METHODS FOR TREATING OR PREVENTING CONTACT-ACTIVATION PATHWAY-ASSOCIATED DISEASES USING iRNA COMPOSITIONS TARGETING FACTOR XII (HAGEMAN FACTOR) (F12)

Abstract
The present invention relates to methods of use of RNAi agents, e.g., double stranded RNAi agents, targeting a Factor XII (Hageman Factor (F12) gene, for treating subjects having a contact activation pathway-associated disease, such as a thrombophilia or hereditary angioedema (HAE), methods for preventing at least one symptom in a subject having a contact activation pathway-associated disease, such as a thrombus formation or an angioedema attack, and RNAi agents targeting an F12 gene, for use in the methods of the invention.
Description
SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted electronically in XML format and is hereby incorporated by reference in its entirety. Said XML copy, created on Feb. 20, 2024, is named 121301_07604_SL.xml and is 9,423,173 bytes in size. The sequence listing is part of the specification and is incorporated in its entirety by reference herein.


BACKGROUND OF THE INVENTION

The blood coagulation system is essential for hemostasis, responding to vascular injury with local production of a clot formed of fibrin mesh and activated platelets. Blood coagulation, thrombin generation, and fibrin formation can be initiated by two distinct pathways, referred to as the extrinsic and intrinsic pathways.


The extrinsic pathway involves binding of plasma factor VIIa (FVIIa) to extravascular tissue factor (TF) at a site of vessel injury.


The intrinsic pathway is initiated by the surface-dependent activation of plasma factor XII (F12) to F12a in a process called contact activation. Contact activation involves two other proteins, prekallikrein and high molecular weight kininogen which circulate as a bi-molecular complex. Collectively, these three proteins, FXII, prekallikrein and HK, comprise the “contact activation pathway,” also referred to as the “Kallikrein-Kinin System.” When the contact activation pathway is initiated by binding of F12 to negatively charged surfaces (or macromolecules), a conformational change in F12 is induced resulting in formation of active F12 (F12a). F12a cleaves prekallikrein to generate active kallikrein ((α-kallikrein), which in turn reciprocally activates F12 to generate additional F12a. The active kallikrein then digests high-molecular-weight kininogen to liberate bradykinin. F12a generated by contact activation also activates factor XI (F11) to F11a, triggering a series of proteolytic cleavage events that culminates in thrombin generation and fibrin clot formation.


Interestingly, it has been shown that the contact system is not required for hemostasis.


Humans and other animals deficient in a contact activation protein are largely asymptomatic and homozygous F12 deficiency is not associated with any disease or disorder. However, the contact system has been shown to play an important role in thrombotic disease, as pharmacologic inhibition of F12a or ablation of the F12 or high molecular weight kininogen genes can protect mice from experimentally induced thrombosis in a variety of models.


In healthy subjects, a homeostatic balance between procoagulant forces and anticoagulant and fibrinolytic forces exists. However, numerous genetic, acquired, and environmental factors can dysregulate this balance in favor of coagulation, leading to thrombosis, the pathologic formation of thrombi, triggering life-threatening events For example, formation of thrombi in a vein may result in, e.g., deep venous thrombosis (DVT), and formation of thrombi in an artery or a cardiac chamber may result in, e.g., myocardial infarction or stroke. Thrombi may obstruct blood flow at the site of formation or detach and embolize to block a distant blood vessel (e.g., a pulmonary embolism or embolic stroke).


Acquired/enviornomental factors that can lead to pathological contact activation and contact pathway-mediated thrombosis include various dental, surgical and medical settings, such as atrial fibrillation, cancer treatment, immobilization, central venous catheters, implants, and extracorporeal oxygenation. As a result of such medical and surgical settings, tissue damage releases tissue factor and exposes various triggers of the contact pathway, such as DNA, RNA, phosphate, collagen, and laminin) which activate the contact pathway leading to thrombosis.


A genetic disorder that dysregulates the homeostatic balance between procoagulant forces and anticoagulant and fibrinolytic forces is Hereditary Angioedema (HAE). HAE is a rare autosomal dominant disorder that causes recurrent edema and swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genetials and a nonpruritic rash in one-third of patients. Untreated HAE patients experience an average of one-to-two angioedema attacks per month, but the frequency and severity of episodes can vary significantly. Edema swelling is often disfiguring and disabling, results in frequent hospitalization, and patients sometimes require psychiatric care to treat disease-associated anxiety. Abdominal attacks can cause severe pain, nausea and vomiting, and sometimes lead to inappropriate surgeries. Furthermore, over half of HAE patients also experience life-threatening laryngeal edema during their lifetime that may require emergency tracheostomy to prevent asphyxiation. HAE affects an estimated 6,000 to 10,000 individuals of varying ethnic groups in the United States and causes significant economic harm to patients, accounting for 15,000 to 30,000 hospital visits and 20 to 100 sick days per year.


HAE results from a mutation of the C1 inhibitor (C1INH, SERPING1) gene that results in a deficiency of C1INH protein. Over 250 different C1INH mutations have been demonstrated to cause an HAE clinical presentation. These C1INH mutations are typically inherited genetically, however, up to 25% of HAE cases result from de novo mutation of C1INH. HAE type I is caused by C1INH mutations that result in lower levels of truncated or misfolded proteins that are inefficiently secreted, and accounts for approximately 85% of HAE cases. HAE type II constitutes about 15% of cases and is caused by mutations near the C1INH's active site that result in normal levels of dysfunctional C1INH protein. In addition, HAE type III, a rare third form the disease, occurs because of a gain-of-function mutation in coagulation factor XII (F12) (Hageman Factor).


C1 inhibitor is a serine protease inhibitor of the serpin family and a major inhibitor of proteases in the complement and contact activation pathways, as well as a minor inhibitor of fibrinolytic protease plasmin. These plasma proteolytic cascades are activated during an HAE attack, generating substances that increase vascular permeability, e.g., bradykinin. Studies have shown that the bradykinin peptide, which activates proinflammatory signaling pathways that dilate vessels and induces chemotaxis of neutrophils, is the primary substance that enhances vascular permeability in an HAE attack by binding to the bradykinin receptor on vascular endothelial cells.


Typically, C1INH inhibits the autoactivation of F12 the ability of F12a to activate prekallilrein, the activation of high molecular weight kininogen by kallikrein, and the feedback activation of F12 by kallikrein. Consequently, mutations causing C1INH deficiency or F12 gain-of-function result in excess production of bradykinin and onset of HAE angioedema.


Currently, HAE may be treated with 17α-alkylated androgens prophylactically to reduce to probability of recurrent episodes, or with disease-specific therapeutics to treat acute attacks. About 70% of individuals with HAE are treated with androgens or remain untreated, and about 30% receive therapeutics. Androgens are unsuitable for short-term treatment of acute attacks because they take several days to become effective, and they can have significant side effects and may affect growth and development adversely. As a result, androgens are used only for long-term prophylaxis and are typically not administered to pregnant women or children. Furthermore, current therapeutics used to treat acute attacks must be administered intravenously numerous times per week or may cause side-effects that require drug administration and subsequent patient monitoring in a hospital, thereby limiting their regular prophylactic use to manage the disease long-term. Therefore, in the absence of regimens which be administered safely, effectively and by more convenient routes and regimens to treat acute angioedema attacks and prophylactically manage recurrent attacks in a large proportion of patients, including pregnant women and children, there is a need for alternative therapies for subjects suffering from HAE.


Accordingly, there is a need in the art for compositions and methods to inhibit thrombosis in a subject at risk of forming a thrombus, such as a subject having a genetic, an acquired, or an environmental risk of forming a thrombus.


SUMMARY OF THE INVENTION

The present invention provides methods of treating or preventing a subject having a contact activation pathway-associated disease, e.g., thrombophilia, hereditary angioedema (HAE), Flectcher Factor Deficiency, or essential hypertension, using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a Factor XII (F12) gene. The present invention also provides methods of preventing at least one symptom, such as thrombus formation or an angioedema attack, in a subject having a contact activation pathway-associated disease using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a Factor XII (F12) gene. In addition, the present invention provides iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a contact activation pathway-associated gene, such as a Factor XII (F12) gene, for use in the methods of the present invention.


Accordingly, in one aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) agent for use in the treatment of a subject having a contact activation pathway-associated disease. The dsRNA agent includes 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 F12, wherein the region of complementarity comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899), wherein when the dsRNA agent is administered to the subject, hemostasis in the subject is not inhibited.


In another aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) agent that inhibits the expression of F12 for use in preventing at least one symptom in a subject having a contact activation pathway-associated disease. The dsRNA agent includes 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 F12, wherein the region of complementarity comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899), wherein when the dsRNA agent to the subject, hemostasis in the subject is not inhibited.


In one aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) agent that inhibits the expression of F12 for use in preventing formation of a thrombus in a subject at risk of forming a thrombus. The dsRNA agent includes 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 F12, wherein the region of complementarity comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899), wherein when the dsRNA agent to the subject, hemostasis in the subject is not inhibited.


In one embodiment, the subject is a human.


The contact activation pathway-associated disease may be thrombophilia, hereditary angioedema (HAE), Flectcher Factor Deficiency, or essential hypertension.


Administration of the dsRNA agent to the subject may decrease platelet deposition in the subject and/or decrease fibrin deposition in the subject.


The dsRNA may be suitable for administration to the subject at a dose of about 0.01 mg/kg to about 10 mg/kg or about 0.5 mg/kg to about 50 mg/kg.


In one embodiment, the dsRNA agent is suitable for subcutaneous administration to the subject.


The region of complementarity may be at least 16, 17, 18, 19, 20, 21, 22, or 23 nucleotides in length.


In one embodiment, each strand of the dsRNA may is no more than 30 nucleotides in length.


In one embodiment, each of the sense strand and the antisense strand independently is 21 to 23 nucleotides in length. In another embodiment, the sense strand is 21 nucleotides in length and the antisense strand is 23 nucleotides in length.


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


In one embodiment, substantially all of the nucleotides of the dsRNA agent are modified nucleotides.


In one embodiment, the modified nucleotide of the dsRNA agent is selected from the group consisting of a deoxy-nucleotide, a 3′-terminal deoxy-thymine (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, and a nucleotide comprising a 5′-phosphate mimic.


In one embodiment, the dsRNA agent further comprises at least one phosphorothioate internucleotide linkage. In another embodiment, the dsRNA agent further comprises 6-8 phosphorothioate internucleotide linkages.


In one embodiment, at least one strand of the dsRNA agent comprises a 3′ overhang of at least 1 nucleotide. In another embodiment, the dsRNA agent, at least one strand of the dsRNA agent 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 through a monovalent, a bivalent, or a trivalent branched linker.


In one embodiment, the ligand is




embedded image


In one embodiment, the dsRNA 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 comprises a sense strand comprising the nucleotide sequence of 5′-AACUCAAUAAAGUGCUUUGAA-3′ (SEQ ID NO:891), and an antisense strand comprising the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899).


In one embodiment, the dsRNA agent comprises a sense strand comprising the sequence of 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO:907) and an antisense strand comprising the sequence of 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO:915), and wherein a, c, g, and u are 2′-O-methyl (2′-OMe) A, C, G, and U; Af, Cf, Gf, and Uf are 2′-fluoro A, C, G, and U; and s is a phosphorothioate linkage.


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


In one aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) agent for use in the treatment of a subject having a contact activation pathway-associated disease. The dsRNA agent includes a sense strand and an antisense strand forming a double stranded region, wherein the sense strand comprises the sequence of 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO:907) and an antisense strand comprising the sequence of 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO:915), and wherein a, c, g, and u are 2′-O-methyl (2′-OMe) A, C, G, and U; Af, Cf, Gf, and Uf are 2′-fluoro A, C, G, and U; and s is a phosphorothioate linkage, wherein when the dsRNA agent is administered to the subject, hemostasis in the subject is not inhibited.


In another aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) agent that inhibits the expression of F12 for use in preventing at least one symptom in a subject having a contact activation pathway-associated disease. The dsRNA agent includes a sense strand and an antisense strand forming a double stranded region, wherein the sense strand comprises the sequence of 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO:907) and an antisense strand comprising the sequence of 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO:915), and wherein a, c, g, and u are 2′-O-methyl (2′-OMe) A, C, G, and U; Af, Cf, Gf, and Uf are 2′-fluoro A, C, G, and U; and s is a phosphorothioate linkage, wherein when the dsRNA agent is administered to the subject, hemostasis in the subject is not inhibited.


In one aspect, the present invention provides a double stranded ribonucleic acid (dsRNA) agent that inhibits the expression of F12 for use in preventing formation of a thrombus in a subject at risk of forming a thrombus. The dsRNA agent includes a sense strand and an antisense strand forming a double stranded region, wherein the sense strand comprises the sequence of 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO:907) and an antisense strand comprising the sequence of 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO:915), and wherein a, c, g, and u are 2′-O-methyl (2′-OMe) A, C, G, and U; Af, Cf, Gf, and Uf are 2′-fluoro A, C, G, and U; and s is a phosphorothioate linkage, wherein when the dsRNA agent is administered to the subject, hemostasis in the subject is not inhibited.


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


In one embodiment, the subject is a human.


The contact activation pathway-associated diseasemay be thrombophilia, hereditary angioedema (HAE), Flectcher Factor Deficiency, or essential hypertension.


Administration of the dsRNA agent to the subject may decrease platelet deposition in the subject and/or decrease fibrin deposition in the subject.


In one aspect, the present invention provides a method of treating a subject having a contact activation pathway-associated disease. The method includes administering to the subject a therapeutically effective amount of a double stranded ribonucleic acid (dsRNA) agent for inhibiting expression of F12, wherein the dsRNA agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, wherein administration of the dsRNA agent to the subject does not inhibit hemostasis in the subject, thereby treating the subject.


In another aspect, the present invention provides a method of preventing at least one symptom in a subject having a contact activation pathway-associated disease. The method includes administering to the subject a prohylactically effective amount of a double stranded ribonucleic acid (dsRNA) agent for inhibiting expression of F12, wherein the dsRNA agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, wherein administration of the dsRNA agent to the subject does not inhibit hemostasis in the subject, thereby preventing at least one symptom in the subject.


In one aspect, the present invention provides a method of preventing formation of a thrombus in a subject at risk of forming a thrombus. The method includes administering to the subject a prophylactically effective amount of a double stranded ribonucleic acid (dsRNA) agent for inhibiting expression of F12, wherein the dsRNA agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, wherein administration of the dsRNA agent to the subject does not inhibit hemostasis in the subject, thereby preventing formation of a thrombus in the subject at risk of forming a thrombus.


In one embodiment, the subject is a human.


The contact activation pathway-associated disease may be thrombophilia, hereditary angioedema (HAE), Flectcher Factor Deficiency, or essential hypertension.


The administration of the dsRNA agent to the subject may decrease platelet deposition in the subject and/or may decrease fibrin deposition in the subject.


The dsRNA agent may be administered to the subject at a dose of about wherein the dsRNA is administered at a dose of about 0.01 mg/kg to about 10 mg/kg or about 0.5 mg/kg to about 50 mg/kg.


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


The region of complementarity of the dsRNA agents for use in the methods of the invention may be at least 17 nucleotides in length.


Each strand of the dsRNA agents for use in the methods of the invention may be no more than 30 nucleotides in length.


In one embodiment, the dsRNA agent for use in the methods of the invention comprises at least one modified nucleotide.


In another embodiment, substantially all of the nucleotides of the dsRNA agent are modified nucleotides.


In one embodiment, the modified nucleotide of the dsRNA agent for use in the methods of the invention is selected from the group consisting of a deoxy-nucleotide, a 3′-terminal deoxy-thymine (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, and a nucleotide comprising a 5′-phosphate mimic.


In one embodiment, the dsRNA agent for use in the methods of the invention further comprises at least one phosphorothioate internucleotide linkage.


In one embodiment, at least one strand of the dsRNA agent for use in the methods of the invention comprises a 3′ overhang of at least 1 nucleotide.


In one embodiment, at least one strand of the dsRNA agent for use in the methods of the invention further comprises a ligand.


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


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




embedded image


In certain embodiments, the dsRNA 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 antisense strand of the dsRNA agent comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotide from the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899).


In one embodiment, the dsRNA agent comprises a sense strand comprising the nucleotide sequence of 5′-AACUCAAUAAAGUGCUUUGAA-3′ (SEQ ID NO:891), and an antisense strand comprising the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899).


In one embodiment, the dsRNA agent comprises a sense strand comprising the sequence of 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO:907) and an antisense strand comprising the sequence of 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO:915), and wherein a, c, g, and u are 2′-O-methyl (2′-OMe) A, C, G, and U; Af, Cf, Gf, and Uf are 2′-fluoro A, C, G, and U; and s is a phosphorothioate linkage.


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


In one embodiment, the methods and uses of the invention further comprise administering to the subject a double stranded RNAi agent of the invention targeting KLKB1. In another embodiment, the methods and uses of the invention further comprise administering to the subject a double stranded RNAi agent of the invention targeting KNG1.


In one embodiment, the administration of the double stranded RNAi to the subject causes a decrease in bradykinin levels or a decrease in coagulation factor XII activity.


In certain embodiment, the at least one symptom is an angioedema attack. In one embodiment, the at least one symptom is a thrombus formation.


In one embodiment, the methods and uses of the invention further comprise administering an anti-KLKB1 antibody, or antigen-binding fragment thereof, to the subject.


In one embodiment, the methods and uses of the invention further comprise measuring bradykinin and/or coagulation factor XII levels in the subject.


In one embodiment, the subject at risk of forming a thrombus has a contact activation pathway-associated disease or disorder.


In one embodiment, the contact activation pathway-associated disease is thrombophilia. In another embodiment, the contact activation pathway-associated disease is hereditary angioedema (HAE).


In other embodments, the contact activation pathway-associated disease is Flectcher Factor Deficiency or essential hypertension.


In one embodiment, the subject at risk of forming a thrombus is selected from the group consisting of a surgical patient; a medical patient; a pregnant subject; a postpartum subject; a subject that has previously had a thrombus; a subject undergoing hormone replacement therapy; a subject sitting for long periods; and an obese subject.


In another aspect, the present invention provides methods for inhibiting F12 expression in a cell.


The methods include contacting the cell with a double stranded RNAi agent or a pharmaceutical composition of the invention; and maintaining the cell for a time sufficient to obtain degradation of the mRNA transcript of a F12 gene, thereby inhibiting expression of the F12 gene in the cell.


In one aspect, the present invention provides double stranded ribonucleic acid (RNAi) agents for inhibiting expression of Factor XII (Hageman Factor) (F12), wherein the double stranded RNAi agent comprises a sense strand and an antisense strand, wherein the sense strand comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of SEQ ID NO:9 and the antisense strand comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of SEQ ID NO:10.


In another aspect, the present invention provides double stranded ribonucleic acid (RNAi) agents for inhibiting expression of a Factor XII (Hageman Factor) (F12), wherein the double stranded RNAi agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from any one of the antisense sequences listed in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18.


In another aspect, the present invention provides double stranded ribonucleic acid (RNAi) agents for inhibiting expression of a Factor XII (Hageman Factor) (F12), wherein the double stranded RNAi agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2060 of SEQ ID NO:9. In some embodiments, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2030 of SEQ ID NO:9. In other embodiments, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2030-2060 of SEQ ID NO:9. In one embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2010-2040 of SEQ ID NO:9. In one embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2010-2035 of SEQ ID NO:9. In another embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2015-2040 of SEQ ID NO:9. In another embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides fromthe complement of nucleotides 2015-2045 of SEQ ID NO:9. In another embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2020-2050 of SEQ ID NO:9. In another embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2020-2045 of SEQ ID NO:9. In still other embodiments, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from any one of the ranges of SEQ ID NO:9 provided in Table 14 or 15. In one embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2018-2040 of SEQ ID NO:9. In one embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of the antisense strand of AD-67244 (5′-UUCAAAGCACUUUAUUGAGUUUC-3′) (SEQ ID NO: 899). In one embodiment, the sense strand comprises the sense strand nucleotide sequence of AD-67244. In some embodiments, the region of complementarity comprises 15, 16, 17, 18, 19, 20, 21, 22, or 23 nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2015-2040 of SEQ ID NO:9. In some embodiments, the region of complementarity comprises 15, 16, 17, 18, 19, 20, 21, 22, or 23 nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2015-2045 of SEQ ID NO:9. In some embodiments, the region of complementarity comprises 15, 16, 17, 18, 19, 20, 21, 22, or 23 nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2018-2040 of SEQ ID NO:9. In some embodiments, the region of complementarity comprises 15, 16, 17, 18, 19, 20, 21, 22, or 23 nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2018-2045 of SEQ ID NO:9. In one embodiment, the agent comprises at least one modified nucleotide. In another embodiment, all of the nucleotides of theagent are modified nucleotides. In one embodiment, the agent further comprises a ligand, e.g., a ligand attached to the 3′-end of the sense strand. In one embodiment, the sense strand and the antisense strand are each independently 15-30 nucleotides in length. In another embodiment, the sense strand and the antisense strand are each independently 19-25 nucleotides in length.


In one embodiment, the antisense strand comprises a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from any one of the antisense sequences listed in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18.


In one embodiment, the double stranded RNAi agents provided herein comprise at least one modified nucleotide.


In another aspect, the present invention provides double stranded ribonucleic acid (RNAi) agents for inhibiting expression of Factor XII (Hageman Factor) (F12), wherein the double stranded RNAi 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 3 nucleotides from the nucleotide sequence of SEQ ID NO:9 and the antisense strand comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the nucleotide sequence of SEQ ID NO:10, wherein substantially all of the nucleotides of the sense strand and substantially all of the nucleotides of the antisense strand are modified nucleotides, and wherein the sense strand is conjugated to a ligand attached at the 3′-terminus.


In certain embodiments, the dsRNA comprises at least one modified nucleotide. In certain embodiments, the dsRNA comprises no more than 4 (i.e., 4, 3, 2, 1, or 0) unmodified nucleotides in the sense strand. In certain embodiments, the dsRNA comprises no more than 4 (i.e., 4, 3, 2, 1, or 0) unmodified nucleotides in the antisense strand. In certain embodiments, the dsRNA comprises no more than 4 (i.e., 4, 3, 2, 1, or 0) unmodified nucleotides in both the sense strand and the antisense strand. In certain embodiments, all of the nucleotides in the sense strand of the dsRNA are modified nucleotides. In certain embodiments, all of the nucleotides in the antisense strand of the dsRNA are modified nucleotides. In certain embodiments, all of the nucleotides in the sense strand of the dsRNA and all of the nucleotides of the antisense strand are modified nucleotides.


In certain embodiments, the at least one of the modified nucleotides is selected from the group consisting of a deoxy-nucleotide, a 3′-terminal deoxy-thymine (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, and a nucleotide comprising a 5′-phosphate mimic, e.g., a vinyl phosphate.


In one embodiment, at least one of the modified nucleotides is selected from the group consisting of 2′-O-methyl and 2′fluoro modifications.


In certain embodiments, the antisesense strand of the double stranded RNAi agents of any of the invention comprise no more than 8 2′-fluoro modifications, no more than 7 2′-fluoro modifications, no more than 6 2′-fluoro modifications, no more than 5 2′-fluoro modifications, no more than 4 2′-fluoro modifications, no more than 3 2′-fluoro modifications, no more than 2 2′-fluoro modifications, no more than 1 2′-fluoro modifications, or no more than 1 2′-fluoro modifications. In other embodiments, the sesense strand of the double stranded RNAi agents of any of the invention comprise no more than 6 2′-fluoro modifications, no more than 5 2′-fluoro modifications, no more than 4 2′-fluoro modifications, no more than 3 2′-fluoro modifications, no more than 2 2′-fluoro modifications, no more than 1 2′-fluoro modifications, or no more than 1 2′-fluoro modifications.


In one embodiment, the double stranded RNAi agent further comprises at least one phosphorothioate internucleotide linkage. In one embodiment, the double stranded RNAi agent comprises 6-8 phosphorothioate internucleotide linkages.


The region of complementarity may be at least 17 nucleotides in length, 18 nucleotides in length, 19 nucleotides in length, 20 nucleotides in length, or 21 nucleotides in length.


In certain embodiment, the region of complementarity may be 19 to 21 nucleotides in length or 21 to 23 nucleotides in length.


In certain embodiments, each strand of the double stranded RNAi agent is no more than 30 nucleotides in length. In certain embodiments, the double stranded RNAi agent is at least 15 nucleotides in length.


In certain embodiments, at least one strand of the double stranded RNAi agent comprises a 3′ overhang of at least 1 nucleotide. In certain embodiments, the at least one strand comprises a 3′ overhang of at least 2 nucleotides.


In certain embodiments, the double stranded RNAi agent further comprises a ligand. In certain embodiments, the ligand is conjugated to the 3′ end of the sense strand of the dsRNA. In certain embodiments, the ligand is an N-acetylgalactosamine (GalNAc) derivative. In certain embodiments, the ligand is one or more GalNAc derivatives attached through a monovalent, a bivalent, or a trivalent branched linker. In certain embodiments the ligand is




embedded image


In certain embodiments, the dsRNA is conjugated to the ligand awiurivm in the following schematic




embedded image


and, wherein X is O or S.


In one embodiment, the X is O.


In one embodiment, the region of complementarity consists of any one of the antisense sequences listed in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18.


In one embodiment, the dsRNA agent that inhibits the expression of F12 is selected from the group consisting of AD-66170, AD-66173, AD-66176, AD-66125, AD-66172, AD-66167, AD-66165, AD-66168, AD-66163, AD-66116, AD-66126, and AD-67244. In another embodiment, the dsRNA agent that inhibits the expression of F12 is AD-67244.


In one aspect, the present invention provides cells comprising a double stranded RNAi agent of the invention targeting F12.


In one aspect, the present invention provides vectors encoding at least one strand of of a double stranded RNAi agent of the invention targeting F12.


In one aspect, the present invention provides pharmaceutical compositions for inhibiting expression of a F12 gene comprising a double stranded RNAi agent or vector of the invention.


The pharmaceutical compositions provided herein may be administered in an unbuffered solution, e.g., saline or water, or administered with a buffer solution, e.g., a buffer solution comprising acetate, citrate, prolamine, carbonate, or phosphate or any combination thereof. In one embodiment, the buffer solution is phosphate buffered saline (PBS).


In one embodiment, the pharmaceutical compositions of the invention comprise a double stranded RNAi agent as described herein, and a lipid formulation.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 is a graph depicting F12 mRNA suppression following a single subcutaneous 1 mg/kg dose or a single 3 mg/kg dose, or a single 1 mg/kg dose or a single 10 mg/kg dose of the indicated agents at 7-10 days post-dose wild-type mice.



FIG. 2A is a graph depicting the amount of Evans blue dye in the blood of mice administered a single 0 mg/kg, 0.1 mg/kg, 0.3 mg/kg, 1 mg/kg, or 3 mg/kg dose of AD-67244 and captopril at day 7 post-dose.



FIG. 2B is a graph depicting the amount of Evans blue dye in the intestines of mice administered a single 0 mg/kg, 0.1 mg/kg, 0.3 mg/kg, 1 mg/kg, or 3 mg/kg dose of AD-67244 and captopril at day 7 post-dose.



FIG. 2C is a graph depicting F12 mRNA suppression in the liver of mice administered a single 0 mg/kg, 0.1 mg/kg, 0.3 mg/kg, 1 mg/kg, or 3 mg/kg dose of AD-67244 and captopril at day 7 post-dose.



FIG. 2D is a graph depicting the relative permeability of the intestine in mice administered a single 0 mg/kg, 0.1 mg/kg, 0.3 mg/kg, 1 mg/kg, or 3 mg/kg dose of AD-67244 and captopril at day 7 post-dose.



FIG. 3A is a graph depicting the amount of Evans blue dye in the ears of mice administered a single 0.1 mg/kg, 0.5 mg/kg, or 3 mg/kg dose of AD-67244 in combination with a single 10 mg/kg dose of a dsRNA agent targeting C1-INH at day 7 post-dose. Error bars=standard deviation.



FIG. 3B is a graph depicting dose-dependent F12 mRNA suppression following a single subcutaneous 0.1 mg/kg, 0.5 mg/kg, or 3 mg/kg dose of AD-67244 in combination with a single 10 mg/kg dose of a dsRNA agent targeting C1-INH at day 7 post-dose.



FIG. 4 is a graph depicting F12 protein suppression in the plasma of female Cynomolgus monkeys subcutaeoulsy administered a single 3 mg/kg, 1 mg/kg, 0.3 mg/kg, or 0.1 mg/kg dose of AD-67244. The plasma F12 levels shown are the relative F12 protein levels which were normalized to the average pre-dose baseline F12 protein level. Error bars=standard deviation.



FIG. 5 is a graph depicting F12 protein suppression in the plasma of wild-type mice administered a single 0.5 mg/kg dose of either AD-67244 or AD-74841.



FIG. 6 is a graph depicting the effect of 5′-end modifications on the in vivo efficacy of the indicated agents.



FIG. 7A is a graph depicting the fluorescence intensity profile of platelet deposition at the site of electrolytic injury in the vein of mice subcutaneously administered a single 0.3 mg/kg, 0.75 mg/kg, or 10 mg/kg subcutaneous dose of AD-67244 or PBS control. Imaging was performed at day 10 post-dose.



FIG. 7B is a graph depicting the fluorescence intensity profile of fibrin deposition at the site of electrolytic injury in the vein of mice subcutaneously administered a single 0.3 mg/kg, 0.75 mg/kg, or 10 mg/kg subcutaneous dose of AD-67244 or PBS control. Imaging was performed at day 10 post-dose. The percentage of F12 mRNA remaining in the livers of the mice in each AD-67244 treatment group is also indicated on the right of the graph.



FIG. 7C is a graph depicting the amount of F12 mRNA, as a ratio to PBS average, remaining in the livers of mice subcutaneously administered a 0.3 mg/kg, 0.75 mg/kg, or 10 mg/kg dose of AD-67244 compared to the control mice injected with PBS used in the electrolytic injury study.



FIG. 8A is a real time image of platelet and fibrin deposition at the site of electrolytic injury in the vein of a vehicle treated mouse at 1 minute post injury. Fibrin deposits are shown in drak gray and platelet deposits are shown in light gray.



FIG. 8B is a real time image of platelet and fibrin deposition at the site of electrolytic injury in the vein of a mouse administered a single 10 mg/kg subcutaneous dose of AD-67244 at 1 minute post injury. Fibrin deposits are shown in drak gray and platelet deposits are shown in light gray.



FIG. 9A is a graph depicting the time to occlusion, in seconds, at the site of FeCl3 induced injury in the carotid arteries of mice subcutaneously administered a single 10 mg/kg dose of AD-67244 or PBS control.



FIG. 9B is a graph depicting the amount of F12 mRNA, as a ratio to PBS average, remaining in the livers of mice subcutaneously administered a single 10 mg/kg dose of AD-67244 compared to control mice injected with PBS used in the FeCl3 induced injury study.



FIG. 10A is a graph depicting the average hemostatic time at the site of injury in the saphenous veins of mice administered a single subcutaneous 10 mg/kg dose of AD-67244 or PBS control.



FIG. 10B is a graph depicting the time to occlusion, in seconds, at the site of tail tip transection in mice administered a single subcutaneous 10 mg/kg dose of AD-67244, PBS control, or 300 U/kg of heparin.





DETAILED DESCRIPTION OF THE INVENTION

The present invention is based, at least in part, on the surprising discovery that, although agents that target a specific portion of an F12 gene inhibit the formation of a thrombus by inhibiting fibrin and platelet deposition (two molecules required for clotting), such agents do not inhibit hemostasis. Accordingly, such agents are useful for treating subjects having a contact activation pathway-associated disease, such as a thrombophilia without inhibiting hemostasis.


Accordingly, the present invention provides methods of treating a subject having a contact activation pathway-associated disease using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a Factor XII (F12) gene. The present invention also provides methods of preventing at least one symptom, such as thrombus formation or an angioedema attack, in a subject having a contact activation pathway-associated disease using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a Factor XII (F12) gene. In addition, the present invention provides iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a contact activation pathway-associated gene, such as a Factor XII (F12) gene, for use in the methods of the present invention.


