KETOHEXOKINASE (KHK) iRNA COMPOSITIONS AND METHODS OF USE THEREOF

Information

  • Patent Application
  • 20230416748
  • Publication Number
    20230416748
  • Date Filed
    September 01, 2022
    2 years ago
  • Date Published
    December 28, 2023
    11 months ago
Abstract
The present invention relates to RNAi agents, e.g., dsRNA agents, targeting the ketohexokinase (KHK) gene. The invention also relates to methods of using such RNAi agents to inhibit expression of a KHK gene and to methods of treating or preventing a KHK-associated disease in a subject.
Description
SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted electronically in XML file format and is hereby incorporated by reference in its entirety. Said XML copy, created on Apr. 25, 2023, is named 121301-10102_SL.xml and is 4,380,499 bytes in size.


BACKGROUND OF THE INVENTION

Epidemiological studies have shown that a western diet is one of the leading causes of the modern obesity pandemic. Increase in fructose uptake, associated with the use of enriched soft drinks and processed food are proposed to be major contributing factors to the epidemic. High fructose corn sweeteners started gaining widespread use in the food industry by 1967. Although glucose and fructose have the same caloric value per molecule, the two sugars are metabolized differently and utilize different GLUT transporters. Fructose is almost exclusively metabolized in the liver, and unlike the glucose metabolism pathway, the fructose metabolism pathway is not regulated by feedback inhibition by the product (Khaitan Z et al., (2013) J. Nutr. Metab. 2013, Article ID 682673, 1-12). While hexokinase and phosphofructokinase (PFK) regulate the production of glyceraldehyde-3-P from glucose, fructokinase or ketohexokinase (KHK), which is responsible for phosphorylation of fructose to fructose-1-phosphate in the liver, is not down regulated by increasing concentrations of fructose-1-phosphate. As a result, all fructose entering the cell is rapidly phosphorylated. (Cirillo P. et al., (2009) J. Am. Soc. Nephrol. 20: 545-553). Continued utilization of ATP to phosphorylate the fructose to fructose-1-phosphate results in intracellular phosphate depletion, ATP depletion, activation of AMP deaminase and formation of uric acid (Khaitan Z. et al., (2013) J. Nutr. Metab. Article ID 682673, 1-12). Increased uric acid further stimulates the up-regulation of KHK (Lanaspa M. A. et al., (2012) PLOS ONE 7(10): 1-11) and causes endothelial cell and adipocyte dysfunction. Fructose-1-phosphate is subsequently converted to glyceraldehyde by the action of aldolase B and is phosphorylated to glyceraldehyde-3-phosphate. The latter proceeds downstream to the glycolysis pathway to form pyruvate, which enters the citric acid cycle, wherefrom, under well-fed conditions, citrate is exported to the cytosol from the mitochondria, providing Acetyl Coenzyme A for lipogenesis (FIG. 1).


The phosphorylation of fructose by KHK, and subsequent activation of lipogenesis leads to, for example, fatty liver, hypertriglyceridemia, dyslipidemia, and insulin resistance. Proinflammatory changes in renal proximal tubular cells have also been shown to be induced by KHK activity (Cirillo P. et al., (2009) J. Am. Soc. Nephrol. 20: 545-553). The phosphorylation of fructose by KHK is associated with diseases, disorders or conditions such as liver disease (e.g., fatty liver, steatohepatitis), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


Accordingly, there is a need in the art for compositions and methods for treating diseases, disorders, and conditions associated with KHK activity.


SUMMARY OF THE INVENTION

The present invention provides iRNA compositions which affect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a gene encoding ketohexokinase (KHK). The ketohexokinase (KHK) may be within a cell, e.g., a cell within a subject, such as a human subject.


In an aspect, the invention provides a double stranded ribonucleic acid (dsRNA) agent for inhibiting expression of ketohexokinase in a cell, wherein the dsRNA agent comprises a sense strand and an antisense strand forming a double stranded region, wherein the sense strand comprises at least 15 contiguous nucleotides differing by no more than 0, 1, 2, or 3 nucleotides from the nucleotide sequence of SEQ ID NO:1 and the antisense strand comprises at least 15 contiguous nucleotides differing by no more than 1, 2, or 3 nucleotides from the nucleotide sequence of SEQ ID NO:2.


In another aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) for inhibiting expression of ketohexokinase in a cell, wherein said dsRNA comprises a sense strand and an antisense strand forming a double stranded region, wherein the antisense strand comprises a region of complementarity to an mRNA encoding ketohexokinase, and wherein the region of complementarity comprises at least 15 contiguous nucleotides differing by no more than 0, 1, 2, or 3 nucleotides from any one of the antisense nucleotide sequences in any one of Tables 2-5.


In one aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) for inhibiting expression of ketohexokinase in a cell, wherein said dsRNA comprises a sense strand and an antisense strand forming a double stranded region, wherein the sense strand comprises at least 15 contiguous nucleotides differing by no more than 0, 1, 2, or 3 nucleotides from any one of the nucleotide sequence of nucleotides 943-965; 788-810; 734-756; 1016-1038; 1013-1035; 1207-1229; 1149-1171; 574-596; 1207-1229 or 828-850 of the nucleotide sequence of SEQ ID NO:1, and the antisense strand comprises at least 19 contiguous nucleotides from the corresponding nucleotide sequence of SEQ ID NO:2.


In one embodiment, the antisense strand comprises at least 15 contiguous nucleotides differing by nor more than 0, 1, 2, or 3 nucleotides from any one of the antisense strand nucleotide sequences of a duplex selected from the group consisting of AD-252498.1, AD-252339.1, AD-252285.1, AD-252531.1, AD-254265.1, AD-254403.1, AD-252627.1, AD-252146.1, AD-252666.1 and AD-252379.1.


In one embodiment, the dsRNA agent comprises at least one modified nucleotide.


In one embodiment, substantially all of the nucleotides of the sense strand; substantially all of the nucleotides of the antisense strand comprise a modification; or substantially all of the nucleotides of the sense strand and substantially all of the nucleotides of the antisense strand comprise a modification.


In one embodiment, all of the nucleotides of the sense strand comprise a modification; all of the nucleotides of the antisense strand comprise a modification; or all of the nucleotides of the sense strand and all of the nucleotides of the antisense strand comprise a modification.


In one embodiment, at least one of the modified nucleotides is selected from the group consisting of a deoxy-nucleotide, a 3′-terminal deoxythymidine (dT) nucleotide, a 2′-O-methyl modified nucleotide, a 2′-fluoro modified nucleotide, a 2′-deoxy-modified nucleotide, a locked nucleotide, an unlocked nucleotide, a conformationally restricted nucleotide, a constrained ethyl nucleotide, an abasic nucleotide, a 2′-amino-modified nucleotide, a 2′-O-allyl-modified nucleotide, 2′-C-alkyl-modified nucleotide, 2′-hydroxyl-modified nucleotide, a 2′-methoxyethyl modified nucleotide, a 2′-O-alkyl-modified nucleotide, a morpholino nucleotide, a phosphoramidate, a non-natural base comprising nucleotide, a tetrahydropyran modified nucleotide, a 1,5-anhydrohexitol modified nucleotide, a cyclohexenyl modified nucleotide, a nucleotide comprising a phosphorothioate group, a nucleotide comprising a methylphosphonate group, a nucleotide comprising a 5′-phosphate, a nucleotide comprising a 5′-phosphate mimic, a thermally destabilizing nucleotide, a glycol modified nucleotide (GNA), and a 2-O—(N-methylacetamide) modified nucleotide; and combinations thereof.


In one embodiment, the modifications on the nucleotides are selected from the group consisting of LNA, glycol nucleic acid (GNA), hexitol nucleic acid (HNA), 2′-methoxyethyl, 2′-O-alkyl, 2′-O-allyl, 2′-C-allyl, 2′-fluoro, 2′-deoxy, 2′-hydroxyl, and glycol; and combinations thereof.


In one embodiment, at least one of the modified nucleotides is selected from the group consisting of a deoxy-nucleotide, a 2′-O-methyl modified nucleotide, a 2′-fluoro modified nucleotide, a 2′-deoxy-modified nucleotide, a glycol modified nucleotide (GNA), e.g., Ggn, Cgn, Tgn, or Agn, and, a vinyl-phosphonate nucleotide; and combinations thereof.


In another embodiment, at least one of the modifications on the nucleotides is a thermally destabilizing nucleotide modification.


In one embodiment, the thermally destabilizing nucleotide modification is selected from the group consisting of an abasic modification; a mismatch with the opposing nucleotide in the duplex; and destabilizing sugar modification, a 2′-deoxy modification, an acyclic nucleotide, an unlocked nucleic acids (UNA), and a glycerol nucleic acid (GNA).


The double stranded region may be 19-30 nucleotide pairs in length; 19-25 nucleotide pairs in length; 19-23 nucleotide pairs in length; 23-27 nucleotide pairs in length; or 21-23 nucleotide pairs in length.


In one embodiment, each strand is independently no more than 30 nucleotides in length.


In one embodiment, the sense strand is 21 nucleotides in length and the antisense strand is 23 nucleotides in length.


The region of complementarity may be at least 17 nucleotides in length; between 19 and 23 nucleotides in length; or 19 nucleotides in length.


In one embodiment, at least one strand comprises a 3′ overhang of at least 1 nucleotide. In another embodiment, at least one strand comprises a 3′ overhang of at least 2 nucleotides.


In one embodiment, the dsRNA agent further comprises a ligand.


In one embodiment, the ligand is conjugated to the 3′ end of the sense strand of the dsRNA agent.


In one embodiment, the ligand is an N-acetylgalactosamine (GalNAc) derivative.


In one embodiment, the ligand is one or more GalNAc derivatives attached through a monovalent, bivalent, or trivalent branched linker.


In one embodiment, the ligand is




embedded image


In one embodiment, the dsRNA agent is conjugated to the ligand as shown in the following schematic




embedded image


and, wherein X is O or S.


In one embodiment, the X is O.


In one embodiment, the dsRNA agent further comprises at least one phosphorothioate or methylphosphonate internucleotide linkage.


In one embodiment, the phosphorothioate or methylphosphonate internucleotide linkage is at the 3′-terminus of one strand, e.g., the antisense strand or the sense strand.


In another embodiment, the phosphorothioate or methylphosphonate internucleotide linkage is at the 5′-terminus of one strand, e.g., the antisense strand or the sense strand.


In one embodiment, the phosphorothioate or methylphosphonate internucleotide linkage is at the both the 5′- and 3′-terminus of one strand. In one embodiment, the strand is the antisense strand.


In one embodiment, the base pair at the 1 position of the 5′-end of the antisense strand of the duplex is an AU base pair.


The present invention also provides cells containing any of the dsRNA agents of the invention and pharmaceutical compositions comprising any of the dsRNA agents of the invention.


The pharmaceutical composition of the invention may include dsRNA agent in an unbuffered solution, e.g., saline or water, or the pharmaceutical composition of the invention may include the dsRNA agent is in a buffer solution, e.g., a buffer solution comprising acetate, citrate, prolamine, carbonate, or phosphate or any combination thereof; or phosphate buffered saline (PBS).


In one aspect, the present invention provides a method of inhibiting expression of a ketohexokinase (KHK) gene in a cell. The method includes contacting the cell with any of the dsRNAs of the invention or any of the pharmaceutical compositions of the invention, thereby inhibiting expression of the KHK gene in the cell.


In one embodiment, the cell is within a subject, e.g., a human subject, e.g., a subject having a ketohexokinase-associated disorder, such as a ketohexokinase-associated disorder selected from the group consisting of liver disease (e.g., fatty liver, steatohepatitis, especially non-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


In one embodiment, contacting the cell with the dsRNA agent inhibits the expression of KHK by at least 50%, 60%, 70%, 80%, 90%, or 95%.


In one embodiment, inhibiting expression of ketohexokinase decreases KHK protein level in serum of the subject by at least 50%, 60%, 70%, 80%, 90%, or 95%.


In one aspect, the present invention provides a method of treating a subject having a disorder that would benefit from reduction in ketohexokinase (KHK) expression. The method includes administering to the subject a therapeutically effective amount of any of the dsRNAs of the invention or any of the pharmaceutical compositions of the invention, thereby treating the subject having the disorder that would benefit from reduction in KHK expression.


In another aspect, the present invention provides a method of preventing at least one symptom in a subject having a disorder that would benefit from reduction in ketohexokinase (KHK) expression. The method includes administering to the subject a prophylactically effective amount of any of the dsRNAs of the invention or any of the pharmaceutical compositions of the invention, thereby preventing at least one symptom in the subject having the disorder that would benefit from reduction in KHK expression.


In certain embodiments, the administration of the dsRNA to the subject causes a decrease in fructose metabolism. In certain embodiments, the administration of the dsRNA causes a decrease in the level of KHK in the subject, especially hepatic KHK, especially KHK-C in a subject with elevated KHK. In certain embodiments, the administration of the dsRNA causes a decrease in fructose metabolism in the subject. In certain embodiments, the administration of the dsRNA causes a decrease in the level of uric acid, e.g., serum uric acid, in a subject with elevated serum uric acid, e.g., elevated serum uric acid associated with gout. In certain embodiments, the administration of the dsRNA causes a normalization of serum lipids, e.g., triglycerides including postprandial triglycerides, LDL, HDL, or cholesterol, in a subject with at least one abnormal serum lipid level. In certain embodiments, the administration of the dsRNA causes a normalization of lipid deposition, e.g., a decrease of lipid deposition in the liver (e.g., decrease of NAFLD or NASH), a decrease of visceral fat deposition, a decrease in body weight. In certain embodiments, the administration of the dsRNA causes a normalization of insulin or glucose response in a subject with abnormal insulin response not related to an immune response to insulin, or abnormal glucose response. In certain embodiments, the administration of the dsRNA results in an improvement of kidney function, or a stoppage or reduction of the rate of loss of kidney function. In certain embodiments, the dsRNA causes a reduction of hypertension, i.e., elevated blood pressure.


In one embodiment, the disorder is a ketohexokinase (KHK)-associated disorder. In certain embodiments, the KHK-associated disease is a liver disease, e.g., fatty liver disease such as NAFLD or NASH. In certain embodiments, the KHK-associated disease is dyslipidemia, e.g., elevated serum triglycerides, elevated serum LDL, elevated serum cholesterol, lowered serum HDL, postprandial hypertriglyceridemia. In another embodiment, the KHK-associated disease is a disorder of glycemic control, e.g., insulin resistance not resulting from an immune response against insulin, glucose resistance, type 2 diabetes. In certain embodiments, the KHK-associated disease is a cardiovascular disease, e.g., hypertension, endothelial cell dysfunction. In certain embodiments, the KHK-associated disease is a kidney disease, e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease. In certain embodiments, the KHK-associated disease is metabolic syndrome. In certain embodiments, the KHK-associated disease is a disease of lipid deposition or dysfunction, e.g., visceral adipose deposition, fatty liver, obesity. In certain embodiments, the KHK-associated disease is a disease of elevated uric acid, e.g., gout, hyperuricemia. In certain embodiments, the KHK-associated disease is an eating disorder such as excessive sugar craving.


In one embodiment, the subject is human.


In one embodiment, the dsRNA agent is administered to the subject at a dose of about 0.01 mg/kg to about 50 mg/kg.


In one embodiment, the dsRNA agent is administered to the subject subcutaneously.


In one embodiment, the methods of the invention include further determining the level of ketohexokinase in a sample(s) from the subject.


In one embodiment, the level of ketohexokinase in the subject sample(s) is a ketohexokinase protein level in a blood or serum sample(s).


In certain embodiments, the methods of the invention further comprise administering to the subject an additional therapeutic agent.


In certain embodiments, treatments known in the art for the various KHK-associated diseases are used in combination with the RNAi agents of the invention.


In various embodiments, the methods of the invention further comprise measuring the uric acid level, especially serum uric acid level, in the subject. In various embodiments, the methods of the invention further comprise measuring the urine fructose level in the subject. In various embodiments, the methods of the invention further comprise measuring a serum lipid level in a subject. In certain embodiments, the methods of the invention further include measuring insulin or glucose sensitivity in a subject. In certain embodiments, a decrease in the levels of expression or activity of fructose metabolism indicates that the KHK-associated disease is being treated or prevented.


The present invention also provides kits comprising any of the dsRNAs of the invention or any of the pharmaceutical compositions of the invention, and optionally, instructions for use.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 depicts the classic and alternative lipogenic pathways of fructose. In the classical pathway, triglycerides (TG) are a direct product of fructose metabolism by the action of multiple enzymes including aldolase B (Aldo B) and fatty acid synthase (FAS). In an alternative pathway, uric acid produced from the nucleotide turnover that occurs during the phosphorylation of fructose to fructose-1-phosphate (F-1-P) results in the generation of mitochondrial oxidative stress (mtROS), which causes a decrease in the activity of aconitase (ACO2) in the Krebs cycle. As a consequence, the ACO2 substrate, citrate, accumulates and is released to the cytosol where it acts as substrate for TG synthesis through the activation of ATP citrate lyase (ACL) and fatty acid synthase. AMPD2, AMP deaminase 2; IMP, inosine monophosphate; PO4, phosphate (from Johnson et al. (2013) Diabetes. 62:3307-3315).



FIG. 2 is a graph depicting the level of human KHK mRNA following subcutaneous administration of a single 10 mg/kg dose of the indicated dsRNA agents to mice.





DETAILED DESCRIPTION OF THE INVENTION

The present invention provides iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a ketohexokinase (KHK) gene. The gene may be within a cell, e.g., a cell within a subject, such as a human. The use of these iRNAs enables the targeted degradation of mRNAs of the corresponding gene (ketohexokinase gene) in mammals.


The iRNAs of the invention have been designed to target the human ketohexokinase gene, including portions of the gene that are conserved in the ketohexokinase orthologs of other mammalian species. Without intending to be limited by theory, it is believed that a combination or sub-combination of the foregoing properties and the specific target sites or the specific modifications in these iRNAs confer to the iRNAs of the invention improved efficacy, stability, potency, durability, and safety.


Accordingly, the present invention provides methods for treating and preventing a ketohexokinase-associated disorder, disease, or conditions, e.g., liver disease (e.g., fatty liver, steatohepatitis, NAFLD, NASH), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance not due to an immune response to insulin, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving, using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a ketohexokinase gene.


The iRNAs of the invention include an RNA strand (the antisense strand) having a region which is up to about 30 nucleotides or less in length, e.g., 19-30, 19-29, 19-28, 19-27, 19-26, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-30, 20-29, 20-28, 20-27, 20-26, 20-25, 20-24,20-23, 20-22, 20-21, 21-30, 21-29, 21-28, 21-27, 21-26, 21-25, 21-24, 21-23, or 21-22 nucleotides in length, which region is substantially complementary to at least part of an mRNA transcript of a KHK gene. In certain embodiments, the RNAi agents of the disclosure include an RNA strand (the antisense strand) having a region which is about 21-23 nucleotides in length, which region is substantially complementary to at least part of an mRNA transcript of a KHK gene.


In certain embodiments, one or both of the strands of the double stranded RNAi agents of the invention is up to 66 nucleotides in length, e.g., 36-66, 26-36, 25-36, 31-60, 22-43, 27-53 nucleotides in length, with a region of at least 19 contiguous nucleotides that is substantially complementary to at least a part of an mRNA transcript of a KHK gene. In some embodiments, such iRNA agents having longer length antisense strands may include a second RNA strand (the sense strand) of 20-60 nucleotides in length wherein the sense and antisense strands form a duplex of 18-30 contiguous nucleotides.


The use of iRNAs of the invention enables the targeted degradation of mRNAs of the corresponding gene (ketohexokinase gene) in mammals. Using in vitro assays, the present inventors have demonstrated that iRNAs targeting a KHK gene can potently mediate RNAi, resulting in significant inhibition of expression of a KHK gene. Thus, methods and compositions including these iRNAs are useful for treating a subject having a ketohexokinase-associated disorder, e.g., liver disease (e.g., fatty liver, steatohepatitis, NAFLD, NASH), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance not due to an immune response to insulin, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


Accordingly, the present invention provides methods and combination therapies for treating a subject having a disorder that would benefit from inhibiting or reducing the expression of a KHK gene, e.g., a ketohexokinase-associated disease, such as liver disease (e.g., fatty liver, steatohepatitis, NAFLD, NASH), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance not due to an immune response to insulin, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving, using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a KHK gene.


The present invention also provides methods for preventing at least one symptom in a subject having a disorder that would benefit from inhibiting or reducing the expression of a KHK gene, e.g., liver disease (e.g., fatty liver, steatohepatitis, NAFLD, NASH), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance not due to an immune response to insulin, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


In certain embodiments, the administration of the dsRNA to the subject causes a decrease in fructose metabolism. In certain embodiments, the administration of the dsRNA causes a decrease in the level of KHK in the subject, especially hepatic KHK, especially KHK-C in a subject with elevated KHK. In certain embodiments, the administration of the dsRNA causes a decrease in fructose metabolism in the subject. In certain embodiments, the administration of the dsRNA causes a decrease in the level of uric acid, e.g., serum uric acid, in a subject with elevated serum uric acid, e.g., elevated serum uric acid associated with gout. In certain embodiments, the administration of the dsRNA causes a normalization of serum lipids, e.g., triglycerides including postprandial triglycerides, LDL, HDL, or cholesterol, in a subject with at least one abnormal serum lipid level. In certain embodiments, the administration of the dsRNA causes a normalization of lipid deposition, e.g., a decrease of lipid deposition in the liver (e.g., decrease of NAFLD or NASH), a decrease of visceral fat deposition, a decrease in body weight. In certain embodiments, the administration of the dsRNA causes a normalization of insulin or glucose response in a subject with abnormal insulin response not related to an immune response to insulin, or abnormal glucose response. In certain embodiments, the administration of the dsRNA results in an improvement of kidney function, or a stoppage or reduction of the rate of loss of kidney function. In certain embodiments, the dsRNA causes a reduction of hypertension, i.e., elevated blood pressure.


The following detailed description discloses how to make and use compositions containing iRNAs to inhibit the expression of a KHK gene as well as compositions, uses, and methods for treating subjects that would benefit from inhibition and/or reduction of the expression of a KHK gene, e.g., subjects susceptible to or diagnosed with a ketohexokinase-associated disorder.


I. Definitions

In order that the present invention may be more readily understood, certain terms are first defined. In addition, it should be noted that whenever a value or range of values of a parameter are recited, it is intended that values and ranges intermediate to the recited values are also intended to be part of this invention.


The articles “a” and “an” are used herein to refer to one or to more than one (i.e., to at least one) of the grammatical object of the article. By way of example, “an element” means one element or more than one element, e.g., a plurality of elements.


The term “including” is used herein to mean, and is used interchangeably with, the phrase “including but not limited to”.


The term “or” is used herein to mean, and is used interchangeably with, the term “and/or,” unless context clearly indicates otherwise. For example, “sense strand or antisense strand” is understood as “sense strand or antisense strand or sense strand and antisense strand.”


The term “about” is used herein to mean within the typical ranges of tolerances in the art. For example, “about” can be understood as about 2 standard deviations from the mean. In certain embodiments, about means±10%. In certain embodiments, about means±5%. When about is present before a series of numbers or a range, it is understood that “about” can modify each of the numbers in the series or range.


The term “at least”, “no less than”, or “or more” prior to a number or series of numbers is understood to include the number adjacent to the term “at least”, and all subsequent numbers or integers that could logically be included, as clear from context. For example, the number of nucleotides in a nucleic acid molecule must be an integer. For example, “at least 19 nucleotides of a 21 nucleotide nucleic acid molecule” means that 19, 20, or 21 nucleotides have the indicated property. When at least is present before a series of numbers or a range, it is understood that “at least” can modify each of the numbers in the series or range.


As used herein, “no more than” or “less than” is understood as the value adjacent to the phrase and logical lower values or integers, as logical from context, to zero. For example, a duplex with an overhang of “no more than 2 nucleotides” has a 2, 1, or 0 nucleotide overhang. When “no more than” is present before a series of numbers or a range, it is understood that “no more than” can modify each of the numbers in the series or range. As used herein, ranges include both the upper and lower limit.


As used herein, methods of detection can include determination that the amount of analyte present is below the level of detection of the method.


In the event of a conflict between an indicated target site and the nucleotide sequence for a sense or antisense strand, the indicated sequence takes precedence.


In the event of a conflict between a sequence and its indicated site on a transcript or other sequence, the nucleotide sequence recited in the specification takes precedence.


As used herein, the term “KHK” refers to the well-known gene that encodes ketohexokinase, as well as to its protein product.


The KHK (Ketohexokinase) gene is located on chromosome 2p23 and encodes ketohexokinase, also known as fructokinase. KHK is a phosphotransferase enzyme with an alcohol as the phosphate acceptor. KHK belongs to the ribokinase family of carbohydrate kinases (Trinh et al., ACTA Cryst., D65: 201-211). Two isoforms of ketohexokinase have been identified, KHK-A (various a) and KHK-C (various b), that result from alternative splicing of the full length mRNA. KHK-C mRNA is expressed at high levels, predominantly in the liver, kidney and small intestine. KHK-C has a much lower Km for fructose binding that KHK-A, and as a result, is highly effective in phosphorylating dietary fructose.


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477611 (variant 10, XM_017004061.1; SEQ ID NO: 1; reverse complement, SEQ ID NO: 2).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477602 (variant 1, XM_006712008.4; SEQ ID NO: 3; reverse complement, SEQ ID NO: 4).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477603 (variant 2, XM_006712009.4; SEQ ID NO: 5; reverse complement, SEQ ID NO: 6).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477604 (variant 3, XM_005264294.4; SEQ ID NO: 7; reverse complement, SEQ ID NO: 8).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477605 (variant 4, XM_017004060.2; SEQ ID NO: 9; reverse complement, SEQ ID NO: 10).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477606 (variant 5, XM_006712010.4; SEQ ID NO: 11; reverse complement, SEQ ID NO: 12).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477607 (variant 6, XM_006712011.4; SEQ ID NO: 13; reverse complement, SEQ ID NO: 14).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477608 (variant 7, XM_006712012.4; SEQ ID NO: 15; reverse complement, SEQ ID NO: 16).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477609 (variant 8, XM_005264296.4; SEQ ID NO: 17; reverse complement, SEQ ID NO: 18).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477610 (variant 9, XM_006712013.4; SEQ ID NO: 19; reverse complement, SEQ ID NO: 20).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477612 (variant 11, XM_006712014.4; SEQ ID NO: 21; reverse complement, SEQ ID NO: 22).


The sequence of a human KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 1370477613 (variant 12, XM_005264298.4; SEQ ID NO: 23; reverse complement, SEQ ID NO: 24).


The sequence of a human KHK-C mRNA transcript may be found at, for example, GenBank Accession No. GI: 1519473652 (variant b, NM_006488.3; SEQ ID NO:25; reverse complement, SEQ ID NO: 26).


The sequence of a human KHK-A mRNA transcript may be found at, for example GenBank Accession No. GI: 1676318137 (variant a, NM_000221.3; SEQ ID NO:27; reverse complement, SEQ ID NO: 28).


The sequence of a mouse (Mus musculus) KHK mRNA transcript may be found at, for example, GenBank Accession No. GI: 887229617 (variant 1, NM_001310524.1; SEQ ID NO:29; reverse complement, SEQ ID NO: 30).


The sequence of a rat (Rattus norvegicus) KHK mRNA transcript may be found at, for example GenBank Accession No. GI: 126432547 (NM_031855.3; SEQ ID NO:31; reverse complement, SEQ ID NO: 32).


The sequence of a rabbit (Oryctolagus cuniculus) KHK mRNA transcript may be found at, for example GenBank Accession No. GI: 1040208599 (variant 2, XM_017340872.1; SEQ ID NO:33; reverse complement, SEQ ID NO: 34).


The sequence of a Macaca mulatta KHK mRNA transcript may be found at, for example GenBank Accession No. GI: 1622855994 (variant 1, XM_015111942.2; SEQ ID NO:35; reverse complement, SEQ ID NO: 36).


Further information on KHK can be found, for example, at www.ncbi.nlm.nih.gov/gene/3795.


Additional examples of KHK mRNA sequences are readily available through publicly available databases, e.g., GenBank, UniProt, OMIM, and the Macaca genome project web site.


The term “KHK,” as used herein, also refers to naturally occurring DNA sequence variations of the KHK gene, such as a single nucleotide polymorphism (SNP) in the KHK gene. Exemplary SNPs in the KHK DNA sequence may be found through the dbSNP database available at www.ncbi.nlm.nih.gov/projects/SNP/.


Exemplary KHK nucleotide sequences may also be found in SEQ ID NOs:1-36. SEQ ID NOs:2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34 and 36 are the reverse complement sequences of SEQ ID NOs:1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33 and 35 respectively.


The entire contents of each of the foregoing GenBank Accession numbers and the Gene database numbers are incorporated herein by reference as of the date of filing this application.


As used herein, “target sequence” refers to a contiguous portion of the nucleotide sequence of an mRNA molecule formed during the transcription of a ketohexokinase gene, including mRNA that is a product of RNA processing of a primary transcription product. The target portion of the sequence will be at least long enough to serve as a substrate for iRNA-directed cleavage at or near that portion of the nucleotide sequence of an mRNA molecule formed during the transcription of a KHK gene. In one embodiment, the target sequence is within the protein coding region of KHK.


The target sequence may be from about 19-36 nucleotides in length, e.g., about 19-30 nucleotides in length. For example, the target sequence can be about 19-30 nucleotides, 19-30, 19-29, 19-28, 19-27, 19-26, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-30, 20-29, 20-28, 20-27, 20-26, 20-25, 20-24, 20-23, 20-22, 20-21, 21-30, 21-29, 21-28, 21-27, 21-26, 21-25, 21-24, 21-23, or 21-22 nucleotides in length. In some embodiments, the target sequence is about 19 to about 30 nucleotides in length. In other embodiments, the target sequence is about 19 to about 25 nucleotides in length. In still other embodiments, the target sequence is about 19 to about 23 nucleotides in length. In some embodiments, the target sequence is about 21 to about 23 nucleotides in length. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the invention.


As used herein, the term “strand comprising a sequence” refers to an oligonucleotide comprising a chain of nucleotides that is described by the sequence referred to using the standard nucleotide nomenclature.


“G,” “C,” “A,” “T,” and “U” each generally stand for a nucleotide that contains guanine, cytosine, adenine, thymidine, and uracil as a base, respectively. However, it will be understood that the term “ribonucleotide” or “nucleotide” can also refer to a modified nucleotide, as further detailed below, or a surrogate replacement moiety (see, e.g., Table 1). The skilled person is well aware that guanine, cytosine, adenine, and uracil can be replaced by other moieties without substantially altering the base pairing properties of an oligonucleotide comprising a nucleotide bearing such replacement moiety. For example, without limitation, a nucleotide comprising inosine as its base can base pair with nucleotides containing adenine, cytosine, or uracil. Hence, nucleotides containing uracil, guanine, or adenine can be replaced in the nucleotide sequences of dsRNA featured in the invention by a nucleotide containing, for example, inosine. In another example, adenine and cytosine anywhere in the oligonucleotide can be replaced with guanine and uracil, respectively to form G-U Wobble base pairing with the target mRNA. Sequences containing such replacement moieties are suitable for the compositions and methods featured in the invention.


The terms “iRNA”, “RNAi agent,” “iRNA agent,”, “RNA interference agent” as used interchangeably herein, refer to an agent that contains RNA as that term is defined herein, and which mediates the targeted cleavage of an RNA transcript via an RNA-induced silencing complex (RISC) pathway. iRNA directs the sequence-specific degradation of mRNA through a process known as RNA interference (RNAi). The iRNA modulates, e.g., inhibits, the expression of a ketohexokinase gene in a cell, e.g., a cell within a subject, such as a mammalian subject.


In one embodiment, an RNAi agent of the invention includes a single stranded RNA that interacts with a target RNA sequence, e.g., a ketohexokinase target mRNA sequence, to direct the cleavage of the target RNA. Without wishing to be bound by theory it is believed that long double stranded RNA introduced into cells is broken down into siRNA by a Type III endonuclease known as Dicer (Sharp et al. (2001) Genes Dev. 15:485). Dicer, a ribonuclease-III-like enzyme, processes the dsRNA into 19-23 base pair short interfering RNAs with characteristic two base 3′ overhangs (Bernstein, et al., (2001) Nature 409:363). The siRNAs are then incorporated into an RNA-induced silencing complex (RISC) where one or more helicases unwind the siRNA duplex, enabling the complementary antisense strand to guide target recognition (Nykanen, et al., (2001) Cell 107:309). Upon binding to the appropriate target mRNA, one or more endonucleases within the RISC cleave the target to induce silencing (Elbashir, et al., (2001) Genes Dev. 15:188). Thus, in one aspect the invention relates to a single stranded RNA (siRNA) generated within a cell and which promotes the formation of a RISC complex to effect silencing of the target gene, i.e., a ketohexokinase (KHK) gene. Accordingly, the term “siRNA” is also used herein to refer to an iRNA as described above.


In certain embodiments, the RNAi agent may be a single-stranded siRNA (ssRNAi) that is introduced into a cell or organism to inhibit a target mRNA. Single-stranded RNAi agents bind to the RISC endonuclease, Argonaute 2, which then cleaves the target mRNA. The single-stranded siRNAs are generally 15-30 nucleotides and are chemically modified. The design and testing of single-stranded siRNAs are described in U.S. Pat. No. 8,101,348 and in Lima et al., (2012) Cell 150:883-894, the entire contents of each of which are hereby incorporated herein by reference. Any of the antisense nucleotide sequences described herein may be used as a single-stranded siRNA as described herein or as chemically modified by the methods described in Lima et al., (2012) Cell 150:883-894.


In certain embodiments, an “iRNA” for use in the compositions, uses, and methods of the invention is a double stranded RNA and is referred to herein as a “double stranded RNA agent,” “double stranded RNA (dsRNA) molecule,” “dsRNA agent,” or “dsRNA”. The term “dsRNA”, refers to a complex of ribonucleic acid molecules, having a duplex structure comprising two anti-parallel and substantially complementary nucleic acid strands, referred to as having “sense” and “antisense” orientations with respect to a target RNA, i.e., a ketohexokinase (KHK) gene. In some embodiments of the invention, a double stranded RNA (dsRNA) triggers the degradation of a target RNA, e.g., an mRNA, through a post-transcriptional gene-silencing mechanism referred to herein as RNA interference or RNAi.


In general, the majority of nucleotides of each strand of a dsRNA molecule are ribonucleotides, but as described in detail herein, each or both strands can also include one or more non-ribonucleotides, e.g., a deoxyribonucleotide or a modified nucleotide. In addition, as used in this specification, an “iRNA” may include ribonucleotides with chemical modifications; an iRNA may include substantial modifications at multiple nucleotides.


As used herein, the term “modified nucleotide” refers to a nucleotide having, independently, a modified sugar moiety, a modified internucleotide linkage, or modified nucleobase, or any combination thereof. Thus, the term modified nucleotide encompasses substitutions, additions or removal of, e.g., a functional group or atom, to internucleoside linkages, sugar moieties, or nucleobases. The modifications suitable for use in the agents of the invention include all types of modifications disclosed herein or known in the art. Any such modifications, as used in a siRNA type molecule, are encompassed by “iRNA” or “RNAi agent” for the purposes of this specification and claims.


In certain embodiments of the instant disclosure, inclusion of a deoxy-nucleotide—which is acknowledged as a naturally occurring form of nucleotide—if present within a RNAi agent can be considered to constitute a modified nucleotide.


The duplex region may be of any length that permits specific degradation of a desired target RNA through a RISC pathway, and may range from about 19 to 36 base pairs in length, e.g., about 19-30 base pairs in length, for example, about 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, or 36 base pairs in length, such as about 19-30, 19-29, 19-28, 19-27, 19-26, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-30, 20-29, 20-28, 20-27, 20-26, 20-25, 20-24,20-23, 20-22, 20-21, 21-30, 21-29, 21-28, 21-27, 21-26, 21-25, 21-24, 21-23, or 21-22 base pairs in length. In certain embodiments, the duplex region is 19-21 base pairs in length, e.g., 21 base pairs in length. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the disclosure.


The two strands forming the duplex structure may be different portions of one larger RNA molecule, or they may be separate RNA molecules. Where the two strands are part of one larger molecule, and therefore are connected by an uninterrupted chain of nucleotides between the 3′-end of one strand and the 5′-end of the respective other strand forming the duplex structure, the connecting RNA chain is referred to as a “hairpin loop.” A hairpin loop can comprise at least one unpaired nucleotide. In some embodiments, the hairpin loop can comprise at least 2, 3, 4, 5, 6, 7, 8, 9, 10, 20, 23 or more unpaired nucleotides. In some embodiments, the hairpin loop can be 10 or fewer nucleotides. In some embodiments, the hairpin loop can be 8 or fewer unpaired nucleotides. In some embodiments, the hairpin loop can be 4-10 unpaired nucleotides. In some embodiments, the hairpin loop can be 4-8 nucleotides.


In certain embodiment, the two strands of double-stranded oligomeric compound can be linked together. The two strands can be linked to each other at both ends, or at one end only. By linking at one end is meant that 5′-end of first strand is linked to the 3′-end of the second strand or 3′-end of first strand is linked to 5′-end of the second strand. When the two strands are linked to each other at both ends, 5′-end of first strand is linked to 3′-end of second strand and 3′-end of first strand is linked to 5′-end of second strand. The two strands can be linked together by an oligonucleotide linker including, but not limited to, (N)n; wherein N is independently a modified or unmodified nucleotide and n is 3-23. In some embodiments, n is 3-10, e.g., 3, 4, 5, 6, 7, 8, 9, or 10. In some embodiments, the oligonucleotide linker is selected from the group consisting of GNRA, (G)4, (U)4, and (dT)4, wherein N is a modified or unmodified nucleotide and R is a modified or unmodified purine nucleotide. Some of the nucleotides in the linker can be involved in base-pair interactions with other nucleotides in the linker. The two strands can also be linked together by a non-nucleosidic linker, e.g. a linker described herein. It will be appreciated by one of skill in the art that any oligonucleotide chemical modifications or variations describe herein can be used in the oligonucleotide linker.


Hairpin and dumbbell type oligomeric compounds will have a duplex region equal to or at least 14, 15, 15, 16, 17, 18, 19, 29, 21, 22, 23, 24, or 25 nucleotide pairs. The duplex region can be equal to or less than 200, 100, or 50, in length. In some embodiments, ranges for the duplex region are 15-30, 17 to 23, 19 to 23, and 19 to 21 nucleotides pairs in length.


The hairpin oligomeric compounds can have a single strand overhang or terminal unpaired region, in some embodiments at the 3′, and in some embodiments on the antisense side of the hairpin. In some embodiments, the overhangs are 1-4, more generally 2-3 nucleotides in length. The hairpin oligomeric compounds that can induce RNA interference are also referred to as “shRNA” herein.


Where the two substantially complementary strands of a dsRNA are comprised by separate RNA molecules, those molecules need not be, but can be covalently connected. Where the two strands are connected covalently by means other than an uninterrupted chain of nucleotides between the 3′-end of one strand and the 5′-end of the respective other strand forming the duplex structure, the connecting structure is referred to as a “linker.” The RNA strands may have the same or a different number of nucleotides. The maximum number of base pairs is the number of nucleotides in the shortest strand of the dsRNA minus any overhangs that are present in the duplex. In addition to the duplex structure, an RNAi may comprise one or more nucleotide overhangs. In one embodiment of the RNAi agent, at least one strand comprises a 3′ overhang of at least 1 nucleotide. In another embodiment, at least one strand comprises a 3′ overhang of at least 2 nucleotides, e.g., 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, or 15 nucleotides. In other embodiments, at least one strand of the RNAi agent comprises a 5′ overhang of at least 1 nucleotide. In certain embodiments, at least one strand comprises a 5′ overhang of at least 2 nucleotides, e.g., 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, or 15 nucleotides. In still other embodiments, both the 3′ and the 5′ end of one strand of the RNAi agent comprise an overhang of at least 1 nucleotide.


In certain embodiments, an iRNA agent of the invention is a dsRNA, each strand of which comprises 19-23 nucleotides, that interacts with a target RNA sequence, e.g., a ketohexokinase (KHK) gene, to direct cleavage of the target RNA.


In some embodiments, an iRNA of the invention is a dsRNA of 24-30 nucleotides that interacts with a target RNA sequence, e.g., a KHK target mRNA sequence, to direct the cleavage of the target RNA.


As used herein, the term “nucleotide overhang” refers to at least one unpaired nucleotide that protrudes from the duplex structure of a double stranded iRNA. For example, when a 3′-end of one strand of a dsRNA extends beyond the 5′-end of the other strand, or vice versa, there is a nucleotide overhang. A dsRNA can comprise an overhang of at least one nucleotide; alternatively the overhang can comprise at least two nucleotides, at least three nucleotides, at least four nucleotides, at least five nucleotides or more. A nucleotide overhang can comprise or consist of a nucleotide/nucleoside analog, including a deoxynucleotide/nucleoside. The overhang(s) can be on the sense strand, the antisense strand, or any combination thereof. Furthermore, the nucleotide(s) of an overhang can be present on the 5′-end, 3′-end, or both ends of either an antisense or sense strand of a dsRNA.


In one embodiment of the dsRNA, at least one strand comprises a 3′ overhang of at least 1 nucleotide. In another embodiment, at least one strand comprises a 3′ overhang of at least 2 nucleotides, e.g., 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, or 15 nucleotides. In other embodiments, at least one strand of the RNAi agent comprises a 5′ overhang of at least 1 nucleotide. In certain embodiments, at least one strand comprises a 5′ overhang of at least 2 nucleotides, e.g., 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, or 15 nucleotides. In still other embodiments, both the 3′ and the 5′ end of one strand of the RNAi agent comprise an overhang of at least 1 nucleotide.


In one embodiment, the antisense strand of a dsRNA has a 1-10 nucleotide, e.g., a 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 nucleotide, overhang at the 3′-end or the 5′-end. In one embodiment, the sense strand of a dsRNA has a 1-10 nucleotide, e.g., a 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 nucleotide, overhang at the 3′-end or the 5′-end. In another embodiment, one or more of the nucleotides in the overhang is replaced with a nucleoside thiophosphate.


In certain embodiments, the antisense strand of a dsRNA has a 1-10 nucleotides, e.g., a 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 nucleotide, overhang at the 3′-end or the 5′-end. In certain embodiments, the overhang on the sense strand or the antisense strand, or both, can include extended lengths longer than 10 nucleotides, e.g., 1-30 nucleotides, 2-30 nucleotides, 10-30 nucleotides, 10-25 nucleotides, 10-20 nucleotides, or 10-15 nucleotides in length. In certain embodiments, an extended overhang is on the sense strand of the duplex. In certain embodiments, an extended overhang is present on the 3′ end of the sense strand of the duplex. In certain embodiments, an extended overhang is present on the 5′ end of the sense strand of the duplex. In certain embodiments, an extended overhang is on the antisense strand of the duplex. In certain embodiments, an extended overhang is present on the 3′end of the antisense strand of the duplex. In certain embodiments, an extended overhang is present on the 5′end of the antisense strand of the duplex. In certain embodiments, one or more of the nucleotides in the extended overhang is replaced with a nucleoside thiophosphate. In certain embodiments, the overhang includes a self-complementary portion such that the overhang is capable of forming a hairpin structure that is stable under physiological conditions.


“Blunt” or “blunt end” means that there are no unpaired nucleotides at that end of the double stranded RNA agent, i.e., no nucleotide overhang. A “blunt ended” double stranded RNA agent is double stranded over its entire length, i.e., no nucleotide overhang at either end of the molecule. The RNAi agents of the invention include RNAi agents with no nucleotide overhang at one end (i.e., agents with one overhang and one blunt end) or with no nucleotide overhangs at either end. Most often such a molecule will be double-stranded over its entire length.


The term “antisense strand” or “guide strand” refers to the strand of an iRNA, e.g., a dsRNA, which includes a region that is substantially complementary to a target sequence, e.g., a KHK mRNA.


As used herein, the term “region of complementarity” refers to the region on the antisense strand that is substantially complementary to a sequence, for example a target sequence, e.g., a ketohexokinase nucleotide sequence, as defined herein. Where the region of complementarity is not fully complementary to the target sequence, the mismatches can be in the internal or terminal regions of the molecule. Generally, the most tolerated mismatches are in the terminal regions, e.g., within 5, 4, or 3 nucleotides of the 5′- or 3′-end of the iRNA. In some embodiments, a double stranded RNA agent of the invention includes a nucleotide mismatch in the antisense strand. In some embodiments, the antisense strand of the double stranded RNA agent of the invention includes no more than 4 mismatches with the target mRNA, e.g., the antisense strand includes 4, 3, 2, 1, or 0 mismatches with the target mRNA. In some embodiments, the antisense strand double stranded RNA agent of the invention includes no more than 4 mismatches with the sense strand, e.g., the antisense strand includes 4, 3, 2, 1, or 0 mismatches with the sense strand. In some embodiments, a double stranded RNA agent of the invention includes a nucleotide mismatch in the sense strand. In some embodiments, the sense strand of the double stranded RNA agent of the invention includes no more than 4 mismatches with the antisense strand, e.g., the sense strand includes 4, 3, 2, 1, or 0 mismatches with the antisense strand. In some embodiments, the nucleotide mismatch is, for example, within 5, 4, 3 nucleotides from the 3′-end of the iRNA. In another embodiment, the nucleotide mismatch is, for example, in the 3′-terminal nucleotide of the iRNA agent. In some embodiments, the mismatch(s) is not in the seed region.


Thus, an RNAi agent as described herein can contain one or more mismatches to the target sequence. In one embodiment, a RNAi agent as described herein contains no more than 3 mismatches (i.e., 3, 2, 1, or 0 mismatches). In one embodiment, an RNAi agent as described herein contains no more than 2 mismatches. In one embodiment, an RNAi agent as described herein contains no more than 1 mismatch. In one embodiment, an RNAi agent as described herein contains 0 mismatches. In certain embodiments, if the antisense strand of the RNAi agent contains mismatches to the target sequence, the mismatch can optionally be restricted to be within the last 5 nucleotides from either the 5′- or 3′-end of the region of complementarity. For example, in such embodiments, for a 23 nucleotide RNAi agent, the strand which is complementary to a region of a KHK gene, generally does not contain any mismatch within the central 13 nucleotides. The methods described herein or methods known in the art can be used to determine whether an RNAi agent containing a mismatch to a target sequence is effective in inhibiting the expression of a KHK gene. Consideration of the efficacy of RNAi agents with mismatches in inhibiting expression of a KHK gene is important, especially if the particular region of complementarity in a KHK gene is known to have polymorphic sequence variation within the population.


The term “sense strand” or “passenger strand” as used herein, refers to the strand of an iRNA that includes a region that is substantially complementary to a region of the antisense strand as that term is defined herein.


As used herein, “substantially all of the nucleotides are modified” are largely but not wholly modified and can include not more than 5, 4, 3, 2, or 1 unmodified nucleotides.


As used herein, the term “cleavage region” refers to a region that is located immediately adjacent to the cleavage site. The cleavage site is the site on the target at which cleavage occurs. In some embodiments, the cleavage region comprises three bases on either end of, and immediately adjacent to, the cleavage site. In some embodiments, the cleavage region comprises two bases on either end of, and immediately adjacent to, the cleavage site. In some embodiments, the cleavage site specifically occurs at the site bound by nucleotides 10 and 11 of the antisense strand, and the cleavage region comprises nucleotides 11, 12 and 13.


As used herein, and unless otherwise indicated, the term “complementary,” when used to describe a first nucleotide sequence in relation to a second nucleotide sequence, refers to the ability of an oligonucleotide or polynucleotide comprising the first nucleotide sequence to hybridize and form a duplex structure under certain conditions with an oligonucleotide or polynucleotide comprising the second nucleotide sequence, as will be understood by the skilled person. Such conditions can, for example, be stringent conditions, where stringent conditions can include: 400 mM NaCl, 40 mM PIPES pH 6.4, 1 mM EDTA, 50° C. or 70° C. for 12-16 hours followed by washing (see, e.g., “Molecular Cloning: A Laboratory Manual, Sambrook, et al. (1989) Cold Spring Harbor Laboratory Press). Other conditions, such as physiologically relevant conditions as can be encountered inside an organism, can apply. The skilled person will be able to determine the set of conditions most appropriate for a test of complementarity of two sequences in accordance with the ultimate application of the hybridized nucleotides.


Complementary sequences within an iRNA, e.g., within a dsRNA as described herein, include base-pairing of the oligonucleotide or polynucleotide comprising a first nucleotide sequence to an oligonucleotide or polynucleotide comprising a second nucleotide sequence over the entire length of one or both nucleotide sequences. Such sequences can be referred to as “fully complementary” with respect to each other herein. However, where a first sequence is referred to as “substantially complementary” with respect to a second sequence herein, the two sequences can be fully complementary, or they can form one or more, but generally not more than 5, 4, 3, or 2 mismatched base pairs upon hybridization for a duplex up to 30 base pairs, while retaining the ability to hybridize under the conditions most relevant to their ultimate application, e.g., inhibition of gene expression, in vitro or in vivo. However, where two oligonucleotides are designed to form, upon hybridization, one or more single stranded overhangs, such overhangs shall not be regarded as mismatches with regard to the determination of complementarity. For example, a dsRNA comprising one oligonucleotide 21 nucleotides in length and another oligonucleotide 23 nucleotides in length, wherein the longer oligonucleotide comprises a sequence of 21 nucleotides that is fully complementary to the shorter oligonucleotide, can yet be referred to as “fully complementary” for the purposes described herein.


“Complementary” sequences, as used herein, can also include, or be formed entirely from, non-Watson-Crick base pairs or base pairs formed from non-natural and modified nucleotides, in so far as the above requirements with respect to their ability to hybridize are fulfilled. Such non-Watson-Crick base pairs include, but are not limited to, G:U Wobble or Hoogsteen base pairing.


The terms “complementary,” “fully complementary” and “substantially complementary” herein can be used with respect to the base matching between the sense strand and the antisense strand of a dsRNA, or between two oligonucleotides or polynucleotides, such as the antisense strand of a double stranded RNA agent and a target sequence, as will be understood from the context of their use.


As used herein, a polynucleotide that is “substantially complementary to at least part of” a messenger RNA (mRNA) refers to a polynucleotide that is substantially complementary to a contiguous portion of the mRNA of interest (e.g., an mRNA encoding a ketohexokinase gene). For example, a polynucleotide is complementary to at least a part of a ketohexokinase mRNA if the sequence is substantially complementary to a non-interrupted portion of an mRNA encoding a ketohexokinase gene.


Accordingly, in some embodiments, the antisense polynucleotides disclosed herein are fully complementary to the target KHK sequence.


In other embodiments, the antisense polynucleotides disclosed herein are substantially complementary to the target KHK sequence and comprise a contiguous nucleotide sequence which is at least 80% complementary over its entire length to the equivalent region of the nucleotide sequence of any one of SEQ ID NOs:1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33 or 35, or a fragment of any one of SEQ ID NOs:1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33 or 35, such as about 85%, about 90%, about 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, or about 99% complementary.


In some embodiments, the antisense polynucleotides disclosed herein are substantially complementary to a fragment of a target KHK sequence and comprise a contiguous nucleotide sequence which is at least 80% complementary over its entire length to a fragment of SEQ ID NO: 1 selected from the group of nucleotides 943-965; 788-810; 734-756; 1016-1038; 1013-1035; 1207-1229; 1149-1171; 574-596; 1207-1229 or 828-850 of SEQ ID NO: 1, such as about 85%, about 90%, about 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, or about 99% complementary.


In other embodiments, the antisense polynucleotides disclosed herein are substantially complementary to the target KHK sequence and comprise a contiguous nucleotide sequence which is at least about 80% complementary over its entire length to any one of the sense strand nucleotide sequences in any one of any one of Tables 2-5, or a fragment of any one of the sense strand nucleotide sequences in any one of Tables 2-5, such as about 85%, about 90%, about 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, about 99%, or 100% complementary.


In one embodiment, an RNAi agent of the disclosure includes a sense strand that is substantially complementary to an antisense polynucleotide which, in turn, is the same as a target KHK sequence, and wherein the sense strand polynucleotide comprises a contiguous nucleotide sequence which is at least about 80% complementary over its entire length to the equivalent region of the nucleotide sequence of SEQ ID NOs: 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34 or 36, or a fragment of any one of SEQ ID NOs:2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34 or 36, such as about 85%, about 90%, about 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, about 99%, or 100% complementary.


In some embodiments, an iRNA of the invention includes a sense strand that is substantially complementary to an antisense polynucleotide which, in turn, is complementary to a target ketohexokinase sequence, and wherein the sense strand polynucleotide comprises a contiguous nucleotide sequence which is at least about 80% complementary over its entire length to any one of the antisense strand nucleotide sequences in any one of any one of Tables 2-5, or a fragment of any one of the antisense strand nucleotide sequences in any one of Tables 2-5, such as about 85%, about 90%, about 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, about 99%, or 100% complementary


In certain embodiments, the sense and antisense strands are selected from any one of duplexes AD-252498.1, AD-252339.1, AD-252285.1, AD-252531.1, AD-254265.1, AD-254403.1, AD-252627.1, AD-252146.1, AD-252666.1 and AD-252379.1.


In some embodiments, the double-stranded region of a double-stranded iRNA agent is equal to or at least, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 23, 24, 25, 26, 27, 28, 29, 30 or more nucleotide pairs in length.


In some embodiments, the antisense strand of a double-stranded iRNA agent is equal to or at least 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides in length.


In some embodiments, the sense strand of a double-stranded iRNA agent is equal to or at least 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides in length.


In one embodiment, the sense and antisense strands of the double-stranded iRNA agent are each 15 to 30 nucleotides in length.


In one embodiment, the sense and antisense strands of the double-stranded iRNA agent are each 19 to 25 nucleotides in length.


In one embodiment, the sense and antisense strands of the double-stranded iRNA agent are each 21 to 23 nucleotides in length.


In one embodiment, the sense strand of the iRNA agent is 21-nucleotides in length, and the antisense strand is 23-nucleotides in length, wherein the strands form a double-stranded region of 21 consecutive base pairs having a 2-nucleotide long single stranded overhangs at the 3-end.


In some embodiments, the majority of nucleotides of each strand are ribonucleotides, but as described in detail herein, each or both strands can also include one or more non-ribonucleotides, e.g., a deoxyribonucleotide and/or a modified nucleotide. In addition, an “iRNA” may include ribonucleotides with chemical modifications. Such modifications may include all types of modifications disclosed herein or known in the art. Any such modifications, as used in an iRNA molecule, are encompassed by “iRNA” for the purposes of this specification and claims.


In certain embodiments of the instant disclosure, inclusion of a deoxy-nucleotide if present within an RNAi agent can be considered to constitute a modified nucleotide.


In an aspect of the invention, an agent for use in the methods and compositions of the invention is a single-stranded antisense oligonucleotide molecule that inhibits a target mRNA via an antisense inhibition mechanism. The single-stranded antisense oligonucleotide molecule is complementary to a sequence within the target mRNA. The single-stranded antisense oligonucleotides can inhibit translation in a stoichiometric manner by base pairing to the mRNA and physically obstructing the translation machinery, see Dias, N. et al., (2002) Mol Cancer Ther 1:347-355. The single-stranded antisense oligonucleotide molecule may be about 14 to about 30 nucleotides in length and have a sequence that is complementary to a target sequence. For example, the single-stranded antisense oligonucleotide molecule may comprise a sequence that is at least about 14, 15, 16, 17, 18, 19, 20, or more contiguous nucleotides from any one of the antisense sequences described herein.


In one embodiment, at least partial suppression of the expression of a KHK gene, is assessed by a reduction of the amount of KHK mRNA which can be isolated from or detected in a first cell or group of cells in which a KHK gene is transcribed and which has or have been treated such that the expression of a KHK gene is inhibited, as compared to a second cell or group of cells substantially identical to the first cell or group of cells but which has or have not been so treated (control cells). The degree of inhibition may be expressed in terms of:









(

mRNA


in


control


cells

)

-

(

mRNA


in


treated


cells

)



(

mRNA


in


control


cells

)



100

%




The phrase “contacting a cell with an iRNA,” such as a dsRNA, as used herein, includes contacting a cell by any possible means. Contacting a cell with an iRNA includes contacting a cell in vitro with the iRNA or contacting a cell in vivo with the iRNA. The contacting may be done directly or indirectly. Thus, for example, the iRNA may be put into physical contact with the cell by the individual performing the method, or alternatively, the iRNA may be put into a situation that will permit or cause it to subsequently come into contact with the cell.


