Compositions and methods for inhibiting expression of transthyretin

1. A method of inhibiting TTR expression in a cell, the method comprising:

(a) contacting the cell with a double-stranded ribonucleic acid (dsRNA) for inhibiting expression of transthyretin (TTR), wherein the dsRNA comprises a sense strand and an antisense strand, the antisense strand comprising a region complementary to an mRNA encoding transthyretin (TTR), wherein the region of complementarity comprises SEQ ID NO:170 and each strand of the dsRNA is 19, 20, 21, 22, 23, or 24 nucleotides in length; and

(b) maintaining the cell produced in step (a) for a time sufficient to obtain degradation of the mRNA transcript of a TTR gene, thereby inhibiting expression of the TTR gene in the cell.

2. The method of claim 1 , wherein the method is performed in vitro.

3. The method of claim 1 , wherein the method is performed in vivo.

4. The method of claim 1 , wherein the region of complementarity consists of SEQ ID NO:170.

5. The method of claim 1 , wherein the sense strand consists of SEQ ID NO:449 and the antisense strand consists of SEQ ID NO:450.

6. The method of claim 1 , wherein the sense strand consists of SEQ ID NO:729 and the antisense strand consists of SEQ ID NO:730.

7. The method of claim 1 , wherein the sense strand consists of SEQ ID NO:1009 and the antisense strand consists of SEQ ID NO:1010 and the DsRnA is formulated in a lipid formulation.

8. The method of claim 1 , wherein each strand is 21 nucleotides in length.

9. The method of claim 1 , wherein the dsRNA comprises at least one modified nucleotide.

10. The method of claim 1 , wherein the dsRNA comprises at least one modified nucleotide chosen from the group of: a 2′-O-methyl modified nucleotide, a nucleotide comprising a 5′-phosphorothioate group, a terminal nucleotide linked to a cholesteryl derivative or dodecanoic acid bisdecylamide group, a 2′-deoxy-2′-fluoro modified nucleotide, a 2′-deoxy-modified nucleotide, a locked nucleotide, an abasic nucleotide, 2′-amino-modified nucleotide, 2′-alkyl-modified nucleotide, morpholino nucleotide, a phosphoramidate, and a non-natural base comprising nucleotide.

11. The method of claim 1 , wherein the dsRNA comprises at least one 2′-O-methyl modified nucleotide.

12. The method of claim 1 , wherein the dsRNA is conjugated to a ligand.

13. The method of claim 1 , wherein the dsRNA is formulated in a lipid formulation.

14. The method of claim 1 , wherein the dsRNA is formulated in a lipid formulation comprising MC3.

15. The method of claim 1 , wherein contacting the cell with the dsRNA results in at least one of the following:

a) about 95% inhibition of TTR mRNA expression as measured by a real time PCR assay, wherein the cell is a HepG2 cell or a Hep3B cell, and the dsRNA concentration is 10 nM;

b) about 74% inhibition of TTR mRNA expression as measured by a branched DNA assay, wherein the cell is a HepG2 cell or a Hep3B cell and the dsRNA concentration is 10 nM;

c) the dsRNA has an IC50 of less than 10 pM in a HepG2 cell and the dsRNA concentration is 10 nM;

d) the dsRNA has an ED50 of about 1 mg/kg;

e) the dsRNA reduces TTR expression by 98.9% as measured by real-time PCR in a Hep3B cell and the dsRNA concentration is 0.1 nM;

f) the dsRNA reduces TTR expression by 99.4% as measured by real-time PCR in a Hep3B cell and the dsRNA concentration is 10 nM.

16. A method of treating a disorder mediated by TTR expression comprising administering to a human in need of such treatment a therapeutically effective amount of a double-stranded ribonucleic acid (dsRNA) for inhibiting expression of transthyretin (TTR), wherein the dsRNA comprises a sense strand and an antisense strand, the antisense strand comprising a region complementary to an mRNA encoding transthyretin (TTR), wherein the region of complementarity comprises SEQ ID NO:170 and each strand of the dsRNA is 19, 20, 21, 22, 23, or 24 nucleotides in length, wherein the disorder is a transthyretin amyloidosis selected from the group consisting of familial amyloidotic polyneuropathy (FAP), familial amyloidotic cardiomyopathy (FAC), leptomeningeal/CNS amyloidosis, senile systemic amyloidosis (SSA) and senile cardiac amyloidosis (SCA).

17. The method of claim 16 , wherein the dsRNA is administered to the human at about 0.01, 0.1, 0.3, 0.5, 1.0, 2.5, or 5.0 mg/kg.

18. The method of claim 16 , wherein the dsRNA is administered to the human at about 1.0 mg/kg.

19. The method of claim 16 , wherein the dsRNA is formulated in a lipid formulation.

20. The method of claim 16 , wherein the dsRNA is formulated in a lipid formulation comprising MC3.

21. The method of claim 16 , wherein the human has a liver disorder.

22. The method of claim 16 , wherein the human is further provided a liver transplant.

23. The method of claim 16 , wherein administration of the dsRNA results in at least one of the following:

a) reduction of TTR mRNA by about 80% in human liver, wherein the therapeutic amount is 3 mg/kg;

b) no immunostimulatory activity in the human as measured by IFN-alpha and TNF-alpha ELISA assays;

c) reduction of liver TTR mRNA levels by about 97% or serum TTR protein levels by about 90%, wherein the therapeutic amound is 6 mg/kg;

d) reduction of liver TTR mRNA levels and/or serum TTR protein levels up to 22 days, wherein therapeutic amount is 6 mg/kg or 3 mg/kg or

e) suppression of serum TTR protein levels up to day 14 post-treatment wherein therapeutic amount is 1 mg/kg or 3 mg/kg.

24. The method of claim 16 , wherein the dsRNA is formulated in a lipid formulation comprising MC3 and administration of the dsRNA results in at least one of the following:

a) reduction of TTR mRNA levels by about 85 to 90% at a therapeutic amount of 0.3 mg/kg, relative to a PBC control group or

b) reduction TTR mRNA levels by about 50% at a therapeutic amount 0.1 mg/kg, relative to a PBC control group or

c) reduction TTR protein levels in a dose-dependent manner relative to a PBC control group as measured by a western blot or

d) suppression of serum TTR protein levels up to day 14 post-treatment when the therapeutic amount is 1 mg/kg or 3 mg/kg.

25. The method of claim 1 , wherein the sense strand consists of SEQ ID NO:1009 and the antisense strand consists of SEQ ID NO:1010 and the dsRNA is lipid formulated in a formulation comprising MC3.

26. The method of claim 16 , wherein the sense strand consists of SEQ ID NO:1009 and the antisense strand consists of SEQ ID NO:1010 and the dsRNA is lipid formulated in a formulation comprising MC3.

27. A method of treating familial amyloidotic polyneuropathy (FAP) comprising administering to a human in need of such treatment a double-stranded ribonucleic acid (dsRNA) comprising a sense strand and an antisense strand, the sense strand consisting of SEQ ID NO:1009 and the antisense strand consisting of SEQ ID NO:1010, wherein the dsRNA is in a formulation comprising the cationic lipid MC3 and the dsRNA is administered at a dose of 0.3 mg/kg.

28. The method of claim 16 , wherein the dsRNA is administered intraveneously.

29. The method of claim 6 , wherein the dsRNA is formulated in a lipid formulation.

30. The method of claim 6 , wherein the dsRNA is formulated in a lipid formulation comprising MC3.