The iRNAs of the invention may include an RNA strand (the antisense strand) having a region which is about 30 nucleotides or less in length, e.g., 15-30, 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, which region is substantially complementary to at least part of an mRNA transcript of a contact activation pathway gene, i.e., the F12 gene.


In certain embodiments, the iRNAs of the invention include an RNA strand (the antisense strand) which can include longer lengths, for example up to 66 nucleotides, 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 contact activation pathway gene, i.e., the F12 gene. These iRNAs with the longer length antisense strands preferably 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.


Accordingly, the present invention also provides methods for treating a subject having a disorder that would benefit from inhibiting or reducing the expression of a contact activation pathway gene, e.g., a contact activation pathway-associated disease, such as a thrombophilia or hereditary angioedema (HAE), using iRNA compositions which effect the RNA-induced silencing complex (RISC)-mediated cleavage of RNA transcripts of a contact activation pathway gene.


Very low dosages of the iRNAs of the invention, in particular, can specifically and efficiently mediate RNA interference (RNAi), resulting in significant inhibition of expression of the corresponding gene (contact activation pathway gene).


The following detailed description discloses how to make and use compositions containing iRNAs to inhibit the expression of a contact activation pathway gene (i.e., an F12 gene) as well as compositions, uses, and methods for treating subjects having diseases and disorders that would benefit from inhibition and/or reduction of the expression of a contact activation pathway gene (i.e., an F12 gene).


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.


The term “at least” 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 18 nucleotides of a 21 nucleotide nucleic acid molecule” means that 18, 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, ranges include both the upper and lower limit.


Unless otherwise specified, the term “contact activation pathway gene” as used herein refers to a KLKB1 gene, an F12 gene, or a KNG1 gene. The contact activation pathway gene may be within a cell, e.g., a cell within a subject, such as a human.


In one embodiment, the contact activation pathway gene is F12.


As used herein, “Factor XII (Hageman Factor),” used interchangeably with the terms “coagulation factor XII,” “FXII,” “F12,” active “F12,” and “F12a,” refers to the naturally occurring gene that encodes the zymogen form of F12a. F12 a is an enzyme (EC 3.4.21.38) of the serine protease (or serine endopeptidase) class that cleaves prekallikrein to form kallikrein, which subsequently releases bradykinin from high-molecular weight kininogen and activates F12. The amino acid and complete coding sequences of the reference sequence of the F12 gene may be found in, for example, GenBank Accession No. GI:145275212 (RefSeq Accession No. NM_000505; SEQ ID NO:9; SEQ ID NO:10). Mammalian orthologs of the human F12 gene may be found in, for example, GenBank Accession Nos. GI:544441267 (RefSeq Accession No. XM_005558647, cynomolgus monkey; SEQ ID NO:11 and SEQ ID NO:12); GI:805299477 (RefSeq Accession No. NM_021489, mouse; SEQ ID NO:13 and SEQ ID NO:14); GI:62078740 (RefSeq Accession No. NM_001014006, rat; SEQ ID NO:15 and SEQ ID NO:16).


Additional examples of F12 mRNA sequences are readily available using publicly available databases, e.g., GenBank, UniProt, and OMIM.


As used herein, “Kallikrein B, Plasma (Fletcher Factor) 1,” used interchangeably with the terms “Prekallikrein” and “KLKB1,” refers to the naturally occurring gene that encodes the zymogen form of kallikrein, prekallikrein. Plasma prekallikrein is converted to plasma kallikrein (also referred to as active kallikrein) by F12a and proteolytically releases bradykinin from high-molecular weight kininogen and activates F12. Bradykinin is a peptide that enhances vascular permeability and is present in elevated levels in HAE patients. The amino acid and complete coding sequences of the reference sequence of the KLKB1 gene may be found in, for example, GenBank Accession No. GI:78191797 (RefSeq Accession No. NM_000892.3; SEQ ID NO:1; SEQ ID NO:2). Mammalian orthologs of the human KLKB1 gene may be found in, for example, GenBank Accession Nos. GI:544436072 (RefSeq Accession No. XM_005556482, cynomolgus monkey; SEQ ID NO:7 and SEQ ID NO:8); GI:380802470 (RefSeq Accession No. JU329355, rhesus monkey); GI:236465804 (RefSeq Accession No. NM_008455, mouse; SEQ ID NO:3 and SEQ ID NO:4); GI:162138904 (RefSeq Accession No. NM_012725, rat; SEQ ID NO:5 and SEQ ID NO:6).


Additional examples of KLKB1 mRNA sequences are readily available using publicly available databases, e.g., GenBank, UniProt, and OMIM.


As used herein, “Kininogen 1,” used interchangeably with the terms “Fitzgerald Factor,” “Williams-Fitzgerald-Flaujeac Factor,” “high-molecular weight kininogen” (“HMWK” or “HK”), “low-molecular weight kininogen” (“LMWK)”, and “KNG1,” refers to the naturally occurring gene that is alternatively spliced to generate HMWK and LMWK. Cleavage of HMWK by active kallikrein releases bradykinin. The amino acid and complete coding sequences of the reference sequence of the KNG1 gene may be found in, for example, GenBank Accession No. GI:262050545 (RefSeq Accession No. NM_001166451; SEQ ID NO:17; SEQ ID NO:18). Mammalian orthologs of the human KNG1 gene may be found in, for example, GenBank Accession Nos. GI:544410550 (RefSeq Accession No. XM_005545463, cynomolgus monkey; SEQ ID NO:19 and SEQ ID NO:20); GI:156231028 (RefSeq Accession No. NM_001102409, mouse; SEQ ID NO:21 and SEQ ID NO:22); GI:80861400 (RefSeq Accession No. NM_012696, rat; SEQ ID NO:23 and SEQ ID NO:23).


Additional examples of KNG1 mRNA sequences are readily available using publicly available databases, e.g., GenBank, UniProt, and OMIM.


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 camel, a llama, a horse, a goat, a rabbit, a sheep, a hamster, a guinea pig, a cat, a dog, a rat, a mouse, a horse, and a whale), or a bird (e.g., a duck or a goose). In an embodiment, the subject is a human, such as a human being treated or assessed for a disease, disorder or condition that would benefit from reduction in contact activation pathway gene expression (i.e., F12 gene expression) and/or replication; a human at risk for a disease, disorder or condition that would benefit from reduction in contact activation pathway gene expression; a human having a disease, disorder or condition that would benefit from reduction in contact activation pathway gene expression; and/or human being treated for a disease, disorder or condition that would benefit from reduction in contact activation pathway gene expression, as described herein.


As used herein, the terms “treating” or “treatment” refer to a beneficial or desired result including, but not limited to, alleviation or amelioration of one or more symptoms associated with contact activation pathway gene expression (i.e., F12 gene expression) and/or contact activation pathway protein production (i.e., F12 protein production), e.g., a thrombophilia, e.g., the formation of a thrombus, the presence of elevated bradykinin, heredity angioedema (HAE), such as hereditary angioedema type I; hereditary angioedema type II; hereditary angioedema type III; or any other hereditary angioedema caused by elevated levels of bradykinin, an angioedema attack, edema swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genetials, prodrome; laryngeal swelling; nonpruritic rash; nausea; vomiting; abdominal pain. “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 contact activation pathway gene expression and/or contact activation pathway protein production 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%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, or more and is preferably down to a level accepted as within the range of normal for an individual without such disorder.


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 contact activation pathway gene and/or production of a contact activation pathway protein, refers to a reduction in the likelihood that a subject will develop a symptom associated with such a disease, disorder, or condition, or a reduction in the frequency and/or duration of a symptom associated with such a disease, disorder, or condition, e.g., a symptom of contact activation pathway gene expression, such as the formation of a venous thrombus, an arterial thrombus, a cardiac chamber thrombus, a thromboembolism, the presence of elevated bradykinin, an angioedema attack, hereditary angioedema type I; hereditary angioedema type II; hereditary angioedema type III; any other hereditary angioedema caused by elevated levels of bradykinin; edema swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genetials, prodrome; laryngeal swelling; nonpruritic rash; nausea; vomiting; abdominal pain. The failure to develop a disease, disorder or condition, or the reduction in the development of a symptom 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 symptoms delayed (e.g., by days, weeks, months or years) is considered effective prevention.


As used herein, the term “contact activation pathway-associated disease,” is a disease or disorder that is caused by, or associated with contact activation pathway gene expression (i.e., F12 gene expression) or contact activation pathway protein production (i.e., F12 protein production). The term “contact activation pathway-associated disease” includes a disease, disorder or condition that would benefit from reduction in contact activation pathway gene expression and/or contact activation pathway protein activity. A contact activation pathway-associated disease may be a genetic disorder or an acquired disorder.


Non-limiting examples of contact activation pathway-associated diseases include, for example, thrombophilia, heredity angioedema (HAE) (such as hereditary angioedema type I; hereditary angioedema type II; hereditary angioedema type III; or any other hereditary angioedema caused by elevated levels of bradykinin), prekallikrein deficiency (inherited or acquired), also known as Fletcher Factor Deficiency, malignant essential hypertension, hypertension, end stage renal disease.


In one embodiment, the contact activation pathway-associated disease is a thrombophilia. As used herein, the term “thrombophilia,” also referred to as “hypercoagulability” or “a prothrombotic state”, is any disease or disorder associated with an abnormality of blood coagulation that increases the risk of thrombosis and the development of a thrombus. As used herein, the term “thrombosis” refers to the process of local coagulation or clotting of the blood (formation of a “thrombus” or “clot”) in a part of the circulatory system. A thrombophilia may be inherited, acquired, or the result on an environmental condition. Exemplary inherited thrombophilias include inherited antithrombin deficiency, inherited Protein C deficiency, inherited Protein S deficiency, inherited Factor V Leiden thrombophilia, and Prothrombin (Factor II) G20210A. An exemplary acquired thrombophilia includes Antiphospholipid syndrome. Acquired/environmentally acquired thrombophilias may be the result of, for example trauma, fracture, surgery, e.g., orthopedic surgery, oncological surgery, oral contraceptive use, hormone replacement therapy, pregnancy, puerperium, hypercoaguability, previous thrombus, age, immobilization (e.g., more than three days of bed rest), prolonged travel, metabolic syndrome, and air pollution (see, e.g., Previtali, et al. (2011) Blood Transfus 9:120).


Accordingly, “subjects at risk of forming a thrombus” include surgical patients (e.g., subjects having general surgery, dental surgery, orthopedic surgery (e.g., knee or hip replacement surgery), trauma surgery, oncological surgery); medical patients (e.g., subjects having an immobilizing disease, e.g., subjects having more than three days of bed rest and/or subjects having long-term use of an intravenous catheter; subjects having atrial fibrillation; elderly subjects; subjects having renal impairment; subjects having a prosthetic heart valve; subjects having heart failure; subjects having cancer); pregnant subjects; postpartum subjects; subjects that have previously had a thrombus; subjects undergoing hormone replacement therapy; subjects sitting for long periods of time, such as in a plane or car; and obese subjects.


In one embodiment, the contact activation pathway-associated disease is hereditary angioedema (HAE). As used herein, “hereditary angioedema,” used interchangeably with the term “HAE,” refers to an autosomal dominant disorder caused by mutation of the C1 inhibitor (C1INH), SERPING1) gene or the coagulation factor XII (F12) gene that causes recurrent edema swelling in patients. Typical symptoms of HAE include severe swelling of the arms, legs, hands, feet, face, tongue and larynx, abdomen, trunk, genitals, nausea, vomiting, abdominal pain, and nonpriuric rash. Elevanted levels of bradykinin peptide are observed during HAE attacks or episodes.


In another embodiment, the contact activation pathway-associated disease is prekallikrein deficiency.


In another embodiment, the contact activation pathway-associated disease is malignant essential hypertension.


In another embodiment, the contact activation pathway-associated disease is hypertension.


In another embodiment, the contact activation pathway-associated disease is end stage renal disease.


“Therapeutically effective amount,” as used herein, is intended to include the amount of an RNAi agent that, when administered to a patient for treating a subject having HAE and/or contact activation pathway-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, stage of pathological processes mediated by contact activation pathway gene expression, the types of preceding or concomitant treatments, if any, and other individual characteristics of the patient 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 who does not yet experience or display symptoms of a contact activation pathway-associated disease, but who may be predisposed or at risk, 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 “prophylacticaly effective amount” also includes an amount of an RNAi agent that produces some desired local or systemic effect at a reasonable benefit/risk ratio applicable to any treatment. RNAi agents 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.


As used herein, the term “hemostasis” is the process which causes bleeding to stop, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). Hemostasis occurs when blood is present outside of the body or a blood vessel and includes 1) vascular spasm, which constricts the damaged vessel to allow less blood to be lost; 2) platelet plug formation (e.g., platelets stick together to form a temporary seal to cover the break in the vessel wall); and 3) coagulation or blood clotting (e.g., reinforcement of the platelet plug with fibrin threads.


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), the retina or parts of the retina (e.g., retinal pigment epithelium), the central nervous system or parts of the central nervous system (e.g., ventricles or choroid plexus), or the pancreas or certain cells or parts of the pancreas. In some embodiments, a “sample derived from a subject” refers tocerebrospinal fluid obtained from the subject. In preferred embodiments, a “sample derived from a subject” refers to blood or plasma drawn from the subject. In further embodiments, a “sample derived from a subject” refers to liver tissue (or subcomponents thereof) or retinal tissue (or subcomponents thereof) derived from the subject.


As used herein, “target sequence” refers to a contiguous portion of the nucleotide sequence of an mRNA molecule formed during the transcription of a contact activation pathway gene, including mRNA that is a product of RNA processing of a primary transcription product. In one embodiment, 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 contact activation pathway gene. In one embodiment, the target sequence is within the protein coding region of the contact activation pathway gene. In another embodiment, the target sequence is within the 3′ UTR of the contact activation pathway gene.


The target sequence may be from about 9-36 nucleotides in length, e.g., about 15-30 nucleotides in length. For example, the target sequence can be from about 15-30 nucleotides, 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. 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 2). 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 an F12 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 contact activation pathway gene, i.e., an F12 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 contact activation pathway gene. Accordingly, the term “siRNA” is also used herein to refer to an RNAi as described above.


In another embodiment, the RNAi agent may be a single-stranded siRNA 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 another embodiment, 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 RNAi 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 contact activation pathway gene, i.e., an F12 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 and/or a modified nucleotide. In addition, as used in this specification, an “RNAi agent” may include ribonucleotides with chemical modifications; an RNAi agent 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, and/or modified nucleobase. 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 “RNAi agent” for the purposes of this specification and claims.


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 9 to 36 base pairs in length, e.g., about 15-30 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 15-30, 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. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the invention.


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, at least 3, at least 4, at least 5, at least 6, at least 7, at least 8, at least 9, at least 10, at least 20, at least 23 or more unpaired nucleotides.


Where the two substantially complementary strands of a dsRNA are comprised by separate RNA molecules, those molecules need not, 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, an RNAi agent of the invention is a dsRNA of 24-30 nucleotides that interacts with a target RNA sequence, e.g., a contact activation pathway gene, i.e., an F12 target mRNA sequence, to direct the cleavage of the target RNA. Without wishing to be bound by theory, 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).


As used herein, the term “nucleotide overhang” refers to at least one unpaired nucleotide that protrudes from the duplex structure of an iRNA, e.g., a dsRNA. 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, 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 and/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 and/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 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, 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 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 RNAi agent, i.e., no nucleotide overhang. A “blunt ended” RNAi agent is a dsRNA that 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 nucleotide overhangs at one end (i.e., agents with one overhang and one blunt end) or with nucleotide overhangs at both ends.


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 F12 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 contact activation pathway gene 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, 3, 2, or 1 nucleotides of the 5′- and/or 3′-terminus of the iRNA. In one embodiment, a double stranded RNAi agent of the invention include a nucleotide mismatch in the antisense strand. In another embodiment, a double stranded RNAi agent of the invention include a nucleotide mismatch in the sense strand. In one embodiment, the nucleotide mismatch is, for example, within 5, 4, 3, 2, or 1 nucleotides from the 3′-terminus of the iRNA. In another embodiment, the nucleotide mismatch is, for example, in the 3′-terminal nucleotide of the iRNA.


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, 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 via a RISC pathway. 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 and/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 Hoogstein 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 the antisense strand of an iRNA 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 contact activation pathway gene). For example, a polynucleotide is complementary to at least a part of an F12 mRNA if the sequence is substantially complementary to a non-interrupted portion of an mRNA encoding an F12 gene.


Accordingly, in some embodiments, the sense strand polynucleotides and the antisense polynucleotides disclosed herein are fully complementary to the target contact activation pathway gene sequence.


In one embodiment, the antisense polynucleotides disclosed herein are fully complementary to the target F12 sequence. In other embodiments, the antisense polynucleotides disclosed herein are substantially complementary to the target F12 sequence and comprise 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:9 or 10, or a fragment of SEQ ID Nos:9 or 10, such as about 85%, about 86%, about 87%, about 88%, about 89%, about 90%, about % 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, or about 99% complementary.


In other embodiment, the antisense strand polynucleotides are substantially complementary to the target F12 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 Tables 3, 4, 9-12, 14, 15, 17, and 18, or a fragment of any one of the antisense strand nucleotide sequences in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18, such as about 85%, about 86%, about 87%, about 88%, about 89%, about 90%, about % 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, or about 99% complementary.


In one embodiment, an RNAi agent of the invention includes a sense strand that is substantially complementary to an antisense polynucleotide which, in turn, is complementary to a target F12 sequence and comprise a contiguous nucleotide sequence which is at least about 80% complementary over its entire length to any one of antisense strand nucleotide sequences in any one ofTables 3, 4, 9-12, 14, 15, 17, and 18, or a fragment of any one of the antisense strand nucleotide sequences in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18, such as about 85%, about 86%, about 87%, about 88%, about 89%, about 90%, about % 91%, about 92%, about 93%, about 94%, about 95%, about 96%, about 97%, about 98%, or about 99% complementary.


In general, 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 one aspect of the invention, an agent for use in the methods and compositions of the invention is a single-stranded antisense RNA molecule that inhibits a target mRNA via an antisense inhibition mechanism. The single-stranded antisense RNA 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 RNA molecule may be about 15 to about 30 nucleotides in length and have a sequence that is complementary to a target sequence. For example, the single-stranded antisense RNA molecule may comprise a sequence that is at least about 15, 16, 17, 18, 19, 20, or more contiguous nucleotides from any one of the antisense sequences described herein.


II. Methods of Treating or Preventing Contact Activation Pathway-Associated Diseases

The present invention provides therapeutic and prophylactic methods for treating a subject having a contact activation pathway-associated disease.


In one aspect, the present invention provides methods of treating a subject having a contact-activation-associated disease. The methods include administering to a subject having a contact activation pathway gene-associated disease, disorder, and/or condition, or prone to developing, a contact activation pathway gene-associated disease, disorder, and/or condition, a therapeutically effective amount of an iRNA agent targeting an F12 gene, e.g., a dsRNA agent comprising a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, or a pharmaceutical composition comprising such agents. In the therapeutic methods of the invention, administration of the dsRNA agents to the subject does not inhibit hemostasis in the subject and, e.g., decreases platelet deposition in the subject and/or decreases fibrin deposition in the subject.


The present invention provides dsRNA agents that inhibit the expression of F12 for therapeutic and prophylactic use in a subject having a contact activation pathway-associated disease.


In one aspect, the present invention provides dsRNA agents that inhibit the expression of F12 for use in treating a subject having a contact-activation-associated disease. The dsRNA agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, or a pharmaceutical composition comprising such agents. Administration of the dsRNA agents to the subject does not inhibit hemostasis in the subject and, e.g., decreases platelet deposition in the subject and/or decreases fibrin deposition in the subject.


Non-limiting examples of contact activation pathway gene-associated diseases include, for example, a thrombophilia, heredity angioedema (HAE) (such as hereditary angioedema type I; hereditary angioedema type II; hereditary angioedema type III; or any other hereditary angioedema caused by elevated levels of bradykinin), prekallikrein deficiency, malignant essential hypertension, hypertension, end stage renal disease, Fletcher Factor Deficiency, edema swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genitals, prodrome; laryngeal swelling; nonpruritic rash; nausea; vomiting; abdominal pain.


In one embodiment, the contact activation pathway gene-associated disease is a thrombophilia. In another embodiment, the contact activation pathway gene-associated disease is HAE. In another embodiment, the contact activation pathway gene-associated disease is prekallikrein deficiency. In another embodiment, the contact activation pathway gene-associated disease is malignant essential hypertension. In another embodiment, the contact activation pathway gene-associated disease is hypertension. In another embodiment, the contact activation pathway gene-associated disease is end stage renal disease. In another embodiment, the contact activation pathway gene-associated disease is Fletcher Factor Deficiency.


In one aspect, the invention provides methods of preventing at least one symptom in a subject having a contact activation pathway-associated disease, e.g., a thrombophilia, hereditary angioedema (HAE), e.g., a thrombus formation, the presence of elevated bradykinin, edema swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genitals, prodrome; laryngeal swelling; nonpruritic rash; nausea; vomiting; abdominal pain. The methods include administering to the subject a prohylactically effective amount of an iRNA agent targeting an F12 gene, e.g. a dsRNA agent comprising a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, or a pharmaceutical composition comprising such agents, thereby preventing at least one symptom in a subject having a contact activation pathway-associated disease. In the prophylactic methods of the invention, administration of the dsRNA agents to the subject, does not inhibit hemostasis in the subject and, e.g., decreases platelet deposition in the subject and/or decreases fibrin deposition in the subject.


In another aspect, the present invention provides methods of preventing the formation of a thrombus in a subject at risk of forming a thrombus. The methods include administering to the subject a prohylactically effective amount of an iRNA agent targeting an F12 gene, e.g. a dsRNA agent comprising a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, or a pharmaceutical composition comprising such agents, thereby preventing the formation of a thrombus in the subject at risk of forming a thrombus. Administration of the dsRNA agents to the subject at risk of forming a thrombus does not inhibit hemostasis in the subject and, e.g., decreases platelet deposition in the subject and/or decreases fibrin deposition in the subject.


In one aspect, the invention provides a dsRNA agent that inhibits the expression of F12 for use in preventing at least one symptom in a subject having a contact activation pathway-associated disease, e.g., a thrombophilia, hereditary angioedema (HAE), e.g., a thrombus formation, the presence of elevated bradykinin, edema swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genitals, prodrome; laryngeal swelling; nonpruritic rash; nausea; vomiting; abdominal pain. The dsRNA agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, or a pharmaceutical composition comprising such agents. Administration of the dsRNA agents to the subject does not inhibit hemostasis in the subject and, e.g., decreases platelet deposition in the subject and/or decreases fibrin deposition in the subject.


In another aspect, the present invention provides dsRNA agents that inhibit the expression of F12 for use in preventing the formation of a thrombus in a subject at risk of forming a thrombus. The dsRNA agent comprises a sense strand and an antisense strand, the antisense strand comprising a region of complementarity which comprises at least 15 contiguous nucleotides differing by no more than 3 nucleotides from the complement of nucleotides 2000-2040 of SEQ ID NO:9, or a pharmaceutical composition comprising such agents. Administration of the dsRNA agents to the subject does not inhibit hemostasis in the subject and, e.g., decreases platelet deposition in the subject and/or decreases fibrin deposition in the subject.


“Subjects at risk of forming a thrombus” include surgical patients (e.g., subjects having general surgery, dental surgery, orthopedic surgery (e.g., knee or hip replacement surgery), trauma surgery, oncological sugery); medical patients (e.g., subjects having an immobilizing disease, e.g., subjects having more than three days of bed rest and/or subjects having long-term use of an intravenous catheter; subjects having atrial fibrillation; elderly subjects; subjects having renal impairment; subjects having a prosthetic heart valve; subjects having heart failure; subjects having cancer); pregnant subjects; postpartum subjects; subjects that have previously had a thrombus; subjects undergoing hormone replacement therapy; subjects sitting for long periods of time, such as in a plane or car; and obese subjects.


Methods to assess hemostasis, platelet deposition, and fibrin deposition are known to one of ordinary skill in the art and may include, for example, thrombin:antithrombin complex levels as a measure of thrombin generation portential, bleeding time, prothrombin time (PT), platelet count, and/or activated partial thromboplastin time (aPTT). Inhibition may be assessed by a decrease in an absolute or relative level of one or more of these variables 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).


The present invention also provides therapeutic and prophylactic methods (and uses) which include administering to a subject having a contact activation pathway gene-associated disease, disorder, and/or condition, or prone to developing, a contact activation pathway gene-associated disease, disorder, and/or condition, compositions comprising an iRNA agent (i.e., an iRNA agent targeting an F12 gene, or a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or pharmaceutical compositions comprising an iRNA agent (i.e., an iRNA agent targeting an F12 gene, or a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or vectors comprising an iRNA (i.e., an iRNA agent targeting an F12 gene, or a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene) of the invention.


iRNA agents targeting KLKB1 and KNG1 useful in any of the combination therapies and compositions of the invention may be found in U.S. Patent Publication No.: 2018/0100150 and International Publication No. WO 2016/179342, the entire contents of each of which are incorporated herein by reference.


The methods and uses of the invention are useful for treating a subject having a contact activation pathway gene-associated disease, e.g., a subject that would benefit from reduction in contact activation pathway gene expression and/or contact activation pathway protein production. In one aspect, the present invention provides methods of reducing the level of Factor XII (Hageman Factor) (F12) gene expression in a subject having hereditary angioedema (HAE). In another aspect, the present invention provides methods of reducing the level of F12 protein in a subject with HAE.


The present invention also provides methods of reducing the level of bradykinin in a subject with contact activation pathway-associated disease, e.g., a thrombophilia or hereditary angioedema. For example, in one embodiment, the invention provides methods of reducing the level of bradykinin in a subject with hereditary angioedema which include administering to the subject a therapeutically effective amount or a prophylactically effective amount of a dsRNA agent of the invention, (i.e., an iRNA agent targeting an F12 gene, or a combination of of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or a pharmaceutical composition or vector comprising such agents, or combinations of such agents.


In one aspect, the present invention provides methods of treating a subject having a contact activation pathway-associated disease, e.g., a thrombophilia, hereditary angioedema type I; hereditary angioedema type II; hereditary angioedema type III; any other hereditary angioedema caused by elevated levels of bradykinin. In one embodiment, the treatment methods and uses of the invention include administering to the subject, e.g., a human, a therapeutically effective amount of an iRNA agent of the invention targeting an F12 gene or a pharmaceutical composition comprising an iRNA agent of the invention targeting an F12 gene or a vector of the invention comprising an iRNA agent targeting an F12 gene.


In other embodiments, the treatment methods and uses of the invention include administering to the subject, e.g., a human, a therapeutically effective amount of a combination of dsRNA agents of the invention, (i.e., a combination of an iRNA agent targeting an F12 gene, or a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or a pharmaceutical composition or vector comprising such agents, or combinations of such agents.


In another aspect, the present invention provides methods of treating a subject having HAE. In one embodiment, the methods and uses of the invention for treating a subject having HAE include administering to the subject, e.g., a human, a therapeutically effective amount of an iRNA agent of the invention targeting a F12 gene or a pharmaceutical composition comprising an iRNA agent of the invention targeting a F12 gene or a vector of the invention comprising an iRNA agent targeting an F12 gene. In other embodiments, the methods and uses of the invention for treating a subject having HAE include administering to the subject, e.g., a human, a therapeutically effective amount of a combination of dsRNA agents of the invention, (i.e., a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or a pharmaceutical composition or vector comprising such agents, or combinations of such agents.


In another aspect, the present invention provides methods of treating a subject having a thrombophilia. In one embodiment, the methods and uses of the invention for treating a subject having thrombophilia include administering to the subject, e.g., a human, a therapeutically effective amount of an iRNA agent of the invention targeting a F12 gene or a pharmaceutical composition comprising an iRNA agent of the invention targeting a F12 gene or a vector of the invention comprising an iRNA agent targeting an F12 gene. In other embodiments, the methods and uses of the invention for treating a subject having thrombophilia include administering to the subject, e.g., a human, a therapeutically effective amount of a combination of dsRNA agents of the invention, (i.e., a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or a pharmaceutical composition or vector comprising such agents, or combinations of such agents.


In one aspect, the present invention provides methods of preventing an angioedema attack in a subject having HAE. The methods include administering to the subject a prohylactically effective amount of the iRNA agent, e.g. dsRNA, pharmaceutical compositions, or vectors of the invention, thereby preventing the formation of a thrombus in the subject at risk of forming a thrombus. In one embodiment, the prophylactic methods and uses of the invention include administering to the subject, e.g., a human, a prophylactically effective amount of an iRNA agent of the invention targeting an F12 gene or a pharmaceutical composition comprising an iRNA agent of the invention targeting an F12 gene or a vector of the invention comprising an iRNA agent targeting an F12 gene. In other embodiments, the prophylactic methods (and uses) of the invention include administering to the subject, e.g., a human, a prophylactically effective amount of a combination of dsRNA agents of the invention, (i.e., a combination of an iRNA agent targeting an F12 gene and an iRNA agent targeting a KNG1 gene, or a combination of an iRNA agent targeting a KLKB1 gene and an iRNA agent targeting an F12 gene), or a pharmaceutical composition or vector comprising such agents, or combinations of such agents.


In another aspect, the present invention provides uses of a therapeutically effective amount of an iRNA agent of the invention for treating a subject, e.g., a subject that would benefit from a reduction and/or inhibition of F12 gene expression.


In one aspect, the present invention provides uses of an iRNA agent, e.g., a dsRNA, of the invention targeting an F12 gene or pharmaceutical composition comprising an iRNA agent targeting an F12 gene in the manufacture of a medicament for treating a subject, e.g., a subject that would benefit from a reduction and/or inhibition of F12 gene expression and/or F12 protein production, such as a subject having a disorder that would benefit from reduction in F12 gene expression, e.g., a contact activation pathway-associated disease.


In another aspect, the invention provides uses of an iRNA, e.g., a dsRNA, of the invention for preventing at least one symptom in a subject suffering from a disorder that would benefit from a reduction and/or inhibition of F12 gene expression and/or F12 protein production.


In a further aspect, the present invention provides uses of an iRNA agent of the invention in the manufacture of a medicament for preventing at least one symptom in a subject suffering from a disorder that would benefit from a reduction and/or inhibition of F12 gene expression and/or F12 protein production, such as a contact activation pathway-associated disease.


In one embodiment, an iRNA agent targeting F12 is administered to a subject having hereditary angioedema (HAE) and/or a contact activation pathway-associated disease such that the expression of a F12 gene, e.g., in a cell, tissue, blood or other tissue or fluid of the subject are reduced by at least about 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%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 62%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or at least about 99% or more when the dsRNA agent is administered to the subject.


The methods and uses of the invention include administering a composition described herein such that expression of the target F12 gene is decreased, such as for about 1, 2, 3, 4 5, 6, 7, 8, 12, 16, 18, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, or about 80 hours. In one embodiment, expression of the target F12 gene is decreased for an extended duration, e.g., at least about two, three, four, five, six, seven days or more, e.g., about one week, two weeks, three weeks, or about four weeks or longer.


Administration of the dsRNA according to the methods and uses of the invention may result in a reduction of the severity, signs, symptoms, and/or markers of such diseases or disorders in a patient with hereditary angioedema (HAE) and/or contact activation pathway-associated disease. By “reduction” in this context is meant a statistically significant decrease in such level. The reduction can be, for example, at least about 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or about 100%.