Contacting a cell in vitro may be done, for example, by incubating the cell with the iRNA. Contacting a cell in vivo may be done, for example, by injecting the iRNA into or near the tissue where the cell is located, or by injecting the iRNA into another area, e.g., the bloodstream or the subcutaneous space, such that the agent will subsequently reach the tissue where the cell to be contacted is located. For example, the iRNA may contain or be coupled to a ligand, e.g., GalNAc, that directs the iRNA to a site of interest, e.g., the liver. Combinations of in vitro and in vivo methods of contacting are also possible. For example, a cell may also be contacted in vitro with an iRNA and subsequently transplanted into a subject.


In certain embodiments, contacting a cell with an iRNA includes “introducing” or “delivering the iRNA into the cell” by facilitating or effecting uptake or absorption into the cell. Absorption or uptake of an iRNA can occur through unaided diffusion or active cellular processes, or by auxiliary agents or devices. Introducing an iRNA into a cell may be in vitro or in vivo. For example, for in vivo introduction, iRNA can be injected into a tissue site or administered systemically. In vitro introduction into a cell includes methods known in the art such as electroporation and lipofection. Further approaches are described herein below or are known in the art.


The term “lipid nanoparticle” or “LNP” is a vesicle comprising a lipid layer encapsulating a pharmaceutically active molecule, such as a nucleic acid molecule, e.g., an iRNA or a plasmid from which an iRNA is transcribed. LNPs are described in, for example, U.S. Pat. Nos. 6,858,225, 6,815,432, 8,158,601, and 8,058,069, the entire contents of which are hereby incorporated herein by reference.


As used herein, a “subject” is an animal, such as a mammal, including a primate (such as a human, a non-human primate, e.g., a monkey, and a chimpanzee), a non-primate (such as a cow, a pig, a horse, a goat, a rabbit, a sheep, a hamster, a guinea pig, a cat, a dog, a rat, or a mouse), or a bird that expresses the target gene, either endogenously or heterologously. In an embodiment, the subject is a human, such as a human being treated or assessed for a disease or disorder that would benefit from reduction in KHK expression; a human at risk for a disease or disorder that would benefit from reduction in KHK expression; a human having a disease or disorder that would benefit from reduction in KHK expression; or human being treated for a disease or disorder that would benefit from reduction in KHK expression as described herein. In some embodiments, the subject is a female human. In other embodiments, the subject is a male human. In one embodiment, the subject is an adult subject. In another embodiment, the subject is a pediatric subject.


As used herein, the terms “treating” or “treatment” refer to a beneficial or desired result, such as reducing at least one sign or symptom of a KHK-associated disorder in a subject. Treatment also includes a reduction of one or more sign or symptoms associated with unwanted KHK expression; diminishing the extent of unwanted KHK activation or stabilization; amelioration or palliation of unwanted KHK activation or stabilization. “Treatment” can also mean prolonging survival as compared to expected survival in the absence of treatment.


The term “lower” in the context of the level of KHK in a subject or a disease marker or symptom refers to a statistically significant decrease in such level. The decrease can be, for example, at least 10%, 15%, 20%, 25%, 30%, %, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or more. In certain embodiments, a decrease is at least 20%. In certain embodiments, the decrease is at least 50% in a disease marker, e.g., protein or gene expression level. “Lower” in the context of the level of KHK in a subject is decreased to a level accepted as within the range of normal for an individual without such disorder. In certain embodiments, the expression of the target is normalized, i.e., decreased towards or to a level accepted as within the range of normal for an individual without such disorder, e.g., normalization of body weight, blood pressure, or a serum lipid level. As used here, “lower” in a subject can refer to lowering of gene expression or protein production in a cell in a subject does not require lowering of expression in all cells or tissues of a subject. For example, as used herein, lowering in a subject can include lowering of gene expression or protein production in the liver of a subject.


The term “lower” can also be used in association with normalizing a symptom of a disease or condition, i.e. decreasing the difference between a level in a subject suffering from a KHK-associated disease towards or to a level in a normal subject not suffering from a KHK-associated disease. For example, if a subject with a normal weight of 70 kg weighs 90 kg prior to treatment (20 kg overweight) and 80 kg after treatment (10 kg overweight), the subject's weight is lowered towards a normal weight by 50% (10/20×100%). Similarly, if the HDL level of a woman is increased from 50 mg/dL (poor) to 57 mg/dL, with a normal level being 60 mg/dL, the difference between the prior level of the subject and the normal level is decreased by 70% (difference of 10 mg/dL between subject level and normal is decreased by 7 mg/dL, 7/10×100%). As used herein, if a disease is associated with an elevated value for a symptom, “normal” is considered to be the upper limit of normal. If a disease is associated with a decreased value for a symptom, “normal” is considered to be the lower limit of normal.


As used herein, “prevention” or “preventing,” when used in reference to a disease, disorder or condition thereof, that would benefit from a reduction in expression of a KHK gene or production of KHK protein, refers to a reduction in the likelihood that a subject will develop a symptom associated with such a disease, disorder, or condition, e.g., a sign or symptom of KHK gene expression or KHK activity and increased fructose metabolism. Without being bound by mechanism, it is known that fructose phosphorylation catalyzed by KHK to form fructose-1-phosphate is not regulated by feedback inhibition which can result in depletion of ATP and intracellular phosphate, an increase AMP levels, which results in the production of uric acid. Further, the fructose-1-phosphate is metabolized to glyceraldehyde which feeds into the citric acid cycle increasing the production of acetyl Co-A stimulating fatty acid synthesis. Diseases and conditions associated with elevated uric acid and fatty acid synthesis include, e.g., liver disease (e.g., fatty liver, steatohepatitis including non-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance not related to immune response to insulin, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, disease of lipid deposition or dysfunction (e.g., adipocyte dysfunction, visceral adipose deposition, obesity), disease of elevated uric acid (e.g., hyperuricemia, gout), and eating disorders such as excessive sugar craving. The failure to develop a disease, disorder or condition, or the reduction in the development of a symptom or comorbidity associated with such a disease, disorder or condition (e.g., by at least about 10% on a clinically accepted scale for that disease or disorder), or the exhibition of delayed signs or symptoms or disease progression by days, weeks, months or years is considered effective prevention.


As used herein, the term “ketohexokinase disease” or “KHK-associated disease,” is a disease or disorder that is caused by, or associated with, KHK gene expression or KHK protein production. The term “KHK-associated disease” includes a disease, disorder or condition that would benefit from a decrease in KHK gene expression, replication, or protein activity. Non-limiting examples of KHK-associated diseases include, for example, liver disease (e.g., fatty liver, steatohepatitis including non-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance not related to immune response to insulin, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, disease of lipid deposition or dysfunction (e.g., adipocyte dysfunction, visceral adipose deposition, obesity), disease of elevated uric acid (e.g., hyperuricemia, gout), and eating disorders such as excessive sugar craving. Further details regarding signs and symptoms of the various diseases or conditions are provided herein and are well known in the art.


In certain embodiments, a KHK-associated disease is associated with elevated uric acid (e.g. hyperuricemia, gout).


In certain embodiments, a KHK-associated disease is associated with elevated lipid levels (e.g., fatty liver, steatohepatitis including non-alcoholic steatohepatitis (NASH), dyslipidemia).


“Therapeutically effective amount,” as used herein, is intended to include the amount of an RNAi agent that, when administered to a subject having a KHK-associated disease, is sufficient to effect treatment of the disease (e.g., by diminishing, ameliorating, or maintaining the existing disease or one or more symptoms of disease). The “therapeutically effective amount” may vary depending on the RNAi agent, how the agent is administered, the disease and its severity and the history, age, weight, family history, genetic makeup, the types of preceding or concomitant treatments, if any, and other individual characteristics of the subject to be treated.


“Prophylactically effective amount,” as used herein, is intended to include the amount of an RNAi agent that, when administered to a subject having a KHK-associated disorder, is sufficient to prevent or ameliorate the disease or one or more symptoms of the disease. Ameliorating the disease includes slowing the course of the disease or reducing the severity of later-developing disease. The “prophylactically effective amount” may vary depending on the RNAi agent, how the agent is administered, the degree of risk of disease, and the history, age, weight, family history, genetic makeup, the types of preceding or concomitant treatments, if any, and other individual characteristics of the patient to be treated.


A “therapeutically-effective amount” or “prophylactically effective amount” also includes an amount of an RNAi agent that produces some desired effect at a reasonable benefit/risk ratio applicable to any treatment. The iRNA employed in the methods of the present invention may be administered in a sufficient amount to produce a reasonable benefit/risk ratio applicable to such treatment.


The phrase “pharmaceutically acceptable” is employed herein to refer to those compounds, materials, compositions, or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human subjects and animal subjects without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.


The phrase “pharmaceutically-acceptable carrier” as used herein means a pharmaceutically-acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, excipient, manufacturing aid (e.g., lubricant, talc magnesium, calcium or zinc stearate, or steric acid), or solvent encapsulating material, involved in carrying or transporting the subject compound from one organ, or portion of the body, to another organ, or portion of the body. Each carrier must be “acceptable” in the sense of being compatible with the other ingredients of the formulation and not injurious to the subject being treated. Such carriers are known in the art. Pharmaceutically acceptable carriers include carriers for administration by injection.


The term “sample,” as used herein, includes a collection of similar fluids, cells, or tissues isolated from a subject, as well as fluids, cells, or tissues present within a subject. Examples of biological fluids include blood, serum and serosal fluids, plasma, cerebrospinal fluid, ocular fluids, lymph, urine, saliva, and the like. Tissue samples may include samples from tissues, organs, or localized regions. For example, samples may be derived from particular organs, parts of organs, or fluids or cells within those organs. In certain embodiments, samples may be derived from the liver (e.g., whole liver or certain segments of liver or certain types of cells in the liver, such as, e.g., hepatocytes). In some embodiments, a “sample derived from a subject” refers to urine obtained from the subject. A “sample derived from a subject” can refer to blood or blood derived serum or plasma from the subject.


II. iRNAs of the Invention

The present invention provides iRNAs which inhibit the expression of a ketohexokinase gene. In some embodiments, the iRNA includes double stranded ribonucleic acid (dsRNA) molecules for inhibiting the expression of a KHK gene in a cell, such as a cell within a subject, e.g., a mammal, such as a human susceptible to developing a ketohexokinase-associated disorder. The dsRNAi agent includes an antisense strand having a region of complementarity which is complementary to at least a part of an mRNA formed in the expression of a KHK gene. The region of complementarity is about 19-30 nucleotides in length (e.g., about 30, 29, 28, 27, 26, 25, 24, 23, 22, 21, 20, or 19 nucleotides in length). Upon contact with a cell expressing the KHK gene, the iRNA inhibits the expression of the KHK gene (e.g., a human, a primate, a non-primate, or a rat KHK gene) by at least about 50% as assayed by, for example, a PCR or branched DNA (bDNA)-based method, or by a protein-based method, such as by immunofluorescence analysis, using, for example, western blotting or flow cytometric techniques. In some embodiments, inhibition of expression is determined by the qPCR method provided in the examples herein with the siRNA at, e.g., a 10 nM concentration, in an appropriate organism cell line provided therein. In some embodiments, inhibition of expression in vivo is determined by knockdown of the human gene in a rodent expressing the human gene, e.g., a mouse or an AAV-infected mouse expressing the human target gene, e.g., when administered as single dose, e.g., at 3 mg/kg at the nadir of RNA expression.


A dsRNA includes two RNA strands that are complementary and hybridize to form a duplex structure under conditions in which the dsRNA will be used. One strand of a dsRNA (the antisense strand) includes a region of complementarity that is substantially complementary, and generally fully complementary, to a target sequence. The target sequence can be derived from the sequence of an mRNA formed during the expression of a KHK gene. The other strand (the sense strand) includes a region that is complementary to the antisense strand, such that the two strands hybridize and form a duplex structure when combined under suitable conditions. As described elsewhere herein and as known in the art, the complementary sequences of a dsRNA can also be contained as self-complementary regions of a single nucleic acid molecule, as opposed to being on separate oligonucleotides.


Generally, the duplex structure is 15 to 30 base pairs in length, e.g., 15-29, 15-28, 15-27, 15-26, 15-25, 15-24, 15-23, 15-22, 15-21, 15-20, 15-19, 15-18, 15-17, 18-30, 18-29, 18-28, 18-27, 18-26, 18-25, 18-24, 18-23, 18-22, 18-21, 18-20, 19-30, 19-29, 19-28, 19-27, 19-26, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-30, 20-29, 20-28, 20-27, 20-26, 20-25, 20-24,20-23, 20-22, 20-21, 21-30, 21-29, 21-28, 21-27, 21-26, 21-25, 21-24, 21-23, or 21-22 base pairs in length. In certain embodiments, the duplex structure is 18 to 25 base pairs in length, e.g., 18-25, 18-24, 18-23, 18-22, 18-21, 18-20, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-25, 20-24,20-23, 20-22, 20-21, 21-25, 21-24, 21-23, 21-22, 22-25, 22-24, 22-23, 23-25, 23-24 or 24-25 base pairs in length, for example, 19-21 basepairs in length. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the disclosure.


Similarly, the region of complementarity to the target sequence is 15 to 30 nucleotides in length, e.g., 15-29, 15-28, 15-27, 15-26, 15-25, 15-24, 15-23, 15-22, 15-21, 15-20, 15-19, 15-18, 15-17, 18-30, 18-29, 18-28, 18-27, 18-26, 18-25, 18-24, 18-23, 18-22, 18-21, 18-20, 19-30, 19-29, 19-28, 19-27, 19-26, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-30, 20-29, 20-28, 20-27, 20-26, 20-25, 20-24,20-23, 20-22, 20-21, 21-30, 21-29, 21-28, 21-27, 21-26, 21-25, 21-24, 21-23, or 21-22 nucleotides in length, for example 19-23 nucleotides in length or 21-23 nucleotides in length. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the disclosure.


In some embodiments, the duplex structure is 19 to 30 base pairs in length. Similarly, the region of complementarity to the target sequence is 19 to 30 nucleotides in length.


In some embodiments, the dsRNA is about 19 to about 23 nucleotides in length, or about 25 to about 30 nucleotides in length. In general, the dsRNA is long enough to serve as a substrate for the Dicer enzyme. For example, it is well-known in the art that dsRNAs longer than about 21-23 nucleotides in length may serve as substrates for Dicer. As the ordinarily skilled person will also recognize, the region of an RNA targeted for cleavage will most often be part of a larger RNA molecule, often an mRNA molecule. Where relevant, a “part” of an mRNA target is a contiguous sequence of an mRNA target of sufficient length to allow it to be a substrate for RNAi-directed cleavage (i.e., cleavage through a RISC pathway).


One of skill in the art will also recognize that the duplex region is a primary functional portion of a dsRNA, e.g., a duplex region of about 19 to about 30 base pairs, e.g., about 19-30, 19-29, 19-28, 19-27, 19-26, 19-25, 19-24, 19-23, 19-22, 19-21, 19-20, 20-30, 20-29, 20-28, 20-27, 20-26, 20-25, 20-24,20-23, 20-22, 20-21, 21-30, 21-29, 21-28, 21-27, 21-26, 21-25, 21-24, 21-23, or 21-22 base pairs. Thus, in one embodiment, to the extent that it becomes processed to a functional duplex, of e.g., 15-30 base pairs, that targets a desired RNA for cleavage, an RNA molecule or complex of RNA molecules having a duplex region greater than 30 base pairs is a dsRNA. Thus, an ordinarily skilled artisan will recognize that in one embodiment, a miRNA is a dsRNA. In another embodiment, a dsRNA is not a naturally occurring miRNA. In another embodiment, an iRNA agent useful to target ketohexokinase gene expression is not generated in the target cell by cleavage of a larger dsRNA.


A dsRNA as described herein can further include one or more single-stranded nucleotide overhangs e.g., 1-4, 2-4, 1-3, 2-3, 1, 2, 3, or 4 nucleotides. dsRNAs having at least one nucleotide overhang can have superior inhibitory properties relative to their blunt-ended counterparts. A nucleotide overhang can comprise or consist of a nucleotide/nucleoside analog, including a deoxynucleotide/nucleoside. The overhang(s) can be on the sense strand, the antisense strand, or any combination thereof. Furthermore, the nucleotide(s) of an overhang can be present on the 5′-end, 3′-end, or both ends of an antisense or sense strand of a dsRNA.


A dsRNA can be synthesized by standard methods known in the art. Double stranded RNAi compounds of the invention may be prepared using a two-step procedure. First, the individual strands of the double stranded RNA molecule are prepared separately. Then, the component strands are annealed. The individual strands of the siRNA compound can be prepared using solution-phase or solid-phase organic synthesis or both. Organic synthesis offers the advantage that the oligonucleotide strands comprising unnatural or modified nucleotides can be easily prepared. Similarly, single-stranded oligonucleotides of the invention can be prepared using solution-phase or solid-phase organic synthesis or both.


iRNA compounds of the invention may be prepared using a two-step procedure. First, the individual strands of the double stranded RNA molecule are prepared separately. Then, the component strands are annealed. The individual strands of the siRNA compound can be prepared using solution-phase or solid-phase organic synthesis or both. Organic synthesis offers the advantage that the oligonucleotide strands comprising unnatural or modified nucleotides can be easily prepared. Single-stranded oligonucleotides of the invention can be prepared using solution-phase or solid-phase organic synthesis or both.


An siRNA can be produced, e.g., in bulk, by a variety of methods. Exemplary methods include: organic synthesis and RNA cleavage, e.g., in vitro cleavage.


An siRNA can be made by separately synthesizing a single stranded RNA molecule, or each respective strand of a double-stranded RNA molecule, after which the component strands can then be annealed.


A large bioreactor, e.g., the OligoPilot II from Pharmacia Biotec AB (Uppsala Sweden), can be used to produce a large amount of a particular RNA strand for a given siRNA. The OligoPilotII reactor can efficiently couple a nucleotide using only a 1.5 molar excess of a phosphoramidite nucleotide. To make an RNA strand, ribonucleotides amidites are used. Standard cycles of monomer addition can be used to synthesize the 21 to 23 nucleotide strand for the siRNA. Typically, the two complementary strands are produced separately and then annealed, e.g., after release from the solid support and deprotection.


Organic synthesis can be used to produce a discrete siRNA species. The complementary of the species to a KHK gene can be precisely specified. For example, the species may be complementary to a region that includes a polymorphism, e.g., a single nucleotide polymorphism. Further the location of the polymorphism can be precisely defined. In some embodiments, the polymorphism is located in an internal region, e.g., at least 4, 5, 7, or 9 nucleotides from one or both of the termini.


In one embodiment, RNA generated is carefully purified to remove endsiRNA is cleaved in vitro into siRNAs, for example, using a Dicer or comparable RNAse III-based activity. For example, the dsiRNA can be incubated in an in vitro extract from Drosophila or using purified components, e.g., a purified RNAse or RISC complex (RNA-induced silencing complex). See, e.g., Ketting et al. Genes Dev 2001 Oct. 15; 15(20):2654-9 and Hammond Science 2001 Aug. 10; 293(5532):1146-50.


dsiRNA cleavage generally produces a plurality of siRNA species, each being a particular 21 to 23 nt fragment of a source dsiRNA molecule. For example, siRNAs that include sequences complementary to overlapping regions and adjacent regions of a source dsiRNA molecule may be present.


Regardless of the method of synthesis, the siRNA preparation can be prepared in a solution (e.g., an aqueous and/or organic solution) that is appropriate for formulation. For example, the siRNA preparation can be precipitated and redissolved in pure double-distilled water, and lyophilized. The dried siRNA can then be resuspended in a solution appropriate for the intended formulation process.


In an aspect, a dsRNA of the invention includes at least two nucleotide sequences, a sense sequence and an anti-sense sequence. The sense strand is selected from the group of sequences provided in any one of Tables 2-5, and the corresponding antisense strand of the sense strand is selected from the group of sequences of any one of Tables 2-5. In this aspect, one of the two sequences is complementary to the other of the two sequences, with one of the sequences being substantially complementary to a sequence of an mRNA generated in the expression of a ketohexokinase gene. As such, in this aspect, a dsRNA will include two oligonucleotides, where one oligonucleotide is described as the sense strand in any one of Tables 2-5, and the second oligonucleotide is described as the corresponding antisense strand of the sense strand in any one of Tables 2-5.


In certain embodiments, the substantially complementary sequences of the dsRNA are contained on separate oligonucleotides. In other embodiments, the substantially complementary sequences of the dsRNA are contained on a single oligonucleotide.


In certain embodiments, the sense or antisense strand is selected from the sense or antisense strand of any one of duplexes AD-252498.1, AD-252339.1, AD-252285.1, AD-252531.1, AD-254265.1, AD-254403.1, AD-252627.1, AD-252146.1, AD-252666.1 and AD-252379.1.


It will be understood that, although the sequences in Tables 2 and 4 are not described as modified or conjugated sequences, the RNA of the iRNA of the invention e.g., a dsRNA of the invention, may comprise any one of the sequences set forth in any one of Tables 2-5 that is un-modified, un-conjugated, or modified or conjugated differently than described therein. In other words, the invention encompasses dsRNA of Tables 2-5 which are un-modified, un-conjugated, modified, or conjugated, as described herein.


The skilled person is well aware that dsRNAs having a duplex structure of about 20 to 23 base pairs, e.g., 21, base pairs have been hailed as particularly effective in inducing RNA interference (Elbashir et al., EMBO 2001, 20:6877-6888). However, others have found that shorter or longer RNA duplex structures can also be effective (Chu and Rana (2007) RNA 14:1714-1719; Kim et al. (2005) Nat Biotech 23:222-226). In the embodiments described above, by virtue of the nature of the oligonucleotide sequences provided in any one of Tables 2-5, dsRNAs described herein can include at least one strand of a length of minimally 21 nucleotides. It can be reasonably expected that shorter duplexes having any one of the sequences in any one of Tables 2-5 minus only a few nucleotides on one or both ends can be similarly effective as compared to the dsRNAs described above. Hence, dsRNAs having a sequence of at least 19, 20, or more contiguous nucleotides derived from any one of the sequences of any one of Tables 2-5, and differing in their ability to inhibit the expression of a ketohexokinase gene by not more than about 5, 10, 15, 20, 25, or 30% inhibition from a dsRNA comprising the full sequence, are contemplated to be within the scope of the present invention.


In addition, the RNAs provided in Tables 2-5 identify a site(s) in a ketohexokinase transcript that is susceptible to RISC-mediated cleavage. As such, the present invention further features iRNAs that target within one of these sites. As used herein, an iRNA is said to target within a particular site of an RNA transcript if the iRNA promotes cleavage of the transcript anywhere within that particular site. Such an iRNA will generally include at least about 19 contiguous nucleotides from any one of the sequences provided in any one of Tables 2-5 coupled to additional nucleotide sequences taken from the region contiguous to the selected sequence in a ketohexokinase gene.


An RNAi agent as described herein can contain one or more mismatches to the target sequence. In one embodiment, an RNAi agent as described herein contains no more than 3 mismatches (i.e., 3, 2, 1, or 0 mismatches). In one embodiment, an RNAi agent as described herein contains no more than 2 mismatches. In one embodiment, an RNAi agent as described herein contains no more than 1 mismatch. In one embodiment, an RNAi agent as described herein contains 0 mismatches. In certain embodiments, if the antisense strand of the RNAi agent contains mismatches to the target sequence, the mismatch can optionally be restricted to be within the last 5 nucleotides from either the 5′- or 3′-end of the region of complementarity. For example, in such embodiments, for a 23 nucleotide RNAi agent, the strand which is complementary to a region of a KHK gene generally does not contain any mismatch within the central 13 nucleotides. The methods described herein or methods known in the art can be used to determine whether an RNAi agent containing a mismatch to a target sequence is effective in inhibiting the expression of a KHK gene. Consideration of the efficacy of RNAi agents with mismatches in inhibiting expression of a KHK gene is important, especially if the particular region of complementarity in a KHK gene is known to have polymorphic sequence variation within the population.


III. Modified iRNAs of the Invention

In certain embodiments, the RNA of the iRNA of the invention e.g., a dsRNA, is un-modified, and does not comprise, e.g., chemical modifications or conjugations known in the art and described herein. In other embodiments, the RNA of an iRNA of the invention, e.g., a dsRNA, is chemically modified to enhance stability or other beneficial characteristics. In certain embodiments of the invention, substantially all of the nucleotides of an iRNA of the invention are modified. In other embodiments of the invention, all of the nucleotides of an iRNA or substantially all of the nucleotides of an iRNA are modified, i.e., not more than 5, 4, 3, 2, or 1 unmodified nucleotides are present in a strand of the iRNA.


The nucleic acids featured in the invention can be synthesized or modified by methods well established in the art, such as those described in “Current protocols in nucleic acid chemistry,” Beaucage, S. L. et al. (Edrs.), John Wiley & Sons, Inc., New York, NY, USA, which is hereby incorporated herein by reference. Modifications include, for example, end modifications, e.g., 5′-end modifications (phosphorylation, conjugation, inverted linkages) or 3′-end modifications (conjugation, DNA nucleotides, inverted linkages, etc.); base modifications, e.g., replacement with stabilizing bases, destabilizing bases, or bases that base pair with an expanded repertoire of partners, removal of bases (abasic nucleotides), or conjugated bases; sugar modifications (e.g., at the 2′-position or 4′-position) or replacement of the sugar; or backbone modifications, including modification or replacement of the phosphodiester linkages. Specific examples of iRNA compounds useful in the embodiments described herein include, but are not limited to RNAs containing modified backbones or no natural internucleoside linkages. RNAs having modified backbones include, among others, those that do not have a phosphorus atom in the backbone. For the purposes of this specification, and as sometimes referenced in the art, modified RNAs that do not have a phosphorus atom in their internucleoside backbone can also be considered to be oligonucleosides. In some embodiments, a modified iRNA will have a phosphorus atom in its internucleoside backbone.


Modified RNA backbones include, for example, phosphorothioates, chiral phosphorothioates, phosphorodithioates, phosphotriesters, aminoalkylphosphotriesters, methyl and other alkyl phosphonates including 3-alkylene phosphonates and chiral phosphonates, phosphinates, phosphoramidates including 3′-amino phosphoramidate and aminoalkylphosphoramidates, thionophosphoramidates, thionoalkylphosphonates, thionoalkylphosphotriesters, and boranophosphates having normal 3′-5′ linkages, 2′-5′-linked analogs of these, and those having inverted polarity wherein the adjacent pairs of nucleoside units are linked 3′-5′ to 5′-3′ or 2′-5′ to 5′-2′. Various salts, mixed salts and free acid forms are also included. In some embodiments of the invention, the dsRNA agents of the invention are in a free acid form. In other embodiments of the invention, the dsRNA agents of the invention are in a salt form. In one embodiment, the dsRNA agents of the invention are in a sodium salt form. In certain embodiments, when the dsRNA agents of the invention are in the sodium salt form, sodium ions are present in the agent as counterions for substantially all of the phosphodiester and/or phosphorothiotate groups present in the agent. Agents in which substantially all of the phosphodiester and/or phosphorothioate linkages have a sodium counterion include not more than 5, 4, 3, 2, or 1 phosphodiester and/or phosphorothioate linkages without a sodium counterion. In some embodiments, when the dsRNA agents of the invention are in the sodium salt form, sodium ions are present in the agent as counterions for all of the phosphodiester and/or phosphorothiotate groups present in the agent.


Representative U.S. patents that teach the preparation of the above phosphorus-containing linkages include, but are not limited to, U.S. Pat. Nos. 3,687,808; 4,469,863; 4,476,301; 5,023,243; 5,177,195; 5,188,897; 5,264,423; 5,276,019; 5,278,302; 5,286,717; 5,321,131; 5,399,676; 5,405,939; 5,453,496; 5,455,233; 5,466,677; 5,476,925; 5,519,126; 5,536,821; 5,541,316; 5,550,111; 5,563,253; 5,571,799; 5,587,361; 5,625,050; 6,028,188; 6,124,445; 6,160,109; 6,169,170; 6,172,209; 6,239,265; 6,277,603; 6,326,199; 6,346,614; 6,444,423; 6,531,590; 6,534,639; 6,608,035; 6,683,167; 6,858,715; 6,867,294; 6,878,805; 7,015,315; 7,041,816; 7,273,933; 7,321,029; and U.S. Pat. RE39464, the entire contents of each of which are hereby incorporated herein by reference.


Modified RNA backbones that do not include a phosphorus atom therein have backbones that are formed by short chain alkyl or cycloalkyl internucleoside linkages, mixed heteroatoms 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; 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.


Representative U.S. patents that teach the preparation of the above oligonucleosides include, but are not limited to, U.S. Pat. Nos. 5,034,506; 5,166,315; 5,185,444; 5,214,134; 5,216,141; 5,235,033; 5,64,562; 5,264,564; 5,405,938; 5,434,257; 5,466,677; 5,470,967; 5,489,677; 5,541,307; 5,561,225; 5,596,086; 5,602,240; 5,608,046; 5,610,289; 5,618,704; 5,623,070; 5,663,312; 5,633,360; 5,677,437; and 5,677,439, the entire contents of each of which are hereby incorporated herein by reference.


Suitable RNA mimetics are contemplated for use in iRNAs provided herein, in which both the sugar and the internucleoside linkage, i.e., the backbone, of the nucleotide units are replaced with novel groups. The base units are maintained for hybridization with an appropriate nucleic acid target compound. One such oligomeric compound in which an RNA mimetic that has been shown to have excellent hybridization properties is referred to as a peptide nucleic acid (PNA). In PNA compounds, the sugar backbone of an RNA is replaced with an amide containing backbone, in particular an aminoethylglycine backbone. The nucleobases are retained and are bound directly or indirectly to aza nitrogen atoms of the amide portion of the backbone. Representative US patents that teach the preparation of PNA compounds include, but are not limited to, U.S. Pat. Nos. 5,539,082; 5,714,331; and 5,719,262, the entire contents of each of which are hereby incorporated herein by reference. Additional PNA compounds suitable for use in the iRNAs of the invention are described in, for example, in Nielsen et al., Science, 1991, 254, 1497-1500.


Some embodiments featured in the disclosure include RNAs with phosphorothioate backbones and oligonucleosides with heteroatom backbones, and in particular —CH2—NH—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 —N(CH3)—CH2—CH2— of the above-referenced U.S. Pat. No. 5,489,677, and the amide backbones of the above-referenced U.S. Pat. No. 5,602,240. In some embodiments, the RNAs featured herein have morpholino backbone structures of the above-referenced U.S. Pat. No. 5,034,506. The native phosphodiester backbone can be represented as O—P(O)(OH)—OCH2-.


Modified RNAs can also contain one or more substituted sugar moieties. The RNAi agents, e.g., dsRNAs, featured herein can include 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 can be substituted or unsubstituted C1 to C10 alkyl or C2 to C10 alkenyl and alkynyl. Exemplary suitable modifications include O[(CH2)nO]mCH3, O(CH2nOCH3, 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. In other embodiments, dsRNAs include one of the following at the 2′ position: C1 to C10 lower alkyl, substituted lower alkyl, alkaryl, aralkyl, O-alkaryl or O-aralkyl, SH, SCH3, OCN, Cl, Br, CN, CF3, OCF3, SOCH3, SO2CH3, ONO2, NO2, N3, NH2, heterocycloalkyl, heterocycloalkaryl, aminoalkylamino, polyalkylamino, substituted silyl, an RNA cleaving group, a reporter group, an intercalator, a group for improving the pharmacokinetic properties of a RNAi agent, or a group for improving the pharmacodynamic properties of a RNAi agent, and other substituents having similar properties. In some embodiments, the modification includes a 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 alkoxy-alkoxy group. Another exemplary modification is 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-dimethylaminoethoxyethyl or 2′-DMAEOE), i.e., 2′-O—CH2—O—CH2—N(CH3)2. Further exemplary modifications include: 5′-Me-2′-F nucleotides, 5′-Me-2′-OMe nucleotides, 5′-Me-2′-deoxynucleotides, (both R and S isomers in these three families); 2′-alkoxyalkyl; and 2′-NMA (N-methylacetamide).


Other modifications include 2′-methoxy (2′-OCH3), 2-aminopropoxy (2′-OCH2CH2CH2NH2) and 2′-fluoro (2′-F). Similar modifications can also be made at other positions on the RNA of an iRNA, particularly the 3′ position of the sugar on the 3′ terminal nucleotide or in 2′-5′ linked dsRNAs and the 5′ position of 5′ terminal nucleotide. iRNAs can also have sugar mimetics such as cyclobutyl moieties in place of the pentofuranosyl sugar. Representative US 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; and 5,700,920, certain of which are commonly owned with the instant application. The entire contents of each of the foregoing are hereby incorporated herein by reference.


An iRNA can also include nucleobase (often referred to in the art 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). Modified nucleobases include other synthetic and natural nucleobases such as deoxythymidine (dT), 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 uracil and cytosine, 6-azo uracil, cytosine and thymine, 5-uracil (pseudouracil), 4-thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioalkyl, 8-hydroxyl anal 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, 8-azaguanine and 8-azaadenine, 7-deazaguanine and 7-daazaadenine and 3-deazaguanine and 3-deazaadenine. Further nucleobases include those disclosed in U.S. Pat. No. 3,687,808, those disclosed in Modified Nucleosides in Biochemistry, Biotechnology and Medicine, Herdewijn, P. ed. Wiley-VCH, 2008; those disclosed in The Concise Encyclopedia Of Polymer Science And Engineering, pages 858-859, Kroschwitz, J. L, ed. John Wiley & Sons, 1990, these disclosed by Englisch et al., Angewandte Chemie, International Edition, 1991, 30, 613, and those disclosed by Sanghvi, Y S., Chapter 15, dsRNA Research and Applications, pages 289-302, Crooke, S. T. and Lebleu, B., Ed., CRC Press, 1993. Certain of these nucleobases are particularly useful for increasing the binding affinity of the oligomeric compounds featured in the invention. These include 5-substituted pyrimidines, 6-azapyrimidines and N-2, N-6 and 0-6 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. (Sanghvi, Y. S., Crooke, S. T. and Lebleu, B., Eds., dsRNA Research and Applications, CRC Press, Boca Raton, 1993, pp. 276-278) and are exemplary base substitutions, even more particularly when combined with 2′-O-methoxyethyl sugar modifications.


Representative U.S. patents that teach the preparation of certain of the above noted modified nucleobases as well as other modified nucleobases include, but are not limited to, the above noted U.S. Pat. Nos. 3,687,808, 4,845,205; 5,130,30; 5,134,066; 5,175,273; 5,367,066; 5,432,272; 5,457,187; 5,459,255; 5,484,908; 5,502,177; 5,525,711; 5,552,540; 5,587,469; 5,594,121, 5,596,091; 5,614,617; 5,681,941; 5,750,692; 6,015,886; 6,147,200; 6,166,197; 6,222,025; 6,235,887; 6,380,368; 6,528,640; 6,639,062; 6,617,438; 7,045,610; 7,427,672; and 7,495,088, the entire contents of each of which are hereby incorporated herein by reference.


An RNAi agent of the disclosure can also be modified to include one or more bicyclic sugar moities. A “bicyclic sugar” is a furanosyl ring modified by a ring formed by the bridging of two carbons, whether adjacent or non-adjacent atoms. A “bicyclic nucleoside” (“BNA”) is a nucleoside having a sugar moiety comprising a ring formed by bridging comprising a bridge connecting two carbons, whether adjacent or non-adjacent, two carbon atoms of the sugar ring, thereby forming a bicyclic ring system. In certain embodiments, the bridge connects the 4′-carbon and the 2′-carbon of the sugar ring, optionally, via the 2′-acyclic oxygen atom. Thus, in some embodiments an agent of the disclosure may include one or more locked nucleic acids (LNA). A locked nucleic acid is a nucleotide having a modified ribose moiety in which the ribose moiety comprises an extra bridge connecting the 2′ and 4′ carbons. In other words, an LNA is a nucleotide comprising a bicyclic sugar moiety comprising a 4′-CH2-O-2′ bridge. This structure effectively “locks” the ribose in the 3′-endo structural conformation. The addition of locked nucleic acids to siRNAs has been shown to increase siRNA stability in serum, and to reduce off-target effects (Elmen, J. et al., (2005) Nucleic Acids Research 33(1):439-447; Mook, O R. et al., (2007) Mol Canc Ther 6(3):833-843; Grunweller, A. et al., (2003) Nucleic Acids Research 31(12):3185-3193). Examples of bicyclic nucleosides for use in the polynucleotides of the disclosure include without limitation nucleosides comprising a bridge between the 4′ and the 2′ ribosyl ring atoms. In certain embodiments, the antisense polynucleotide agents of the disclosure include one or more bicyclic nucleosides comprising a 4′ to 2′ bridge.


A locked nucleoside can be represented by the structure (omitting stereochemistry),




embedded image




    • wherein B is a nucleobase or modified nucleobase and L is the linking group that joins the 2′-carbon to the 4′-carbon of the ribose ring.





Examples of such 4′ to 2′ bridged bicyclic nucleosides, include but are not limited to 4′-(CH2)—O-2′ (LNA); 4′-(CH2)—S-2′; 4′-(CH2)2-O-2′ (ENA); 4′-CH(CH3)—O-2′ (also referred to as “constrained ethyl” or “cEt”) and 4′-CH(CH2OCH3)—O-2′ (and analogs thereof; see, e.g., U.S. Pat. No. 7,399,845); 4′-C(CH3)(CH3)—O-2′ (and analogs thereof; see e.g., U.S. Pat. No. 8,278,283); 4′-CH2—N(OCH3)-2′ (and analogs thereof; see e.g., U.S. Pat. No. 8,278,425); 4′-CH2—O—N(CH3)-2′ (see, e.g., U.S. Patent Publication No. 2004/0171570); 4′-CH2—N(R)—O-2′, wherein R is H, C1-C12 alkyl, or a nitrogen protecting group (see, e.g., U.S. Pat. No. 7,427,672); 4′-CH2—C(H)(CH3)-2′ (see, e.g., Chattopadhyaya et al., J. Org. Chem., 2009, 74, 118-134); and 4′-CH2—C(═CH2)-2′ (and analogs thereof; see, e.g., U.S. Pat. No. 8,278,426). The entire contents of each of the foregoing are hereby incorporated herein by reference.


Additional representative U.S. patents and U.S. patent publications that teach the preparation of locked nucleic acid nucleotides include, but are not limited to, the following: U.S. Pat. Nos. 6,268,490; 6,525,191; 6,670,461; 6,770,748; 6,794,499; 6,998,484; 7,053,207; 7,034,133; 7,084,125; 7,399,845; 7,427,672; 7,569,686; 7,741,457; 8,022,193; 8,030,467; 8,278,425; 8,278,426; 8,278,283; US 2008/0039618; and US 2009/0012281, the entire contents of each of which are hereby incorporated herein by reference.


Any of the foregoing bicyclic nucleosides can be prepared having one or more stereochemical sugar configurations including for example α-L-ribofuranose and β-D-ribofuranose (see WO 99/14226).


An RNAi agent of the disclosure can also be modified to include one or more constrained ethyl nucleotides. As used herein, a “constrained ethyl nucleotide” or “cEt” is a locked nucleic acid comprising a bicyclic sugar moiety comprising a 4′-CH(CH3)-O-2′ bridge (i.e., L in the preceding structure). In one embodiment, a constrained ethyl nucleotide is in the S conformation referred to herein as “S-cEt.”


An iRNA of the invention may also include one or more “conformationally restricted nucleotides” (“CRN”). CRN are nucleotide analogs with a linker connecting the C2′ and C4′ carbons of ribose or the KHK and —C5′ carbons of ribose. CRN lock the ribose ring into a stable conformation and increase the hybridization affinity to mRNA. The linker is of sufficient length to place the oxygen in an optimal position for stability and affinity resulting in less ribose ring puckering.


Representative publications that teach the preparation of certain of the above noted CRN include, but are not limited to, U.S. Patent Publication No. 2013/0190383; and PCT publication WO 2013/036868, the entire contents of each of which are hereby incorporated herein by reference.


In some embodiments, an iRNA of the invention comprises one or more monomers that are UNA (unlocked nucleic acid) nucleotides. UNA is unlocked acyclic nucleic acid, wherein any of the bonds of the sugar has been removed, forming an unlocked “sugar” residue. In one example, UNA also encompasses monomer with bonds between C1′-C4′ have been removed (i.e. the covalent carbon-oxygen-carbon bond between the C1′ and C4′ carbons). In another example, the C2′-KHK′ bond (i.e. the covalent carbon-carbon bond between the C2′ and KHK′ carbons) of the sugar has been removed (see Nuc. Acids Symp. Series, 52, 133-134 (2008) and Fluiter et al., Mol. Biosyst., 2009, 10, 1039 hereby incorporated by reference).


Representative U.S. publications that teach the preparation of UNA include, but are not limited to, U.S. Pat. No. 8,314,227; and U.S. Patent Publication Nos. 2013/0096289; 2013/0011922; and 2011/0313020, the entire contents of each of which are hereby incorporated herein by reference.


Potentially stabilizing modifications to the ends of RNA molecules can include N-(acetylaminocaproyl)-4-hydroxyprolinol (Hyp-C6-NHAc), N-(caproyl-4-hydroxyprolinol (Hyp-C6), N-(acetyl-4-hydroxyprolinol (Hyp-NHAc), thymidine-2′-O-deoxythymidine (ether), N-(aminocaproyl)-4-hydroxyprolinol (Hyp-C6-amino), 2-docosanoyl-uridine-3′-phosphate, inverted base dT(idT) and others. Disclosure of this modification can be found in WO 2011/005861.


Other modifications of the nucleotides of an iRNA of the invention include a 5′ phosphate or 5′ phosphate mimic, e.g., a 5′-terminal phosphate or phosphate mimic on the antisense strand of an iRNA. Suitable phosphate mimics are disclosed in, for example U.S. Patent Publication No. 2012/0157511, the entire contents of which are incorporated herein by reference.


A. Modified iRNAs Comprising Motifs of the Invention


In certain aspects of the invention, the double stranded RNA agents of the invention include agents with chemical modifications as disclosed, for example, in WO2013/075035, the entire contents of each of which are incorporated herein by reference. WO2013/075035 provides motifs of three identical modifications on three consecutive nucleotides may be introduced into a sense strand or antisense strand of a dsRNAi agent, particularly at or near the cleavage site. In some embodiments, the sense strand and antisense strand of the dsRNAi agent may otherwise be completely modified. The introduction of these motifs interrupts the modification pattern, if present, of the sense or antisense strand. The dsRNAi agent may be optionally conjugated with a GalNAc derivative ligand, for instance on the sense strand.


More specifically, when the sense strand and antisense strand of the double stranded RNA agent are completely modified to have one or more motifs of three identical modifications on three consecutive nucleotides at or near the cleavage site of at least one strand of a dsRNAi agent.


Accordingly, the invention provides double stranded RNA agents capable of inhibiting the expression of a target gene (i.e., KHK gene) in vivo. The RNAi agent comprises a sense strand and an antisense strand. Each strand of the RNAi agent may be, for example, 17-30 nucleotides in length, 25-30 nucleotides in length, 27-30 nucleotides in length, 19-25 nucleotides in length, 19-23 nucleotides in length, 19-21 nucleotides in length, 21-25 nucleotides in length, or 21-23 nucleotides in length.


The sense strand and antisense strand typically form a duplex double stranded RNA (“dsRNA”), also referred to herein as “dsRNAi agent.” The duplex region of a dsRNAi agent may be, for example, the duplex region can be 27-30 nucleotide pairs in length, 19-25 nucleotide pairs in length, 19-23 nucleotide pairs in length, 19-21 nucleotide pairs in length, 21-25 nucleotide pairs in length, or 21-23 nucleotide pairs in length. In another example, the duplex region is selected from 19, 20, 21, 22, 23, 24, 25, 26, and 27 nucleotides in length.


In certain embodiments, the dsRNAi agent may contain one or more overhang regions or capping groups at the 3′-end, 5′-end, or both ends of one or both strands. The overhang can be, independently, 1-6 nucleotides in length, for instance 2-6 nucleotides in length, 1-5 nucleotides in length, 2-5 nucleotides in length, 1-4 nucleotides in length, 2-4 nucleotides in length, 1-3 nucleotides in length, 2-3 nucleotides in length, or 1-2 nucleotides in length. In certain embodiments, the overhang regions can include extended overhang regions as provided above. The overhangs can be the result of one strand being longer than the other, or the result of two strands of the same length being staggered. The overhang can form a mismatch with the target mRNA or it can be complementary to the gene sequences being targeted or can be another sequence. The first and second strands can also be joined, e.g., by additional bases to form a hairpin, or by other non-base linkers.


In certain embodiments, the nucleotides in the overhang region of the dsRNAi agent can each independently be a modified or unmodified nucleotide including, but no limited to 2′-sugar modified, such as, 2′-F, 2′-O-methyl, thymidine (T), 2′-O-methoxyethyl-5-methyluridine (Teo), 2′-O-methoxyethyladenosine (Aeo), 2′-O-methoxyethyl-5-methylcytidine (m5Ceo), and any combinations thereof.


For example, TT can be an overhang sequence for either end on either strand. The overhang can form a mismatch with the target mRNA or it can be complementary to the gene sequences being targeted or can be another sequence.


The 5′- or 3′-overhangs at the sense strand, antisense strand, or both strands of the dsRNAi agent may be phosphorylated. In some embodiments, the overhang region(s) contains two nucleotides having a phosphorothioate between the two nucleotides, where the two nucleotides can be the same or different. In some embodiments, the overhang is present at the 3′-end of the sense strand, antisense strand, or both strands. In some embodiments, this 3′-overhang is present in the antisense strand. In some embodiments, this 3′-overhang is present in the sense strand.


The dsRNAi agent may contain only a single overhang, which can strengthen the interference activity of the RNAi, without affecting its overall stability. For example, the single-stranded overhang may be located at the 3′-end of the sense strand or, alternatively, at the 3-end of the antisense strand. The RNAi may also have a blunt end, located at the 5′-end of the antisense strand (or the 3′-end of the sense strand) or vice versa. Generally, the antisense strand of the dsRNAi agent has a nucleotide overhang at the 3′-end, and the 5′-end is blunt. While not wishing to be bound by theory, the asymmetric blunt end at the 5′-end of the antisense strand and 3′-end overhang of the antisense strand favor the guide strand loading into RISC process.


In certain embodiments, the dsRNAi agent is a double ended blunt-ended of 19 nucleotides in length, wherein the sense strand contains at least one motif of three 2′-F modifications on three consecutive nucleotides at positions 7, 8, 9 from the 5′end. The antisense strand contains at least one motif of three 2′-O-methyl modifications on three consecutive nucleotides at positions 11, 12, 13 from the 5′end.


In other embodiments, the dsRNAi agent is a double ended blunt-ended of 20 nucleotides in length, wherein the sense strand contains at least one motif of three 2′-F modifications on three consecutive nucleotides at positions 8, 9, 10 from the 5′end. The antisense strand contains at least one motif of three 2′-O-methyl modifications on three consecutive nucleotides at positions 11, 12, 13 from the 5′end.


In yet other embodiments, the dsRNAi agent is a double ended blunt-ended of 21 nucleotides in length, wherein the sense strand contains at least one motif of three 2′-F modifications on three consecutive nucleotides at positions 9, 10, 11 from the 5′end. The antisense strand contains at least one motif of three 2′-O-methyl modifications on three consecutive nucleotides at positions 11, 12, 13 from the 5′end.


In certain embodiments, the dsRNAi agent comprises a 21 nucleotide sense strand and a 23 nucleotide antisense strand, wherein the sense strand contains at least one motif of three 2′-F modifications on three consecutive nucleotides at positions 9, 10, 11 from the 5′end; the antisense strand contains at least one motif of three 2′-O-methyl modifications on three consecutive nucleotides at positions 11, 12, 13 from the 5′end, wherein one end of the RNAi agent is blunt, while the other end comprises a 2 nucleotide overhang. In some embodiments, the 2 nucleotide overhang is at the 3′-end of the antisense strand.


When the 2 nucleotide overhang is at the 3′-end of the antisense strand, there may be two phosphorothioate internucleotide linkages between the terminal three nucleotides, wherein two of the three nucleotides are the overhang nucleotides, and the third nucleotide is a paired nucleotide next to the overhang nucleotide. In one embodiment, the RNAi agent additionally has two phosphorothioate internucleotide linkages between the terminal three nucleotides at both the 5′-end of the sense strand and at the 5′-end of the antisense strand. In certain embodiments, every nucleotide in the sense strand and the antisense strand of the dsRNAi agent, including the nucleotides that are part of the motifs are modified nucleotides. In certain embodiments each residue is independently modified with a 2′-O-methyl or 3′-fluoro, e.g., in an alternating motif. Optionally, the dsRNAi agent further comprises a ligand (such as GalNAc).


In certain embodiments, the dsRNAi agent comprises a sense and an antisense strand, wherein the sense strand is 25-30 nucleotide residues in length, wherein starting from the 5′ terminal nucleotide (position 1) positions 1 to 23 of the first strand comprise at least 8 ribonucleotides; the antisense strand is 36-66 nucleotide residues in length and, starting from the 3′ terminal nucleotide, comprises at least 8 ribonucleotides in the positions paired with positions 1-23 of sense strand to form a duplex; wherein at least the 3′ terminal nucleotide of antisense strand is unpaired with sense strand, and up to 6 consecutive 3′ terminal nucleotides are unpaired with sense strand, thereby forming a 3′ single stranded overhang of 1-6 nucleotides; wherein the 5′ terminus of antisense strand comprises from 10-30 consecutive nucleotides which are unpaired with sense strand, thereby forming a 10-30 nucleotide single stranded 5′ overhang; wherein at least the sense strand 5′ terminal and 3′ terminal nucleotides are base paired with nucleotides of antisense strand when sense and antisense strands are aligned for maximum complementarity, thereby forming a substantially duplexed region between sense and antisense strands; and antisense strand is sufficiently complementary to a target RNA along at least 19 ribonucleotides of antisense strand length to reduce target gene expression when the double stranded nucleic acid is introduced into a mammalian cell; and wherein the sense strand contains at least one motif of three 2′-F modifications on three consecutive nucleotides, where at least one of the motifs occurs at or near the cleavage site. The antisense strand contains at least one motif of three 2′-O-methyl modifications on three consecutive nucleotides at or near the cleavage site.


In certain embodiments, the dsRNAi agent comprises sense and antisense strands, wherein the dsRNAi agent comprises a first strand having a length which is at least 25 and at most 29 nucleotides and a second strand having a length which is at most 30 nucleotides with at least one motif of three 2′-O-methyl modifications on three consecutive nucleotides at position 11, 12, 13 from the 5′ end; wherein the 3′ end of the first strand and the 5′ end of the second strand form a blunt end and the second strand is 1-4 nucleotides longer at its 3′ end than the first strand, wherein the duplex region which is at least 25 nucleotides in length, and the second strand is sufficiently complementary to a target mRNA along at least 19 nucleotide of the second strand length to reduce target gene expression when the RNAi agent is introduced into a mammalian cell, and wherein Dicer cleavage of the dsRNAi agent preferentially results in an siRNA comprising the 3′-end of the second strand, thereby reducing expression of the target gene in the mammal. Optionally, the dsRNAi agent further comprises a ligand.


In certain embodiments, the sense strand of the dsRNAi agent contains at least one motif of three identical modifications on three consecutive nucleotides, where one of the motifs occurs at the cleavage site in the sense strand.


In certain embodiments, the antisense strand of the dsRNAi agent can also contain at least one motif of three identical modifications on three consecutive nucleotides, where one of the motifs occurs at or near the cleavage site in the antisense strand.


For a dsRNAi agent having a duplex region of 19-23 nucleotides in length, the cleavage site of the antisense strand is typically around the 10, 11, and 12 positions from the 5′-end. Thus the motifs of three identical modifications may occur at the 9, 10, 11 positions; the 10, 11, 12 positions; the 11, 12, 13 positions; the 12, 13, 14 positions; or the 13, 14, 15 positions of the antisense strand, the count starting from the first nucleotide from the 5′-end of the antisense strand, or, the count starting from the first paired nucleotide within the duplex region from the 5′-end of the antisense strand. The cleavage site in the antisense strand may also change according to the length of the duplex region of the dsRNAi agent from the 5′-end.


The sense strand of the dsRNAi agent may contain at least one motif of three identical modifications on three consecutive nucleotides at the cleavage site of the strand; and the antisense strand may have at least one motif of three identical modifications on three consecutive nucleotides at or near the cleavage site of the strand. When the sense strand and the antisense strand form a dsRNA duplex, the sense strand and the antisense strand can be so aligned that one motif of the three nucleotides on the sense strand and one motif of the three nucleotides on the antisense strand have at least one nucleotide overlap, i.e., at least one of the three nucleotides of the motif in the sense strand forms a base pair with at least one of the three nucleotides of the motif in the antisense strand. Alternatively, at least two nucleotides may overlap, or all three nucleotides may overlap.


In some embodiments, the sense strand of the dsRNAi agent may contain more than one motif of three identical modifications on three consecutive nucleotides. The first motif may occur at or near the cleavage site of the strand and the other motifs may be a wing modification. The term “wing modification” herein refers to a motif occurring at another portion of the strand that is separated from the motif at or near the cleavage site of the same strand. The wing modification is either adjacent to the first motif or is separated by at least one or more nucleotides. When the motifs are immediately adjacent to each other then the chemistries of the motifs are distinct from each other, and when the motifs are separated by one or more nucleotide than the chemistries can be the same or different. Two or more wing modifications may be present. For instance, when two wing modifications are present, each wing modification may occur at one end relative to the first motif which is at or near cleavage site or on either side of the lead motif.


Like the sense strand, the antisense strand of the dsRNAi agent may contain more than one motifs of three identical modifications on three consecutive nucleotides, with at least one of the motifs occurring at or near the cleavage site of the strand. This antisense strand may also contain one or more wing modifications in an alignment similar to the wing modifications that may be present on the sense strand.


In some embodiments, the wing modification on the sense strand or antisense strand of the dsRNAi agent typically does not include the first one or two terminal nucleotides at the 3′-end, 5′-end, or both ends of the strand.


In other embodiments, the wing modification on the sense strand or antisense strand of the dsRNAi agent typically does not include the first one or two paired nucleotides within the duplex region at the 3′-end, 5′-end, or both ends of the strand.


When the sense strand and the antisense strand of the dsRNAi agent each contain at least one wing modification, the wing modifications may fall on the same end of the duplex region, and have an overlap of one, two, or three nucleotides.


When the sense strand and the antisense strand of the dsRNAi agent each contain at least two wing modifications, the sense strand and the antisense strand can be so aligned that two modifications each from one strand fall on one end of the duplex region, having an overlap of one, two, or three nucleotides; two modifications each from one strand fall on the other end of the duplex region, having an overlap of one, two or three nucleotides; two modifications one strand fall on each side of the lead motif, having an overlap of one, two or three nucleotides in the duplex region.


In some embodiments, every nucleotide in the sense strand and antisense strand of the dsRNAi agent, including the nucleotides that are part of the motifs, may be modified. Each nucleotide may be modified with the same or different modification which can include one or more alteration of one or both of the non-linking phosphate oxygens or of one or more of the linking phosphate oxygens; alteration of a constituent of the ribose sugar, e.g., of the 2′-hydroxyl on the ribose sugar; wholesale replacement of the phosphate moiety with “dephospho” linkers; modification or replacement of a naturally occurring base; and replacement or modification of the ribose-phosphate backbone.


As nucleic acids are polymers of subunits, many of the modifications occur at a position which is repeated within a nucleic acid, e.g., a modification of a base, or a phosphate moiety, or a non-linking O of a phosphate moiety. In some cases the modification will occur at all of the subject positions in the nucleic acid but in many cases it will not. By way of example, a modification may only occur at a 3′- or 5′ terminal position, may only occur in a terminal region, e.g., at a position on a terminal nucleotide or in the last 2, 3, 4, 5, or 10 nucleotides of a strand. A modification may occur in a double strand region, a single strand region, or in both. A modification may occur only in the double strand region of an RNA or may only occur in a single strand region of a RNA. For example, a phosphorothioate modification at a non-linking O position may only occur at one or both termini, may only occur in a terminal region, e.g., at a position on a terminal nucleotide or in the last 2, 3, 4, 5, or 10 nucleotides of a strand, or may occur in double strand and single strand regions, particularly at termini. The 5′-end or ends can be phosphorylated.


