76
51
35
26
18


388824
86
78
59
38
24
20


388833
84
79
60
33
19
13


Control #1
99
95
106
67
63
48


Control #2
100
102
88
77
64
49









GMO4478 Cells

Several antisense oligonucleotides targeted to huntingtin were selected for additional testing in GMO4478 cells, which are fibroblasts derived from and HD patient. The testing was performed according to the procedure used for GMO4281 cells. The results are shown in the following table as average percent inhibition, relative to untreated cells.







TABLE 8







Dose response inhibition of human


huntingtin in GMO4478 fibroblasts









Oligonucleotide Treatment Concentration












Isis No.
9.375 nM
18.75 nM
37.5 nM
75.0 nM
150.0 nM















387892
45
29
17
10
7


387898
50
27
9
2
2


387902
40
22
9
3
2


387916
60
39
18
6
3


388240
60
34
16
5
6


388249
78
56
34
13
7


388816
75
48
26
8
7


388817
70
52
37
38
32


388824
65
42
21
9
8


388833
43
31
16
7
3


Control #1
95
88
73
58
48


Control #2
101
94
90
64
56









Each of the antisense oligonucleotides targeted to human huntingtin efficiently reduced huntingtin mRNA levels, in both GMO4478 and GMO4281 fibroblasts. The control oligonucleotides were not able to effectively inhibit huntingtin mRNA levels, particularly at lower doses.
The potency of antisense oligonucleotides targeted to huntingtin is summarized in Table 9. The potency is illustrated as IC50, which is the concentration at which a 50% reduction in huntingtin mRNA levels is observed. This table also indicates the huntingtin sequence to which the antisense oligonucleotides are complementary, as well as the corresponding 5′ target site. Particular features of the region of the huntingtin sequence to which the antisense oligonucleotides are complementary are also shown. Additionally indicated is the species of huntingtin gene to which the antisense oligonucleotides are targeted. The target regions to which these inhibitory antisense oligonucleotides are complementary are herein referred to as “validated target segments.”







TABLE 9







Summary of potent antisense oligonucleotides targeted to huntingtin














Target
5′

Target region



IC50
SEQ ID
Target
Target nucleic
within human














Isis No
A549
GM04281
GM04478
NO
Site
acid specifity
huntingtin gene

















387892
84
32
5
4
3209
Human-Mouse
exon 23:exon 24


387898
47
31
8
4
4036
Human-Mouse-
exon 30








Rat


387902
39
35
5
4
4269
Human-Mouse
exon 31


387916
61
42
13
4
5801
Human-Rat
exon 42


388240
63
39
12
4
4558
Human; >4 mm to
exon 34








rodent


388249
63
45
24
4
6769
human; >5 mm to
exon 48:exon 49








rodent


388816
69
34
19
45
1650
targets R6/2
intron 1








insert;








>5 mm to mouse


388817
98
48
25
45
1670
targets R6/2
intron 1








insert;








>5 mm to mouse


388824
81
50
15
45
1817
targets R6/2
intron 1








insert; 5 mm to








mouse


388833
103
48
5
45
1128
targets CAG
exon 1








repeat region









As the antisense oligonucleotides reduced huntingtin mRNA levels in cells isolated from HD patients, the antisense oligonucleotides are candidate therapeutic agents for the reduction of huntingtin mRNA levels in vivo. In one embodiment, the antisense oligonucleotides, having demonstrated potency in vitro, are further tested in experimental animal models, including experimental models of Huntington's Disease (HD), to identify antisense oligonucleotides that may reduce huntingtin mRNA in humans. Accordingly, in one embodiment, the antisense oligonucleotides are administered at therapeutically effect amounts to a human, for the treatment or amelioration of Huntington's Disease (HD). In another embodiment, the antisense oligonucleotides are administered at therapeutically effective amounts, to delay the onset of Huntington's Disease (HD).
Example 6
Antisense Inhibition of Huntingtin in Neuronal Cell Lines
Several antisense oligonucleotides targeted to huntingtin were selected for additional testing in huntingtin neuronal cell lines. Mouse striatum cell lines with wild-type huntingtin, STHdhQ7/7 (Q7/7), and mutant huntingtin, STHdhQ111/111 (Q111/111) were transfected with various doses of oligos 387902 and 387916, ranging from approximately 0.05 μM, to 10 μM. A 200V, 2 msec pulse in a 2 mm gap cuvette was used for electroporation transfection. One million cells were electroporated in the presence of the indicated amount of oligonucleotide. Following electroporation, the cells were plated at a density of 5×104 cells per well. The results are reported in the Table 10 as percent huntingtin mRNA as compared to no oligo control, with each concentration performed in triplicate.