Efficacy of treatment or prevention of disease can be assessed, for example by measuring disease progression, disease remission, symptom severity, reduction in pain, quality of life, dose of a medication required to sustain a treatment effect, level of a disease marker or any other measurable parameter appropriate for a given disease being treated or targeted for prevention. It is well within the ability of one skilled in the art to monitor efficacy of treatment or prevention by measuring any one of such parameters, or any combination of parameters. For example, efficacy of treatment of HAE may be assessed, for example, by periodic monitoring of HAE symptoms or bradykinin levels. Comparison of the later readings with the initial readings provide a physician an indication of whether the treatment is effective. It is well within the ability of one skilled in the art to monitor efficacy of treatment or prevention by measuring any one of such parameters, or any combination of parameters. In connection with the administration of an iRNA targeting a contact activation pathway gene or pharmaceutical composition thereof, “effective against” a contact activation pathway-associated disease indicates that administration in a clinically appropriate manner results in a beneficial effect for at least a statistically significant fraction of patients, such as improvement of symptoms, a cure, a reduction in disease, extension of life, improvement in quality of life, or other effect generally recognized as positive by medical doctors familiar with treating HAE and/or a contact activation pathway-associated disease and the related causes.


A treatment or preventive effect is evident when there is a statistically significant improvement in one or more parameters of disease status, or by a failure to worsen or to develop symptoms where they would otherwise be anticipated. As an example, a favorable change of at least 10% in a measurable parameter of disease, and preferably at least 20%, 30%, 40%, 50% or more can be indicative of effective treatment. Efficacy for a given iRNA drug or formulation of that drug can also be judged using an experimental animal model for the given disease as known in the art. When using an experimental animal model, efficacy of treatment is evidenced when a statistically significant reduction in a marker or symptom is observed.


Subjects can be administered a therapeutic amount of iRNA, such as about 0.01 mg/kg, 0.02 mg/kg, 0.03 mg/kg, 0.04 mg/kg, 0.05 mg/kg, 0.1 mg/kg, 0.15 mg/kg, 0.2 mg/kg, 0.25 mg/kg, 0.3 mg/kg, 0.35 mg/kg, 0.4 mg/kg, 0.45 mg/kg, 0.5 mg/kg, 0.55 mg/kg, 0.6 mg/kg, 0.65 mg/kg, 0.7 mg/kg, 0.75 mg/kg, 0.8 mg/kg, 0.85 mg/kg, 0.9 mg/kg, 0.95 mg/kg, 1.0 mg/kg, 1.1 mg/kg, 1.2 mg/kg, 1.3 mg/kg, 1.4 mg/kg, 1.5 mg/kg, 1.6 mg/kg, 1.7 mg/kg, 1.8 mg/kg, 1.9 mg/kg, 2.0 mg/kg, 2.1 mg/kg, 2.2 mg/kg, 2.3 mg/kg, 2.4 mg/kg, 2.5 mg/kg dsRNA, 2.6 mg/kg dsRNA, 2.7 mg/kg dsRNA, 2.8 mg/kg dsRNA, 2.9 mg/kg dsRNA, 3.0 mg/kg dsRNA, 3.1 mg/kg dsRNA, 3.2 mg/kg dsRNA, 3.3 mg/kg dsRNA, 3.4 mg/kg dsRNA, 3.5 mg/kg dsRNA, 3.6 mg/kg dsRNA, 3.7 mg/kg dsRNA, 3.8 mg/kg dsRNA, 3.9 mg/kg dsRNA, 4.0 mg/kg dsRNA, 4.1 mg/kg dsRNA, 4.2 mg/kg dsRNA, 4.3 mg/kg dsRNA, 4.4 mg/kg dsRNA, 4.5 mg/kg dsRNA, 4.6 mg/kg dsRNA, 4.7 mg/kg dsRNA, 4.8 mg/kg dsRNA, 4.9 mg/kg dsRNA, 5.0 mg/kg dsRNA, 5.1 mg/kg dsRNA, 5.2 mg/kg dsRNA, 5.3 mg/kg dsRNA, 5.4 mg/kg dsRNA, 5.5 mg/kg dsRNA, 5.6 mg/kg dsRNA, 5.7 mg/kg dsRNA, 5.8 mg/kg dsRNA, 5.9 mg/kg dsRNA, 6.0 mg/kg dsRNA, 6.1 mg/kg dsRNA, 6.2 mg/kg dsRNA, 6.3 mg/kg dsRNA, 6.4 mg/kg dsRNA, 6.5 mg/kg dsRNA, 6.6 mg/kg dsRNA, 6.7 mg/kg dsRNA, 6.8 mg/kg dsRNA, 6.9 mg/kg dsRNA, 7.0 mg/kg dsRNA, 7.1 mg/kg dsRNA, 7.2 mg/kg dsRNA, 7.3 mg/kg dsRNA, 7.4 mg/kg dsRNA, 7.5 mg/kg dsRNA, 7.6 mg/kg dsRNA, 7.7 mg/kg dsRNA, 7.8 mg/kg dsRNA, 7.9 mg/kg dsRNA, 8.0 mg/kg dsRNA, 8.1 mg/kg dsRNA, 8.2 mg/kg dsRNA, 8.3 mg/kg dsRNA, 8.4 mg/kg dsRNA, 8.5 mg/kg dsRNA, 8.6 mg/kg dsRNA, 8.7 mg/kg dsRNA, 8.8 mg/kg dsRNA, 8.9 mg/kg dsRNA, 9.0 mg/kg dsRNA, 9.1 mg/kg dsRNA, 9.2 mg/kg dsRNA, 9.3 mg/kg dsRNA, 9.4 mg/kg dsRNA, 9.5 mg/kg dsRNA, 9.6 mg/kg dsRNA, 9.7 mg/kg dsRNA, 9.8 mg/kg dsRNA, 9.9 mg/kg dsRNA, 9.0 mg/kg dsRNA, 10 mg/kg dsRNA, 15 mg/kg dsRNA, 20 mg/kg dsRNA, 25 mg/kg dsRNA, 30 mg/kg dsRNA, 35 mg/kg dsRNA, 40 mg/kg dsRNA, 45 mg/kg dsRNA, or about 50 mg/kg dsRNA. In one embodiment, subjects can be administered 0.5 mg/kg of the dsRNA. Values and ranges intermediate to the recited values are also intended to be part of this invention.


In certain embodiments, for example, when a composition of the invention comprises a dsRNA as described herein and a lipid, subjects can be administered a therapeutic amount of iRNA, such as about 0.01 mg/kg to about 5 mg/kg, about 0.01 mg/kg to about 10 mg/kg, about 0.05 mg/kg to about 5 mg/kg, about 0.05 mg/kg to about 10 mg/kg, about 0.1 mg/kg to about 5 mg/kg, about 0.1 mg/kg to about 10 mg/kg, about 0.2 mg/kg to about 5 mg/kg, about 0.2 mg/kg to about 10 mg/kg, about 0.3 mg/kg to about 5 mg/kg, about 0.3 mg/kg to about 10 mg/kg, about 0.4 mg/kg to about 5 mg/kg, about 0.4 mg/kg to about 10 mg/kg, about 0.5 mg/kg to about 5 mg/kg, about 0.5 mg/kg to about 10 mg/kg, about 1 mg/kg to about 5 mg/kg, about 1 mg/kg to about 10 mg/kg, about 1.5 mg/kg to about 5 mg/kg, about 1.5 mg/kg to about 10 mg/kg, about 2 mg/kg to about 2.5 mg/kg, about 2 mg/kg to about 10 mg/kg, about 3 mg/kg to about 5 mg/kg, about 3 mg/kg to about 10 mg/kg, about 3.5 mg/kg to about 5 mg/kg, about 4 mg/kg to about 5 mg/kg, about 4.5 mg/kg to about 5 mg/kg, about 4 mg/kg to about 10 mg/kg, about 4.5 mg/kg to about 10 mg/kg, about 5 mg/kg to about 10 mg/kg, about 5.5 mg/kg to about 10 mg/kg, about 6 mg/kg to about 10 mg/kg, about 6.5 mg/kg to about 10 mg/kg, about 7 mg/kg to about 10 mg/kg, about 7.5 mg/kg to about 10 mg/kg, about 8 mg/kg to about 10 mg/kg, about 8.5 mg/kg to about 10 mg/kg, about 9 mg/kg to about 10 mg/kg, or about 9.5 mg/kg to about 10 mg/kg. Values and ranges intermediate to the recited values are also intended to be part of this invention.


For example, the dsRNA may be administered at a dose of about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, 5, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 6, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7, 7.8, 7.9, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9, or about 10 mg/kg. Values and ranges intermediate to the recited values are also intended to be part of this invention.


In other embodiments, for example, when a composition of the invention comprises a dsRNA as described herein and an N-acetylgalactosamine, subjects can be administered a therapeutic amount of iRNA, such as a dose of about 0.1 to about 50 mg/kg, about 0.25 to about 50 mg/kg, about 0.5 to about 50 mg/kg, about 0.75 to about 50 mg/kg, about 1 to about 50 mg/kg, about 1.5 to about 50 mg/kg, about 2 to about 50 mg/kg, about 2.5 to about 50 mg/kg, about 3 to about 50 mg/kg, about 3.5 to about 50 mg/kg, about 4 to about 50 mg/kg, about 4.5 to about 50 mg/kg, about 5 to about 50 mg/kg, about 7.5 to about 50 mg/kg, about 10 to about 50 mg/kg, about 15 to about 50 mg/kg, about 20 to about 50 mg/kg, about 20 to about 50 mg/kg, about 25 to about 50 mg/kg, about 25 to about 50 mg/kg, about 30 to about 50 mg/kg, about 35 to about 50 mg/kg, about 40 to about 50 mg/kg, about 45 to about 50 mg/kg, about 0.1 to about 45 mg/kg, about 0.25 to about 45 mg/kg, about 0.5 to about 45 mg/kg, about 0.75 to about 45 mg/kg, about 1 to about 45 mg/kg, about 1.5 to about 45 mg/kg, about 2 to about 45 mg/kg, about 2.5 to about 45 mg/kg, about 3 to about 45 mg/kg, about 3.5 to about 45 mg/kg, about 4 to about 45 mg/kg, about 4.5 to about 45 mg/kg, about 5 to about 45 mg/kg, about 7.5 to about 45 mg/kg, about 10 to about 45 mg/kg, about 15 to about 45 mg/kg, about 20 to about 45 mg/kg, about 20 to about 45 mg/kg, about 25 to about 45 mg/kg, about 25 to about 45 mg/kg, about 30 to about 45 mg/kg, about 35 to about 45 mg/kg, about 40 to about 45 mg/kg, about 0.1 to about 40 mg/kg, about 0.25 to about 40 mg/kg, about 0.5 to about 40 mg/kg, about 0.75 to about 40 mg/kg, about 1 to about 40 mg/kg, about 1.5 to about 40 mg/kg, about 2 to about 40 mg/kg, about 2.5 to about 40 mg/kg, about 3 to about 40 mg/kg, about 3.5 to about 40 mg/kg, about 4 to about 40 mg/kg, about 4.5 to about 40 mg/kg, about 5 to about 40 mg/kg, about 7.5 to about 40 mg/kg, about 10 to about 40 mg/kg, about 15 to about 40 mg/kg, about 20 to about 40 mg/kg, about 20 to about 40 mg/kg, about 25 to about 40 mg/kg, about 25 to about 40 mg/kg, about 30 to about 40 mg/kg, about 35 to about 40 mg/kg, about 0.1 to about 30 mg/kg, about 0.25 to about 30 mg/kg, about 0.5 to about 30 mg/kg, about 0.75 to about 30 mg/kg, about 1 to about 30 mg/kg, about 1.5 to about 30 mg/kg, about 2 to about 30 mg/kg, about 2.5 to about 30 mg/kg, about 3 to about 30 mg/kg, about 3.5 to about 30 mg/kg, about 4 to about 30 mg/kg, about 4.5 to about 30 mg/kg, about 5 to about 30 mg/kg, about 7.5 to about 30 mg/kg, about 10 to about 30 mg/kg, about 15 to about 30 mg/kg, about 20 to about 30 mg/kg, about 20 to about 30 mg/kg, about 25 to about 30 mg/kg, about 0.1 to about 20 mg/kg, about 0.25 to about 20 mg/kg, about 0.5 to about 20 mg/kg, about 0.75 to about 20 mg/kg, about 1 to about 20 mg/kg, about 1.5 to about 20 mg/kg, about 2 to about 20 mg/kg, about 2.5 to about 20 mg/kg, about 3 to about 20 mg/kg, about 3.5 to about 20 mg/kg, about 4 to about 20 mg/kg, about 4.5 to about 20 mg/kg, about 5 to about 20 mg/kg, about 7.5 to about 20 mg/kg, about 10 to about 20 mg/kg, or about 15 to about 20 mg/kg. In one embodiment, when a composition of the invention comprises a dsRNA as described herein and an N-acetylgalactosamine, subjects can be administered a therapeutic amount of about 10 to about 30 mg/kg of dsRNA. Values and ranges intermediate to the recited values are also intended to be part of this invention.


For example, subjects can be administered a therapeutic amount of iRNA, such as about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9, 3, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.8, 4.9, 5, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 6, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7, 7.8, 7.9, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.8, 8.9, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9, 10, 10.5, 11, 11.5, 12, 12.5, 13, 13.5, 14, 14.5, 15, 15.5, 16, 16.5, 17, 17.5, 18, 18.5, 19, 19.5, 20, 20.5, 21, 21.5, 22, 22.5, 23, 23.5, 24, 24.5, 25, 25.5, 26, 26.5, 27, 27.5, 28, 28.5, 29, 29.5, 30, 31, 32, 33, 34, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, or about 50 mg/kg. Values and ranges intermediate to the recited values are also intended to be part of this invention.


In certain embodiments of the invention, for example, when a double stranded RNAi agent includes a modification (e.g., one or more motifs of three identical modifications on three consecutive nucleotides), including one such motif at or near the cleavage site of the agent, six phosphorothioate linkages, and a ligand, such an agent is administered at a dose of about 0.01 to about 0.5 mg/kg, about 0.01 to about 0.4 mg/kg, about 0.01 to about 0.3 mg/kg, about 0.01 to about 0.2 mg/kg, about 0.01 to about 0.1 mg/kg, about 0.01 mg/kg to about 0.09 mg/kg, about 0.01 mg/kg to about 0.08 mg/kg, about 0.01 mg/kg to about 0.07 mg/kg, about 0.01 mg/kg to about 0.06 mg/kg, about 0.01 mg/kg to about 0.05 mg/kg, about 0.02 to about 0.5 mg/kg, about 0.02 to about 0.4 mg/kg, about 0.02 to about 0.3 mg/kg, about 0.02 to about 0.2 mg/kg, about 0.02 to about 0.1 mg/kg, about 0.02 mg/kg to about 0.09 mg/kg, about 0.02 mg/kg to about 0.08 mg/kg, about 0.02 mg/kg to about 0.07 mg/kg, about 0.02 mg/kg to about 0.06 mg/kg, about 0.02 mg/kg to about 0.05 mg/kg, about 0.03 to about 0.5 mg/kg, about 0.03 to about 0.4 mg/kg, about 0.03 to about 0.3 mg/kg, about 0.03 to about 0.2 mg/kg, about 0.03 to about 0.1 mg/kg, about 0.03 mg/kg to about 0.09 mg/kg, about 0.03 mg/kg to about 0.08 mg/kg, about 0.03 mg/kg to about 0.07 mg/kg, about 0.03 mg/kg to about 0.06 mg/kg, about 0.03 mg/kg to about 0.05 mg/kg, about 0.04 to about 0.5 mg/kg, about 0.04 to about 0.4 mg/kg, about 0.04 to about 0.3 mg/kg, about 0.04 to about 0.2 mg/kg, about 0.04 to about 0.1 mg/kg, about 0.04 mg/kg to about 0.09 mg/kg, about 0.04 mg/kg to about 0.08 mg/kg, about 0.04 mg/kg to about 0.07 mg/kg, about 0.04 mg/kg to about 0.06 mg/kg, about 0.05 to about 0.5 mg/kg, about 0.05 to about 0.4 mg/kg, about 0.05 to about 0.3 mg/kg, about 0.05 to about 0.2 mg/kg, about 0.05 to about 0.1 mg/kg, about 0.05 mg/kg to about 0.09 mg/kg, about 0.05 mg/kg to about 0.08 mg/kg, or about 0.05 mg/kg to about 0.07 mg/kg. Values and ranges intermediate to the foregoing recited values are also intended to be part of this invention, e.g., the RNAi agent may be administered to the subject at a dose of about 0.015 mg/kg to about 0.45 mg/kg.


For example, the RNAi agent, e.g., RNAi agent in a pharmaceutical composition, may be administered at a dose of about 0.01 mg/kg, 0.0125 mg/kg, 0.015 mg/kg, 0.0175 mg/kg, 0.02 mg/kg, 0.0225 mg/kg, 0.025 mg/kg, 0.0275 mg/kg, 0.03 mg/kg, 0.0325 mg/kg, 0.035 mg/kg, 0.0375 mg/kg, 0.04 mg/kg, 0.0425 mg/kg, 0.045 mg/kg, 0.0475 mg/kg, 0.05 mg/kg, 0.0525 mg/kg, 0.055 mg/kg, 0.0575 mg/kg, 0.06 mg/kg, 0.0625 mg/kg, 0.065 mg/kg, 0.0675 mg/kg, 0.07 mg/kg, 0.0725 mg/kg, 0.075 mg/kg, 0.0775 mg/kg, 0.08 mg/kg, 0.0825 mg/kg, 0.085 mg/kg, 0.0875 mg/kg, 0.09 mg/kg, 0.0925 mg/kg, 0.095 mg/kg, 0.0975 mg/kg, 0.1 mg/kg, 0.125 mg/kg, 0.15 mg/kg, 0.175 mg/kg, 0.2 mg/kg, 0.225 mg/kg, 0.25 mg/kg, 0.275 mg/kg, 0.3 mg/kg, 0.325 mg/kg, 0.35 mg/kg, 0.375 mg/kg, 0.4 mg/kg, 0.425 mg/kg, 0.45 mg/kg, 0.475 mg/kg, or about 0.5 mg/kg. Values intermediate to the foregoing recited values are also intended to be part of this invention.


In some embodiments, the RNAi agent is administered as a fixed dose of between about 100 mg to about 900 mg, e.g., between about 100 mg to about 850 mg, between about 100 mg to about 800 mg, between about 100 mg to about 750 mg, between about 100 mg to about 700 mg, between about 100 mg to about 650 mg, between about 100 mg to about 600 mg, between about 100 mg to about 550 mg, between about 100 mg to about 500 mg, between about 200 mg to about 850 mg, between about 200 mg to about 800 mg, between about 200 mg to about 750 mg, between about 200 mg to about 700 mg, between about 200 mg to about 650 mg, between about 200 mg to about 600 mg, between about 200 mg to about 550 mg, between about 200 mg to about 500 mg, between about 300 mg to about 850 mg, between about 300 mg to about 800 mg, between about 300 mg to about 750 mg, between about 300 mg to about 700 mg, between about 300 mg to about 650 mg, between about 300 mg to about 600 mg, between about 300 mg to about 550 mg, between about 300 mg to about 500 mg, between about 400 mg to about 850 mg, between about 400 mg to about 800 mg, between about 400 mg to about 750 mg, between about 400 mg to about 700 mg, between about 400 mg to about 650 mg, between about 400 mg to about 600 mg, between about 400 mg to about 550 mg, or between about 400 mg to about 500 mg.


In some embodiments, the RNAi agent is administered as a fixed dose of about 100 mg, about 125 mg, about 150 mg, about 175 mg, 200 mg, about 225 mg, about 250 mg, about 275 mg, about 300 mg, about 325 mg, about 350 mg, about 375 mg, about 400 mg, about 425 mg, about 450 mg, about 475 mg, about 500 mg, about 525 mg, about 550 mg, about 575 mg, about 600 mg, about 625 mg, about 650 mg, about 675 mg, about 700 mg, about 725 mg, about 750 mg, about 775 mg, about 800 mg, about 825 mg, about 850 mg, about 875 mg, or about 900 mg.


The iRNA can be administered by intravenous infusion over a period of time, such as over a 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, or about a 25 minute period. The administration may be repeated, for example, on a regular basis, such as weekly, biweekly (i.e., every two weeks) for one month, two months, three months, four months or longer. After an initial treatment regimen, the treatments can be administered on a less frequent basis. For example, after administration weekly or biweekly for three months, administration can be repeated once per month, for six months or a year or longer.


Administration of the iRNA can reduce the presence of contact activation pathway protein (i.e., F12 protein, and KLKB1 protein and/or KNG1 protein) and/or bradykinin levels, e.g., in a cell, tissue, blood, urine or other compartment of the patient by at least about 5%, 6%, 7%, 8%, 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%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or at least about 99% or more.


Before administration of a full dose of the iRNA, patients can be administered a smaller dose, such as a 5% infusion, and monitored for adverse effects, such as an allergic reaction. In another example, the patient can be monitored for unwanted immunostimulatory effects, such as increased cytokine (e.g., TNF-alpha or INF-alpha) levels.


Owing to the inhibitory effects on contact activation pathway gene expression, a composition according to the invention or a pharmaceutical composition prepared therefrom can enhance the quality of life.


An iRNA of the invention may be administered in “naked” form, where the modified or unmodified iRNA agent is directly suspended in aqueous or suitable buffer solvent, as a “free iRNA.” A free iRNA is administered in the absence of a pharmaceutical composition. The free 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 a reduction and/or inhibition of contact activation pathway gene expression are those having hereditary angioedema (HAE) and/or a contact activation pathway-associated disease or disorder as described herein.


Treatment of a subject that would benefit from a reduction and/or inhibition of contact activation pathway gene expression includes therapeutic and prophylactic treatment.


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 contact activation pathway gene expression, e.g., a subject having a contact activation pathway-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.


For example, in certain embodiments, an iRNA targeting a contact activation pathway gene is administered in combination with, e.g., an agent useful in treating an contact activation pathway-associated disease as described elsewhere herein. For example, additional therapeutics and therapeutic methods suitable for treating a subject that would benefit from reduction in contact activation pathway gene expression, e.g., a subject having a contact activation pathway-associated disease, include an iRNA agent targeting a different portion of the contact activation pathway gene, an androgen, or a therapeutic agent, e.g., a C1INH replacement protein, a kallikrein inhibitor peptide, a bradkinin B2 receptor antagonist peptide, or other therapeutic agents and/or procedures for treating a contact activation pathway-associated disease or a combination of any of the foregoing. In one embodiment, the additional therapeutic is selected from the group consisting of an androgen, such as danazol or oxandrolone, Berinert®, Cinryze™, Rhuconest®, Ecallantide, Firazyr®, Kalbitor®, and a combination of any of the foregoing.


In certain embodiments, a first iRNA agent targeting a contact activation pathway gene is administered in combination with a second iRNA agent targeting a different portion of the contact activation pathway gene. For example, the first RNAi agent comprises a first sense strand and a first antisense strand forming a double stranded region, wherein substantially all of the nucleotides of said first sense strand and substantially all of the nucleotides of the first antisense strand are modified nucleotides, wherein said first sense strand is conjugated to a ligand attached at the 3′-terminus, and wherein the ligand is one or more GalNAc derivatives attached through a bivalent or trivalent branched linker; and the second RNAi agent comprises a second sense strand and a second antisense strand forming a double stranded region, wherein substantially all of the nucleotides of the second sense strand and substantially all of the nucleotides of the second antisense strand are modified nucleotides, wherein the second sense strand is conjugated to a ligand attached at the 3′-terminus, and wherein the ligand is one or more GalNAc derivatives attached through a bivalent or trivalent branched linker.


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


In one embodiment, the at least one of the modified nucleotides is selected from the group consisting of a 3′-terminal deoxy-thymine (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, and a nucleotide comprising a 5′-phosphate mimic.


In certain embodiments, a first iRNA agent targeting a contact activation pathway gene is administered in combination with a second iRNA agent targeting a gene that is different from the contact activation pathway gene. For example, the iRNA agent targeting the F12 gene may be administered in combination with an iRNA agent targeting the KLKB1 gene. The first iRNA agent targeting a F12 gene and the second iRNA agent targeting a gene different from the F12 gene, e.g., the KLKB1 gene, may be administered as parts of the same pharmaceutical composition. Alternatively, the first iRNA agent targeting a F12 gene and the second iRNA agent targeting a gene different from the F12 gene, e.g., the KLKB1 gene, may be administered as parts of different pharmaceutical compositions.


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.


The present invention also provides methods of using an iRNA agent of the invention and/or a composition containing an iRNA agent of the invention to reduce and/or inhibit contact activation pathway gene expression (i.e., F12 expression) in a cell. In other aspects, the present invention provides an iRNA of the invention and/or a composition comprising an iRNA of the invention for use in reducing and/or inhibiting contact activation pathway gene expression (i.e., F12 expression) in a cell. In yet other aspects, use of an iRNA of the invention and/or a composition comprising an iRNA of the invention for the manufacture of a medicament for reducing and/or inhibiting contact activation pathway gene expression (i.e., F12 expression) in a cell are provided. In still other aspects, the the present invention provides an iRNA of the invention and/or a composition comprising an iRNA of the invention for use in reducing and/or inhibiting contact activation pathway protein production (i.e., F12 protein production) in a cell. In yet other aspects, use of an iRNA of the invention and/or a composition comprising an iRNA of the invention for the manufacture of a medicament for reducing and/or inhibiting contact activation pathway protein production (i.e., F12 protein production) in a cell are provided. The methods and uses include contacting the cell with an iRNA, e.g., a dsRNA, of the invention and maintaining the cell for a time sufficient to obtain degradation of the mRNA transcript of the contact activation pathway gene, thereby inhibiting expression of the contact activation pathway gene or inhibiting contact activation pathway protein production in the cell.


Reduction in gene expression can be assessed by any methods known in the art. For example, a reduction in the expression of F12 may be determined by determining the mRNA expression level of F12 using methods routine to one of ordinary skill in the art, e.g., Northern blotting, qRT-PCR, by determining the protein level of F12 using methods routine to one of ordinary skill in the art, such as Western blotting, immunological techniques, flow cytometry methods, ELISA, and/or by determining a biological activity of F12.


In the methods and uses of the invention the cell may be contacted 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 contact activation pathway gene, e.g., a cell from a subject having hereditary angioedema (HAE) or a cell comprising an expression vector comprising a contact activation pathway gene or portion of a contact activation pathway gene. A cell suitable for use in the methods and uses of the invention may be a mammalian cell, e.g., a primate cell (such as a human cell or a non-human primate cell, e.g., a monkey cell or a chimpanzee cell), a non-primate cell (such as a cow cell, a pig cell, a camel cell, a llama cell, a horse cell, a goat cell, a rabbit cell, a sheep cell, a hamster, a guinea pig cell, a cat cell, a dog cell, a rat cell, a mouse cell, a lion cell, a tiger cell, a bear cell, or a buffalo cell), a bird cell (e.g., a duck cell or a goose cell), or a whale cell. In one embodiment, the cell is a human cell.


Contact activation pathway gene expression may be inhibited in the cell by at least about 5%, 6%, 7%, 8%, 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%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or about 100%.


Contact activation pathway protein production may be inhibited in the cell by at least about 5%, 6%, 7%, 8%, 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%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or about 100%.


The in vivo methods and uses 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 contact activation pathway gene of the mammal to be treated. When the organism to be treated is a human, the composition can be administered by any means known in the art including, but not limited to subcutaneous, intravenous, oral, intraperitoneal, or parenteral routes, including intracranial (e.g., intraventricular, intraparenchymal and intrathecal), intramuscular, transdermal, airway (aerosol), nasal, rectal, and topical (including buccal and sublingual) administration. In certain embodiments, the compositions are administered by subcutaneous or intravenous infusion or injection. In one embodiment, the compositions are administered by subcutaneous 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 F12, 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 preferred 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 preferred 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 subject.


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 another aspect, the present invention also provides methods for inhibiting the expression of an F12 gene in a mammal, e.g., a human. The present invention also provides a composition comprising an iRNA, e.g., a dsRNA, that targets an F12 gene in a cell of a mammal for use in inhibiting expression of the F12 gene in the mammal. In another aspect, the present invention provides use of an iRNA, e.g., a dsRNA, that targets an F12 gene in a cell of a mammal in the manufacture of a medicament for inhibiting expression of the F12 gene in the mammal.


The methods and uses include administering to the mammal, e.g., a human, a composition comprising an iRNA, e.g., a dsRNA, that targets an F12 gene in a cell of the mammal and maintaining the mammal for a time sufficient to obtain degradation of the mRNA transcript of the F12 gene, thereby inhibiting expression of the F12 gene in the mammal.


Reduction in gene expression can be assessed in peripheral blood sample of the iRNA-administered subject by any methods known it the art, e.g. qRT-PCR, described herein. Reduction in protein production can be assessed by any methods known it the art and by methods, e.g., ELISA or Western blotting, described herein. In one embodiment, a tissue sample serves as the tissue material for monitoring the reduction in contact activation pathway gene and/or protein expression. In another embodiment, a blood sample serves as the tissue material for monitoring the reduction in contact activation pathway gene and/or protein expression.


In one embodiment, verification of RISC medicated cleavage of target in vivo following administration of iRNA agent is done by performing 5′-RACE or modifications of the protocol as known in the art (Lasham A et al., (2010) Nucleic Acid Res., 38 (3) p-e19) (Zimmermann et al. (2006) Nature 441: 111-4).


III. Methods For Inhibiting Contact Activation Pathway Gene Expression

The present invention also provides methods of inhibiting expression of a contact activation pathway gene (i.e.,an F12 gene) in a cell.


In one embodiment, the invention provides methods for inhibiting expression of an F12 gene in a cell. The methods include contacting a cell with an RNAi agent, e.g., double stranded RNAi agent, in an amount effective to inhibit expression of F12 in the cell, thereby inhibiting expression of F12 in the cell.


Contacting of a cell with an RNAi agent, e.g., a double stranded RNAi agent, may be done in vitro or in vivo. Contacting a cell in vivo with the RNAi agent includes contacting a cell or group of cells within a subject, e.g., a human subject, with the RNAi agent. 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 preferred embodiments, the targeting ligand is a carbohydrate moiety, e.g., a GalNAc3 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 contact activation pathway gene” is intended to refer to inhibition of expression of any contact activation pathway gene (such as, e.g., a mouse contact activation pathway gene, a rat contact activation pathway gene, a monkey contact activation pathway gene, or a human contact activation pathway gene) as well as variants or mutants of a contact activation pathway gene.


The phrase “inhibiting expression of F12” is intended to refer to inhibition of expression of any F12 gene (such as, e.g., a mouse F12 gene, a rat F12 gene, a monkey F12 gene, or a human F12 gene) as well as variants or mutants of an F12 gene. Thus, the F12 gene may be a wild-type F12 gene, a mutant F12 gene (such as a mutant F12 gene), or a transgenic F12 gene in the context of a genetically manipulated cell, group of cells, or organism.


“Inhibiting expression of an F12 gene” includes any level of inhibition of an F12 gene, e.g., at least partial suppression of the expression of an F12 gene. The expression of the F12 gene may be assessed based on the level, or the change in the level, of any variable associated with F12 gene expression, e.g., F12 mRNA level, F12 protein level, or the number or extent of amyloid deposits. This level may be assessed in an individual cell or in a group of cells, including, for example, a sample derived from a subject.


Inhibition may be assessed by a decrease in an absolute or relative level of one or more variables that are associated with contact activation pathway gene 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 contact activation pathway gene (i.e., an F12 gene) is inhibited by at least about 5%, at least about 10%, at least about 15%, at least about 20%, at least about 25%, at least about 30%, at least about 35%,at least about 40%, at least about 45%, at least about 50%, at least about 55%, at least about 60%, at least about 65%, at least about 70%, at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%. at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%.


Inhibition of the expression of a contact activation pathway 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 contact activation pathway gene is transcribed and which has or have been treated (e.g., by contacting the cell or cells with an RNAi agent of the invention, or by administering an RNAi agent of the invention to a subject in which the cells are or were present) such that the expression of a contact activation pathway 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)). In preferred embodiments, the inhibition is assessed by 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


%




Alternatively, inhibition of the expression of a contact activation pathway gene may be assessed in terms of a reduction of a parameter that is functionally linked to contact activation pathway gene expression, e.g., KLKB1 protein expression, F12 protein expression, KNG1 protein expression, fibrin deposition, thrombus generation, or bradykinin level. Contact activation pathway gene silencing may be determined in any cell expressing a contact activation pathway gene, either constitutively or by genomic engineering, and by any assay known in the art.