It may be possible, e.g., to enhance stability, to include particular bases in overhangs, or to include modified nucleotides or nucleotide surrogates, in single strand overhangs, e.g., in a 5′- or 3′-overhang, or in both. For example, it can be desirable to include purine nucleotides in overhangs. In some embodiments all or some of the bases in a 3′- or 5′-overhang may be modified, e.g., with a modification described herein. Modifications can include, e.g., the use of modifications at the 2′ position of the ribose sugar with modifications that are known in the art, e.g., the use of deoxyribonucleotides, 2′-deoxy-2′-fluoro (2′-F) or 2′-O-methyl modified instead of the ribosugar of the nucleobase, and modifications in the phosphate group, e.g., phosphorothioate modifications. Overhangs need not be homologous with the target sequence.


In some embodiments, each residue of the sense strand and antisense strand is independently modified with LNA, CRN, cET, UNA, glycol nucleic acid (GNA), hexitol nucleic acid (HNA), 2′-methoxyethyl, 2′-O-methyl, 2′-O-allyl, 2′-C-allyl, 2′-deoxy, 2′-hydroxyl, or 2′-fluoro. The strands can contain more than one modification. In one embodiment, each residue of the sense strand and antisense strand is independently modified with 2′-O-methyl or 2′-fluoro.


At least two different modifications are typically present on the sense strand and antisense strand. Those two modifications may be the 2′-O-methyl or 2′-fluoro modifications, or others.


In certain embodiments, the Na or Nb comprise modifications of an alternating pattern. The term “alternating motif” as used herein refers to a motif having one or more modifications, each modification occurring on alternating nucleotides of one strand. The alternating nucleotide may refer to one per every other nucleotide or one per every three nucleotides, or a similar pattern. For example, if A, B and C each represent one type of modification to the nucleotide, the alternating motif can be “ABABABABABAB . . . ,” “AABBAABBAABB . . . ,” “AABAABAABAAB . . . ,” “AAABAAABAAAB . . . ,” “AAABBBAAABBB . . . ,” or “ABCABCABCABC . . . ,” etc.


The type of modifications contained in the alternating motif may be the same or different. For example, if A, B, C, D each represent one type of modification on the nucleotide, the alternating pattern, i.e., modifications on every other nucleotide, may be the same, but each of the sense strand or antisense strand can be selected from several possibilities of modifications within the alternating motif such as “ABABAB . . . ”, “ACACAC . . . ” “BDBDBD . . . ” or “CDCDCD . . . ,” etc.


In some embodiments, the dsRNAi agent of the invention comprises the modification pattern for the alternating motif on the sense strand relative to the modification pattern for the alternating motif on the antisense strand is shifted. The shift may be such that the modified group of nucleotides of the sense strand corresponds to a differently modified group of nucleotides of the antisense strand and vice versa. For example, the sense strand when paired with the antisense strand in the dsRNA duplex, the alternating motif in the sense strand may start with “ABABAB” from 5′ to 3′ of the strand and the alternating motif in the antisense strand may start with “BABABA” from 5′ to 3′ of the strand within the duplex region. As another example, the alternating motif in the sense strand may start with “AABBAABB” from 5′ to 3′ of the strand and the alternating motif in the antisense strand may start with “BBAABBAA” from 5′ to 3′ of the strand within the duplex region, so that there is a complete or partial shift of the modification patterns between the sense strand and the antisense strand.


In some embodiments, the dsRNAi agent comprises the pattern of the alternating motif of 2′-O-methyl modification and 2′-F modification on the sense strand initially has a shift relative to the pattern of the alternating motif of 2′-O-methyl modification and 2′-F modification on the antisense strand initially, i.e., the 2′-O-methyl modified nucleotide on the sense strand base pairs with a 2′-F modified nucleotide on the antisense strand and vice versa. The 1 position of the sense strand may start with the 2′-F modification, and the 1 position of the antisense strand may start with the 2′-O-methyl modification.


The introduction of one or more motifs of three identical modifications on three consecutive nucleotides to the sense strand or antisense strand interrupts the initial modification pattern present in the sense strand or antisense strand. This interruption of the modification pattern of the sense or antisense strand by introducing one or more motifs of three identical modifications on three consecutive nucleotides to the sense or antisense strand may enhance the gene silencing activity against the target gene.


In some embodiments, when the motif of three identical modifications on three consecutive nucleotides is introduced to any of the strands, the modification of the nucleotide next to the motif is a different modification than the modification of the motif. For example, the portion of the sequence containing the motif is “ . . . NaYYYNb . . . ,” where “Y” represents the modification of the motif of three identical modifications on three consecutive nucleotide, and “Na” and “Nb” represent a modification to the nucleotide next to the motif “YYY” that is different than the modification of Y, and where Na and Nb can be the same or different modifications. Alternatively, Na or Nb may be present or absent when there is a wing modification present.


The iRNA may further comprise at least one phosphorothioate or methylphosphonate internucleotide linkage. The phosphorothioate or methylphosphonate internucleotide linkage modification may occur on any nucleotide of the sense strand, antisense strand, or both strands in any position of the strand. For instance, the internucleotide linkage modification may occur on every nucleotide on the sense strand or antisense strand; each internucleotide linkage modification may occur in an alternating pattern on the sense strand or antisense strand; or the sense strand or antisense strand may contain both internucleotide linkage modifications in an alternating pattern. The alternating pattern of the internucleotide linkage modification on the sense strand may be the same or different from the antisense strand, and the alternating pattern of the internucleotide linkage modification on the sense strand may have a shift relative to the alternating pattern of the internucleotide linkage modification on the antisense strand. In one embodiment, a double-stranded RNAi agent comprises 6-8 phosphorothioate internucleotide linkages. In some embodiments, the antisense strand comprises two phosphorothioate internucleotide linkages at the 5′-end and two phosphorothioate internucleotide linkages at the 3′-end, and the sense strand comprises at least two phosphorothioate internucleotide linkages at either the 5′-end or the 3′-end.


In some embodiments, the dsRNAi agent comprises a phosphorothioate or methylphosphonate internucleotide linkage modification in the overhang region. For example, the overhang region may contain two nucleotides having a phosphorothioate or methylphosphonate internucleotide linkage between the two nucleotides. Internucleotide linkage modifications also may be made to link the overhang nucleotides with the terminal paired nucleotides within the duplex region. For example, at least 2, 3, 4, or all the overhang nucleotides may be linked through phosphorothioate or methylphosphonate internucleotide linkage, and optionally, there may be additional phosphorothioate or methylphosphonate internucleotide linkages linking the overhang nucleotide with a paired nucleotide that is next to the overhang nucleotide. For instance, there may be at least two phosphorothioate internucleotide linkages between the terminal three nucleotides, in which two of the three nucleotides are overhang nucleotides, and the third is a paired nucleotide next to the overhang nucleotide. These terminal three nucleotides may be at the 3′-end of the antisense strand, the 3′-end of the sense strand, the 5′-end of the antisense strand, or the 5′end of the antisense strand.


In some embodiments, the 2-nucleotide overhang is at the 3′-end of the antisense strand, and there are two phosphorothioate internucleotide linkages between the terminal three nucleotides, wherein two of the three nucleotides are the overhang nucleotides, and the third nucleotide is a paired nucleotide next to the overhang nucleotide. Optionally, the dsRNAi agent may additionally have two phosphorothioate internucleotide linkages between the terminal three nucleotides at both the 5′-end of the sense strand and at the 5′-end of the antisense strand.


In one embodiment, the dsRNAi agent comprises mismatch(es) with the target, within the duplex, or combinations thereof. The mismatch may occur in the overhang region or the duplex region. The base pair may be ranked on the basis of their propensity to promote dissociation or melting (e.g., on the free energy of association or dissociation of a particular pairing, the simplest approach is to examine the pairs on an individual pair basis, though next neighbor or similar analysis can also be used). In terms of promoting dissociation: A:U is preferred over G:C; G:U is preferred over G:C; and I:C is preferred over G:C (I=inosine). Mismatches, e.g., non-canonical or other than canonical pairings (as described elsewhere herein) are preferred over canonical (A:T, A:U, G:C) pairings; and pairings which include a universal base are preferred over canonical pairings.


In certain embodiments, the dsRNAi agent comprises at least one of the first 1, 2, 3, 4, or 5 base pairs within the duplex regions from the 5′-end of the antisense strand independently selected from the group of: A:U, G:U, I:C, and mismatched pairs, e.g., non-canonical or other than canonical pairings or pairings which include a universal base, to promote the dissociation of the antisense strand at the 5′-end of the duplex.


In certain embodiments, the nucleotide at the 1 position within the duplex region from the 5′-end in the antisense strand is selected from A, dA, dU, U, and dT. Alternatively, at least one of the first 1, 2, or 3 base pair within the duplex region from the 5′-end of the antisense strand is an AU base pair. For example, the first base pair within the duplex region from the 5′-end of the antisense strand is an AU base pair.


In other embodiments, the nucleotide at the 3′-end of the sense strand is deoxythymidine (dT) or the nucleotide at the 3′-end of the antisense strand is deoxythymidine (dT). For example, there is a short sequence of deoxythymidine nucleotides, for example, two dT nucleotides on the 3′-end of the sense, antisense strand, or both strands.


In certain embodiments, the sense strand sequence may be represented by formula (I):





5′np-Na—(XXX)i—Nb—YYY—Nb—(ZZZ)j—Na-nq3′  (I)

    • wherein:
    • i and j are each independently 0 or 1;
    • p and q are each independently 0-6;
    • each Na independently represents an oligonucleotide sequence comprising 0-25 modified nucleotides, each sequence comprising at least two differently modified nucleotides;
    • each Nb independently represents an oligonucleotide sequence comprising 0-10 modified nucleotides;
    • each np and nq independently represent an overhang nucleotide;
    • wherein Nb and Y do not have the same modification; and
    • XXX, YYY, and ZZZ each independently represent one motif of three identical modifications on three consecutive nucleotides. In some embodiments, YYY is all 2′-F modified nucleotides.


In some embodiments, the Na or Nb comprises modifications of alternating pattern.


In some embodiments, the YYY motif occurs at or near the cleavage site of the sense strand.


For example, when the dsRNAi agent has a duplex region of 17-23 nucleotides in length, the YYY motif can occur at or the vicinity of the cleavage site (e.g.: can occur at positions 6, 7, 8; 7, 8, 9; 8, 9, 10; 9, 10, 11; 10, 11, 12; or 11, 12, 13) of the sense strand, the count starting from the first nucleotide, from the 5′-end; or optionally, the count starting at the first paired nucleotide within the duplex region, from the 5′-end.


In one embodiment, i is 1 and j is 0, or i is 0 and j is 1, or both i and j are 1. The sense strand can therefore be represented by the following formulas:





5′np-Na—YYY—Nb—ZZZ—Na-nq3′  (Ib);





5′np-Na—XXX—Nb—YYY—Na-nq3′  (Ic); or





5′np-Na—XXX—Nb—YYY—Nb—ZZZ—Na-nq3′  (Id).


When the sense strand is represented by formula (Ib), Nb represents an oligonucleotide sequence comprising 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. Each Na independently can represent an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the sense strand is represented as formula (Ic), Nb represents an oligonucleotide sequence comprising 0-10, 0-7, 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. Each Na can independently represent an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the sense strand is represented as formula (Id), each Nb independently represents an oligonucleotide sequence comprising 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. In some embodiments, Nb is 0, 1, 2, 3, 4, 5, or 6 Each Na can independently represent an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


Each of X, Y and Z may be the same or different from each other.


In other embodiments, i is 0 and j is 0, and the sense strand may be represented by the formula:





5′np-Na—YYY—Na-nq3′  (Ia).


When the sense strand is represented by formula (Ia), each Na independently can represent an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


In one embodiment, the antisense strand sequence of the RNAi may be represented by formula (II):





5′nq′—Na′—(Z′Z′Z′)k—Nb′—Y′Y′Y′—Nb′X′X′X′)l—N′a-np′3′  (II)

    • wherein:
    • k and l are each independently 0 or 1;
    • p′ and q1 are each independently 0-6;
    • each Na′ independently represents an oligonucleotide sequence comprising 0-25 modified nucleotides, each sequence comprising at least two differently modified nucleotides;
    • each Nb′ independently represents an oligonucleotide sequence comprising 0-10 modified nucleotides;
    • each np′ and nq′ independently represent an overhang nucleotide;
    • wherein Nb′ and Y′ do not have the same modification; and
    • X′X′X′, Y′Y′Y′, and Z′Z′Z′ each independently represent one motif of three identical modifications on three consecutive nucleotides.


In some embodiments, the Na′ or Nb′ comprises modifications of alternating pattern.


The Y′Y′Y′ motif occurs at or near the cleavage site of the antisense strand. For example, when the dsRNAi agent has a duplex region of 17-23 nucleotides in length, the Y′Y′Y′ motif can occur at positions 9, 10, 11; 10, 11, 12; 11, 12, 13; 12, 13, 14; or 13, 14, 15 of the antisense strand, with the count starting from the first nucleotide, from the 5′-end; or optionally, the count starting at the first paired nucleotide within the duplex region, from the 5′-end. In some embodiments, the Y′Y′Y′ motif occurs at positions 11, 12, 13.


In certain embodiments, Y′Y′Y′ motif is all 2′-OMe modified nucleotides.


In certain embodiments, k is 1 and l is 0, or k is 0 and l is 1, or both k and l are 1.


The antisense strand can therefore be represented by the following formulas:





5′nq′-Na′—Z′Z′Z′—Nb′—Y′Y′Y′—Na′-np′3′  (IIb);





5′nq′-Na′—Y′Y′Y′—Nb′—X′X′X′-np′3′  (IIc); or





5′nq′-Na′—Z′Z′Z′—Nb′—Y′Y′Y′—Nb′—X′X′X′—Na′-np′3′  (IId).


When the antisense strand is represented by formula (IIb), Nb′ represents an oligonucleotide sequence comprising 0-10, 0-7, 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. Each Na′ independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the antisense strand is represented as formula (IIc), Nb′ represents an oligonucleotide sequence comprising 0-10, 0-7, 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. Each Na′ independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the antisense strand is represented as formula (IId), each Nb′ independently represents an oligonucleotide sequence comprising 0-10, 0-7, 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides.


Each Na′ independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides. In some embodiments, Nb is 0, 1, 2, 3, 4, 5, or 6.


In other embodiments, k is 0 and 1 is 0 and the antisense strand may be represented by the formula:





5′np′-Na′—Y′Y′Y′—Na′-nq′3′  (Ia).


When the antisense strand is represented as formula (IIa), each Na′ independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


Each of X′, Y′ and Z′ may be the same or different from each other.


Each nucleotide of the sense strand and antisense strand may be independently modified with LNA, CRN, UNA, cEt, glycol nucleic acid (GNA), hexitol nucleic acid (HNA), 2′-methoxyethyl, 2′-O-methyl, 2′-O-allyl, 2′-C-allyl, 2′-hydroxyl, or 2′-fluoro. For example, each nucleotide of the sense strand and antisense strand is independently modified with 2′-O-methyl or 2′-fluoro. Each X, Y, Z, X′, Y′, and Z′, in particular, may represent a 2′-O-methyl modification or a 2′-fluoro modification.


In some embodiments, the sense strand of the dsRNAi agent may contain YYY motif occurring at 9, 10, and 11 positions of the strand when the duplex region is 21 nt, the count starting from the first nucleotide from the 5′-end, or optionally, the count starting at the first paired nucleotide within the duplex region, from the 5′-end; and Y represents 2′-F modification. The sense strand may additionally contain XXX motif or ZZZ motifs as wing modifications at the opposite end of the duplex region; and XXX and ZZZ each independently represents a 2′-OMe modification or 2′-F modification.


In some embodiments the antisense strand may contain Y′Y′Y′ motif occurring at positions 11, 12, 13 of the strand, the count starting from the first nucleotide from the 5′-end, or optionally, the count starting at the first paired nucleotide within the duplex region, from the 5′-end; and Y′ represents 2′-O-methyl modification. The antisense strand may additionally contain X′X′X′ motif or Z′Z′Z′ motifs as wing modifications at the opposite end of the duplex region; and X′X′X′ and Z′Z′Z′ each independently represents a 2′-OMe modification or 2′-F modification.


The sense strand represented by any one of the above formulas (Ia), (Ib), (Ic), and (Id) forms a duplex with an antisense strand being represented by any one of formulas (IIa), (IIb), (IIc), and (IId), respectively.


Accordingly, the dsRNAi agents for use in the methods of the invention may comprise a sense strand and an antisense strand, each strand having 14 to 30 nucleotides, the iRNA duplex represented by formula (III):





sense: 5′np-Na—(XXX)i—Nb—YYY—Nb—(ZZZ)j—Na-nq3′





antisense: 3′np′—Na′—(X′X′X′)k—Nb′—Y′Y′Y′—Nb′—(Z′Z′Z′)l—Na′-nq′5′  (III)

    • wherein:
    • i, j, k, and 1 are each independently 0 or 1;
    • p, p′, q, and q1 are each independently 0-6;
    • each Na and Na′ independently represents an oligonucleotide sequence comprising 0-25 modified nucleotides, each sequence comprising at least two differently modified nucleotides;
    • each Nb and Nb′ independently represents an oligonucleotide sequence comprising 0-10 modified nucleotides;
    • wherein each np′, np, nq′, and nq, each of which may or may not be present, independently represents an overhang nucleotide; and
    • XXX, YYY, ZZZ, X′X′X′, Y′Y′Y′, and Z′Z′Z′ each independently represent one motif of three identical modifications on three consecutive nucleotides.


In one embodiment, i is 0 and j is 0; or i is 1 and j is 0; or i is 0 and j is 1; or both i and j are 0; or both i and j are 1. In another embodiment, k is 0 and 1 is 0; or k is 1 and 1 is 0; k is 0 and 1 is 1; or both k and 1 are 0; or both k and 1 are 1.


Exemplary combinations of the sense strand and antisense strand forming an iRNA duplex include the formulas below:





5′np-Na—YYY—Na-nq3′





3′np′—Na′—Y′Y′Y′—Na′nq′5′  (IIIa)





5′np-Na—YYY—Nb—ZZZ—Na-nq3′





3′np′—Na′—Y′Y′Y′—Nb′—Z′Z′Z′—Na′nq′5′  (IIIb)





5′np-Na—XXX—Nb—YYY—Na-nq3′





3′np′—Na′—X′X′X′—Nb′—Y′Y′Y′—Na′-nq′5′  (IIIc)





5′np-Na—XXX—Nb—YYY—Nb—ZZZ—Na-nq3′





3′np′—Na′—X′X′X′—Nb′—Y′Y′Y′—Nb′—Z′Z′Z′—Na-nq′5′   (IIId)


When the dsRNAi agent is represented by formula (IIIa), each Na independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the dsRNAi agent is represented by formula (IIIb), each Nb independently represents an oligonucleotide sequence comprising 1-10, 1-7, 1-5, or 1-4 modified nucleotides. Each Na independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the dsRNAi agent is represented as formula (IIIc), each Nb, Nb′ independently represents an oligonucleotide sequence comprising 0-10, 0-7, 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. Each Na independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides.


When the dsRNAi agent is represented as formula (IIId), each Nb, Nb′ independently represents an oligonucleotide sequence comprising 0-10, 0-7, 0-10, 0-7, 0-5, 0-4, 0-2, or 0 modified nucleotides. Each Na, Na′ independently represents an oligonucleotide sequence comprising 2-20, 2-15, or 2-10 modified nucleotides. Each of Na, Na′, Nb, and Nb′ independently comprises modifications of alternating pattern.


Each of X, Y, and Z in formulas (III), (IIIa), (IIIb), (IIIc), and (IIId) may be the same or different from each other.


When the dsRNAi agent is represented by formula (III), (IIIa), (IIIb), (IIIc), and (IIId), at least one of the Y nucleotides may form a base pair with one of the Y′ nucleotides. Alternatively, at least two of the Y nucleotides form base pairs with the corresponding Y′ nucleotides; or all three of the Y nucleotides all form base pairs with the corresponding Y′ nucleotides.


When the dsRNAi agent is represented by formula (IIIb) or (IIId), at least one of the Z nucleotides may form a base pair with one of the Z′ nucleotides. Alternatively, at least two of the Z nucleotides form base pairs with the corresponding Z′ nucleotides; or all three of the Z nucleotides all form base pairs with the corresponding Z′ nucleotides.


When the dsRNAi agent is represented as formula (IIIc) or (IIId), at least one of the X nucleotides may form a base pair with one of the X′ nucleotides. Alternatively, at least two of the X nucleotides form base pairs with the corresponding X′ nucleotides; or all three of the X nucleotides all form base pairs with the corresponding X′ nucleotides.


In certain embodiments, the modification on the Y nucleotide is different than the modification on the Y′ nucleotide, the modification on the Z nucleotide is different than the modification on the Z′ nucleotide, or the modification on the X nucleotide is different than the modification on the X′ nucleotide.


In certain embodiments, when the dsRNAi agent is represented by formula (IIId), the Na modifications are 2′-O-methyl or 2′-fluoro modifications. In other embodiments, when the RNAi agent is represented by formula (IIId), the Na modifications are 2′-O-methyl or 2′-fluoro modifications and np′>0 and at least one np′ is linked to a neighboring nucleotide a via phosphorothioate linkage. In yet other embodiments, when the RNAi agent is represented by formula (IIId), the Na modifications are 2′-O-methyl or 2′-fluoro modifications, np′>0 and at least one np′ is linked to a neighboring nucleotide via phosphorothioate linkage, and the sense strand is conjugated to one or more GalNAc derivatives attached through a bivalent or trivalent branched linker (described below). In other embodiments, when the RNAi agent is represented by formula (IIId), the Na modifications are 2′-O-methyl or 2′-fluoro modifications, np′>0 and at least one np′ is linked to a neighboring nucleotide via phosphorothioate linkage, the sense strand comprises at least one phosphorothioate linkage, and the sense strand is conjugated to one or more GalNAc derivatives attached through a bivalent or trivalent branched linker.


In some embodiments, when the dsRNAi agent is represented by formula (IIIa), the Na modifications are 2′-O-methyl or 2′-fluoro modifications, np′>0 and at least one np′ is linked to a neighboring nucleotide via phosphorothioate linkage, the sense strand comprises at least one phosphorothioate linkage, and the sense strand is conjugated to one or more GalNAc derivatives attached through a bivalent or trivalent branched linker.


In some embodiments, the dsRNAi agent is a multimer containing at least two duplexes represented by formula (III), (IIIa), (IIIb), (IIIc), and (IIId), wherein the duplexes are connected by a linker. The linker can be cleavable or non-cleavable. Optionally, the multimer further comprises a ligand. Each of the duplexes can target the same gene or two different genes; or each of the duplexes can target same gene at two different target sites.


In some embodiments, the dsRNAi agent is a multimer containing three, four, five, six, or more duplexes represented by formula (III), (IIIa), (IIIb), (IIIc), and (IIId), wherein the duplexes are connected by a linker. The linker can be cleavable or non-cleavable. Optionally, the multimer further comprises a ligand. Each of the duplexes can target the same gene or two different genes; or each of the duplexes can target same gene at two different target sites.


In one embodiment, two dsRNAi agents represented by at least one of formulas (III), (IIIa), (IIIb), (IIIc), and (IIId) are linked to each other at the 5′ end, and one or both of the 3′ ends, and are optionally conjugated to a ligand. Each of the agents can target the same gene or two different genes; or each of the agents can target same gene at two different target sites.


In certain embodiments, an RNAi agent of the invention may contain a low number of nucleotides containing a 2′-fluoro modification, e.g., 10 or fewer nucleotides with 2′-fluoro modification. For example, the RNAi agent may contain 10, 9, 8, 7, 6, 5, 4, 3, 2, 1 or 0 nucleotides with a 2′-fluoro modification. In a specific embodiment, the RNAi agent of the invention contains 10 nucleotides with a 2′-fluoro modification, e.g., 4 nucleotides with a 2′-fluoro modification in the sense strand and 6 nucleotides with a 2′-fluoro modification in the antisense strand. In another specific embodiment, the RNAi agent of the invention contains 6 nucleotides with a 2′-fluoro modification, e.g., 4 nucleotides with a 2′-fluoro modification in the sense strand and 2 nucleotides with a 2′-fluoro modification in the antisense strand.


In other embodiments, an RNAi agent of the invention may contain an ultra low number of nucleotides containing a 2′-fluoro modification, e.g., 2 or fewer nucleotides containing a 2′-fluoro modification. For example, the RNAi agent may contain 2, 1 of 0 nucleotides with a 2′-fluoro modification. In a specific embodiment, the RNAi agent may contain 2 nucleotides with a 2′-fluoro modification, e.g., 0 nucleotides with a 2-fluoro modification in the sense strand and 2 nucleotides with a 2′-fluoro modification in the antisense strand.


Various publications describe multimeric iRNAs that can be used in the methods of the invention. Such publications include WO2007/091269, U.S. Pat. No. 7,858,769, WO2010/141511, WO2007/117686, WO2009/014887, and WO2011/031520 the entire contents of each of which are hereby incorporated herein by reference.


In certain embodiments, the compositions and methods of the disclosure include a vinyl phosphonate (VP) modification of an RNAi agent as described herein. In exemplary embodiments, a 5′-vinyl phosphonate modified nucleotide of the disclosure has the structure:




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wherein X is O or S;

    • R is hydrogen, hydroxy, fluoro, or C1-20alkoxy (e.g., methoxy or n-hexadecyloxy);
    • R5′ is ═C(H)—P(O)(OH)2 and the double bond between the C5′ carbon and R5′ is in the E or Z orientation (e.g., E orientation); and
    • B is a nucleobase or a modified nucleobase, optionally where B is adenine, guanine, cytosine, thymine, or uracil.


A vinyl phosphonate of the instant disclosure may be attached to either the antisense or the sense strand of a dsRNA of the disclosure. In certain embodiments, a vinyl phosphonate of the instant disclosure is attached to the antisense strand of a dsRNA, optionally at the 5′ end of the antisense strand of the dsRNA.


Vinyl phosphate modifications are also contemplated for the compositions and methods of the instant disclosure. An exemplary vinyl phosphate structure includes the preceding structure, where R5′ is ═C(H)—OP(O)(OH)2 and the double bond between the C5′ carbon and R5′ is in the E or Z orientation (e.g., E orientation).


As described in more detail below, the iRNA that contains conjugations of one or more carbohydrate moieties to an iRNA can optimize one or more properties of the iRNA. In many cases, the carbohydrate moiety will be attached to a modified subunit of the iRNA. For example, the ribose sugar of one or more ribonucleotide subunits of a iRNA can be replaced with another moiety, e.g., a non-carbohydrate (e.g., cyclic) carrier to which is attached a carbohydrate ligand. A ribonucleotide subunit in which the ribose sugar of the subunit has been so replaced is referred to herein as a ribose replacement modification subunit (RRMS). A cyclic carrier may be a carbocyclic ring system, i.e., all ring atoms are carbon atoms, or a heterocyclic ring system, i.e., one or more ring atoms may be a heteroatom, e.g., nitrogen, oxygen, sulfur. The cyclic carrier may be a monocyclic ring system, or may contain two or more rings, e.g. fused rings. The cyclic carrier may be a fully saturated ring system, or it may contain one or more double bonds.


The ligand may be attached to the polynucleotide via a carrier. The carriers include (i) at least one “backbone attachment point,” sich as two “backbone attachment points” and (ii) at least one “tethering attachment point.” A “backbone attachment point” as used herein refers to a functional group, e.g. a hydroxyl group, or generally, a bond available for, and that is suitable for incorporation of the carrier into the backbone, e.g., the phosphate, or modified phosphate, e.g., sulfur containing, backbone, of a ribonucleic acid. A “tethering attachment point” (TAP) in some embodiments refers to a constituent ring atom of the cyclic carrier, e.g., a carbon atom or a heteroatom (distinct from an atom which provides a backbone attachment point), that connects a selected moiety. The moiety can be, e.g., a carbohydrate, e.g. monosaccharide, disaccharide, trisaccharide, tetrasaccharide, oligosaccharide, or polysaccharide. Optionally, the selected moiety is connected by an intervening tether to the cyclic carrier. Thus, the cyclic carrier will often include a functional group, e.g., an amino group, or generally, provide a bond, that is suitable for incorporation or tethering of another chemical entity, e.g., a ligand to the constituent ring.


The iRNA may be conjugated to a ligand via a carrier, wherein the carrier can be cyclic group or acyclic group; in some embodiments, the cyclic group is selected from pyrrolidinyl, pyrazolinyl, pyrazolidinyl, imidazolinyl, imidazolidinyl, piperidinyl, piperazinyl, [1,3]dioxolane, oxazolidinyl, isoxazolidinyl, morpholinyl, thiazolidinyl, isothiazolidinyl, quinoxalinyl, pyridazinonyl, tetrahydrofuryl, and decalin; in some embodiments, the acyclic group is a serinol backbone or diethanolamine backbone.


i. Thermally Destabilizing Modifications


In certain embodiments, a dsRNA molecule can be optimized for RNA interference by incorporating thermally destabilizing modifications in the seed region of the antisense strand. As used herein “seed region” means at positions 2-9 of the 5′-end of the referenced strand. For example, thermally destabilizing modifications can be incorporated in the seed region of the antisense strand to reduce or inhibit off-target gene silencing.


The term “thermally destabilizing modification(s)” includes modification(s) that would result with a dsRNA with a lower overall melting temperature (Tm) than the Tm of the dsRNA without having such modification(s). For example, the thermally destabilizing modification(s) can decrease the Tm of the dsRNA by 1-4° C., such as one, two, three or four degrees Celcius. And, the term “thermally destabilizing nucleotide” refers to a nucleotide containing one or more thermally destabilizing modifications.


It has been discovered that dsRNAs with an antisense strand comprising at least one thermally destabilizing modification of the duplex within the first 9 nucleotide positions, counting from the 5′ end, of the antisense strand have reduced off-target gene silencing activity. Accordingly, in some embodiments, the antisense strand comprises at least one (e.g., one, two, three, four, five or more) thermally destabilizing modification of the duplex within the first 9 nucleotide positions of the 5′ region of the antisense strand. In some embodiments, one or more thermally destabilizing modification(s) of the duplex is/are located in positions 2-9, or in some embodiments positions 4-8, from the 5′-end of the antisense strand. In some further embodiments, the thermally destabilizing modification(s) of the duplex is/are located at position 6, 7 or 8 from the 5′-end of the antisense strand. In still some further embodiments, the thermally destabilizing modification of the duplex is located at position 7 from the 5′-end of the antisense strand. In some embodiments, the thermally destabilizing modification of the duplex is located at position 2, 3, 4, 5 or 9 from the 5′-end of the antisense strand.


An iRNA agent comprises a sense strand and an antisense strand, each strand having 14 to 40 nucleotides. The RNAi agent may be represented by formula (L):




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In formula (L), B1, B2, B3, B1′, B2′, B3′, and B4′ each are independently a nucleotide containing a modification selected from the group consisting of 2′-O-alkyl, 2′-substituted alkoxy, 2′-substituted alkyl, 2′-halo, ENA, and BNA/LNA. In one embodiment, B1, B2, B3, B1′, B2′, B3′, and B4′ each contain 2′-OMe modifications. In one embodiment, B1, B2, B3, B1′, B2′, B3′, and B4′ each contain 2′-OMe or 2′-F modifications. In one embodiment, at least one of B1, B2, B3, B1′, B2′, B3′, and B4′ contain 2′-O—N-methylacetamido (2′-O-NMA) modification.


C1 is a thermally destabilizing nucleotide placed at a site opposite to the seed region of the antisense strand (i.e., at positions 2-8 of the 5′-end of the antisense strand). For example, C1 is at a position of the sense strand that pairs with a nucleotide at positions 2-8 of the 5′-end of the antisense strand. In one example, C1 is at position 15 from the 5′-end of the sense strand. C1 nucleotide bears the thermally destabilizing modification which can include abasic modification; mismatch with the opposing nucleotide in the duplex; and sugar modification such as 2′-deoxy modification or acyclic nucleotide e.g., unlocked nucleic acids (UNA) or glycerol nucleic acid (GNA). In one embodiment, Cl has thermally destabilizing modification selected from the group consisting of: i) mismatch with the opposing nucleotide in the antisense strand; ii) abasic modification selected from the group consisting of:




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and iii) sugar modification selected from the group consisting of:




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wherein B is a modified or unmodified nucleobase, R1 and R2 independently are H, halogen, OR3, or alkyl; and R3 is H, alkyl, cycloalkyl, aryl, aralkyl, heteroaryl or sugar. In one embodiment, the thermally destabilizing modification in C1 is a mismatch selected from the group consisting of G:G, G:A, G:U, G:T, A:A, A:C, C:C, C:U, C:T, U:U, T:T, and U:T; and optionally, at least one nucleobase in the mismatch pair is a 2-deoxy nucleobase. In one example, the thermally destabilizing modification in C1 is GNA or




embedded image


T1, T1′, T2′, and T3′ each independently represent a nucleotide comprising a modification providing the nucleotide a steric bulk that is less or equal to the steric bulk of a 2′-OMe modification. A steric bulk refers to the sum of steric effects of a modification. Methods for determining steric effects of a modification of a nucleotide are known to one skilled in the art. The modification can be at the 2′ position of a ribose sugar of the nucleotide, or a modification to a non-ribose nucleotide, acyclic nucleotide, or the backbone of the nucleotide that is similar or equivalent to the 2′ position of the ribose sugar, and provides the nucleotide a steric bulk that is less than or equal to the steric bulk of a 2′-OMe modification. For example, T1, T1′, T2′, and T3′ are each independently selected from DNA, RNA, LNA, 2′-F, and 2′-F-5′-methyl. In one embodiment, T1 is DNA. In one embodiment, T1′ is DNA, RNA or LNA. In one embodiment, T2′ is DNA or RNA. In one embodiment, T3′ is DNA or RNA.

    • n1, n3, and q1 are independently 4 to 15 nucleotides in length.
    • n5, q3, and q7 are independently 1-6 nucleotide(s) in length.
    • n4, q2, and q6 are independently 1-3 nucleotide(s) in length; alternatively, n4 is 0.
    • q5 is independently 0-10 nucleotide(s) in length.
    • n2 and q4 are independently 0-3 nucleotide(s) in length.


Alternatively, n4 is 0-3 nucleotide(s) in length.


In one embodiment, n4 can be 0. In one example, n4 is 0, and q2 and q6 are 1. In another example, n4 is 0, and q2 and q6 are 1, with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, n4, q2, and q6 are each 1.


In one embodiment, n2, n4, q2, q4, and q6 are each 1.


In one embodiment, C1 is at position 14-17 of the 5′-end of the sense strand, when the sense strand is 19-22 nucleotides in length, and n4 is 1. In one embodiment, C1 is at position 15 of the 5′-end of the sense strand


In one embodiment, T3′ starts at position 2 from the 5′ end of the antisense strand. In one example, T3′ is at position 2 from the 5′ end of the antisense strand and q6 is equal to 1.


In one embodiment, T1′ starts at position 14 from the 5′ end of the antisense strand. In one example, T1′ is at position 14 from the 5′ end of the antisense strand and q2 is equal to 1.


In an exemplary embodiment, T3′ starts from position 2 from the 5′ end of the antisense strand and T1′ starts from position 14 from the 5′ end of the antisense strand. In one example, T3′ starts from position 2 from the 5′ end of the antisense strand and q6 is equal to 1 and T1′ starts from position 14 from the 5′ end of the antisense strand and q2 is equal to 1.


In one embodiment, T1′ and T3′ are separated by 11 nucleotides in length (i.e. not counting the T1′ and T3′ nucleotides).


In one embodiment, T1′ is at position 14 from the 5′ end of the antisense strand. In one example, T1′ is at position 14 from the 5′ end of the antisense strand and q2 is equal to 1, and the modification at the 2′ position or positions in a non-ribose, acyclic or backbone that provide less steric bulk than a 2′-OMe ribose.


In one embodiment, T3′ is at position 2 from the 5′ end of the antisense strand. In one example, T3′ is at position 2 from the 5′ end of the antisense strand and q6 is equal to 1, and the modification at the 2′ position or positions in a non-ribose, acyclic or backbone that provide less than or equal to steric bulk than a 2′-OMe ribose.


In one embodiment, T1 is at the cleavage site of the sense strand. In one example, T1 is at position 11 from the 5′ end of the sense strand, when the sense strand is 19-22 nucleotides in length, and n2 is 1. In an exemplary embodiment, T1 is at the cleavage site of the sense strand at position 11 from the 5′ end of the sense strand, when the sense strand is 19-22 nucleotides in length, and n2 is 1, In one embodiment, T2′ starts at position 6 from the 5′ end of the antisense strand. In one example, T2′ is at positions 6-10 from the 5′ end of the antisense strand, and q4 is 1.


In an exemplary embodiment, T1 is at the cleavage site of the sense strand, for instance, at position 11 from the 5′ end of the sense strand, when the sense strand is 19-22 nucleotides in length, and n2 is 1; T1′ is at position 14 from the 5′ end of the antisense strand, and q2 is equal to 1, and the modification to T1′ is at the 2′ position of a ribose sugar or at positions in a non-ribose, acyclic or backbone that provide less steric bulk than a 2′-OMe ribose; T2′ is at positions 6-10 from the 5′ end of the antisense strand, and q4 is 1; and T3′ is at position 2 from the 5′ end of the antisense strand, and q6 is equal to 1, and the modification to T3′ is at the 2′ position or at positions in a non-ribose, acyclic or backbone that provide less than or equal to steric bulk than a 2′-OMe ribose. In one embodiment, T2′ starts at position 8 from the 5′ end of the antisense strand. In one example, T2′ starts at position 8 from the 5′ end of the antisense strand, and q4 is 2.


In one embodiment, T2′ starts at position 9 from the 5′ end of the antisense strand. In one example, T2′ is at position 9 from the 5′ end of the antisense strand, and q4 is 1.


In one embodiment, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 1, B3′ is 2′-OMe or 2′-F, q5 is 6, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 1, B3′ is 2′-OMe or 2′-F, q5 is 6, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 6, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 7, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 6, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 7, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 1, B3′ is 2′-OMe or 2′-F, q5 is 6, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 1, B3′ is 2′-OMe or 2′-F, q5 is 6, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 5, T2′ is 2′-F, q4 is 1, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; optionally with at least 2 additional TT at the 3′-end of the antisense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 5, T2′ is 2′-F, q4 is 1, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; optionally with at least 2 additional TT at the 3′-end of the antisense strand; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within positions 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand).


The RNAi agent can comprise a phosphorus-containing group at the 5′-end of the sense strand or antisense strand. The 5′-end phosphorus-containing group can be 5′-end phosphate (5′-P), 5′-end phosphorothioate (5′-PS), 5′-end phosphorodithioate (5′-PS2), 5′-end vinylphosphonate (5′-VP), 5′-end methylphosphonate (MePhos), or 5′-deoxy-5′-C-malonyl




embedded image


When the 5′-end phosphorus-containing group is 5′-end vinylphosphonate (5′-VP), the 5′-VP can be either 5′-E-VP isomer (i.e., trans-vinylphosphate,




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5′-Z—VP isomer (i.e., cis-vinylphosphate,




embedded image


or mixtures thereof.


In one embodiment, the RNAi agent comprises a phosphorus-containing group at the 5′-end of the sense strand. In one embodiment, the RNAi agent comprises a phosphorus-containing group at the 5′-end of the antisense strand.


In one embodiment, the RNAi agent comprises a 5′-P. In one embodiment, the RNAi agent comprises a 5′-P in the antisense strand.


In one embodiment, the RNAi agent comprises a 5′-PS. In one embodiment, the RNAi agent comprises a 5′-PS in the antisense strand.


In one embodiment, the RNAi agent comprises a 5′-VP. In one embodiment, the RNAi agent comprises a 5′-VP in the antisense strand. In one embodiment, the RNAi agent comprises a 5′-E-VP in the antisense strand. In one embodiment, the RNAi agent comprises a 5′-Z—VP in the antisense strand.


In one embodiment, the RNAi agent comprises a 5′-PS2. In one embodiment, the RNAi agent comprises a 5′-PS2 in the antisense strand.


In one embodiment, the RNAi agent comprises a 5′-PS2. In one embodiment, the RNAi agent comprises a 5′-deoxy-5′-C-malonyl in the antisense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n1 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The dsRNA agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof. In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1. The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The dsRNAi RNA agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1. The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-P.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-VP. The 5′-VP may be 5′-E-VP, 5′-Z—VP, or combination thereof.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS2.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-P and a targeting ligand. In one embodiment, the 5′-P is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS and a targeting ligand. In one embodiment, the 5′-PS is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-VP (e.g., a 5′-E-VP, 5′-Z—VP, or combination thereof), and a targeting ligand.


In one embodiment, the 5′-VP is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS2 and a targeting ligand. In one embodiment, the 5′-PS2 is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl and a targeting ligand. In one embodiment, the 5′-deoxy-5′-C-malonyl is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-P and a targeting ligand. In one embodiment, the 5′-P is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-PS and a targeting ligand. In one embodiment, the 5′-PS is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-VP (e.g., a 5′-E-VP, 5′-Z—VP, or combination thereof) and a targeting ligand. In one embodiment, the 5′-VP is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-PS2 and a targeting ligand. In one embodiment, the 5′-PS2 is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-OMe, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl and a targeting ligand. In one embodiment, the 5′-deoxy-5′-C-malonyl is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-P and a targeting ligand. In one embodiment, the 5′-P is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS and a targeting ligand. In one embodiment, the 5′-PS is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-VP (e.g., a 5′-E-VP, 5′-Z—VP, or combination thereof) and a targeting ligand. In one embodiment, the 5′-VP is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS2 and a targeting ligand. In one embodiment, the 5′-PS2 is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, T2′ is 2′-F, q4 is 2, B3′ is 2′-OMe or 2′-F, q5 is 5, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl and a targeting ligand. In one embodiment, the 5′-deoxy-5′-C-malonyl is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-P and a targeting ligand. In one embodiment, the 5′-P is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS and a targeting ligand. In one embodiment, the 5′-PS is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-VP (e.g., a 5′-E-VP, 5′-Z—VP, or combination thereof) and a targeting ligand. In one embodiment, the 5′-VP is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-PS2 and a targeting ligand. In one embodiment, the 5′-PS2 is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In one embodiment, B1 is 2′-OMe or 2′-F, n1 is 8, T1 is 2′F, n2 is 3, B2 is 2′-OMe, n3 is 7, n4 is 0, B3 is 2′-OMe, n5 is 3, B1′ is 2′-OMe or 2′-F, q1 is 9, T1′ is 2′-F, q2 is 1, B2′ is 2′-OMe or 2′-F, q3 is 4, q4 is 0, B3′ is 2′-OMe or 2′-F, q5 is 7, T3′ is 2′-F, q6 is 1, B4′ is 2′-F, and q7 is 1; with two phosphorothioate internucleotide linkage modifications within position 1-5 of the sense strand (counting from the 5′-end of the sense strand), and two phosphorothioate internucleotide linkage modifications at positions 1 and 2 and two phosphorothioate internucleotide linkage modifications within positions 18-23 of the antisense strand (counting from the 5′-end of the antisense strand). The RNAi agent also comprises a 5′-deoxy-5′-C-malonyl and a targeting ligand. In one embodiment, the 5′-deoxy-5′-C-malonyl is at the 5′-end of the antisense strand, and the targeting ligand is at the 3′-end of the sense strand.


In a particular embodiment, an RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker; and
      • (iii) 2′-F modifications at positions 1, 3, 5, 7, 9 to 11, 13, 17, 19, and 21, and 2′-OMe modifications at positions 2, 4, 6, 8, 12, 14 to 16, 18, and 20 (counting from the 5′ end); and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3, 5, 9, 11 to 13, 15, 17, 19, 21, and 23, and 2′F modifications at positions 2, 4, 6 to 8, 10, 14, 16, 18, 20, and 22 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);
    • wherein the dsRNA agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, an RNAi agent of the present invention comprises:

    • (a) a sense strand having:
    • (i) a length of 21 nucleotides;
    • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
    • (iii) 2′-F modifications at positions 1, 3, 5, 7, 9 to 11, 13, 15, 17, 19, and 21, and 2′-OMe modifications at positions 2, 4, 6, 8, 12, 14, 16, 18, and 20 (counting from the 5′ end); and
    • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3, 5, 7, 9, 11 to 13, 15, 17, 19, and 21 to 23, and 2′F modifications at positions 2, 4, 6, 8, 10, 14, 16, 18, and 20 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1 to 6, 8, 10, and 12 to 21, 2′-F modifications at positions 7, and 9, and a deoxy-nucleotide (e.g. dT) at position 11 (counting from the 5′ end); and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3, 7, 9, 11, 13, 15, 17, and 19 to 23, and 2′-F modifications at positions 2, 4 to 6, 8, 10, 12, 14, 16, and 18 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1 to 6, 8, 10, 12, 14, and 16 to 21, and 2′-F modifications at positions 7, 9, 11, 13, and 15; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 5, 7, 9, 11, 13, 15, 17, 19, and 21 to 23, and 2′-F modifications at positions 2 to 4, 6, 8, 10, 12, 14, 16, 18, and 20 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1 to 9, and 12 to 21, and 2′-F modifications at positions 10, and 11; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3, 5, 7, 9, 11 to 13, 15, 17, 19, and 21 to 23, and 2′-F modifications at positions 2, 4, 6, 8, 10, 14, 16, 18, and 20 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-F modifications at positions 1, 3, 5, 7, 9 to 11, and 13, and 2′-OMe modifications at positions 2, 4, 6, 8, 12, and 14 to 21; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3, 5 to 7, 9, 11 to 13, 15, 17 to 19, and 21 to 23, and 2′-F modifications at positions 2, 4, 8, 10, 14, 16, and 20 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1, 2, 4, 6, 8, 12, 14, 15, 17, and 19 to 21, and 2′-F modifications at positions 3, 5, 7, 9 to 11, 13, 16, and 18; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 25 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 4, 6, 7, 9, 11 to 13, 15, 17, and 19 to 23, 2′-F modifications at positions 2, 3, 5, 8, 10, 14, 16, and 18, and desoxy-nucleotides (e.g. dT) at positions 24 and 25 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a four nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1 to 6, 8, and 12 to 21, and 2′-F modifications at positions 7, and 9 to 11; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3 to 5, 7, 8, 10 to 13, 15, and 17 to 23, and 2′-F modifications at positions 2, 6, 9, 14, and 16 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1 to 6, 8, and 12 to 21, and 2′-F modifications at positions 7, and 9 to 11; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 23 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3 to 5, 7, 10 to 13, 15, and 17 to 23, and 2′-F modifications at positions 2, 6, 8, 9, 14, and 16 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 21 and 22, and between nucleotide positions 22 and 23 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In another particular embodiment, a RNAi agent of the present invention comprises:

    • (a) a sense strand having:
      • (i) a length of 19 nucleotides;
      • (ii) an ASGPR ligand attached to the 3′-end, wherein said ASGPR ligand comprises three GalNAc derivatives attached through a trivalent branched linker;
      • (iii) 2′-OMe modifications at positions 1 to 4, 6, and 10 to 19, and 2′-F modifications at positions 5, and 7 to 9; and
      • (iv) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 2 and 3 (counting from the 5′ end);
    • and
    • (b) an antisense strand having:
      • (i) a length of 21 nucleotides;
      • (ii) 2′-OMe modifications at positions 1, 3 to 5, 7, 10 to 13, 15, and 17 to 21, and 2′-F modifications at positions 2, 6, 8, 9, 14, and 16 (counting from the 5′ end); and
      • (iii) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21 (counting from the 5′ end);


        wherein the RNAi agents have a two nucleotide overhang at the 3′-end of the antisense strand, and a blunt end at the 5′-end of the antisense strand.


In certain embodiments, the iRNA for use in the methods of the invention is an agent selected from agents listed in any one of Tables 2-5. These agents may further comprise a ligand.


III. iRNAs Conjugated to Ligands

Another modification of the RNA of an iRNA of the invention involves chemically linking to the iRNA one or more ligands, moieties or conjugates that enhance the activity, cellular distribution, or cellular uptake of the iRNA e.g., into a cell. Such moieties include but are not limited to lipid moieties such as a cholesterol moiety (Letsinger et al., Proc. Natl. Acid. Sci. USA, 1989, 86: 6553-6556). In other embodiments, the ligand is cholic acid (Manoharan et al., Biorg. Med. Chem. Let., 1994, 4:1053-1060), a thioether, e.g., beryl-S-tritylthiol (Manoharan et al., Ann. N.Y. Acad. Sci., 1992, 660:306-309; Manoharan et al., Biorg. Med. Chem. Let., 1993, 3:2765-2770), a thiocholesterol (Oberhauser et al., Nucl. Acids Res., 1992, 20:533-538), an aliphatic chain, e.g., dodecandiol or undecyl residues (Saison-Behmoaras et al., EMBO J, 1991, 10:1111-1118; Kabanov et al., FEBS Lett., 1990, 259:327-330; Svinarchuk et al., Biochimie, 1993, 75:49-54), a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethyl-ammonium 1,2-di-O-hexadecyl-rac-glycero-3-phosphonate (Manoharan et al., Tetrahedron Lett., 1995, 36:3651-3654; Shea et al., Nucl. Acids Res., 1990, 18:3777-3783), a polyamine or a polyethylene glycol chain (Manoharan et al., Nucleosides & Nucleotides, 1995, 14:969-973), or adamantane acetic acid (Manoharan et al., Tetrahedron Lett., 1995, 36:3651-3654), a palmityl moiety (Mishra et al., Biochim. Biophys. Acta, 1995, 1264:229-237), or an octadecylamine or hexylamino-carbonyloxycholesterol moiety (Crooke et al., J. Pharmacol. Exp. Ther., 1996, 277:923-937).


In certain embodiments, a ligand alters the distribution, targeting, or lifetime of an iRNA agent into which it is incorporated. In certain embodiments a ligand provides an enhanced affinity for a selected target, e.g., molecule, cell or cell type, compartment, e.g., a cellular or organ compartment, tissue, organ or region of the body, as, e.g., compared to a species absent such a ligand. In some embodiments, ligands do not take part in duplex pairing in a duplexed nucleic acid.


Ligands can include a naturally occurring substance, such as a protein (e.g., human serum albumin (HSA), low-density lipoprotein (LDL), or globulin); carbohydrate (e.g., a dextran, pullulan, chitin, chitosan, inulin, cyclodextrin, N-acetylglucosamine, N-acetylgalactosamine, or hyaluronic acid); or a lipid. The ligand can also be a recombinant or synthetic molecule, such as a synthetic polymer, e.g., a synthetic polyamino acid. Examples of polyamino acids include polyamino acid is a polylysine (PLL), poly L-aspartic acid, poly L-glutamic acid, styrene-maleic acid anhydride copolymer, poly(L-lactide-co-glycolied) copolymer, divinyl ether-maleic anhydride copolymer, N-(2-hydroxypropyl)methacrylamide copolymer (HMPA), polyethylene glycol (PEG), polyvinyl alcohol (PVA), polyurethane, poly(2-ethylacryllic acid), N-isopropylacrylamide polymers, or polyphosphazine. Example of polyamines include: polyethylenimine, polylysine (PLL), spermine, spermidine, polyamine, pseudopeptide-polyamine, peptidomimetic polyamine, dendrimer polyamine, arginine, amidine, protamine, cationic lipid, cationic porphyrin, quaternary salt of a polyamine, or an alpha helical peptide.


Ligands can also include targeting groups, e.g., a cell or tissue targeting agent, e.g., a lectin, glycoprotein, lipid or protein, e.g., an antibody, that binds to a specified cell type such as a kidney cell. A targeting group can be a thyrotropin, melanotropin, lectin, glycoprotein, surfactant protein A, Mucin carbohydrate, multivalent lactose, multivalent galactose, N-acetyl-galactosamine, N-acetyl-glucosamine multivalent mannose, multivalent fucose, glycosylated polyaminoacids, multivalent galactose, transferrin, bisphosphonate, polyglutamate, polyaspartate, a lipid, cholesterol, a steroid, bile acid, folate, vitamin B12, vitamin A, biotin, or an RGD peptide or RGD peptide mimetic. In certain embodiments, the ligand is a multivalent galactose, e.g., an N-acetyl-galactosamine.


Other examples of ligands include dyes, intercalating agents (e.g. acridines), cross-linkers (e.g. psoralene, mitomycin C), porphyrins (TPPC4, texaphyrin, Sapphyrin), polycyclic aromatic hydrocarbons (e.g., phenazine, dihydrophenazine), artificial endonucleases (e.g. EDTA), lipophilic molecules, e.g., cholesterol, cholic acid, adamantane acetic acid, 1-pyrene butyric acid, dihydrotestosterone, 1,3-Bis-O(hexadecyl)glycerol, geranyloxyhexyl group, hexadecylglycerol, borneol, menthol, 1,3-propanediol, heptadecyl group, palmitic acid, myristic acid,O3-(oleoyl)lithocholic acid, O3-(oleoyl)cholenic acid, dimethoxytrityl, or phenoxazine) and peptide conjugates (e.g., antennapedia peptide, Tat peptide), alkylating agents, phosphate, amino, mercapto, PEG (e.g., PEG-40K), MPEG, [MPEG]2, polyamino, alkyl, substituted alkyl, radiolabeled markers, enzymes, haptens (e.g. biotin), transport/absorption facilitators (e.g., aspirin, vitamin E, folic acid), synthetic ribonucleases (e.g., imidazole, bisimidazole, histamine, imidazole clusters, acridine-imidazole conjugates, Eu3+ complexes of tetraazamacrocycles), dinitrophenyl, HRP, or AP.


Ligands can be proteins, e.g., glycoproteins, or peptides, e.g., molecules having a specific affinity for a co-ligand, or antibodies e.g., an antibody, that binds to a specified cell type such as a hepatic cell. Ligands can also include hormones and hormone receptors. They can also include non-peptidic species, such as lipids, lectins, carbohydrates, vitamins, cofactors, multivalent lactose, multivalent galactose, N-acetyl-galactosamine, N-acetyl-glucosamine multivalent mannose, or multivalent fucose. The ligand can be, for example, a lipopolysaccharide, an activator of p38 MAP kinase, or an activator of NF-κB.


The ligand can be a substance, e.g., a drug, which can increase the uptake of the iRNA agent into the cell, for example, by disrupting the cell's cytoskeleton, e.g., by disrupting the cell's microtubules, microfilaments, or intermediate filaments. The drug can be, for example, taxol, vincristine, vinblastine, cytochalasin, nocodazole, japlakinolide, latrunculin A, phalloidin, swinholide A, indanocine, or myoservin.


In some embodiments, a ligand attached to an iRNA as described herein acts as a pharmacokinetic modulator (PK modulator). PK modulators include lipophiles, bile acids, steroids, phospholipid analogues, peptides, protein binding agents, PEG, vitamins, etc. Exemplary PK modulators include, but are not limited to, cholesterol, fatty acids, cholic acid, lithocholic acid, dialkylglycerides, diacylglyceride, phospholipids, sphingolipids, naproxen, ibuprofen, vitamin E, biotin. Oligonucleotides that comprise a number of phosphorothioate linkages are also known to bind to serum protein, thus short oligonucleotides, e.g., oligonucleotides of about 5 bases, 10 bases, 15 bases, or 20 bases, comprising multiple of phosphorothioate linkages in the backbone are also amenable to the present invention as ligands (e.g. as PK modulating ligands). In addition, aptamers that bind serum components (e.g. serum proteins) are also suitable for use as PK modulating ligands in the embodiments described herein.


Ligand-conjugated iRNAs of the invention may be synthesized by the use of an oligonucleotide that bears a pendant reactive functionality, such as that derived from the attachment of a linking molecule onto the oligonucleotide (described below). This reactive oligonucleotide may be reacted directly with commercially-available ligands, ligands that are synthesized bearing any of a variety of protecting groups, or ligands that have a linking moiety attached thereto.


The oligonucleotides used in the conjugates of the present 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 methods for such synthesis known in the art may additionally or alternatively be employed. It is also known to use similar techniques to prepare other oligonucleotides, such as the phosphorothioates and alkylated derivatives.


In the ligand-conjugated iRNAs and ligand-molecule bearing sequence-specific linked nucleosides of the present invention, the oligonucleotides and oligonucleosides may be assembled on a suitable DNA synthesizer utilizing standard nucleotide or nucleoside precursors, or nucleotide or nucleoside conjugate precursors that already bear the linking moiety, ligand-nucleotide or nucleoside-conjugate precursors that already bear the ligand molecule, or non-nucleoside ligand-bearing building blocks.


