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 ADA 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 to a polypeptide of interest in a human subject, comprising:
(i) intravenously administering to the subject a first dose of a lipid nanoparticle (LNP) comprising a 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 the mRNA comprises one or more modified nucleobases; and
(ii) intravenously administering to the subject a second dose of the LNP, 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.
2. The method of claim 1 , wherein the one or more modified nucleobases is selected from: pseudouridine (ψ), 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, 2′-O-methyl uridine and 5-methyl-cytidine (m 5 C), N6-methyl-adenosine (m 6 A) or N6-methyl-adenosine (m 6 A) and 5-methyl-cytidine (m 5 C).
3. The method of claim 1 , wherein all uracil nucleobases in the mRNA are replaced with modified uracil nucleobases.
4. The method of claim 3 , wherein the modified uracil nucleobases are selected from pseudouridines (ψ), 1-methyl-pseudouridines (m 1 ψ), and 5-methoxy-uridines (mo 5 U).
5. The method of claim 1 , wherein the polypeptide of interest is a therapeutic protein, cytokine, growth factor, antibody or fusion protein.
6. The method of claim 1 , wherein the miR-142 binding site comprises the sequence of SEQ ID NO: 3.
7. The method of claim 1 , wherein the 3′UTR comprises three miR-142-3p binding sites.
8. The method of claim 7 , wherein the 3′UTR comprises the sequence of SEQ ID NO: 38.
9. The method of claim 1 , wherein the 3′UTR comprises a sequence selected from SEQ ID NOs: 2, 31 and 37.
10. The method of claim 1 , wherein the LNP comprises an ionizable lipid, a structural lipid, a phospholipid and a PEG lipid.
11. 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.
12. The method of claim 11 , 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.
13. A method of reducing or inhibiting a systemic ADA response to a polypeptide of interest in a human subject, comprising:
(i) intravenously administering to the subject a first dose of a LNP comprising a mRNA comprising an open reading frame encoding a polypeptide of interest and a 3′UTR comprising at least one miR-142-3p binding site, wherein the mRNA comprises one or more modified nucleobases;
(ii) detecting a level of anti-drug antibodies in a sample from the subject; and
(ii) intravenously administering to the subject a second dose of the LNP when the level of anti-drug antibodies in the sample is diminished, such that a systemic ADA response to the polypeptide of interest is reduced or inhibited in the subject.
14. The method of claim 13 , wherein the one or more modified nucleobases is selected from: pseudouridine (ψ), 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, 2′-O-methyl uridine and 5-methyl-cytidine (m 5 C), N6-methyl-adenosine (m 6 A) or N6-methyl-adenosine (m 6 A) and 5-methyl-cytidine (m 5 C).
15. The method of claim 13 , wherein all uracil nucleobases in the mRNA are replaced with modified uracil nucleobases.
16. The method of claim 15 , wherein the modified uracil nucleobases are selected from pseudouridines (ψ), 1-methyl-pseudouridines (m 1 ψ), and 5-methoxy-uridines (mo 5 U).
17. The method of claim 13 , wherein the polypeptide of interest is a therapeutic protein, cytokine, growth factor, antibody or fusion protein.
18. The method of claim 13 , wherein the miR-142 binding site comprises the sequence of SEQ ID NO: 3.
19. The method of claim 13 , wherein the 3′UTR comprises three miR-142-3p binding sites.
20. The method of claim 19 , wherein the 3′UTR comprises the sequence of SEQ ID NO: 38.
21. The method of claim 13 , wherein the 3′UTR comprises a sequence selected from SEQ ID NOs: 2, 31 and 37.
22. The method of claim 13 , wherein the LNP comprises an ionizable lipid, a structural lipid, a phospholipid and a PEG lipid.
23. The method of claim 13 , wherein the reduced or inhibited ADA response comprises a reduced or inhibited IgG antibody response to the polypeptide of interest.
24. The method of claim 23 , 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.
25. The method of claim 24 , 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.