Inhibition of the expression of a contact activation pathway protein may be manifested by a reduction in the level of a contact activation pathway protein that is expressed by a cell or group of cells (e.g., the level of protein expressed in a 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.


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


The level of contact activation pathway mRNA that is expressed by a cell or group of cells, or the level of circulating contact activation pathway mRNA, may be determined using any method known in the art for assessing mRNA expression. In one embodiment, the level of expression of a contact activation pathway gene in a sample is determined by detecting a transcribed polynucleotide, or portion thereof, e.g., mRNA of the F12 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 (Melton et al., Nuc. Acids Res. 12:7035), Northern blotting, in situ hybridization, and microarray analysis. Circulating KLKB1 mRNA may be detected using methods the described in PCT/US2012/043584, the entire contents of which are hereby incorporated herein by reference.


In one embodiment, the level of expression of a contact activation pathway gene 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 contact activation pathway gene. 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 F12 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 contact activation pathway gene mRNA.


An alternative method for determining the level of expression of a contact activation pathway gene in a sample involves the process of nucleic acid amplification and/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. Natl. Acad. Sci. USA 88:189-193), self sustained sequence replication (Guatelli et al. (1990) Proc. Natl. Acad. Sci. USA 87:1874-1878), transcriptional amplification system (Kwoh et al. (1989) Proc. Natl. 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 a contact activation pathway gene is determined by quantitative fluorogenic RT-PCR (i.e., the TaqMan™ System).


The expression levels of a contact activation pathway 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 F12 expression level may also comprise using nucleic acid probes in solution.


In preferred 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.


The level of contact activation pathway 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 can be monitored by detecting or monitoring a reduction in a symptom of a contact activation pathway-associated disease, such as reduction in edema swelling of the extremities, face, larynx, upper respiratory tract, abdomen, trunk, and genitals, prodrome; laryngeal swelling; nonpruritic rash; nausea; vomiting; or abdominal pain. These symptoms may be assessed in vitro or in vivo using any method known in the art.


The term “sample” as used herein refers to 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, lymph, urine, cerebrospinal fluid, saliva, ocular fluids, 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 organis. 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), the retina or parts of the retina (e.g., retinal pigment epithelium), the central nervous system or parts of the central nervous system (e.g., ventricles or choroid plexus), or the pancreas or certain cells or parts of the pancreas. In preferred embodiments, a “sample derived from a subject” refers to blood or plasma drawn from the subject. In further embodiments, a “sample derived from a subject” refers to liver tissue or retinal tissue derived from the subject.


In some embodiments of the methods of the invention, the RNAi agent is administered to a subject such that the RNAi agent is delivered to a specific site within the subject. The inhibition of expression of a contact activation pathway gene may be assessed using measurements of the level or change in the level of contact activation pathway gene mRNA or contact activation pathway protein in a sample derived from fluid or tissue from the specific site within the subject. In preferred embodiments, the site is selected from the group consisting of liver, choroid plexus, retina, and pancreas. The site may also be a subsection or subgroup of cells from any one of the aforementioned sites. The site may also include cells that express a particular type of receptor.


IV. iRNAs of the Invention

The present invention provides iRNAs which inhibit the expression of a contact activation pathway gene (i.e., an F12 gene). In one embodiment, the iRNA agent includes double stranded ribonucleic acid (dsRNA) molecules for inhibiting the expression of a contact activation pathway gene in a cell, such as a cell within a subject, e.g., a mammal, such as a human having a contact activation pathway-associated disease, e.g., a thrombophilia or hereditary angioedema, or at risk of developing a contact activation pathway-associated disease, e.g., a thrombophilia, or an angioedema attack. The dsRNA 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 contact activation pathway gene. The region of complementarity is about 30 nucleotides or less in length (e.g., about 30, 29, 28, 27, 26, 25, 24, 23, 22, 21, 20, 19, or 18 nucleotides or less in length). Upon contact with a cell expressing the contact activation pathway gene, the iRNA inhibits the expression of the contact activation pathway gene (e.g., a human, a primate, a non-primate, or a bird contact activation pathway gene) by at least about 10% 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.


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 contact activation pathway gene (i.e., an F12 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 between 15 and 30 base pairs in length, e.g., between, 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. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the invention.


Similarly, the region of complementarity to the target sequence is between 15 and 30 nucleotides in length, e.g., between 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. Ranges and lengths intermediate to the above recited ranges and lengths are also contemplated to be part of the invention.


In some embodiments, the dsRNA is about 15 to about 20 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 9 to 36 base pairs, e.g., about 10-36, 11-36, 12-36, 13-36, 14-36, 15-36, 9-35, 10-35, 11-35, 12-35, 13-35, 14-35, 15-35, 9-34, 10-34, 11-34, 12-34, 13-34, 14-34, 15-34, 9-33, 10-33, 11-33, 12-33, 13-33, 14-33, 15-33, 9-32, 10-32, 11-32, 12-32, 13-32, 14-32, 15-32, 9-31, 10-31, 11-31, 12-31, 13-32, 14-31, 15-31, 15-30, 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. 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 contact activation pathway 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, 2, 3, or 4 nucleotides. dsRNAs having at least one nucleotide overhang can have unexpectedly 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 either an antisense or sense strand of a dsRNA.


A dsRNA can be synthesized by standard methods known in the art as further discussed below, e.g., by use of an automated DNA synthesizer, such as are commercially available from, for example, Biosearch, Applied Biosystems, Inc.


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.


In one 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 3, 4, 9-12, 14, 15, 17, and 18, and the corresponding antisense strand of the sense strand is selected from the group of sequences of any one of Tables 3, 4, 9-12, 14, 15, 17, and 18.


In one embodiment, the sense strand is selected from the group of sequences provided in any one of any one of Tables 9, 10, 19C, 19D, 20, 21, 23, 24, 26, and 27, and the corresponding antisense strand of the sense strand is selected from the group of sequences of any one of Tables 9, 10, 19C, 19D, 20, 21, 23, 24, 26, and 27. 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 an F12 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 9, 10, 19C, 19D, 20, 21, 23, 24, 26, and 27, and the second oligonucleotide is described as the corresponding antisense strand of the sense strand in any one of Tables 9, 10, 19C, 19D, 20, 21, 23, 24, 26, and 27. In one embodiment, the substantially complementary sequences of the dsRNA are contained on separate oligonucleotides. In another embodiment, the substantially complementary sequences of the dsRNA are contained on a single oligonucleotide.


It will be understood that, although some of the sequences in Tables 3, 4, 9-12, 14, 15, 17, and 18 are described as modified and/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 Tables 3, 4, 9-12, 14, 15, 17, and 18 that is un-modified, un-conjugated, and/or modified and/or conjugated differently than described therein.


The skilled person is well aware that dsRNAs having a duplex structure of about 20 to about 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 3, 4, 9-12, 14, 15, 17, and 18, 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 one of the sequences of any one of Tables 3, 4, 9-12, 14, 15, 17, and 18 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 15, 16, 17, 18, 19, 20, or more contiguous nucleotides derived from one of the sequences of any one of Tables 3, 4, 9-12, 14, 15, 17, and 18 and differing in their ability to inhibit the expression of an F12 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 any one of Tables 3, 4, 9-12, 14, 15, 17, and 18 identify a site(s) in an F12 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 15 contiguous nucleotides from one of the sequences provided in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18 coupled to additional nucleotide sequences taken from the region contiguous to the selected sequence in the contact activation pathway gene.


While a target sequence is generally about 15-30 nucleotides in length, there is wide variation in the suitability of particular sequences in this range for directing cleavage of any given target RNA. Various software packages and the guidelines set out herein provide guidance for the identification of optimal target sequences for any given gene target, but an empirical approach can also be taken in which a “window” or “mask” of a given size (as a non-limiting example, 21 nucleotides) is literally or figuratively (including, e.g., in silico) placed on the target RNA sequence to identify sequences in the size range that can serve as target sequences. By moving the sequence “window” progressively one nucleotide upstream or downstream of an initial target sequence location, the next potential target sequence can be identified, until the complete set of possible sequences is identified for any given target size selected. This process, coupled with systematic synthesis and testing of the identified sequences (using assays as described herein or as known in the art) to identify those sequences that perform optimally can identify those RNA sequences that, when targeted with an iRNA agent, mediate the best inhibition of target gene expression. Thus, while the sequences identified, for example, in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18 represent effective target sequences, it is contemplated that further optimization of inhibition efficiency can be achieved by progressively “walking the window” one nucleotide upstream or downstream of the given sequences to identify sequences with equal or better inhibition characteristics.


Further, it is contemplated that for any sequence identified, e.g., in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18 further optimization could be achieved by systematically either adding or removing nucleotides to generate longer or shorter sequences and testing those sequences generated by walking a window of the longer or shorter size up or down the target RNA from that point. Again, coupling this approach to generating new candidate targets with testing for effectiveness of iRNAs based on those target sequences in an inhibition assay as known in the art and/or as described herein can lead to further improvements in the efficiency of inhibition. Further still, such optimized sequences can be adjusted by, e.g., the introduction of modified nucleotides as described herein or as known in the art, addition or changes in overhang, or other modifications as known in the art and/or discussed herein to further optimize the molecule (e.g., increasing serum stability or circulating half-life, increasing thermal stability, enhancing transmembrane delivery, targeting to a particular location or cell type, increasing interaction with silencing pathway enzymes, increasing release from endosomes) as an expression inhibitor.


An iRNA as described herein can contain one or more mismatches to the target sequence. In one embodiment, an iRNA as described herein contains no more than 3 mismatches. If the antisense strand of the iRNA contains mismatches to a target sequence, it is preferable that the area of mismatch is not located in the center of the region of complementarity. If the antisense strand of the iRNA contains mismatches to the target sequence, it is preferable that the mismatch be restricted to be within the last 5 nucleotides from either the 5′- or 3′-end of the region of complementarity. For example, for a 23 nucleotide iRNA agent the strand which is complementary to a region of a contact activation pathway 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 iRNA containing a mismatch to a target sequence is effective in inhibiting the expression of a contact activation pathway gene. Consideration of the efficacy of iRNAs with mismatches in inhibiting expression of a contact activation pathway gene is important, especially if the particular region of complementarity in a contact activation pathway gene is known to have polymorphic sequence variation within the population.


V. Modified iRNAs of the Invention

In one embodiment, the RNA of the iRNA of the invention e.g., a dsRNA, is un-modified, and does not comprise, e.g., chemical modifications and/or conjugations known in the art and described herein. In another embodiment, 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 of the invention are modified iRNAs of the invention in which “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. In some embodiments, substantially all of the nucleotides of an iRNA of the invention are modified and the iRNA comprises no more than 8 2′-fluoro modifications (e.g., no more than 7 2′-fluoro modifications, no more than 6 2′-fluoro modifications, no more than 5 2′-fluoro modification, no more than 4 2′-fluoro modifications, no more than 3 2′-fluoro modifications, or no more than 2 2′-fluoro modifications) on the sense strand and no more than 6 2′-fluoro modifications (e.g., no more than 5 2′-fluoro modifications, no more than 4 2′-fluoro modifications, no more than 3 2′-fluoro modifications, or no more than 2 2′-fluoro modifications) on the antisense strand. In other embodiments, all of the nucleotides of an iRNA of the invention are modified and the iRNA comprises no more than 8 2′-fluoro modifications (e.g., no more than 7 2′-fluoro modifications, no more than 6 2′-fluoro modifications, no more than 5 2′-fluoro modification, no more than 4 2′-fluoro modifications, no more than 3 2′-fluoro modifications, or no more than 2 2′-fluoro modifications) on the sense strand and no more than 6 2′-fluoro modifications (e.g., no more than 5 2′-fluoro modifications, no more than 4 2′-fluoro modifications, no more than 3 2′-fluoro modifications, or no more than 2 2′-fluoro modifications) on the antisense strand.


The nucleic acids featured in the invention can be synthesized and/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; and/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.


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.


In other embodiments, suitable RNA mimetics are contemplated for use in iRNAs, 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, 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 U.S. 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 invention 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-[wherein the native phosphodiester backbone is represented as —O—PO—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.


Modified RNAs can also contain one or more substituted sugar moieties. The iRNAs, 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-0-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]nCH3, O(CH2)−nOCH3, 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 an iRNA, or a group for improving the pharmacodynamic properties of an iRNA, 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(CH2)2.


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 U.S. 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.


The RNA of 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 deoxy-thymine (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.


The RNA of an iRNA can also be modified to include one or more bicyclic sugar moities. A “bicyclic sugar” is a furanosyl ring modified by the bridging of two atoms. A“bicyclic nucleoside” (“BNA”) is a nucleoside having a sugar moiety comprising a bridge connecting 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. Thus, in some embodiments an agent of the invention 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, OR. 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 invention 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 invention include one or more bicyclic nucleosides comprising a 4′ to 2′ bridge. 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)-0-2′ (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 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 US 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).


The RNA of an iRNA 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. 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 C3 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, US Patent Publication No. 2013/0190383; and PCT publication WO 2013/036868, the entire contents of each of which are hereby incorporated herein by reference.


One or more of the nucleotides of an iRNA of the invention may also include a hydroxymethyl substituted nucleotide. A “hydroxymethyl substituted nucleotide” is an acyclic 2′-3′-seco-nucleotide, also referred to as an “unlocked nucleic acid” (“UNA”) modification


Representative U.S. publications that teach the preparation of UNA include, but are not limited to, U.S. Pat. No. 8,314,227; and US 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′-0-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 PCT Publication No. 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 RNAi agent. Suitable phosphate mimics are disclosed in, for example US 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 RNAi agents of the invention include agents with chemical modifications as disclosed, for example, in U.S. Provisional Application No. 61/561,710, filed on Nov. 18, 2011, or in PCT/US2012/065691, filed on Nov. 16, 2012, the entire contents of each of which are incorporated herein by reference.


As shown herein and in Provisional Application No. 61/561,710 or PCT Application No. PCT/US2012/065691, a superior result may be obtained by introducing one or more motifs of three identical modifications on three consecutive nucleotides into a sense strand and/or antisense strand of an RNAi agent, particularly at or near the cleavage site. In some embodiments, the sense strand and antisense strand of the RNAi agent may otherwise be completely modified. The introduction of these motifs interrupts the modification pattern, if present, of the sense and/or antisense strand. The RNAi agent may be optionally conjugated with a GalNAc derivative ligand, for instance on the sense strand.


The resulting RNAi agents present superior gene silencing activity. More specifically, it has been surprisingly discovered that when the sense strand and antisense strand of the double stranded RNAi 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 an RNAi agent, the gene silencing activity of the RNAi agent was superiorly enhanced.


Accordingly, the invention provides double stranded RNAi agents capable of inhibiting the expression of a target gene (i.e., a contact activation pathway gene, i.e. an F12 gene) in vivo. The RNAi agent comprises a sense strand and an antisense strand. Each strand of the RNAi agent may range from 12-30 nucleotides in length. For example, each strand may be between 14-30 nucleotides in length, 17-30 nucleotides in length, 25-30 nucleotides in length, 27-30 nucleotides in length, 17-23 nucleotides in length, 17-21 nucleotides in length, 17-19 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 an “RNAi agent.” The duplex region of an RNAi agent may be 12-30 nucleotide pairs in length. For example, the duplex region can be between 14-30 nucleotide pairs in length, 17-30 nucleotide pairs in length, 27-30 nucleotide pairs in length, 17-23 nucleotide pairs in length, 17-21 nucleotide pairs in length, 17-19 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 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, and 27 nucleotides in length.


In one embodiment, the RNAi agent may contain one or more overhang regions and/or capping groups at the 3′-end, 5′-end, or both ends of one or both strands. The overhang can be 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. 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 one embodiment, the nucleotides in the overhang region of the RNAi agent can each independently be a modified or unmodified nucleotide including, but no limited to 2′-sugar modified, such as, 2-F, 2′-Omethyl, 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 RNAi 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 one embodiment, the overhang is present at the 3′-end of the sense strand, antisense strand, or both strands. In one embodiment, this 3′-overhang is present in the antisense strand. In one embodiment, this 3′-overhang is present in the sense strand.


The RNAi 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-terminal end of the sense strand or, alternatively, at the 3-terminal 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 RNAi 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 one embodiment, the RNAi agent is a double ended bluntmer 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 another embodiment, the RNAi agent is a double ended bluntmer 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 another embodiment, the RNAi agent is a double ended bluntmer 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 one embodiment, the RNAi 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. Preferably, 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 one embodiment, every nucleotide in the sense strand and the antisense strand of the RNAi agent, including the nucleotides that are part of the motifs are modified nucleotides. In one embodiment each residue is independently modified with a 2′-O-methyl or 3′-fluoro, e.g., in an alternating motif. Optionally, the RNAi agent further comprises a ligand (preferably GalNAc3).


In one embodiment, the RNAi 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 one embodiment, the RNAi agent comprises sense and antisense strands, wherein the RNAi 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 RNAi 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 RNAi agent further comprises a ligand.


In one embodiment, the sense strand of the RNAi 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 one embodiment, the antisense strand of the RNAi 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 an RNAi agent having a duplex region of 17-23 nucleotide 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; 10, 11, 12 positions; 11, 12, 13 positions; 12, 13, 14 positions; or 13, 14, 15 positions of the antisense strand, the count starting from the 1st nucleotide from the 5′-end of the antisense strand, or, the count starting from the 1st 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 RNAi from the 5′-end.


The sense strand of the RNAi 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 one embodiment, the sense strand of the RNAi 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 adajacent 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 chemistry 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 RNAi 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 one embodiment, the wing modification on the sense strand or antisense strand of the RNAi 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 another embodiment, the wing modification on the sense strand or antisense strand of the RNAi 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 RNAi 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 RNAi 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 one embodiment, every nucleotide in the sense strand and antisense strand of the RNAi 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 and/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 a 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 one embodiment, each residue of the sense strand and antisense strand is independently modified with LNA, CRN, cET, UNA, HNA, CeNA, 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 one embodiment, the Na and/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 one embodiment, the RNAi 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′-3′ of the strand and the alternating motif in the antisense strand may start with “BABABA” from 5′-3′ of the strand within the duplex region. As another example, the alternating motif in the sense strand may start with “AABBAABB” from 5′-3′ of the strand and the alternating motif in the antisenese strand may start with “BBAABBAA” from 5′-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 one embodiment, the RNAi 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 and/or antisense strand interrupts the initial modification pattern present in the sense strand and/or antisense strand. This interruption of the modification pattern of the sense and/or antisense strand by introducing one or more motifs of three identical modifications on three consecutive nucleotides to the sense and/or antisense strand surprisingly enhances the gene silencing activity to the target gene.


In one embodiment, 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 and/or Nb may be present or absent when there is a wing modification present.


The RNAi agent 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 or 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 and/or antisense strand; each internucleotide linkage modification may occur in an alternating pattern on the sense strand and/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 6-8phosphorothioate internucleotide linkages. In one embodiment, the antisense strand comprises two phosphorothioate internucleotide linkages at the 5′-terminus and two phosphorothioate internucleotide linkages at the 3′-terminus, and the sense strand comprises at least two phosphorothioate internucleotide linkages at either the 5′-terminus or the 3′-terminus.


In one embodiment, the RNAi 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, and/or the 5′end of the antisense strand.


In one embodiment, 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 RNAi 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 RNAi agent comprises mismatch(es) with the target, within the duplex, or combinations thereof. The mistmatch 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 one embodiment, the RNAi 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 one embodiment, the nucleotide at the 1 position within the duplex region from the 5′-end in the antisense strand is selected from the group consisting of 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 another embodiment, the nucleotide at the 3′-end of the sense strand is deoxy-thymine (dT). In another embodiment, the nucleotide at the 3′-end of the antisense strand is deoxy-thymine (dT). In one embodiment, there is a short sequence of deoxy-thymine nucleotides, for example, two dT nucleotides on the 3′-end of the sense and/or antisense strand.


In one embodiment, the sense strand sequence may be represented by formula (I):











(I)



5′ np-Na-(X X X)i-Nb-Y Y Y-Nb-(Z Z Z)j-Na-nq 3′








    • 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. Preferably YYY is all 2′-F modified nucleotides.





In one embodiment, the Na and/or Nb comprise modifications of alternating pattern.


In one embodiment, the YYY motif occurs at or near the cleavage site of the sense strand. For example, when the RNAi 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 1st nucleotide, from the 5′-end; or optionally, the count starting at the 1st 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:











(Ib)



5′ np-Na-YYY-Nb-ZZZ-Na-nq 3′;







(Ic)



5′ np-Na-XXX-Nb-YYY-Na-nq 3′;



or







(Id)



5′ np-Na-XXX-Nb-YYY-Nb-ZZZ-Na-nq 3′.






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. Preferably, 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:











(Ia)



5′ np-Na-YYY-Na-nq 3′.






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):











(II)



5′ nq′-Na′-(Z′Z′Z′)K-Nb′-Y′Y′Y′-







Nb′-(X′X′X′)l-N′a-np′ 3′








    • wherein:

    • k and 1 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

    • 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, the Na′ and/or Nb′ comprise modifications of alternating pattern.


The Y′Y′Y′ motif occurs at or near the cleavage site of the antisense strand. For example, when the RNAi agent has a duplex region of 17-23nucleotidein 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 1st nucleotide, from the 5′-end; or optionally, the count starting at the 14′ paired nucleotide within the duplex region, from the 5′-end. Preferably, the Y′Y′Y′ motif occurs at positions 11, 12, 13.


In one embodiment, Y′Y′Y′ motif is all 2′-OMe modified nucleotides.


In one embodiment, k is 1 and 1 is 0, or k is 0 and 1 is 1, or both k and 1 are 1.


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









(IIb)


5′ nq′-Na′-Z′Z′Z′-Nb′-Y′Y′Y′-Na′-np′ 3′;





(IIc)


5′ nq′-Na′-Y′Y′Y′-Nb′-X′X′X′-np′ 3′;


or





(IId)


5′ nq′-Na′-Z′Z′Z′-Nb′-Y′Y′Y′-Nb′-X′X′X′-Na′-np 3′.






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. Preferably, 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:











(Ia)



5′ np′-Na′-Y′Y′Y′-Na′-nq′ 3′.






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, HNA, CeNA, 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 one embodiment, the sense strand of the RNAi 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 1stnucleotide from the 5′-end, or optionally, the count starting at the 1st 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 one embodiment the antisense strand may contain Y′Y′Y′ motif occurring at positions 11, 12, 13 of the strand, the count starting from the 1st nucleotide from the 5′-end, or optionally, the count starting at the 14′ 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 a antisense strand being represented by any one of formulas (IIa), (IIb), (IIc), and (IId), respectively.


Accordingly, the RNAi 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 RNAi duplex represented by formula (III):











(III)



sense:



5′ np-Na-(X X X)i-Nb-Y Y Y-Nb-(Z Z Z)j-Na-nq 3′







antisense:



3′ np′-Na′-(X′X′X′)K-Nb′-Y′Y′Y′-







Nb′-(Z′Z′Z′)I-Na′-nq′ 5′








    • wherein:

    • i, j, k, and 1 are each independently 0 or 1;

    • p, p′, q, and q′ 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 a RNAi duplex include the formulas below:









(IIIa)


5′ np-Na-Y Y Y-Na-nq 3′





3′ np′-Na′-Y′Y′Y′-Na′nq′ 5′





(IIIb)


5′ np-Na-Y Y Y-Nb-Z Z Z-Na-nq 3′





3′ np′-Na-Y′Y′Y′-No′-Z′Z′Z′-Na′nq′ 5′





(IIIc)


5′ np-Na-X X X-Nb-Y Y Y-Na-nq 3′





3′ np′-Na′-X′X′X′-ND′-Y′Y′Y′-Na′-nq′ 5′





(IIId)


5′ np-Na-X X X-Nb-Y Y Y-Nb-Z Z Z-Na-nq 3′





3′ np′-Na′-X′X′X′-ND′-Y′Y′Y′-No′-Z′Z′Z′-Na-nq 5′






When the RNAi 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 RNAi 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 RNAi 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 RNAi 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 Omodified 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 RNAi 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 RNAi 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 RNAi 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 one embodiment, 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, and/or the modification on the X nucleotide is different than the modification on the X′ nucleotide.


In one embodiment, when the RNAi agent is represented by formula (IIId), the Na modifications are 2′-O-methyl or 2′-fluoro modifications. In another embodiment, 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 another embodiment, 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 another embodiment, 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 one embodiment, when the RNAi 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 one embodiment, the RNAi 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 one embodiment, the RNAi 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 RNAi agents represented by formula (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 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.


Various publications describe multimeric RNAi agents 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.


As described in more detail below, the RNAi agent that contains conjugations of one or more carbohydrate moieties to a RNAi agent can optimize one or more properties of the RNAi agent. In many cases, the carbohydrate moiety will be attached to a modified subunit of the RNAi agent. For example, the ribose sugar of one or more ribonucleotide subunits of a dsRNA agent can be replaced with another moiety, e.g., a non-carbohydrate (preferably 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,” preferably 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 and 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 RNAi agents may be conjugated to a ligand via a carrier, wherein the carrier can be cyclic group or acyclic group; preferably, 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; preferably, the acyclic group is selected from serinol backbone or diethanolamine backbone.


In certain specific embodiments, the RNAi agent for use in the methods of the invention is an agent selected from the group of agents listed in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18. In one embodiment, the agent is any one of the agents listed in any one of Tables 3, 4, 9-12, 14, 15, 17, and 18. These agents may further comprise a ligand.


VI. iRNAs Conjugated to Ligands

Another modification of the RNA of an iRNA of the invention involves chemically linking to the RNA one or more ligands, moieties or conjugates that enhance the activity, cellular distribution or cellular uptake of the iRNA. 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), 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-0-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 one embodiment, a ligand alters the distribution, targeting or lifetime of an iRNA agent into which it is incorporated. In preferred 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. Preferred ligands will 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-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-gulucoseamine 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.


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-gulucosamine 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, and/or intermediate filaments. The drug can be, for example, taxon, 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 etc. 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 oligonucleotides 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 means 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 oligonucleotides 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 one embodiment, the ligand or conjugate is a lipid or lipid-based molecule. Such a lipid or lipid-based molecule preferably 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, and/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 a preferred embodiment, the lipid based ligand binds HSA. Preferably, it binds HSA with a sufficient affinity such that the conjugate will be preferably 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 another preferred embodiment, the lipid based ligand binds HSA weakly or not at all, such that the conjugate will be preferably 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, preferably a helical cell-permeation agent. Preferably, 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 preferably an alpha-helical agent, which preferably 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: 26). An RFGF analogue (e.g., amino acid sequence AALLPVLLAAP (SEQ ID NO: 27) 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: 28) and the Drosophila Antennapedia protein (RQIKIWFQNRRMKWKK (SEQ ID NO: 29) 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. Preferred 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 oligonucleotide further comprises a carbohydrate. The carbohydrate conjugated iRNA are 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 HBV and above (e.g., HBV, C6, C7, or C8) sugars; di- and trisaccharides include sugars having two or three monosaccharide units (e.g., HBV, C6, C7, or C8).


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




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


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 GalNAc or GalNAc derivative attached to the iRNA agent. In another embodiment, 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.


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 and/or a cell permeation peptide.


Additional carbohydrate conjugates 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, substituted or unsubstituted heterocyclic; where R8 is hydrogen, acyl, aliphatic or substituted aliphatic. In one embodiment, the linker is between about 1-24 atoms, 2-24, 3-24, 4-24, 5-24, 6-24, 6-18, 7-18, 8-18 atoms, 7-17, 8-17, 6-16, 7-16, 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 a preferred embodiment, 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 about 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 preferred 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 preferred embodiments, useful candidate compounds are cleaved 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 serum (or under in vitro conditions selected to mimic extracellular conditions).


i. Redox Cleavable Linking Groups


In one embodiment, 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 another embodiment, 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-Preferred embodiments are —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—, —O—P(S)(H)—S—. A preferred embodiment is —O—P(O)(OH)—O—. These candidates can be evaluated using methods analogous to those described above.


iii. Acid Cleavable Linking Groups


In another embodiment, 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 preferred 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). A preferred 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 another embodiment, 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 another embodiment, 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 one embodiment, 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 (XXXII)-(XXXV):




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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 wherin 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; andRa 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 (XXXV):




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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 and 5,688,941; 6,294,664; 6,320,017; 6,576,752; 6,783,931; 6,900,297; 7,037,646; 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, preferably dsRNAs, which 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, and/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. P 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-0-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 an 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.


VII. 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 having a disease, disorder or condition associated with contact activation pathway gene expression) 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 RL. (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. The non-specific effects of an iRNA can be minimized by local administration, for example, by direct injection or implantation into a tissue or topically administering the preparation. Local administration to a treatment site maximizes local concentration of the agent, limits the exposure of the agent to systemic tissues that can otherwise be harmed by the agent or that can degrade the agent, and permits a lower total dose of the iRNA molecule to be administered. Several studies have shown successful knockdown of gene products when an iRNA is administered locally. For example, intraocular delivery of a VEGF dsRNA by intravitreal injection in cynomolgus monkeys (Tolentino, M J., et al (2004) Retina 24:132-138) and subretinal injections in mice (Reich, S J., et al (2003) Mol. Vis. 9:210-216) were both shown to prevent neovascularization in an experimental model of age-related macular degeneration. In addition, direct intratumoral injection of a dsRNA in mice reduces tumor volume (Pille, J., et al (2005) Mol. Ther.11:267-274) and can prolong survival of tumor-bearing mice (Kim, W J., et al (2006) Mol. Ther. 14:343-350; Li, S., et al (2007) Mol. Ther. 15:515-523). 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) and to the lungs by intranasal administration (Howard, K A., et al (2006) Mol. Ther. 14:476-484; Zhang, X., et al (2004) J. Biol. Chem. 279:10677-10684; Bitko, V., et al (2005) Nat. Med. 11:50-55). For administering an iRNA systemically for the treatment of a disease, the RNA can be modified or alternatively delivered using a drug delivery system; both methods act to prevent the rapid degradation of the dsRNA by endo- and exo-nucleases in vivo. Modification of the RNA or the pharmaceutical carrier can also permit targeting of the iRNA composition 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). Conjugation of an iRNA to an aptamer has been shown to inhibit tumor growth and mediate tumor regression in a mouse model of prostate cancer (McNamara, J O., et al (2006) Nat. Biotechnol. 24:1005-1015). 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 SH., 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), Oligofectamine, “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 ME., 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 a contact activation pathway 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).


The individual strand or strands of an iRNA can be transcribed from a promoter on an expression vector. Where two separate strands are to be expressed to generate, for example, a dsRNA, two separate expression vectors can be co-introduced (e.g., by transfection or infection) into a target cell. Alternatively each individual strand of a dsRNA can be transcribed by promoters both of which are located on the same expression plasmid. In one embodiment, a dsRNA is expressed as inverted repeat polynucleotides joined by a linker polynucleotide sequence such that the dsRNA has a stem and loop structure.


iRNA expression vectors are generally DNA plasmids or viral vectors. Expression vectors compatible with eukaryotic cells, preferably those compatible with vertebrate cells, can be used to produce recombinant constructs for the expression of an iRNA as described herein. Eukaryotic cell expression vectors are well known in the art and are available from a number of commercial sources. Typically, such vectors are provided containing convenient restriction sites for insertion of the desired nucleic acid segment. Delivery of iRNA expressing vectors can be systemic, such as by intravenous or intramuscular administration, by administration to target cells ex-planted from the patient followed by reintroduction into the patient, or by any other means that allows for introduction into a desired target cell.


iRNA expression plasmids can be transfected into target cells as a complex with cationic lipid carriers (e.g., Oligofectamine) or non-cationic lipid-based carriers (e.g., Transit-TKOT′). Multiple lipid transfections for iRNA-mediated knockdowns targeting different regions of a target RNA over a period of a week or more are also contemplated by the invention. Successful introduction of vectors into host cells can be monitored using various known methods. For example, transient transfection can be signaled with a reporter, such as a fluorescent marker, such as Green Fluorescent Protein (GFP). Stable transfection of cells ex vivo can be ensured using markers that provide the transfected cell with resistance to specific environmental factors (e.g., antibiotics and drugs), such as hygromycin B resistance.