When using nucleotide-conjugate precursors that already bear a linking moiety, the synthesis of the sequence-specific linked nucleosides is typically completed, and the ligand molecule is then reacted with the linking moiety to form the ligand-conjugated oligonucleotide. In some embodiments, the oligonucleotides or linked nucleosides of the present invention are synthesized by an automated synthesizer using phosphoramidites derived from ligand-nucleoside conjugates in addition to the standard phosphoramidites and non-standard phosphoramidites that are commercially available and routinely used in oligonucleotide synthesis.


A. Lipid Conjugates


In certain embodiments, the ligand or conjugate is a lipid or lipid-based molecule. Such a lipid or lipid-based molecule in some embodiments binds a serum protein, e.g., human serum albumin (HSA). An HSA binding ligand allows for distribution of the conjugate to a target tissue, e.g., a non-kidney target tissue of the body. For example, the target tissue can be the liver, including parenchymal cells of the liver. Other molecules that can bind HSA can also be used as ligands. For example, naproxen or aspirin can be used. A lipid or lipid-based ligand can (a) increase resistance to degradation of the conjugate, (b) increase targeting or transport into a target cell or cell membrane, or (c) can be used to adjust binding to a serum protein, e.g., HSA.


A lipid based ligand can be used to inhibit, e.g., control the binding of the conjugate to a target tissue. For example, a lipid or lipid-based ligand that binds to HSA more strongly will be less likely to be targeted to the kidney and therefore less likely to be cleared from the body. A lipid or lipid-based ligand that binds to HSA less strongly can be used to target the conjugate to the kidney.


In certain embodiments, the lipid based ligand binds HSA. In some embodiments, it binds HSA with a sufficient affinity such that the conjugate will be in some embodiments distributed to a non-kidney tissue. However, it is preferred that the affinity not be so strong that the HSA-ligand binding cannot be reversed.


In other embodiments, the lipid based ligand binds HSA weakly or not at all, such that the conjugate will be in some embodiments distributed to the kidney. Other moieties that target to kidney cells can also be used in place of, or in addition to, the lipid based ligand.


In another aspect, the ligand is a moiety, e.g., a vitamin, which is taken up by a target cell, e.g., a proliferating cell. These are particularly useful for treating disorders characterized by unwanted cell proliferation, e.g., of the malignant or non-malignant type, e.g., cancer cells.


Exemplary vitamins include vitamin A, E, and K. Other exemplary vitamins include are B vitamin, e.g., folic acid, B12, riboflavin, biotin, pyridoxal or other vitamins or nutrients taken up by target cells such as liver cells. Also included are HSA and low density lipoprotein (LDL).


B. Cell Permeation Agents


In another aspect, the ligand is a cell-permeation agent, in some embodiments a helical cell-permeation agent. In some embodiments, the agent is amphipathic. An exemplary agent is a peptide such as tat or antennopedia. If the agent is a peptide, it can be modified, including a peptidylmimetic, invertomers, non-peptide or pseudo-peptide linkages, and use of D-amino acids. The helical agent is in some embodiments an alpha-helical agent, which in some embodiments has a lipophilic and a lipophobic phase.


The ligand can be a peptide or peptidomimetic. A peptidomimetic (also referred to herein as an oligopeptidomimetic) is a molecule capable of folding into a defined three-dimensional structure similar to a natural peptide. The attachment of peptide and peptidomimetics to iRNA agents can affect pharmacokinetic distribution of the iRNA, such as by enhancing cellular recognition and absorption. The peptide or peptidomimetic moiety can be about 5-50 amino acids long, e.g., about 5, 10, 15, 20, 25, 30, 35, 40, 45, or 50 amino acids long.


A peptide or peptidomimetic can be, for example, a cell permeation peptide, cationic peptide, amphipathic peptide, or hydrophobic peptide (e.g., consisting primarily of Tyr, Trp, or Phe). The peptide moiety can be a dendrimer peptide, constrained peptide or crosslinked peptide. In another alternative, the peptide moiety can include a hydrophobic membrane translocation sequence (MTS). An exemplary hydrophobic MTS-containing peptide is RFGF having the amino acid sequence AAVALLPAVLLALLAP (SEQ ID NO: 37). An RFGF analogue (e.g., amino acid sequence AALLPVLLAAP (SEQ ID NO:38) containing a hydrophobic MTS can also be a targeting moiety. The peptide moiety can be a “delivery” peptide, which can carry large polar molecules including peptides, oligonucleotides, and protein across cell membranes. For example, sequences from the HIV Tat protein (GRKKRRQRRRPPQ (SEQ ID NO:39) and the Drosophila Antennapedia protein (RQIKIWFQNRRMKWKK (SEQ ID NO:40) have been found to be capable of functioning as delivery peptides. A peptide or peptidomimetic can be encoded by a random sequence of DNA, such as a peptide identified from a phage-display library, or one-bead-one-compound (OBOC) combinatorial library (Lam et al., Nature, 354:82-84, 1991). Examples of a peptide or peptidomimetic tethered to a dsRNA agent via an incorporated monomer unit for cell targeting purposes is an arginine-glycine-aspartic acid (RGD)-peptide, or RGD mimic. A peptide moiety can range in length from about 5 amino acids to about 40 amino acids. The peptide moieties can have a structural modification, such as to increase stability or direct conformational properties. Any of the structural modifications described below can be utilized.


An RGD peptide for use in the compositions and methods of the invention may be linear or cyclic, and may be modified, e.g., glycosylated or methylated, to facilitate targeting to a specific tissue(s). RGD-containing peptides and peptidiomimemtics may include D-amino acids, as well as synthetic RGD mimics. In addition to RGD, one can use other moieties that target the integrin ligand. Exemplary conjugates of this ligand target PECAM-1 or VEGF.


A “cell permeation peptide” is capable of permeating a cell, e.g., a microbial cell, such as a bacterial or fungal cell, or a mammalian cell, such as a human cell. A microbial cell-permeating peptide can be, for example, an α-helical linear peptide (e.g., LL-37 or Ceropin P1), a disulfide bond-containing peptide (e.g., α-defensin, β-defensin or bactenecin), or a peptide containing only one or two dominating amino acids (e.g., PR-39 or indolicidin). A cell permeation peptide can also include a nuclear localization signal (NLS). For example, a cell permeation peptide can be a bipartite amphipathic peptide, such as MPG, which is derived from the fusion peptide domain of HIV-1 gp41 and the NLS of SV40 large T antigen (Simeoni et al., Nucl. Acids Res. 31:2717-2724, 2003).


C. Carbohydrate Conjugates


In some embodiments of the compositions and methods of the invention, an iRNA further comprises a carbohydrate. The carbohydrate conjugated iRNA is advantageous for the in vivo delivery of nucleic acids, as well as compositions suitable for in vivo therapeutic use, as described herein. As used herein, “carbohydrate” refers to a compound which is either a carbohydrate per se made up of one or more monosaccharide units having at least 6 carbon atoms (which can be linear, branched or cyclic) with an oxygen, nitrogen or sulfur atom bonded to each carbon atom; or a compound having as a part thereof a carbohydrate moiety made up of one or more monosaccharide units each having at least six carbon atoms (which can be linear, branched or cyclic), with an oxygen, nitrogen or sulfur atom bonded to each carbon atom. Representative carbohydrates include the sugars (mono-, di-, tri-, and oligosaccharides containing from about 4, 5, 6, 7, 8, or 9 monosaccharide units), and polysaccharides such as starches, glycogen, cellulose and polysaccharide gums. Specific monosaccharides include C5 and above (e.g., C5, C6, C7, or C8) sugars; di- and trisaccharides include sugars having two or three monosaccharide units (e.g., C5, C6, C7, or C8).


In certain embodiments, a carbohydrate conjugate for use in the compositions and methods of the invention is a monosaccharide.


In certain embodiments, the monosaccharide is an N-acetylgalactosamine (GalNAc). GalNAc conjugates, which comprise one or more N-acetylgalactosamine (GalNAc) derivatives, are described, for example, in U.S. Pat. No. 8,106,022, the entire content of which is hereby incorporated herein by reference. In some embodiments, the GalNAc conjugate serves as a ligand that targets the iRNA to particular cells. In some embodiments, the GalNAc conjugate targets the iRNA to liver cells, e.g., by serving as a ligand for the asialoglycoprotein receptor of liver cells (e.g., hepatocytes).


In some embodiments, the carbohydrate conjugate comprises one or more GalNAc derivatives. The GalNAc derivatives may be attached via a linker, e.g., a bivalent or trivalent branched linker. In some embodiments the GalNAc conjugate is conjugated to the 3′ end of the sense strand. In some embodiments, the GalNAc conjugate is conjugated to the iRNA agent (e.g., to the 3′ end of the sense strand) via a linker, e.g., a linker as described herein. In some embodiments the GalNAc conjugate is conjugated to the 5′ end of the sense strand. In some embodiments, the GalNAc conjugate is conjugated to the iRNA agent (e.g., to the 5′ end of the sense strand) via a linker, e.g., a linker as described herein.


In certain embodiments of the invention, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a monovalent linker. In some embodiments, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a bivalent linker. In yet other embodiments of the invention, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a trivalent linker. In other embodiments of the invention, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a tetravalent linker.


In certain embodiments, the double stranded RNAi agents of the invention comprise one GalNAc or GalNAc derivative attached to the iRNA agent. In certain embodiments, the double stranded RNAi agents of the invention comprise a plurality (e.g., 2, 3, 4, 5, or 6) GalNAc or GalNAc derivatives, each independently attached to a plurality of nucleotides of the double stranded RNAi agent through a plurality of monovalent linkers.


In some embodiments, for example, when the two strands of an iRNA agent of the invention are part of one larger molecule connected by an uninterrupted chain of nucleotides between the 3′-end of one strand and the 5′-end of the respective other strand forming a hairpin loop comprising, a plurality of unpaired nucleotides, each unpaired nucleotide within the hairpin loop may independently comprise a GalNAc or GalNAc derivative attached via a monovalent linker. The hairpin loop may also be formed by an extended overhang in one strand of the duplex.


In some embodiments, for example, when the two strands of an iRNA agent of the invention are part of one larger molecule connected by an uninterrupted chain of nucleotides between the 3′-end of one strand and the 5′-end of the respective other strand forming a hairpin loop comprising, a plurality of unpaired nucleotides, each unpaired nucleotide within the hairpin loop may independently comprise a GalNAc or GalNAc derivative attached via a monovalent linker. The hairpin loop may also be formed by an extended overhang in one strand of the duplex.


In one embodiment, a carbohydrate conjugate for use in the compositions and methods of the invention is selected from the group consisting of:




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wherein Y is O or S and n is 3-6 (Formula XXIV);




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wherein Y is O or S and n is 3-6 (Formula XXV);




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wherein X is O or S (Formula XXVII);




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In another embodiment, a carbohydrate conjugate for use in the compositions and methods of the invention is a monosaccharide. In one embodiment, the monosaccharide is an N-acetylgalactosamine, such as




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In some embodiments, the RNAi agent is attached to the carbohydrate conjugate via a linker as shown in the following schematic, wherein X is O or S




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In some embodiments, the RNAi agent is conjugated to L96 as defined in Table 1 and shown below:




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Another representative carbohydrate conjugate for use in the embodiments described herein includes, but is not limited to,




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(Formula XXXVI), when one of X or Y is an oligonucleotide, the other is a hydrogen.


In some embodiments, a suitable ligand is a ligand disclosed in WO 2019/055633, the entire contents of which are incorporated herein by reference. In one embodiment the ligand comprises the structure below:




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In certain embodiments of the invention, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a monovalent linker. In some embodiments, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a bivalent linker. In yet other embodiments of the invention, the GalNAc or GalNAc derivative is attached to an iRNA agent of the invention via a trivalent linker.


In one embodiment, the double stranded RNAi agents of the invention comprise one or more GalNAc or GalNAc derivative attached to the iRNA agent. The GalNAc may be attached to any nucleotide via a linker on the sense strand or antsisense strand. The GalNac may be attached to the 5′-end of the sense strand, the 3′ end of the sense strand, the 5′-end of the antisense strand, or the 3′-end of the antisense strand. In one embodiment, the GalNAc is attached to the 3′ end of the sense strand, e.g., via a trivalent linker.


In other embodiments, the double stranded RNAi agents of the invention comprise a plurality (e.g., 2, 3, 4, 5, or 6) GalNAc or GalNAc derivatives, each independently attached to a plurality of nucleotides of the double stranded RNAi agent through a plurality of linkers, e.g., monovalent linkers.


In some embodiments, for example, when the two strands of an iRNA agent of the invention is part of one larger molecule connected by an uninterrupted chain of nucleotides between the 3′-end of one strand and the 5′-end of the respective other strand forming a hairpin loop comprising, a plurality of unpaired nucleotides, each unpaired nucleotide within the hairpin loop may independently comprise a GalNAc or GalNAc derivative attached via a monovalent linker.


In some embodiments, the carbohydrate conjugate further comprises one or more additional ligands as described above, such as, but not limited to, a PK modulator or a cell permeation peptide.


Additional carbohydrate conjugates and linkers suitable for use in the present invention include those described in PCT Publication Nos. WO 2014/179620 and WO 2014/179627, the entire contents of each of which are incorporated herein by reference.


D. Linkers


In some embodiments, the conjugate or ligand described herein can be attached to an iRNA oligonucleotide with various linkers that can be cleavable or non-cleavable.


The term “linker” or “linking group” means an organic moiety that connects two parts of a compound, e.g., covalently attaches two parts of a compound. Linkers typically comprise a direct bond or an atom such as oxygen or sulfur, a unit such as NR8, C(O), C(O)NH, SO, SO2, SO2NH or a chain of atoms, such as, but not limited to, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl, heteroarylalkynyl, heterocyclylalkyl, heterocyclylalkenyl, heterocyclylalkynyl, aryl, heteroaryl, heterocyclyl, cycloalkyl, cycloalkenyl, alkylarylalkyl, alkylarylalkenyl, alkylarylalkynyl, alkenylarylalkyl, alkenylarylalkenyl, alkenylarylalkynyl, alkynylarylalkyl, alkynylarylalkenyl, alkynylarylalkynyl, alkylheteroarylalkyl, alkylheteroarylalkenyl, alkylheteroarylalkynyl, alkenylheteroarylalkyl, alkenylheteroarylalkenyl, alkenylheteroarylalkynyl, alkynylheteroarylalkyl, alkynylheteroarylalkenyl, alkynylheteroarylalkynyl, alkylheterocyclylalkyl, alkylheterocyclylalkenyl, alkylhererocyclylalkynyl, alkenylheterocyclylalkyl, alkenylheterocyclylalkenyl, alkenylheterocyclylalkynyl, alkynylheterocyclylalkyl, alkynylheterocyclylalkenyl, alkynylheterocyclylalkynyl, alkylaryl, alkenylaryl, alkynylaryl, alkylheteroaryl, alkenylheteroaryl, alkynylhereroaryl, which one or more methylenes can be interrupted or terminated by O, S, S(O), SO2, N(R8), C(O), substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, or substituted or unsubstituted heterocyclic; where R8 is hydrogen, acyl, aliphatic, or substituted aliphatic. In one embodiment, the linker is about 1-24 atoms, 2-24, 3-24, 4-24, 5-24, 6-24, 6-18, 7-18, 8-18, 7-17, 8-17, 6-16, 7-17, or 8-16 atoms.


A cleavable linking group is one which is sufficiently stable outside the cell, but which upon entry into a target cell is cleaved to release the two parts the linker is holding together. In certain embodiments, the cleavable linking group is cleaved at least about 10 times, 20, times, 30 times, 40 times, 50 times, 60 times, 70 times, 80 times, 90 times, or more, or at least 100 times faster in a target cell or under a first reference condition (which can, e.g., be selected to mimic or represent intracellular conditions) than in the blood of a subject, or under a second reference condition (which can, e.g., be selected to mimic or represent conditions found in the blood or serum).


Cleavable linking groups are susceptible to cleavage agents, e.g., pH, redox potential, or the presence of degradative molecules. Generally, cleavage agents are more prevalent or found at higher levels or activities inside cells than in serum or blood. Examples of such degradative agents include: redox agents which are selected for particular substrates or which have no substrate specificity, including, e.g., oxidative or reductive enzymes or reductive agents such as mercaptans, present in cells, that can degrade a redox cleavable linking group by reduction; esterases; endosomes or agents that can create an acidic environment, e.g., those that result in a pH of five or lower; enzymes that can hydrolyze or degrade an acid cleavable linking group by acting as a general acid, peptidases (which can be substrate specific), and phosphatases.


A cleavable linkage group, such as a disulfide bond can be susceptible to pH. The pH of human serum is 7.4, while the average intracellular pH is slightly lower, ranging from about 7.1-7.3. Endosomes have a more acidic pH, in the range of 5.5-6.0, and lysosomes have an even more acidic pH at around 5.0. Some linkers will have a cleavable linking group that is cleaved at a certain pH, thereby releasing a cationic lipid from the ligand inside the cell, or into the desired compartment of the cell.


A linker can include a cleavable linking group that is cleavable by a particular enzyme. The type of cleavable linking group incorporated into a linker can depend on the cell to be targeted. For example, a liver-targeting ligand can be linked to a cationic lipid through a linker that includes an ester group. Liver cells are rich in esterases, and therefore the linker will be cleaved more efficiently in liver cells than in cell types that are not esterase-rich. Other cell-types rich in esterases include cells of the lung, renal cortex, and testis.


Linkers that contain peptide bonds can be used when targeting cell types rich in peptidases, such as liver cells and synoviocytes.


In general, the suitability of a candidate cleavable linking group can be evaluated by testing the ability of a degradative agent (or condition) to cleave the candidate linking group. It will also be desirable to also test the candidate cleavable linking group for the ability to resist cleavage in the blood or when in contact with other non-target tissue. Thus, one can determine the relative susceptibility to cleavage between a first and a second condition, where the first is selected to be indicative of cleavage in a target cell and the second is selected to be indicative of cleavage in other tissues or biological fluids, e.g., blood or serum. The evaluations can be carried out in cell free systems, in cells, in cell culture, in organ or tissue culture, or in whole animals. It can be useful to make initial evaluations in cell-free or culture conditions and to confirm by further evaluations in whole animals. In some embodiments, useful candidate compounds are cleaved at least about 2, 4, 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 times faster in the cell (or under in vitro conditions selected to mimic intracellular conditions) as compared to blood or serum (or under in vitro conditions selected to mimic extracellular conditions).


i. Redox Cleavable Linking Groups


In certain embodiments, a cleavable linking group is a redox cleavable linking group that is cleaved upon reduction or oxidation. An example of reductively cleavable linking group is a disulphide linking group (—S—S—). To determine if a candidate cleavable linking group is a suitable “reductively cleavable linking group,” or for example is suitable for use with a particular iRNA moiety and particular targeting agent one can look to methods described herein. For example, a candidate can be evaluated by incubation with dithiothreitol (DTT), or other reducing agent using reagents know in the art, which mimic the rate of cleavage which would be observed in a cell, e.g., a target cell. The candidates can also be evaluated under conditions which are selected to mimic blood or serum conditions. In one, candidate compounds are cleaved by at most about 10% in the blood. In other embodiments, useful candidate compounds are degraded at least about 2, 4, 10, 20, 30, 40, 50, 60, 70, 80, 90, or about 100 times faster in the cell (or under in vitro conditions selected to mimic intracellular conditions) as compared to blood (or under in vitro conditions selected to mimic extracellular conditions). The rate of cleavage of candidate compounds can be determined using standard enzyme kinetics assays under conditions chosen to mimic intracellular media and compared to conditions chosen to mimic extracellular media.


ii. Phosphate-Based Cleavable Linking Groups


In certain embodiments, a cleavable linker comprises a phosphate-based cleavable linking group. A phosphate-based cleavable linking group is cleaved by agents that degrade or hydrolyze the phosphate group. An example of an agent that cleaves phosphate groups in cells are enzymes such as phosphatases in cells. Examples of phosphate-based linking groups are —O—P(O)(ORk)-O—, —O—P(S)(ORk)-O—, —O—P(S)(SRk)-O—, —S—P(O)(ORk)-O—, —O—P(O)(ORk)-S—, —S—P(O)(ORk)-S—, —O—P(S)(ORk)-S—, —S—P(S)(ORk)-O—, —O—P(O)(Rk)-O—, —O—P(S)(Rk)-O—, —S—P(O)(Rk)-O—, —S—P(S)(Rk)-O—, —S—P(O)(Rk)-S—, —O—P(S)(Rk)-S, wherein Rk at each occurrence can be, independently, C1-C20 alkyl, C1-C20 haloalkyl, C6-C10 aryl, or C7-C12 aralkyl. Exemplary embodiments include —O—P(O)(OH)—O—, —O—P(S)(OH)—O—, —O—P(S)(SH)—O—, —S—P(O)(OH)—O—, —O—P(O)(OH)—S—, —S—P(O)(OH)—S—, —O—P(S)(OH)—S—, —S—P(S)(OH)—O—, —O—P(O)(H)—O—, —O—P(S)(H)—O—, —S—P(O)(H)—O, —S—P(S)(H)—O—, —S—P(O)(H)—S—, and —O—P(S)(H)—S—. In one embodiment, a phosphate-based linking group is —O—P(O)(OH)—O—. These candidates can be evaluated using methods analogous to those described above.


iii. Acid Cleavable Linking Groups


In certain embodiments, a cleavable linker comprises an acid cleavable linking group. An acid cleavable linking group is a linking group that is cleaved under acidic conditions. In some embodiments acid cleavable linking groups are cleaved in an acidic environment with a pH of about 6.5 or lower (e.g., about 6.0, 5.75, 5.5, 5.25, 5.0, or lower), or by agents such as enzymes that can act as a general acid. In a cell, specific low pH organelles, such as endosomes and lysosomes can provide a cleaving environment for acid cleavable linking groups. Examples of acid cleavable linking groups include but are not limited to hydrazones, esters, and esters of amino acids. Acid cleavable groups can have the general formula —C═NN—, C(O)O, or —OC(O). An exemplary embodiment is when the carbon attached to the oxygen of the ester (the alkoxy group) is an aryl group, substituted alkyl group, or tertiary alkyl group such as dimethyl pentyl or t-butyl. These candidates can be evaluated using methods analogous to those described above.


iv. Ester-Based Linking Groups


In other embodiments, a cleavable linker comprises an ester-based cleavable linking group. An ester-based cleavable linking group is cleaved by enzymes such as esterases and amidases in cells. Examples of ester-based cleavable linking groups include, but are not limited to, esters of alkylene, alkenylene and alkynylene groups. Ester cleavable linking groups have the general formula —C(O)O—, or —OC(O)—. These candidates can be evaluated using methods analogous to those described above.


v. Peptide-Based Cleaving Groups


In yet other embodiments, a cleavable linker comprises a peptide-based cleavable linking group. A peptide-based cleavable linking group is cleaved by enzymes such as peptidases and proteases in cells. Peptide-based cleavable linking groups are peptide bonds formed between amino acids to yield oligopeptides (e.g., dipeptides, tripeptides etc.) and polypeptides. Peptide-based cleavable groups do not include the amide group (—C(O)NH—). The amide group can be formed between any alkylene, alkenylene or alkynelene. A peptide bond is a special type of amide bond formed between amino acids to yield peptides and proteins. The peptide based cleavage group is generally limited to the peptide bond (i.e., the amide bond) formed between amino acids yielding peptides and proteins and does not include the entire amide functional group. Peptide-based cleavable linking groups have the general formula —NHCHRAC(O)NHCHRBC(O)—, where RA and RB are the R groups of the two adjacent amino acids. These candidates can be evaluated using methods analogous to those described above.


In some embodiments, an iRNA of the invention is conjugated to a carbohydrate through a linker. Non-limiting examples of iRNA carbohydrate conjugates with linkers of the compositions and methods of the invention include, but are not limited to,




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when one of X or Y is an oligonucleotide, the other is a hydrogen.


In certain embodiments of the compositions and methods of the invention, a ligand is one or more “GalNAc” (N-acetylgalactosamine) derivatives attached through a bivalent or trivalent branched linker.


In one embodiment, a dsRNA of the invention is conjugated to a bivalent or trivalent branched linker selected from the group of structures shown in any of formula (XLV)-(XLVI):




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    • wherein:

    • q2A, q2B, q3A, q3B, q4A, q4B, q5A, q5B and q5C represent independently for each occurrence 0-20 and wherein the repeating unit can be the same or different;

    • P2A, P2B, P3A, P3B, P4A, P4B, P5A, P5B, P5C, T2A, T2B, T3A, T3B, T4A, T4B, T4A, T5B, T5C are each independently for each occurrence absent, CO, NH, O, S, OC(O), NHC(O), CH2, CH2NH or CH2O;

    • Q2A, Q2B, Q3A, Q3B, Q4A, Q4B, Q5A, Q5B, Q5C are independently for each occurrence absent, alkylene, substituted alkylene wherein one or more methylenes can be interrupted or terminated by one or more of O, S, S(O), SO2, N(RN), C(R′)═C(R″), C≡C or C(O);

    • R2A, R2B, R3A, R3B, R4A, R4B, R5A, R5B, R5C are each independently for each occurrence absent NH, O, S, CH2, C(O)O, C(O)NH, NHCH(Ra)C(O), —C(O)—CH(Ra)—NH—, CO. CH═N—O,







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or heterocyclyl;

    • L2A, L2B, L3A, L3B, L4A, L4B, L5A, L5B and L5C represent the ligand; i.e. each independently for each occurrence a monosaccharide (such as GalNAc), disaccharide, trisaccharide, tetrasaccharide, oligosaccharide, or polysaccharide; and Ra is H or amino acid side chain. Trivalent conjugating GalNAc derivatives are particularly useful for use with RNAi agents for inhibiting the expression of a target gene, such as those of formula (XLIX):




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wherein L5A, L5B and L5C represent a monosaccharide, such as GalNAc derivative.


Examples of suitable bivalent and trivalent branched linker groups conjugating GalNAc derivatives include, but are not limited to, the structures recited above as formulas II, VII, XI, X, and XIII.


Representative U.S. patents that teach the preparation of RNA conjugates include, but are not limited to, U.S. Pat. Nos. 4,828,979; 4,948,882; 5,218,105; 5,525,465; 5,541,313; 5,545,730; 5,552,538; 5,578,717, 5,580,731; 5,591,584; 5,109,124; 5,118,802; 5,138,045; 5,414,077; 5,486,603; 5,512,439; 5,578,718; 5,608,046; 4,587,044; 4,605,735; 4,667,025; 4,762,779; 4,789,737; 4,824,941; 4,835,263; 4,876,335; 4,904,582; 4,958,013; 5,082,830; 5,112,963; 5,214,136; 5,082,830; 5,112,963; 5,214,136; 5,245,022; 5,254,469; 5,258,506; 5,262,536; 5,272,250; 5,292,873; 5,317,098; 5,371,241, 5,391,723; 5,416,203, 5,451,463; 5,510,475; 5,512,667; 5,514,785; 5,565,552; 5,567,810; 5,574,142; 5,585,481; 5,587,371; 5,595,726; 5,597,696; 5,599,923; 5,599,928; 5,688,941; 6,294,664; 6,320,017; 6,576,752; 6,783,931; 6,900,297; 7,037,646; and 8,106,022, the entire contents of each of which are hereby incorporated herein by reference.


It is not necessary for all positions in a given compound to be uniformly modified, and in fact more than one of the aforementioned modifications can be incorporated in a single compound or even at a single nucleoside within an iRNA. The present invention also includes iRNA compounds that are chimeric compounds.


“Chimeric” iRNA compounds or “chimeras,” in the context of this invention, are iRNA compounds, in some embodiments dsRNAi agents, that contain two or more chemically distinct regions, each made up of at least one monomer unit, i.e., a nucleotide in the case of a dsRNA compound. These iRNAs typically contain at least one region wherein the RNA is modified so as to confer upon the iRNA increased resistance to nuclease degradation, increased cellular uptake, or increased binding affinity for the target nucleic acid. An additional region of the iRNA can serve as a substrate for enzymes capable of cleaving RNA:DNA or RNA:RNA hybrids. 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, thereby greatly enhancing the efficiency of iRNA inhibition of gene expression. Consequently, comparable results can often be obtained with shorter iRNAs when chimeric dsRNAs are used, compared to phosphorothioate deoxy dsRNAs hybridizing to the same target region. Cleavage of the RNA target can be routinely detected by gel electrophoresis and, if necessary, associated nucleic acid hybridization techniques known in the art.


In certain instances, the RNA of an iRNA can be modified by a non-ligand group. A number of non-ligand molecules have been conjugated to iRNAs in order to enhance the activity, cellular distribution or cellular uptake of the iRNA, and procedures for performing such conjugations are available in the scientific literature. Such non-ligand moieties have included lipid moieties, such as cholesterol (Kubo, T. et al., Biochem. Biophys. Res. Comm., 2007, 365(1):54-61; Letsinger et al., Proc. Natl. Acad. Sci. USA, 1989, 86:6553), cholic acid (Manoharan et al., Bioorg. Med. Chem. Lett., 1994, 4:1053), a thioether, e.g., hexyl-S-tritylthiol (Manoharan et al., Ann. N.Y. Acad. Sci., 1992, 660:306; Manoharan et al., Bioorg. Med. Chem. Let., 1993, 3:2765), a thiocholesterol (Oberhauser et al., Nucl. Acids Res., 1992, 20:533), an aliphatic chain, e.g., dodecandiol or undecyl residues (Saison-Behmoaras et al., EMBO J., 1991, 10:111; Kabanov et al., FEBS Lett., 1990, 259:327; Svinarchuk et al., Biochimie, 1993, 75:49), a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethylammonium 1,2-di-O-hexadecyl-rac-glycero-3-H-phosphonate (Manoharan et al., Tetrahedron Lett., 1995, 36:3651; Shea et al., Nucl. Acids Res., 1990, 18:3777), a polyamine or a polyethylene glycol chain (Manoharan et al., Nucleosides & Nucleotides, 1995, 14:969), or adamantane acetic acid (Manoharan et al., Tetrahedron Lett., 1995, 36:3651), a palmityl moiety (Mishra et al., Biochim. Biophys. Acta, 1995, 1264:229), or an octadecylamine or hexylamino-carbonyl-oxycholesterol moiety (Crooke et al., J. Pharmacol. Exp. Ther., 1996, 277:923). Representative United States patents that teach the preparation of such RNA conjugates have been listed above. Typical conjugation protocols involve the synthesis of RNAs bearing an aminolinker at one or more positions of the sequence. The amino group is then reacted with the molecule being conjugated using appropriate coupling or activating reagents. The conjugation reaction can be performed either with the RNA still bound to the solid support or following cleavage of the RNA, in solution phase. Purification of the RNA conjugate by HPLC typically affords the pure conjugate.


IV. Delivery of an iRNA of the Invention

The delivery of an iRNA of the invention to a cell e.g., a cell within a subject, such as a human subject (e.g., a subject in need thereof, such as a subject susceptible to or diagnosed with a ketohexokinase-associated disorder) can be achieved in a number of different ways. For example, delivery may be performed by contacting a cell with an iRNA of the invention either in vitro or in vivo. In vivo delivery may also be performed directly by administering a composition comprising an iRNA, e.g., a dsRNA, to a subject. Alternatively, in vivo delivery may be performed indirectly by administering one or more vectors that encode and direct the expression of the iRNA. These alternatives are discussed further below.


In general, any method of delivering a nucleic acid molecule (in vitro or in vivo) can be adapted for use with an iRNA of the invention (see e.g., Akhtar S. and Julian R L. (1992) Trends Cell. Biol. 2(5):139-144 and WO94/02595, which are incorporated herein by reference in their entireties). For in vivo delivery, factors to consider in order to deliver an iRNA molecule include, for example, biological stability of the delivered molecule, prevention of non-specific effects, and accumulation of the delivered molecule in the target tissue. RNA interference has also shown success with local delivery to the CNS by direct injection (Dorn, G., et al. (2004) Nucleic Acids 32:e49; Tan, P H., et al (2005) Gene Ther. 12:59-66; Makimura, H., et al (2002) BMC Neurosci. 3:18; Shishkina, G T., et al (2004) Neuroscience 129:521-528; Thakker, E R., et al (2004) Proc. Natl. Acad. Sci. U.S.A. 101:17270-17275; Akaneya, Y., et al (2005) J. Neurophysiol. 93:594-602). Modification of the RNA or the pharmaceutical carrier can also permit targeting of the iRNA to the target tissue and avoid undesirable off-target effects. iRNA molecules can be modified by chemical conjugation to lipophilic groups such as cholesterol to enhance cellular uptake and prevent degradation. For example, an iRNA directed against ApoB conjugated to a lipophilic cholesterol moiety was injected systemically into mice and resulted in knockdown of apoB mRNA in both the liver and jejunum (Soutschek, J., et al (2004) Nature 432:173-178).


In an alternative embodiment, the iRNA can be delivered using drug delivery systems such as a nanoparticle, a dendrimer, a polymer, liposomes, or a cationic delivery system. Positively charged cationic delivery systems facilitate binding of an iRNA molecule (negatively charged) and also enhance interactions at the negatively charged cell membrane to permit efficient uptake of an iRNA by the cell. Cationic lipids, dendrimers, or polymers can either be bound to an iRNA, or induced to form a vesicle or micelle (see e.g., Kim S H, et al (2008) Journal of Controlled Release 129(2):107-116) that encases an iRNA. The formation of vesicles or micelles further prevents degradation of the iRNA when administered systemically. Methods for making and administering cationic-iRNA complexes are well within the abilities of one skilled in the art (see e.g., Sorensen, D R, et al (2003) J. Mol. Biol 327:761-766; Verma, U N, et al (2003) Clin. Cancer Res. 9:1291-1300; Arnold, A S et al (2007) J. Hypertens. 25:197-205, which are incorporated herein by reference in their entirety). Some non-limiting examples of drug delivery systems useful for systemic delivery of iRNAs include DOTAP (Sorensen, D R., et al (2003), supra; Verma, U N, et al (2003), supra), “solid nucleic acid lipid particles” (Zimmermann, T S, et al (2006) Nature 441:111-114), cardiolipin (Chien, P Y, et al (2005) Cancer Gene Ther. 12:321-328; Pal, A, et al (2005) Int J. Oncol. 26:1087-1091), polyethyleneimine (Bonnet M E, et al (2008) Pharm. Res. August 16 Epub ahead of print; Aigner, A. (2006) J. Biomed. Biotechnol. 71659), Arg-Gly-Asp (RGD) peptides (Liu, S. (2006) Mol. Pharm. 3:472-487), and polyamidoamines (Tomalia, D A, et al (2007) Biochem. Soc. Trans. 35:61-67; Yoo, H., et al (1999) Pharm. Res. 16:1799-1804). In some embodiments, an iRNA forms a complex with cyclodextrin for systemic administration. Methods for administration and pharmaceutical compositions of iRNAs and cyclodextrins can be found in U.S. Pat. No. 7,427,605, which is herein incorporated by reference in its entirety.


A. Vector Encoded iRNAs of the Invention


iRNA targeting the ketohexokinase gene can be expressed from transcription units inserted into DNA or RNA vectors (see, e.g., Couture, A, et al., TIG. (1996), 12:5-10; Skillern, A, et al., International PCT Publication No. WO 00/22113, Conrad, International PCT Publication No. WO 00/22114, and Conrad, U.S. Pat. No. 6,054,299). Expression can be transient (on the order of hours to weeks) or sustained (weeks to months or longer), depending upon the specific construct used and the target tissue or cell type. These transgenes can be introduced as a linear construct, a circular plasmid, or a viral vector, which can be an integrating or non-integrating vector. The transgene can also be constructed to permit it to be inherited as an extrachromosomal plasmid (Gassmann, et al., Proc. Natl. Acad. Sci. USA (1995) 92:1292).


Viral vector systems which can be utilized with the methods and compositions described herein include, but are not limited to, (a) adenovirus vectors; (b) retrovirus vectors, including but not limited to lentiviral vectors, moloney murine leukemia virus, etc.; (c) adeno-associated virus vectors; (d) herpes simplex virus vectors; (e) SV 40 vectors; (f) polyoma virus vectors; (g) papilloma virus vectors; (h) picornavirus vectors; (i) pox virus vectors such as an orthopox, e.g., vaccinia virus vectors or avipox, e.g. canary pox or fowl pox; and (j) a helper-dependent or gutless adenovirus. Replication-defective viruses can also be advantageous. Different vectors will or will not become incorporated into the cells' genome. The constructs can include viral sequences for transfection, if desired. Alternatively, the construct can be incorporated into vectors capable of episomal replication, e.g. EPV and EBV vectors. Constructs for the recombinant expression of an iRNA will generally require regulatory elements, e.g., promoters, enhancers, etc., to ensure the expression of the iRNA in target cells. Other aspects to consider for vectors and constructs are known in the art.


V. Pharmaceutical Compositions of the Invention

The present invention also includes pharmaceutical compositions and formulations which include the iRNAs of the invention. In one embodiment, provided herein are pharmaceutical compositions containing an iRNA, as described herein, and a pharmaceutically acceptable carrier. The pharmaceutical compositions containing the iRNA are useful for preventing or treating a ketohexokinase-associated disorder. Such pharmaceutical compositions are formulated based on the mode of delivery. One example is compositions that are formulated for systemic administration via parenteral delivery, e.g., by subcutaneous (SC), intramuscular (IM), or intravenous (IV) delivery. The pharmaceutical compositions of the invention may be administered in dosages sufficient to inhibit expression of a ketohexokinase gene.


In some embodiments, the pharmaceutical compositions of the invention are sterile. In another embodiment, the pharmaceutical compositions of the invention are pyrogen free.


The pharmaceutical compositions of the invention may be administered in dosages sufficient to inhibit expression of a ketohexokinase gene. In general, a suitable dose of an iRNA of the invention will be in the range of about 0.001 to about 200.0 milligrams per kilogram body weight of the recipient per day, generally in the range of about 1 to 50 mg per kilogram body weight per day. Typically, a suitable dose of an iRNA of the invention will be in the range of about 0.1 mg/kg to about 5.0 mg/kg, or about 0.3 mg/kg and about 3.0 mg/kg. A repeat-dose regimen may include administration of a therapeutic amount of iRNA on a regular basis, such as every month, once every 3-6 months, or once a year. In certain embodiments, the iRNA is administered about once per month to about once per six months.


After an initial treatment regimen, the treatments can be administered on a less frequent basis. Duration of treatment can be determined based on the severity of disease.


In other embodiments, a single dose of the pharmaceutical compositions can be long lasting, such that doses are administered at not more than 1, 2, 3, or 4 month intervals. In some embodiments of the invention, a single dose of the pharmaceutical compositions of the invention is administered about once per month. In other embodiments of the invention, a single dose of the pharmaceutical compositions of the invention is administered quarterly (i.e., about every three months). In other embodiments of the invention, a single dose of the pharmaceutical compositions of the invention is administered twice per year (i.e., about once every six months).


The skilled artisan will appreciate that certain factors can influence the dosage and timing required to effectively treat a subject, including but not limited to mutations present in the subject, previous treatments, the general health or age of the subject, and other diseases present. Moreover, treatment of a subject with a prophylactically or therapeutically effective amount, as appropriate, of a composition can include a single treatment or a series of treatments.


The iRNA can be delivered in a manner to target a particular tissue (e.g., hepatocytes).


Pharmaceutical compositions of the present invention include, but are not limited to, solutions, emulsions, and liposome-containing formulations. These compositions can be generated from a variety of components that include, but are not limited to, preformed liquids, self-emulsifying solids, and self-emulsifying semisolids. Formulations include those that target the liver.


The pharmaceutical formulations of the present invention, which can conveniently be presented in unit dosage form, can 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.


A. Additional Formulations


i. Emulsions


The compositions of the present invention can be prepared and formulated as emulsions. Emulsions are typically heterogeneous systems of one liquid dispersed in another in the form of droplets usually exceeding 0.1 μm in diameter (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich N G., and Ansel H C., 2004, Lippincott Williams & Wilkins (8th ed.), New York, NY; Idson, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 199; Rosoff, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., Volume 1, p. 245; Block in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 2, p. 335; Higuchi et al., in Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pa., 1985, p. 301). Emulsions are often biphasic systems comprising two immiscible liquid phases intimately mixed and dispersed with each other. In general, emulsions can be of either the water-in-oil (w/o) or the oil-in-water (o/w) variety. When an aqueous phase is finely divided into and dispersed as minute droplets into a bulk oily phase, the resulting composition is called a water-in-oil (w/o) emulsion. Alternatively, when an oily phase is finely divided into and dispersed as minute droplets into a bulk aqueous phase, the resulting composition is called an oil-in-water (o/w) emulsion. Emulsions can contain additional components in addition to the dispersed phases, and the active drug which can be present as a solution either in the aqueous phase, oily phase or itself as a separate phase. Pharmaceutical excipients such as emulsifiers, stabilizers, dyes, and anti-oxidants can also be present in emulsions as needed. Pharmaceutical emulsions can also be multiple emulsions that are comprised of more than two phases such as, for example, in the case of oil-in-water-in-oil (o/w/o) and water-in-oil-in-water (w/o/w) emulsions. Such complex formulations often provide certain advantages that simple binary emulsions do not. Multiple emulsions in which individual oil droplets of an o/w emulsion enclose small water droplets constitute a w/o/w emulsion. Likewise a system of oil droplets enclosed in globules of water stabilized in an oily continuous phase provides an o/w/o emulsion.


Emulsions are characterized by little or no thermodynamic stability. Often, the dispersed or discontinuous phase of the emulsion is well dispersed into the external or continuous phase and maintained in this form through the means of emulsifiers or the viscosity of the formulation. Other means of stabilizing emulsions entail the use of emulsifiers that can be incorporated into either phase of the emulsion. Emulsifiers can broadly be classified into four categories: synthetic surfactants, naturally occurring emulsifiers, absorption bases, and finely dispersed solids (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich N G., and Ansel H C., 2004, Lippincott Williams & Wilkins (8th ed.), New York, NY; Idson, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 199).


Synthetic surfactants, also known as surface active agents, have found wide applicability in the formulation of emulsions and have been reviewed in the literature (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich N G., and Ansel H C., 2004, Lippincott Williams & Wilkins (8th ed.), New York, NY; Rieger, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 285; Idson, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), Marcel Dekker, Inc., New York, N.Y., 1988, volume 1, p. 199). Surfactants are typically amphiphilic and comprise a hydrophilic and a hydrophobic portion. The ratio of the hydrophilic to the hydrophobic nature of the surfactant has been termed the hydrophile/lipophile balance (HLB) and is a valuable tool in categorizing and selecting surfactants in the preparation of formulations. Surfactants can be classified into different classes based on the nature of the hydrophilic group: nonionic, anionic, cationic, and amphoteric (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich N G., and Ansel H C., 2004, Lippincott Williams & Wilkins (8th ed.), New York, NY Rieger, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 285).


A large variety of non-emulsifying materials are also included in emulsion formulations and contribute to the properties of emulsions. These include fats, oils, waxes, fatty acids, fatty alcohols, fatty esters, humectants, hydrophilic colloids, preservatives, and antioxidants (Block, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 335; Idson, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 199).


The application of emulsion formulations via dermatological, oral, and parenteral routes, and methods for their manufacture have been reviewed in the literature (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich N G., and Ansel H C., 2004, Lippincott Williams & Wilkins (8th ed.), New York, NY; Idson, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 199).


ii. Microemulsions


In one embodiment of the present invention, the compositions of iRNAs and nucleic acids are formulated as microemulsions. A microemulsion can be defined as a system of water, oil, and amphiphile which is a single optically isotropic and thermodynamically stable liquid solution (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich N G., and Ansel H C., 2004, Lippincott Williams & Wilkins (8th ed.), New York, NY; Rosoff, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 245). Typically microemulsions are systems that are prepared by first dispersing an oil in an aqueous surfactant solution and then adding a sufficient amount of a fourth component, generally an intermediate chain-length alcohol to form a transparent system. Therefore, microemulsions have also been described as thermodynamically stable, isotropically clear dispersions of two immiscible liquids that are stabilized by interfacial films of surface-active molecules (Leung and Shah, in: Controlled Release of Drugs: Polymers and Aggregate Systems, Rosoff, M., Ed., 1989, VCH Publishers, New York, pages 185-215).


iii. Microparticles


An iRNA of the invention may be incorporated into a particle, e.g., a microparticle. Microparticles can be produced by spray-drying, but may also be produced by other methods including lyophilization, evaporation, fluid bed drying, vacuum drying, or a combination of these techniques.


iv. Penetration Enhancers


In one embodiment, the present invention employs various penetration enhancers to effect the efficient delivery of nucleic acids, particularly iRNAs, to the skin of animals. Most drugs are present in solution in both ionized and nonionized forms. However, usually only lipid soluble or lipophilic drugs readily cross cell membranes. It has been discovered that even non-lipophilic drugs can cross cell membranes if the membrane to be crossed is treated with a penetration enhancer. In addition to aiding the diffusion of non-lipophilic drugs across cell membranes, penetration enhancers also enhance the permeability of lipophilic drugs.


Penetration enhancers can be classified as belonging to one of five broad categories, i.e., surfactants, fatty acids, bile salts, chelating agents, and non-chelating non-surfactants (see e.g., Malmsten, M. Surfactants and polymers in drug delivery, Informa Health Care, New York, NY, 2002; Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, p. 92). Each of the above mentioned classes of penetration enhancers and their use in manufacture of pharmaceutical compositions and delivery of pharmaceutical agents are well known in the art.


v. Excipients


In contrast to a carrier compound, a “pharmaceutical carrier” or “excipient” is a pharmaceutically acceptable solvent, suspending agent, or any other pharmacologically inert vehicle for delivering one or more nucleic acids to an animal. The excipient can 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. Such agent are well known in the art.


vi. Other Components


The compositions of the present invention can additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels. Thus, for example, the compositions can contain additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-inflammatory agents, or can contain additional materials useful in physically formulating various dosage forms of the compositions of the present invention, such as dyes, flavoring agents, preservatives, antioxidants, opacifiers, thickening agents and stabilizers. However, such materials, when added, should not unduly interfere with the biological activities of the components of the compositions of the present invention. The formulations can be sterilized and, if desired, mixed with auxiliary agents, e.g., lubricants, preservatives, stabilizers, wetting agents, emulsifiers, salts for influencing osmotic pressure, buffers, colorings, flavorings, or aromatic substances, and the like which do not deleteriously interact with the nucleic acid(s) of the formulation.


Aqueous suspensions can contain substances which increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol, or dextran. The suspension can also contain stabilizers.


In some embodiments, pharmaceutical compositions featured in the invention include (a) one or more iRNA and (b) one or more agents which function by a non-iRNA mechanism and which are useful in treating a ketohexokinase-associated disorder, e.g., hypertriglyceridemia.


Toxicity and prophylactic efficacy of such compounds can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD50 (the dose lethal to 50% of the population) and the ED50 (the dose prophylactically effective in 50% of the population). The dose ratio between toxic and therapeutic effects is the therapeutic index and it can be expressed as the ratio LD50/ED50. Compounds that exhibit high therapeutic indices are preferred.


The data obtained from cell culture assays and animal studies can be used in formulating a range of dosage for use in humans. The dosage of compositions featured herein in the invention lies generally within a range of circulating concentrations that include the ED50, or an ED80 or ED90, with little or no toxicity. The dosage can vary within this range depending upon the dosage form employed and the route of administration utilized. For any compound used in the methods featured in the invention, the prophylactically effective dose can be estimated initially from cell culture assays. A dose can be formulated in animal models to achieve a circulating plasma concentration range of the compound or, when appropriate, of the polypeptide product of a target sequence (e.g., achieving a decreased concentration of the polypeptide) that includes the IC50 (i.e., the concentration of the test compound which achieves a half-maximal inhibition of symptoms) or higher levels of inhibition as determined in cell culture. Such information can be used to more accurately determine useful doses in humans. Levels in plasma can be measured, for example, by high performance liquid chromatography.


In addition to their administration, as discussed above, the iRNAs featured in the invention can be administered in combination with other known agents used for the prevention or treatment of a ketohexokinase-associated disorder, e.g., hypertriglyceridemia. In any event, the administering physician can adjust the amount and timing of iRNA administration on the basis of results observed using standard measures of efficacy known in the art or described herein.


VI. Methods For Inhibiting Ketohexokinase Expression

The present invention also provides methods of inhibiting expression of a KHK gene in a cell. The methods include contacting a cell with an RNAi agent, e.g., double stranded RNA agent, in an amount effective to inhibit expression of KHK in the cell, thereby inhibiting expression of KHK in the cell.


Contacting of a cell with an iRNA, e.g., a double stranded RNA agent, may be done in vitro or in vivo. Contacting a cell in vivo with the iRNA includes contacting a cell or group of cells within a subject, e.g., a human subject, with the iRNA. Combinations of in vitro and in vivo methods of contacting a cell are also possible. Contacting a cell may be direct or indirect, as discussed above. Furthermore, contacting a cell may be accomplished via a targeting ligand, including any ligand described herein or known in the art. In some embodiments, the targeting ligand is a carbohydrate moiety, e.g., a GalNAKHK ligand, or any other ligand that directs the RNAi agent to a site of interest.


The term “inhibiting,” as used herein, is used interchangeably with “reducing,” “silencing,” “downregulating”, “suppressing”, and other similar terms, and includes any level of inhibition.


The phrase “inhibiting expression of a ketohexokinase” is intended to refer to inhibition of expression of any ketohexokinase gene (such as, e.g., a mouse ketohexokinase gene, a rat ketohexokinase gene, a monkey ketohexokinase gene, or a human ketohexokinase gene) as well as variants or mutants of a ketohexokinase gene. Thus, the ketohexokinase gene may be a wild-type ketohexokinase gene, a mutant ketohexokinase gene, or a transgenic ketohexokinase gene in the context of a genetically manipulated cell, group of cells, or organism.


“Inhibiting expression of a ketohexokinase gene” includes any level of inhibition of a ketohexokinase gene, e.g., at least partial suppression of the expression of a ketohexokinase gene. The expression of the ketohexokinase gene may be assessed based on the level, or the change in the level, of any variable associated with ketohexokinase gene expression, e.g., ketohexokinase mRNA level or ketohexokinase protein level. This level may be assessed in an individual cell or in a group of cells, including, for example, a sample derived from a subject. It is understood that ketohexokinase is expressed predominantly in the liver, but also in the brain, gall bladder, heart, and kidney, and is present in circulation.


Inhibition may be assessed by a decrease in an absolute or relative level of one or more variables that are associated with ketohexokinase expression compared with a control level. The control level may be any type of control level that is utilized in the art, e.g., a pre-dose baseline level, or a level determined from a similar subject, cell, or sample that is untreated or treated with a control (such as, e.g., buffer only control or inactive agent control).


In some embodiments of the methods of the invention, expression of a ketohexokinase gene is inhibited by at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95%, or to below the level of detection of the assay. In some embodiments, expression of a ketohexokinase gene is inhibited by at least 70%. It is further understood that inhibition of ketohexokinase expression in certain tissues, e.g., in liver, without a significant inhibition of expression in other tissues, e.g., brain, may be desirable. In some embodiments, expression level is determined using the assay method provided in Example 2 with a 10 nM siRNA concentration in the appropriate species matched cell line.


In certain embodiments, inhibition of expression in vivo is determined by knockdown of the human gene in a rodent expressing the human gene, e.g., an AAV-infected mouse expressing the human target gene (i.e., ketohexokinase), e.g., when administered as a single dose, e.g., at 3 mg/kg at the nadir of RNA expression. Knockdown of expression of an endogenous gene in a model animal system can also be determined, e.g., after administration of a single dose at, e.g., 3 mg/kg at the nadir of RNA expression. Such systems are useful when the nucleic acid sequence of the human gene and the model animal gene are sufficiently close such that the human iRNA provides effective knockdown of the model animal gene. RNA expression in liver is determined using the PCR methods provided in Example 2.


Inhibition of the expression of a ketohexokinase gene may be manifested by a reduction of the amount of mRNA expressed by a first cell or group of cells (such cells may be present, for example, in a sample derived from a subject) in which a ketohexokinase gene is transcribed and which has or have been treated (e.g., by contacting the cell or cells with an iRNA of the invention, or by administering an iRNA of the invention to a subject in which the cells are or were present) such that the expression of a ketohexokinase gene is inhibited, as compared to a second cell or group of cells substantially identical to the first cell or group of cells but which has not or have not been so treated (control cell(s) not treated with an iRNA or not treated with an iRNA targeted to the gene of interest). In some embodiments, the inhibition is assessed by the method provided in Example 2 using a 10 nM siRNA concentration in the species matched cell line and expressing the level of mRNA in treated cells as a percentage of the level of mRNA in control cells, using the following formula:









(

mRNA


in


control


cells

)

-

(

mRNA


in


treated


cells

)



(

mRNA


in


control


cells

)



100

%




In other embodiments, inhibition of the expression of a ketohexokinase gene may be assessed in terms of a reduction of a parameter that is functionally linked to ketohexokinase gene expression, e.g., ketohexokinase protein level in blood or serum from a subject. Ketohexokinase gene silencing may be determined in any cell expressing ketohexokinase, either endogenous or heterologous from an expression construct, and by any assay known in the art.


Inhibition of the expression of a ketohexokinase protein may be manifested by a reduction in the level of the ketohexokinase protein that is expressed by a cell or group of cells or in a subject sample (e.g., the level of protein in a blood sample derived from a subject). As explained above, for the assessment of mRNA suppression, the inhibition of protein expression levels in a treated cell or group of cells may similarly be expressed as a percentage of the level of protein in a control cell or group of cells, or the change in the level of protein in a subject sample, e.g., blood or serum derived therefrom.


A control cell, a group of cells, or subject sample that may be used to assess the inhibition of the expression of a ketohexokinase gene includes a cell, group of cells, or subject sample that has not yet been contacted with an RNAi agent of the invention. For example, the control cell, group of cells, or subject sample may be derived from an individual subject (e.g., a human or animal subject) prior to treatment of the subject with an RNAi agent or an appropriately matched population control.


The level of ketohexokinase mRNA that is expressed by a cell or group of cells may be determined using any method known in the art for assessing mRNA expression. In one embodiment, the level of expression of ketohexokinase in a sample is determined by detecting a transcribed polynucleotide, or portion thereof, e.g., mRNA of the ketohexokinase gene. RNA may be extracted from cells using RNA extraction techniques including, for example, using acid phenol/guanidine isothiocyanate extraction (RNAzol B; Biogenesis), RNeasy™ RNA preparation kits (Qiagen®) or PAXgene™ (PreAnalytix™, Switzerland). Typical assay formats utilizing ribonucleic acid hybridization include nuclear run-on assays, RT-PCR, RNase protection assays, northern blotting, in situ hybridization, and microarray analysis.


In some embodiments, the level of expression of ketohexokinase is determined using a nucleic acid probe. The term “probe”, as used herein, refers to any molecule that is capable of selectively binding to a specific ketohexokinase. Probes can be synthesized by one of skill in the art, or derived from appropriate biological preparations. Probes may be specifically designed to be labeled. Examples of molecules that can be utilized as probes include, but are not limited to, RNA, DNA, proteins, antibodies, and organic molecules.


Isolated mRNA can be used in hybridization or amplification assays that include, but are not limited to, Southern or northern analyses, polymerase chain reaction (PCR) analyses and probe arrays. One method for the determination of mRNA levels involves contacting the isolated mRNA with a nucleic acid molecule (probe) that can hybridize to ketohexokinase mRNA. In one embodiment, the mRNA is immobilized on a solid surface and contacted with a probe, for example by running the isolated mRNA on an agarose gel and transferring the mRNA from the gel to a membrane, such as nitrocellulose. In an alternative embodiment, the probe(s) are immobilized on a solid surface and the mRNA is contacted with the probe(s), for example, in an Affymetrix® gene chip array. A skilled artisan can readily adapt known mRNA detection methods for use in determining the level of ketohexokinase mRNA.


