Methods for therapeutic administration of messenger ribonucleic acid drugs
The disclosure features methods of reducing or inhibiting an anti-drug antibody response in a subject, as well as methods of reducing or inhibiting unwanted immune cell activation in a subject to be treated with a messenger RNA (mRNA), comprising administering to the subject a mRNA, e.g., a chemically modified messenger RNA (mmRNA), encoding a polypeptide of interest, wherein the mRNA comprises at least one microRNA (miR) binding site for a miR expressed in immune cells, such as miR-126 binding site and/or miR-142 binding site, such that an anti-drug antibody response to the polypeptide or interest, or unwanted immune cell activation (e.g., B cell activation, cytokine secretion), is reduced or inhibited in the subject. The disclosure further provides therapeutic treatment regimens designed to reduce or inhibit AD A or unwanted immune cell activation (e.g., B cell activation, cytokine secretion) in a subject being treated with mRNA-based therapeutics.
1. A method of reducing or inhibiting a systemic anti-drug antibody (ADA) response in a human subject, comprising intravenously administering to the subject a lipid nanoparticle (LNP) comprising a messenger RNA (mRNA) comprising an open reading frame encoding a polypeptide of interest, and a 3′UTR comprising at least one microRNA (miR) 142-3p binding site, wherein all uracil nucleobases in the mRNA are replaced with modified uracil nucleobases,
such that a systemic ADA response to the polypeptide of interest is reduced or inhibited in the subject, wherein the reduced or inhibited ADA response comprises a reduced or inhibited IgG antibody response to the polypeptide of interest in the subject.
2. The method of claim 1 , wherein all cytosine nucleobases in the mRNA are replaced with modified cytosine nucleobases.
3. The method of claim 2 , wherein the modified nucleobase is selected from the group consisting of: pseudouridine («), pseudouridine (ψ) and 5-methyl-cytidine (m 5 C), 1-methyl-pseudouridine (m 1 ψ), 1-methyl-pseudouridine (m 1 ψ) and 5-methyl-cytidine (m 5 C), 2-thiouridine (s 2 U), 2-thiouridine and 5-methyl-cytidine (m 5 C), 5-methoxy-uridine (mo 5 U), 5-methoxy-uridine (mo 5 U) and 5-methyl-cytidine (m 5 C), 2′-O-methyl uridine, and 2′-O-methyl uridine and 5-methyl-cytidine (m 5 C).
4. The method of claim 1 , wherein the polypeptide of interest is a therapeutic protein, cytokine, growth factor, antibody or fusion protein.
5. The method of claim 1 , wherein the mRNA comprises at least one miR-142-3p binding site comprising the sequence shown in SEQ ID NO: 3.
6. The method of claim 1 , wherein the mRNA comprises three miR-142-3p binding sites.
7. The method of claim 1 , wherein the LNP comprises an ionizable lipid.
8. The method of claim 7 , wherein the LNP comprises a structural lipid, a phospholipid, and a PEG lipid.
9. The method of claim 1 , wherein the 3′ UTR comprises a sequence selected from SEQ ID NOs: 2, 31, or 37.
10. The method of claim 6 , wherein the 3′ UTR comprises three miR-142-3p binding sites, and wherein the 3′ UTR comprises the sequence set forth in SEQ ID NO: 38.
11. The method of claim 1 , wherein the modified uracil nucleobase is selected from pseudouridine («), 1-methyl-pseudouridine (m 1 «), and 5-methoxy-uridine (mo 5 U).
12. The method of claim 11 , wherein the modified uracil nucleobase is pseudouridine (ψ).
13. The method of claim 11 , wherein the modified uracil nucleobase is 1-methyl-pseudouridine (m 1 ψ).
14. The method of claim 11 , wherein the modified uracil nucleobase is 5-methoxy-uridine (mo 5 U).
15. The method of claim 1 , wherein the reduced IgG antibody response to the polypeptide of interest is below a threshold value based on results for one or more negative control samples.
16. The method of claim 15 , wherein the control sample is a level of IgG antibody response by a subject administered an LNP comprising the mRNA encoding the polypeptide of interest without a miR-142-3p binding site.