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 further described below.


Vectors useful for the delivery of an iRNA will include regulatory elements (promoter, enhancer, etc.) sufficient for expression of the iRNA in the desired target cell or tissue. The regulatory elements can be chosen to provide either constitutive or regulated/inducible expression.


Expression of the iRNA can be precisely regulated, for example, by using an inducible regulatory sequence that is sensitive to certain physiological regulators, e.g., circulating glucose levels, or hormones (Docherty et al., 1994, FASEB J. 8:20-24). Such inducible expression systems, suitable for the control of dsRNA expression in cells or in mammals include, for example, regulation by ecdysone, by estrogen, progesterone, tetracycline, chemical inducers of dimerization, and isopropyl-beta-D1-thiogalactopyranoside (IPTG). A person skilled in the art would be able to choose the appropriate regulatory/promoter sequence based on the intended use of the iRNA transgene.


Viral vectors that contain nucleic acid sequences encoding an iRNA can be used. For example, a retroviral vector can be used (see Miller et al., Meth. Enzymol. 217:581-599 (1993)). These retroviral vectors contain the components necessary for the correct packaging of the viral genome and integration into the host cell DNA. The nucleic acid sequences encoding an iRNA are cloned into one or more vectors, which facilitate delivery of the nucleic acid into a patient. More detail about retroviral vectors can be found, for example, in Boesen et al., Biotherapy 6:291-302 (1994), which describes the use of a retroviral vector to deliver the mdr1 gene to hematopoietic stem cells in order to make the stem cells more resistant to chemotherapy. Other references illustrating the use of retroviral vectors in gene therapy are: Clowes et al., J. Clin. Invest. 93:644-651 (1994); Kiem et al., Blood 83:1467-1473 (1994); Salmons and Gunzberg, Human Gene Therapy 4:129-141 (1993); and Grossman and Wilson, Curr. Opin. in Genetics and Devel. 3:110-114 (1993). Lentiviral vectors contemplated for use include, for example, the HIV based vectors described in U.S. Pat. Nos. 6,143,520; 5,665,557; and 5,981,276, which are herein incorporated by reference.


Adenoviruses are also contemplated for use in delivery of iRNAs of the invention. Adenoviruses are especially attractive vehicles, e.g., for delivering genes to respiratory epithelia. Adenoviruses naturally infect respiratory epithelia where they cause a mild disease. Other targets for adenovirus-based delivery systems are liver, the central nervous system, endothelial cells, and muscle. Adenoviruses have the advantage of being capable of infecting non-dividing cells. Kozarsky and Wilson, Current Opinion in Genetics and Development 3:499-503 (1993) present a review of adenovirus-based gene therapy. Bout et al., Human Gene Therapy 5:3-10 (1994) demonstrated the use of adenovirus vectors to transfer genes to the respiratory epithelia of rhesus monkeys. Other instances of the use of adenoviruses in gene therapy can be found in Rosenfeld et al., Science 252:431-434 (1991); Rosenfeld et al., Cell 68:143-155 (1992); Mastrangeli et al., J. Clin. Invest. 91:225-234 (1993); PCT Publication WO94/12649; and Wang, et al., Gene Therapy 2:775-783 (1995). A suitable AV vector for expressing an iRNA featured in the invention, a method for constructing the recombinant AV vector, and a method for delivering the vector into target cells, are described in Xia H et al. (2002), Nat. Biotech. 20: 1006-1010.


Adeno-associated virus (AAV) vectors may also be used to delivery an iRNA of the invention (Walsh et al., Proc. Soc. Exp. Biol. Med. 204:289-300 (1993); U.S. Pat. No. 5,436,146). In one embodiment, the iRNA can be expressed as two separate, complementary single-stranded RNA molecules from a recombinant AAV vector having, for example, either the U6 or H1 RNA promoters, or the cytomegalovirus (CMV) promoter. Suitable AAV vectors for expressing the dsRNA featured in the invention, methods for constructing the recombinant AV vector, and methods for delivering the vectors into target cells are described in Samulski R et al. (1987), J. Virol. 61: 3096-3101; Fisher K J et al. (1996), J. Virol, 70: 520-532; Samulski R et al. (1989), J. Virol. 63: 3822-3826; U.S. Pat. Nos. 5,252,479; 5,139,941; International Patent Application No. WO 94/13788; and International Patent Application No. WO 93/24641, the entire disclosures of which are herein incorporated by reference.


Another viral vector suitable for delivery of an iRNA of the inevtion is a pox virus such as a vaccinia virus, for example an attenuated vaccinia such as Modified Virus Ankara (MVA) or NYVAC, an avipox such as fowl pox or canary pox.


The tropism of viral vectors can be modified by pseudotyping the vectors with envelope proteins or other surface antigens from other viruses, or by substituting different viral capsid proteins, as appropriate. For example, lentiviral vectors can be pseudotyped with surface proteins from vesicular stomatitis virus (VSV), rabies, Ebola, Mokola, and the like. AAV vectors can be made to target different cells by engineering the vectors to express different capsid protein serotypes; see, e.g., Rabinowitz J E et al. (2002), J Virol 76:791-801, the entire disclosure of which is herein incorporated by reference.


The pharmaceutical preparation of a vector can include the vector in an acceptable diluent, or can include a slow release matrix in which the gene delivery vehicle is imbedded. Alternatively, where the complete gene delivery vector can be produced intact from recombinant cells, e.g., retroviral vectors, the pharmaceutical preparation can include one or more cells which produce the gene delivery system.


VIII. 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 treating a disease or disorder associated with the expression or activity of a contact activation pathway gene (i.e., an F12 gene). 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. Another example is compositions that are formulated for direct delivery into the brain parenchyma, e.g., by infusion into the brain, such as by continuous pump infusion. The pharmaceutical compositions of the invention may be administered in dosages sufficient to inhibit expression of a contact activation pathway gene.


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 intravenous (IV) or for subcutaneous delivery. Another example is compositions that are formulated for direct delivery into the liver, e.g., by infusion into the liver, such as by continuous pump infusion.


The pharmaceutical compositions of the invention may be administered in dosages sufficient to inhibit expression of a contact activation pathway 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, preferably about 0.3 mg/kg and about 3.0 mg/kg. A repeat-dose regimine may include administration of a therapeutic amount of iRNA on a regular basis, such as every other day or once a year. In certain embodiments, the iRNA is administered about once per month to about once per quarter (i.e., about once every three months).


After an initial treatment regimen, the treatments can be administered on a less frequent basis.


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 the severity of the disease or disorder, previous treatments, the general health and/or age of the subject, and other diseases present. Moreover, treatment of a subject with a therapeutically effective amount of a composition can include a single treatment or a series of treatments. Estimates of effective dosages and in vivo half-lives for the individual iRNAs encompassed by the invention can be made using conventional methodologies or on the basis of in vivo testing using an appropriate animal model, as described elsewhere herein.


Advances in mouse genetics have generated a number of mouse models for the study of various human diseases, such as disorders that would benefit from reduction in the expression of a contact activation pathway gene.


The pharmaceutical compositions of the present invention can be administered in a number of ways depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration can be topical (e.g., by a transdermal patch), pulmonary, e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal, oral or parenteral. Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; subdermal, e.g., via an implanted device; or intracranial, e.g., by intraparenchymal, intrathecal or intraventricular, administration.


The iRNA can be delivered in a manner to target a particular tissue, such as the liver (e.g., the hepatocytes of the liver).


Pharmaceutical compositions and formulations for topical administration can include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids, and powders. Conventional pharmaceutical carriers, aqueous, powder, or oily bases, thickeners and the like can be necessary or desirable. Coated condoms, gloves and the like can also be useful. Suitable topical formulations include those in which the iRNAs featured in the invention are in admixture with a topical delivery agent such as lipids, liposomes, fatty acids, fatty acid esters, steroids, chelating agents, and surfactants. Suitable lipids and liposomes include neutral (e.g., dioleoylphosphatidyl DOPE ethanolamine, dimyristoylphosphatidyl choline DMPC, distearolyphosphatidyl choline), negative (e.g., dimyristoylphosphatidyl glycerol DMPG), and cationic (e.g., dioleoyltetramethylaminopropyl DOTAP and dioleoylphosphatidyl ethanolamine DOTMA). iRNAs featured in the invention can be encapsulated within liposomes or can form complexes thereto, in particular to cationic liposomes. Alternatively, iRNAs can be complexed to lipids, in particular to cationic lipids. Suitable fatty acids and esters include but are not limited to arachidonic acid, oleic acid, eicosanoic acid, lauric acid, caprylic acid, capric acid, myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein, dilaurin, glyceryl 1-monocaprate, 1-dodecylazacycloheptan-2-one, an acylcarnitine, an acylcholine, or a C1-20 alkyl ester (e.g., isopropylmyristate IPM), monoglyceride or diglyceride; or pharmaceutically acceptable salt thereof. Topical formulations are described in detail in U.S. Pat. No. 6,747,014, which is incorporated herein by reference.


A. iRNA Formulations Comprising Membranous Molecular Assemblies An iRNA for use in the compositions and methods of the invention can be formulated for delivery in a membranous molecular assembly, e.g., a liposome or a micelle. As used herein, the term “liposome” refers to a vesicle composed of amphiphilic lipids arranged in at least one bilayer, e.g., one bilayer or a plurality of bilayers. Liposomes include unilamellar and multilamellar vesicles that have a membrane formed from a lipophilic material and an aqueous interior. The aqueous portion contains the iRNA composition. The lipophilic material isolates the aqueous interior from an aqueous exterior, which typically does not include the iRNA composition, although in some examples, it may. Liposomes are useful for the transfer and delivery of active ingredients to the site of action. Because the liposomal membrane is structurally similar to biological membranes, when liposomes are applied to a tissue, the liposomal bilayer fuses with bilayer of the cellular membranes. As the merging of the liposome and cell progresses, the internal aqueous contents that include the iRNA are delivered into the cell where the iRNA can specifically bind to a target RNA and can mediate iRNA. In some cases the liposomes are also specifically targeted, e.g., to direct the iRNA to particular cell types.


A liposome containing an iRNA agent can be prepared by a variety of methods. In one example, the lipid component of a liposome is dissolved in a detergent so that micelles are formed with the lipid component. For example, the lipid component can be an amphipathic cationic lipid or lipid conjugate. The detergent can have a high critical micelle concentration and may be nonionic. Exemplary detergents include cholate, CHAPS, octylglucoside, deoxycholate, and lauroyl sarcosine. The iRNA agent preparation is then added to the micelles that include the lipid component. The cationic groups on the lipid interact with the iRNA agent and condense around the iRNA agent to form a liposome. After condensation, the detergent is removed, e.g., by dialysis, to yield a liposomal preparation of iRNA agent.


If necessary a carrier compound that assists in condensation can be added during the condensation reaction, e.g., by controlled addition. For example, the carrier compound can be a polymer other than a nucleic acid (e.g., spermine or spermidine). pH can also adjusted to favor condensation.


Methods for producing stable polynucleotide delivery vehicles, which incorporate a polynucleotide/cationic lipid complex as structural components of the delivery vehicle, are further described in, e.g., WO 96/37194, the entire contents of which are incorporated herein by reference. Liposome formation can also include one or more aspects of exemplary methods described in Felgner, P. L. et al., Proc. Natl. Acad. Sci., USA 8:7413-7417, 1987; U.S. Pat. Nos. 4,897,355; 5,171,678; Bangham, et al. M. Mol. Biol. 23:238, 1965; Olson, et al. Biochim. Biophys. Acta 557:9, 1979; Szoka, et al. Proc. Natl. Acad. Sci. 75: 4194, 1978; Mayhew, et al. Biochim. Biophys. Acta 775:169, 1984; Kim, et al. Biochim. Biophys. Acta 728:339, 1983; and Fukunaga, et al. Endocrinol. 115:757, 1984. Commonly used techniques for preparing lipid aggregates of appropriate size for use as delivery vehicles include sonication and freeze-thaw plus extrusion (see, e.g., Mayer, et al. Biochim. Biophys. Acta 858:161, 1986). Microfluidization can be used when consistently small (50 to 200 nm) and relatively uniform aggregates are desired (Mayhew, et al. Biochim. Biophys. Acta 775:169, 1984). These methods are readily adapted to packaging iRNA agent preparations into liposomes.


Liposomes fall into two broad classes. Cationic liposomes are positively charged liposomes which interact with the negatively charged nucleic acid molecules to form a stable complex. The positively charged nucleic acid/liposome complex binds to the negatively charged cell surface and is internalized in an endosome. Due to the acidic pH within the endosome, the liposomes are ruptured, releasing their contents into the cell cytoplasm (Wang et al., Biochem. Biophys. Res. Commun., 1987, 147, 980-985).


Liposomes which are pH-sensitive or negatively-charged, entrap nucleic acids rather than complex with it. Since both the nucleic acid and the lipid are similarly charged, repulsion rather than complex formation occurs. Nevertheless, some nucleic acid is entrapped within the aqueous interior of these liposomes. pH-sensitive liposomes have been used to deliver nucleic acids encoding the thymidine kinase gene to cell monolayers in culture. Expression of the exogenous gene was detected in the target cells (Zhou et al., Journal of Controlled Release, 1992, 19, 269-274).


One major type of liposomal composition includes phospholipids other than naturally-derived phosphatidylcholine. Neutral liposome compositions, for example, can be formed from dimyristoyl phosphatidylcholine (DMPC) or dipalmitoyl phosphatidylcholine (DPPC). Anionic liposome compositions generally are formed from dimyristoyl phosphatidylglycerol, while anionic fusogenic liposomes are formed primarily from dioleoyl phosphatidylethanolamine (DOPE). Another type of liposomal composition is formed from phosphatidylcholine (PC) such as, for example, soybean PC, and egg PC. Another type is formed from mixtures of phospholipid and/or phosphatidylcholine and/or cholesterol.


Examples of other methods to introduce liposomes into cells in vitro and in vivo include U.S. Pat. Nos. 5,283,185; 5,171,678; WO 94/00569; WO 93/24640; WO 91/16024; Felgner, J. Biol. Chem. 269:2550, 1994; Nabel, Proc. Natl. Acad. Sci. 90:11307, 1993; Nabel, Human Gene Ther. 3:649, 1992; Gershon, Biochem. 32:7143, 1993; and Strauss EMBO J. 11:417, 1992.


Non-ionic liposomal systems have also been examined to determine their utility in the delivery of drugs to the skin, in particular systems comprising non-ionic surfactant and cholesterol. Non-ionic liposomal formulations comprising Novasome™ I (glyceryl dilaurate/cholesterol/polyoxyethylene-10-stearyl ether) and Novasome™ II (glyceryl distearate/cholesterol/polyoxyethylene-10-stearyl ether) were used to deliver cyclosporin-A into the dermis of mouse skin. Results indicated that such non-ionic liposomal systems were effective in facilitating the deposition of cyclosporine A into different layers of the skin (Hu et al. S.T.P.Pharma. Sci., 1994, 4(6) 466).


Liposomes also include “sterically stabilized” liposomes, a term which, as used herein, refers to liposomes comprising one or more specialized lipids that, when incorporated into liposomes, result in enhanced circulation lifetimes relative to liposomes lacking such specialized lipids. Examples of sterically stabilized liposomes are those in which part of the vesicle-forming lipid portion of the liposome (A) comprises one or more glycolipids, such as monosialoganglioside GM1, or (B) is derivatized with one or more hydrophilic polymers, such as a polyethylene glycol (PEG) moiety. While not wishing to be bound by any particular theory, it is thought in the art that, at least for sterically stabilized liposomes containing gangliosides, sphingomyelin, or PEG-derivatized lipids, the enhanced circulation half-life of these sterically stabilized liposomes derives from a reduced uptake into cells of the reticuloendothelial system (RES) (Allen et al., FEBS Letters, 1987, 223, 42; Wu et al., Cancer Research, 1993, 53, 3765).


Various liposomes comprising one or more glycolipids are known in the art. Papahadjopoulos et al. (Ann. N.Y. Acad. Sci., 1987, 507, 64) reported the ability of monosialoganglioside GM1, galactocerebroside sulfate and phosphatidylinositol to improve blood half-lives of liposomes. These findings were expounded upon by Gabizon et al. (Proc. Natl. Acad. Sci. U.S.A., 1988, 85, 6949). U.S. Pat. No. 4,837,028 and WO 88/04924, both to Allen et al., disclose liposomes comprising (1) sphingomyelin and (2) the ganglioside GM1 or a galactocerebroside sulfate ester. U.S. Pat. No. 5,543,152 (Webb et al.) discloses liposomes comprising sphingomyelin. Liposomes comprising 1,2-sn-dimyristoylphosphatidylcholine are disclosed in WO 97/13499 (Lim et al).


In one embodiment, cationic liposomes are used. Cationic liposomes possess the advantage of being able to fuse to the cell membrane. Non-cationic liposomes, although not able to fuse as efficiently with the plasma membrane, are taken up by macrophages in vivo and can be used to deliver iRNA agents to macrophages.


Further advantages of liposomes include: liposomes obtained from natural phospholipids are biocompatible and biodegradable; liposomes can incorporate a wide range of water and lipid soluble drugs; liposomes can protect encapsulated iRNA agents in their internal compartments from metabolism and degradation (Rosoff, in “Pharmaceutical Dosage Forms,” Lieberman, Rieger and Banker (Eds.), 1988, volume 1, p. 245). Important considerations in the preparation of liposome formulations are the lipid surface charge, vesicle size and the aqueous volume of the liposomes.


A positively charged synthetic cationic lipid, N-[1-(2,3-dioleyloxy)propyl]-N,N,N-trimethylammonium chloride (DOTMA) can be used to form small liposomes that interact spontaneously with nucleic acid to form lipid-nucleic acid complexes which are capable of fusing with the negatively charged lipids of the cell membranes of tissue culture cells, resulting in delivery of iRNA agent (see, e.g., Felgner, P. L. et al., Proc. Natl. Acad. Sci., USA 8:7413-7417, 1987 and U.S. Pat. No. 4,897,355 for a description of DOTMA and its use with DNA).


A DOTMA analogue, 1,2-bis(oleoyloxy)-3-(trimethylammonia)propane (DOTAP) can be used in combination with a phospholipid to form DNA-complexing vesicles. Lipofectin™ Bethesda Research Laboratories, Gaithersburg, Md.) is an effective agent for the delivery of highly anionic nucleic acids into living tissue culture cells that comprise positively charged DOTMA liposomes which interact spontaneously with negatively charged polynucleotides to form complexes. When enough positively charged liposomes are used, the net charge on the resulting complexes is also positive. Positively charged complexes prepared in this way spontaneously attach to negatively charged cell surfaces, fuse with the plasma membrane, and efficiently deliver functional nucleic acids into, for example, tissue culture cells. Another commercially available cationic lipid, 1,2-bis(oleoyloxy)-3,3-(trimethylammonia)propane (“DOTAP”) (Boehringer Mannheim, Indianapolis, Indiana) differs from DOTMA in that the oleoyl moieties are linked by ester, rather than ether linkages.


Other reported cationic lipid compounds include those that have been conjugated to a variety of moieties including, for example, carboxyspermine which has been conjugated to one of two types of lipids and includes compounds such as 5-carboxyspermylglycine dioctaoleoylamide (“DOGS”) (Transfectam™, Promega, Madison, Wisconsin) and dipalmitoylphosphatidylethanolamine 5-carboxyspermyl-amide (“DPPES”) (see, e.g., U.S. Pat. No. 5,171,678).


Another cationic lipid conjugate includes derivatization of the lipid with cholesterol (“DC-Chol”) which has been formulated into liposomes in combination with DOPE (See, Gao, X. and Huang, L., Biochim. Biophys. Res. Commun. 179:280, 1991). Lipopolylysine, made by conjugating polylysine to DOPE, has been reported to be effective for transfection in the presence of serum (Zhou, X. et al., Biochim. Biophys. Acta 1065:8, 1991). For certain cell lines, these liposomes containing conjugated cationic lipids, are said to exhibit lower toxicity and provide more efficient transfection than the DOTMA-containing compositions. Other commercially available cationic lipid products include DMRIE and DMRIE-HP (Vical, La Jolla, California) and Lipofectamine (DOSPA) (Life Technology, Inc., Gaithersburg, Maryland). Other cationic lipids suitable for the delivery of oligonucleotides are described in WO 98/39359 and WO 96/37194.


Liposomal formulations are particularly suited for topical administration, liposomes present several advantages over other formulations. Such advantages include reduced side effects related to high systemic absorption of the administered drug, increased accumulation of the administered drug at the desired target, and the ability to administer iRNA agent into the skin. In some implementations, liposomes are used for delivering iRNA agent to epidermal cells and also to enhance the penetration of iRNA agent into dermal tissues, e.g., into skin. For example, the liposomes can be applied topically. Topical delivery of drugs formulated as liposomes to the skin has been documented (see, e.g., Weiner et al., Journal of Drug Targeting, 1992, vol. 2,405-410 and du Plessis et al., Antiviral Research, 18, 1992, 259-265; Mannino, R. J. and Fould-Fogerite, S., Biotechniques 6:682-690, 1988; Itani, T. et al. Gene 56:267-276. 1987; Nicolau, C. et al. Meth. Enz. 149:157-176, 1987; Straubinger, R. M. and Papahadjopoulos, D. Meth. Enz. 101:512-527, 1983; Wang, C. Y. and Huang, L., Proc. Natl. Acad. Sci. USA 84:7851-7855, 1987).


Non-ionic liposomal systems have also been examined to determine their utility in the delivery of drugs to the skin, in particular systems comprising non-ionic surfactant and cholesterol. Non-ionic liposomal formulations comprising Novasome I (glyceryl dilaurate/cholesterol/polyoxyethylene-10-stearyl ether) and Novasome II (glyceryl distearate/cholesterol/polyoxyethylene-10-stearyl ether) were used to deliver a drug into the dermis of mouse skin. Such formulations with iRNA agent are useful for treating a dermatological disorder.


Liposomes that include iRNA can be made highly deformable. Such deformability can enable the liposomes to penetrate through pore that are smaller than the average radius of the liposome. For example, transfersomes are a type of deformable liposomes. Transferosomes can be made by adding surface edge activators, usually surfactants, to a standard liposomal composition. Transfersomes that include iRNA agent can be delivered, for example, subcutaneously by infection in order to deliver iRNA agent to keratinocytes in the skin. In order to cross intact mammalian skin, lipid vesicles must pass through a series of fine pores, each with a diameter less than 50 nm, under the influence of a suitable transdermal gradient. In addition, due to the lipid properties, these transferosomes can be self-optimizing (adaptive to the shape of pores, e.g., in the skin), self-repairing, and can frequently reach their targets without fragmenting, and often self-loading.


Other formulations amenable to the present invention are described in U.S. provisional application Ser. No. 61/018,616, filed Jan. 2, 2008; 61/018,611, filed Jan. 2, 2008; 61/039,748, filed Mar. 26, 2008; 61/047,087, filed Apr. 22, 2008 and 61/051,528, filed May 8, 2008. PCT application no PCT/US2007/080331, filed Oct. 3, 2007 also describes formulations that are amenable to the present invention.


Transfersomes are yet another type of liposomes, and are highly deformable lipid aggregates which are attractive candidates for drug delivery vehicles. Transfersomes can be described as lipid droplets which are so highly deformable that they are easily able to penetrate through pores which are smaller than the droplet. Transfersomes are adaptable to the environment in which they are used, e.g., they are self-optimizing (adaptive to the shape of pores in the skin), self-repairing, frequently reach their targets without fragmenting, and often self-loading. To make transfersomes it is possible to add surface edge-activators, usually surfactants, to a standard liposomal composition. Transfersomes have been used to deliver serum albumin to the skin. The transfersome-mediated delivery of serum albumin has been shown to be as effective as subcutaneous injection of a solution containing serum albumin.


Surfactants find wide application in formulations such as emulsions (including microemulsions) and liposomes. The most common way of classifying and ranking the properties of the many different types of surfactants, both natural and synthetic, is by the use of the hydrophile/lipophile balance (HLB). The nature of the hydrophilic group (also known as the “head”) provides the most useful means for categorizing the different surfactants used in formulations (Rieger, in “Pharmaceutical Dosage Forms”, Marcel Dekker, Inc., New York, N.Y., 1988, p. 285).


If the surfactant molecule is not ionized, it is classified as a nonionic surfactant. Nonionic surfactants find wide application in pharmaceutical and cosmetic products and are usable over a wide range of pH values. In general their HLB values range from 2 to about 18 depending on their structure. Nonionic surfactants include nonionic esters such as ethylene glycol esters, propylene glycol esters, glyceryl esters, polyglyceryl esters, sorbitan esters, sucrose esters, and ethoxylated esters. Nonionic alkanolamides and ethers such as fatty alcohol ethoxylates, propoxylated alcohols, and ethoxylated/propoxylated block polymers are also included in this class. The polyoxyethylene surfactants are the most popular members of the nonionic surfactant class.


If the surfactant molecule carries a negative charge when it is dissolved or dispersed in water, the surfactant is classified as anionic. Anionic surfactants include carboxylates such as soaps, acyl lactylates, acyl amides of amino acids, esters of sulfuric acid such as alkyl sulfates and ethoxylated alkyl sulfates, sulfonates such as alkyl benzene sulfonates, acyl isethionates, acyl taurates and sulfosuccinates, and phosphates. The most important members of the anionic surfactant class are the alkyl sulfates and the soaps.


If the surfactant molecule carries a positive charge when it is dissolved or dispersed in water, the surfactant is classified as cationic. Cationic surfactants include quaternary ammonium salts and ethoxylated amines. The quaternary ammonium salts are the most used members of this class.


If the surfactant molecule has the ability to carry either a positive or negative charge, the surfactant is classified as amphoteric. Amphoteric surfactants include acrylic acid derivatives, substituted alkylamides, N-alkylbetaines and phosphatides.


The use of surfactants in drug products, formulations and in emulsions has been reviewed (Rieger, in “Pharmaceutical Dosage Forms”, Marcel Dekker, Inc., New York, N.Y., 1988, p. 285).


The iRNA for use in the methods of the invention can also be provided as micellar formulations. “Micelles” are defined herein as a particular type of molecular assembly in which amphipathic molecules are arranged in a spherical structure such that all the hydrophobic portions of the molecules are directed inward, leaving the hydrophilic portions in contact with the surrounding aqueous phase. The converse arrangement exists if the environment is hydrophobic.


A mixed micellar formulation suitable for delivery through transdermal membranes may be prepared by mixing an aqueous solution of the siRNA composition, an alkali metal C8 to C22 alkyl sulphate, and a micelle forming compounds. Exemplary micelle forming compounds include lecithin, hyaluronic acid, pharmaceutically acceptable salts of hyaluronic acid, glycolic acid, lactic acid, chamomile extract, cucumber extract, oleic acid, linoleic acid, linolenic acid, monoolein, monooleates, monolaurates, borage oil, evening of primrose oil, menthol, trihydroxy oxo cholanyl glycine and pharmaceutically acceptable salts thereof, glycerin, polyglycerin, lysine, polylysine, triolein, polyoxyethylene ethers and analogues thereof, polidocanol alkyl ethers and analogues thereof, chenodeoxycholate, deoxycholate, and mixtures thereof. The micelle forming compounds may be added at the same time or after addition of the alkali metal alkyl sulphate. Mixed micelles will form with substantially any kind of mixing of the ingredients but vigorous mixing in order to provide smaller size micelles.


In one method a first micellar composition is prepared which contains the siRNA composition and at least the alkali metal alkyl sulphate. The first micellar composition is then mixed with at least three micelle forming compounds to form a mixed micellar composition. In another method, the micellar composition is prepared by mixing the siRNA composition, the alkali metal alkyl sulphate and at least one of the micelle forming compounds, followed by addition of the remaining micelle forming compounds, with vigorous mixing.


Phenol and/or m-cresol may be added to the mixed micellar composition to stabilize the formulation and protect against bacterial growth. Alternatively, phenol and/or m-cresol may be added with the micelle forming ingredients. An isotonic agent such as glycerin may also be added after formation of the mixed micellar composition.


For delivery of the micellar formulation as a spray, the formulation can be put into an aerosol dispenser and the dispenser is charged with a propellant. The propellant, which is under pressure, is in liquid form in the dispenser. The ratios of the ingredients are adjusted so that the aqueous and propellant phases become one, i.e., there is one phase. If there are two phases, it is necessary to shake the dispenser prior to dispensing a portion of the contents, e.g., through a metered valve. The dispensed dose of pharmaceutical agent is propelled from the metered valve in a fine spray.


Propellants may include hydrogen-containing chlorofluorocarbons, hydrogen-containing fluorocarbons, dimethyl ether and diethyl ether. In certain embodiments, HFA 134a (1,1,1,2 tetrafluoroethane) may be used.


The specific concentrations of the essential ingredients can be determined by relatively straightforward experimentation. For absorption through the oral cavities, it is often desirable to increase, e.g., at least double or triple, the dosage for through injection or administration through the gastrointestinal tract.


B. Lipid Particles

iRNAs, e.g., dsRNAs of in the invention may be fully encapsulated in a lipid formulation, e.g., a LNP, or other nucleic acid-lipid particle.


As used herein, the term “LNP” refers to a stable nucleic acid-lipid particle. LNPs typically contain a cationic lipid, a non-cationic lipid, and a lipid that prevents aggregation of the particle (e.g., a PEG-lipid conjugate). LNPs are extremely useful for systemic applications, as they exhibit extended circulation lifetimes following intravenous (i.v.) injection and accumulate at distal sites (e.g., sites physically separated from the administration site). LNPs include “pSPLP,” which include an encapsulated condensing agent-nucleic acid complex as set forth in PCT Publication No. WO 00/03683. The particles of the present invention typically have a mean diameter of about 50 nm to about 150 nm, more typically about 60 nm to about 130 nm, more typically about 70 nm to about 110 nm, most typically about 70 nm to about 90 nm, and are substantially nontoxic. In addition, the nucleic acids when present in the nucleic acid-lipid particles of the present invention are resistant in aqueous solution to degradation with a nuclease. Nucleic acid-lipid particles and their method of preparation are disclosed in, e.g., U.S. Pat. Nos. 5,976,567; 5,981,501; 6,534,484; 6,586,410; 6,815,432; U.S. Publication No. 2010/0324120 and PCT Publication No. WO 96/40964.


In one embodiment, the lipid to drug ratio (mass/mass ratio) (e.g., lipid to dsRNA ratio) will be in the range of from about 1:1 to about 50:1, from about 1:1 to about 25:1, from about 3:1 to about 15:1, from about 4:1 to about 10:1, from about 5:1 to about 9:1, or about 6:1 to about 9:1. Ranges intermediate to the above recited ranges are also contemplated to be part of the invention.