An alternative method for determining the level of expression of ketohexokinase in a sample involves the process of nucleic acid amplification or reverse transcriptase (to prepare cDNA) of for example mRNA in the sample, e.g., by RT-PCR (the experimental embodiment set forth in Mullis, 1987, U.S. Pat. No. 4,683,202), ligase chain reaction (Barany (1991) Proc. Nat. Acad. Sci. USA 88:189-193), self sustained sequence replication (Guatelli et al. (1990) Proc. Nat. Acad. Sci. USA 87:1874-1878), transcriptional amplification system (Kwoh et al. (1989) Proc. Natd. Acad. Sci. USA 86:1173-1177), Q-Beta Replicase (Lizardi et al. (1988) Bio/Technology 6:1197), rolling circle replication (Lizardi et al., U.S. Pat. No. 5,854,033) or any other nucleic acid amplification method, followed by the detection of the amplified molecules using techniques well known to those of skill in the art. These detection schemes are especially useful for the detection of nucleic acid molecules if such molecules are present in very low numbers. In particular aspects of the invention, the level of expression of KHK is determined by quantitative fluorogenic RT-PCR (i.e., the TaqMan™ System). In some embodiments, expression level is determined by the method provided in Example 2 using, e.g., a 10 nM siRNA concentration, in the species matched cell line.


The expression levels of ketohexokinase mRNA may be monitored using a membrane blot (such as used in hybridization analysis such as northern, Southern, dot, and the like), or microwells, sample tubes, gels, beads or fibers (or any solid support comprising bound nucleic acids). See U.S. Pat. Nos. 5,770,722, 5,874,219, 5,744,305, 5,677,195 and 5,445,934, which are incorporated herein by reference. The determination of ketohexokinase expression level may also comprise using nucleic acid probes in solution.


In some embodiments, the level of mRNA expression is assessed using branched DNA (bDNA) assays or real time PCR (qPCR). The use of these methods is described and exemplified in the Examples presented herein. In some embodiments, expression level is determined by the method provided in Example 2 using a 10 nM siRNA concentration in the species matched cell line.


The level of KHK protein expression may be determined using any method known in the art for the measurement of protein levels. Such methods include, for example, electrophoresis, capillary electrophoresis, high performance liquid chromatography (HPLC), thin layer chromatography (TLC), hyperdiffusion chromatography, fluid or gel precipitin reactions, absorption spectroscopy, a colorimetric assays, spectrophotometric assays, flow cytometry, immunodiffusion (single or double), immunoelectrophoresis, western blotting, radioimmunoassay (RIA), enzyme-linked immunosorbent assays (ELISAs), immunofluorescent assays, electrochemiluminescence assays, and the like.


In some embodiments, the efficacy of the methods of the invention are assessed by a decrease in KHK mRNA or protein level (e.g., in a liver biopsy).


In some embodiments of the methods of the invention, the iRNA is administered to a subject such that the iRNA is delivered to a specific site within the subject. The inhibition of expression of ketohexokinase may be assessed using measurements of the level or change in the level of ketohexokinase mRNA or ketohexokinase protein in a sample derived from fluid or tissue from the specific site within the subject (e.g., liver or blood).


As used herein, the terms detecting or determining a level of an analyte are understood to mean performing the steps to determine if a material, e.g., protein, RNA, is present. As used herein, methods of detecting or determining include detection or determination of an analyte level that is below the level of detection for the method used.


VII. Prophylactic and Treatment Methods of the Invention

The present invention also provides methods of using an iRNA of the invention or a composition containing an iRNA of the invention to inhibit expression of ketohexokinase, thereby preventing or treating a ketohexokinase-associated disorder, e.g., an ketohexokinase-associated disorder is selected from the group consisting of liver disease (e.g., fatty liver, steatohepatitis, especially non-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving. In the methods of the invention the cell may be contacted with the siRNA in vitro or in vivo, i.e., the cell may be within a subject.


A cell suitable for treatment using the methods of the invention may be any cell that expresses a ketohexokinase gene, e.g., a liver cell, a brain cell, a gall bladder cell, a heart cell, or a kidney cell, or a liver cell. A cell suitable for use in the methods of the invention may be a mammalian cell, e.g., a primate cell (such as a human cell, including human cell in a chimeric non-human animal, or a non-human primate cell, e.g., a monkey cell or a chimpanzee cell), or a non-primate cell. In certain embodiments, the cell is a human cell, e.g., a human liver cell. In the methods of the invention, ketohexokinase expression is inhibited in the cell by at least 50, 55, 60, 65, 70, 75, 80, 85, 90, or 95, or to a level below the level of detection of the assay.


The in vivo methods of the invention may include administering to a subject a composition containing an iRNA, where the iRNA includes a nucleotide sequence that is complementary to at least a part of an RNA transcript of the ketohexokinase gene of the mammal to which the RNAi agent is to be administered. The composition can be administered by any means known in the art including, but not limited to oral, intraperitoneal, or parenteral routes, including intracranial (e.g., intraventricular, intraparenchymal, and intrathecal), intravenous, intramuscular, subcutaneous, transdermal, airway (aerosol), nasal, rectal, and topical (including buccal and sublingual) administration. In certain embodiments, the compositions are administered by intravenous infusion or injection. In certain embodiments, the compositions are administered by subcutaneous injection. In certain embodiments, the compositions are administered by intramuscular injection.


In some embodiments, the administration is via a depot injection. A depot injection may release the iRNA in a consistent way over a prolonged time period. Thus, a depot injection may reduce the frequency of dosing needed to obtain a desired effect, e.g., a desired inhibition of KHK, or a therapeutic or prophylactic effect. A depot injection may also provide more consistent serum concentrations. Depot injections may include subcutaneous injections or intramuscular injections. In some embodiments, the depot injection is a subcutaneous injection.


In some embodiments, the administration is via a pump. The pump may be an external pump or a surgically implanted pump. In certain embodiments, the pump is a subcutaneously implanted osmotic pump. In other embodiments, the pump is an infusion pump. An infusion pump may be used for intravenous, subcutaneous, arterial, or epidural infusions. In some embodiments, the infusion pump is a subcutaneous infusion pump. In other embodiments, the pump is a surgically implanted pump that delivers the iRNA to the liver.


The mode of administration may be chosen based upon whether local or systemic treatment is desired and based upon the area to be treated. The route and site of administration may be chosen to enhance targeting.


In one aspect, the present invention also provides methods for inhibiting the expression of a ketohexokinase gene in a mammal. The methods include administering to the mammal a composition comprising a dsRNA that targets a ketohexokinase gene in a cell of the mammal and maintaining the mammal for a time sufficient to obtain degradation of the mRNA transcript of the ketohexokinase gene, thereby inhibiting expression of the ketohexokinase gene in the cell. Reduction in gene expression can be assessed by any methods known in the art and by methods, e.g. qRT-PCR, described herein, e.g., in Example 2. Reduction in protein production can be assessed by any methods known it the art, e.g. ELISA. In certain embodiments, a puncture liver biopsy sample serves as the tissue material for monitoring the reduction in the ketohexokinase gene or protein expression. In other embodiments, a blood sample serves as the subject sample for monitoring the reduction in the ketohexokinase protein expression.


The present invention further provides methods of treatment in a subject in need thereof, e.g., a subject diagnosed with a ketohexokinase-associated disorder, such as, liver disease (e.g., fatty liver, steatohepatitis, especiallynon-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


The present invention further provides methods of prophylaxis in a subject in need thereof. The treatment methods of the invention include administering an iRNA of the invention to a subject, e.g., a subject that would benefit from a reduction of ketohexokinase expression, in a prophylactically effective amount of an iRNA targeting a ketohexokinase gene or a pharmaceutical composition comprising an iRNA targeting a ketohexokinase gene.


In one embodiment, a ketohexokinase-associated disease is selected from the group consisting of liver disease (e.g., fatty liver, steatohepatitis, especiallynon-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


An iRNA of the invention may be administered as a “free iRNA.” A free iRNA is administered in the absence of a pharmaceutical composition. The naked iRNA may be in a suitable buffer solution. The buffer solution may comprise acetate, citrate, prolamine, carbonate, or phosphate, or any combination thereof. In one embodiment, the buffer solution is phosphate buffered saline (PBS). The pH and osmolarity of the buffer solution containing the iRNA can be adjusted such that it is suitable for administering to a subject.


Alternatively, an iRNA of the invention may be administered as a pharmaceutical composition, such as a dsRNA liposomal formulation.


Subjects that would benefit from an inhibition of KHK gene expression are subjects susceptible to or diagnosed with a KHK-associated disorder, such as e.g., an ketohexokinase-associated disorder is selected from the group consisting of liver disease (e.g., fatty liver, steatohepatitis, especiallynon-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


In an embodiment, the method includes administering a composition featured herein such that expression of the target ketohexokinase gene is decreased, such as for about 1, 2, 3, 4, 5, 6, 1-6, 1-3, or 3-6 months per dose. In certain embodiments, the composition is administered once every 3-6 months.


In some embodiments, the iRNAs useful for the methods and compositions featured herein specifically target RNAs (primary or processed) of the target ketohexokinase gene. Compositions and methods for inhibiting the expression of these genes using iRNAs can be prepared and performed as described herein.


Administration of the iRNA according to the methods of the invention may result prevention or treatment of a ketohexokinase-associated disorder, e.g., liver disease (e.g., fatty liver, steatohepatitis, especially non-alcoholic steatohepatitis (NASH)), dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), cardiovascular disease (e.g., hypertension, endothelial cell dysfunction), kidney disease (e.g., acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, chronic kidney disease), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, hyperuricemia, gout, eating disorders, and excessive sugar craving.


Subjects can be administered a therapeutic amount of iRNA, such as about 0.01 mg/kg to about 200 mg/kg.


The iRNA is in some embodiments administered subcutaneously, i.e., by subcutaneous injection. One or more injections may be used to deliver the desired dose of iRNA to a subject. The injections may be repeated over a period of time.


The administration may be repeated on a regular basis. In certain embodiments, after an initial treatment regimen, the treatments can be administered on a less frequent basis. A repeat-dose regimen may include administration of a therapeutic amount of iRNA on a regular basis, such as once per month to once a year. In certain embodiments, the iRNA is administered about once per month to about once every three months, or about once every three months to about once every six months.


The invention further provides methods and uses of an iRNA agent or a pharmaceutical composition thereof for treating a subject that would benefit from reduction and/or inhibition of KHK gene expression, e.g., a subject having a KHK-associated disease, in combination with other pharmaceuticals and/or other therapeutic methods, e.g., with known pharmaceuticals and/or known therapeutic methods, such as, for example, those which are currently employed for treating these disorders.


Accordingly, in some aspects of the invention, the methods which include either a single iRNA agent of the invention, further include administering to the subject one or more additional therapeutic agents. The iRNA agent and an additional therapeutic agent and/or treatment may be administered at the same time and/or in the same combination, e.g., parenterally, or the additional therapeutic agent can be administered as part of a separate composition or at separate times and/or by another method known in the art or described herein.


In one embodiment, an iRNA agent is administered in combination with an ezetimibe/simvastatin combination (e.g., Vytorin® (Merck/Schering-Plough Pharmaceuticals)). In one embodiment, the iRNA agent is administered to the patient, and then the additional therapeutic agent is administered to the patient (or vice versa). In another embodiment, the iRNA agent and the additional therapeutic agent are administered at the same time.


The iRNA agent and an additional therapeutic agent and/or treatment may be administered at the same time and/or in the same combination, e.g., parenterally, or the additional therapeutic agent can be administered as part of a separate composition or at separate times and/or by another method known in the art or described herein.


VIII. Diagnostic Criteria and Treatment for KHK-Associated Diseases

Diagnostic criteria, therapeutic agents, and considerations for treatment for various KHK-associated diseases are provided below.


A. Hyperuricemia

Serum uric acid levels are not routinely obtained as clinical lab values. However, hyperuricemia (elevated uric acid) is associated with a number of diseases and conditions including gout, NAFLD, NASH, metabolic disorder, insulin resistance (not resulting from an immune response to insulin), cardiovascular disease, hypertension, and type 2 diabetes. It is expected that decreasing KHK expression can be useful in the prevention or treatment of one or more conditions associated with elevated serum uric acid levels. Further, it is expected that a subject would derive clinical benefit from normalization of serum uric acid levels towards or to a normal serum uric acid level, e.g., no more than 6.8 mg/dl, or no more than 6 mg/dl, even in the absence of overt signs or symptoms of one or more conditions associated with elevated uric acid.


Animal models of hyperuricemia include, for example, high fructose diet, e.g., in rats and mice, which can induce one or more of fat accumulation including fatty liver, insulin resistance, type 2 diabetes, obesity including visceral obesity, metabolic syndrome, decreased adiponectin secretion, reduced renal function, and inflammation (see, e.g., Johnson et al. (2013) Diabetes. 62:3307-3315). Administration of oxonic acid, a uricase inhibitor, can also be used to induce hyperuricemia (see, e.g., Mazalli et al. (2001) Hypertens. 38:1101-1106). Genetic models of hyperuricemia include the B6; 129S7-Uoxtm1Bay/J mouse available from Jackson Laboratory (/jaxmice.jax.org/strain/002223.html) which develops hyperuricemia, with 10-fold higher levels of serum uric acid levels.


Various treatments for hyperuricemia are known in the art. However, some of the agents can only be used in limited populations. For example, allopurinol is a xanthine oxidase inhibitor that is used to reduce serum uric acid levels for the treatment of a number of conditions, e.g., gout, cardiovascular disease including ischemia-reperfusion injury, hypertension, atherosclerosis, and stroke, and inflammatory diseases (Pacher et al., (2006) Pharma. Rev. 58:87-114). However, the use of allopurinol is contraindicated in subjects with impaired renal function, e.g., chronic kidney disease, hypothyroidism, hyperinsulinemia, or insulin resistance; or in subjects predisposed to kidney disease or impaired renal function, e.g., subjects with hypertension, metabolic disorder, diabetes, and the elderly. Further, allopurinol should not be taken by subjects taking oral coagulants or probencid as well as subjects taking diuretics, especially thiazide diuretics or other drugs that can reduce kidney function or have potential kidney toxicity.


In certain embodiments, the compositions and methods of the invention are used in combination with other compositions and methods to treat hyperuricemia, e.g., allopurinol, oxypurinol, febuxostat. In certain embodiments, the compositions and methods of the invention are used for treatment of subjects with reduced kidney function or susceptible to reduced kidney function, e.g., due to age, comorbidities, or drug interactions.


B. Gout

Gout affects approximately 1 in 40 adults, most commonly men between 30-60 years of age. Gout less commonly affects women. Gout is one of a few types of arthritis where future damage to joints can be avoided by treatment. Gout is characterized by recurrent attacks of acute inflammatory arthritis caused by an inflammatory reaction to uric acid crystals in the joint due to hyperuricemia resulting from insufficient renal clearance of uric acid or excessive uric acid production. Fructose associated gout is sometimes associated with variants of transporters expressed in the kidney, intestine, and liver. Gout is characterized by the formation and deposition of tophi, monosodium urate (MSU) crystals, in the joints and subcutaneously. Pain associated with gout is not related to the size of the tophi, but is a result of an immune response against the MSU crystals. There is a linear inverse relation between serum uric acid and the rate of decrease in tophus size. For example, in one study of 18 patients with non-tophaceous gout, serum uric acid declined to 2.7-5.4 mg/dL (0.16-0.32 mM) in all subjects within 3 months of starting urate lowering therapy (Pascual and Sivera (2007) Ann. Rheum. Dis. 66:1056-1058). However, it took 12 months with normalized serum uric acid for MSU crystals to disappear from asymptomatic knee or first MTP joints in patients who had gout for less than 10 years, vs. 18 months in those with gout for more than 10 years. Therefore, effective treatment of gout does not require complete clearance of tophi or resolution of all symptoms, e.g., joint pain and swelling, inflammation, but simply a reduction in at least one sign or symptom of gout, e.g., reduction in severity or frequency of gout attacks, in conjunction with a reduction in serum urate levels.


Animal models of gout include oxonic acid-induced hyperuricemia (see, e.g., Jang et al. (2014) Mycobiology. 42:296-300).


Currently available treatments for gout are contraindicated or ineffective in a number of subjects. Allopurinol, a common first line treatment to reduce uric acid levels in subjects with gout, is contraindicated in a number of populations, especially those with compromised renal function, as discussed above. Further, a number of subjects fail treatment with allopurinol, e.g., subjects who suffer gout flares despite treatment, or subjects who suffer from rashes or hypersensitivity reactions associated with allopurinol.


In certain embodiments, the compositions and methods of the invention are used in combination with other agents to reduce serum uric acid. In certain embodiments, the compositions and methods of the invention are used in combination with agents for treatment of symptoms of gout, e.g., analgesic or anti-inflammatory agents, e.g., NSAIDS. In certain embodiments, the compositions and methods of the invention are used for treatment of subjects with reduced kidney function or susceptible to reduced kidney function, e.g., due to age, comorbidities, or drug interactions.


C. Liver Disease

NAFLD is associated with hyperuricemia (Xu et al. (2015) J. Hepatol. 62:1412-1419) which, in turn, is associated with elevated fructose metabolism. The definition of nonalcoholic fatty liver disease (NAFLD) requires that (a) there is evidence of hepatic steatosis, either by imaging or by histology and (b) there are no causes for secondary hepatic fat accumulation such as significant alcohol consumption, use of steatogenic medication or hereditary disorders. In the majority of patients, NAFLD is associated with metabolic risk factors such as obesity, diabetes mellitus, and dyslipidemia. NAFLD is histologically further categorized into nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). NAFL is defined as the presence of hepatic steatosis with no evidence of hepatocellular injury in the form of ballooning of the hepatocytes. NASH is defined as the presence of hepatic steatosis and inflammation with hepatocyte injury (ballooning) with or without fibrosis (Chalasani et al. (2012) Hepatol. 55:2005-2023). It is generally agreed that patients with simple steatosis have very slow, if any, histological progression, while patients with NASH can exhibit histological progression to cirrhotic-stage disease. The long term outcomes of patients with NAFLD and NASH have been reported in several studies. Their findings can be summarized as follows; (a) patients with NAFLD have increased overall mortality compared to matched control populations, (b) the most common cause of death in patients with NAFLD, NAFL, and NASH is cardiovascular disease, and (c) patients with NASH (but not NAFL) have an increased liver-related mortality rate.


Animal models of NAFLD include various high fat- or high fructose-fed animal models. Genetic models of NAFLD include the B6.129S7-Ldlrtm1Her/J and the B6.129S4-Ptentm1Hwu/J mice available from The Jackson Laboratory.


Treatment of NAFLD is typically to manage the conditions that resulted in development of NAFLD. For example, patients with dyslipidemia are treated with agents to normalize cholesterol or triglycerides, as needed, to treat or prevent further progression of NAFLD. Patients with type 2 diabetes are treated with agents to normalize glucose or insulin sensitivity. Lifestyle changes, e.g., changes in diet and exercise, are also used to treat NAFLD. In a mouse model of NAFLD, treatment with allopurinol both prevented the development of hepatic steatosis, but also significantly ameliorated established hepatic steatosis in mice (Xu et al., J. Hepatol. 62:1412-1419, 2015).


In certain embodiments, the compositions and methods of the invention are used in combination with other agents to reduce serum uric acid. In certain embodiments, the compositions and methods of the invention are used in combination with agents for treatment of symptoms of NAFLD. In certain embodiments, the compositions and methods of the invention are used for treatment of subjects with reduced kidney function or susceptible to reduced kidney function, e.g., due to age, comorbidities, or drug interactions.


D. Dyslipidemia, Disorders of Glycemic Control, Metabolic Syndrome, and Obesity

Dyslipidemia (e.g., hyperlipidemia, high LDL cholesterol, low HDL cholesterol, hypertriglyceridemia, postprandial hypertriglyceridemia), disorders of glycemic control (e.g., insulin resistance, type 2 diabetes), metabolic syndrome, adipocyte dysfunction, visceral adipose deposition, obesity, and excessive sugar craving are associated with elevated fructose metabolism. Characteristics or diagnostic criteria for the conditions are provided below. Animal models of metabolic disorder and the component features include various high fat- or high fructose-fed animal models. Genetic models include leptin deficient B6.Cg-Lepob/J, commonly known as ob or ob/ob mice, which are available from The Jackson Laboratory.


Normal and abnormal fasting levels of the lipids are provided in the table below.














Lipid
Value
Interpretation


















Total
Below 200
mg/dL
Desirable


cholesterol
200-239
mg/dL
Borderline high



240
mg/dL and above
High


LDL
Below 70
mg/dL
Best for people who have


cholesterol


heart disease or diabetes.



Below 100
mg/dL
Optimal for people at





risk of heart disease.



100-129
mg/dL
Near optimal if there





is no heart disease.





High if there is heart





disease.



130-159
mg/dL
Borderline high if there





is no heart disease.





High if there is heart





disease.



160-189
mg/dL
High if there is no heart





disease. Very high if





there is heart disease.



190
mg/dL and above
Very high









HDL
Below 40 mg/dL (men)
Poor


cholesterol
Below 50 mg/dL (women)











50-59
mg/dL
Moderate



60
mg/dL and above
Normal


Triglycerides
Below 150
mg/dL
Desirable



150-199
mg/dL
Borderline high



200-499
mg/dL
High



500
mg/dL and above
Very High









Postprandial hypertriglyceridemia is principally initiated by overproduction or decreased catabolism of triglyceride-rich lipoproteins (TRLs) and is a consequence of predisposing genetic variations and medical conditions such as obesity and insulin resistance.


Insulin resistance is characterized by the presence of at least one of:

    • 1. A fasting blood glucose level of 100-125 mg/dL taken at two different times; or
    • 2. An oral glucose tolerance test with a result of a glucose level of 140-199 mg/dL at 2 hours after glucose consumption.


As used herein, insulin resistance does not include a lack of response to insulin as a result of an immune response to administered insulin as often occurs in late stages of insulin dependent diabetes, especially type 1 diabetes.


Type 2 diabetes is characterized by at least one of:

    • 1. A fasting blood glucose level≥126 mg/dL taken at two different times;
    • 2. A hemoglobin A1c (A1C) test with a result of ≥6.5% or higher; or
    • 3. An oral glucose tolerance test with a result of a glucose level≥200 mg/dL at 2 hours after glucose consumption.


Pharmacological treatments for type 2 diabetes and insulin resistance include treatment with agents to normalize blood sugar such as metformin (e.g., glucophage, glumetza), sulfonylureas (e.g., glyburide, glipizide, glimepiride), meglitinides (e.g., repaglinide, nateglinide), thiazolidinediones (rosiglitazone, pioglitazone), DPP-4 inhibitors (sitagliptin, saxagliptin, linagliptin), GLP-1 receptor antagonists (exenatide, liraglutide), and SGLT2 inhibitors (e.g., canagliflozin, dapagliflozin).


Obesity is characterized as disease of excess body fat. Body mass index (BMI), which is calculated by dividing body weight in kilograms (kg) by height in meters (m) squared, provides a reasonable estimate of body fat for most, but not all, people. Generally, a BMI below 18.5 is characterized as underweight, 18-.5 to24.9 is normal, 25.0-29.9 is overweight, 30.0-34.9 is obese (class I), 35-39.9 is obese (class II), and 40.0 and higher is extremely obese (class III).


Methods for assessment of subcutaneous vs. visceral fat are provided, for example, in Wajchenberg (2000) Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome, Endocr Rev. 21:697-738, which is incorporated herein by reference.


Metabolic syndrome is characterized by a cluster of conditions defined as at least three of the five following metabolic risk factors:

    • 1. Large waistline (≥35 inches for women or ≥40 inches for men);
    • 2. High triglyceride level (≥150 mg/dl);
    • 3. Low HDL cholesterol (≤50 mg/dl for women or ≤40 mg/dl for men);
    • 4. Elevated blood pressure (≥130/85) or on medicine to treat high blood pressure; and
    • 5. High fasting blood sugar (≥100 mg/dl) or being in medicine to treat high blood sugar.


As with NAFLD, the agents for treatment of metabolic syndrome depend on the specific risk factors present, e.g., normalize lipids when lipids are abnormal, normalize glucose or insulin sensitivity when they are abnormal.


Metabolic syndrome, insulin resistance, and type 2 diabetes are often associated with decreased renal function or the potential for decreased renal function.


In certain embodiments, the compositions and methods of the invention are for use in treatment of subjects with dyslipidemia, disorders of glycemic control, metabolic syndrome, and obesity. For example, in certain embodiments, the compositions and methods of the invention are for use in subjects with metabolic syndrome, insulin resistance, or type 2 diabetes and chronic kidney disease. In certain embodiments, the compositions and methods are for use in subjects with metabolic syndrome, insulin resistance, or type 2 diabetes who are suffering from one or more of cardiovascular disease, hypothyroidism, or inflammatory disease; or elderly subjects (e.g., over 65). In certain embodiments, the compositions and methods are for use in subjects with metabolic syndrome, insulin resistance, or type 2 diabetes who are also taking a drug that can reduce kidney function as demonstrated by the drug label. For example, in certain embodiments the compositions and methods of the invention are for use in subjects with metabolic syndrome, insulin resistance, or type 2 diabetes who are being treated with oral coagulants or probencid. For example, in certain embodiments the compositions and methods of the invention are for use in subjects with metabolic syndrome, insulin resistance, or type 2 diabetes who are being treated with diuretics, especially thiazide diuretics.


In certain embodiments, the compositions and methods of the invention are used in combination with other agents to reduce serum uric acid. In certain embodiments, the compositions and methods of the invention are used in combination with agents for treatment of symptoms of metabolic syndrome, insulin resistance, or type 2 diabetes. In certain embodiments, subjects are treated with e.g., agents to decrease blood pressure, e.g., diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, alpha blockers, alpha-2 receptor antagonists, combined alpha- and beta-blockers, central agonists, peripheral adrenergic inhibitors, and blood vessel dialators; agents to decrease cholesterol, e.g., statins, selective cholesterol absorption inhibitors, resins, or lipid lowering therapies; or agents to normalize blood sugar, e.g., metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor antagonists, and SGLT2 inhibitors.


In certain embodiments, the compositions and methods of the invention are used for treatment of subjects with reduced kidney function or susceptible to reduced kidney function, e.g., due to age, comorbidities, or drug interactions.


The iRNA and additional therapeutic agents may be administered at the same time or in the same combination, e.g., parenterally, or the additional therapeutic agent can be administered as part of a separate composition or at separate times or by another method known in the art or described herein.


E. Cardiovascular Disease

In certain embodiments, the compositions and methods of the invention are for use in treatment of subjects with cardiovascular disease. For example, in certain embodiments, the compositions and methods of the invention are for use in subjects with cardiovascular disease and chronic kidney disease. In certain embodiments, the compositions and methods are for use in subjects with cardiovascular disease who are suffering from one or more of metabolic disorder, insulin resistance,hyperinsulinemia, diabetes, hypothyroidism, or inflammatory disease. In certain embodiments, the compositions and methods are for use in subjects with cardiovascular disease who are also taking a drug that can reduce kidney function as demonstrated by the drug label. For example, in certain embodiments the compositions and methods of the invention are for use in subjects with cardiovascular disease who are being treated with oral coagulants or probencid. For example, in certain embodiments the compositions and methods of the invention are for use in subjects with cardiovascular disease who are being treated with diuretics, especially thiazide diuretics. For example, in certain embodiments the compositions and methods of the invention are for use in subjects with cardiovascular disease who have failed treatment with allopurinol.


In certain embodiments, the compositions and methods of the invention are used in combination with other agents to reduce serum uric acid. In certain embodiments, the compositions and methods of the invention are used in combination with agents for treatment of symptoms of cardiovascular disease, e.g., agents to decrease blood pressure, e.g., diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, alpha blockers, alpha-2 receptor antagonists, combined alpha- and beta-blockers, central agonists, peripheral adrenergic inhibitors, and blood vessel dialators; or agents to decrease cholesterol, e.g., statins, selective cholesterol absorption inhibitors, resins, or lipid lowering therapies.


F. Kidney Disease

Kidney disease includes, for example, acute kidney disorder, tubular dysfunction, proinflammatory changes to the proximal tubules, and chronic kidney disease.


Acute kidney (renal) failure occurs when the kidneys suddenly become unable to filter waste products from the blood resulting in accumulation of dangerous levels of wastes in serum and systemic chemical imbalance. Acute kidney failure can develop rapidly over a few hours or a few days, and is most common in individuals who are already hospitalized, particularly in critically ill individuals who need intensive care. Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you're otherwise in good health, you may recover normal or nearly normal kidney function.


Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can accumulate in the body. Signs and symptoms of kidney disease may include nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, changes in urine output, decreased mental sharpness, muscle twitches and cramps, hiccups, swelling of feet and ankles, persistent itching, chest pain, if fluid builds up around the lining of the heart, shortness of breath, if fluid builds up in the lungs, high blood pressure (hypertension) that's difficult to control. Signs and symptoms of chronic kidney disease are often nonspecific and can develop slowly, and may not appear until irreversible damage has occurred.


Kidney disease is treated by removing the damaging agent or condition that is causing kidney damage, e.g. normalize blood pressure to improve kidney function, end treatment with agents that can induce kidney damage, reduce inflammation that is causing kidney damage, or by providing renal support (e.g., renal dialysis) to assist kidney function.


Renal function is typically determined using one or more routine laboratory tests, BUN (blood urea nitrogen), creatinine (blood), creatinine (urine), or creatinine clearance (see, e.g., www.nlm.nih.gov/medlineplus/ency/article/003435.htm). The tests may also be diagnostic of conditions in other organs.


Generally, a BUN level of 6 to 20 mg/dL is considered normal, although normal values may vary among different laboratories. Elevated BUN level can be indicative of kidney disease, including glomerulonephritis, pyelonephritis, and acute tubular necrosis, or kidney failure.


A normal result for blood creatinine is 0.7 to 1.3 mg/dL for men and 0.6 to 1.1 mg/dL for women. Elevated blood creatinine can be indicative of compromised kidney function due to kidney damage or failure, infection, or reduced blood flow.


Urine creatinine (24-hour sample) values can range from 500 to 2000 mg/day. Results depend on age and amount of lean body mass. Normal results are 14 to 26 mg per kg of body mass per day for men


And 11 to 20 mg per kg of body mass per day for women. Abnormal results can be indicative of kidney damage, such as damage to the tubule cells, kidney failure, decreased blood flow to the kidneys, or kidney infection (pyelonephritis).


The creatinine clearance test helps provide information regarding kidney function by comparing the creatinine level in urine with the creatinine level in blood. Clearance is often measured as milliliters per minute (ml/min). Normal values are 97 to 137 ml/min. for men and 88 to 128 ml/min. for women. Lower than normal creatinine clearance can be indicative of kidney damage, such as damage to the tubule cells, kidney failure, decreased blood flow to the kidneys, or reduced glomerular filtration in the kidneys.


In certain embodiments, the compositions and methods of the invention can be used for the treatment of kidney disease. It is expected that such agents would not cause damage to the kidney.


VIIII. Kits

In certain aspects, the instant disclosure provides kits that include a suitable container containing a pharmaceutical formulation of a siRNA compound, e.g., a double-stranded siRNA compound, or ssiRNA compound, (e.g., a precursor, e.g., a larger siRNA compound which can be processed into a ssiRNA compound, or a DNA which encodes an siRNA compound, e.g., a double-stranded siRNA compound, or ssiRNA compound, or precursor thereof).


Such kits include one or more dsRNA agent(s) and instructions for use, e.g., instructions for administering a prophylactically or therapeutically effective amount of a dsRNA agent(s). The dsRNA agent may be in a vial or a pre-filled syringe. The kits may optionally further comprise means for administering the dsRNA agent (e.g., an injection device, such as a pre-filled syringe), or means for measuring the inhibition of KHK (e.g., means for measuring the inhibition of KHK mRNA, KHK protein, and/or KHK activity). Such means for measuring the inhibition of KHK may comprise a means for obtaining a sample from a subject, such as, e.g., a plasma sample. The kits of the invention may optionally further comprise means for determining the therapeutically effective or prophylactically effective amount.


In certain embodiments the individual components of the pharmaceutical formulation may be provided in one container, e.g., a vial or a pre-filled syringe. Alternatively, it may be desirable to provide the components of the pharmaceutical formulation separately in two or more containers, e.g., one container for a siRNA compound preparation, and at least another for a carrier compound. The kit may be packaged in a number of different configurations such as one or more containers in a single box. The different components can be combined, e.g., according to instructions provided with the kit. The components can be combined according to a method described herein, e.g., to prepare and administer a pharmaceutical composition. The kit can also include a delivery device.


This invention is further illustrated by the following examples which should not be construed as limiting. The entire contents of all references, patents and published patent applications cited throughout this application, as well as the informal Sequence Listing and Figures, are hereby incorporated herein by reference.


EXAMPLES
Example 1. iRNA Synthesis
Source of Reagents

Where the source of a reagent is not specifically given herein, such reagent can be obtained from any supplier of reagents for molecular biology at a quality/purity standard for application in molecular biology.


siRNA Design


siRNAs targeting the human Ketohexokinase (KHK) gene, “ketohexokinase isoform X10” (human: NCBI refseqID XM_017004061.1; NCBI GeneID: 3795) was designed using custom R and Python scripts. The human XM_017004061 REFSEQ mRNA, version 1, has a length of 2283 bases. Detailed lists of the unmodified KHK sense and antisense strand nucleotide sequences are shown in Tables 2 and 4. Detailed lists of the modified ketohexokinase sense and antisense strand nucleotide sequences are shown in Tables 3 and 5.


It is to be understood that, throughout the application, a duplex name without a decimal is equivalent to a duplex name with a decimal which merely references the batch number of the duplex. For example, AD-959917 is equivalent to AD-959917.1.


siRNA Synthesis


siRNAs were synthesized and annealed using routine methods known in the art.


Briefly, siRNA sequences were synthesized at 1 μmol scale on a Mermade 192 synthesizer (BioAutomation) using the solid support mediated phosphoramidite chemistry. The solid support was controlled pore glass (500 A) loaded with custom GalNAc ligand or universal solid support (AM biochemical). Ancillary synthesis reagents, 2′-F and 2′-O-Methyl RNA and deoxy phosphoramidites were obtained from Thermo-Fisher (Milwaukee, WI) and Hongene (China). 2′F 2′-O-Methyl, GNA (glycol nucleic acids), 5′phosphate and other modifications were introduced using the corresponding phosphoramidites. Synthesis of 3′ GalNAc conjugated single strands was performed on a GalNAc modified CPG support. Custom CPG universal solid support was used for the synthesis of antisense single strands. Coupling time for all phosphoramidites (100 mM in acetonitrile) was 5 min employing 5-Ethylthio-1H-tetrazole (ETT) as activator (0.6 M in acetonitrile). Phosphorothioate linkages were generated using a 50 mM solution of 3-((Dimethylamino-methylidene) amino)-3H-1,2,4-dithiazole-3-thione (DDTT, obtained from Chemgenes (Wilmington, MA, USA)) in anhydrous acetonitrile/pyridine (1:1 v/v). Oxidation time was 3 minutes. All sequences were synthesized with final removal of the DMT group (“DMT off”).


Upon completion of the solid phase synthesis, oligoribonucleotides were cleaved from the solid support and deprotected in sealed 96 deep well plates using 200 μL Aqueous Methylamine reagents at 60° C. for 20 minutes. For sequences containing 2′ ribo residues (2′-OH) that are protected with a tert-butyl dimethyl silyl (TBDMS) group, a second step deprotection was performed using TEA.3HF (triethylamine trihydro fluoride) reagent. To the methylamine deprotection solution, 200 uL of dimethyl sulfoxide (DMSO) and 300 ul TEA.3HF reagent was added and the solution was incubated for additional 20 min at 60° C. At the end of cleavage and deprotection step, the synthesis plate was allowed to come to room temperature and was precipitated by addition of 1 mL of acetontile: ethanol mixture (9:1). The plates were cooled at −80 C for 2 hrs, superanatant decanted carefully with the aid of a multi channel pipette. The oligonucleotide pellet was re-suspended in 20 mM NaOAc buffer and were desalted using a 5 mL HiTrap size exclusion column (GE Healthcare) on an AKTA Purifier System equipped with an A905 autosampler and a Frac 950 fraction collector. Desalted samples were collected in 96-well plates. Samples from each sequence were analyzed by LC-MS to confirm the identity, UV (260 nm) for quantification and a selected set of samples by IEX chromatography to determine purity.


Annealing of single strands was performed on a Tecan liquid handling robot. Equimolar mixture of sense and antisense single strands were combined and annealed in 96 well plates. After combining the complementary single strands, the 96-well plate was sealed tightly and heated in an oven at 100° C. for 10 minutes and allowed to come slowly to room temperature over a period 2-3 hours. The concentration of each duplex was normalized to 10 μM in 1×PBS and then submitted for in vitro screening assays.


Example 2. In Vitro Screening Methods
Cell Culture and 384-Well Transfections

Hep3b cells (ATCC, Manassas, VA) were grown to near confluence at 37° C. in an atmosphere of 5% CO2 in Eagle's Minimum Essential Medium (Gibco) supplemented with 10% FBS (ATCC) before being released from the plate by trypsinization. Transfection was carried out by adding 5 μl of Opti-MEM plus 0.1 μl of Lipofectamine RNAiMax per well (Invitrogen, Carlsbad CA. cat #13778-150) to 5 μl of each siRNA duplex to an individual well in a 384-well plate. The mixture was then incubated at room temperature for 15 minutes. Forty μl of Eagle's Minimum Essential Medium (ATCC Cat #30-2003) containing ˜5×103 Hep3B cells were then added to the siRNA mixture. Cells were incubated for 24 hours prior to RNA purification. Single dose experiments were performed at 10 nM.


Total RNA Isolation Using DYNABEADS mRNA Isolation Kit (Invitrogen™, Part #: 610-12)


RNA was isolated using an automated protocol on a BioTek-EL406 platform using DYNABEADs (Invitrogen, cat #61012). Briefly, 70 μl of Lysis/Binding Buffer and 10 μl of lysis buffer containing 3 μl of magnetic beads were added to the plate with cells. Plates were incubated on an electromagnetic shaker for 10 minutes at room temperature and then magnetic beads were captured and the supernatant was removed. Bead-bound RNA was then washed 2 times with 150 μl Wash Buffer A and once with Wash Buffer B. Beads were then washed with 150 μl Elution Buffer, re-captured and supernatant removed.


cDNA Synthesis Using ABI High Capacity cDNA Reverse Transcription Kit (Applied Biosystems, Foster City, CA, Cat #4368813)


A master mix of 1.2 μl 10× Buffer, 0.48 μl 25× dNTPs, 1.2 μl Random primers, 0.6 μl Reverse Transcriptase, 0.6 μl RNase inhibitor and 7.92 μl of H2O per reaction were added per well. Plates were sealed, mixed, and then incubated on an electromagnetic shaker for 10 minutes at room temperature, followed by incubation at 37° C. for 2 hours.


Real Time PCR

Two μl of cDNA were added to a master mix containing 0.5 μl of human GAPDH TaqMan Probe (4326317E), amd 0.5 μl KHK human probe (Hs01071998_m1) and 5 μl Lightcycler 480 probe master mix (Roche Cat #04887301001) per well in a 384 well plates (Roche cat #04887301001). Real time PCR was done in a LightCycler480 Real Time PCR system (Roche). Each duplex was tested at least two times and data were normalized to cells transfected with a non-targeting control siRNA. To calculate relative fold change, real time data were analyzed using the ΔΔCt method and normalized to assays performed with cells transfected with a non-targeting control siRNA.


The results of the single dose screen of the dsRNA agents in Tables 2 are 3 are shown in Table 6 and the results of the single dose screen of the dsRNA agents Tables 4 and 5 are shown in Table 7.









TABLE 1







Abbreviations of nucleotide monomers used in nucleic acid sequence representation. It will


be understood that these monomers, when present in an oligonucleotide, are mutually linked by 5′-3′-


phosphodiester bonds.








Abbreviation
Nucleotide(s)





A
Adenosine-3′-phosphate


Ab
beta-L-adenosine-3′-phosphate


Abs
beta-L-adenosine-3′-phosphorothioate


Af
2′-fluoroadenosine-3′-phosphate


Afs
2′-fluoroadenosine-3′-phosphorothioate


As
adenosine-3′-phosphorothioate


C
cytidine-3′-phosphate


Cb
beta-L-cytidine-3′-phosphate


Cbs
beta-L-cytidine-3′-phosphorothioate


Cf
2′-fluorocytidine-3′-phosphate


Cfs
2′-fluorocytidine-3′-phosphorothioate


Cs
cytidine-3′-phosphorothioate


G
guanosine-3′-phosphate


Gb
beta-L-guanosine-3′-phosphate


Gbs
beta-L-guanosine-3′-phosphorothioate


Gf
2′-fluoroguanosine-3′-phosphate


Gfs
2′-fluoroguanosine-3′-phosphorothioate


Gs
guanosine-3′-phosphorothioate


T
5′-methyluridine-3′-phosphate


Tf
2′-fluoro-5-methyluridine-3′-phosphate


Tfs
2′-fluoro-5-methyluridine-3′-phosphorothioate


Ts
5-methyluridine-3′-phosphorothioate


U
Uridine-3′-phosphate


Uf
2′-fluorouridine-3′-phosphate


Ufs
2′-fluorouridine-3′-phosphorothioate


Us
uridine-3′-phosphorothioate


N
any nucleotide, modified or unmodified


a
2′-O-methyladenosine-3′-phosphate


as
2′-O-methyladenosine-3′-phosphorothioate


c
2′-O-methylcytidine-3′-phosphate


cs
2′-O-methylcytidine-3′-phosphorothioate


g
2′-O-methylguanosine-3′-phosphate


gs
2′-O-methylguanosine-3′-phosphorothioate


t
2′-O-methyl-5-methyluridine-3′-phosphate


ts
2′-O-methyl-5-methyluridine-3′-phosphorothioate


u
2′-O-methyluridine-3′-phosphate


us
2′-O-methyluridine-3′-phosphorothioate


s
phosphorothioate linkage


L10
N-(cholesterylcarboxamidocaproyl)-4-hydroxyprolinol (Hyp-C6-Chol)


L96
N-[tris(GalNAc-alkyl)-amidodecanoyl)]-4-hydroxyprolinol



(Hyp-(GalNAc-alkyl)3)





embedded image







Y34
2-hydroxymethyl-tetrahydrofurane-4-methoxy-3-phosphate (abasic 2′-OMe furanose)


Y44
inverted abasic DNA (2-hydroxymethyl-tetrahydrofurane-5-phosphate)


(Agn)
Adenosine-glycol nucleic acid (GNA)


(Cgn)
Cytidine-glycol nucleic acid (GNA)


(Ggn)
Guanosine-glycol nucleic acid (GNA)


(Tgn)
Thymidine-glycol nucleic acid (GNA) S-Isomer


P
Phosphate


VP
Vinyl-phosphonate


dA
2′-deoxyadenosine-3′-phosphate


dAs
2′-deoxyadenosine-3′-phosphorothioate


dC
2′-deoxycytidine-3′-phosphate


dCs
2′-deoxycytidine-3′-phosphorothioate


dG
2′-deoxyguanosine-3′-phosphate


dGs
2′-deoxyguanosine-3′-phosphorothioate


dT
2′-deoxythymidine-3′-phosphate


dTs
2′-deoxythymidine-3′-phosphorothioate


dU
2′-deoxyuridine


dUs
2′-deoxyuridine-3′-phosphorothioate


(C2p)
cytidine-2′-phosphate


(G2p)
guanosine-2′-phosphate


(U2p)
uridine-2′-phosphate


(A2p)
adenosine-2′-phosphate


(Chd)
2′-O-hexadecyl-cytidine-3′-phosphate


(Ahd)
2′-O-hexadecyl-adenosine-3′-phosphate


(Ghd)
2′-O-hexadecyl-guanosine-3′-phosphate


(Uhd)
2′-O-hexadecyl-uridine-3′-phosphate
















TABLE 2







Unmodified Sense and Antisense Strand Sequences of Ketohexokinase dsRNA Agents















SEQ


SEQ



Duplex
Sense Sequence
ID
Position in
Antisense Sequence
ID
Position in


Name
5′ to 3′
NO:
XM_017004061.1
5′ to 3′
NO:
XM_017004061.1





AD-251799.1
UUCUCUUUGCAUUCUCGAGAU
 41
133-153
AUCUCGAGAAUGCAAAGAGAAAA
110
131-153





AD-253006.1
CCUGCGUUGUGCAGACUCUAU
 42
1748-1768
AUAGAGTCUGCACAACGCAGGGC
111
1746-1768





AD-251816.1
AGAUCGCUUAGCCGCGCUUUA
 43
150-170
UAAAGCGCGGCUAAGCGAUCUCG
112
148-170





AD-251798.1
UUUCUCUUUGCAUUCUCGAGA
 44
132-152
UCUCGAGAAUGCAAAGAGAAAAU
113
130-152





AD-251855.1
GUGAGUCCAUCUGACAAGCGA
 45
189-209
UCGCUUGUCAGAUGGACUCACAG
114
187-209





AD-252223.1
CCAACUCCUGCACCGUUCUCU
 46
653-673
AGAGAACGGUGCAGGAGUUGGAC
115
651-673





AD-252530.1
CUUGUAUGGUCGUGUGAGGAA
 47
1017-1037
UUCCUCACACGACCAUACAAGCC
116
1015-1037





AD-252341.1
GAUCCACAUUGAGGGCCGGAA
 48
792-812
UUCCGGCCCUCAAUGUGGAUCCA
117
790-812





AD-252484.1
GCUGUUUGGCUACGGAGACGU
 49
930-950
ACGUCUCCGUAGCCAAACAGCUG
118
928-950





AD-253313.1
CUGCCAUUUAAUUAGCUGCAU
 50
2139-2159
AUGCAGCUAAUUAAAUGGCAGAU
119
2137-2159





AD-252117.1
GAGAAGCAGAUCCUGUGCGUU
 51
529-549
AACGCACAGGAUCUGCUUCUCUU
120
527-549





AD-251856.1
UGAGUCCAUCUGACAAGCGAU
 52
190-210
AUCGCUTGUCAGAUGGACUCACA
121
188-210





AD-251808.1
CAUUCUCGAGAUCGCUUAGCU
 53
142-162
AGCUAAGCGAUCUCGAGAAUGCA
122
140-162





AD-251857.1
GAGUCCAUCUGACAAGCGAGU
 54
191-211
ACUCGCTUGUCAGAUGGACUCAC
123
189-211





AD-252378.1
AAGAUGCUGCAGCGGAUAGAU
 55
829-849
AUCUAUCCGCUGCAGCAUCUUCA
124
827-849





AD-251809.1
AUUCUCGAGAUCGCUUAGCCU
 56
143-163
AGGCUAAGCGAUCUCGAGAAUGC
125
141-163





AD-251886.1
GCUGAGAAGUGGGAGGCGUUU
 57
220-240
AAACGCCUCCCACUUCUCAGCCU
126
218-240





AD-252381.1
AUGCUGCAGCGGAUAGACGCA
 58
832-852
UGCGUCTAUCCGCUGCAGCAUCU
127
830-852





AD-251800.1
UCUCUUUGCAUUCUCGAGAUU
 59
134-154
AAUCUCGAGAAUGCAAAGAGAAA
128
132-154





AD-251801.1
CUCUUUGCAUUCUCGAGAUCU
 60
135-155
AGAUCUCGAGAAUGCAAAGAGAA
129
133-155





AD-253132.1
UGGAGCCCACCUUGGAAUUAA
 61
1940-1960
UUAAUUCCAAGGUGGGCUCCAAG
130
1938-1960





AD-252146.1
CCUGGUGGACAAGUACCCUAA
 62
576-596
UUAGGGTACUUGUCCACCAGGCU
131
574-596





AD-251811.1
UCUCGAGAUCGCUUAGCCGCU
 63
145-165
AGCGGCTAAGCGAUCUCGAGAAU
132
143-165





AD-251858.1
AGUCCAUCUGACAAGCGAGGA
 64
192-212
UCCUCGCUUGUCAGAUGGACUCA
133
190-212





AD-252483.1
AGCUGUUUGGCUACGGAGACU
 65
929-949
AGUCUCCGUAGCCAAACAGCUGG
134
927-949





AD-252380.1
GAUGCUGCAGCGGAUAGACGU
 66
831-851
ACGUCUAUCCGCUGCAGCAUCUU
135
829-851





AD-253310.1
AAUCUGCCAUUUAAUUAGCUU
 67
2136-2156
AAGCUAAUUAAAUGGCAGAUUUU
136
2134-2156





AD-251807.1
GCAUUCUCGAGAUCGCUUAGU
 68
141-161
ACUAAGCGAUCUCGAGAAUGCAA
137
139-161





AD-252531.1
UUGUAUGGUCGUGUGAGGAAA
 69
1018-1038
UUUCCUCACACGACCAUACAAGC
138
1016-1038





AD-252376.1
UGAAGAUGCUGCAGCGGAUAU
 70
827-847
AUAUCCGCUGCAGCAUCUUCACC
139
825-847





AD-252715.1
CUGCAGGGCUUUGAUGGCAUU
 71
1258-1278
AAUGCCAUCAAAGCCCUGCAGGC
140
1256-1278





AD-252490.1
UGGCUACGGAGACGUGGUGUU
 72
936-956
AACACCACGUCUCCGUAGCCAAA
141
934-956





AD-252377.1
GAAGAUGCUGCAGCGGAUAGA
 73
828-848
UCUAUCCGCUGCAGCAUCUUCAC
142
826-848





AD-252628.1
AGCUGGAGACACCUUCAAUGU
 74
1152-1172
ACAUUGAAGGUGUCUCCAGCUCC
143
1150-1172





AD-252486.1
UGUUUGGCUACGGAGACGUGU
 75
932-952
ACACGUCUCCGUAGCCAAACAGC
144
930-952





AD-251806.1
UGCAUUCUCGAGAUCGCUUAU
 76
140-160
AUAAGCGAUCUCGAGAAUGCAAA
145
138-160





AD-251817.1
GAUCGCUUAGCCGCGCUUUAA
 77
151-171
UUAAAGCGCGGCUAAGCGAUCUC
146
149-171





AD-253083.1
GCCCACCAGCCUGUGAUUUGA
 78
1853-1873
UCAAAUCACAGGCUGGUGGGCAG
147
1851-1873





AD-252498.1
AGACGUGGUGUUUGUCAGCAA
 79
945-965
UUGCUGACAAACACCACGUCUCC
148
943-965





AD-252379.1
AGAUGCUGCAGCGGAUAGACU
 80
830-850
AGUCUATCCGCUGCAGCAUCUUC
149
828-850





AD-252118.1
AGAAGCAGAUCCUGUGCGUGU
 81
530-550
ACACGCACAGGAUCUGCUUCUCU
150
528-550





AD-252529.1
GCUUGUAUGGUCGUGUGAGGA
 82
1016-1036
UCCUCACACGACCAUACAAGCCC
151
1014-1036





AD-251810.1
UUCUCGAGAUCGCUUAGCCGU
 83
144-164
ACGGCUAAGCGAUCUCGAGAAUG
152
142-164





AD-252314.1
UGAGAAGGUUGAUCUGACCCA
 84
762-782
UGGGUCAGAUCAACCUUCUCAAA
153
760-782





AD-251805.1
UUGCAUUCUCGAGAUCGCUUA
 85
139-159
UAAGCGAUCUCGAGAAUGCAAAG
154
137-159





AD-253008.1
UGCGUUGUGCAGACUCUAUUU
 86
1750-1770
AAAUAGAGUCUGCACAACGCAGG
155
1748-1770





AD-252222.1
UCCAACUCCUGCACCGUUCUU
 87
652-672
AAGAACGGUGCAGGAGUUGGACG
156
650-672





AD-251815.1
GAGAUCGCUUAGCCGCGCUUU
 88
149-169
AAAGCGCGGCUAAGCGAUCUCGA
157
147-169





AD-252485.1
CUGUUUGGCUACGGAGACGUU
 89
931-951
AACGUCTCCGUAGCCAAACAGCU
158
929-951





AD-252627.1
GAGCUGGAGACACCUUCAAUU
 90
1151-1171
AAUUGAAGGUGUCUCCAGCUCCC
159
1149-1171





AD-251885.1
GGCUGAGAAGUGGGAGGCGUU
 91
219-239
AACGCCTCCCACUUCUCAGCCUU
160
217-239





AD-252497.1
GAGACGUGGUGUUUGUCAGCA
 92
944-964
UGCUGACAAACACCACGUCUCCG
161
942-964





AD-252116.1
AGAGAAGCAGAUCCUGUGCGU
 93
528-548
ACGCACAGGAUCUGCUUCUCUUC
162
526-548





AD-251797.1
UUUUCUCUUUGCAUUCUCGAU
 94
131-151
AUCGAGAAUGCAAAGAGAAAAUG
163
129-151





AD-253133.1
GGAGCCCACCUUGGAAUUAAU
 95
1941-1961
AUUAAUTCCAAGGUGGGCUCCAA
164
1939-1961





AD-251804.1
UUUGCAUUCUCGAGAUCGCUU
 96
138-158
AAGCGATCUCGAGAAUGCAAAGA
165
136-158





AD-252600.1
CUCCACUCGGAUGCUUUCCCU
 97
1105-1125
AGGGAAAGCAUCCGAGUGGAGCA
166
1103-1125





AD-252528.1
GGCUUGUAUGGUCGUGUGAGU
 98
1015-1035
ACUCACACGACCAUACAAGCCCC
167
1013-1035





AD-252450.1
GGCUACGGAGACGUGGUGUUU
 99
798-818
AAACACCACGUCUCCGUAGCCAA
168
796-818





AD-252313.1
UUGAGAAGGUUGAUCUGACCU
100
761-781
AGGUCAGAUCAACCUUCUCAAAG
169
759-781





AD-253134.1
GAGCCCACCUUGGAAUUAAGU
101
1942-1962
ACUUAATUCCAAGGUGGGCUCCA
170
1940-1962





AD-252543.1
CUUGUCUGUGCCUGGGCUGAU
102
1048-1068
AUCAGCCCAGGCACAGACAAGCA
171
1046-1068





AD-251802.1
UCUUUGCAUUCUCGAGAUCGU
103
136-156
ACGAUCTCGAGAAUGCAAAGAGA
172
134-156





AD-252666.1
GCAGGAAGCACUGAGAUUCGU
104
1209-1229
ACGAAUCUCAGUGCUUCCUGCAC
173
1207-1229





AD-251812.1
CUCGAGAUCGCUUAGCCGCGU
105
146-166
ACGCGGCUAAGCGAUCUCGAGAA
174
144-166





AD-252632.1
GGAGACACCUUCAAUGCCUCU
106
1156-1176
AGAGGCAUUGAAGGUGUCUCCAG
175
1154-1176





AD-251803.1
CUUUGCAUUCUCGAGAUCGCU
107
137-157
AGCGAUCUCGAGAAUGCAAAGAG
176
135-157





AD-252339.1
UGGAUCCACAUUGAGGGCCGU
108
790-810
ACGGCCCUCAAUGUGGAUCCACU
177
788-810





AD-252285.1
CUGCCAGAUGUGUCUGCUACA
109
736-756
UGUAGCAGACACAUCUGGCAGGC
178
734-756
















TABLE 3







Modified Sense and Antisense Strand Sequences of Ketohexokinase dsRNA Agents















SEQ

SEQ

SEQ


Duplex
Sense Sequence
ID
Antisense Sequence
ID
mRNA target Sequence
ID


Name
5′ to 3′
NO:
5′ to 3′
NO:
5′ to 3′
NO:





