Compositions and methods of treating muscle atrophy and myotonic dystrophy
Disclosed herein are polynucleic acid molecules, pharmaceutical compositions, and methods for treating muscle atrophy or myotonic dystrophy.
1. A single-stranded antisense oligonucleotide (ASO) conjugate comprising an anti-transferrin receptor antibody conjugated to an ASO sequence that hybridizes to a target sequence in exons 1-13 of human DMPK mRNA excluding CUG repeats and mediates RNA interference against the human DMPK mRNA preferentially in a muscle cell in a human subject, wherein the anti-transferrin receptor antibody comprises two light chain variable domains and two heavy chain variable domains; and wherein the ASO sequence is 8 to 30 nucleotides in length.
2. The ASO conjugate of claim 1 , wherein the ASO sequence comprises at least one 2′ modified nucleotide, at least one modified internucleotide linkage, or at least one inverted abasic moiety.
3. The ASO conjugate of claim 1 , wherein mediation of RNA interference against the human DMPK mRNA modulates muscle atrophy or myotonic dystrophy in a subject.
4. The ASO conjugate of claim 1 , wherein the ASO sequence mediates RNA interference against the human DMPK mRNA via RNase H activity in the muscle cell.
5. The ASO conjugate of claim 1 , wherein the anti-transferrin receptor antibody binds to a transferrin receptor on cell surface of the muscle cell.
6. The ASO conjugate of claim 1 , wherein the ASO sequence hybridizes to at least 8 contiguous bases in the exons 1-13 of the human DMPK mRNA.
7. The ASO conjugate of claim 1 , wherein the ASO conjugate comprises a linker connecting the anti-transferrin receptor antibody to the ASO sequence.
8. The ASO conjugate of claim 2 , wherein the at least one 2′ modified nucleotide:
comprises 2′-O-methyl, 2′-O-methoxyethyl (2′-O-MOE), 2′-O-aminopropyl, 2′-deoxy, 2′-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), 2′-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA) modified nucleotide;
comprises locked nucleic acid (LNA) or ethylene nucleic acid (ENA); or
comprises a combination thereof.
9. The ASO conjugate of claim 2 , wherein the at least one modified internucleotide linkage comprises a phosphorothioate linkage or a phosphorodithioate linkage.
10. The ASO conjugate of claim 2 , wherein the ASO sequence comprises 3 or more 2′ modified nucleotides selected from 2′-O-methyl and 2′-deoxy-2′-11 fluoro.
11. The ASO conjugate of claim 1 , wherein the ASO conjugate has a drug to antibody ratio of from about 1 to about 4.
12. The ASO conjugate of claim 1 , wherein the ASO sequence comprises a 5′-terminal vinylphosphonate modified nucleotide.
13. The ASO conjugate of claim 3 , wherein the muscle atrophy is associated with myotonic dystrophy type 1 (DM1).
14. The ASO conjugate of claim 3 , wherein the myotonic dystrophy is DM1.
15. The ASO of claim 1 , wherein the ASO conjugate is formulated for parenteral administration.
16. A method of treating myotonic dystrophy in a subject in need thereof, comprising:
administering to the subject a therapeutically effective amount of a single-stranded antisense oligonucleotide (ASO) conjugate comprising an anti-transferrin receptor antibody conjugated to an ASO sequence that hybridizes to a target sequence in exons 1-13 of human DMPK mRNA excluding CUG repeats, wherein the anti-transferrin receptor antibody comprises two light chain variable domains and two heavy chain variable domains, and
wherein the ASO conjugate mediates RNA interference against the human DMPK mRNA preferentially in muscle cells in a human subject and wherein the ASO sequence is 8 to 30 nucleotides in length, thereby treating the myotonic dystrophy in the subject.
17. The ASO conjugate of claim 1 , wherein the ASO sequence that hybridizes to the target sequence of the human DMPK mRNA is selected from a group consisting of SEQ ID NOs: 6111-8814.
18. The ASO conjugate of claim 1 , wherein the ASO sequence that hybridizes to the target sequence of the human DMPK mRNA is selected from a group consisting of SEQ ID NOs: 11519-14222.
19. The ASO conjugate of claim 1 , wherein the ASO sequence that hybridizes to the target sequence in exons 2-13 of the human DMPK mRNA is selected from SEQ ID NOs: 11903, 11961, 11962, 11963, 12051, 12052, 12053, 12057, 12058, 12059, 12061, 12062, 12094, 12095, 12099, 12101, 12102, 12208, 12234, 12235, 12303, 12304, 12307, 12544, 12545, 12546, 12547, 12555, 12557, 12559, 12561, 12562, 12565, 12589, 12591, 12780, 12781, 12782, 12783, 12785, 12786, 12787, 12792, 12794, 12801, 12815, 12860, 12861, 12862, 12864, 13343, 13404, 13408, 13416, 13463, 13478, 13644, 13645, 13667, 13668, 13786, 13790, 14046, 14047, 14048, 14049, 14050, 14072, 14076, 14118, 14146, 14147, 14149, 14154, 14157, 14193, 14194, 14197, 14198, 14199, and 14200.
20. The ASO conjugate of claim 19 , wherein the ASO sequence that hybridizes to the target sequence in exons 4, 5, and 6 of the human DMPK mRNA is selected from SEQ ID NOs: 12102, 12234, 12303, 12304, and 12307.
21. The ASO conjugate of claim 19 , wherein the ASO sequence that hybridizes to the target sequence in exons 7 and 8 of the human DMPK mRNA is selected from SEQ ID NOs: 12544, 12545, 12546, 12547, 12555, 12557, 12559, 12561, 12562, 12565, 12589, 12783, and 12815.
22. The ASO conjugate of claim 19 , wherein the ASO sequence that hybridizes to the target sequence in exon 9 of the human DMPK mRNA is selected from SEQ ID NOs: 12860, 12861, 12862, and 12864.
23. The ASO conjugate of claim 19 , wherein the ASO sequence that hybridizes to the target sequence in exon 13 of the human DMPK mRNA is selected from SEQ ID NOs: 13343, 13463, 13478, 14047, 14048, 14049, 14072, 14146, 14147, 14199, and 14200.