TABLE 10







Inhibition of huntingtin in mouse neuronal cell lines












Q7/7

Q111/111













387902
387916
387902
387916


[Oligo]μM
% mHtt
% mHtt
% mHtt
% mHtt














0
100.0
100.0
100.0
100.0


0.675
85.9
36.5
156.4
59.3


1.25
50.2
34.5
103.4
31.4


3
31.4
11.0
38.9
18.8


5
12.2
1.6
16.5
6.4


10
5.5
2.7
6.8
3.1









In subsequent studies, cells are evaluated for phenotypic response by measuring caspase activity using the Promega Apo-ONE® Homogeneous Caspase-3/7 commercial assay. Briefly, cells are plated and Lipofectin® transfected the next day. After 48 hours the media is changed to serum-free DMEM for 24 h prior to the caspase assay.
Example 7
In Vivo Antisense Inhibition of Huntingtin
In order to evaluate the effects of antisense inhibition of a gene in the central nervous system, it is beneficial to deliver antisense oligonucleotides directly to the central nervous system, for example, by intracerebroventricular (ICV), intrathecal (IT), or intraparenchymal administration. To evaluate the effects of antisense inhibition of huntingtin in the central nervous system of animals, antisense oligonucleotides targeted to huntingtin were administered to mice via ICV delivery.
ISIS 387902, 387916, 387918, 388249, 388503, 388509, and 388816 were selected for in vivo testing. Saline-treated mice were used as control animals. Each treatment or control group included four animals. Surgically implanted Alzet mini-pumps continuously infused antisense oligonucleotides into mice at a dose of 100 ug/day over a two-week period. During the treatment period, mice were monitored for any clinical changes, such as body weight changes. At the end of the treatment period, mice were sacrificed and major organs were isolated. RNA was prepared from brain and liver tissues, and subjected to quantitative real-time PCR analysis to measure the reduction in mouse huntingtin mRNA levels.
Each antisense oligonucleotide targeted to huntingtin reduced huntingtin mRNA levels in mouse brain, as shown in the following table. The species of huntingtin nucleic acid to which each antisense oligonucleotide is targeted is also shown. Mouse huntingtin mRNA levels represent the average for each treatment group and are expressed as percentage of saline control (% saline control).







TABLE 11







In vivo antisense inhibition of mouse huntingtin












Huntingtin
Huntingtin mRNA




nucleic acid
levels, % of


Isis No.
SEQ ID NO:
target species
saline control





387902
105
human, mouse
37%


387916
125
human, rat
32%




(single mismatch




to mouse)