AD-251799.1
ususcucuUfuGfCfAfuucucgagauL96
179
asUfscucg(Agn)
248
UUUUCUCUUUGCAUUCUCGAGAU
317





gaaugcAfaAfgagaasasa








AD-253006.1
cscsugcgUfuGfUfGfcagacucuauL96
180
asUfsagag(Tgn)
249
GCCCUGCGUUGUGCAGACUCUAU
318





cugcacAfaCfgcaggsgsc








AD-251816.1
asgsaucgCfuUfAfGfccgcgcuuuaL96
181
usAfsaagc(Ggn)
250
CGAGAUCGCUUAGCCGCGCUUUA
319





cggcuaAfgCfgaucuscsg








AD-251798.1
ususucucUfuUfGfCfauucucgagaL96
182
usCfsucga(Ggn)
251
AUUUUCUCUUUGCAUUCUCGAGA
320





aaugcaAfaGfagaaasasu








AD-251855.1
gsusgaguCfcAfUfCfugacaagcgaL96
183
usCfsgcuu(Ggn)
252
CUGUGAGUCCAUCUGACAAGCGA
321





ucagauGfgAfcucacsasg








AD-252223.1
cscsaacuCfcUfGfCfaccguucucuL96
184
asGfsagaa(Cgn)
253
GUCCAACUCCUGCACCGUUCUCU
322





ggugcaGfgAfguuggsasc








AD-252530.1
csusuguaUfgGfUfCfgugugaggaaL96
185
usUfsccuc(Agn)
254
GGCUUGUAUGGUCGUGUGAGGAA
323





cacgacCfaUfacaagscsc








AD-252341.1
gsasuccaCfaUfUfGfagggccggaaL96
186
usUfsccgg(Cgn)
255
UGGAUCCACAUUGAGGGCCGGAA
324





ccucaaUfgUfggaucscsa








AD-252484.1
gscsuguuUfgGfCfUfacggagacguL96
187
asCfsgucu(Cgn)
256
CAGCUGUUUGGCUACGGAGACGU
325





cguagcCfaAfacagcsusg








AD-253313.1
csusgccaUfuUfAfAfuuagcugcauL96
188
asUfsgcag(Cgn)
257
AUCUGCCAUUUAAUUAGCUGCAU
326





uaauuaAfaUfggcagsasu








AD-252117.1
gsasgaagCfaGfAfUfccugugcguuL96
189
asAfscgca(Cgn)
258
AAGAGAAGCAGAUCCUGUGCGUG
327





aggaucUfgCfuucucsusu








AD-251856.1
usgsagucCfaUfCfUfgacaagcgauL96
190
asUfscgcu(Tgn)
259
UGUGAGUCCAUCUGACAAGCGAG
328





gucagaUfgGfacucascsa








AD-251808.1
csasuucuCfgAfGfAfucgcuuagcuL96
191
asGfscuaa(Ggn)
260
UGCAUUCUCGAGAUCGCUUAGCC
329





cgaucuCfgAfgaaugscsa








AD-251857.1
gsasguccAfuCfUfGfacaagcgaguL96
192
asCfsucgc(Tgn)
261
GUGAGUCCAUCUGACAAGCGAGG
330





ugucagAfuGfgacucsasc








AD-252378.1
asasgaugCfuGfCfAfgcggauagauL96
193
asUfscuau(Cgn)
262
UGAAGAUGCUGCAGCGGAUAGAC
331





cgcugcAfgCfaucuuscsa








AD-251809.1
asusucucGfaGfAfUfcgcuuagccuL96
194
asGfsgcua(Agn)
263
GCAUUCUCGAGAUCGCUUAGCCG
332





gcgaucUfcGfagaausgsc








AD-251886.1
gscsugagAfaGfUfGfggaggcguuuL96
195
asAfsacgc(Cgn)
264
AGGCUGAGAAGUGGGAGGCGUUG
333





ucccacUfuCfucagcscsu








AD-252381.1
asusgcugCfaGfCfGfgauagacgcaL96
196
usGfscguc(Tgn)
265
AGAUGCUGCAGCGGAUAGACGCA
334





auccgcUfgCfagcauscsu








AD-251800.1
uscsucuuUfgCfAfUfucucgagauuL96
197
asAfsucuc(Ggn)
266
UUUCUCUUUGCAUUCUCGAGAUC
335





agaaugCfaAfagagasasa








AD-251801.1
csuscuuuGfcAfUfUfcucgagaucuL96
198
asGfsaucu(Cgn)
267
UUCUCUUUGCAUUCUCGAGAUCG
336





gagaauGfcAfaagagsasa








AD-253132.1
usgsgagcCfcAfCfCfuuggaauuaaL96
199
usUfsaauu(Cgn)
268
CUUGGAGCCCACCUUGGAAUUAA
337





caagguGfgGfcuccasasg








AD-252146.1
cscsugguGfgAfCfAfaguacccuaaL96
200
usUfsaggg(Tgn)
269
AGCCUGGUGGACAAGUACCCUAA
338





acuuguCfcAfccaggscsu








AD-251811.1
uscsucgaGfaUfCfGfcuuagccgcuL96
201
asGfscggc(Tgn)
270
AUUCUCGAGAUCGCUUAGCCGCG
339





aagcgaUfcUfcgagasasu








AD-251858.1
asgsuccaUfcUfGfAfcaagcgaggaL96
202
usCfscucg(Cgn)
271
UGAGUCCAUCUGACAAGCGAGGA
340





uugucaGfaUfggacuscsa








AD-252483.1
asgscuguUfuGfGfCfuacggagacuL96
203
asGfsucuc(Cgn)
272
CCAGCUGUUUGGCUACGGAGACG
341





guagccAfaAfcagcusgsg








AD-252380.1
gsasugcuGfcAfGfCfggauagacguL96
204
asCfsgucu(Agn)
273
AAGAUGCUGCAGCGGAUAGACGC
342





uccgcuGfcAfgcaucsusu








AD-253310.1
asasucugCfcAfUfUfuaauuagcuuL96
205
asAfsgcua(Agn)
274
AAAAUCUGCCAUUUAAUUAGCUG
343





uuaaauGfgCfagauususu








AD-251807.1
gscsauucUfcGfAfGfaucgcuuaguL96
206
asCfsuaag(Cgn)
275
UUGCAUUCUCGAGAUCGCUUAGC
344





gaucucGfaGfaaugcsasa








AD-252531.1
ususguauGfgUfCfGfugugaggaaaL96
207
usUfsuccu(Cgn)
276
GCUUGUAUGGUCGUGUGAGGAAA
345





acacgaCfcAfuacaasgsc








AD-252376.1
usgsaagaUfgCfUfGfcagcggauauL96
208
asUfsaucc(Ggn)
277
GGUGAAGAUGCUGCAGCGGAUAG
346





cugcagCfaUfcuucascsc








AD-252715.1
csusgcagGfgCfUfUfugauggcauuL96
209
asAfsugcc(Agn)
278
GCCUGCAGGGCUUUGAUGGCAUC
347





ucaaagCfcCfugcagsgsc








AD-252490.1
usgsgcuaCfgGfAfGfacgugguguuL96
210
asAfscacc(Agn)
279
UUUGGCUACGGAGACGUGGUGUU
348





cgucucCfgUfagccasasa








AD-252377.1
gsasagauGfcUfGfCfagcggauagaL96
211
usCfsuauc(Cgn)
280
GUGAAGAUGCUGCAGCGGAUAGA
349





gcugcaGfcAfucuucsasc








AD-252628.1
asgscuggAfgAfCfAfccuucaauguL96
212
asCfsauug(Agn)
281
GGAGCUGGAGACACCUUCAAUGC
350





agguguCfuCfcagcuscsc








AD-252486.1
usgsuuugGfcUfAfCfggagacguguL96
213
asCfsacgu(Cgn)
282
GCUGUUUGGCUACGGAGACGUGG
351





uccguaGfcCfaaacasgsc








AD-251806.1
usgscauuCfuCfGfAfgaucgcuuauL96
214
asUfsaagc(Ggn)
283
UUUGCAUUCUCGAGAUCGCUUAG
352





aucucgAfgAfaugcasasa








AD-251817.1
gsasucgcUfuAfGfCfcgcgcuuuaaL96
215
usUfsaaag(Cgn)
284
GAGAUCGCUUAGCCGCGCUUUAA
353





gcggcuAfaGfcgaucsusc








AD-253083.1
gscsccacCfaGfCfCfugugauuugaL96
216
usCfsaaau(Cgn)
285
CUGCCCACCAGCCUGUGAUUUGA
354





acaggcUfgGfugggcsasg








AD-252498.1
asgsacguGfgUfGfUfuugucagcaaL96
217
usUfsgcug(Agn)
286
GGAGACGUGGUGUUUGUCAGCAA
355





caaacaCfcAfcgucuscsc








AD-252379.1
asgsaugcUfgCfAfGfcggauagacuL96
218
asGfsucua(Tgn)
287
GAAGAUGCUGCAGCGGAUAGACG
356





ccgcugCfaGfcaucususc








AD-252118.1
asgsaagcAfgAfUfCfcugugcguguL96
219
asCfsacgc(Agn)
288
AGAGAAGCAGAUCCUGUGCGUGG
357





caggauCfuGfcuucuscsu








AD-252529.1
gscsuuguAfuGfGfUfcgugugaggaL96
220
usCfscuca(Cgn)
289
GGGCUUGUAUGGUCGUGUGAGGA
358





acgaccAfuAfcaagcscsc








AD-251810.1
ususcucgAfgAfUfCfgcuuagccguL96
221
asCfsggcu(Agn)
290
CAUUCUCGAGAUCGCUUAGCCGC
359





agcgauCfuCfgagaasusg








AD-252314.1
usgsagaaGfgUfUfGfaucugacccaL96
222
usGfsgguc(Agn)
291
UUUGAGAAGGUUGAUCUGACCCA
360





gaucaaCfcUfucucasasa








AD-251805.1
ususgcauUfcUfCfGfagaucgcuuaL96
223
usAfsagcg(Agn)
292
CUUUGCAUUCUCGAGAUCGCUUA
361





ucucgaGfaAfugcaasasg








AD-253008.1
usgscguuGfuGfCfAfgacucuauuuL96
224
asAfsauag(Agn)
293
CCUGCGUUGUGCAGACUCUAUUC
362





gucugcAfcAfacgcasgsg








AD-252222.1
uscscaacUfcCfUfGfcaccguucuuL96
225
asAfsgaac(Ggn)
294
CGUCCAACUCCUGCACCGUUCUC
363





gugcagGfaGfuuggascsg








AD-251815.1
gsasgaucGfcUfUfAfgccgcgcuuuL96
226
asAfsagcg(Cgn)
295
UCGAGAUCGCUUAGCCGCGCUUU
364





ggcuaaGfcGfaucucsgsa








AD-252485.1
csusguuuGfgCfUfAfcggagacguuL96
227
asAfscguc(Tgn)
296
AGCUGUUUGGCUACGGAGACGUG
365





ccguagCfcAfaacagscsu








AD-252627.1
gsasgcugGfaGfAfCfaccuucaauuL96
228
asAfsuuga(Agn)
297
GGGAGCUGGAGACACCUUCAAUG
366





ggugucUfcCfagcucscsc








AD-251885.1
gsgscugaGfaAfGfUfgggaggcguuL96
229
asAfscgcc(Tgn)
298
AAGGCUGAGAAGUGGGAGGCGUU
367





cccacuUfcUfcagccsusu








AD-252497.1
gsasgacgUfgGfUfGfuuugucagcaL96
230
usGfscuga(Cgn)
299
CGGAGACGUGGUGUUUGUCAGCA
368





aaacacCfaCfgucucscsg








AD-252116.1
asgsagaaGfcAfGfAfuccugugcguL96
231
asCfsgcac(Agn)
300
GAAGAGAAGCAGAUCCUGUGCGU
369





ggaucuGfcUfucucususc








AD-251797.1
ususuucuCfuUfUfGfcauucucgauL96
232
asUfscgag(Agn)
301
CAUUUUCUCUUUGCAUUCUCGAG
370





augcaaAfgAfgaaaasusg








AD-253133.1
gsgsagccCfaCfCfUfuggaauuaauL96
233
asUfsuaau(Tgn)
302
UUGGAGCCCACCUUGGAAUUAAG
371





ccaaggUfgGfgcuccsasa








AD-251804.1
ususugcaUfuCfUfCfgagaucgcuuL96
234
asAfsgcga(Tgn)
303
UCUUUGCAUUCUCGAGAUCGCUU
372





cucgagAfaUfgcaaasgsa








AD-252600.1
csusccacUfcGfGfAfugcuuucccuL96
235
asGfsggaa(Agn)
304
UGCUCCACUCGGAUGCUUUCCCG
373





gcauccGfaGfuggagscsa








AD-252528.1
gsgscuugUfaUfGfGfucgugugaguL96
236
asCfsucac(Agn)
305
GGGGCUUGUAUGGUCGUGUGAGG
374





cgaccaUfaCfaagccscsc








AD-252450.1
gsgscuacGfgAfGfAfcgugguguuuL96
237
asAfsacac(Cgn)
306
UUGGCUACGGAGACGUGGUGUUU
375





acgucuCfcGfuagccsasa








AD-252313.1
ususgagaAfgGfUfUfgaucugaccuL96
238
asGfsguca(Ggn)
307
CUUUGAGAAGGUUGAUCUGACCC
376





aucaacCfuUfcucaasasg








AD-253134.1
gsasgcccAfcCfUfUfggaauuaaguL96
239
asCfsuuaa(Tgn)
308
UGGAGCCCACCUUGGAAUUAAGG
377





uccaagGfuGfggcucscsa








AD-252543.1
csusugucUfgUfGfCfcugggcugauL96
240
asUfscagc(Cgn)
309
UGCUUGUCUGUGCCUGGGCUGAG
378





caggcaCfaGfacaagscsa








AD-251802.1
uscsuuugCfaUfUfCfucgagaucguL96
241
asCfsgauc(Tgn)
310
UCUCUUUGCAUUCUCGAGAUCGC
379





cgagaaUfgCfaaagasgsa








AD-252666.1
gscsaggaAfgCfAfCfugagauucguL96
242
asCfsgaau(Cgn)
311
GUGCAGGAAGCACUGAGAUUCGG
380





ucagugCfuUfccugcsasc








AD-251812.1
csuscgagAfuCfGfCfuuagccgcguL96
243
asCfsgcgg(Cgn)
312
UUCUCGAGAUCGCUUAGCCGCGC
381





uaagcgAfuCfucgagsasa








AD-252632.1
gsgsagacAfcCfUfUfcaaugccucuL96
244
asGfsaggc(Agn)
313
CUGGAGACACCUUCAAUGCCUCC
382





uugaagGfuGfucuccsasg








AD-251803.1
csusuugcAfuUfCfUfcgagaucgcuL96
245
asGfscgau(Cgn)
314
CUCUUUGCAUUCUCGAGAUCGCU
383





ucgagaAfuGfcaaagsasg








AD-252339.1
usgsgaucCfaCfAfUfugagggccguL96
246
asCfsggcc(Cgn)
315
AGUGGAUCCACAUUGAGGGCCGG
384





ucaaugUfgGfauccascsu








AD-252285.1
csusgccaGfaUfGfUfgucugcuacaL96
247
usGfsuagc(Agn)
316
GCCUGCCAGAUGUGUCUGCUACA
385





gacacaUfcUfggcagsgsc
















TABLE 4







Unmodified Sense and Antisense Strand Sequences of Ketohexokinase dsRNA Agents















SEQ


SEQ



Duplex
Sense Sequence
ID
Position in
Antisense Sequence
ID
Position in


Name
5′ to 3′
NO:
XM_017004061.1
5′ to 3′
NO:
XM_017004061.1





AD-253536.1
UUCUCUUUGCAUUCUCGAGAU
 41
133-153
ATCUCGAGAAUGCAAAGAGAAAA
422
131-153





AD-254743.1
CCUGCGUUGUGCAGACUCUAU
 42
1748-1768
ATAGAGTCUGCACAACGCAGGGC
423
1746-1768





AD-253553.1
AGAUCGCUTAGCCGCGCUUUA
386
150-170
UAAAGCGCGGCTAAGCGAUCUCG
424
148-170





AD-253535.1
UUUCUCUUTGCAUUCUCGAGA
387
132-152
UCUCGAGAAUGCAAAGAGAAAAU
113
130-152





AD-253592.1
GUGAGUCCAUCUGACAAGCGA
 45
189-209
UCGCTUGUCAGAUGGACUCACAG
425
187-209





AD-253960.1
CCAACUCCTGCACCGUUCUCU
388
653-673
AGAGAACGGUGCAGGAGUUGGAC
115
651-673





AD-254267.1
CUUGUAUGGUCGUGUGAGGAA
 47
1017-1037
UTCCTCACACGACCAUACAAGCC
426
1015-1037





AD-254078.1
GAUCCACATUGAGGGCCGGAA
389
792-812
UTCCGGCCCUCAATGUGGAUCCA
427
790-812





AD-254216.1
GCUGUUUGGCTACGGAGACGU
390
930-950
ACGUCUCCGUAGCCAAACAGCUG
118
928-950





AD-255050.1
CUGCCAUUTAAUUAGCUGCAU
391
2139-2159
ATGCAGCUAAUTAAAUGGCAGAU
428
2137-2159





AD-253854.1
GAGAAGCAGATCCUGUGCGUU
392
529-549
AACGCACAGGATCTGCUUCUCUU
429
527-549





AD-253593.1
UGAGUCCATCTGACAAGCGAU
393
190-210
ATCGCUTGUCAGATGGACUCACA
430
188-210





AD-253545.1
CAUUCUCGAGAUCGCUUAGCU
 53
142-162
AGCUAAGCGAUCUCGAGAAUGCA
122
140-162





AD-253594.1
GAGUCCAUCUGACAAGCGAGU
 54
191-211
ACUCGCTUGUCAGAUGGACUCAC
123
189-211





AD-254115.1
AAGAUGCUGCAGCGGAUAGAU
 55
829-849
ATCUAUCCGCUGCAGCAUCUUCA
431
827-849





AD-253546.1
AUUCUCGAGATCGCUUAGCCU
394
143-163
AGGCTAAGCGATCTCGAGAAUGC
432
141-163





AD-253623.1
GCUGAGAAGUGGGAGGCGUUU
 57
220-240
AAACGCCUCCCACTUCUCAGCCU
433
218-240





AD-254118.1
AUGCUGCAGCGGAUAGACGCA
 58
832-852
UGCGTCTAUCCGCTGCAGCAUCU
434
830-852





AD-253537.1
UCUCUUUGCATUCUCGAGAUU
395
134-154
AAUCTCGAGAATGCAAAGAGAAA
435
132-154





AD-253538.1
CUCUUUGCAUTCUCGAGAUCU
396
135-155
AGAUCUCGAGAAUGCAAAGAGAA
129
133-155





AD-254869.1
UGGAGCCCACCUUGGAAUUAA
 61
1940-1960
UTAATUCCAAGGUGGGCUCCAAG
436
1938-1960





AD-254065.1
CCCAGUUCAAGUGGAUCCACA
397
779-799
UGUGGATCCACTUGAACUGGGUC
437
777-799





AD-253883.1
CCUGGUGGACAAGUACCCUAA
 62
576-596
UTAGGGTACUUGUCCACCAGGCU
438
574-596





AD-253548.1
UCUCGAGATCGCUUAGCCGCU
398
145-165
AGCGGCTAAGCGATCUCGAGAAU
439
143-165





AD-253595.1
AGUCCAUCTGACAAGCGAGGA
399
192-212
UCCUCGCUUGUCAGAUGGACUCA
133
190-212





AD-254215.1
AGCUGUUUGGCUACGGAGACU
 65
929-949
AGUCTCCGUAGCCAAACAGCUGG
440
927-949





AD-254117.1
GAUGCUGCAGCGGAUAGACGU
 66
831-851
ACGUCUAUCCGCUGCAGCAUCUU
135
829-851





AD-255047.1
AAUCUGCCAUTUAAUUAGCUU
400
2136-2156
AAGCTAAUUAAAUGGCAGAUUUU
441
2134-2156





AD-253544.1
GCAUUCUCGAGAUCGCUUAGU
 68
141-161
ACUAAGCGAUCTCGAGAAUGCAA
442
139-161





AD-254268.1
UUGUAUGGTCGUGUGAGGAAA
401
1018-1038
UTUCCUCACACGACCAUACAAGC
443
1016-1038





AD-254113.1
UGAAGAUGCUGCAGCGGAUAU
 70
827-847
ATAUCCGCUGCAGCAUCUUCACC
444
825-847





AD-254452.1
CUGCAGGGCUTUGAUGGCAUU
402
1258-1278
AAUGCCAUCAAAGCCCUGCAGGC
140
1256-1278





AD-254222.1
UGGCUACGGAGACGUGGUGUU
 72
936-956
AACACCACGUCTCCGUAGCCAAA
445
934-956





AD-254114.1
GAAGAUGCTGCAGCGGAUAGA
403
828-848
UCUATCCGCUGCAGCAUCUUCAC
446
826-848





AD-254364.1
AGCUGGAGACACCUUCAAUGU
 74
1152-1172
ACAUTGAAGGUGUCUCCAGCUCC
447
1150-1172





AD-254218.1
UGUUUGGCTACGGAGACGUGU
404
932-952
ACACGUCUCCGTAGCCAAACAGC
448
930-952





AD-253543.1
UGCAUUCUCGAGAUCGCUUAU
 76
140-160
ATAAGCGAUCUCGAGAAUGCAAA
449
138-160





AD-253554.1
GAUCGCUUAGCCGCGCUUUAA
 77
151-171
UTAAAGCGCGGCUAAGCGAUCUC
450
149-171





AD-254820.1
GCCCACCAGCCUGUGAUUUGA
 78
1853-1873
UCAAAUCACAGGCTGGUGGGCAG
451
1851-1873





AD-254231.1
AGACGUGGTGTUUGUCAGCAA
405
945-965
UTGCTGACAAACACCACGUCUCC
452
943-965





AD-254116.1
AGAUGCUGCAGCGGAUAGACU
 80
830-850
AGUCTATCCGCTGCAGCAUCUUC
453
828-850





AD-253855.1
AGAAGCAGAUCCUGUGCGUGU
 81
530-550
ACACGCACAGGAUCUGCUUCUCU
150
528-550





AD-254266.1
GCUUGUAUGGTCGUGUGAGGA
406
1016-1036
UCCUCACACGACCAUACAAGCCC
151
1014-1036





AD-253547.1
UUCUCGAGAUCGCUUAGCCGU
 83
144-164
ACGGCUAAGCGAUCUCGAGAAUG
152
142-164





AD-254048.1
UGAGAAGGTUGAUCUGACCCA
407
762-782
UGGGTCAGAUCAACCUUCUCAAA
454
760-782





AD-253542.1
UUGCAUUCTCGAGAUCGCUUA
408
139-159
UAAGCGAUCUCGAGAAUGCAAAG
154
137-159





AD-254745.1
UGCGUUGUGCAGACUCUAUUU
 86
1750-1770
AAAUAGAGUCUGCACAACGCAGG
155
1748-1770





AD-253959.1
UCCAACUCCUGCACCGUUCUU
 87
652-672
AAGAACGGUGCAGGAGUUGGACG
156
650-672





AD-253552.1
GAGAUCGCTUAGCCGCGCUUU
409
149-169
AAAGCGCGGCUAAGCGAUCUCGA
157
147-169





AD-254217.1
CUGUUUGGCUACGGAGACGUU
 89
931-951
AACGTCTCCGUAGCCAAACAGCU
455
929-951





AD-254363.1
GAGCUGGAGACACCUUCAAUU
 90
1151-1171
AAUUGAAGGUGTCTCCAGCUCCC
456
1149-1171





AD-253622.1
GGCUGAGAAGTGGGAGGCGUU
410
219-239
AACGCCTCCCACUTCUCAGCCUU
457
217-239





AD-254230.1
GAGACGUGGUGUUUGUCAGCA
 92
944-964
UGCUGACAAACACCACGUCUCCG
161
942-964





AD-253853.1
AGAGAAGCAGAUCCUGUGCGU
 93
528-548
ACGCACAGGAUCUGCUUCUCUUC
162
526-548





AD-253534.1
UUUUCUCUTUGCAUUCUCGAU
411
131-151
ATCGAGAAUGCAAAGAGAAAAUG
458
129-151





AD-254870.1
GGAGCCCACCTUGGAAUUAAU
412
1941-1961
ATUAAUTCCAAGGTGGGCUCCAA
459
1939-1961





AD-253541.1
UUUGCAUUCUCGAGAUCGCUU
 96
138-158
AAGCGATCUCGAGAAUGCAAAGA
165
136-158





AD-254337.1
CUCCACUCGGAUGCUUUCCCU
 97
1105-1125
AGGGAAAGCAUCCGAGUGGAGCA
166
1103-1125





AD-254265.1
GGCUUGUATGGUCGUGUGAGU
413
1015-1035
ACUCACACGACCATACAAGCCCC
460
1013-1035





AD-254223.1
GGCUACGGAGACGUGGUGUUU
 99
937-957
AAACACCACGUCUCCGUAGCCAA
168
935-957





AD-254047.1
UUGAGAAGGUTGAUCUGACCU
414
761-781
AGGUCAGAUCAACCUUCUCAAAG
169
759-781





AD-254871.1
GAGCCCACCUTGGAAUUAAGU
415
1942-1962
ACUUAATUCCAAGGUGGGCUCCA
170
1940-1962





AD-254280.1
CUUGUCUGTGCCUGGGCUGAU
416
1048-1068
ATCAGCCCAGGCACAGACAAGCA
461
1046-1068





AD-253539.1
UCUUUGCATUCUCGAGAUCGU
417
136-156
ACGATCTCGAGAATGCAAAGAGA
462
134-156





AD-254403.1
GCAGGAAGCACUGAGAUUCGU
104
1209-1229
ACGAAUCUCAGTGCUUCCUGCAC
463
1207-1229





AD-253549.1
CUCGAGAUCGCUUAGCCGCGU
105
146-166
ACGCGGCUAAGCGAUCUCGAGAA
174
144-166





AD-254368.1
GGAGACACCUTCAAUGCCUCU
418
1156-1176
AGAGGCAUUGAAGGUGUCUCCAG
175
1154-1176





AD-253540.1
CUUUGCAUTCTCGAGAUCGCU
419
137-157
AGCGAUCUCGAGAAUGCAAAGAG
176
135-157





AD-254076.1
UGGAUCCACATUGAGGGCCGU
420
790-810
ACGGCCCUCAATGTGGAUCCACU
464
788-810





AD-254022.1
CUGCCAGATGTGUCUGCUACA
421
736-756
UGUAGCAGACACATCUGGCAGGC
465
734-756
















TABLE 5







Modified Sense and Antisense Strand Sequences of Ketohexokinase dsRNA Agents















SEQ

SEQ

SEQ


Duplex
Sense Sequence
ID
Antisense Sequence
ID
mRNA target Sequence
ID


Name
5′ to 3′
NO:
5′ to 3′
NO:
5′ to 3′
NO:





AD-253536.1
ususcucuuudGcdAuucucgagauL96
466
asdTscudCgdAgaau
536
UUUUCUCUUUGCAUUCUCGAGAU
317





dGcdAaagagaasasa








AD-254743.1
cscsugcguudGudGcagacucuauL96
467
asdTsagdAgdTcugc
537
GCCCUGCGUUGUGCAGACUCUAU
318





dAcdAacgcaggsgsc








AD-253553.1
asgsaucgcudTadGccgcgcuuuaL96
468
usdAsaadGcdGcggc
538
CGAGAUCGCUUAGCCGCGCUUUA
319





dTadAgcgaucuscsg








AD-253535.1
ususucucuudTgdCauucucgagaL96
469
usdCsucdGadGaaug
539
AUUUUCUCUUUGCAUUCUCGAGA
320





dCadAagagaaasasu








AD-253592.1
gsusgaguccdAudCugacaagcgaL96
470
usdCsgcdTudGucag
540
CUGUGAGUCCAUCUGACAAGCGA
321





dAudGgacucacsasg








AD-253960.1
cscsaacuccdTgdCaccguucucuL96
471
asdGsagdAadCggug
541
GUCCAACUCCUGCACCGUUCUCU
322





dCadGgaguuggsasc








AD-254267.1
csusuguaugdGudCgugugaggaaL96
472
usdTsccdTcdAcacg
542
GGCUUGUAUGGUCGUGUGAGGAA
323





dAcdCauacaagscsc








AD-254078.1
gsasuccacadTudGagggccggaaL96
473
usdTsccdGgdCccuc
543
UGGAUCCACAUUGAGGGCCGGAA
324





dAadTguggaucscsa








AD-254216.1
gscsuguuugdGcdTacggagacguL96
474
asdCsgudCudCcgua
544
CAGCUGUUUGGCUACGGAGACGU
325





dGcdCaaacagcsusg








AD-255050.1
csusgccauudTadAuuagcugcauL96
475
asdTsgcdAgdCuaau
545
AUCUGCCAUUUAAUUAGCUGCAU
326





dTadAauggcagsasu








AD-253854.1
gsasgaagcadGadTccugugcguuL96
476
asdAscgdCadCagga
546
AAGAGAAGCAGAUCCUGUGCGUG
327





dTcdTgcuucucsusu








AD-253593.1
usgsaguccadTcdTgacaagcgauL96
477
asdTscgdCudTguca
547
UGUGAGUCCAUCUGACAAGCGAG
328





dGadTggacucascsa








AD-253545.1
csasuucucgdAgdAucgcuuagcuL96
478
asdGscudAadGcgau
548
UGCAUUCUCGAGAUCGCUUAGCC
329





dCudCgagaaugscsa








AD-253594.1
gsasguccaudCudGacaagcgaguL96
479
asdCsucdGcdTuguc
549
GUGAGUCCAUCUGACAAGCGAGG
330





dAgdAuggacucsasc








AD-254115.1
asasgaugcudGcdAgcggauagauL96
480
asdTscudAudCcgcu
550
UGAAGAUGCUGCAGCGGAUAGAC
331





dGcdAgcaucuuscsa








AD-253546.1
asusucucgadGadTcgcuuagccuL96
481
asdGsgcdTadAgcga
551
GCAUUCUCGAGAUCGCUUAGCCG
332





dTcdTcgagaausgsc








AD-253623.1
gscsugagaadGudGggaggcguuuL96
482
asdAsacdGcdCuccc
552
AGGCUGAGAAGUGGGAGGCGUUG
333





dAcdTucucagcscsu








AD-254118.1
asusgcugcadGcdGgauagacgcaL96
483
usdGscgdTcdTaucc
553
AGAUGCUGCAGCGGAUAGACGCA
334





dGcdTgcagcauscsu








AD-253537.1
uscsucuuugdCadTucucgagauuL96
484
asdAsucdTcdGagaa
554
UUUCUCUUUGCAUUCUCGAGAUC
335





dTgdCaaagagasasa








AD-253538.1
csuscuuugcdAudTcucgagaucuL96
485
asdGsaudCudCgaga
555
UUCUCUUUGCAUUCUCGAGAUCG
336





dAudGcaaagagsasa








AD-254869.1
usgsgagcccdAcdCuuggaauuaaL96
486
usdTsaadTudCcaag
556
CUUGGAGCCCACCUUGGAAUUAA
337





dGudGggcuccasasg








AD-254065.1
cscscaguucdAadGuggauccacaL96
487
usdGsugdGadTccac
557
GACCCAGUUCAAGUGGAUCCACA
606





dTudGaacugggsusc








AD-253883.1
cscsugguggdAcdAaguacccuaaL96
488
usdTsagdGgdTacuu
558
AGCCUGGUGGACAAGUACCCUAA
338





dGudCcaccaggscsu








AD-253548.1
uscsucgagadTcdGcuuagccgcuL96
489
asdGscgdGcdTaagc
559
AUUCUCGAGAUCGCUUAGCCGCG
339





dGadTcucgagasasu








AD-253595.1
asgsuccaucdTgdAcaagcgaggaL96
490
usdCscudCgdCuugu
560
UGAGUCCAUCUGACAAGCGAGGA
340





dCadGauggacuscsa








AD-254215.1
asgscuguuudGgdCuacggagacuL96
491
asdGsucdTcdCguag
561
CCAGCUGUUUGGCUACGGAGACG
341





dCcdAaacagcusgsg








AD-254117.1
gsasugcugcdAgdCggauagacguL96
492
asdCsgudCudAuccg
562
AAGAUGCUGCAGCGGAUAGACGC
342





dCudGcagcaucsusu








AD-255047.1
asasucugccdAudTuaauuagcuuL96
493
asdAsgcdTadAuuaa
563
AAAAUCUGCCAUUUAAUUAGCUG
343





dAudGgcagauususu








AD-253544.1
gscsauucucdGadGaucgcuuaguL96
494
asdCsuadAgdCgauc
564
UUGCAUUCUCGAGAUCGCUUAGC
344





dTcdGagaaugcsasa








AD-254268.1
ususguauggdTcdGugugaggaaaL96
495
usdTsucdCudCacac
565
GCUUGUAUGGUCGUGUGAGGAAA
345





dGadCcauacaasgsc








AD-254113.1
usgsaagaugdCudGcagcggauauL96
496
asdTsaudCcdGcugc
566
GGUGAAGAUGCUGCAGCGGAUAG
346





dAgdCaucuucascsc








AD-254452.1
csusgcagggdCudTugauggcauuL96
497
asdAsugdCcdAucaa
567
GCCUGCAGGGCUUUGAUGGCAUC
347





dAgdCccugcagsgsc








AD-254222.1
usgsgcuacgdGadGacgugguguuL96
498
asdAscadCcdAcguc
568
UUUGGCUACGGAGACGUGGUGUU
348





dTcdCguagccasasa








AD-254114.1
gsasagaugcdTgdCagcggauagaL96
499
usdCsuadTcdCgcug
569
GUGAAGAUGCUGCAGCGGAUAGA
349





dCadGcaucuucsasc








AD-254364.1
asgscuggagdAcdAccuucaauguL96
500
asdCsaudTgdAaggu
570
GGAGCUGGAGACACCUUCAAUGC
350





dGudCuccagcuscsc








AD-254218.1
usgsuuuggcdTadCggagacguguL96
501
asdCsacdGudCuccg
571
GCUGUUUGGCUACGGAGACGUGG
351





dTadGccaaacasgsc








AD-253543.1
usgscauucudCgdAgaucgcuuauL96
502
asdTsaadGcdGaucu
572
UUUGCAUUCUCGAGAUCGCUUAG
352





dCgdAgaaugcasasa








AD-253554.1
gsasucgcuudAgdCcgcgcuuuaaL96
503
usdTsaadAgdCgcgg
573
GAGAUCGCUUAGCCGCGCUUUAA
353





dCudAagcgaucsusc








AD-254820.1
gscsccaccadGcdCugugauuugaL96
504
usdCsaadAudCacag
574
CUGCCCACCAGCCUGUGAUUUGA
354





dGcdTggugggcsasg








AD-254231.1
asgsacguggdTgdTuugucagcaaL96
505
usdTsgcdTgdAcaaa
575
GGAGACGUGGUGUUUGUCAGCAA
355





dCadCcacgucuscsc








AD-254116.1
asgsaugcugdCadGcggauagacuL96
506
asdGsucdTadTccgc
576
GAAGAUGCUGCAGCGGAUAGACG
356





dTgdCagcaucususc








AD-253855.1
asgsaagcagdAudCcugugcguguL96
507
asdCsacdGcdAcagg
577
AGAGAAGCAGAUCCUGUGCGUGG
357





dAudCugcuucuscsu








AD-254266.1
gscsuuguaudGgdTcgugugaggaL96
508
usdCscudCadCacga
578
GGGCUUGUAUGGUCGUGUGAGGA
358





dCcdAuacaagcscsc








AD-253547.1
ususcucgagdAudCgcuuagccguL96
509
asdCsggdCudAagcg
579
CAUUCUCGAGAUCGCUUAGCCGC
359





dAudCucgagaasusg








AD-254048.1
usgsagaaggdTudGaucugacccaL96
510
usdGsggdTcdAgauc
580
UUUGAGAAGGUUGAUCUGACCCA
360





dAadCcuucucasasa








AD-253542.1
ususgcauucdTcdGagaucgcuuaL96
511
usdAsagdCgdAucuc
581
CUUUGCAUUCUCGAGAUCGCUUA
361





dGadGaaugcaasasg








AD-254745.1
usgscguugudGcdAgacucuauuuL96
512
asdAsaudAgdAgucu
582
CCUGCGUUGUGCAGACUCUAUUC
362





dGcdAcaacgcasgsg








AD-253959.1
uscscaacucdCudGcaccguucuuL96
513
asdAsgadAcdGgugc
583
CGUCCAACUCCUGCACCGUUCUC
363





dAgdGaguuggascsg








AD-253552.1
gsasgaucgcdTudAgccgcgcuuuL96
514
asdAsagdCgdCggcu
584
UCGAGAUCGCUUAGCCGCGCUUU
364





dAadGcgaucucsgsa








AD-254217.1
csusguuuggdCudAcggagacguuL96
515
asdAscgdTcdTccgu
585
AGCUGUUUGGCUACGGAGACGUG
365





dAgdCcaaacagscsu








AD-254363.1
gsasgcuggadGadCaccuucaauuL96
516
asdAsuudGadAggug
586
GGGAGCUGGAGACACCUUCAAUG
366





dTcdTccagcucscsc








AD-253622.1
gsgscugagadAgdTgggaggcguuL96
517
asdAscgdCcdTccca
587
AAGGCUGAGAAGUGGGAGGCGUU
367





dCudTcucagccsusu








AD-254230.1
gsasgacgugdGudGuuugucagcaL96
518
usdGscudGadCaaac
588
CGGAGACGUGGUGUUUGUCAGCA
368





dAcdCacgucucscsg








AD-253853.1
asgsagaagcdAgdAuccugugcguL96
519
asdCsgcdAcdAggau
589
GAAGAGAAGCAGAUCCUGUGCGU
369





dCudGcuucucususc








AD-253534.1
ususuucucudTudGcauucucgauL96
520
asdTscgdAgdAaugc
590
CAUUUUCUCUUUGCAUUCUCGAG
370





dAadAgagaaaasusg








AD-254870.1
gsgsagcccadCcdTuggaauuaauL96
521
asdTsuadAudTccaa
591
UUGGAGCCCACCUUGGAAUUAAG
371





dGgdTgggcuccsasa








AD-253541.1
ususugcauudCudCgagaucgcuuL96
522
asdAsgcdGadTcucg
592
UCUUUGCAUUCUCGAGAUCGCUU
372





dAgdAaugcaaasgsa








AD-254337.1
csusccacucdGgdAugcuuucccuL96
523
asdGsggdAadAgcau
593
UGCUCCACUCGGAUGCUUUCCCG
373





dCcdGaguggagscsa








AD-254265.1
gsgscuuguadTgdGucgugugaguL96
524
asdCsucdAcdAcgac
594
GGGGCUUGUAUGGUCGUGUGAGG
374





dCadTacaagccscsc








AD-254223.1
gsgscuacggdAgdAcgugguguuuL96
525
asdAsacdAcdCacgu
595
UUGGCUACGGAGACGUGGUGUUU
375





dCudCcguagccsasa








AD-254047.1
ususgagaagdGudTgaucugaccuL96
526
asdGsgudCadGauca
596
CUUUGAGAAGGUUGAUCUGACCC
376





dAcdCuucucaasasg








AD-254871.1
gsasgcccacdCudTggaauuaaguL96
527
asdCsuudAadTucca
597
UGGAGCCCACCUUGGAAUUAAGG
377





dAgdGugggcucscsa








AD-254280.1
csusugucugdTgdCcugggcugauL96
528
asdTscadGcdCcagg
598
UGCUUGUCUGUGCCUGGGCUGAG
378





dCadCagacaagscsa








AD-253539.1
uscsuuugcadTudCucgagaucguL96
529
asdCsgadTcdTcgag
599
UCUCUUUGCAUUCUCGAGAUCGC
379





dAadTgcaaagasgsa








AD-254403.1
gscsaggaagdCadCugagauucguL96
530
asdCsgadAudCucag
600
GUGCAGGAAGCACUGAGAUUCGG
380





dTgdCuuccugcsasc








AD-253549.1
csuscgagaudCgdCuuagccgcguL96
531
asdCsgcdGgdCuaag
601
UUCUCGAGAUCGCUUAGCCGCGC
381





dCgdAucucgagsasa








AD-254368.1
gsgsagacacdCudTcaaugccucuL96
532
asdGsagdGcdAuuga
602
CUGGAGACACCUUCAAUGCCUCC
382





dAgdGugucuccsasg








AD-253540.1
csusuugcaudTcdTcgagaucgcuL96
533
asdGscgdAudCucga
603
CUCUUUGCAUUCUCGAGAUCGCU
383





dGadAugcaaagsasg








AD-254076.1
usgsgauccadCadTugagggccguL96
534
asdCsggdCcdCucaa
604
AGUGGAUCCACAUUGAGGGCCGG
384





dTgdTggauccascsu








AD-254022.1
csusgccagadTgdTgucugcuacaL96
535
usdGsuadGcdAgaca
605
GCCUGCCAGAUGUGUCUGCUACA
385





dCadTcuggcagsgsc
















TABLE 6







KHK In Vitro 10 nM Screens in Hep3B cells












Avg % KHK




Duplex
mRNA Remaining
SD















AD-251799.1
39.4
4.3



AD-253006.1
65.4
4.5



AD-251816.1
79.6
20.6



AD-251798.1
75.9
8.7



AD-251855.1
62.2
4.6



AD-252223.1
70.1
11.8



AD-252530.1
73.4
23.8



AD-252341.1
67.9
11.5



AD-252484.1
94.0
7.9



AD-253313.1
68.1
6.5



AD-252117.1
31.8
5.0



AD-251856.1
33.9
4.6



AD-251808.1
46.9
2.1



AD-251857.1
66.2
30.9



AD-252378.1
66.9
10.9



AD-251809.1
37.2
6.6



AD-251886.1
71.7
11.2



AD-252381.1
40.8
4.3



AD-251800.1
41.9
3.2



AD-251801.1
69.9
7.2



AD-253132.1
86.4
9.3



AD-252146.1
19.0
2.5



AD-251811.1
46.7
5.7



AD-251858.1
99.4
8.9



AD-252483.1
29.0
3.2



AD-252380.1
90.4
21.8



AD-253310.1
85.1
19.2



AD-251807.1
72.4
6.6



AD-252531.1
13.1
0.8



AD-252376.1
51.1
6.4



AD-252715.1
56.5
6.9



AD-252490.1
76.9
10.1



AD-252377.1
76.2
8.2



AD-252628.1
75.8
2.5



AD-252486.1
71.8
4.2



AD-251806.1
31.7
6.8



AD-251817.1
29.2
2.7



AD-253083.1
61.1
8.0



AD-252498.1
7.3
2.0



AD-252379.1
24.0
4.1



AD-252118.1
51.0
23.3



AD-252529.1
78.9
11.8



AD-251810.1
94.3
3.7



AD-252314.1
42.5
9.8



AD-251805.1
49.6
3.2



AD-253008.1
54.2
2.5



AD-252222.1
47.4
9.7



AD-251815.1
60.1
4.0



AD-252485.1
52.6
51.1



AD-252627.1
18.8
0.9



AD-251885.1
49.6
5.1



AD-252497.1
70.3
12.6



AD-252116.1
49.0
19.2



AD-251797.1
57.7
7.2



AD-253133.1
58.5
8.2



AD-251804.1
42.3
7.4



AD-252600.1
59.5
18.8



AD-252528.1
26.5
1.5



AD-252450.1
51.0
9.6



AD-252313.1
38.7
2.2



AD-253134.1
85.0
10.9



AD-252543.1
69.3
5.8



AD-251802.1
19.4
2.9



AD-252666.1
20.5
4.7



AD-251812.1
23.4
2.8



AD-252632.1
58.0
7.6



AD-251803.1
50.3
10.6



AD-252339.1
12.5
1.2



AD-252285.1
12.9
0.8

















TABLE 7







KHK In Vitro 10 nM Screens in Hep3B cells












Avg % KHK




Duplex
mRNA Remaining
SD















AD-253536.1
52.7
13.0



AD-254743.1
77.8
8.8



AD-253553.1
76.6
5.6



AD-253535.1
113.4
10.1



AD-253592.1
125.7
25.1



AD-253960.1
116.5
13.6



AD-254267.1
64.2
6.3



AD-254078.1
90.6
3.4



AD-254216.1
105.3
9.9



AD-255050.1
92.0
4.4



AD-253854.1
42.8
7.6



AD-253593.1
75.3
7.4



AD-253545.1
78.6
5.3



AD-253594.1
99.4
8.9



AD-254115.1
97.2
5.4



AD-253546.1
77.4
8.0



AD-253623.1
93.9
3.9



AD-254118.1
96.2
7.1



AD-253537.1
47.9
9.7



AD-253538.1
62.6
7.2



AD-254869.1
94.1
4.1



AD-254065.1
41.4
2.0



AD-253883.1
73.7
9.2



AD-253548.1
104.7
5.5



AD-253595.1
111.9
11.2



AD-254215.1
98.9
12.5



AD-254117.1
112.6
7.9



AD-255047.1
80.6
4.9



AD-253544.1
58.0
5.1



AD-254268.1
42.1
2.2



AD-254113.1
70.3
4.0



AD-254452.1
54.4
7.7



AD-254222.1
42.2
2.4



AD-254114.1
88.9
7.1



AD-254364.1
46.5
3.4



AD-254218.1
81.8
3.8



AD-253543.1
50.0
4.0



AD-253554.1
75.2
5.9



AD-254820.1
77.0
4.6



AD-254231.1
48.9
6.7



AD-254116.1
66.8
3.2



AD-253855.1
67.4
12.2



AD-254266.1
36.7
3.6



AD-253547.1
79.9
3.5



AD-254048.1
70.3
7.1



AD-253542.1
32.5
4.2



AD-254745.1
71.9
1.9



AD-253959.1
78.5
11.8



AD-253552.1
82.6
5.5



AD-254217.1
70.7
9.9



AD-254363.1
47.0
5.8



AD-253622.1
77.8
2.6



AD-254230.1
67.3
2.7



AD-253853.1
87.9
7.4



AD-253534.1
78.9
5.8



AD-254870.1
74.5
3.9



AD-253541.1
119.8
78.6



AD-254337.1
74.2
5.5



AD-254265.1
15.7
2.2



AD-254223.1
29.3
2.2



AD-254047.1
63.6
6.0



AD-254871.1
83.1
5.3



AD-254280.1
85.7
16.3



AD-253539.1
35.0
2.9



AD-254403.1
18.1
1.3



AD-253549.1
54.2
5.5



AD-254368.1
91.7
5.8



AD-253540.1
51.0
8.5



AD-254076.1
80.8
8.8



AD-254022.1
36.2
2.2










Example 3. In Vivo Screening of dsRNA Duplexes in Mice

Duplexes of interest, identified from the above in vitro studies, were evaluated in vivo.


In particular, 6-8-week old wild-type mice (C57BL/6) were administered 100 ml of a 2×1011 viral particles/ml solution of an adeno-associated virus 8 (AAV8) vector encoding human ketohexokinase (hKHK AAV) by intravenous tail vein injection at Day −14.


At day 0, mice were subcutaneously administered a single 10 mg/kg dose of a duplex of interest or PBS control (n=3/group). Table 8 provides the treatment groups and duplexes that were administered to the mice.


At day 10 post-dose, animals were sacrificed, liver samples were collected and snap-frozen in liquid nitrogen. Tissue mRNA was extracted and human KHK expression was measured by RT-QPCR, as described above. Human KHK mRNA levels were compared to the mRNA level of the housekeeping gene GAPDH. The values were then normalized to the average of PBS vehicle control group. The data were expressed as percent of baseline value, and presented as mean plus standard deviation. As shown in Table 9 and FIG. 2, human KHK mRNA levels were reduced upon treatment with a single dose of siRNA targeting hKHK at 10 mg/kg.