The cationic lipid can be, for example, N,N-dioleyl-N,N-dimethylammonium chloride (DODAC), N,N-distearyl-N,N-dimethylammonium bromide (DDAB), N-(I-(2,3-dioleoyloxy)propyl)-N,N,N-trimethylammonium chloride (DOTAP), N-(I-(2,3-dioleyloxy)propyl)-N,N,N-trimethylammonium chloride (DOTMA), N,N-dimethyl-2,3-dioleyloxy)propylamine (DODMA), 1,2-DiLinoleyloxy-N,N-dimethylaminopropane (DLinDMA), 1,2-Dilinolenyloxy-N,N-dimethylaminopropane (DLenDMA), 1,2-Dilinoleylcarbamoyloxy-3-dimethylaminopropane (DLin-C-DAP), 1,2-Dilinoleyoxy-3-(dimethylamino)acetoxypropane (Dlin-DAC), 1,2-Dilinoleyoxy-3-morpholinopropane (DLin-MA), 1,2-Dilinoleoyl-3-dimethylaminopropane (DLinDaP), 1,2-Dilinoleylthio-3-dimethylaminopropane (DLin-S-DMA), 1-linoleoyl-2-linoleyloxy-3-dimethylaminopropane (DLin-2-DMAP), 1,2-Dilinoleyloxy-3-trimethylaminopropane chloride salt (DLin-TMA.Cl), 1,2-Dilinoleoyl-3-trimethylaminopropane chloride salt (DLin-TAP.Cl), 1,2-Dilinoleyloxy-3-(N-methylpiperazino)propane (DLin-MPz), or 3-(N,N-Dilinoleylamino)-1,2-propanediol (DLinAP), 3-(N,N-Dioleylamino)-1,2-propanedio (DOAP), 1,2-Dilinoleyloxo-3-(2-N,N-dimethylamino)ethoxypropane (DLin-EG-DMA), 1,2-Dilinolenyloxy-N,N-dimethylaminopropane (DLinDMA), 2,2-Dilinoleyl-4-dimethylaminomethyl-[1,3]-dioxolane (DLin-K-DMA) or analogs thereof, (3aR,5s,6aS)-N,N-dimethyl-2,2-di((9Z,12Z)-octadeca-9,12-dienyl)tetrahydro-3aH-cyclopenta[d][1,3]dioxol-5-amine (ALN100), (6Z,9Z,28Z,31Z)-heptatriaconta-6,9,28,31-tetraen-19-yl 4-(dimethylamino)butanoate (MC3), 1,1′-(2-(4-(2-((2-(bis(2-hydroxydodecyl)amino)ethyl)(2-hydroxydodecyl)amino)ethyl)piperazin-1-yl)ethylazanediyl)didodecan-2-ol (Tech GI), or a mixture thereof. The cationic lipid can comprise from about 20 mol % to about 50 mol % or about 40 mol % of the total lipid present in the particle.


In another embodiment, the compound 2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-dioxolane can be used to prepare lipid-siRNA nanoparticles. Synthesis of 2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-dioxolane is described in U.S. provisional patent application No. 61/107,998 filed on Oct. 23, 2008, which is herein incorporated by reference.


In one embodiment, the lipid-siRNA particle includes 40% 2, 2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-dioxolane: 10% DSPC: 40% Cholesterol: 10% PEG-C-DOMG (mole percent) with a particle size of 63.0±20 nm and a 0.027 siRNA/Lipid Ratio.


The ionizable/non-cationic lipid can be an anionic lipid or a neutral lipid including, but not limited to, distearoylphosphatidylcholine (DSPC), dioleoylphosphatidylcholine (DOPC), dipalmitoylphosphatidylcholine (DPPC), dioleoylphosphatidylglycerol (DOPG), dipalmitoylphosphatidylglycerol (DPPG), dioleoyl-phosphatidylethanolamine (DOPE), palmitoyloleoylphosphatidylcholine (POPC), palmitoyloleoylphosphatidylethanolamine (POPE), dioleoyl-phosphatidylethanolamine 4-(N-maleimidomethyl)-cyclohexane-1-carboxylate (DOPE-mal), dipalmitoyl phosphatidyl ethanolamine (DPPE), dimyristoylphosphoethanolamine (DMPE), distearoyl-phosphatidyl-ethanolamine (DSPE), 16-O-monomethyl PE, 16-O-dimethyl PE, 18-1-trans PE, 1-stearoyl-2-oleoyl-phosphatidyethanolamine (SOPE), cholesterol, or a mixture thereof. The non-cationic lipid can be from about 5 mol % to about 90 mol %, about 10 mol %, or about 58 mol % if cholesterol is included, of the total lipid present in the particle.


The conjugated lipid that inhibits aggregation of particles can be, for example, a polyethyleneglycol (PEG)-lipid including, without limitation, a PEG-diacylglycerol (DAG), a PEG-dialkyloxypropyl (DAA), a PEG-phospholipid, a PEG-ceramide (Cer), or a mixture thereof. The PEG-DAA conjugate can be, for example, a PEG-dilauryloxypropyl (Ci2), a PEG-dimyristyloxypropyl (Ci4), a PEG-dipalmityloxypropyl (Ci6), or a PEG-distearyloxypropyl (C]8). The conjugated lipid that prevents aggregation of particles can be from 0 mol % to about 20 mol % or about 2 mol % of the total lipid present in the particle.


In some embodiments, the nucleic acid-lipid particle further includes cholesterol at, e.g., about 10 mol % to about 60 mol % or about 48 mol % of the total lipid present in the particle.


In one embodiment, the lipidoid ND98-4HCl (MW 1487) (see U.S. patent application Ser. No. 12/056,230, filed Mar. 26, 2008, which is incorporated herein by reference), Cholesterol (Sigma-Aldrich), and PEG-Ceramide C16 (Avanti Polar Lipids) can be used to prepare lipid-dsRNA nanoparticles (i.e., LNPO1 particles). Stock solutions of each in ethanol can be prepared as follows: ND98, 133 mg/ml; Cholesterol, 25 mg/ml, PEG-Ceramide C16, 100 mg/ml. The ND98, Cholesterol, and PEG-Ceramide C16 stock solutions can then be combined in a, e.g., 42:48:10 molar ratio. The combined lipid solution can be mixed with aqueous dsRNA (e.g., in sodium acetate pH 5) such that the final ethanol concentration is about 35-45% and the final sodium acetate concentration is about 100-300 mM. Lipid-dsRNA nanoparticles typically form spontaneously upon mixing. Depending on the desired particle size distribution, the resultant nanoparticle mixture can be extruded through a polycarbonate membrane (e.g., 100 nm cut-off) using, for example, a thermobarrel extruder, such as Lipex Extruder (Northern Lipids, Inc). In some cases, the extrusion step can be omitted. Ethanol removal and simultaneous buffer exchange can be accomplished by, for example, dialysis or tangential flow filtration. Buffer can be exchanged with, for example, phosphate buffered saline (PBS) at about pH 7, e.g., about pH 6.9, about pH 7.0, about pH 7.1, about pH 7.2, about pH 7.3, or about pH 7.4.




embedded image


LNPO1 formulations are described, e.g., in International Application Publication No. WO 2008/042973, which is hereby incorporated by reference.


Additional exemplary lipid-dsRNA formulations are described in Table 1.











TABLE 1







cationic lipid/non-cationic




lipid/cholesterol/PEG-lipid conjugate



Ionizable/Cationic Lipid
Lipid:siRNA ratio







SNALP-1
1,2-Dilinolenyloxy-N,N-
DLinDMA/DPPC/Cholesterol/PEG-cDMA



dimethylaminopropane (DLinDMA)
(57.1/7.1/34.4/1.4)




lipid:siRNA ~7:1


2-XTC
2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-
XTC/DPPC/Cholesterol/PEG-cDMA



dioxolane (XTC)
57.1/7.1/34.4/1.4




lipid:siRNA ~7:1


LNP05
2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-
XTC/DSPC/Cholesterol/PEG-DMG



dioxolane (XTC)
57.5/7.5/31.5/3.5




lipid:siRNA ~6:1


LNP06
2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-
XTC/DSPC/Cholesterol/PEG-DMG



dioxolane (XTC)
57.5/7.5/31.5/3.5




lipid:siRNA ~11:1


LNP07
2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-
XTC/DSPC/Cholesterol/PEG-DMG



dioxolane (XTC)
60/7.5/31/1.5,




lipid:siRNA ~6:1


LNP08
2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-
XTC/DSPC/Cholesterol/PEG-DMG



dioxolane (XTC)
60/7.5/31/1.5,




lipid:siRNA ~11:1


LNP09
2,2-Dilinoleyl-4-dimethylaminoethyl-[1,3]-
XTC/DSPC/Cholesterol/PEG-DMG



dioxolane (XTC)
50/10/38.5/1.5




Lipid:siRNA 10:1


LNP10
(3aR,5s,6aS)-N,N-dimethyl-2,2-
ALN100/DSPC/Cholesterol/PEG-DMG



di((9Z,12Z)-octadeca-9,12-
50/10/38.5/1.5



dienyl)tetrahydro-3aH-
Lipid:siRNA 10:1



cyclopenta[d][1,3]dioxol-5-amine




(ALN100)



LNP11
(6Z,9Z,28Z,31Z)-heptatriaconta-6,9,28,31-
MC-3/DSPC/Cholesterol/PEG-DMG



tetraen-19-yl 4-(dimethylamino)butanoate
50/10/38.5/1.5



(MC3)
Lipid:siRNA 10:1


LNP12
1,1′-(2-(4-(2-((2-(bis(2-
Tech G1/DSPC/Cholesterol/PEG-DMG



hydroxydodecyl)amino)ethyl)(2-
50/10/38.5/1.5



hydroxydodecyl)amino)ethyl)piperazin-1-
Lipid:siRNA 10:1



yl)ethylazanediyl)didodecan-2-ol (Tech




G1)



LNP13
XTC
XTC/DSPC/Chol/PEG-DMG




50/10/38.5/1.5




Lipid:siRNA: 33:1


LNP14
MC3
MC3/DSPC/Chol/PEG-DMG




40/15/40/5




Lipid:siRNA: 11:1


LNP15
MC3
MC3/DSPC/Chol/PEG-DSG/GalNAc-PEG-




DSG




50/10/35/4.5/0.5




Lipid:siRNA: 11:1


LNP16
MC3
MC3/DSPC/Chol/PEG-DMG




50/10/38.5/1.5




Lipid:siRNA: 7:1


LNP17
MC3
MC3/DSPC/Chol/PEG-DSG




50/10/38.5/1.5




Lipid:siRNA: 10:1


LNP18
MC3
MC3/DSPC/Chol/PEG-DMG




50/10/38.5/1.5




Lipid:siRNA: 12:1


LNP19
MC3
MC3/DSPC/Chol/PEG-DMG




50/10/35/5




Lipid:siRNA: 8:1


LNP20
MC3
MC3/DSPC7Chol/PEG-DPG




50/10/38.5/1.5




Lipid:siRNA: 10:1


LNP21
C12-200
C12-200/DSPC/Chol/PEG-DSG




50/10/38.5/1.5




Lipid:siRNA: 7:1


LNP22
XTC
XTC/DSPC/Chol/PEG-DSG




50/10/38.5/1.5




Lipid:siRNA: 10:1





DSPC: distearoylphosphatidylcholine


DPPC: dipalmitoylphosphatidylcholine


PEG-DMG: PEG-didimyristoyl glycerol (C14-PEG, or PEG-C14) (PEG with avg mol wt of 2000)


PEG-DSG: PEG-distyryl glycerol (C18-PEG, or PEG-C18) (PEG with avg mol wt of 2000)


PEG-cDMA: PEG-carbamoyl-1,2-dimyristyloxypropylamine (PEG with avg mol wt of 2000)







SNALP (1,2-Dilinolenyloxy-N,N-dimethylaminopropane (DLinDMA)) comprising formulations are described in International Publication No. WO2009/127060, filed Apr. 15, 2009, which is hereby incorporated by reference.


XTC comprising formulations are described, e.g., in U.S. Provisional Ser. No. 61/148,366, filed Jan. 29, 2009; U.S. Provisional Ser. No. 61/156,851, filed Mar. 2, 2009; U.S. Provisional Serial No. filed Jun. 10, 2009; U.S. Provisional Ser. No. 61/228,373, filed Jul. 24, 2009; U.S. Provisional Ser. No. 61/239,686, filed Sep. 3, 2009, and International Application No. PCT/US2010/022614, filed Jan. 29, 2010, which are hereby incorporated by reference.


MC3 comprising formulations are described, e.g., in U.S. Publication No. 2010/0324120, filed Jun. 10, 2010, the entire contents of which are hereby incorporated by reference.


ALNY-100 comprising formulations are described, e.g., International patent application number PCT/US09/63933, filed on Nov. 10, 2009, which is hereby incorporated by reference.


C12-200 comprising formulations are described in U.S. Provisional Ser. No. 61/175,770, filed May 5, 2009 and International Application No. PCT/US10/33777, filed May 5, 2010, which are hereby incorporated by reference.


Compositions and formulations for oral administration include powders or granules, microparticulates, nanoparticulates, suspensions or solutions in water or non-aqueous media, capsules, gel capsules, sachets, tablets or minitablets. Thickeners, flavoring agents, diluents, emulsifiers, dispersing aids or binders can be desirable. In some embodiments, oral formulations are those in which dsRNAs featured in the invention are administered in conjunction with one or more penetration enhancer surfactants and chelators. Suitable surfactants include fatty acids and/or esters or salts thereof, bile acids and/or salts thereof. Suitable bile acids/salts include chenodeoxycholic acid (CDCA) and ursodeoxychenodeoxycholic acid (UDCA), cholic acid, dehydrocholic acid, deoxycholic acid, glucholic acid, glycholic acid, glycodeoxycholic acid, taurocholic acid, taurodeoxycholic acid, sodium tauro-24, 25-dihydro-fusidate and sodium glycodihydrofusidate. Suitable fatty acids include arachidonic acid, undecanoic acid, oleic acid, lauric acid, caprylic acid, capric acid, myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein, dilaurin, glyceryl 1-monocaprate, 1-dodecylazacycloheptan-2-one, an acylcarnitine, an acylcholine, or a monoglyceride, a diglyceride or a pharmaceutically acceptable salt thereof (e.g., sodium). In some embodiments, combinations of penetration enhancers are used, for example, fatty acids/salts in combination with bile acids/salts. One exemplary combination is the sodium salt of lauric acid, capric acid and UDCA. Further penetration enhancers include polyoxyethylene-9-lauryl ether, polyoxyethylene-20-cetyl ether. DsRNAs featured in the invention can be delivered orally, in granular form including sprayed dried particles, or complexed to form micro or nanoparticles. DsRNA complexing agents include poly-amino acids; polyimines; polyacrylates; polyalkylacrylates, polyoxethanes, polyalkylcyanoacrylates; cationized gelatins, albumins, starches, acrylates, polyethyleneglycols (PEG) and starches; polyalkylcyanoacrylates; DEAE-derivatized polyimines, pollulans, celluloses and starches. Suitable complexing agents include chitosan, N-trimethylchitosan, poly-L-lysine, polyhistidine, polyornithine, polyspermines, protamine, polyvinylpyridine, polythiodiethylaminomethylethylene P(TDAE), polyaminostyrene (e.g., p-amino), poly(methylcyanoacrylate), poly(ethylcyanoacrylate), poly(butylcyanoacrylate), poly(isobutylcyanoacrylate), poly(isohexylcynaoacrylate), DEAE-methacrylate, DEAE-hexylacrylate, DEAE-acrylamide, DEAE-albumin and DEAE-dextran, polymethylacrylate, polyhexylacrylate, poly(D,L-lactic acid), poly(DL-lactic-co-glycolic acid (PLGA), alginate, and polyethyleneglycol (PEG). Oral formulations for dsRNAs and their preparation are described in detail in U.S. Pat. No. 6,887,906, US Publn. No. 20030027780, and U.S. Pat. No. 6,747,014, each of which is incorporated herein by reference.


Compositions and formulations for parenteral, intraparenchymal (into the brain), intrathecal, intraventricular or intrahepatic administration can include sterile aqueous solutions which can also contain buffers, diluents and other suitable additives such as, but not limited to, penetration enhancers, carrier compounds and other pharmaceutically acceptable carriers or excipients.


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. Particularly preferred are formulations that target the liver when treating hepatic disorders such as hepatic carcinoma.


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 or finely divided solid carriers or both, and then, if necessary, shaping the product.


The compositions of the present invention can be formulated into any of many possible dosage forms such as, but not limited to, tablets, capsules, gel capsules, liquid syrups, soft gels, suppositories, and enemas. The compositions of the present invention can also be formulated as suspensions in aqueous, non-aqueous or mixed media. Aqueous suspensions can further contain substances which increase the viscosity of the suspension including, for example, sodium carboxymethylcellulose, sorbitol and/or dextran. The suspension can also contain stabilizers.


C. 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 NG., and Ansel HC., 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 in either 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. Either of the phases of the emulsion can be a semisolid or a solid, as is the case of emulsion-style ointment bases and creams. 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 NG., and Ansel HC., 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 NG., and Ansel HC., 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 NG., and Ansel HC., 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).


Naturally occurring emulsifiers used in emulsion formulations include lanolin, beeswax, phosphatides, lecithin and acacia. Absorption bases possess hydrophilic properties such that they can soak up water to form w/o emulsions yet retain their semisolid consistencies, such as anhydrous lanolin and hydrophilic petrolatum. Finely divided solids have also been used as good emulsifiers especially in combination with surfactants and in viscous preparations. These include polar inorganic solids, such as heavy metal hydroxides, nonswelling clays such as bentonite, attapulgite, hectorite, kaolin, montmorillonite, colloidal aluminum silicate and colloidal magnesium aluminum silicate, pigments and nonpolar solids such as carbon or glyceryl tristearate.


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).


Hydrophilic colloids or hydrocolloids include naturally occurring gums and synthetic polymers such as polysaccharides (for example, acacia, agar, alginic acid, carrageenan, guar gum, karaya gum, and tragacanth), cellulose derivatives (for example, carboxymethylcellulose and carboxypropylcellulose), and synthetic polymers (for example, carbomers, cellulose ethers, and carboxyvinyl polymers). These disperse or swell in water to form colloidal solutions that stabilize emulsions by forming strong interfacial films around the dispersed-phase droplets and by increasing the viscosity of the external phase.


Since emulsions often contain a number of ingredients such as carbohydrates, proteins, sterols and phosphatides that can readily support the growth of microbes, these formulations often incorporate preservatives. Commonly used preservatives included in emulsion formulations include methyl paraben, propyl paraben, quaternary ammonium salts, benzalkonium chloride, esters of p-hydroxybenzoic acid, and boric acid. Antioxidants are also commonly added to emulsion formulations to prevent deterioration of the formulation. Antioxidants used can be free radical scavengers such as tocopherols, alkyl gallates, butylated hydroxyanisole, butylated hydroxytoluene, or reducing agents such as ascorbic acid and sodium metabisulfite, and antioxidant synergists such as citric acid, tartaric acid, and lecithin.


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 NG., and Ansel HC., 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). Emulsion formulations for oral delivery have been very widely used because of ease of formulation, as well as efficacy from an absorption and bioavailability standpoint (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich NG., and Ansel HC., 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; Idson, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 199). Mineral-oil base laxatives, oil-soluble vitamins and high fat nutritive preparations are among the materials that have commonly been administered orally as o/w emulsions.


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 NG., and Ansel HC., 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). Microemulsions commonly are prepared via a combination of three to five components that include oil, water, surfactant, cosurfactant and electrolyte. Whether the microemulsion is of the water-in-oil (w/o) or an oil-in-water (o/w) type is dependent on the properties of the oil and surfactant used and on the structure and geometric packing of the polar heads and hydrocarbon tails of the surfactant molecules (Schott, in Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pa., 1985, p. 271).


The phenomenological approach utilizing phase diagrams has been extensively studied and has yielded a comprehensive knowledge, to one skilled in the art, of how to formulate microemulsions (see e.g., Ansel's Pharmaceutical Dosage Forms and Drug Delivery Systems, Allen, LV., Popovich NG., and Ansel HC., 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; Block, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds.), 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 335). Compared to conventional emulsions, microemulsions offer the advantage of solubilizing water-insoluble drugs in a formulation of thermodynamically stable droplets that are formed spontaneously.


Surfactants used in the preparation of microemulsions include, but are not limited to, ionic surfactants, non-ionic surfactants, Brij 96, polyoxyethylene oleyl ethers, polyglycerol fatty acid esters, tetraglycerol monolaurate (ML310), tetraglycerol monooleate (M0310), hexaglycerol monooleate (PO310), hexaglycerol pentaoleate (PO500), decaglycerol monocaprate (MCA750), decaglycerol monooleate (M0750), decaglycerol sequioleate (S0750), decaglycerol decaoleate (DA0750), alone or in combination with cosurfactants. The cosurfactant, usually a short-chain alcohol such as ethanol, 1-propanol, and 1-butanol, serves to increase the interfacial fluidity by penetrating into the surfactant film and consequently creating a disordered film because of the void space generated among surfactant molecules. Microemulsions can, however, be prepared without the use of cosurfactants and alcohol-free self-emulsifying microemulsion systems are known in the art. The aqueous phase can typically be, but is not limited to, water, an aqueous solution of the drug, glycerol, PEG300, PEG400, polyglycerols, propylene glycols, and derivatives of ethylene glycol. The oil phase can include, but is not limited to, materials such as Captex 300, Captex 355, Capmul MCM, fatty acid esters, medium chain (C8-C12) mono, di, and tri-glycerides, polyoxyethylated glyceryl fatty acid esters, fatty alcohols, polyglycolized glycerides, saturated polyglycolized C8-C10 glycerides, vegetable oils and silicone oil.


Microemulsions are particularly of interest from the standpoint of drug solubilization and the enhanced absorption of drugs. Lipid based microemulsions (both o/w and w/o) have been proposed to enhance the oral bioavailability of drugs, including peptides (see e.g., U.S. Pat. Nos. 6,191,105; 7,063,860; 7,070,802; 7,157,099; Constantinides et al., Pharmaceutical Research, 1994, 11, 1385-1390; Ritschel, Meth. Find. Exp. Clin. Pharmacol., 1993, 13, 205). Microemulsions afford advantages of improved drug solubilization, protection of drug from enzymatic hydrolysis, possible enhancement of drug absorption due to surfactant-induced alterations in membrane fluidity and permeability, ease of preparation, ease of oral administration over solid dosage forms, improved clinical potency, and decreased toxicity (see e.g., U.S. Pat. Nos. 6,191,105; 7,063,860; 7,070,802; 7,157,099; Constantinides et al., Pharmaceutical Research, 1994, 11, 1385; Ho et al., J. Pharm. Sci., 1996, 85, 138-143). Often microemulsions can form spontaneously when their components are brought together at ambient temperature. This can be particularly advantageous when formulating thermolabile drugs, peptides or iRNAs. Microemulsions have also been effective in the transdermal delivery of active components in both cosmetic and pharmaceutical applications. It is expected that the microemulsion compositions and formulations of the present invention will facilitate the increased systemic absorption of iRNAs and nucleic acids from the gastrointestinal tract, as well as improve the local cellular uptake of iRNAs and nucleic acids.


Microemulsions of the present invention can also contain additional components and additives such as sorbitan monostearate (Grill 3), Labrasol, and penetration enhancers to improve the properties of the formulation and to enhance the absorption of the iRNAs and nucleic acids of the present invention. Penetration enhancers used in the microemulsions of the present invention can be classified as belonging to one of five broad categories-surfactants, fatty acids, bile salts, chelating agents, and non-chelating non-surfactants (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, p. 92). Each of these classes has been discussed above.


iii. Microparticles


An iRNA agent 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 are described below in greater detail.


Surfactants (or “surface-active agents”) are chemical entities which, when dissolved in an aqueous solution, reduce the surface tension of the solution or the interfacial tension between the aqueous solution and another liquid, with the result that absorption of iRNAs through the mucosa is enhanced. In addition to bile salts and fatty acids, these penetration enhancers include, for example, sodium lauryl sulfate, polyoxyethylene-9-lauryl ether and polyoxyethylene-20-cetyl ether) (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); and perfluorochemical emulsions, such as FC-43. Takahashi et al., J. Pharm. Pharmacol., 1988, 40, 252).


Various fatty acids and their derivatives which act as penetration enhancers include, for example, oleic acid, lauric acid, capric acid (n-decanoic acid), myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein (1-monooleoyl-rac-glycerol), dilaurin, caprylic acid, arachidonic acid, glycerol 1-monocaprate, 1-dodecylazacycloheptan-2-one, acylcarnitines, acylcholines, C1-20 alkyl esters thereof (e.g., methyl, isopropyl and t-butyl), and mono- and di-glycerides thereof (i.e., oleate, laurate, caprate, myristate, palmitate, stearate, linoleate, etc.) (see e.g., Touitou, E., et al. Enhancement in Drug Delivery, CRC Press, Danvers, M A, 2006; Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, p.92; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1-33; El Hariri et al., J. Pharm. Pharmacol., 1992, 44, 651-654).


The physiological role of bile includes the facilitation of dispersion and absorption of lipids and fat-soluble vitamins (see e.g., Malmsten, M. Surfactants and polymers in drug delivery, Informa Health Care, New York, NY, 2002; Brunton, Chapter 38 in: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Ed., Hardman et al. Eds., McGraw-Hill, New York, 1996, pp. 934-935). Various natural bile salts, and their synthetic derivatives, act as penetration enhancers. Thus the term “bile salts” includes any of the naturally occurring components of bile as well as any of their synthetic derivatives. Suitable bile salts include, for example, cholic acid (or its pharmaceutically acceptable sodium salt, sodium cholate), dehydrocholic acid (sodium dehydrocholate), deoxycholic acid (sodium deoxycholate), glucholic acid (sodium glucholate), glycholic acid (sodium glycocholate), glycodeoxycholic acid (sodium glycodeoxycholate), taurocholic acid (sodium taurocholate), taurodeoxycholic acid (sodium taurodeoxycholate), chenodeoxycholic acid (sodium chenodeoxycholate), ursodeoxycholic acid (UDCA), sodium tauro-24, 25-dihydro-fusidate (STDHF), sodium glycodihydrofusidate and polyoxyethylene-9-lauryl ether (POE) (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, page 92; Swinyard, Chapter 39 In: Remington's Pharmaceutical Sciences, 18th Ed., Gennaro, ed., Mack Publishing Co., Easton, Pa., 1990, pages 782-783; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1-33; Yamamoto et al., J. Pharm. Exp. Ther., 1992, 263, 25; Yamashita et al., J. Pharm. Sci., 1990, 79, 579-583).


Chelating agents, as used in connection with the present invention, can be defined as compounds that remove metallic ions from solution by forming complexes therewith, with the result that absorption of iRNAs through the mucosa is enhanced. With regards to their use as penetration enhancers in the present invention, chelating agents have the added advantage of also serving as DNase inhibitors, as most characterized DNA nucleases require a divalent metal ion for catalysis and are thus inhibited by chelating agents (Jarrett, J. Chromatogr., 1993, 618, 315-339). Suitable chelating agents include but are not limited to disodium ethylenediaminetetraacetate (EDTA), citric acid, salicylates (e.g., sodium salicylate, 5-methoxysalicylate and homovanilate), N-acyl derivatives of collagen, laureth-9 and N-amino acyl derivatives of beta-diketones (enamines)(see e.g., Katdare, A. et al., Excipient development for pharmaceutical, biotechnology, and drug delivery, CRC Press, Danvers, M A, 2006; Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92; Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1-33; Buur et al., J. Control Rel., 1990, 14, 43-51).


As used herein, non-chelating non-surfactant penetration enhancing compounds can be defined as compounds that demonstrate insignificant activity as chelating agents or as surfactants but that nonetheless enhance absorption of iRNAs through the alimentary mucosa (see e.g., Muranishi, Critical Reviews in Therapeutic Drug Carrier Systems, 1990, 7, 1-33). This class of penetration enhancers includes, for example, unsaturated cyclic ureas, 1-alkyl- and 1-alkenylazacyclo-alkanone derivatives (Lee et al., Critical Reviews in Therapeutic Drug Carrier Systems, 1991, page 92); and non-steroidal anti-inflammatory agents such as diclofenac sodium, indomethacin and phenylbutazone (Yamashita et al., J. Pharm. Pharmacol., 1987, 39, 621-626).


Agents that enhance uptake of iRNAs at the cellular level can also be added to the pharmaceutical and other compositions of the present invention. For example, cationic lipids, such as lipofectin (Junichi et al, U.S. Pat. No. 5,705,188), cationic glycerol derivatives, and polycationic molecules, such as polylysine (Lollo et al., PCT Application WO 97/30731), are also known to enhance the cellular uptake of dsRNAs. Examples of commercially available transfection reagents include, for example Lipofectamine™ (Invitrogen; Carlsbad, CA), Lipofectamine 2000™ (Invitrogen; Carlsbad, CA), 293fectin™ (Invitrogen; Carlsbad, CA), Cellfectin™ (Invitrogen; Carlsbad, CA), DMRIE-C™ (Invitrogen; Carlsbad, CA), FreeStyle™ MAX (Invitrogen; Carlsbad, CA), Lipofectamine™ 2000 CD (Invitrogen; Carlsbad, CA), Lipofectamine™ (Invitrogen; Carlsbad, CA), iRNAMAX (Invitrogen; Carlsbad, CA), Oligofectamine™ (Invitrogen; Carlsbad, CA), Optifect™ (Invitrogen; Carlsbad, CA), X-tremeGENE Q2 Transfection Reagent (Roche; Grenzacherstrasse, Switzerland), DOTAP Liposomal Transfection Reagent (Grenzacherstrasse, Switzerland), DOSPER Liposomal Transfection Reagent (Grenzacherstrasse, Switzerland), or Fugene (Grenzacherstrasse, Switzerland), Transfectam® Reagent (Promega; Madison, WI), TransFast™ Transfection Reagent (Promega; Madison, WI), Tfx™-20 Reagent (Promega; Madison, WI), Tfx™-50 Reagent (Promega; Madison, WI), DreamFect™ (OZ Biosciences; Marseille, France), EcoTransfect (OZ Biosciences; Marseille, France), TransPassa D1 Transfection Reagent (New England Biolabs; Ipswich, MA, USA), LyoVec™/LipoGen™ (Invitrogen; San Diego, CA, USA), PerFectin Transfection Reagent (Genlantis; San Diego, CA, USA), NeuroPORTER Transfection Reagent (Genlantis; San Diego, CA, USA), GenePORTER Transfection reagent (Genlantis; San Diego, CA, USA), GenePORTER 2 Transfection reagent (Genlantis; San Diego, CA, USA), Cytofectin Transfection Reagent (Genlantis; San Diego, CA, USA), BaculoPORTER Transfection Reagent (Genlantis; San Diego, CA, USA), TroganPORTER™ transfection Reagent (Genlantis; San Diego, CA, USA), RiboFect (Bioline; Taunton, MA, USA), PlasFect (Bioline; Taunton, MA, USA), UniFECTOR (B-Bridge International; Mountain View, CA, USA), SureFECTOR (B-Bridge International; Mountain View, CA, USA), or HiFect™ (B-Bridge International, Mountain View, CA, USA), among others.


Other agents can be utilized to enhance the penetration of the administered nucleic acids, including glycols such as ethylene glycol and propylene glycol, pyrrols such as 2-pyrrol, azones, and terpenes such as limonene and menthone.


v. Carriers


Certain compositions of the present invention also incorporate carrier compounds in the formulation. As used herein, “carrier compound” or “carrier” can refer to a nucleic acid, or analog thereof, which is inert (i.e., does not possess biological activity per se) but is recognized as a nucleic acid by in vivo processes that reduce the bioavailability of a nucleic acid having biological activity by, for example, degrading the biologically active nucleic acid or promoting its removal from circulation. The coadministration of a nucleic acid and a carrier compound, typically with an excess of the latter substance, can result in a substantial reduction of the amount of nucleic acid recovered in the liver, kidney or other extracirculatory reservoirs, presumably due to competition between the carrier compound and the nucleic acid for a common receptor. For example, the recovery of a partially phosphorothioate dsRNA in hepatic tissue can be reduced when it is coadministered with polyinosinic acid, dextran sulfate, polycytidic acid or 4-acetamido-4′isothiocyano-stilbene-2,2′-disulfonic acid (Miyao et al., DsRNA Res. Dev., 1995, 5, 115-121; Takakura et al., DsRNA & Nucl. Acid Drug Dev., 1996, 6, 177-183.


vi. 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. Typical pharmaceutical carriers include, but are not limited to, binding agents (e.g., pregelatinized maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose, etc.); fillers (e.g., lactose and other sugars, microcrystalline cellulose, pectin, gelatin, calcium sulfate, ethyl cellulose, polyacrylates or calcium hydrogen phosphate, etc.); lubricants (e.g., magnesium stearate, talc, silica, colloidal silicon dioxide, stearic acid, metallic stearates, hydrogenated vegetable oils, corn starch, polyethylene glycols, sodium benzoate, sodium acetate, etc.); disintegrants (e.g., starch, sodium starch glycolate, etc.); and wetting agents (e.g., sodium lauryl sulphate, etc).