387918
127
human, mouse,
35%




rat


388503
282
mouse
30%


388509
288
mouse
34%









Each of the antisense oligonucleotides shown in Table 11 reduced huntingtin mRNA levels in mouse brain following the ICV infusion period. Furthermore, ISIS 387916, which has one mismatch to mouse huntingtin, was able to reduce mouse huntingtin mRNA levels in vivo.
Example 8
In Vivo Antisense Inhibition in Models of Huntington's Disease
To evaluate the effects of antisense inhibition of huntingtin in the central nervous system of an animal model of HD, antisense oligonucleotides targeted to huntingtin are administered to R6/2 transgenic mice via ICV delivery.
ISIS 387902, 387916, 387918, 388249, 388503, 388509, and 388816 are selected for in vivo testing. Saline-treated mice are used as control animals. Each treatment or control group includes four animals. Surgically implanted Alzet mini-pumps continuously infuse antisense oligonucleotides into mice at a dose of 100 ug/day over a two-week period. During the treatment period, mice are monitored for any clinical changes, such as body weight changes as well as phenotypical behaviors related to the huntingtin transgene. At the end of the treatment period, mice are sacrificed and major organs are isolated. RNA is prepared from brain and liver tissues, and is subjected to quantitative real-time PCR analysis to measure the reduction in mouse huntingtin mRNA levels. Huntingtin protein expression in the tissue is also measured using standard Western blotting techniques.
Example 9
Administration of Antisense Oligonucleotides to Individuals Suffering from Huntington's Disease
Provided herein are methods of treating an individual suffering from Huntington's Disease (HD). Such methods comprise the administration to the cerebrospinal fluid or brain tissue of the individual a pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin. Delivery of the pharmaceutical composition to the cerebrospinal fluid allows for contact of the antisense oligonucleotide with the cells of central nervous system tissues, including tissues affected by HD.
Individuals suffering from HD receive a diagnosis of HD from a physician. The physician's assessment includes the genetic testing of the HD gene, and a neurological examination.
A surgically implanted pump (e.g., a Medtronic SyncroMed® II pump) is used to deliver a pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin to the cerebrospinal fluid or brain of an individual suffering from HD. The pump is surgically implanted per the procedures outlined by the manufacturer. Drug is retained in the reservoir of the pump, and is pumped at a programmed dose preferably into a catheter that is surgically intrathecally implanted.
The reservoir is loaded with a pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin. The pharmaceutical composition is administered at an amount that yields an infusion of 8 mg to 12 mg of antisense oligonucleotide into the cerebrospinal fluid. In some embodiments, the amount of antisense oligonucleotide infused is 10 mg. Administration is for a period of at least 28 days. Individuals are monitored by a medical professional, who evaluates indicators of HD. It is clinically desirable for the administration to slow or halt the progression of HD, or prevent or slow the worsening of, or improve, a symptom or marker of HD.
Example 10
Administration of Antisense Oligonucleotides to Individuals Susceptible to Huntington's Disease
Provided herein are methods of preventing or delaying the onset of Huntington's Disease (HD) in individuals susceptible to HD. Such methods comprise the administration to the cerebrospinal fluid or brain of the individual a pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin. Delivery of the pharmaceutical composition to the cerebrospinal fluid allows for contact of the antisense oligonucleotide with the cells of central nervous system tissues, including tissues affected by HD.
Individuals susceptible to HD are identified by a physician following genetic testing of the HD gene, and a neurological examination.
A surgically implanted pump (e.g., a Medtronic SyncroMed® II pump) is used to deliver a pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin to the cerebrospinal fluid or brain of an individual susceptible to HD. The pump is surgically implanted per the procedures outlined by the manufacturer. Drug is retained in the reservoir of the pump, and is pumped at a programmed dose preferably into a catheter that is surgically intrathecally implanted.
The reservoir is loaded with a pharmaceutical composition comprising an antisense oligonucleotide targeted to huntingtin. The pharmaceutical composition is administered at an amount that yields an infusion of 8 mg to 12 mg of antisense oligonucleotide into the cerebrospinal fluid. In some embodiments, the amount of antisense oligonucleotide infused is 10 mg. Administration is for a period of at least 28 days. Individuals are monitored by a medical professional, who evaluates indicators of HD. It is clinically desirable for the administration to prevent or delay the onset of symptoms of HD.

## Claims

1. An antisense oligonucleotide 12 to 35 nucleotides in length comprising at least 12 consecutive nucleotides having at least 90% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4, wherein the antisense oligonucleotide has a gap segment positioned between 5′ and 3′ wing segments.

2. The antisense oligonucleotide of claim 1, wherein said antisense oligonucleotide comprises at least 12 consecutive nucleotides having at least 95% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4.

3. The antisense oligonucleotide of claim 1, wherein said antisense oligonucleotide comprises at least 12 consecutive nucleotides having 100% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4.

4. The antisense oligonucleotide of claim 1 having at least one modified internucleoside linkage, sugar moiety, or nucleobase.

5. The antisense oligonucleotide of claim 1, wherein the gap segment of the chimeric oligonucleotide is comprised of 2′-deoxynucleotides and the wing segments are comprised of nucleotides having modified sugar moieties.

6. The antisense oligonucleotide of claim 5, wherein the modified sugar moiety is 2′-OMe or a bicyclic nucleic acid.

7. The antisense oligonucleotide of claim 1, wherein the gap segment of the chimeric oligonucleotide consists of ten 2′-deoxynucleotides and each wing segment consists of five 2′-O-methoxyethyl-modified nucleotides.

8. The antisense oligonucleotide of claim 7, wherein said antisense oligonucleotide is 20 nucleotides in length.

9. The antisense oligonucleotide of claim 1, wherein each internucleoside linkage is a phosphorothioate internucleoside linkage.

10. The antisense oligonucleotide of claim 1, wherein the each cytosine is a 5-methylcytosine.

11. The antisense oligonucleotide of claim 1, wherein said oligonucleotide is 17 to 25 nucleotides in length.

12. The antisense oligonucleotide of claim 1, wherein said oligonucleotide is 19 to 23 nucleotides in length.

13. The antisense oligonucleotide of claim 1, wherein said oligonucleotide is 20 nucleotides in length.

14. A pharmaceutical composition comprising an antisense oligonucleotide of claim 1 and a pharmaceutically acceptable diluent.

15. The antisense oligonucleotide of claim 1, which is 17 to 25 nucleotides in length.

16. The antisense oligonucleotide of claim 15, which has at least 95% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4.

17. The antisense oligonucleotide of claim 15, which has 100% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4.

18. The antisense oligonucleotide of claim 1, which is 19 to 23 nucleotides in length.

19. The antisense oligonucleotide of claim 18, which has at least 95% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4.

20. The antisense oligonucleotide of claim 18, which has 100% complementarity to nucleotides 4856-4894 of SEQ ID NO: 4.