TABLE 8







dsRNA Duplexes for In Vivo Screening










Duplex ID
Range in XM_017004061.1







PBS
N/A



AD-252498.1
943-965



AD-252339.1
788-810



AD-252285.1
734-756



AD-252531.1
1016-1038



AD-254265.1
1013-1035



AD-254403.1
1207-1229



AD-252627.1
1149-1171



AD-252146.1
574-596



AD-252666.1
1207-1229



AD-252379.1
828-850



No AAV Control
N/A

















TABLE 9







KHK siRNA In Vivo Screening










Treatment
Average Fold Change
SEM
% Knockdown













PBS
1.02
0.24
0.00


AD-252498.1
0.50
0.21
51.27


AD-252339.1
0.90
0.25
12.10


AD-252285.1
0.55
0.09
46.33


AD-252531.1
0.88
0.27
14.06


AD-254265.1
1.21
0.32
−18.52


AD-254403.1
0.88
0.19
13.63


AD-252627.1
1.04
0.11
−2.34


AD-252146.1
0.63
0.05
37.77


AD-252666.1
0.80
0.12
22.07


AD-252379.1
1.11
0.03
−8.53


No AAV Control
0.00
0.00
0.00

















INFORMAL SEQUENCE LISTING



<210>    1


<211> 2283


<212> DNA


<213> Homo sapiens


<400>    1









ggggcggggc ggggccgccg cgaccgcggg cttcaggcag ggctgcagat gcgaggccca
  60






gctgtacctc gcgtgtcccg ggtcgggagt cggagacgca ggtgcaggag agtgcggggc
 120





aagtagcgca ttttctcttt gcattctcga gatcgcttag ccgcgcttta aaaaggtttg
 180





catcagctgt gagtccatct gacaagcgag gaaactaagg ctgagaagtg ggaggcgttg
 240





ccatctgcag gcccaggcaa cctgctacgg gaagaccggg gaccaagacc tctgggttgg
 300





ctttcctaga cccgctcggg tcttcgggtg tcgcgaggaa gggccctgct cctttcgttc
 360





cctgcacccc tggccgctgc aggtggctcc ctggaggagg agctcccacg cggaggagga
 420





gccagggcag ctgggagcgg ggacaccatc ctcctggata agaggcagag gccgggagga
 480





accccgtcag ccgggcgggc aggaagctct gggagtagcc tcatggaaga gaagcagatc
 540





ctgtgcgtgg ggctagtggt gctggacgtc atcagcctgg tggacaagta ccctaaggag
 600





gactcggaga taaggtgttt gtcccagaga tggcagcgcg gaggcaacgc gtccaactcc
 660





tgcaccgttc tctccctgct cggagccccc tgtgccttca tgggctcaat ggctcctggc
 720





catgttgctg agagcctgcc agatgtgtct gctacagact ttgagaaggt tgatctgacc
 780





cagttcaagt ggatccacat tgagggccgg aacgcatcgg agcaggtgaa gatgctgcag
 840





cggatagacg cacacaacac caggcagcct ccagagcaga agatccgggt gtccgtggag
 900





gtggagaagc cacgagagga gctcttccag ctgtttggct acggagacgt ggtgtttgtc
 960





agcaaagatg tggccaagca cttggggttc cagtcagcag aggaagcctt gaggggcttg
1020





tatggtcgtg tgaggaaagg ggctgtgctt gtctgtgcct gggctgagga gggcgccgac
1080





gccctgggcc ctgatggcaa attgctccac tcggatgctt tcccgccacc ccgcgtggtg
1140





gatacactgg gagctggaga caccttcaat gcctccgtca tcttcagcct ctcccagggg
1200





aggagcgtgc aggaagcact gagattcggg tgccaggtgg ccggcaagaa gtgtggcctg
1260





cagggctttg atggcatcgt gtgagagcag gtgccggctc ctcacacacc atggagacta
1320





ccattgcggc tgcatcgcct tctcccctcc atccagcctg gcgtccaggt tgccctgttc
1380





aggggacaga tgcaagctgt ggggaggact ctgcctgtgt cctgtgttcc ccacagggag
1440





aggctctggg gggatggctg ggggatgcag agcctcagag caaataaatc ttcctcagag
1500





ccagcttctc ctctcaatgt ctgaactgct ctggctgggc attcctgagg ctctgactct
1560





tcgatcctcc ctctttgtgt ccattcccca aattaacctc tccgcccagg cccagaggag
1620





gggctgcctg ggctagagca gcgagaagtg ccctgggctt gccaccagct ctgccctggc
1680





tggggaggac actcggtgcc ccacacccag tgaacctgcc aaagaaaccg tgagagctct
1740





tcggggccct gcgttgtgca gactctattc ccacagctca gaagctggga gtccacaccg
1800





ctgagctgaa ctgacaggcc agtggggggc aggggtgcgc ctcctctgcc ctgcccacca
1860





gcctgtgatt tgatggggtc ttcattgtcc agaaatacct cctcccgctg actgccccag
1920





agcctgaaag tctcaccctt ggagcccacc ttggaattaa gggcgtgcct cagccacaaa
1980





tgtgacccag gatacagagt gttgctgtcc tcagggaggt ccgatctgga acacatattg
2040





gaattggggc caactccaat atagggtggg taaggcctta taatgtaaag agcatataat
2100





gtaaagggct ttagagtgag acagacctgg attaaaatct gccatttaat tagctgcata
2160





tcaccttagg gtacagcact taacgcaatc tgcctcaatt tcttcatctg tcaaatggaa
2220





ccaattctgc ttggctacag aattattgtg aggataaaat catatataaa atgcccagca
2280





tga
2283











<210>    2



<211> 2283


<212> DNA


<213> Homo sapiens


<400>    2









tcatgctggg cattttatat atgattttat cctcacaata attctgtagc caagcagaat
  60






tggttccatt tgacagatga agaaattgag gcagattgcg ttaagtgctg taccctaagg
 120





tgatatgcag ctaattaaat ggcagatttt aatccaggtc tgtctcactc taaagccctt
 180





tacattatat gctctttaca ttataaggcc ttacccaccc tatattggag ttggccccaa
 240





ttccaatatg tgttccagat cggacctccc tgaggacagc aacactctgt atcctgggtc
 300





acatttgtgg ctgaggcacg cccttaattc caaggtgggc tccaagggtg agactttcag
 360





gctctggggc agtcagcggg aggaggtatt tctggacaat gaagacccca tcaaatcaca
 420





ggctggtggg cagggcagag gaggcgcacc cctgcccccc actggcctgt cagttcagct
 480





cagcggtgtg gactcccagc ttctgagctg tgggaataga gtctgcacaa cgcagggccc
 540





cgaagagctc tcacggtttc tttggcaggt tcactgggtg tggggcaccg agtgtcctcc
 600





ccagccaggg cagagctggt ggcaagccca gggcacttct cgctgctcta gcccaggcag
 660





cccctcctct gggcctgggc ggagaggtta atttggggaa tggacacaaa gagggaggat
 720





cgaagagtca gagcctcagg aatgcccagc cagagcagtt cagacattga gaggagaagc
 780





tggctctgag gaagatttat ttgctctgag gctctgcatc ccccagccat ccccccagag
 840





cctctccctg tggggaacac aggacacagg cagagtcctc cccacagctt gcatctgtcc
 900





cctgaacagg gcaacctgga cgccaggctg gatggagggg agaaggcgat gcagccgcaa
 960





tggtagtctc catggtgtgt gaggagccgg cacctgctct cacacgatgc catcaaagcc
1020





ctgcaggcca cacttcttgc cggccacctg gcacccgaat ctcagtgctt cctgcacgct
1080





cctcccctgg gagaggctga agatgacgga ggcattgaag gtgtctccag ctcccagtgt
1140





atccaccacg cggggtggcg ggaaagcatc cgagtggagc aatttgccat cagggcccag
1200





ggcgtcggcg ccctcctcag cccaggcaca gacaagcaca gcccctttcc tcacacgacc
1260





atacaagccc ctcaaggctt cctctgctga ctggaacccc aagtgcttgg ccacatcttt
1320





gctgacaaac accacgtctc cgtagccaaa cagctggaag agctcctctc gtggcttctc
1380





cacctccacg gacacccgga tcttctgctc tggaggctgc ctggtgttgt gtgcgtctat
1440





ccgctgcagc atcttcacct gctccgatgc gttccggccc tcaatgtgga tccacttgaa
1500





ctgggtcaga tcaaccttct caaagtctgt agcagacaca tctggcaggc tctcagcaac
1560





atggccagga gccattgagc ccatgaaggc acagggggct ccgagcaggg agagaacggt
1620





gcaggagttg gacgcgttgc ctccgcgctg ccatctctgg gacaaacacc ttatctccga
1680





gtcctcctta gggtacttgt ccaccaggct gatgacgtcc agcaccacta gccccacgca
1740





caggatctgc ttctcttcca tgaggctact cccagagctt cctgcccgcc cggctgacgg
1800





ggttcctccc ggcctctgcc tcttatccag gaggatggtg tccccgctcc cagctgccct
1860





ggctcctcct ccgcgtggga gctcctcctc cagggagcca cctgcagcgg ccaggggtgc
1920





agggaacgaa aggagcaggg cccttcctcg cgacacccga agacccgagc gggtctagga
1980





aagccaaccc agaggtcttg gtccccggtc ttcccgtagc aggttgcctg ggcctgcaga
2040





tggcaacgcc tcccacttct cagccttagt ttcctcgctt gtcagatgga ctcacagctg
2100





atgcaaacct ttttaaagcg cggctaagcg atctcgagaa tgcaaagaga aaatgcgcta
2160





cttgccccgc actctcctgc acctgcgtct ccgactcccg acccgggaca cgcgaggtac
2220





agctgggcct cgcatctgca gccctgcctg aagcccgcgg tcgcggcggc cccgccccgc
2280





ccc
2283











<210>    3



<211> 1999


<212> DNA


<213> Homo sapiens


<400>    3









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgac agttttgtcc
 720





tggatgacct ccgccgctat tctgtggacc tacgctacac agtctttcag accacaggct
 780





ccgtccccat cgccacggtc atcatcaacg aggccagtgg tagccgcacc atcctatact
 840





atgacagctt cctggtggcc gacttcaggc ggcggggcgt ggacgtgtct caggtggcct
 900





ggcagagcaa gggggacacc cccagctcct gctgcatcat caacaactcc aatggcaacc
 960





gtaccattgt gctccatgac acgagcctgc cagatgtgtc tgctacagac tttgagaagg
1020





ttgatctgac ccagttcaag tggatccaca ttgagggccg gaacgcatcg gagcaggtga
1080





agatgctgca gcggatagac gcacacaaca ccaggcagcc tccagagcag aagatccggg
1140





tgtccgtgga ggtggagaag ccacgagagg agctcttcca gctgtttggc tacggagacg
1200





tggtgggtgc cccattcagc ctctctttgc cacttccagc taatttggtt cttaaaggga
1260





gccagaatcc ttttatcctg cctaccacaa ttggaatagt ggttcctggt ttggtggtgt
1320





ttgaagatgg gggatggggg ttaaagcaaa gaagtagacc cctagccttg ggctccagtg
1380





caggcctcag cagtgagcaa ggagtagaat gtctccaccc caggtgggtg cataggtgta
1440





agaatgccca gagggcttgg gtagggctta aacagccaca gggcaagcct gtgtggaagc
1500





atctcctctc tggggctccc cagtcttttc ctctgcagaa tgagggcaca caactgttct
1560





ctgaggtttc ttccaactca ggggtgtctg gcaggttgtg ggggctgcta gggtgaggga
1620





agggtgggaa ggagacttgc atgagtctct ttttgaaaag gctggatgta aatggaattt
1680





gggaagtaat cccagcatca tagcagaagt tggttggaga ccatccagcc aaggtcctca
1740





accttgtgac ttgtcctcaa ccttggctgc atattaaaaa agatgaatgc aggccaagtg
1800





tagtggctca cacttgtaat cccagagctt tgggaagctg aggtaggagg attgcttgat
1860





gccaggagtc caagaccagc ctggacaaca tagcaagacc cctgtctcta tgaaaataaa
1920





ttaggccaag agcagtgact catacctgta atcccagcac cttgggaggc caatgcagga
1980





ggatcacttc agccagtca
1999











<210>    4



<211> 1999


<212> DNA


<213> Homo sapiens


<400>    4









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctcgtg
1020





tcatggagca caatggtacg gttgccattg gagttgttga tgatgcagca ggagctgggg
1080





gtgtccccct tgctctgcca ggccacctga gacacgtcca cgccccgccg cctgaagtcg
1140





gccaccagga agctgtcata gtataggatg gtgcggctac cactggcctc gttgatgatg
1200





accgtggcga tggggacgga gcctgtggtc tgaaagactg tgtagcgtag gtccacagaa
1260





tagcggcgga ggtcatccag gacaaaactg tcagcaacat ggccaggagc cattgagccc
1320





atgaaggcac agggggctcc gagcagggag agaacggtgc aggagttgga cgcgttgcct
1380





ccgcgctgcc atctctggga caaacacctt atctccgagt cctccttagg gtacttgtcc
1440





accaggctga tgacgtccag caccactagc cccacgcaca ggatctgctt ctcttccatg
1500





aggctactcc cagagcttcc tgcccgcccg gctgacgggg ttcctcccgg cctctgcctc
1560





ttatccagga ggatggtgtc cccgctccca gctgccctgg ctcctcctcc gcgtgggagc
1620





tcctcctcca gggagccacc tgcagcggcc aggggtgcag ggaacgaaag gagcagggcc
1680





cttcctcgcg acacccgaag acccgagcgg gtctaggaaa gccaacccag aggtcttggt
1740





ccccggtctt cccgtagcag gttgcctggg cctgcagatg gcaacgcctc ccacttctca
1800





gccttagttt cctcgcttgt cagatggact cacagctgat gcaaaccttt ttaaagcgcg
1860





gctaagcgat ctcgagaatg caaagagaaa atgcgctact tgccccgcac tctcctgcac
1920





ctgcgtctcc gactcccgac ccgggacacg cgaggtacag ctgggcctcg catctgcagc
1980





cctgcctgaa gcccgcggt
1999











<210>    5



<211> 1996


<212> DNA


<213> Homo sapiens


<400>    5









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgat tttgtcctgg
 720





atgacctccg ccgctattct gtggacctac gctacacagt ctttcagacc acaggctccg
 780





tccccatcgc cacggtcatc atcaacgagg ccagtggtag ccgcaccatc ctatactatg
 840





acagcttcct ggtggccgac ttcaggcggc ggggcgtgga cgtgtctcag gtggcctggc
 900





agagcaaggg ggacaccccc agctcctgct gcatcatcaa caactccaat ggcaaccgta
 960





ccattgtgct ccatgacacg agcctgccag atgtgtctgc tacagacttt gagaaggttg
1020





atctgaccca gttcaagtgg atccacattg agggccggaa cgcatcggag caggtgaaga
1080





tgctgcagcg gatagacgca cacaacacca ggcagcctcc agagcagaag atccgggtgt
1140





ccgtggaggt ggagaagcca cgagaggagc tcttccagct gtttggctac ggagacgtgg
1200





tgggtgcccc attcagcctc tctttgccac ttccagctaa tttggttctt aaagggagcc
1260





agaatccttt tatcctgcct accacaattg gaatagtggt tcctggtttg gtggtgtttg
1320





aagatggggg atgggggtta aagcaaagaa gtagacccct agccttgggc tccagtgcag
1380





gcctcagcag tgagcaagga gtagaatgtc tccaccccag gtgggtgcat aggtgtaaga
1440





atgcccagag ggcttgggta gggcttaaac agccacaggg caagcctgtg tggaagcatc
1500





tcctctctgg ggctccccag tcttttcctc tgcagaatga gggcacacaa ctgttctctg
1560





aggtttcttc caactcaggg gtgtctggca ggttgtgggg gctgctaggg tgagggaagg
1620





gtgggaagga gacttgcatg agtctctttt tgaaaaggct ggatgtaaat ggaatttggg
1680





aagtaatccc agcatcatag cagaagttgg ttggagacca tccagccaag gtcctcaacc
1740





ttgtgacttg tcctcaacct tggctgcata ttaaaaaaga tgaatgcagg ccaagtgtag
1800





tggctcacac ttgtaatccc agagctttgg gaagctgagg taggaggatt gcttgatgcc
1860





aggagtccaa gaccagcctg gacaacatag caagacccct gtctctatga aaataaatta
1920





ggccaagagc agtgactcat acctgtaatc ccagcacctt gggaggccaa tgcaggagga
1980





tcacttcagc cagtca
1996











<210>    6



<211> 1996


<212> DNA


<213> Homo sapiens


<400>    6









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctcgtg
1020





tcatggagca caatggtacg gttgccattg gagttgttga tgatgcagca ggagctgggg
1080





gtgtccccct tgctctgcca ggccacctga gacacgtcca cgccccgccg cctgaagtcg
1140





gccaccagga agctgtcata gtataggatg gtgcggctac cactggcctc gttgatgatg
1200





accgtggcga tggggacgga gcctgtggtc tgaaagactg tgtagcgtag gtccacagaa
1260





tagcggcgga ggtcatccag gacaaaatca gcaacatggc caggagccat tgagcccatg
1320





aaggcacagg gggctccgag cagggagaga acggtgcagg agttggacgc gttgcctccg
1380





cgctgccatc tctgggacaa acaccttatc tccgagtcct ccttagggta cttgtccacc
1440





aggctgatga cgtccagcac cactagcccc acgcacagga tctgcttctc ttccatgagg
1500





ctactcccag agcttcctgc ccgcccggct gacggggttc ctcccggcct ctgcctctta
1560





tccaggagga tggtgtcccc gctcccagct gccctggctc ctcctccgcg tgggagctcc
1620





tcctccaggg agccacctgc agcggccagg ggtgcaggga acgaaaggag cagggccctt
1680





cctcgcgaca cccgaagacc cgagcgggtc taggaaagcc aacccagagg tcttggtccc
1740





cggtcttccc gtagcaggtt gcctgggcct gcagatggca acgcctccca cttctcagcc
1800





ttagtttcct cgcttgtcag atggactcac agctgatgca aaccttttta aagcgcggct
1860





aagcgatctc gagaatgcaa agagaaaatg cgctacttgc cccgcactct cctgcacctg
1920





cgtctccgac tcccgacccg ggacacgcga ggtacagctg ggcctcgcat ctgcagccct
1980





gcctgaagcc cgcggt
1996











<210>    7



<211> 2534


<212> DNA


<213> Homo sapiens


<400>    7









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgac agttttgtcc
 720





tggatgacct ccgccgctat tctgtggacc tacgctacac agtctttcag accacaggct
 780





ccgtccccat cgccacggtc atcatcaacg aggccagtgg tagccgcacc atcctatact
 840





atgacagctt cctggtggcc gacttcaggc gggcgggcgt ggacgtgtct caggtggcct
 900





ggcagagcaa gggggacacc cccagctcct gctgcatcat caacaactcc aatggcaacc
 960





gtaccattgt gctccatgac acgagcctgc cagatgtgtc tgctacagac tttgagaagg
1020





ttgatctgac ccagttcaag tggatccaca ttgagggccg gaacgcatcg gagcaggtga
1080





agatgctgca gcggatagac gcacacaaca ccaggcagcc tccagagcag aagatccggg
1140





tgtccgtgga ggtggagaag ccacgagagg agctcttcca gctgtttggc tacggagacg
1200





tggtgtttgt cagcaaagat gtggccaagc acttggggtt ccagtcagca gaggaagcct
1260





tgaggggctt gtatggtcgt gtgaggaaag gggctgtgct tgtctgtgcc tgggctgagg
1320





agggcgccga cgccctgggc cctgatggca aattgctcca ctcggatgct ttcccgccac
1380





cccgcgtggt ggatacactg ggagctggag acaccttcaa tgcctccgtc atcttcagcc
1440





tctcccaggg gaggagcgtg caggaagcac tgagattcgg gtgccaggtg gccggcaaga
1500





agtgtggcct gcagggcttt gatggcatcg tgtgagagca ggtgccggct cctcacacac
1560





catggagact accattgcgg ctgcatcgcc ttctcccctc catccagcct ggcgtccagg
1620





ttgccctgtt caggggacag atgcaagctg tggggaggac tctgcctgtg tcctgtgttc
1680





cccacaggga gaggctctgg ggggatggct gggggatgca gagcctcaga gcaaataaat
1740





cttcctcaga gccagcttct cctctcaatg tctgaactgc tctggctggg cattcctgag
1800





gctctgactc ttcgatcctc cctctttgtg tccattcccc aaattaacct ctccgcccag
1860





gcccagagga ggggctgcct gggctagagc agcgagaagt gccctgggct tgccaccagc
1920





tctgccctgg ctggggagga cactcggtgc cccacaccca gtgaacctgc caaagaaacc
1980





gtgagagctc ttcggggccc tgcgttgtgc agactctatt cccacagctc agaagctggg
2040





agtccacacc gctgagctga actgacaggc cagtgggggg caggggtgcg cctcctctgc
2100





cctgcccacc agcctgtgat ttgatggggt cttcattgtc cagaaatacc tcctcccgct
2160





gactgcccca gagcctgaaa gtctcaccct tggagcccac cttggaatta agggcgtgcc
2220





tcagccacaa atgtgaccca ggatacagag tgttgctgtc ctcagggagg tccgatctgg
2280





aacacatatt ggaattgggg ccaactccaa tatagggtgg gtaaggcctt ataatgtaaa
2340





gagcatataa tgtaaagggc tttagagtga gacagacctg gattaaaatc tgccatttaa
2400





ttagctgcat atcaccttag ggtacagcac ttaacgcaat ctgcctcaat ttcttcatct
2460





gtcaaatgga accaattctg cttggctaca gaattattgt gaggataaaa tcatatataa
2520





aatgcccagc atga
2534











<210>    8



<211> 2534


<212> DNA


<213> Homo sapiens


<400>    8









tcatgctggg cattttatat atgattttat cctcacaata attctgtagc caagcagaat
  60






tggttccatt tgacagatga agaaattgag gcagattgcg ttaagtgctg taccctaagg
 120





tgatatgcag ctaattaaat ggcagatttt aatccaggtc tgtctcactc taaagccctt
 180





tacattatat gctctttaca ttataaggcc ttacccaccc tatattggag ttggccccaa
 240





ttccaatatg tgttccagat cggacctccc tgaggacagc aacactctgt atcctgggtc
 300





acatttgtgg ctgaggcacg cccttaattc caaggtgggc tccaagggtg agactttcag
 360





gctctggggc agtcagcggg aggaggtatt tctggacaat gaagacccca tcaaatcaca
 420





ggctggtggg cagggcagag gaggcgcacc cctgcccccc actggcctgt cagttcagct
 480





cagcggtgtg gactcccagc ttctgagctg tgggaataga gtctgcacaa cgcagggccc
 540





cgaagagctc tcacggtttc tttggcaggt tcactgggtg tggggcaccg agtgtcctcc
 600





ccagccaggg cagagctggt ggcaagccca gggcacttct cgctgctcta gcccaggcag
 660





cccctcctct gggcctgggc ggagaggtta atttggggaa tggacacaaa gagggaggat
 720





cgaagagtca gagcctcagg aatgcccagc cagagcagtt cagacattga gaggagaagc
 780





tggctctgag gaagatttat ttgctctgag gctctgcatc ccccagccat ccccccagag
 840





cctctccctg tggggaacac aggacacagg cagagtcctc cccacagctt gcatctgtcc
 900





cctgaacagg gcaacctgga cgccaggctg gatggagggg agaaggcgat gcagccgcaa
 960





tggtagtctc catggtgtgt gaggagccgg cacctgctct cacacgatgc catcaaagcc
1020





ctgcaggcca cacttcttgc cggccacctg gcacccgaat ctcagtgctt cctgcacgct
1080





cctcccctgg gagaggctga agatgacgga ggcattgaag gtgtctccag ctcccagtgt
1140





atccaccacg cggggtggcg ggaaagcatc cgagtggagc aatttgccat cagggcccag
1200





ggcgtcggcg ccctcctcag cccaggcaca gacaagcaca gcccctttcc tcacacgacc
1260





atacaagccc ctcaaggctt cctctgctga ctggaacccc aagtgcttgg ccacatcttt
1320





gctgacaaac accacgtctc cgtagccaaa cagctggaag agctcctctc gtggcttctc
1380





cacctccacg gacacccgga tcttctgctc tggaggctgc ctggtgttgt gtgcgtctat
1440





ccgctgcagc atcttcacct gctccgatgc gttccggccc tcaatgtgga tccacttgaa
1500





ctgggtcaga tcaaccttct caaagtctgt agcagacaca tctggcaggc tcgtgtcatg
1560





gagcacaatg gtacggttgc cattggagtt gttgatgatg cagcaggagc tgggggtgtc
1620





ccccttgctc tgccaggcca cctgagacac gtccacgccc cgccgcctga agtcggccac
1680





caggaagctg tcatagtata ggatggtgcg gctaccactg gcctcgttga tgatgaccgt
1740





ggcgatgggg acggagcctg tggtctgaaa gactgtgtag cgtaggtcca cagaatagcg
1800





gcggaggtca tccaggacaa aactgtcagc aacatggcca ggagccattg agcccatgaa
1860





ggcacagggg gctccgagca gggagagaac ggtgcaggag ttggacgcgt tgcctccgcg
1920





ctgccatctc tgggacaaac accttatctc cgagtcctcc ttagggtact tgtccaccag
1980





gctgatgacg tccagcacca ctagccccac gcacaggatc tgcttctctt ccatgaggct
2040





actcccagag cttcctgccc gcccggctga cggggttcct cccggcctct gcctcttatc
2100





caggaggatg gtgtccccgc tcccagctgc cctggctcct cctccgcgtg ggagctcctc
2160





ctccagggag ccacctgcag cggccagggg tgcagggaac gaaaggagca gggcccttcc
2220





tcgcgacacc cgaagacccg agcgggtcta ggaaagccaa cccagaggtc ttggtccccg
2280





gtcttcccgt agcaggttgc ctgggcctgc agatggcaac gcctcccact tctcagcctt
2340





agtttcctcg cttgtcagat ggactcacag ctgatgcaaa cctttttaaa gcgcggctaa
2400





gcgatctcga gaatgcaaag agaaaatgcg ctacttgccc cgcactctcc tgcacctgcg
2460





tctccgactc ccgacccggg acacgcgagg tacagctggg cctcgcatct gcagccctgc
2520





ctgaagcccg cggt
2534











<210>    9



<211> 2531


<212> DNA


<213> Homo sapiens


<400>    9









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgat tttgtcctgg
 720





atgacctccg ccgctattct gtggacctac gctacacagt ctttcagacc acaggctccg
 780





tccccatcgc cacggtcatc atcaacgagg ccagtggtag ccgcaccatc ctatactatg
 840





acagcttcct ggtggccgac ttcaggcggc ggggcgtgga cgtgtctcag gtggcctggc
 900





agagcaaggg ggacaccccc agctcctgct gcatcatcaa caactccaat ggcaaccgta
 960





ccattgtgct ccatgacacg agcctgccag atgtgtctgc tacagacttt gagaaggttg
1020





atctgaccca gttcaagtgg atccacattg agggccggaa cgcatcggag caggtgaaga
1080





tgctgcagcg gatagacgca cacaacacca ggcagcctcc agagcagaag atccgggtgt
1140





ccgtggaggt ggagaagcca cgagaggagc tcttccagct gtttggctac ggagacgtgg
1200





tgtttgtcag caaagatgtg gccaagcact tggggttcca gtcagcagag gaagccttga
1260





ggggcttgta tggtcgtgtg aggaaagggg ctgtgcttgt ctgtgcctgg gctgaggagg
1320





gcgccgacgc cctgggccct gatggcaaat tgctccactc ggatgctttc ccgccacccc
1380





gcgtggtgga tacactggga gctggagaca ccttcaatgc ctccgtcatc ttcagcctct
1440





cccaggggag gagcgtgcag gaagcactga gattcgggtg ccaggtggcc ggcaagaagt
1500





gtggcctgca gggctttgat ggcatcgtgt gagagcaggt gccggctcct cacacaccat
1560





ggagactacc attgcggctg catcgccttc tcccctccat ccagcctggc gtccaggttg
1620





ccctgttcag gggacagatg caagctgtgg ggaggactct gcctgtgtcc tgtgttcccc
1680





acagggagag gctctggggg gatggctggg ggatgcagag cctcagagca aataaatctt
1740





cctcagagcc agcttctcct ctcaatgtct gaactgctct ggctgggcat tcctgaggct
1800





ctgactcttc gatcctccct ctttgtgtcc attccccaaa ttaacctctc cgcccaggcc
1860





cagaggaggg gctgcctggg ctagagcagc gagaagtgcc ctgggcttgc caccagctct
1920





gccctggctg gggaggacac tcggtgcccc acacccagtg aacctgccaa agaaaccgtg
1980





agagctcttc ggggccctgc gttgtgcaga ctctattccc acagctcaga agctgggagt
2040





ccacaccgct gagctgaact gacaggccag tggggggcag gggtgcgcct cctctgccct
2100





gcccaccagc ctgtgatttg atggggtctt cattgtccag aaatacctcc tcccgctgac
2160





tgccccagag cctgaaagtc tcacccttgg agcccacctt ggaattaagg gcgtgcctca
2220





gccacaaatg tgacccagga tacagagtgt tgctgtcctc agggaggtcc gatctggaac
2280





acatattgga attggggcca actccaatat agggtgggta aggccttata atgtaaagag
2340





catataatgt aaagggcttt agagtgagac agacctggat taaaatctgc catttaatta
2400





gctgcatatc accttagggt acagcactta acgcaatctg cctcaatttc ttcatctgtc
2460





aaatggaacc aattctgctt ggctacagaa ttattgtgag gataaaatca tatataaaat
2520





gcccagcatg a
2531











<210>   10



<211> 2531


<212> DNA


<213> Homo sapiens


<400>   10









tcatgctggg cattttatat atgattttat cctcacaata attctgtagc caagcagaat
  60






tggttccatt tgacagatga agaaattgag gcagattgcg ttaagtgctg taccctaagg
 120





tgatatgcag ctaattaaat ggcagatttt aatccaggtc tgtctcactc taaagccctt
 180





tacattatat gctctttaca ttataaggcc ttacccaccc tatattggag ttggccccaa
 240





ttccaatatg tgttccagat cggacctccc tgaggacagc aacactctgt atcctgggtc
 300





acatttgtgg ctgaggcacg cccttaattc caaggtgggc tccaagggtg agactttcag
 360





gctctggggc agtcagcggg aggaggtatt tctggacaat gaagacccca tcaaatcaca
 420





ggctggtggg cagggcagag gaggcgcacc cctgcccccc actggcctgt cagttcagct
 480





cagcggtgtg gactcccagc ttctgagctg tgggaataga gtctgcacaa cgcagggccc
 540





cgaagagctc tcacggtttc tttggcaggt tcactgggtg tggggcaccg agtgtcctcc
 600





ccagccaggg cagagctggt ggcaagccca gggcacttct cgctgctcta gcccaggcag
 660





cccctcctct gggcctgggc ggagaggtta atttggggaa tggacacaaa gagggaggat
 720





cgaagagtca gagcctcagg aatgcccagc cagagcagtt cagacattga gaggagaagc
 780





tggctctgag gaagatttat ttgctctgag gctctgcatc ccccagccat ccccccagag
 840





cctctccctg tggggaacac aggacacagg cagagtcctc cccacagctt gcatctgtcc
 900





cctgaacagg gcaacctgga cgccaggctg gatggagggg agaaggcgat gcagccgcaa
 960





tggtagtctc catggtgtgt gaggagccgg cacctgctct cacacgatgc catcaaagcc
1020





ctgcaggcca cacttcttgc cggccacctg gcacccgaat ctcagtgctt cctgcacgct
1080





cctcccctgg gagaggctga agatgacgga ggcattgaag gtgtctccag ctcccagtgt
1140





atccaccacg cggggtggcg ggaaagcatc cgagtggagc aatttgccat cagggcccag
1200





ggcgtcggcg ccctcctcag cccaggcaca gacaagcaca gcccctttcc tcacacgacc
1260





atacaagccc ctcaaggctt cctctgctga ctggaacccc aagtgcttgg ccacatcttt
1320





gctgacaaac accacgtctc cgtagccaaa cagctggaag agctcctctc gtggcttctc
1380





cacctccacg gacacccgga tcttctgctc tggaggctgc ctggtgttgt gtgcgtctat
1440





ccgctgcagc atcttcacct gctccgatgc gttccggccc tcaatgtgga tccacttgaa
1500





ctgggtcaga tcaaccttct caaagtctgt agcagacaca tctggcaggc tcgtgtcatg
1560





gagcacaatg gtacggttgc cattggagtt gttgatgatg cagcaggagc tgggggtgtc
1620





ccccttgctc tgccaggcca cctgagacac gtccacgccc cgccgcctga agtcggccac
1680





caggaagctg tcatagtata ggatggtgcg gctaccactg gcctcgttga tgatgaccgt
1740





ggcgatgggg acggagcctg tggtctgaaa gactgtgtag cgtaggtcca cagaatagcg
1800





gcggaggtca tccaggacaa aatcagcaac atggccagga gccattgagc ccatgaaggc
1860





acagggggct ccgagcaggg agagaacggt gcaggagttg gacgcgttgc ctccgcgctg
1920





ccatctctgg gacaaacacc ttatctccga gtcctcctta gggtacttgt ccaccaggct
1980





gatgacgtcc agcaccacta gccccacgca caggatctgc ttctcttcca tgaggctact
2040





cccagagctt cctgcccgcc cggctgacgg ggttcctccc ggcctctgcc tcttatccag
2100





gaggatggtg tccccgctcc cagctgccct ggctcctcct ccgcgtggga gctcctcctc
2160





cagggagcca cctgcagcgg ccaggggtgc agggaacgaa aggagcaggg cccttcctcg
2220





cgacacccga agacccgagc gggtctagga aagccaaccc agaggtcttg gtccccggtc
2280





ttcccgtagc aggttgcctg ggcctgcaga tggcaacgcc tcccacttct cagccttagt
2340





ttcctcgctt gtcagatgga ctcacagctg atgcaaacct ttttaaagcg cggctaagcg
2400





atctcgagaa tgcaaagaga aaatgcgcta cttgccccgc actctcctgc acctgcgtct
2460





ccgactcccg acccgggaca cgcgaggtac agctgggcct cgcatctgca gccctgcctg
2520





aagcccgcgg t
2531











<210>   11



<211> 1864


<212> DNA


<213> Homo sapiens


<400>   11









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgac agttttgtcc
 720





tggatgacct ccgccgctat tctgtggacc tacgctacac agtctttcag accacaggct
 780





ccgtccccat cgccacggtc atcatcaacg aggccagtgg tagccgcacc atcctatact
 840





atgacaggag cctgccagat gtgtctgcta cagactttga gaaggttgat ctgacccagt
 900





tcaagtggat ccacattgag ggccggaacg catcggagca ggtgaagatg ctgcagcgga
 960





tagacgcaca caacaccagg cagcctccag agcagaagat ccgggtgtcc gtggaggtgg
1020





agaagccacg agaggagctc ttccagctgt ttggctacgg agacgtggtg ggtgccccat
1080





tcagcctctc tttgccactt ccagctaatt tggttcttaa agggagccag aatcctttta
1140





tcctgcctac cacaattgga atagtggttc ctggtttggt ggtgtttgaa gatgggggat
1200





gggggttaaa gcaaagaagt agacccctag ccttgggctc cagtgcaggc ctcagcagtg
1260





agcaaggagt agaatgtctc caccccaggt gggtgcatag gtgtaagaat gcccagaggg
1320





cttgggtagg gcttaaacag ccacagggca agcctgtgtg gaagcatctc ctctctgggg
1380





ctccccagtc ttttcctctg cagaatgagg gcacacaact gttctctgag gtttcttcca
1440





actcaggggt gtctggcagg ttgtgggggc tgctagggtg agggaagggt gggaaggaga
1500





cttgcatgag tctctttttg aaaaggctgg atgtaaatgg aatttgggaa gtaatcccag
1560





catcatagca gaagttggtt ggagaccatc cagccaaggt cctcaacctt gtgacttgtc
1620





ctcaaccttg gctgcatatt aaaaaagatg aatgcaggcc aagtgtagtg gctcacactt
1680





gtaatcccag agctttggga agctgaggta ggaggattgc ttgatgccag gagtccaaga
1740





ccagcctgga caacatagca agacccctgt ctctatgaaa ataaattagg ccaagagcag
1800





tgactcatac ctgtaatccc agcaccttgg gaggccaatg caggaggatc acttcagcca
1860





gtca
1864











<210>   12



<211> 1864


<212> DNA


<213> Homo sapiens


<400>   12









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctcctg
1020





tcatagtata ggatggtgcg gctaccactg gcctcgttga tgatgaccgt ggcgatgggg
1080





acggagcctg tggtctgaaa gactgtgtag cgtaggtcca cagaatagcg gcggaggtca
1140





tccaggacaa aactgtcagc aacatggcca ggagccattg agcccatgaa ggcacagggg
1200





gctccgagca gggagagaac ggtgcaggag ttggacgcgt tgcctccgcg ctgccatctc
1260





tgggacaaac accttatctc cgagtcctcc ttagggtact tgtccaccag gctgatgacg
1320





tccagcacca ctagccccac gcacaggatc tgcttctctt ccatgaggct actcccagag
1380





cttcctgccc gcccggctga cggggttcct cccggcctct gcctcttatc caggaggatg
1440





gtgtccccgc tcccagctgc cctggctcct cctccgcgtg ggagctcctc ctccagggag
1500





ccacctgcag cggccagggg tgcagggaac gaaaggagca gggcccttcc tcgcgacacc
1560





cgaagacccg agcgggtcta ggaaagccaa cccagaggtc ttggtccccg gtcttcccgt
1620





agcaggttgc ctgggcctgc agatggcaac gcctcccact tctcagcctt agtttcctcg
1680





cttgtcagat ggactcacag ctgatgcaaa cctttttaaa gcgcggctaa gcgatctcga
1740





gaatgcaaag agaaaatgcg ctacttgccc cgcactctcc tgcacctgcg tctccgactc
1800





ccgacccggg acacgcgagg tacagctggg cctcgcatct gcagccctgc ctgaagcccg
1860





cggt
1864











<210>   13



<211> 1829


<212> DNA


<213> Homo sapiens


<400>   13









ggcccagctg tacctcgcgt gtcccgggtc gggagtcgga gacgcaggtg caggagagtg
  60






cggggcaagt agcgcatttt ctctttgcat tctcgagatc gcttagccgc gctttaaaaa
 120





ggtttgcatc agctgtgagt ccatctgaca agcgaggaaa ctaaggctga gaagtgggag
 180





gcgttgccat ctgcaggccc aggcaacctg ctacgggaag accggggacc aagacctctg
 240





ggttggcttt cctagacccg ctcgggtctt cgggtgtcgc gaggaagggc cctgctcctt
 300





tcgttccctg cacccctggc cgctgcaggt ggctccctgg aggaggagct cccacgcgga
 360





ggaggagcca gggcagctgg gagcggggac accatcctcc tggataagag gcagaggccg
 420





ggaggaaccc cgtcagccgg gcgggcagga agctctggga gtagcctcat ggaagagaag
 480





cagatcctgt gcgtggggct agtggtgctg gacgtcatca gcctggtgga caagtaccct
 540





aaggaggact cggagataag gtgtttgtcc cagagatggc agcgcggagg caacgcgtcc
 600





aactcctgca ccgttctctc cctgctcgga gccccctgtg ccttcatggg ctcaatggct
 660





cctggccatg ttgctgactt cctggtggcc gacttcaggc ggcggggcgt ggacgtgtct
 720





caggtggcct ggcagagcaa gggggacacc cccagctcct gctgcatcat caacaactcc
 780





aatggcaacc gtaccattgt gctccatgac acgagcctgc cagatgtgtc tgctacagac
 840





tttgagaagg ttgatctgac ccagttcaag tggatccaca ttgagggccg gaacgcatcg
 900





gagcaggtga agatgctgca gcggatagac gcacacaaca ccaggcagcc tccagagcag
 960





aagatccggg tgtccgtgga ggtggagaag ccacgagagg agctcttcca gctgtttggc
1020





tacggagacg tggtgggtgc cccattcagc ctctctttgc cacttccagc taatttggtt
1080





cttaaaggga gccagaatcc ttttatcctg cctaccacaa ttggaatagt ggttcctggt
1140





ttggtggtgt ttgaagatgg gggatggggg ttaaagcaaa gaagtagacc cctagccttg
1200





ggctccagtg caggcctcag cagtgagcaa ggagtagaat gtctccaccc caggtgggtg
1260





cataggtgta agaatgccca gagggcttgg gtagggctta aacagccaca gggcaagcct
1320





gtgtggaagc atctcctctc tggggctccc cagtcttttc ctctgcagaa tgagggcaca
1380





caactgttct ctgaggtttc ttccaactca ggggtgtctg gcaggttgtg ggggctgcta
1440





gggtgaggga agggtgggaa ggagacttgc atgagtctct ttttgaaaag gctggatgta
1500





aatggaattt gggaagtaat cccagcatca tagcagaagt tggttggaga ccatccagcc
1560





aaggtcctca accttgtgac ttgtcctcaa ccttggctgc atattaaaaa agatgaatgc
1620





aggccaagtg tagtggctca cacttgtaat cccagagctt tgggaagctg aggtaggagg
1680





attgcttgat gccaggagtc caagaccagc ctggacaaca tagcaagacc cctgtctcta
1740





tgaaaataaa ttaggccaag agcagtgact catacctgta atcccagcac cttgggaggc
1800





caatgcagga ggatcacttc agccagtca
1829











<210>   14



<211> 1829


<212> DNA


<213> Homo sapiens


<400>   14









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctcgtg
1020





tcatggagca caatggtacg gttgccattg gagttgttga tgatgcagca ggagctgggg
1080





gtgtccccct tgctctgcca ggccacctga gacacgtcca cgccccgccg cctgaagtcg
1140





gccaccagga agtcagcaac atggccagga gccattgagc ccatgaaggc acagggggct
1200





ccgagcaggg agagaacggt gcaggagttg gacgcgttgc ctccgcgctg ccatctctgg
1260





gacaaacacc ttatctccga gtcctcctta gggtacttgt ccaccaggct gatgacgtcc
1320





agcaccacta gccccacgca caggatctgc ttctcttcca tgaggctact cccagagctt
1380





cctgcccgcc cggctgacgg ggttcctccc ggcctctgcc tcttatccag gaggatggtg
1440





tccccgctcc cagctgccct ggctcctcct ccgcgtggga gctcctcctc cagggagcca
1500





cctgcagcgg ccaggggtgc agggaacgaa aggagcaggg cccttcctcg cgacacccga
1560





agacccgagc gggtctagga aagccaaccc agaggtcttg gtccccggtc ttcccgtagc
1620





aggttgcctg ggcctgcaga tggcaacgcc tcccacttct cagccttagt ttcctcgctt
1680





gtcagatgga ctcacagctg atgcaaacct ttttaaagcg cggctaagcg atctcgagaa
1740





tgcaaagaga aaatgcgcta cttgccccgc actctcctgc acctgcgtct ccgactcccg
1800





acccgggaca cgcgaggtac agctgggcc
1829











<210>   15



<211> 1861


<212> DNA


<213> Homo sapiens


<400>   15









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgat tttgtcctgg
 720





atgacctccg ccgctattct gtggacctac gctacacagt ctttcagacc acaggctccg
 780





tccccatcgc cacggtcatc atcaacgagg ccagtggtag ccgcaccatc ctatactatg
 840





acaggagcct gccagatgtg tctgctacag actttgagaa ggttgatctg acccagttca
 900





agtggatcca cattgagggc cggaacgcat cggagcaggt gaagatgctg cagcggatag
 960





acgcacacaa caccaggcag cctccagagc agaagatccg ggtgtccgtg gaggtggaga
1020





agccacgaga ggagctcttc cagctgtttg gctacggaga cgtggtgggt gccccattca
1080





gcctctcttt gccacttcca gctaatttgg ttcttaaagg gagccagaat ccttttatcc
1140





tgcctaccac aattggaata gtggttcctg gtttggtggt gtttgaagat gggggatggg
1200





ggttaaagca aagaagtaga cccctagcct tgggctccag tgcaggcctc agcagtgagc
1260





aaggagtaga atgtctccac cccaggtggg tgcataggtg taagaatgcc cagagggctt
1320





gggtagggct taaacagcca cagggcaagc ctgtgtggaa gcatctcctc tctggggctc
1380





cccagtcttt tcctctgcag aatgagggca cacaactgtt ctctgaggtt tcttccaact
1440





caggggtgtc tggcaggttg tgggggctgc tagggtgagg gaagggtggg aaggagactt
1500





gcatgagtct ctttttgaaa aggctggatg taaatggaat ttgggaagta atcccagcat
1560





catagcagaa gttggttgga gaccatccag ccaaggtcct caaccttgtg acttgtcctc
1620





aaccttggct gcatattaaa aaagatgaat gcaggccaag tgtagtggct cacacttgta
1680





atcccagagc tttgggaagc tgaggtagga ggattgcttg atgccaggag tccaagacca
1740





gcctggacaa catagcaaga cccctgtctc tatgaaaata aattaggcca agagcagtga
1800





ctcatacctg taatcccagc accttgggag gccaatgcag gaggatcact tcagccagtc
1860





a
1861











<210>   16



<211> 1861


<212> DNA


<213> Homo sapiens


<400>   16









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctcctg
1020





tcatagtata ggatggtgcg gctaccactg gcctcgttga tgatgaccgt ggcgatgggg
1080





acggagcctg tggtctgaaa gactgtgtag cgtaggtcca cagaatagcg gcggaggtca
1140





tccaggacaa aatcagcaac atggccagga gccattgagc ccatgaaggc acagggggct
1200





ccgagcaggg agagaacggt gcaggagttg gacgcgttgc ctccgcgctg ccatctctgg
1260





gacaaacacc ttatctccga gtcctcctta gggtacttgt ccaccaggct gatgacgtcc
1320





agcaccacta gccccacgca caggatctgc ttctcttcca tgaggctact cccagagctt
1380





cctgcccgcc cggctgacgg ggttcctccc ggcctctgcc tcttatccag gaggatggtg
1440





tccccgctcc cagctgccct ggctcctcct ccgcgtggga gctcctcctc cagggagcca
1500





cctgcagcgg ccaggggtgc agggaacgaa aggagcaggg cccttcctcg cgacacccga
1560





agacccgagc gggtctagga aagccaaccc agaggtcttg gtccccggtc ttcccgtagc
1620





aggttgcctg ggcctgcaga tggcaacgcc tcccacttct cagccttagt ttcctcgctt
1680





gtcagatgga ctcacagctg atgcaaacct ttttaaagcg cggctaagcg atctcgagaa
1740





tgcaaagaga aaatgcgcta cttgccccgc actctcctgc acctgcgtct ccgactcccg
1800





acccgggaca cgcgaggtac agctgggcct cgcatctgca gccctgcctg aagcccgcgg
1860





t
1861











<210>   17



<211> 2387


<212> DNA


<213> Homo sapiens


<400>   17









aggcagggct gcagatgcga ggcccagctg tacctcgcgt gtcccgggtc gggagtcgga
  60






gacgcaggtg caggagagtg cggggcaagt agcgcatttt ctctttgcat tctcgagatc
 120





gcttagccgc gctttaaaaa ggtttgcatc agctgtgagt ccatctgaca agcgaggaaa
 180





ctaaggctga gaagtgggag gcgttgccat ctgcaggccc aggcaacctg ctacgggaag
 240





accggggacc aagacctctg ggttggcttt cctagacccg ctcgggtctt cgggtgtcgc
 300





gaggaagggc cctgctcctt tcgttccctg cacccctggc cgctgcaggt ggctccctgg
 360





aggaggagct cccacgcgga ggaggagcca gggcagctgg gagcggggac accatcctcc
 420





tggataagag gcagaggccg ggaggaaccc cgtcagccgg gcgggcagga agctctggga
 480





gtagcctcat ggaagagaag cagatcctgt gcgtggggct agtggtgctg gacgtcatca
 540





gcctggtgga caagtaccct aaggaggact cggagataag gtgtttgtcc cagagatggc
 600





agcgcggagg caacgcgtcc aactcctgca ccgttctctc cctgctcgga gccccctgtg
 660





ccttcatggg ctcaatggct cctggccatg ttgctgacag ttttgtcctg gatgacctcc
 720





gccgctattc tgtggaccta cgctacacag tctttcagac cacaggctcc gtccccatcg
 780





ccacggtcat catcaacgag gccagtggta gccgcaccat cctatactat gacaggagcc
 840





tgccagatgt gtctgctaca gactttgaga aggttgatct gacccagttc aagtggatcc
 900





acattgaggg ccggaacgca tcggagcagg tgaagatgct gcagcggata gacgcacaca
 960





acaccaggca gcctccagag cagaagatcc gggtgtccgt ggaggtggag aagccacgag
1020





aggagctctt ccagctgttt ggctacggag acgtggtgtt tgtcagcaaa gatgtggcca
1080





agcacttggg gttccagtca gcagaggaag ccttgagggg cttgtatggt cgtgtgagga
1140





aaggggctgt gcttgtctgt gcctgggctg aggagggcgc cgacgccctg ggccctgatg
1200





gcaaattgct ccactcggat gctttcccgc caccccgcgt ggtggataca ctgggagctg
1260





gagacacctt caatgcctcc gtcatcttca gcctctccca ggggaggagc gtgcaggaag
1320





cactgagatt cgggtgccag gtggccggca agaagtgtgg cctgcagggc tttgatggca
1380





tcgtgtgaga gcaggtgccg gctcctcaca caccatggag actaccattg cggctgcatc
1440





gccttctccc ctccatccag cctggcgtcc aggttgccct gttcagggga cagatgcaag
1500





ctgtggggag gactctgcct gtgtcctgtg ttccccacag ggagaggctc tggggggatg
1560





gctgggggat gcagagcctc agagcaaata aatcttcctc agagccagct tctcctctca
1620





atgtctgaac tgctctggct gggcattcct gaggctctga ctcttcgatc ctccctcttt
1680





gtgtccattc cccaaattaa cctctccgcc caggcccaga ggaggggctg cctgggctag
1740





agcagcgaga agtgccctgg gcttgccacc agctctgccc tggctgggga ggacactcgg
1800





tgccccacac ccagtgaacc tgccaaagaa accgtgagag ctcttcgggg ccctgcgttg
1860





tgcagactct attcccacag ctcagaagct gggagtccac accgctgagc tgaactgaca
1920





ggccagtggg gggcaggggt gcgcctcctc tgccctgccc accagcctgt gatttgatgg
1980





ggtcttcatt gtccagaaat acctcctccc gctgactgcc ccagagcctg aaagtctcac
2040





ccttggagcc caccttggaa ttaagggcgt gcctcagcca caaatgtgac ccaggataca
2100





gagtgttgct gtcctcaggg aggtccgatc tggaacacat attggaattg gggccaactc
2160





caatataggg tgggtaaggc cttataatgt aaagagcata taatgtaaag ggctttagag
2220





tgagacagac ctggattaaa atctgccatt taattagctg catatcacct tagggtacag
2280





cacttaacgc aatctgcctc aatttcttca tctgtcaaat ggaaccaatt ctgcttggct
2340





acagaattat tgtgaggata aaatcatata taaaatgccc agcatga
2387











<210>   18



<211> 2387


<212> DNA


<213> Homo sapiens


<400>   18









tcatgctggg cattttatat atgattttat cctcacaata attctgtagc caagcagaat
  60






tggttccatt tgacagatga agaaattgag gcagattgcg ttaagtgctg taccctaagg
 120





tgatatgcag ctaattaaat ggcagatttt aatccaggtc tgtctcactc taaagccctt
 180





tacattatat gctctttaca ttataaggcc ttacccaccc tatattggag ttggccccaa
 240





ttccaatatg tgttccagat cggacctccc tgaggacagc aacactctgt atcctgggtc
 300





acatttgtgg ctgaggcacg cccttaattc caaggtgggc tccaagggtg agactttcag
 360





gctctggggc agtcagcggg aggaggtatt tctggacaat gaagacccca tcaaatcaca
 420





ggctggtggg cagggcagag gaggcgcacc cctgcccccc actggcctgt cagttcagct
 480





cagcggtgtg gactcccagc ttctgagctg tgggaataga gtctgcacaa cgcagggccc
 540





cgaagagctc tcacggtttc tttggcaggt tcactgggtg tggggcaccg agtgtcctcc
 600





ccagccaggg cagagctggt ggcaagccca gggcacttct cgctgctcta gcccaggcag
 660





cccctcctct gggcctgggc ggagaggtta atttggggaa tggacacaaa gagggaggat
 720





cgaagagtca gagcctcagg aatgcccagc cagagcagtt cagacattga gaggagaagc
 780





tggctctgag gaagatttat ttgctctgag gctctgcatc ccccagccat ccccccagag
 840





cctctccctg tggggaacac aggacacagg cagagtcctc cccacagctt gcatctgtcc
 900





cctgaacagg gcaacctgga cgccaggctg gatggagggg agaaggcgat gcagccgcaa
 960





tggtagtctc catggtgtgt gaggagccgg cacctgctct cacacgatgc catcaaagcc
1020





ctgcaggcca cacttcttgc cggccacctg gcacccgaat ctcagtgctt cctgcacgct
1080





cctcccctgg gagaggctga agatgacgga ggcattgaag gtgtctccag ctcccagtgt
1140





atccaccacg cggggtggcg ggaaagcatc cgagtggagc aatttgccat cagggcccag
1200





ggcgtcggcg ccctcctcag cccaggcaca gacaagcaca gcccctttcc tcacacgacc
1260





atacaagccc ctcaaggctt cctctgctga ctggaacccc aagtgcttgg ccacatcttt
1320





gctgacaaac accacgtctc cgtagccaaa cagctggaag agctcctctc gtggcttctc
1380





cacctccacg gacacccgga tcttctgctc tggaggctgc ctggtgttgt gtgcgtctat
1440





ccgctgcagc atcttcacct gctccgatgc gttccggccc tcaatgtgga tccacttgaa
1500





ctgggtcaga tcaaccttct caaagtctgt agcagacaca tctggcaggc tcctgtcata
1560





gtataggatg gtgcggctac cactggcctc gttgatgatg accgtggcga tggggacgga
1620





gcctgtggtc tgaaagactg tgtagcgtag gtccacagaa tagcggcgga ggtcatccag
1680





gacaaaactg tcagcaacat ggccaggagc cattgagccc atgaaggcac agggggctcc
1740





gagcagggag agaacggtgc aggagttgga cgcgttgcct ccgcgctgcc atctctggga
1800





caaacacctt atctccgagt cctccttagg gtacttgtcc accaggctga tgacgtccag
1860





caccactagc cccacgcaca ggatctgctt ctcttccatg aggctactcc cagagcttcc
1920





tgcccgcccg gctgacgggg ttcctcccgg cctctgcctc ttatccagga ggatggtgtc
1980





cccgctccca gctgccctgg ctcctcctcc gcgtgggagc tcctcctcca gggagccacc
2040





tgcagcggcc aggggtgcag ggaacgaaag gagcagggcc cttcctcgcg acacccgaag
2100





acccgagcgg gtctaggaaa gccaacccag aggtcttggt ccccggtctt cccgtagcag
2160





gttgcctggg cctgcagatg gcaacgcctc ccacttctca gccttagttt cctcgcttgt
2220





cagatggact cacagctgat gcaaaccttt ttaaagcgcg gctaagcgat ctcgagaatg
2280





caaagagaaa atgcgctact tgccccgcac tctcctgcac ctgcgtctcc gactcccgac
2340





ccgggacacg cgaggtacag ctgggcctcg catctgcagc cctgcct
2387











<210>   19



<211> 1726


<212> DNA


<213> Homo sapiens


<400>   19









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggtgtttgt
 600





cccagagatg gcagcgcgga ggcaacgcgt ccaactcctg caccgttctc tccctgctcg
 660





gagccccctg tgccttcatg ggctcaatgg ctcctggcca tgttgctgag agcctgccag
 720





atgtgtctgc tacagacttt gagaaggttg atctgaccca gttcaagtgg atccacattg
 780





agggccggaa cgcatcggag caggtgaaga tgctgcagcg gatagacgca cacaacacca
 840





ggcagcctcc agagcagaag atccgggtgt ccgtggaggt ggagaagcca cgagaggagc
 900





tcttccagct gtttggctac ggagacgtgg tgggtgcccc attcagcctc tctttgccac
 960





ttccagctaa tttggttctt aaagggagcc agaatccttt tatcctgcct accacaattg
1020





gaatagtggt tcctggtttg gtggtgtttg aagatggggg atgggggtta aagcaaagaa
1080





gtagacccct agccttgggc tccagtgcag gcctcagcag tgagcaagga gtagaatgtc
1140





tccaccccag gtgggtgcat aggtgtaaga atgcccagag ggcttgggta gggcttaaac
1200





agccacaggg caagcctgtg tggaagcatc tcctctctgg ggctccccag tcttttcctc
1260





tgcagaatga gggcacacaa ctgttctctg aggtttcttc caactcaggg gtgtctggca
1320





ggttgtgggg gctgctaggg tgagggaagg gtgggaagga gacttgcatg agtctctttt
1380





tgaaaaggct ggatgtaaat ggaatttggg aagtaatccc agcatcatag cagaagttgg
1440





ttggagacca tccagccaag gtcctcaacc ttgtgacttg tcctcaacct tggctgcata
1500





ttaaaaaaga tgaatgcagg ccaagtgtag tggctcacac ttgtaatccc agagctttgg
1560





gaagctgagg taggaggatt gcttgatgcc aggagtccaa gaccagcctg gacaacatag
1620





caagacccct gtctctatga aaataaatta ggccaagagc agtgactcat acctgtaatc
1680





ccagcacctt gggaggccaa tgcaggagga tcacttcagc cagtca
1726











<210>   20



<211> 1726


<212> DNA


<213> Homo sapiens


<400>   20









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctctca
1020





gcaacatggc caggagccat tgagcccatg aaggcacagg gggctccgag cagggagaga 
1080





acggtgcagg agttggacgc gttgcctccg cgctgccatc tctgggacaa acaccttatc
1140





tccgagtcct ccttagggta cttgtccacc aggctgatga cgtccagcac cactagcccc
1200





acgcacagga tctgcttctc ttccatgagg ctactcccag agcttcctgc ccgcccggct
1260





gacggggttc ctcccggcct ctgcctctta tccaggagga tggtgtcccc gctcccagct
1320





gccctggctc ctcctccgcg tgggagctcc tcctccaggg agccacctgc agcggccagg
1380





ggtgcaggga acgaaaggag cagggccctt cctcgcgaca cccgaagacc cgagcgggtc
1440





taggaaagcc aacccagagg tcttggtccc cggtcttccc gtagcaggtt gcctgggcct
1500





gcagatggca acgcctccca cttctcagcc ttagtttcct cgcttgtcag atggactcac
1560





agctgatgca aaccttttta aagcgcggct aagcgatctc gagaatgcaa agagaaaatg
1620





cgctacttgc cccgcactct cctgcacctg cgtctccgac tcccgacccg ggacacgcga
1680





ggtacagctg ggcctcgcat ctgcagccct gcctgaagcc cgcggt
1726











<210>   21



<211> 1609


<212> DNA


<213> Homo sapiens


<400>   21









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggagcctgc
 600





cagatgtgtc tgctacagac tttgagaagg ttgatctgac ccagttcaag tggatccaca
 660





ttgagggccg gaacgcatcg gagcaggtga agatgctgca gcggatagac gcacacaaca
 720





ccaggcagcc tccagagcag aagatccggg tgtccgtgga ggtggagaag ccacgagagg
 780





agctcttcca gctgtttggc tacggagacg tggtgggtgc cccattcagc ctctctttgc
 840





cacttccagc taatttggtt cttaaaggga gccagaatcc ttttatcctg cctaccacaa
 900





ttggaatagt ggttcctggt ttggtggtgt ttgaagatgg gggatggggg ttaaagcaaa
 960





gaagtagacc cctagccttg ggctccagtg caggcctcag cagtgagcaa ggagtagaat
1020





gtctccaccc caggtgggtg cataggtgta agaatgccca gagggcttgg gtagggctta
1080





aacagccaca gggcaagcct gtgtggaagc atctcctctc tggggctccc cagtcttttc
1140





ctctgcagaa tgagggcaca caactgttct ctgaggtttc ttccaactca ggggtgtctg
1200





gcaggttgtg ggggctgcta gggtgaggga agggtgggaa ggagacttgc atgagtctct
1260





ttttgaaaag gctggatgta aatggaattt gggaagtaat cccagcatca tagcagaagt
1320





tggttggaga ccatccagcc aaggtcctca accttgtgac ttgtcctcaa ccttggctgc
1380





atattaaaaa agatgaatgc aggccaagtg tagtggctca cacttgtaat cccagagctt
1440





tgggaagctg aggtaggagg attgcttgat gccaggagtc caagaccagc ctggacaaca
1500





tagcaagacc cctgtctcta tgaaaataaa ttaggccaag agcagtgact catacctgta
1560





atcccagcac cttgggaggc caatgcagga ggatcacttc agccagtca
1609











<210>   22



<211> 1609


<212> DNA


<213> Homo sapiens


<400>   22









tgactggctg aagtgatcct cctgcattgg cctcccaagg tgctgggatt acaggtatga
  60






gtcactgctc ttggcctaat ttattttcat agagacaggg gtcttgctat gttgtccagg
 120





ctggtcttgg actcctggca tcaagcaatc ctcctacctc agcttcccaa agctctggga
 180





ttacaagtgt gagccactac acttggcctg cattcatctt ttttaatatg cagccaaggt
 240





tgaggacaag tcacaaggtt gaggaccttg gctggatggt ctccaaccaa cttctgctat
 300