Pharmaceutically acceptable organic or inorganic excipients suitable for non-parenteral administration which do not deleteriously react with nucleic acids can also be used to formulate the compositions of the present invention. Suitable pharmaceutically acceptable carriers include, but are not limited to, water, salt solutions, alcohols, polyethylene glycols, gelatin, lactose, amylose, magnesium stearate, talc, silicic acid, viscous paraffin, hydroxymethylcellulose, polyvinylpyrrolidone and the like.


Formulations for topical administration of nucleic acids can include sterile and non-sterile aqueous solutions, non-aqueous solutions in common solvents such as alcohols, or solutions of the nucleic acids in liquid or solid oil bases. The solutions can also contain buffers, diluents and other suitable additives. Pharmaceutically acceptable organic or inorganic excipients suitable for non-parenteral administration which do not deleteriously react with nucleic acids can be used.


Suitable pharmaceutically acceptable excipients include, but are not limited to, water, salt solutions, alcohol, polyethylene glycols, gelatin, lactose, amylose, magnesium stearate, talc, silicic acid, viscous paraffin, hydroxymethylcellulose, polyvinylpyrrolidone and the like.


vii. 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 and/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 and/or dextran. The suspension can also contain stabilizers.


In some embodiments, pharmaceutical compositions featured in the invention include (a) one or more iRNA compounds and (b) one or more agents which function by a non-iRNA mechanism and which are useful in treating a hemolytic disorder. Examples of such agents include, but are not lmited to an anti-inflammatory agent, anti-steatosis agent, anti-viral, and/or anti-fibrosis agent.


In addition, other substances commonly used to protect the liver, such as silymarin, can also be used in conjunction with the iRNAs described herein. Other agents useful for treating liver diseases include telbivudine, entecavir, and protease inhibitors such as telaprevir and other disclosed, for example, in Tung et al., U.S. Application Publication Nos. 2005/0148548, 2004/0167116, and 2003/0144217; and in Hale et al., U.S. Application Publication No. 2004/0127488.


Toxicity and therapeutic 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 therapeutically 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 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 therapeutically 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) 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 effective in treatment of pathological processes mediated by contact activation pathway gene expression (i.e., F12 gene expression). 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.


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 Figures and the Sequence Listing, are hereby incorporated herein by reference.


EXAMPLES
Example 1. F12 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.


Transcripts

siRNA Design


A set of siRNAs targeting the human F12, “coagulation factor XII” (human: NCBI refseqID NM_000505; NCBI GeneID: 2161), as well as toxicology-species F12 orthologs (cynomolgus monkey: XM_005558647; mouse: NM_021489; rat, NM_001014006) were designed using custom R and Python scripts. The human F12 REFSEQ mRNA has a length of 2060 bases. The rationale and method for the set of siRNA designs is as follows: the predicted efficacy for every potential 19mer siRNA from position 50 through position 2060 (the coding region and 3′ UTR) of human F12 mRNA (containing the the coding region and 3′ UTR) was determined using a linear model that predicted the direct measure of mRNA knockdown based on the data of more than 20,000 distinct siRNA designs targeting a large number of vertebrate genes. Subsets of the F12 siRNAs were designed with perfect or near-perfect matches between human, cynomolgus and rhesus monkey. A further subset was designed with perfect or near-perfect matches to mouse and rat F12 orthologs. For each strand of the siRNA, a custom Python script was used in a brute force search to measure the number and positions of mismatches between the siRNA and all potential alignments in the target species transcriptome. Extra weight was given to mismatches in the seed region, defined here as positions 2-9 of the antisense oligonucleotide, as well the cleavage site of the siRNA, defined here as positions 10-11 of the antisense oligonucleotide. The relative weights for the mismatches were 2.8 for seed mismatches, 1.2 for cleavage site mismatches, and 1 mismatches in other positions up through antisense position 19. Mismatches in the first position were ignored. A specificity score was calculated for each strand by summing the value of each weighted mismatch. Preference was given to siRNAs whose antisense score in human and cynomolgus monkey was >=3.0 and predicted efficacy was >=70% knockdown of the F12 transcript.


A detailed list of the unmodified F12 sense and antisense strand sequences is shown in Table 3. A detailed list of the modified F12 sense and antisense strand sequences is shown in Table 4.


siRNA Synthesis


F12 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 L 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 F12 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 X PBS and then submitted for in vitro screening assays.









TABLE 2







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


Af
2′-fluoroadenosine-3′-phosphate


Afs
2′-fluoroadenosine-3′-phosphorothioate


As
adenosine-3′-phosphorothioate


C
cytidine-3′-phosphate


Cf
2′-fluorocytidine-3′-phosphate


Cfs
2′-fluorocytidine-3′-phosphorothioate


Cs
cytidine-3′-phosphorothioate


G
guanosine-3′-phosphate


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 (G, A, C, T or U)


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


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



Hyp-(GalNAc-alkyl)3


(dt)
deoxy-thymine


Y34
2-hydroxymethyl-tetrahydrofurane-4-methoxy-3-phosphate



(abasic 2′-OMe furanose)


Y44
2-hydroxymethyl-tetrahydrofurane-5-phosphate


(Agn)
Adenosine-glycol nucleic acid (GNA)


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


(Cgn)
Cytidine-glycol nucleic acid (GNA)


P
Phosphate


VP
Vinyl-phosphate
















TABLE 3 







Unmodified F12 Sequences















sense

SEQ
antis

Position
SEQ


Duplex
oligo
Sense Sequence 
ID
oligo
Antisense Sequence 
in
ID


name
name
5′ to 3′
NO:
name
5′ to 3′
NM_000505
NO:

















AD-66186
A-132464
GGUGAGCUUGGAGUCAACACU
378
A-132465
AGUGUUGACUCCAAGCUCACCAG
 79_102
428





AD-66157
A-132406
GAGCUUGGAGUCAACACUUUA
379
A-132407
UAAAGUGUUGACUCCAAGCUCAC
 82_105
429





AD-66118
A-132326
CUUGGAGUCAACACUUUCGAU
380
A-132327
AUCGAAAGUGUUGACUCCAAGCU
 85_108
430





AD-66115
A-132320
UUGGAGUCAACACUUUCGAUU
381
A-132321
AAUCGAAAGUGUUGACUCCAAGC
 86_109
431





AD-66170
A-132432
AACACUUUCGAUUCCACCUUA
382
A-132433
UAAGGUGGAAUCGAAAGUGUUGA
 94_117
432





AD-66166
A-132424
AGGAGCAUAAGUACAAAGCUA
383
A-132425
UAGCUUUGUACUUAUGCUCCUUG
126_149
433





AD-66173
A-132438
GAGCAUAAGUACAAAGCUGAA
384
A-132439
UUCAGCUUUGUACUUAUGCUCCU
128_151
434





AD-66177
A-132446
UAAGUACAAAGCUGAAGAGCA
385
A-132447
UGCUCUUCAGCUUUGUACUUAUG
133_156
435





AD-66161
A-132414
AAGUACAAAGCUGAAGAGCAA
386
A-132415
UUGCUCUUCAGCUUUGUACUUAU
134_157
436





AD-66114
A-132318
UACCACAAAUGUACCCACAAA
387
A-132319
UUUGUGGGUACAUUUGUGGUACA
218_241
437





AD-66179
A-132450
CCACAAAUGUACCCACAAGGA
388
A-132451
UCCUUGUGGGUACAUUUGUGGUA
220_243
438





AD-66160
A-132412
UACUGUUUGGAGCCCAAGAAA
389
A-132413
UUUCUUGGGCUCCAAACAGUAUC
305_328
439





AD-66171
A-132434
ACUGUUUGGAGCCCAAGAAAA
390
A-132435
UUUUCUUGGGCUCCAAACAGUAU
306_329
440





AD-66189
A-132470
CUGUUUGGAGCCCAAGAAAGU
391
A-132471
ACUUUCUUGGGCUCCAAACAGUA
307_330
441





AD-66122
A-132334
GGAGCCCAAGAAAGUGAAAGA
392
A-132335
UCUUUCACUUUCUUGGGCUCCAA
313_336
442





AD-66176
A-132444
GAGCCCAAGAAAGUGAAAGAA
393
A-132445
UUCUUUCACUUUCUUGGGCUCCA
314_337
443





AD-66125
A-132340
AGCCCAAGAAAGUGAAAGACA
394
A-132341
UGUCUUUCACUUUCUUGGGCUCC
315_338
444





AD-66112
A-132314
GCCCAAGAAAGUGAAAGACCA
395
A-132315
UGGUCUUUCACUUUCUUGGGCUC
316_339
445





AD-66172
A-132436
CCCAAGAAAGUGAAAGACCAA
396
A-132437
UUGGUCUUUCACUUUCUUGGGCU
317_340
446





AD-66127
A-132344
CAAGAAAGUGAAAGACCAUUA
397
A-132345
UAAUGGUCUUUCACUUUCUUGGG
319_342
447





AD-66162
A-132416
GAAAGUGAAAGACCACUGCAA
398
A-132417
UUGCAGUGGUCUUUCACUUUCUU
322_345
448





AD-66181
A-132454
AAAGUGAAAGACCACUGCAGA
399
A-132455
UCUGCAGUGGUCUUUCACUUUCU
323_346
449





AD-66184
A-132460
UCACUGGAAACCACUGCCAGA
400
A-132461
UCUGGCAGUGGUUUCCAGUGAGG
420_443
450





AD-66182
A-132456
ACUGCCAGAAAGAGAAGUGCU
401
A-132457
AGCACUUCUCUUUCUGGCAGUGG
432_455
451





AD-66167
A-132426
CUGCCAGAAAGAGAAGUGCUU
402
A-132427
AAGCACUUCUCUUUCUGGCAGUG
433_456
452





AD-66165
A-132422
CAGAAAGAGAAGUGCUUUGAA
403
A-132423
UUCAAAGCACUUCUCUUUCUGGC
437_460
453





AD-66155
A-132402
AGAAAGAGAAGUGCUUUGAGA
404
A-132403
UCUCAAAGCACUUCUCUUUCUGG
438_461
454





AD-66159
A-132410
AGUGCUUUGAGCCUCAGCUUA
405
A-132411
UAAGCUGAGGCUCAAAGCACUUC
447_470
455





AD-66168
A-132428
UUCCACAAGAAUGAGAUAUGA
406
A-132429
UCAUAUCUCAUUCUUGUGGAAAA
476_499
456





AD-66185
A-132462
UCCACAAGAAUGAGAUAUGGU
407
A-132463
ACCAUAUCUCAUUCUUGUGGAAA
477_500
457





AD-66156
A-132404
CCACAAGAAUGAGAUAUGGUA
408
A-132405
UACCAUAUCUCAUUCUUGUGGAA
478_501
458





AD-66113
A-132316
AAGAAUGAGAUAUGGUAUAGA
409
A-132317
UCUAUACCAUAUCUCAUUCUUGU
482_505
459





AD-66188
A-132468
UGGUAUAGAACUGAGCAAGCA
410
A-132469
UGCUUGCUCAGUUCUAUACCAUA
494_517
460





AD-66190
A-132472
GUAUAGAACUGAGCAAGCAGA
411
A-132473
UCUGCUUGCUCAGUUCUAUACCA
496_519
461





AD-66180
A-132452
AUAGAACUGAGCAAGCAGCUA
412
A-132453
UAGCUGCUUGCUCAGUUCUAUAC
498_521
462





AD-66117
A-132324
CCAGAUGCCAGUGCAAGGGUA
413
A-132325
UACCCUUGCACUGGCAUCUGGCC
522_545
463





AD-66169
A-132430
GCCAGUGCAAGGGUCCUGAUA
414
A-132431
UAUCAGGACCCUUGCACUGGCAU
528_551
464





AD-66174
A-132440
CAGUGCAAGGGUCCUGAUGCA
415
A-132441
UGCAUCAGGACCCUUGCACUGGC
530_553
465





AD-66175
A-132442
ACCAAGGCAAGCUGCUAUGAU
416
A-132443
AUCAUAGCAGCUUGCCUUGGUGU
683_706
466





AD-66158
A-132408
CCAAGGCAAGCUGCUAUGAUA
417
A-132409
UAUCAUAGCAGCUUGCCUUGGUG
684_707
467





AD-66119
A-132328
AGGCUUCAUGUCCCACUCAUA
418
A-132329
UAUGAGUGGGACAUGAAGCCUAG
974_997
468





AD-66187
A-132466
GGCUCCGCAAGAGUCUGUCUU
419
A-132467
AAGACAGACUCUUGCGGAGCCGC
1131_1154
469





AD-66163
A-132418
GCUCCGCAAGAGUCUGUCUUA
420
A-132419
UAAGACAGACUCUUGCGGAGCCG
1132_1155
470





AD-66116
A-132322
CCGCAAGAGUCUGUCUUCGAU
421
A-132323
AUCGAAGACAGACUCUUGCGGAG
1135_1158
471





AD-66137
A-132364
GUUCGAGGGGGCUGAAGAAUA
422
A-132365
UAUUCUUCAGCCCCCUCGAACUG
1570_1593
472





AD-66183
A-132458
GGAAGGCAAGAUUGUGUCCCA
423
A-132459
UGGGACACAAUCUUGCCUUCCAU
1956_1979
473





AD-66164
A-132420
AGGCAAGAUUGUGUCCCAUUA
424
A-132421
UAAUGGGACACAAUCUUGCCUUC
1959_1982
474





AD-66121
A-132332
AACUCAAUAAAGUGCUUUGAA
425
A-132333
UUCAAAGCACUUUAUUGAGUUUC
2017_2040
475





AD-66126
A-132342
AAUAAAGUGCUUUGAAAACGU
426
A-132343
ACGUUUUCAAAGCACUUUAUUGA
2022_2045
476





AD-66178
A-132448
AGUGCUUUGAAAAUGCUGAGA
427
A-132449
UCUCAGCAUUUUCAAAGCACUUU
2027_2050
477
















TABLE 4 







Modified F12 Sequences














sense

SEQ
antis

SEQ


Duplex
oligo

ID
oligo

ID


name
name
Sense Sequence 5′ to 3′
NO:
name
Antisense Sequence 5′ to 3′
NO:





AD-66186
A-132464
GfsgsUfgAfgCfuUfGfGfaGf
478
A-132465
asGfsuGfuUfgAfcUfccaAfgCfuC
528




uCfaAfcAfcUfL96


faCfcsasg






AD-66157
A-132406
GfsasGfcUfuGfgAfGfUfcAf
479
A-132407
usAfsaAfgUfgUfuGfacuCfcAfaG
529




aCfaCfuUfuML96


fcUfcsasc






AD-66118
A-132326
CfsusUfgGfaGfuCfAfAfcAf
480
A-132327
asUfscGfaAfaGfuGfuugAfcUfcC
530




cUfuUfcGfaUfL96


faAfgscsu






AD-66115
A-132320
UfsusGfgAfgUfcAfAfCfaCf
481
A-132321
asAfsuCfgAfaAfgUfguuGfaCfuC
531




uUfuCfgAfuUfL96


fcAfasgsc






AD-66170
A-132432
AfsasCfaCfuUfuCfGfAfuUf
482
A-132433
usAfsaGfgUfgGfaAfucgAfaAfgU
532




cCfaCfcUfuAfL96


fgUfusgsa






AD-66166
A-132424
AfsgsGfaGfcAfuAfAfGfuAf
483
A-132425
usAfsgCfuUfuGfuAfcuuAfuGfcU
533




cAfaAfgCfuAfL96


fcCfususg






AD-66173
A-132438
GfsasGfcAfuAfaGfUfAfcAf
484
A-132439
usUfscAfgCfuUfuGfuacUfuAfuG
534




aAfgCfuGfaAfL96


fcUfcscsu






AD-66177
A-132446
UfsasAfgUfaCfaAfAfGfcUf
485
A-132447
usGfscUfcUfuCfaGfcuuUfgUfaC
535




gAfaGfaGfcAfL96


fuUfasusg






AD-66161
A-132414
AfsasGfuAfcAfaAfGfCfuGf
486
A-132415
usUfsgCfuCfuUfcAfgcuUfuGfuA
536




aAfgAfgCfaAfL96


fcUfusasu






AD-66114
A-132318
UfsasCfcAfcAfaAfUfGfuAf
487
A-132319
usUfsuGfuGfgGfuAfcauUfuGfuG
537




cCfcAfcAfaAfL96


fgUfascsa






AD-66179
A-132450
CfscsAfcAfaAfuGfUfAfcCf
488
A-132451
usCfscUfuGfuGfgGfuacAfuUfuG
538




cAfcAfaGfgAfL96


fuGfgsusa






AD-66160
A-132412
UfsasCfuGfuUfuGfGfAfgCf
489
A-132413
usUfsuCfuUfgGfgCfuccAfaAfcA
539




cCfaAfgAfaAfL96


fgUfasusc






AD-66171
A-132434
AfscsUfgUfuUfgGfAfGfcCf
490
A-132435
usUfsuUfcUfuGfgGfcucCfaAfaC
540




cAfaGfaAfaAfL96


faGfusasu






AD-66189
A-132470
CfsusGfuUfuGfgAfGfCfcCf
491
A-132471
asCfsuUfuCfuUfgGfgcuCfcAfaA
541




aAfgAfaAfgUfL96


fcAfgsusa






AD-66122
A-132334
GfsgsAfgCfcCfaAfGfAfaAf
492
A-132335
usCfsuUfuCfaCfuUfucuUfgGfgC
542




gUfgAfaAfgAfL96


fuCfcsasa






AD-66176
A-132444
GfsasGfcCfcAfaGfAfAfaGf
493
A-132445
usUfscUfuUfcAfcUfuucUfuGfgG
543




uGfaAfaGfaAfL96


fcUfcscsa






AD-66125
A-132340
AfsgsCfcCfaAfgAfAfAfgUf
494
A-132341
usGfsuCfuUfuCfaCfuuuCfuUfgG
544




gAfaAfgAfcAfL96


fgCfuscsc






AD-66112
A-132314
GfscsCfcAfaGfaAfAfGfuGf
495
A-132315
usGfsgUfcUfuUfcAfcuuUfcUfuG
545




aAfaGfaCfcAfL96


fgGfcsusc






AD-66172
A-132436
CfscsCfaAfgAfaAfGfUfgAf
496
A-132437
usUfsgGfuCfuUfuCfacuUfuCfuU
546




aAfgAfcCfaAfL96


fgGfgscsu






AD-66127
A-132344
CfsasAfgAfaAfgUfGfAfaAf
497
A-132345
usAfsaUfgGfuCfuUfucaCfuUfuC
547




gAfcCfaUfuAfL96


fuUfgsgsg






AD-66162
A-132416
GfsasAfaGfuGfaAfAfGfaCf
498
A-132417
usUfsgCfaAfuGfgUfcuuUfcAfcU
548




cAfuUfgCfaAfL96


fuUfcsusu






AD-66181
A-132454
AfsasAfgUfgAfaAfGfAfcCf
499
A-132455
usCfsuGfcAfaUfgGfucuUfuCfaC
549




aUfuGfcAfgAfL96


fuUfuscsu






AD-66184
A-132460
UfscsAfcUfgGfaAfAfCfcAf
500
A-132461
usCfsuGfgCfaGfuGfguuUfcCfaG
550




cUfgCfcAfgAfL96


fuGfasgsg






AD-66182
A-132456
AfscsUfgCfcAfgAfAfAfgAf
501
A-132457
asGfscAfcUfuCfuCfuuuCfuGfgC
551




gAfaGfuGfcUfL96


faGfusgsg






AD-66167
A-132426
CfsusGfcCfaGfaAfAfGfaGf
502
A-132427
asAfsgCfaCfuUfcUfcuuUfcUfgG
552




aAfgUfgCfuUfL96


fcAfgsusg






AD-66165
A-132422
CfsasGfaAfaGfaGfAfAfgUf
503
A-132423
usUfscAfaAfgCfaCfuucUfcUfuU
553




gCfuUfuGfaAfL96


fcUfgsgsc






AD-66155
A-132402
AfsgsAfaAfgAfgAfAfGfuGf
504
A-132403
usCfsuCfaAfaGfcAfcuuCfuCfuU
554




cUfuUfgAfgAfL96


fuCfusgsg






AD-66159
A-132410
AfsgsUfgCfuUfuGfAfGfcCf
505
A-132411
usAfsaGfcUfgAfgGfcucAfaAfgC
555




uCfaGfcUfuAfL96


faCfususc






AD-66168
A-132428
UfsusCfcAfcAfaGfAfAfuGf
506
A-132429
usCfsaUfaUfcUfcAfuucUfuGfuG
556




aGfaUfaUfgAfL96


fgAfasasa






AD-66185
A-132462
UfscsCfaCfaAfgAfAfUfgAf
507
A-132463
asCfscAfuAfuCfuCfauuCfuUfgU
557




gAfuAfuGfgUfL96


fgGfasasa






AD-66156
A-132404
CfscsAfcAfaGfaAfUfGfaGf
508
A-132405
usAfscCfaUfaUfcUfcauUfcUfuG
558




aUfaUfgGfuAfL96


fuGfgsasa






AD-66113
A-132316
AfsasGfaAfuGfaGfAfUfaUf
509
A-132317
usCfsuAfuAfcCfaUfaucUfcAfuU
559




gGfuAfuAfgAfL96


fcUfusgsu






AD-66188
A-132468
UfsgsGfuAfuAfgAfAfCfuGf
510
A-132469
usGfscUfuGfcUfcAfguuCfuAfuA
560




aGfcAfaGfcAfL96


fcCfasusa






AD-66190
A-132472
GfsusAfuAfgAfaCfUfGfaGf
511
A-132473
usCfsuGfcUfuGfcUfcagUfuCfuA
561




cAfaGfcAfgAfL96


fuAfcscsa






AD-66180
A-132452
AfsusAfgAfaCfuGfAfGfcAf
512
A-132453
usAfsgCfuGfcUfuGfcucAfgUfuC
562




aGfcAfgCfuAfL96


fuAfusasc






AD-66117
A-132324
CfscsAfgAfuGfcCfAfGfuGf
513
A-132325
usAfscCfcUfuGfcAfcugGfcAfuC
563




cAfaGfgGfuAfL96


fuGfgscsc






AD-66169
A-132430
GfscsCfaGfuGfcAfAfGfgGf
514
A-132431
usAfsuCfaGfgAfcCfcuuGfcAfcU
564




uCfcUfgAfuAfL96


fgGfcsasu






AD-66174
A-132440
CfsasGfuGfcAfaGfGfGfuCf
515
A-132441
usGfscAfuCfaGfgAfcccUfuGfcA
565




cUfgAfuGfcAfL96


fcUfgsgsc






AD-66175
A-132442
AfscsCfaAfgGfcAfAfGfcUf
516
A-132443
asUfscAfuAfgCfaGfcuuGfcCfuU
566




gCfuAfuGfaUfL96


fgGfusgsu






AD-66158
A-132408
CfscsAfaGfgCfaAfGfCfuGf
517
A-132409
usAfsuCfaUfaGfcAfgcuUfgCfcU
567




cUfaUfgAfuAfL96


fuGfgsusg






AD-66119
A-132328
AfsgsGfcUfuCfaUfGfUfcCf
518
A-132329
usAfsuGfaGfuGfgGfacaUfgAfaG
568




cAfcUfcAfuAfL96


fcCfusasg






AD-66187
A-132466
GfsgsCfuCfcGfcAfAfGfaGf
519
A-132467
asAfsgAfcAfgAfcUfcuuGfcGfgA
569




uCfuGfuCfuUfL96


fgCfcsgsc






AD-66163
A-132418
GfscsUfcCfgCfaAfGfAfgUf
520
A-132419
usAfsaGfaCfaGfaCfucuUfgCfgG
570




cUfgUfcUfuAfL96


faGfcscsg






AD-66116
A-132322
CfscsGfcAfaGfaGfUfCfuGf
521
A-132323
asUfscGfaAfgAfcAfgacUfcUfuG
571




uCfuUfcGfaUfL96


fcGfgsasg






AD-66137
A-132364
GfsusUfcGfaGfgGfGfGfcUf
522
A-132365
usAfsuUfcUfuCfaGfcccCfcUfcG
572




gAfaGfaAfuAfL96


faAfcsusg






AD-66183
A-132458
GfsgsAfaGfgCfaAfGfAfuUf
523
A-132459
usGfsgGfaCfaCfaAfucuUfgCfcU
573




gUfgUfcCfcAfL96


fuCfcsasu






AD-66164
A-132420
AfsgsGfcAfaGfaUfUfGfuGf
524
A-132421
usAfsaUfgGfgAfcAfcaaUfcUfuG
574




uCfcCfaUfuAfL96


fcCfususc






AD-66121
A-132332
AfsasCfuCfaAfuAfAfAfgUf
525
A-132333
usUfscAfaAfgCfaCfuuuAfuUfgA
575




gCfuUfuGfaAfL96


fgUfususc






AD-66126
A-132342
AfsasUfaAfaGfuGfCfUfuUf
526
A-132343
asCfsgUfuUfuCfaAfagcAfcUfuU
576




gAfaAfaCfgUfL96


faUfusgsa






AD-66178
A-132448
AfsgsUfgCfuUfuGfAfAfaAf
527
A-132449
usCfsuCfaGfcAfuUfuucAfaAfgC
577




uGfcUfgAfgAfL96


faCfususu









Example 2. In Vitro Screening of F12 siRNA Duplexes
Cell Culture and Transfections

Hep3b or Primary Mouse Hepatocyte cells (PMH) (MSCP10, Lot #MC613) were transfected by adding 4.9 μl of Opti-MEM plus 0.1 μl of Lipofectamine RNAiMax per well (Invitrogen, Carlsbad CA. cat #13778-150) to 5 μl of siRNA duplexes per well into a 384-well plate and incubated at room temperature for 15 minutes. Forty l of DMEM (Hep3b) of William's E Medium (PMH) containing about 5×103 cells was then added to the siRNA mixture. Cells were incubated for 24 hours prior to RNA purification.


Single dose experiments were performed at 10 nM and 0.01 nM final duplex concentration and dose response experiments were done over a range of doses from 10 nM to 36 fM final duplex concentration over 8, 6-fold dilutions.


Total RNA Isolation Using DYNABEADS mRNA Isolation Kit:


RNA was isolated using an automated protocol on a BioTek-EL406 μlatform using DYNABEADs (Invitrogen, cat #61012). Briefly, 50 μl of Lysis/Binding Buffer and 25 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 the supernatant was removed.


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


Ten μl of a master mix containing 1 μl 10X Buffer, 0.4 μl 25X dNTPs, 1 μl 10x Random primers, 0.5 μl Reverse Transcriptase, 0.5 μl RNase inhibitor and 6.6 μl of H2O per reaction was added to RNA isolated as described above. Plates were sealed, mixed, and incubated on an electromagnetic shaker for 10 minutes at room temperature, followed by 2 hours 37° C. Plates were then incubated at 81° C. for 8 minutes.


Real Time PCR:

Two μl of cDNA were added to a master mix containing 0.5 μl of GAPDH TaqMan Probe (Hs99999905_m1 or 4352339E), 0.5 μl F12 probe (Hs00166821 or Mm00491349) 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 performed using a LightCycler480 Real Time PCR system (Roche) using the ΔΔCt(RQ) assay. Each duplex was tested in four independent transfections.


To calculate relative fold change, real time data were analyzed using the ΔΔCt method and normalized to assays performed with cells transfected with 10 nM AD-1955, or mock transfected cells. IC50s were calculated using a 4 parameter fit model using XLFit and normalized to cells transfected with AD-1955, a non-targeting control, or naïve cells.


The sense and antisense sequences ofAD-1955 are:











SENSE:



(SEQ ID NO: 2343)



cuuAcGcuGAGuAcuucGAdTsdT;







ANTISENSE:



(SEQ ID NO: 2344)



UCGAAGuACUcAGCGuAAGdTsdT.






Table 5 shows the results of a single dose screen in Hep3b cells transfected with the indicated human F12 iRNAs. Table 6 shows the results of a single dose response screen in Hep3b cells transfected with the indicated human F12 iRNAs. Table 7 shows the results of a single dose screen in primary mouse hepatocytes transfected with the indicated mouse F12 iRNAs. Table 8 shows the results of a dose response screen in primary mouse hepatocytes transfected with the indicated human F12 iRNAs. Data are expressed as percent of 8mRNA remaining relative to AD-1955.









TABLE 5







F12 Single Dose Screen in Hep3bCells














10 nM
0.1 nM
10 nM
0.1 nM



DuplexId
AVG
AVG
STDEV
STDEV
















AD-66186
33.1
88.4
5.3
12.6



AD-66157
62.2
85.3
9.6
13.2



AD-66118
47.4
59.4
2.9
10.6



AD-66115
54.8
73.9
4.8
3



AD-66170
31.6
57.3
3.9
12.5



AD-66166
74.7
88.8
14.3
15.8



AD-66173
22.3
58.5
7.6
11.8



AD-66177
52.9
86.7
6.9
6.3



AD-66161
50.3
59.9
7.9
10



AD-66114
42.1
82.3
5.3
8.5



AD-66179
78.4
101.4
14.3
16.1



AD-66160
45.4
82.3
13.4
18.5



AD-66171
74.8
126.2
12.1
28.2



AD-66189
49.3
78.1
16.6
9.1



AD-66122
47.2
94.9
7.4
7.5



AD-66176
42.7
69.4
5.2
7



AD-66125
46
91.8
7.5
17.4



AD-66112
60.4
136.8
11.4
14.4



AD-66172
34.9
70.2
13.1
11.1



AD-66127
39.5
73.3
8.5
12.4



AD-66162
79.1
93.6
13
24.7



AD-66181
59.8
101.7
1.2
5.4



AD-66184
34
72.9
7.8
14.9



AD-66182
47
101
8.8
7.9



AD-66167
30.3
60.2
2.6
5.9



AD-66165
44.3
63.2
11.4
22.3



AD-66155
45.3
72.8
13.5
16.1



AD-66159
49.6
98
8.4
31.2



AD-66168
25.5
52.9
5.8
16.6



AD-66185
40.8
81.7
3.8
11.5



AD-66156
30.8
75.6
4.4
5.4



AD-66113
42.1
76
8.1
5.9



AD-66188
43.9
82.1
9.1
15.4



AD-66190
40.2
74.9
9
8.3



AD-66180
34.6
83.1
6.6
23.3



AD-66117
48.9
108.1
4.1
9.5



AD-66169
64.9
89.4
9.8
1.9



AD-66174
55.4
107.6
7.9
23



AD-66175
37.9
104.7
4
19.7



AD-66158
55
107.3
14.7
31.7



AD-66119
27.6
69.8
3.4
4.3



AD-66187
53.3
105
19.6
9.6



AD-66163
33.6
53.9
5.1
4.9



AD-66116
33.9
57.4
10.4
12.6



AD-66137
103.4
136.7
6.6
15.9



AD-66183
36.5
91.9
8
12.7



AD-66164
31.3
78.2
5.1
6.4



AD-66121
26.5
72.1
2.7
18.3



AD-66126
33.2
56.7
2.6
12.6



AD-66178
51.1
72.1
6.3
16.5
















TABLE 6







F12 Dose Response Screen in Hep3b Cells










DuplexId
IC50 (nM)






AD-66170
0.085



AD-66173
0.244



AD-66176
N/A



AD-66125
N/A



AD-66172
0.398



AD-66167
0.457



AD-66165
0.058



AD-66168
0.657



AD-66163
0.481



AD-66116
0.089



AD-66126
0.086
















TABLE 7







F12 Single Dose Screen in Primary Mouse Hepatocytes














10 nM
0.1 nM
10 nM
0.1 nM



DuplexId
AVG
AVG
STDEV
STDEV
















AD-66186
93.1
102.6
2
6.6



AD-66157
97.4
114.5
16.5
17



AD-66118
65.9
93
11.6
11.9



AD-66115
61.8
89
5.5
8.9



AD-66170
88
98.5
11.7
8.4



AD-66166
106.8
98.5
8.8
5.2



AD-66173
106.8
106
11.2
14.8



AD-66177
87.5
103
3.6
3.2



AD-66161
94.4
103.1
7
15.9



AD-66114
38.6
79.1
4.1
5



AD-66179
71.1
105.7
6.8
18.2



AD-66160
14.6
106.8
1.2
8.7



AD-66171
17.7
102.5
2.3
6.1



AD-66189
9.1
90.2
1.3
6.1



AD-66122
14.4
95.7
0.7
13.9



AD-66176
10.9
85.8
2.1
4.6



AD-66125
12.6
80.5
2.1
6.2



AD-66112
19.1
82
7.2
3.5



AD-66172
4.2
75.3
0.4
6.7



AD-66127
7.4
48.4
3.7
7.3



AD-66162
3.9
30.6
1.9
4.9



AD-66181
7.2
69.2
0.9
4.1



AD-66184
93.6
110.9
4.1
6.8



AD-66182
13.4
89.9
1.3
2



AD-66167
4.8
55.5
0.5
2.6



AD-66165
2.1
18.7
0.3
3.6



AD-66155
5.7
48
0.7
5.1



AD-66159
7.2
88.7
0.5
3.7



AD-66168
65.6
105.6
1.6
11.3



AD-66185
96
108.9
3.1
16



AD-66156
56.8
107.2
3.5
8.8



AD-66113
72.8
88.7
4.8
5.5



AD-66188
117.5
95.5
17.3
4.9



AD-66190
118.3
96.5
5.8
8.4



AD-66180
121.4
109.3
15.2
6.6



AD-66117
72.3
89.1
7.4
8.5



AD-66169
89.4
103.7
8.8
4.2



AD-66174
92
103.4
18.1
8.4



AD-66175
89.5
112.9
13.7
8.9



AD-66158
103.9
105.3
11.5
15.2



AD-66119
66.5
92
8.9
9



AD-66187
109.1
107
16.4
10.3



AD-66163
89.9
106
6.8
6.1



AD-66116
69.8
97
8.2
10.6



AD-66137
17.6
94.1
2.1
8.7



AD-66183
100.1
109.6
7.6
8.4



AD-66164
84
98.8
10.2
9.8



AD-66121
2.5
30.5
0.4
3.2



AD-66126
4.1
22.3
0.3
2.3



AD-66178
79.6
112.8
6.8
16.5
















TABLE 8







F12 Dose Response Screen in Primary Mouse Hepatocytes










DuplexId
IC50 (nM)






AD-66170
N/A



AD-66173
N/A



AD-66176
3.571



AD-66125
14.962 



AD-66172
1.104



AD-66167
1.013



AD-66165
0.231



AD-66168
N/A



AD-66163
N/A



AD-66116
N/A



AD-66121
0.119



AD-66126
0.045









Example 3. In Vivo F12 Silencing in Wild-Type Mice

Three of the most active agents targeting F12, described above, were selected for further evaluation. In particular, additional agents targeting nucleotides 2017-2040, or nucleotides 315-338, or nucleotides 438-459 of NM_000505 (an F12 gene) were synthesized as described above. The in vivo efficacy of these additional agents was assessed by administration of a single subcutaneous dose of the agent to wild-type C57BL/6 mice and determining the level of mRNA at 7-10 days post-dose. The unmodified nucleotide sequences of the sense and antisense strands of the agents targeting F12 are provided in Table 9, and the modified nucleotide sequences of the sense and antisense strands of the agents are provided in Table 10.