gatgctggga ttacttccca aattccattt acatccagcc ttttcaaaaa gagactcatg
 360





caagtctcct tcccaccctt ccctcaccct agcagccccc acaacctgcc agacacccct
 420





gagttggaag aaacctcaga gaacagttgt gtgccctcat tctgcagagg aaaagactgg
 480





ggagccccag agaggagatg cttccacaca ggcttgccct gtggctgttt aagccctacc
 540





caagccctct gggcattctt acacctatgc acccacctgg ggtggagaca ttctactcct
 600





tgctcactgc tgaggcctgc actggagccc aaggctaggg gtctacttct ttgctttaac
 660





ccccatcccc catcttcaaa caccaccaaa ccaggaacca ctattccaat tgtggtaggc
 720





aggataaaag gattctggct ccctttaaga accaaattag ctggaagtgg caaagagagg
 780





ctgaatgggg cacccaccac gtctccgtag ccaaacagct ggaagagctc ctctcgtggc
 840





ttctccacct ccacggacac ccggatcttc tgctctggag gctgcctggt gttgtgtgcg
 900





tctatccgct gcagcatctt cacctgctcc gatgcgttcc ggccctcaat gtggatccac
 960





ttgaactggg tcagatcaac cttctcaaag tctgtagcag acacatctgg caggctcctt
1020





atctccgagt cctccttagg gtacttgtcc accaggctga tgacgtccag caccactagc
1080





cccacgcaca ggatctgctt ctcttccatg aggctactcc cagagcttcc tgcccgcccg
1140





gctgacgggg ttcctcccgg cctctgcctc ttatccagga ggatggtgtc cccgctccca
1200





gctgccctgg ctcctcctcc gcgtgggagc tcctcctcca gggagccacc tgcagcggcc
1260





aggggtgcag ggaacgaaag gagcagggcc cttcctcgcg acacccgaag acccgagcgg
1320





gtctaggaaa gccaacccag aggtcttggt ccccggtctt cccgtagcag gttgcctggg
1380





cctgcagatg gcaacgcctc ccacttctca gccttagttt cctcgcttgt cagatggact
1440





cacagctgat gcaaaccttt ttaaagcgcg gctaagcgat ctcgagaatg caaagagaaa
1500





atgcgctact tgccccgcac tctcctgcac ctgcgtctcc gactcccgac ccgggacacg
1560





cgaggtacag ctgggcctcg catctgcagc cctgcctgaa gcccgcggt
1609











<210>   23



<211> 2144


<212> DNA


<213> Homo sapiens


<400>   23









accgcgggct tcaggcaggg ctgcagatgc gaggcccagc tgtacctcgc gtgtcccggg
  60






tcgggagtcg gagacgcagg tgcaggagag tgcggggcaa gtagcgcatt ttctctttgc
 120





attctcgaga tcgcttagcc gcgctttaaa aaggtttgca tcagctgtga gtccatctga
 180





caagcgagga aactaaggct gagaagtggg aggcgttgcc atctgcaggc ccaggcaacc
 240





tgctacggga agaccgggga ccaagacctc tgggttggct ttcctagacc cgctcgggtc
 300





ttcgggtgtc gcgaggaagg gccctgctcc tttcgttccc tgcacccctg gccgctgcag
 360





gtggctccct ggaggaggag ctcccacgcg gaggaggagc cagggcagct gggagcgggg
 420





acaccatcct cctggataag aggcagaggc cgggaggaac cccgtcagcc gggcgggcag
 480





gaagctctgg gagtagcctc atggaagaga agcagatcct gtgcgtgggg ctagtggtgc
 540





tggacgtcat cagcctggtg gacaagtacc ctaaggagga ctcggagata aggagcctgc
 600





cagatgtgtc tgctacagac tttgagaagg ttgatctgac ccagttcaag tggatccaca
 660





ttgagggccg gaacgcatcg gagcaggtga agatgctgca gcggatagac gcacacaaca
 720





ccaggcagcc tccagagcag aagatccggg tgtccgtgga ggtggagaag ccacgagagg
 780





agctcttcca gctgtttggc tacggagacg tggtgtttgt cagcaaagat gtggccaagc
 840





acttggggtt ccagtcagca gaggaagcct tgaggggctt gtatggtcgt gtgaggaaag
 900





gggctgtgct tgtctgtgcc tgggctgagg agggcgccga cgccctgggc cctgatggca
 960





aattgctcca ctcggatgct ttcccgccac cccgcgtggt ggatacactg ggagctggag
1020





acaccttcaa tgcctccgtc atcttcagcc tctcccaggg gaggagcgtg caggaagcac
1080





tgagattcgg gtgccaggtg gccggcaaga agtgtggcct gcagggcttt gatggcatcg
1140





tgtgagagca ggtgccggct cctcacacac catggagact accattgcgg ctgcatcgcc
1200





ttctcccctc catccagcct ggcgtccagg ttgccctgtt caggggacag atgcaagctg
1260





tggggaggac tctgcctgtg tcctgtgttc cccacaggga gaggctctgg ggggatggct
1320





gggggatgca gagcctcaga gcaaataaat cttcctcaga gccagcttct cctctcaatg
1380





tctgaactgc tctggctggg cattcctgag gctctgactc ttcgatcctc cctctttgtg
1440





tccattcccc aaattaacct ctccgcccag gcccagagga ggggctgcct gggctagagc
1500





agcgagaagt gccctgggct tgccaccagc tctgccctgg ctggggagga cactcggtgc
1560





cccacaccca gtgaacctgc caaagaaacc gtgagagctc ttcggggccc tgcgttgtgc
1620





agactctatt cccacagctc agaagctggg agtccacacc gctgagctga actgacaggc
1680





cagtgggggg caggggtgcg cctcctctgc cctgcccacc agcctgtgat ttgatggggt
1740





cttcattgtc cagaaatacc tcctcccgct gactgcccca gagcctgaaa gtctcaccct
1800





tggagcccac cttggaatta agggcgtgcc tcagccacaa atgtgaccca ggatacagag
1860





tgttgctgtc ctcagggagg tccgatctgg aacacatatt ggaattgggg ccaactccaa
1920





tatagggtgg gtaaggcctt ataatgtaaa gagcatataa tgtaaagggc tttagagtga
1980





gacagacctg gattaaaatc tgccatttaa ttagctgcat atcaccttag ggtacagcac
2040





ttaacgcaat ctgcctcaat ttcttcatct gtcaaatgga accaattctg cttggctaca
2100





gaattattgt gaggataaaa tcatatataa aatgcccagc atga
2144











<210>   24



<211> 2144


<212> DNA


<213> Homo sapiens


<400>   24









tcatgctggg cattttatat atgattttat cctcacaata attctgtagc caagcagaat
  60






tggttccatt tgacagatga agaaattgag gcagattgcg ttaagtgctg taccctaagg
 120





tgatatgcag ctaattaaat ggcagatttt aatccaggtc tgtctcactc taaagccctt
 180





tacattatat gctctttaca ttataaggcc ttacccaccc tatattggag ttggccccaa
 240





ttccaatatg tgttccagat cggacctccc tgaggacagc aacactctgt atcctgggtc
 300





acatttgtgg ctgaggcacg cccttaattc caaggtgggc tccaagggtg agactttcag
 360





gctctggggc agtcagcggg aggaggtatt tctggacaat gaagacccca tcaaatcaca
 420





ggctggtggg cagggcagag gaggcgcacc cctgcccccc actggcctgt cagttcagct
 480





cagcggtgtg gactcccagc ttctgagctg tgggaataga gtctgcacaa cgcagggccc
 540





cgaagagctc tcacggtttc tttggcaggt tcactgggtg tggggcaccg agtgtcctcc
 600





ccagccaggg cagagctggt ggcaagccca gggcacttct cgctgctcta gcccaggcag
 660





cccctcctct gggcctgggc ggagaggtta atttggggaa tggacacaaa gagggaggat
 720





cgaagagtca gagcctcagg aatgcccagc cagagcagtt cagacattga gaggagaagc
 780





tggctctgag gaagatttat ttgctctgag gctctgcatc ccccagccat ccccccagag
 840





cctctccctg tggggaacac aggacacagg cagagtcctc cccacagctt gcatctgtcc
 900





cctgaacagg gcaacctgga cgccaggctg gatggagggg agaaggcgat gcagccgcaa
 960





tggtagtctc catggtgtgt gaggagccgg cacctgctct cacacgatgc catcaaagcc
1020





ctgcaggcca cacttcttgc cggccacctg gcacccgaat ctcagtgctt cctgcacgct
1080





cctcccctgg gagaggctga agatgacgga ggcattgaag gtgtctccag ctcccagtgt
1140





atccaccacg cggggtggcg ggaaagcatc cgagtggagc aatttgccat cagggcccag
1200





ggcgtcggcg ccctcctcag cccaggcaca gacaagcaca gcccctttcc tcacacgacc
1260





atacaagccc ctcaaggctt cctctgctga ctggaacccc aagtgcttgg ccacatcttt
1320





gctgacaaac accacgtctc cgtagccaaa cagctggaag agctcctctc gtggcttctc
1380





cacctccacg gacacccgga tcttctgctc tggaggctgc ctggtgttgt gtgcgtctat
1440





ccgctgcagc atcttcacct gctccgatgc gttccggccc tcaatgtgga tccacttgaa
1500





ctgggtcaga tcaaccttct caaagtctgt agcagacaca tctggcaggc tccttatctc
1560





cgagtcctcc ttagggtact tgtccaccag gctgatgacg tccagcacca ctagccccac
1620





gcacaggatc tgcttctctt ccatgaggct actcccagag cttcctgccc gcccggctga
1680





cggggttcct cccggcctct gcctcttatc caggaggatg gtgtccccgc tcccagctgc
1740





cctggctcct cctccgcgtg ggagctcctc ctccagggag ccacctgcag cggccagggg
1800





tgcagggaac gaaaggagca gggcccttcc tcgcgacacc cgaagacccg agcgggtcta
1860





ggaaagccaa cccagaggtc ttggtccccg gtcttcccgt agcaggttgc ctgggcctgc
1920





agatggcaac gcctcccact tctcagcctt agtttcctcg cttgtcagat ggactcacag
1980





ctgatgcaaa cctttttaaa gcgcggctaa gcgatctcga gaatgcaaag agaaaatgcg
2040





ctacttgccc cgcactctcc tgcacctgcg tctccgactc ccgacccggg acacgcgagg
2100





tacagctggg cctcgcatct gcagccctgc ctgaagcccg cggt
2144





<210>   25



<211> 2397



<212> DNA



<213> Homo sapiens



<400>   25



aggcagggct gcagatgcga ggcccagctg tacctcgcgt gtcccgggtc gggagtcgga
  60





gacgcaggtg caggagagtg cggggcaagt agcgcatttt ctctttgcat tctcgagatc
 120





gcttagccgc gctttaaaaa ggtttgcatc agctgtgagt ccatctgaca agcgaggaaa
 180





ctaaggctga gaagtgggag gcgttgccat ctgcaggccc aggcaacctg ctacgggaag
 240





accggggacc aagacctctg ggttggcttt cctagacccg ctcgggtctt cgggtgtcgc
 300





gaggaagggc cctgctcctt tcgttccctg cacccctggc cgctgcaggt ggctccctgg
 360





aggaggagct cccacgcgga ggaggagcca gggcagctgg gagcggggac accatcctcc
 420





tggataagag gcagaggccg ggaggaaccc cgtcagccgg gcgggcagga agctctggga
 480





gtagcctcat ggaagagaag cagatcctgt gcgtggggct agtggtgctg gacgtcatca
 540





gcctggtgga caagtaccct aaggaggact cggagataag gtgtttgtcc cagagatggc
 600





agcgcggagg caacgcgtcc aactcctgca ccgttctctc cctgctcgga gccccctgtg
 660





ccttcatggg ctcaatggct cctggccatg ttgctgactt cctggtggcc gacttcaggc
 720





ggcggggcgt ggacgtgtct caggtggcct ggcagagcaa gggggacacc cccagctcct
 780





gctgcatcat caacaactcc aatggcaacc gtaccattgt gctccatgac acgagcctgc
 840





cagatgtgtc tgctacagac tttgagaagg ttgatctgac ccagttcaag tggatccaca
 900





ttgagggccg gaacgcatcg gagcaggtga agatgctgca gcggatagac gcacacaaca
 960





ccaggcagcc tccagagcag aagatccggg tgtccgtgga ggtggagaag ccacgagagg
1020





agctcttcca gctgtttggc tacggagacg tggtgtttgt cagcaaagat gtggccaagc
1080





acttggggtt ccagtcagca gaggaagcct tgaggggctt gtatggtcgt gtgaggaaag
1140





gggctgtgct tgtctgtgcc tgggctgagg agggcgccga cgccctgggc cctgatggca
1200





aattgctcca ctcggatgct ttcccgccac cccgcgtggt ggatacactg ggagctggag
1260





acaccttcaa tgcctccgtc atcttcagcc tctcccaggg gaggagcgtg caggaagcac
1320





tgagattcgg gtgccaggtg gccggcaaga agtgtggcct gcagggcttt gatggcatcg
1380





tgtgagagca ggtgccggct cctcacacac catggagact accattgcgg ctgcatcgcc
1440





ttctcccctc catccagcct ggcgtccagg ttgccctgtt caggggacag atgcaagctg
1500





tggggaggac tctgcctgtg tcctgtgttc cccacaggga gaggctctgg ggggatggct
1560





gggggatgca gagcctcaga gcaaataaat cttcctcaga gccagcttct cctctcaatg
1620





tctgaactgc tctggctggg cattcctgag gctctgactc ttcgatcctc cctctttgtg
1680





tccattcccc aaattaacct ctccgcccag gcccagagga ggggctgcct gggctagagc
1740





agcgagaagt gccctgggct tgccaccagc tctgccctgg ctggggagga cactcggtgc
1800





cccacaccca gtgaacctgc caaagaaacc gtgagagctc ttcggggccc tgcgttgtgc
1860





agactctatt cccacagctc agaagctggg agtccacacc gctgagctga actgacaggc
1920





cagtgggggg caggggtgcg cctcctctgc cctgcccacc agcctgtgat ttgatggggt
1980





cttcattgtc cagaaatacc tcctcccgct gactgcccca gagcctgaaa gtctcaccct
2040





tggagcccac cttggaatta agggcgtgcc tcagccacaa atgtgaccca ggatacagag
2100





tgttgctgtc ctcagggagg tccgatctgg aacacatatt ggaattgggg ccaactccaa
2160





tatagggtgg gtaaggcctt ataatgtaaa gagcatataa tgtaaagggc tttagagtga
2220





gacagacctg gattaaaatc tgccatttaa ttagctgcat atcaccttag ggtacagcac
2280





ttaacgcaat ctgcctcaat ttcttcatct gtcaaatgga accaattctg cttggctaca
2340





gaattattgt gaggataaaa tcatatataa aatgcccagc atgatgcctg atgtgta
2397











<210>   26



<211> 2397


<212> DNA


<213> Homo sapiens


<400>   26









tacacatcag gcatcatgct gggcatttta tatatgattt tatcctcaca ataattctgt
  60






agccaagcag aattggttcc atttgacaga tgaagaaatt gaggcagatt gcgttaagtg
 120





ctgtacccta aggtgatatg cagctaatta aatggcagat tttaatccag gtctgtctca
 180





ctctaaagcc ctttacatta tatgctcttt acattataag gccttaccca ccctatattg
 240





gagttggccc caattccaat atgtgttcca gatcggacct ccctgaggac agcaacactc
 300





tgtatcctgg gtcacatttg tggctgaggc acgcccttaa ttccaaggtg ggctccaagg
 360





gtgagacttt caggctctgg ggcagtcagc gggaggaggt atttctggac aatgaagacc
 420





ccatcaaatc acaggctggt gggcagggca gaggaggcgc acccctgccc cccactggcc
 480





tgtcagttca gctcagcggt gtggactccc agcttctgag ctgtgggaat agagtctgca
 540





caacgcaggg ccccgaagag ctctcacggt ttctttggca ggttcactgg gtgtggggca
 600





ccgagtgtcc tccccagcca gggcagagct ggtggcaagc ccagggcact tctcgctgct
 660





ctagcccagg cagcccctcc tctgggcctg ggcggagagg ttaatttggg gaatggacac
 720





aaagagggag gatcgaagag tcagagcctc aggaatgccc agccagagca gttcagacat
 780





tgagaggaga agctggctct gaggaagatt tatttgctct gaggctctgc atcccccagc
 840





catcccccca gagcctctcc ctgtggggaa cacaggacac aggcagagtc ctccccacag
 900





cttgcatctg tcccctgaac agggcaacct ggacgccagg ctggatggag gggagaaggc
 960





gatgcagccg caatggtagt ctccatggtg tgtgaggagc cggcacctgc tctcacacga
1020





tgccatcaaa gccctgcagg ccacacttct tgccggccac ctggcacccg aatctcagtg
1080





cttcctgcac gctcctcccc tgggagaggc tgaagatgac ggaggcattg aaggtgtctc
1140





cagctcccag tgtatccacc acgcggggtg gcgggaaagc atccgagtgg agcaatttgc
1200





catcagggcc cagggcgtcg gcgccctcct cagcccaggc acagacaagc acagcccctt
1260





tcctcacacg accatacaag cccctcaagg cttcctctgc tgactggaac cccaagtgct
1320





tggccacatc tttgctgaca aacaccacgt ctccgtagcc aaacagctgg aagagctcct
1380





ctcgtggctt ctccacctcc acggacaccc ggatcttctg ctctggaggc tgcctggtgt
1440





tgtgtgcgtc tatccgctgc agcatcttca cctgctccga tgcgttccgg ccctcaatgt
1500





ggatccactt gaactgggtc agatcaacct tctcaaagtc tgtagcagac acatctggca
1560





ggctcgtgtc atggagcaca atggtacggt tgccattgga gttgttgatg atgcagcagg
1620





agctgggggt gtcccccttg ctctgccagg ccacctgaga cacgtccacg ccccgccgcc
1680





tgaagtcggc caccaggaag tcagcaacat ggccaggagc cattgagccc atgaaggcac
1740





agggggctcc gagcagggag agaacggtgc aggagttgga cgcgttgcct ccgcgctgcc
1800





atctctggga caaacacctt atctccgagt cctccttagg gtacttgtcc accaggctga
1860





tgacgtccag caccactagc cccacgcaca ggatctgctt ctcttccatg aggctactcc
1920





cagagcttcc tgcccgcccg gctgacgggg ttcctcccgg cctctgcctc ttatccagga
1980





ggatggtgtc cccgctccca gctgccctgg ctcctcctcc gcgtgggagc tcctcctcca
2040





gggagccacc tgcagcggcc aggggtgcag ggaacgaaag gagcagggcc cttcctcgcg
2100





acacccgaag acccgagcgg gtctaggaaa gccaacccag aggtcttggt ccccggtctt
2160





cccgtagcag gttgcctggg cctgcagatg gcaacgcctc ccacttctca gccttagttt
2220





cctcgcttgt cagatggact cacagctgat gcaaaccttt ttaaagcgcg gctaagcgat
2280





ctcgagaatg caaagagaaa atgcgctact tgccccgcac tctcctgcac ctgcgtctcc
2340





gactcccgac ccgggacacg cgaggtacag ctgggcctcg catctgcagc cctgcct
2397











<210>   27



<211> 2397


<212> DNA


<213> Homo sapiens


<400>   27









aggcagggct gcagatgcga ggcccagctg tacctcgcgt gtcccgggtc gggagtcgga
  60






gacgcaggtg caggagagtg cggggcaagt agcgcatttt ctctttgcat tctcgagatc
 120





gcttagccgc gctttaaaaa ggtttgcatc agctgtgagt ccatctgaca agcgaggaaa
 180





ctaaggctga gaagtgggag gcgttgccat ctgcaggccc aggcaacctg ctacgggaag
 240





accggggacc aagacctctg ggttggcttt cctagacccg ctcgggtctt cgggtgtcgc
 300





gaggaagggc cctgctcctt tcgttccctg cacccctggc cgctgcaggt ggctccctgg
 360





aggaggagct cccacgcgga ggaggagcca gggcagctgg gagcggggac accatcctcc
 420





tggataagag gcagaggccg ggaggaaccc cgtcagccgg gCgggcagga agctctggga
 480





gtagcctcat ggaagagaag cagatcctgt gcgtggggct agtggtgctg gacgtcatca
 540





gcctggtgga caagtaccct aaggaggact cggagataag gtgtttgtcc cagagatggc
 600





agcgcggagg caacgcgtcc aactcctgca ccgttctctc cctgctcgga gccccctgtg
 660





ccttcatggg ctcaatggct cctggccatg ttgctgattt tgtcctggat gacctccgcc
 720





gctattctgt ggacctacgc tacacagtct ttcagaccac aggctccgtc cccatcgcca
 780





cggtcatcat caacgaggcc agtggtagcc gcaccatcct atactatgac aggagcctgc
 840





cagatgtgtc tgctacagac tttgagaagg ttgatctgac ccagttcaag tggatccaca
 900





ttgagggccg gaacgcatcg gagcaggtga agatgctgca gcggatagac gcacacaaca
 960





ccaggcagcc tccagagcag aagatccggg tgtccgtgga ggtggagaag ccacgagagg
1020





agctcttcca gctgtttggc tacggagacg tggtgtttgt cagcaaagat gtggccaagc
1080





acttggggtt ccagtcagca gaggaagcct tgaggggctt gtatggtcgt gtgaggaaag
1140





gggctgtgct tgtctgtgcc tgggctgagg agggcgccga cgccctgggc cctgatggca
1200





aattgctcca ctcggatgct ttcccgccac cccgcgtggt ggatacactg ggagctggag
1260





acaccttcaa tgcctccgtc atcttcagcc tctcccaggg gaggagcgtg caggaagcac
1320





tgagattcgg gtgccaggtg gccggcaaga agtgtggcct gcagggcttt gatggcatcg
1380





tgtgagagca ggtgccggct cctcacacac catggagact accattgcgg ctgcatcgcc
1440





ttctcccctc catccagcct ggcgtccagg ttgccctgtt caggggacag atgcaagctg
1500





tggggaggac tctgcctgtg tcctgtgttc cccacaggga gaggctctgg ggggatggct
1560





gggggatgca gagcctcaga gcaaataaat cttcctcaga gccagcttct cctctcaatg
1620





tctgaactgc tctggctggg cattcctgag gctctgactc ttcgatcctc cctctttgtg
1680





tccattcccc aaattaacct ctccgcccag gcccagagga ggggctgcct gggctagagc
1740





agcgagaagt gccctgggct tgccaccagc tctgccctgg ctggggagga cactcggtgc
1800





cccacaccca gtgaacctgc caaagaaacc gtgagagctc ttcggggccc tgcgttgtgc
1860





agactctatt cccacagctc agaagctggg agtccacacc gctgagctga actgacaggc
1920





cagtgggggg caggggtgcg cctcctctgc cctgcccacc agcctgtgat ttgatggggt
1980





cttcattgtc cagaaatacc tcctcccgct gactgcccca gagcctgaaa gtctcaccct
2040





tggagcccac cttggaatta agggcgtgcc tcagccacaa atgtgaccca ggatacagag
2100





tgttgctgtc ctcagggagg tccgatctgg aacacatatt ggaattgggg ccaactccaa
2160





tatagggtgg gtaaggcctt ataatgtaaa gagcatataa tgtaaagggc tttagagtga
2220





gacagacctg gattaaaatc tgccatttaa ttagctgcat atcaccttag ggtacagcac
2280





ttaacgcaat ctgcctcaat ttcttcatct gtcaaatgga accaattctg cttggctaca
2340





gaattattgt gaggataaaa tcatatataa aatgcccagc atgatgcctg atgtgta
2397











<210>   28



<211> 2397


<212> DNA


<213> Homo sapiens


<400>   28









tacacatcag gcatcatgct gggcatttta tatatgattt tatcctcaca ataattctgt
  60






agccaagcag aattggttcc atttgacaga tgaagaaatt gaggcagatt gcgttaagtg
 120





ctgtacccta aggtgatatg cagctaatta aatggcagat tttaatccag gtctgtctca
 180





ctctaaagcc ctttacatta tatgctcttt acattataag gccttaccca ccctatattg
 240





gagttggccc caattccaat atgtgttcca gatcggacct ccctgaggac agcaacactc
 300





tgtatcctgg gtcacatttg tggctgaggc acgcccttaa ttccaaggtg ggctccaagg
 360





gtgagacttt caggctctgg ggcagtcagc gggaggaggt atttctggac aatgaagacc
 420





ccatcaaatc acaggctggt gggcagggca gaggaggcgc acccctgccc cccactggcc
 480





tgtcagttca gctcagcggt gtggactccc agcttctgag ctgtgggaat agagtctgca
 540





caacgcaggg ccccgaagag ctctcacggt ttctttggca ggttcactgg gtgtggggca
 600





ccgagtgtcc tccccagcca gggcagagct ggtggcaagc ccagggcact tctcgctgct
 660





ctagcccagg cagcccctcc tctgggcctg ggcggagagg ttaatttggg gaatggacac
 720





aaagagggag gatcgaagag tcagagcctc aggaatgccc agccagagca gttcagacat
 780





tgagaggaga agctggctct gaggaagatt tatttgctct gaggctctgc atcccccagc
 840





catcccccca gagcctctcc ctgtggggaa cacaggacac aggcagagtc ctccccacag
 900





cttgcatctg tcccctgaac agggcaacct ggacgccagg ctggatggag gggagaaggc
 960





gatgcagccg caatggtagt ctccatggtg tgtgaggagc cggcacctgc tctcacacga
1020





tgccatcaaa gccctgcagg ccacacttct tgccggccac ctggcacccg aatctcagtg
1080





cttcctgcac gctcctcccc tgggagaggc tgaagatgac ggaggcattg aaggtgtctc
1140





cagctcccag tgtatccacc acgcggggtg gcgggaaagc atccgagtgg agcaatttgc
1200





catcagggcc cagggcgtcg gcgccctcct cagcccaggc acagacaagc acagcccctt
1260





tcctcacacg accatacaag cccctcaagg cttcctctgc tgactggaac cccaagtgct
1320





tggccacatc tttgctgaca aacaccacgt ctccgtagcc aaacagctgg aagagctcct
1380





ctcgtggctt ctccacctcc acggacaccc ggatcttctg ctctggaggc tgcctggtgt
1440





tgtgtgcgtc tatccgctgc agcatcttca cctgctccga tgcgttccgg ccctcaatgt
1500





ggatccactt gaactgggtc agatcaacct tctcaaagtc tgtagcagac acatctggca
1560





ggctcctgtc atagtatagg atggtgcggc taccactggc ctcgttgatg atgaccgtgg
1620





cgatggggac ggagcctgtg gtctgaaaga ctgtgtagcg taggtccaca gaatagcggc
1680





ggaggtcatc caggacaaaa tcagcaacat ggccaggagc cattgagccc atgaaggcac
1740





agggggctcc gagcagggag agaacggtgc aggagttgga cgcgttgcct ccgcgctgcc
1800





atctctggga caaacacctt atctccgagt cctccttagg gtacttgtcc accaggctga
1860





tgacgtccag caccactagc cccacgcaca ggatctgctt ctcttccatg aggctactcc
1920





cagagcttcc tgcccgcccg gctgacgggg ttcctcccgg cctctgcctc ttatccagga
1980





ggatggtgtc cccgctccca gctgccctgg ctcctcctcc gcgtgggagc tcctcctcca
2040





gggagccacc tgcagcggcc aggggtgcag ggaacgaaag gagcagggcc cttcctcgcg
2100





acacccgaag acccgagcgg gtctaggaaa gccaacccag aggtcttggt ccccggtctt
2160





cccgtagcag gttgcctggg cctgcagatg gcaacgcctc ccacttctca gccttagttt
2220





cctcgcttgt cagatggact cacagctgat gcaaaccttt ttaaagcgcg gctaagcgat
2280





ctcgagaatg caaagagaaa atgcgctact tgccccgcac tctcctgcac ctgcgtctcc
2340





gactcccgac ccgggacacg cgaggtacag ctgggcctcg catctgcagc cctgcct
2397











<210>   29



<211> 1590


<212> DNA


<213> Mus musculus


<400>   29









gagggagaga acgcttgctt ctgtgctccg cctgcgaagg cgaagtttct gttgccagac
  60






tgtgctagtc cgggtggtcc agggtctgca gcaggcgcag agggatcgga aaggcgatgc
 120





attactagtg cgctttcgct ttgacagctg aggcggaaaa gtgagagggc ctgccattgg
 180





ccgggctagg taacccaccc ttgcaaagca gaaagctccc tgcgggagga gttctgcacg
 240





cagaggagga gccaaggtag ccagtgagaa gttgggacac ggtcctccag tagataagag
 300





gcagagccca gcaggaaccc cctctgcttg cgggtaggaa gcttggggag cagcctcatg
 360





gaagagaagc agatcctgtg cgtggggctg gtggtgctgg acatcatcaa tgtggtggac
 420





aaatacccag aggaagacac ggatcgcagg tgcctgtccc agagatggca gcgtggaggc
 480





aacgcatcca actcctgcac tgtcctttcc ttgcttggag cccgctgtgc cttcatgggc
 540





tctttggccc ctggccacgt tgccgatttt gtcctggatg acctccgcca acattctgtg
 600





gacttacgat atgtggtcct tcagaccgag ggctccatcc ccacttctac agtcatcatc
 660





aacgaggcca gcggcagccg caccattctg cacgcctaca gcttcctggt ggctgacttc
 720





aggcagaggg gcgtggatgt gtctcaagtg acttggcaga gccagggaga taccccttgc
 780





tcttgctgca tcgtcaacaa ctccaatggc tcccgtacca ttatactcta cgacacgaac
 840





ctgccagatg tgtctgctaa ggactttgag aaggtcgatc tgacccggtt caagtggatc
 900





cacattgagg gccggaatgc atcggaacag gtgaagatgc tgcagcggat agaggagcac
 960





aatgccaagc agcctctgcc acagaaggtc cgggtgtcgg tggagataga gaagccccgt
1020





gaggagctct tccagttgtt tagctatggt gaggtggtgt ttgtcagcaa agatgtggcc
1080





aagcacctgg ggttccagtc agcagtggag gccctgaggg gcttgtacag tcgagtgaag
1140





aaaggggcta cgcttgtctg tgcctgggct gaggagggtg ccgatgccct gggccccgat
1200





ggtcagctgc tccactcaga tgccttccca ccgccccgag tagtagacac tcttggggct
1260





ggagacacct tcaatgcctc tgtcatcttc agcctctcga agggaaacag catgcaagag
1320





gccctgagat tcgggtgcca ggtggctggc aagaagtgtg gcttgcaggg gtttgatggc
1380





attgtgtgag aggcaagcgg caccagctcg atacctcaga ggctggcacc atgcctgcca
1440





ctgccttctc tacttcctcc agcttagcat ccagctgcca ttccccggca ggtgtgggat
1500





gtgggacagc ctctgtctgt gtctgcgtct ctgtatacct atctcctctc tgcagatacc
1560





tggagcaaat aaatcttccc ctgagccagc
1590











<210>   30



<211> 1590


<212> DNA


<213> Mus musculus


<400>   30









gctggctcag gggaagattt atttgctcca ggtatctgca gagaggagat aggtatacag
  60






agacgcagac acagacagag gctgtcccac atcccacacc tgccggggaa tggcagctgg
 120





atgctaagct ggaggaagta gagaaggcag tggcaggcat ggtgccagcc tctgaggtat
 180





cgagctggtg ccgcttgcct ctcacacaat gccatcaaac ccctgcaagc cacacttctt
 240





gccagccacc tggcacccga atctcagggc ctcttgcatg ctgtttccct tcgagaggct
 300





gaagatgaca gaggcattga aggtgtctcc agccccaaga gtgtctacta ctcggggcgg
 360





tgggaaggca tctgagtgga gcagctgacc atcggggccc agggcatcgg caccctcctc
 420





agcccaggca cagacaagcg tagccccttt cttcactcga ctgtacaagc ccctcagggc
 480





ctccactgct gactggaacc ccaggtgctt ggccacatct ttgctgacaa acaccacctc
 540





accatagcta aacaactgga agagctcctc acggggcttc tctatctcca ccgacacccg
 600





gaccttctgt ggcagaggct gcttggcatt gtgctcctct atccgctgca gcatcttcac
 660





ctgttccgat gcattccggc cctcaatgtg gatccacttg aaccgggtca gatcgacctt
 720





ctcaaagtcc ttagcagaca catctggcag gttcgtgtcg tagagtataa tggtacggga
 780





gccattggag ttgttgacga tgcagcaaga gcaaggggta tctccctggc tctgccaagt
 840





cacttgagac acatccacgc ccctctgcct gaagtcagcc accaggaagc tgtaggcgtg
 900





cagaatggtg cggctgccgc tggcctcgtt gatgatgact gtagaagtgg ggatggagcc
 960





ctcggtctga aggaccacat atcgtaagtc cacagaatgt tggcggaggt catccaggac
1020





aaaatcggca acgtggccag gggccaaaga gcccatgaag gcacagcggg ctccaagcaa
1080





ggaaaggaca gtgcaggagt tggatgcgtt gcctccacgc tgccatctct gggacaggca
1140





cctgcgatcc gtgtcttcct ctgggtattt gtccaccaca ttgatgatgt ccagcaccac
1200





cagccccacg cacaggatct gcttctcttc catgaggctg ctccccaagc ttcctacccg
1260





caagcagagg gggttcctgc tgggctctgc ctcttatcta ctggaggacc gtgtcccaac
1320





ttctcactgg ctaccttggc tcctcctctg cgtgcagaac tcctcccgca gggagctttc
1380





tgctttgcaa gggtgggtta cctagcccgg ccaatggcag gccctctcac ttttccgcct
1440





cagctgtcaa agcgaaagcg cactagtaat gcatcgcctt tccgatccct ctgcgcctgc
1500





tgcagaccct ggaccacccg gactagcaca gtctggcaac agaaacttcg ccttcgcagg
1560





cggagcacag aagcaagcgt tctctccctc
1590











<210>   31



<211> 1307


<212> DNA


<213> Rattus norvegicus


<400>   31









gtgagagggt ctgccattgg ccggactagg taaccaaacc ctcgcaacag cagaaagcac
  60






cctgcgggag gagctccgca ggcagaggag gagccagggt agcccctgag aagttgggac
 120





acggtcctgc ggtagataag agacagagtc tagcaggaat cccctccgct tgcgggtagg
 180





aagcttgggg agcagcctca tggaagagaa gcagatcctg tgcgtggggc tggtggtgct
 240





ggacatcatc aatgtggtgg acaaataccc agaggaagac acggatcgca ggtgcctatc
 300





ccagagatgg cagcgtggag gcaacgcgtc caactcctgc actgtgcttt ccttgctcgg
 360





agcccgctgt gccttcatgg gctcgctggc ccatggccat gttgccgact tcctggtggc
 420





cgacttcagg cggaggggtg tggatgtgtc tcaagtggcc tggcagagcc agggagatac
 480





cccttgctcc tgctgcatcg tcaacaactc caatggctcc cgtaccatta ttctctacga
 540





cacgaacctg ccagatgtgt ctgctaagga ctttgagaag gtcgatctga cccggttcaa
 600





gtggatccac attgagggcc ggaatgcatc ggaacaggta aagatgctac agcggataga
 660





acagtacaat gccacgcagc ctctgcagca gaaggtccgg gtgtccgtgg agatagagaa
 720





gccccgagag gaactcttcc agctgttcgg ctatggagag gtggtgtttg tcagcaaaga
 780





tgtggccaag cacctggggt tccggtcagc aggggaggcc ctgaagggct tgtacagtcg
 840





tgtgaagaaa ggggctacgc tcatctgtgc ctgggctgag gagggagccg atgccctggg
 900





ccccgacggc cagctgctcc actcagatgc cttcccacca ccccgagtag tagacactct
 960





cggggctgga gacaccttca atgcctctgt catcttcagc ctctccaagg gaaacagcat
1020





gcaggaggcc ctgagattcg ggtgccaggt ggctggcaag aagtgtggct tgcaggggtt
1080





tgatggcatt gtgtgagaga tgagcggtgg gaggtagcag ctcgacacct cagaggctgg
1140





caccactgcc tgccattgcc ttcttcattt catccagcct ggcgtctggc tgcccagttc
1200





cctgggccag tgtaggctgt ggaacgggtc tttctgtctc ttctctgcag acacctggag
1260





caaataaatc ttcccctgag ccaaaaaaaa aaaaaaaaaa aaaaaaa
1307











<210>   32



<211> 1307


<212> DNA


<213> Rattus norvegicus


<400>   32









tttttttttt tttttttttt tttttggctc aggggaagat ttatttgctc caggtgtctg
  60






cagagaagag acagaaagac ccgttccaca gcctacactg gcccagggaa ctgggcagcc
 120





agacgccagg ctggatgaaa tgaagaaggc aatggcaggc agtggtgcca gcctctgagg
 180





tgtcgagctg ctacctccca ccgctcatct ctcacacaat gccatcaaac ccctgcaagc
 240





cacacttctt gccagccacc tggcacccga atctcagggc ctcctgcatg ctgtttccct
 300





tggagaggct gaagatgaca gaggcattga aggtgtctcc agccccgaga gtgtctacta
 360





ctcggggtgg tgggaaggca tctgagtgga gcagctggcc gtcggggccc agggcatcgg
 420





ctccctcctc agcccaggca cagatgagcg tagccccttt cttcacacga ctgtacaagc
 480





ccttcagggc ctcccctgct gaccggaacc ccaggtgctt ggccacatct ttgctgacaa
 540





acaccacctc tccatagccg aacagctgga agagttcctc tcggggcttc tctatctcca
 600





cggacacccg gaccttctgc tgcagaggct gcgtggcatt gtactgttct atccgctgta
 660





gcatctttac ctgttccgat gcattccggc cctcaatgtg gatccacttg aaccgggtca
 720





gatcgacctt ctcaaagtcc ttagcagaca catctggcag gttcgtgtcg tagagaataa
 780





tggtacggga gccattggag ttgttgacga tgcagcagga gcaaggggta tctccctggc
 840





tctgccaggc cacttgagac acatccacac ccctccgcct gaagtcggcc accaggaagt
 900





cggcaacatg gccatgggcc agcgagccca tgaaggcaca gcgggctccg agcaaggaaa
 960





gcacagtgca ggagttggac gcgttgcctc cacgctgcca tctctgggat aggcacctgc
1020





gatccgtgtc ttcctctggg tatttgtcca ccacattgat gatgtccagc accaccagcc
1080





ccacgcacag gatctgcttc tcttccatga ggctgctccc caagcttcct acccgcaagc
1140





ggaggggatt cctgctagac tctgtctctt atctaccgca ggaccgtgtc ccaacttctc
1200





aggggctacc ctggctcctc ctctgcctgc ggagctcctc ccgcagggtg ctttctgctg
1260





ttgcgagggt ttggttacct agtccggcca atggcagacc ctctcac
1307











<210>   33



<211> 2461


<212> DNA


<213> Oryctolagus cuniculus


<400>   33









cgagcccggg ggacgagcta ggaagctgag gtccgggagt gggaggtgtt gccacctgcg
  60






aggccaggtc ggccgcttcg gggagacctc gggatcggcc ctcttgggcc ggcctgggtc
 120





cttgggctgc ggcggccggg gccctgctcc gttccctgca ccctccggcg ccgccgtgga
 180





ctcccggggg aggagctgtg cacgcggagg aggagccggg gcagcccctg ggagcgggac
 240





cggccctgcg ggataagagg cagggcccgg gaaggcactc cgacagcctg gcgggcccaa
 300





agctcgggcg cagcctcatg gaggagaagc agatcctgtg cgtggggctg gtggtgctgg
 360





acgtcatcaa tgtagtggac aagtacccgg aggaggacac ggacagcagg tgcttgtccc
 420





agagatggca gcgtggaggc aatgcgtcca actcctgcac tgtgctgtcc ctgctcggag
 480





ccccctgtgc cttcatgggc tcgctggctg ctgaccacgt tgccgactgc gctgtgctcc
 540





cctcaacctt cgtcgaactg cgccccctgg ctcgcttgcc ctggcagctt tgtcctggag
 600





gacctgcgcc gctattctgt ggacctacgc tacacagtct ttcagaccca gggctctgtc
 660





cccacctcca cagtcatcat cagcgaggcc actgggagcc gcaccatcct ccacgcctac
 720





agcttcctgg tggccgactt caggcggcgg ggcgtggacg tgtctcaggt ggcctggcag
 780





gacaggggag agaccccctg ctcctgctgc atcgtcaaca gcaccaatgg ttcccgtacc
 840





attgtgctct acgacacgaa cctgccagat gtgtctgcta aggactttga gaaggttgat
 900





ctgaaccggt tcaagtggat ccacattgag ggacggaacg catcggagca ggtgaagatg
 960





ctgcagagga tagaacagca caacgccagg cagcctgcag agcagaggat ccgggtgtcc
1020





gtggagatag agaagccccg ggaggagctg ttccagctgt ttggctatgg agaggtggtg
1080





tttgtcagca aagacgtggc caggcacctg ggcttcggct ccgcggagga agccctcagg
1140





ggcttgtact cgcgtgtgcg gaaaggggcc acgctggtct gcgcctgggc cgagcagggc
1200





gccgacgcgc tgggccccga cggccagctg ctgcactccg acgccgtgtc gcccccacga
1260





gtggtggata ctctgggggc cggagacacc ttcaacgcct ccgtcatctt cagcctgtcc
1320





caggggaaga gcatgctgga ggcactgagg tttggctgca aggtggccgg caagaagtgt
1380





ggtgtgcatg gcttcgatgg catcgtgtga gaggccccag gcctggcatc gcccgtgtgt
1440





ccagcctggc gtcccagctg ccctgctcct tgctggccgt ggggaggggt ctgtgtgtgc
1500





cctgtgtcgc ctcccacccc tctccttgca gagccacaga gcaaataaac ctcctctgag
1560





ccggcgtccc ctctatctgc ttcctggtgg ctggggactc ccacggcttc caaccacggt
1620





cctccctcct cccctccatt cctcaacttg accttcacac ccagaccgct acaaggaggc
1680





gctgcccagg ccagggcagc aggaagtgcc ccagccttgc cacccgccct gtcctcgggg
1740





tgcagaaggc tcagccgtcc ctgcactggg cagaggcctt gagccatcac cccccccaac
1800





cccgccccga ccccctgcag gcaaggacgc ttcactcgta ccctgcagca agcctggaga
1860





aaatcgcccc tgggccccaa gcggctgagc ccctggactg gccagtgctt tggcagcctc
1920





tctgtggtca ggtggggcct tcaccgccca agcctgcctc cttgaggggc tgcctggagc
1980





ctgcaaggtc caccctcggc acctgcctta cggttaaggc agctgcgacc cagggtccag
2040





ggtcctccct ctggcagatc gggtgtggag ggcctgtggg aactggggac tgccacgctt
2100





tgcctggggt ttgagtgtcc cagggttcct gcgttggagt tcagtcccct ttgtgaggtg
2160





cgatgagggt gggaactgtg gggtgtagag gcagggcctg tgcgggtgtc tagacttaca
2220





caaggtcgtt agggttgagc tctgggattg aatcctggtg gttctgtatg aaggggacca
2280





cagcgcctgt gcgcgtgcac acgctcacac acacacacac gcacgcacac acagagcatc
2340





tcgccatgcg gtgccctgtg ccccttggga ctctcagcag gaaggccata tcaccagatg
2400





tggccccacc gcctgggacc agaactgcaa gccaaaataa acctcttttc tttataagtt
2460





a
2461











<210>   34



<211> 2461


<212> DNA


<213> Oryctolagus cuniculus


<400>   34









taacttataa agaaaagagg tttattttgg cttgcagttc tggtcccagg cggtggggcc
  60






acatctggtg atatggcctt cctgctgaga gtcccaaggg gcacagggca ccgcatggcg
 120





agatgctctg tgtgtgcgtg cgtgtgtgtg tgtgtgagcg tgtgcacgcg cacaggcgct
 180





gtggtcccct tcatacagaa ccaccaggat tcaatcccag agctcaaccc taacgacctt
 240





gtgtaagtct agacacccgc acaggccctg cctctacacc ccacagttcc caccctcatc
 300





gcacctcaca aaggggactg aactccaacg caggaaccct gggacactca aaccccaggc
 360





aaagcgtggc agtccccagt tcccacaggc cctccacacc cgatctgcca gagggaggac
 420





cctggaccct gggtcgcagc tgccttaacc gtaaggcagg tgccgagggt ggaccttgca
 480





ggctccaggc agcccctcaa ggaggcaggc ttgggcggtg aaggccccac ctgaccacag
 540





agaggctgcc aaagcactgg ccagtccagg ggctcagccg cttggggccc aggggcgatt
 600





ttctccaggc ttgctgcagg gtacgagtga agcgtccttg cctgcagggg gtcggggcgg
 660





ggttgggggg ggtgatggct caaggcctct gcccagtgca gggacggctg agccttctgc
 720





accccgagga cagggcgggt ggcaaggctg gggcacttcc tgctgccctg gcctgggcag
 780





cgcctccttg tagcggtctg ggtgtgaagg tcaagttgag gaatggaggg gaggagggag
 840





gaccgtggtt ggaagccgtg ggagtcccca gccaccagga agcagataga ggggacgccg
 900





gctcagagga ggtttatttg ctctgtggct ctgcaaggag aggggtggga ggcgacacag
 960





ggcacacaca gacccctccc cacggccagc aaggagcagg gcagctggga cgccaggctg
1020





gacacacggg cgatgccagg cctggggcct ctcacacgat gccatcgaag ccatgcacac
1080





cacacttctt gccggccacc ttgcagccaa acctcagtgc ctccagcatg ctcttcccct
1140





gggacaggct gaagatgacg gaggcgttga aggtgtctcc ggcccccaga gtatccacca
1200





ctcgtggggg cgacacggcg tcggagtgca gcagctggcc gtcggggccc agcgcgtcgg
1260





cgccctgctc ggcccaggcg cagaccagcg tggccccttt ccgcacacgc gagtacaagc
1320





ccctgagggc ttcctccgcg gagccgaagc ccaggtgcct ggccacgtct ttgctgacaa
1380





acaccacctc tccatagcca aacagctgga acagctcctc ccggggcttc tctatctcca
1440





cggacacccg gatcctctgc tctgcaggct gcctggcgtt gtgctgttct atcctctgca
1500





gcatcttcac ctgctccgat gcgttccgtc cctcaatgtg gatccacttg aaccggttca
1560





gatcaacctt ctcaaagtcc ttagcagaca catctggcag gttcgtgtcg tagagcacaa
1620





tggtacggga accattggtg ctgttgacga tgcagcagga gcagggggtc tctcccctgt
1680





cctgccaggc cacctgagac acgtccacgc cccgccgcct gaagtcggcc accaggaagc
1740





tgtaggcgtg gaggatggtg cggctcccag tggcctcgct gatgatgact gtggaggtgg
1800





ggacagagcc ctgggtctga aagactgtgt agcgtaggtc cacagaatag cggcgcaggt
1860





cctccaggac aaagctgcca gggcaagcga gccagggggc gcagttcgac gaaggttgag
1920





gggagcacag cgcagtcggc aacgtggtca gcagccagcg agcccatgaa ggcacagggg
1980





gctccgagca gggacagcac agtgcaggag ttggacgcat tgcctccacg ctgccatctc
2040





tgggacaagc acctgctgtc cgtgtcctcc tccgggtact tgtccactac attgatgacg
2100





tccagcacca ccagccccac gcacaggatc tgcttctcct ccatgaggct gcgcccgagc
2160





tttgggcccg ccaggctgtc ggagtgcctt cccgggccct gcctcttatc ccgcagggcc
2220





ggtcccgctc ccaggggctg ccccggctcc tcctccgcgt gcacagctcc tcccccggga
2280





gtccacggcg gcgccggagg gtgcagggaa cggagcaggg ccccggccgc cgcagcccaa
2340





ggacccaggc cggcccaaga gggccgatcc cgaggtctcc ccgaagcggc cgacctggcc
2400





tcgcaggtgg caacacctcc cactcccgga cctcagcttc ctagctcgtc ccccgggctc
2460





g
2461











<210>   35



<211> 1773


<212> DNA


<213> Macaca mulatta


<400>   35









gggccgggca gccgcgacca cggtcttcag gcagggctgc agatgcaggc ccagctctac
  60






ctcgcgggtc cagggtcggg agtccgagac gcaggtgcag cagagggcgg ggcacgtagc
 120





gcatttccag cgcattttct ctttgcattc tcgagatcgc ttagccgcgc tttagaaagg
 180





tttgcatcag ctccgagtcc atctgacaag cgaggaaact gaggctgaga agtgggaggc
 240





gttgccatct gcaggcccag gcaacctgct acgggaagac cgggggccaa gacctccggg
 300





ttggctttcc caggccagct tgggtcttcg ggtgtcggga gcaaaggccc agctcctttc
 360





gtttcctgca cccctcgccg ctgcaggtgg ctccctggag gaggagctcc cacgcggagg
 420





aggagccagg gcagctggga gcgaggacac catcctcctg gataacaggc agaggccggg
 480





aggaacccgt cagtcgggcg ggcaggaagc tctgggatca gcctcatgga agagaagcag
 540





atcctgtgcg tggggctagt ggtgctggac gtcatcagcc tggtggacaa gtaccctaag
 600





gaggactcag agataaggtg cttgtcccag agatggcaac gcggaggcaa cgcgtccaac
 660





tcctgcaccg ttctctccct gctcggagcc ccctgtgcct tcatgggctc aatggcccct
 720





ggccatgttg ctgattttgt cctggatgac ctccgccgct attctgtgga cctacgctac
 780





acggtctttc agaccacggg ctccgtcccc atcgccacgg tcatcatcaa cgaggccagt
 840





ggtagccgca ccatcctata ctacgacagc ttcctggtgg ccgacttcag gcggcggggt
 900





gtggacgtgt ctcaggtggc ctggcagagc aagggggaca cccccagctc ctgctgcatc
 960





atcaacaact ccaatggcaa ccgtaccatt gtgctccatg acacgagcct gccagatgtg
1020





tctgctacgg actttgagaa ggttgatctg acccagttca agtggatcca cattgagggc
1080





cggaacgcat cggagcaggt gaagatgctg cagcggatag acgcgcacaa caccaggcag
1140





cctccagagc agaagatccg ggtgtccgtg gaggtggaga agccacaaga ggagctcttt
1200





cagctgtttg gctacggaga cgtggtgttt gtcagcaaag atgtggccaa gcacttgggg
1260





ttccagtcag caggggaagc cctgaggggc ttgtatggtc gtgtgaggaa aggggctgtg
1320





cttgtctgtg cctgggctga ggagggcgcc gacgccctgg gccctgatgg caaactgatc
1380





cactcggatg ctttcccgcc accccgcgtg gtggataccc tgggggctgg agacaccttc
1440





aatgcctccg tcatcttcag cctctcccag gggaggagcg tgcaggaagc actgagattc
1500





ggatgccagg tggccggcaa gaagtgtggc cagcagggct ttgatggcat cgtgtcagag
1560





ccggtgcggt aggaggtgcc ggctccccgc acactatgga ggctgacatt gcggctgcat
1620





cgccttctcc cctccatcca gcctggcatc caggttgccc tgctcagggg acagatgcag
1680





gctgtgggga ggactccgcc tgtgtcctgt gttccccaca cgtctctccc tgcagagcct
1740





cagagcgaat aaatcttcct cagagccagc ttc
1773











<210>   36



<211> 1773


<212> DNA


<213> Macaca mulatta


<400>   36









gaagctggct ctgaggaaga tttattcgct ctgaggctct gcagggagag acgtgtgggg
  60






aacacaggac acaggcggag tcctccccac agcctgcatc tgtcccctga gcagggcaac
 120





ctggatgcca ggctggatgg aggggagaag gcgatgcagc cgcaatgtca gcctccatag
 180





tgtgcgggga gccggcacct cctaccgcac cggctctgac acgatgccat caaagccctg
 240





ctggccacac ttcttgccgg ccacctggca tccgaatctc agtgcttcct gcacgctcct
 300





cccctgggag aggctgaaga tgacggaggc attgaaggtg tctccagccc ccagggtatc
 360





caccacgcgg ggtggcggga aagcatccga gtggatcagt ttgccatcag ggcccagggc
 420





gtcggcgccc tcctcagccc aggcacagac aagcacagcc cctttcctca cacgaccata
 480





caagcccctc agggcttccc ctgctgactg gaaccccaag tgcttggcca catctttgct
 540





gacaaacacc acgtctccgt agccaaacag ctgaaagagc tcctcttgtg gcttctccac
 600





ctccacggac acccggatct tctgctctgg aggctgcctg gtgttgtgcg cgtctatccg
 660





ctgcagcatc ttcacctgct ccgatgcgtt ccggccctca atgtggatcc acttgaactg
 720





ggtcagatca accttctcaa agtccgtagc agacacatct ggcaggctcg tgtcatggag
 780





cacaatggta cggttgccat tggagttgtt gatgatgcag caggagctgg gggtgtcccc
 840





cttgctctgc caggccacct gagacacgtc cacaccccgc cgcctgaagt cggccaccag
 900





gaagctgtcg tagtatagga tggtgcggct accactggcc tcgttgatga tgaccgtggc
 960





gatggggacg gagcccgtgg tctgaaagac cgtgtagcgt aggtccacag aatagcggcg
1020





gaggtcatcc aggacaaaat cagcaacatg gccaggggcc attgagccca tgaaggcaca
1080





gggggctccg agcagggaga gaacggtgca ggagttggac gcgttgcctc cgcgttgcca
1140





tctctgggac aagcacctta tctctgagtc ctccttaggg tacttgtcca ccaggctgat
1200





gacgtccagc accactagcc ccacgcacag gatctgcttc tcttccatga ggctgatccc
1260





agagcttcct gcccgcccga ctgacgggtt cctcccggcc tctgcctgtt atccaggagg
1320





atggtgtcct cgctcccagc tgccctggct cctcctccgc gtgggagctc ctcctccagg
1380





gagccacctg cagcggcgag gggtgcagga aacgaaagga gctgggcctt tgctcccgac
1440





acccgaagac ccaagctggc ctgggaaagc caacccggag gtcttggccc ccggtcttcc
1500





cgtagcaggt tgcctgggcc tgcagatggc aacgcctccc acttctcagc ctcagtttcc
1560





tcgcttgtca gatggactcg gagctgatgc aaacctttct aaagcgcggc taagcgatct
1620





cgagaatgca aagagaaaat gcgctggaaa tgcgctacgt gccccgccct ctgctgcacc
1680





tgcgtctcgg actcccgacc ctggacccgc gaggtagagc tgggcctgca tctgcagccc
1740





tgcctgaaga ccgtggtcgc ggctgcccgg ccc
1773






EQUIVALENTS

Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments and methods described herein. Such equivalents are intended to be encompassed by the scope of the following claims.

Claims
  • 1. A double stranded ribonucleic acid (dsRNA) for inhibiting expression of ketohexokinase (KHK) in a cell, (a) wherein said dsRNA comprises a sense strand and an antisense strand forming a double stranded region, wherein the antisense strand comprises a region of complementarity to an mRNA encoding KHK, and wherein the region of complementarity comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from any one of the antisense nucleotide sequences in any one of Tables 2-5; or(b) wherein said dsRNA comprises a sense strand and an antisense strand forming a double stranded region, wherein the sense strand comprises at least 15 contiguous nucleotides differing by no more than three nucleotides from any one of the nucleotide sequence of nucleotides 943-965; 788-810; 734-756; 1016-1038; 1013-1035; 1207-1229; 1149-1171; 574-596; 1207-1229 or 828-850 of SEQ ID NO: 1, and the antisense strand comprises at least 15 contiguous nucleotides from the corresponding nucleotide sequence of SEQ ID NO:2.
  • 2.-5. (canceled)
  • 6. The dsRNA agent of claim 1, wherein all of the nucleotides of the sense strand comprise a modification; all of the nucleotides of the antisense strand comprise a modification; or all of the nucleotides of the sense strand and all of the nucleotides of the antisense strand comprise a modification.
  • 7. The dsRNA agent of claim 6, wherein at least one of the modified nucleotides is selected from the group consisting of a deoxy-nucleotide, a 3′-terminal deoxythymidine (dT) nucleotide, a 2′-O-methyl modified nucleotide, a 2′-fluoro modified nucleotide, a 2′-deoxy-modified nucleotide, a locked nucleotide, an unlocked nucleotide, a conformationally restricted nucleotide, a constrained ethyl nucleotide, an abasic nucleotide, a 2′-amino-modified nucleotide, a 2′-O-allyl-modified nucleotide, 2′-C-alkyl-modified nucleotide, 2′-hydroxly-modified nucleotide, a 2′-methoxyethyl modified nucleotide, a 2′-O-alkyl-modified nucleotide, a morpholino nucleotide, a phosphoramidate, a non-natural base comprising nucleotide, a tetrahydropyran modified nucleotide, a 1,5-anhydrohexitol modified nucleotide, a cyclohexenyl modified nucleotide, a nucleotide comprising a phosphorothioate group, a nucleotide comprising a methylphosphonate group, a nucleotide comprising a 5′-phosphate, a nucleotide comprising a 5′-phosphate mimic, a thermally destabilizing nucleotide, a glycol modified nucleotide (GNA), and a 2-O—(N-methylacetamide) modified nucleotide; and combinations thereof.
  • 8.-11. (canceled)
  • 12. The dsRNA agent of claim 1, wherein the double stranded region is 19-30 nucleotide pairs in length.
  • 13.-16. (canceled)
  • 17. The dsRNA agent of claim 1, wherein each strand is independently no more than 30 nucleotides in length.
  • 18.-21. (canceled)
  • 22. The dsRNA agent of claim 1, wherein at least one strand comprises a 3′ overhang of at least 1 nucleotide or wherein at least one strand comprises a 3′ overhang of at least 2 nucleotides.
  • 23. (canceled)
  • 24. The dsRNA agent of claim 1, further comprising a ligand.
  • 25. The dsRNA agent of claim 24, wherein the ligand is conjugated to the 3′ end of the sense strand of the dsRNA agent.
  • 26. The dsRNA agent of claim 24, wherein the ligand is an N-acetylgalactosamine (GalNAc) derivative.
  • 27. The dsRNA agent of claim 24, wherein the ligand is one or more GalNAc derivatives attached through a monovalent, bivalent, or trivalent branched linker.
  • 28. The dsRNA agent of claim 26, wherein the ligand is
  • 29. The dsRNA agent of claim 28, wherein the dsRNA agent is conjugated to the ligand as shown in the following schematic
  • 30. The dsRNA agent of claim 29, wherein the X is O.
  • 31. The dsRNA agent of claim 1, wherein the dsRNA agent further comprises at least one phosphorothioate or methylphosphonate internucleotide linkage.
  • 32.-40. (canceled)
  • 41. An isolated cell containing the dsRNA agent of claim 1.
  • 42. A pharmaceutical composition for inhibiting expression of a gene encoding ketohexokinase (KHK) comprising the dsRNA agent of claim 1.
  • 43.-47. (canceled)
  • 48. A method of inhibiting expression of a ketohexokinase (KHK) gene in a cell, the method comprising contacting the cell with the dsRNA agent of claim 1, thereby inhibiting expression of the KHK gene in the cell.
  • 49.-53. (canceled)
  • 54. A method of treating a subject having a disorder that would benefit from reduction in ketohexokinase expression, comprising administering to the subject a therapeutically effective amount of the dsRNA agent of claim 1, thereby treating the subject having the disorder that would benefit from reduction in ketohexokinase expression.
  • 55. (canceled)
  • 56. The method of claim 54, wherein the disorder is a ketohexokinase-associated disorder.
  • 57. The method of claim 56, wherein the KHK-associated disease is selected from the group consisting of liver disease, dyslipidemia or abnormal lipid deposition or dysfunction, a disorder of glycemic control, kidney disease, and cardiovascular disease.
  • 58.-66. (canceled)
  • 67. The method of claim 54, wherein the subject is human.
  • 68. (canceled)
  • 69. The method of claim 54, wherein the dsRNA agent is administered to the subject at a dose of about 0.01 mg/kg to about 50 mg/kg.
  • 70. The method of claim 54, wherein the dsRNA agent is administered to the subject subcutaneously.
  • 71.-76. (canceled)
  • 77. A kit, a vial, or a syringe comprising the dsRNA agent of claim 1.
  • 78. (canceled)
  • 79. (canceled)
RELATED APPLICATIONS

This application is a 35 § U.S.C. 111(a) continuation application which claims the benefit of priority to PCT/US2021/020983, filed on Mar. 5, 2021, which claims the benefit of priority to U.S. Provisional Application No. 62/985,948, filed on Mar. 6, 2020. The entire contents of each of the foregoing applications are incorporated herein by reference.

Provisional Applications (1)
Number Date Country
62985948 Mar 2020 US
Continuations (1)
Number Date Country
Parent PCT/US2021/020983 Mar 2021 US
Child 17900921 US