In particular, wild-type C57BL/6 mice were administered either a single 1 mg/kg dose or a single 3 mg/kg dose, or a single 1 mg/kg dose or a single 10 mg/kg dose of the agent and the level of F12 mRNA was determined at 7-10 days post-dose. The results of these assays are provided in FIG. 1 demonstrate that AD-67244 was the most efficiacious agent targeting a F12 gene that was tested.









TABLE 9







Unmodified sense and antisense strand sequences of agents targeting F12


















Sense
Antisense








Antisense
Position
Position








Start
in GenBank
in GenBank

SEQ

SEQ


Duplex
Tar-
Position
Reference
Reference
Sense
ID
Antisense
ID


Name
get
on mRNA
Sequence
Sequence
Sequence
NO
Sequence
NO


















AD-
F12
2018
NM_000505.3
NM_000505.3_201
AACUCAAUAAA
890
UUCAAAGCACUU
898


66121


_2020-2040_s
8-2040_as
GUGCUUUGAA

UAUUGAGUUUC






AD-
F12
2018
NM_000505.3
NM_000505.3_201
AACUCAAUAAA
891
UUCAAAGCACUU
899


67244


_2020-2040_s
8-2040_as
GUGCUUUGAA

UAUUGAGUUUC






AD-
F12
2018
NM_000505.3
NM_000505.3_201
AACUCAAUAAA
892
UUCAAAGCACUU
900


67245


_2020-2040_s
8-2040_as
GUGCUUUGAA

UAUUGAGUUUC






AD-
F12
316
NM_000505.3
NM_000505.3_316-
AGCCCAAGAAA
893
UGUCUUUCACUU
901


66125


_318-338_s
338_as
GUGAAAGACA

UCUUGGGCUCC






AD-
F12
2023
NM_000505.3
NM_000505.3_202
AAUAAAGUGCU
894
ACGUUUUCAAAG
902


67246


_2025-2045_s
3-2045_as
UUGAAAACGU

CACUUUAUUGA






AD-
F12
2023
NM_000505.3
NM_000505.3_202
AAUAAAGUGCU
895
ACGUUUUCAAAG
903


67247


_2025-2045_s
3-2045_as
UUGAAAACGU

CACUUUAUUGA






AD-
F12
438
NM_000029.3
NM_000029.3_438-
CAGAAAGAGAA
896
UUCAAAGCACUU
904


67248


_440-460_s
460_as
GUGCUUUGAA

CUCUUUCUGGC






AD-
F12
438
NM_000029.3
NM_000029.3_438-
CAGAAAGAGAA
897
UUCAAAGCACUU
905


67249


_440-460_s
460_as
GUGCUUUGAA

CUCUUUCUGGC
















TABLE 10







Modified sense and antisense strand sequences of agents targeting F12


















Sense
Antisense








Antisense
Position
Position








Start
in GenBank
in GenBank

SEQ

SEQ


Duplex
Tar-
Position
Reference
Reference

ID
Antisense
ID


Name
get
on mRNA
Sequence
Sequence
Sense Sequence
NO
Sequence
NO


















AD-
F12
2018
NM_000505.3
NM_000505.3_
AfsasCfuCfaAfu
906
usUfscAfaAf
914


66121


_2020-2040_s
2018-2040_as
AfAfAfgUfgCfuU

gCfaCfuuuAf








fuGfaAfL96

uUfgAfgUfus










usc






AD-
F12
2018
NM_000505.3
NM_000505.3_
asascucaAfuAfA
907
usUfscaaAfg
915


67244


_2020-2040_s
2018-2040_as
fAfgugcuuugaaL

CfAfcuuuAfu








96

Ufgaguususc






AD-
F12
2018
NM_000505.3
NM_000505.3_
asascucaAfuAf
908
UfsUfscaaAf
916


67245


_2020-2040_s
2018-2040_as
AfAfgugcuuuga

gCfAfcuuuAf








aL96

uUfgaguusus










c






AD-
F12
316
NM_000505.3
NM_000505.3_
AfsgsCfcCfaAf
909
usGfsuCfuUfu
917


66125


_318-338_s
316-338_as
gAfAfAfgUfgAf

CfaCfuuuCfuU








aAfgAfc

fgGfgCfuscsc








AfL96








AD-
F12
2023
NM_000505.3
NM_000505.3_
asasuaaaGfuGf
910
asCfsguuUfuC
918


67246


_2025-2045_s
2023-2045_as
CfUfuugaaaacg

fAfaagcAfcUf








uL96

uuauusgsa






AD-
F12
2023
NM_000505.3
NM_000505.3_
asasuaaaGfuGf
911
AfsCfsguuUfu
919


67247


_2025-2045_s
2023-2045_as
CfUfuugaaaacg

CfAfaagcAfcU








uL96

fuuauusgsa






AD-
F12
438
NM_000029.3
NM_000029.3_
csasgaaaGfaGf
912
usUfscaaAfgC
920


67248


_440-460_s
438-460_as
AfAfgugcuuuga

fAfcuucUfcUf








aL96

uucugsgsc






AD-
F12
438
NM_000029.3
NM_000029.3_
csasgaaaGfaGf
913
UfsUfscaaAfg
921


67249


_440-460_s
438-460_as
AfAfgugcuuuga

CfAfcuucUfcU








aL96

fuucugsgsc









Example 4. In Vivo F12 Silencing in ACE-Inhibitor Induced Vascular Permeability Mouse Model

To determine the in vivo efficacy of a single dose of a subset of the agents described above to reduce human F12 mRNA levels, wild-type C57BL/6 female mice were subcutaneously administered a single 0 mg/kg, 0.1 mg/kg 0.3 mg/kg, 1 mg/kg or 3 mg/kg dose of AD-67244 (targeting F12). At day 7 post-dose, animals were intravenously administered 2.5 mg/kg of the angiotensin-converting enzyme (ACE) inhibitor, captopril, in order to induce vascular permeability. Fifteen minutes after administration of captopril, animals were intravenously administered 30 mg/kg Evans blue dye. Fifteen minutes after Evans Blue dye administration, animals were sacrificed and blood, intestine, and liver samples were collected. Evans Blue dye was extracted and quantified from the blood and intestine samples, and target mRNA levels were determined in the liver samples.


The results of these assays using an agent targeting F12 (AD-AD-67244) are shown in FIGS. 2A-2D.


Example 5. Synthesis and In Vitro Screening of F12 siRNA Duplexes

Additional iRNA agents targeting F12 were designed, synsthesized and screened for in vitro efficacy, as described above. A detailed list of the additional unmodified F12 sense and antisense strand sequences is shown in Table 11. A detailed list of the additional modified F12 sense and antisense strand sequences is shown in Table 12. Table 13 shows the results of a single dose screen in Hep3b cells transfected with the indicated additional F12 iRNAs. Data are expressed as percent of mRNA remaining relative to AD-1955.









TABLE 11







F12 Unmodified Sequences















SEQ


SEQ



Duplex
Sense Sequence
ID
Position in
Antisense Sequence
ID
Position in


Name
5′ to 3′
NO
NM_000505.3
5′ to 3′
NO
NM_000505.3
















AD-70653
GACUCCUGGAUAGGCAGCU
946
12-30
AGCUGCCUAUCCAGGAGUC
1130
12-30





AD-70654
UAGGCAGCUGGACCAACGA
947
22-40
UCGUUGGUCCAGCUGCCUA
1131
22-40





AD-70655
ACCAACGGACGGAUGCCAU
948
33-51
AUGGCAUCCGUCCGUUGGU
1132
33-51





AD-70656
AUGCCAUGAGGGCUCUGCU
949
45-63
AGCAGAGCCCUCAUGGCAU
1133
45-63





AD-70657
GCUCUGCUGCUCCUGGGGU
950
56-74
ACCCCAGGAGCAGCAGAGC
1134
56-74





AD-70658
UCCUGGGGUUCCUGCUGGU
951
66-84
ACCAGCAGGAACCCCAGGA
1135
66-84





AD-70659
CUGCUGGUGAGCUUGGAGU
952
77-95
ACUCCAAGCUCACCAGCAG
1136
77-95





AD-70660
CUUGGAGUCAACACUUUCA
953
 88-106
UGAAAGUGUUGACUCCAAG
1137
 88-106





AD-70661
ACUUUCGAUUCCACCUUGA
954
100-118
UCAAGGUGGAAUCGAAAGU
1138
100-118





AD-70662
CCACCUUGGGAAGCCCCCA
955
110-128
UGGGGGCUUCCCAAGGUGG
1139
110-128





AD-70663
GCCCCCAAGGAGCAUAAGU
956
122-140
ACUUAUGCUCCUUGGGGGC
1140
122-140





AD-70664
CAUAAGUACAAAGCUGAAA
957
134-152
UUUCAGCUUUGUACUUAUG
1141
134-152





AD-70665
AAGCUGAAGAGCACACAGU
958
144-162
ACUGUGUGCUCUUCAGCUU
1142
144-162





AD-70666
ACACAGUCGUUCUCACUGU
959
156-174
ACAGUGAGAACGACUGUGU
1143
156-174





AD-70667
UUCUCACUGUCACCGGGGA
960
165-183
UCCCCGGUGACAGUGAGAA
1144
165-183





AD-70668
ACCGGGGAGCCCUGCCACU
961
176-194
AGUGGCAGGGCUCCCCGGU
1145
176-194





AD-70669
UGCCACUUCCCCUUCCAGU
962
188-206
ACUGGAAGGGGAAGUGGCA
1146
188-206





AD-70670
UUCCAGUACCACCGGCAGA
963
200-218
UCUGCCGGUGGUACUGGAA
1147
200-218





AD-70671
ACCGGCAGCUGUACCACAA
964
210-228
UUGUGGUACAGCUGCCGGU
1148
210-228





AD-70672
UACCACAAAUGUACCCACA
965
221-239
UGUGGGUACAUUUGUGGUA
1149
221-239





AD-70673
UACCCACAAGGGCCGGCCA
966
232-250
UGGCCGGCCCUUGUGGGUA
1150
232-250





AD-70674
GCCGGCCAGGCCCUCAGCA
967
243-261
UGCUGAGGGCCUGGCCGGC
1151
243-261





AD-70675
CUCAGCCCUGGUGUGCUAA
968
255-273
UUAGCACACCAGGGCUGAG
1152
255-273





AD-70676
UGUGCUACCACCCCCAACU
969
266-284
AGUUGGGGGUGGUAGCACA
1153
266-284





AD-70677
ACCCCCAACUUUGAUCAGA
970
275-293
UCUGAUCAAAGUUGGGGGU
1154
275-293





AD-70678
AUCAGGACCAGCGAUGGGA
971
288-306
UCCCAUCGCUGGUCCUGAU
1155
288-306





AD-70679
AGCGAUGGGGAUACUGUUU
972
297-315
AAACAGUAUCCCCAUCGCU
1156
297-315





AD-70680
UACUGUUUGGAGCCCAAGA
973
308-326
UCUUGGGCUCCAAACAGUA
1157
308-326





AD-70681
CCAAGAAAGUGAAAGACCA
974
321-339
UGGUCUUUCACUUUCUUGG
1158
321-339





AD-70682
AAAGACCACUGCAGCAAAC
975
332-350
GUUUGCUGCAGUGGUCUUU
1159
332-350





AD-70683
UGCAGCAAACACAGCCCCU
976
341-359
AGGGGCUGUGUUUGCUGCA
1160
341-359





AD-70684
AGCCCCUGCCAGAAAGGAA
977
353-371
UUCCUUUCUGGCAGGGGCU
1161
353-371





AD-70685
AGAAAGGAGGGACCUGUGU
978
363-381
ACACAGGUCCCUCCUUUCU
1162
363-381





AD-70686
ACCUGUGUGAACAUGCCAA
979
374-392
UUGGCAUGUUCACACAGGU
1163
374-392





AD-70687
AUGCCAAGCGGCCCCCACU
980
386-404
AGUGGGGGCCGCUUGGCAU
1164
386-404





AD-70688
GCCCCCACUGUCUCUGUCA
981
396-414
UGACAGAGACAGUGGGGGC
1165
396-414





AD-70689
CACCUCACUGGAAACCACU
982
419-437
AGUGGUUUCCAGUGAGGUG
1166
419-437





AD-70690
AACCACUGCCAGAAAGAGA
983
431-449
UCUCUUUCUGGCAGUGGUU
1167
431-449





AD-70691
CAGAAAGAGAAGUGCUUUA
984
440-458
UAAAGCACUUCUCUUUCUG
1168
440-458





AD-70692
UGCUUUGAGCCUCAGCUUA
985
452-470
UAAGCUGAGGCUCAAAGCA
1169
452-470





AD-70693
CAGCUUCUCCGGUUUUUCA
986
464-482
UGAAAAACCGGAGAAGCUG
1170
464-482





AD-70694
CGGUUUUUCCACAAGAAUA
987
473-491
UAUUCUUGUGGAAAAACCG
1171
473-491





AD-70695
CAAGAAUGAGAUAUGGUAU
988
484-502
AUACCAUAUCUCAUUCUUG
1172
484-502





AD-70696
UAUGGUAUAGAACUGAGCA
989
495-513
UGCUCAGUUCUAUACCAUA
1173
495-513





AD-70697
UGAGCAAGCAGCUGUGGCA
990
508-526
UGCCACAGCUGCUUGCUCA
1174
508-526





AD-70698
GCUGUGGCCAGAUGCCAGU
991
518-536
ACUGGCAUCUGGCCACAGC
1175
518-536





AD-70699
AUGCCAGUGCAAGGGUCCU
992
529-547
AGGACCCUUGCACUGGCAU
1176
529-547





AD-70700
AAGGGUCCUGAUGCCCACU
993
539-557
AGUGGGCAUCAGGACCCUU
1177
539-557





AD-70701
UGCCCACUGCCAGCGGCUA
994
550-568
UAGCCGCUGGCAGUGGGCA
1178
550-568





AD-70702
CGGCUGGCCAGCCAGGCCU
995
563-581
AGGCCUGGCUGGCCAGCCG
1179
563-581





AD-70703
AGCCAGGCCUGCCGCACCA
996
572-590
UGGUGCGGCAGGCCUGGCU
1180
572-590





AD-70704
CGCACCAACCCGUGCCUCA
997
584-602
UGAGGCACGGGUUGGUGCG
1181
584-602





AD-70705
UGCCUCCAUGGGGGUCGCU
998
596-614
AGCGACCCCCAUGGAGGCA
1182
596-614





AD-70706
GGGGUCGCUGCCUAGAGGU
999
606-624
ACCUCUAGGCAGCGACCCC
1183
606-624





AD-70707
CUAGAGGUGGAGGGCCACA
1000
617-635
UGUGGCCCUCCACCUCUAG
1184
617-635





AD-70708
AGGGCCACCGCCUGUGCCA
1001
627-645
UGGCACAGGCGGUGGCCCU
1185
627-645





AD-70709
UGUGCCACUGCCCGGUGGA
1002
639-657
UCCACCGGGCAGUGGCACA
1186
639-657





AD-70710
CGGUGGGCUACACCGGAGA
1003
651-669
UCUCCGGUGUAGCCCACCG
1187
651-669





AD-70711
ACCGGAGCCUUCUGCGACA
1004
662-680
UGUCGCAGAAGGCUCCGGU
1188
662-680





AD-70712
UUCUGCGACGUGGACACCA
1005
671-689
UGGUGUCCACGUCGCAGAA
1189
671-689





AD-70713
GACACCAAGGCAAGCUGCU
1006
683-701
AGCAGCUUGCCUUGGUGUC
1190
683-701





AD-70714
CAAGCUGCUAUGAUGGCCA
1007
693-711
UGGCCAUCAUAGCAGCUUG
1191
693-711





AD-70715
GAUGGCCGCGGGCUCAGCU
1008
704-722
AGCUGAGCCCGCGGCCAUC
1192
704-722





AD-70716
UCAGCUACCGCGGCCUGGA
1009
717-735
UCCAGGCCGCGGUAGCUGA
1193
717-735





AD-70717
CGGCCUGGCCAGGACCACA
1010
727-745
UGUGGUCCUGGCCAGGCCG
1194
727-745





AD-70718
AGGACCACGCUCUCGGGUA
1011
737-755
UACCCGAGAGCGUGGUCCU
1195
737-755





AD-70719
UCGGGUGCGCCCUGUCAGA
1012
749-767
UCUGACAGGGCGCACCCGA
1196
749-767





AD-70720
CUGUCAGCCGUGGGCCUCA
1013
760-778
UGAGGCCCACGGCUGACAG
1197
760-778





AD-70721
UGGGCCUCGGAGGCCACCU
1014
770-788
AGGUGGCCUCCGAGGCCCA
1198
770-788





AD-70722
CCACCUACCGGAACGUGAA
1015
783-801
UUCACGUUCCGGUAGGUGG
1199
783-801





AD-70723
AACGUGACUGCCGAGCAAA
1016
794-812
UUUGCUCGGCAGUCACGUU
1200
794-812





AD-70724
CGAGCAAGCGCGGAACUGA
1017
805-823
UCAGUUCCGCGCUUGCUCG
1201
805-823





AD-70725
CGGAACUGGGGACUGGGCA
1018
815-833
UGCCCAGUCCCCAGUUCCG
1202
815-833





AD-70726
GACUGGGCGGCCACGCCUU
1019
825-843
AAGGCGUGGCCGCCCAGUC
1203
825-843





AD-70727
ACGCCUUCUGCCGGAACCA
1020
837-855
UGGUUCCGGCAGAAGGCGU
1204
837-855





AD-70728
CGGAACCCGGACAACGACA
1021
848-866
UGUCGUUGUCCGGGUUCCG
1205
848-866





AD-70729
AACGACAUCCGCCCGUGGU
1022
860-878
ACCACGGGCGGAUGUCGUU
1206
860-878





AD-70730
GCCCGUGGUGCUUCGUGCU
1023
870-888
AGCACGAAGCACCACGGGC
1207
870-888





AD-70731
UUCGUGCUGAACCGCGACA
1024
881-899
UGUCGCGGUUCAGCACGAA
1208
881-899





AD-70732
ACCGCGACCGGCUGAGCUA
1025
891-909
UAGCUCAGCCGGUCGCGGU
1209
891-909





AD-70733
CUGAGCUGGGAGUACUGCA
1026
902-920
UGCAGUACUCCCAGCUCAG
1210
902-920





AD-70734
UACUGCGACCUGGCACAGU
1027
914-932
ACUGUGCCAGGUCGCAGUA
1211
914-932





AD-70735
UGGCACAGUGCCAGACCCA
1028
924-942
UGGGUCUGGCACUGUGCCA
1212
924-942





AD-70736
AGACCCCAACCCAGGCGGA
1029
936-954
UCCGCCUGGGUUGGGGUCU
1213
936-954





AD-70737
AGGCGGCGCCUCCGACCCA
1030
948-966
UGGGUCGGAGGCGCCGCCU
1214
948-966





AD-70738
UCCGACCCCGGUGUCCCCU
1031
958-976
AGGGGACACCGGGGUCGGA
1215
958-976





AD-70739
UGUCCCCUAGGCUUCAUGU
1032
969-987
ACAUGAAGCCUAGGGGACA
1216
969-987





AD-70740
UUCAUGUCCCACUCAUGCA
1033
981-999
UGCAUGAGUGGGACAUGAA
1217
981-999





AD-70741
ACUCAUGCCCGCGCAGCCA
1034
 991-1009
UGGCUGCGCGGGCAUGAGU
1218
 991-1009





AD-70742
CGCAGCCGGCACCGCCGAA
1035
1002-1020
UUCGGCGGUGCCGGCUGCG
1219
1002-1020





AD-70743
ACCGCCGAAGCCUCAGCCA
1036
1012-1030
UGGCUGAGGCUUCGGCGGU
1220
1012-1030





AD-70744
UCAGCCCACGACCCGGACA
1037
1024-1042
UGUCCGGGUCGUGGGCUGA
1221
1024-1042





AD-70745
ACCCGGACCCCGCCUCAGU
1038
1034-1052
ACUGAGGCGGGGUCCGGGU
1222
1034-1052





AD-70562
CCUCAGUCCCAGACCCCGA
1039
1046-1064
UCGGGGUCUGGGACUGAGG
1223
1046-1064





AD-70563
AGACCCCGGGAGCCUUGCA
1040
1056-1074
UGCAAGGCUCCCGGGGUCU
1224
1056-1074





AD-70564
CCUUGCCGGCGAAGCGGGA
1041
1068-1086
UCCCGCUUCGCCGGCAAGG
1225
1068-1086





AD-70565
AAGCGGGAGCAGCCGCCUU
1042
1079-1097
AAGGCGGCUGCUCCCGCUU
1226
1079-1097





AD-70566
AGCCGCCUUCCCUGACCAA
1043
1089-1107
UUGGUCAGGGAAGGCGGCU
1227
1089-1107





AD-70567
UGACCAGGAACGGCCCACU
1044
1101-1119
AGUGGGCCGUUCCUGGUCA
1228
1101-1119





AD-70568
CGGCCCACUGAGCUGCGGA
1045
1111-1129
UCCGCAGCUCAGUGGGCCG
1229
1111-1129





AD-70569
UGCGGGCAGCGGCUCCGCA
1046
1124-1142
UGCGGAGCCGCUGCCCGCA
1230
1124-1142





AD-70570
CGGCUCCGCAAGAGUCUGU
1047
1133-1151
ACAGACUCUUGCGGAGCCG
1231
1133-1151





AD-70571
AGUCUGUCUUCGAUGACCA
1048
1145-1163
UGGUCAUCGAAGACAGACU
1232
1145-1163





AD-70572
CGAUGACCCGCGUCGUUGA
1049
1155-1173
UCAACGACGCGGGUCAUCG
1233
1155-1173





AD-70573
UCGUUGGCGGGCUGGUGGA
1050
1167-1185
UCCACCAGCCCGCCAACGA
1234
1167-1185





AD-70574
UGGUGGCGCUACGCGGGGA
1051
1179-1197
UCCCCGCGUAGCGCCACCA
1235
1179-1197





AD-70575
UACGCGGGGCGCACCCCUA
1052
1188-1206
UAGGGGUGCGCCCCGCGUA
1236
1188-1206





AD-70576
ACCCCUACAUCGCCGCGCU
1053
1200-1218
AGCGCGGCGAUGUAGGGGU
1237
1200-1218





AD-70577
GCCGCGCUGUACUGGGGCA
1054
1211-1229
UGCCCCAGUACAGCGCGGC
1238
1211-1229





AD-70578
CUGGGGCCACAGUUUCUGA
1055
1222-1240
UCAGAAACUGUGGCCCCAG
1239
1222-1240





AD-70579
UUUCUGCGCCGGCAGCCUA
1056
1234-1252
UAGGCUGCCGGCGCAGAAA
1240
1234-1252





AD-70580
CGGCAGCCUCAUCGCCCCA
1057
1243-1261
UGGGGCGAUGAGGCUGCCG
1241
1243-1261





AD-70581
UCGCCCCCUGCUGGGUGCU
1058
1254-1272
AGCACCCAGCAGGGGGCGA
1242
1254-1272





AD-70582
UGGGUGCUGACGGCCGCUA
1059
1265-1283
UAGCGGCCGUCAGCACCCA
1243
1265-1283





AD-70583
GCCGCUCACUGCCUGCAGA
1060
1277-1295
UCUGCAGGCAGUGAGCGGC
1244
1277-1295





AD-70584
CUGCAGGACCGGCCCGCAA
1061
1289-1307
UUGCGGGCCGGUCCUGCAG
1245
1289-1307





AD-70585
GGCCCGCACCCGAGGAUCU
1062
1299-1317
AGAUCCUCGGGUGCGGGCC
1246
1299-1317





AD-70586
CGAGGAUCUGACGGUGGUA
1063
1309-1327
UACCACCGUCAGAUCCUCG
1247
1309-1327





AD-70587
GUGGUGCUCGGCCAGGAAA
1064
1322-1340
UUUCCUGGCCGAGCACCAC
1248
1322-1340





AD-70588
GCCAGGAACGCCGUAACCA
1065
1332-1350
UGGUUACGGCGUUCCUGGC
1249
1332-1350





AD-70589
CGUAACCACAGCUGUGAGA
1066
1343-1361
UCUCACAGCUGUGGUUACG
1250
1343-1361





AD-70590
UGUGAGCCGUGCCAGACGU
1067
1355-1373
ACGUCUGGCACGGCUCACA
1251
1355-1373





AD-70591
UGCCAGACGUUGGCCGUGA
1068
1364-1382
UCACGGCCAACGUCUGGCA
1252
1364-1382





AD-70592
GCCGUGCGCUCCUACCGCU
1069
1376-1394
AGCGGUAGGAGCGCACGGC
1253
1376-1394





AD-70593
UACCGCUUGCACGAGGCCU
1070
1388-1406
AGGCCUCGUGCAAGCGGUA
1254
1388-1406





AD-70594
ACGAGGCCUUCUCGCCCGU
1071
1398-1416
ACGGGCGAGAAGGCCUCGU
1255
1398-1416





AD-70595
UCGCCCGUCAGCUACCAGA
1072
1409-1427
UCUGGUAGCUGACGGGCGA
1256
1409-1427





AD-70596
CUACCAGCACGACCUGGCU
1073
1420-1438
AGCCAGGUCGUGCUGGUAG
1257
1420-1438





AD-70597
ACCUGGCUCUGUUGCGCCU
1074
1431-1449
AGGCGCAACAGAGCCAGGU
1258
1431-1449





AD-70598
UUGCGCCUUCAGGAGGAUA
1075
1442-1460
UAUCCUCCUGAAGGCGCAA
1259
1442-1460





AD-70599
GAGGAUGCGGACGGCAGCU
1076
1454-1472
AGCUGCCGUCCGCAUCCUC
1260
1454-1472





AD-70600
ACGGCAGCUGCGCGCUCCU
1077
1464-1482
AGGAGCGCGCAGCUGCCGU
1261
1464-1482





AD-70601
CGCUCCUGUCGCCUUACGU
1078
1476-1494
ACGUAAGGCGACAGGAGCG
1262
1476-1494





AD-70602
CCUUACGUUCAGCCGGUGU
1079
1487-1505
ACACCGGCUGAACGUAAGG
1263
1487-1505





AD-70603
AGCCGGUGUGCCUGCCAAA
1080
1497-1515
UUUGGCAGGCACACCGGCU
1264
1497-1515





AD-70604
UGCCAAGCGGCGCCGCGCA
1081
1509-1527
UGCGCGGCGCCGCUUGGCA
1265
1509-1527





AD-70605
GCGCCGCGCGACCCUCCGA
1082
1518-1536
UCGGAGGGUCGCGCGGCGC
1266
1518-1536





AD-70606
CCCUCCGAGACCACGCUCU
1083
1529-1547
AGAGCGUGGUCUCGGAGGG
1267
1529-1547





AD-70607
CGCUCUGCCAGGUGGCCGA
1084
1542-1560
UCGGCCACCUGGCAGAGCG
1268
1542-1560





AD-70608
AGGUGGCCGGCUGGGGCCA
1085
1551-1569
UGGCCCCAGCCGGCCACCU
1269
1551-1569





AD-70609
UGGGGCCACCAGUUCGAGA
1086
1562-1580
UCUCGAACUGGUGGCCCCA
1270
1562-1580





AD-70610
UUCGAGGGGGCGGAGGAAU
1087
1574-1592
AUUCCUCCGCCCCCUCGAA
1271
1574-1592





AD-70611
CGGAGGAAUAUGCCAGCUU
1088
1584-1602
AAGCUGGCAUAUUCCUCCG
1272
1584-1602





AD-70612
CAGCUUCCUGCAGGAGGCA
1089
1597-1615
UGCCUCCUGCAGGAAGCUG
1273
1597-1615





AD-70613
AGGAGGCGCAGGUACCGUU
1090
1608-1626
AACGGUACCUGCGCCUCCU
1274
1608-1626





AD-70614
AGGUACCGUUCCUCUCCCU
1091
1617-1635
AGGGAGAGGAACGGUACCU
1275
1617-1635





AD-70615
CUCUCCCUGGAGCGCUGCU
1092
1628-1646
AGCAGCGCUCCAGGGAGAG
1276
1628-1646





AD-70616
CGCUGCUCAGCCCCGGACA
1093
1640-1658
UGUCCGGGGCUGAGCAGCG
1277
1640-1658





AD-70617
CCGGACGUGCACGGAUCCU
1094
1652-1670
AGGAUCCGUGCACGUCCGG
1278
1652-1670





AD-70618
CGGAUCCUCCAUCCUCCCA
1095
1663-1681
UGGGAGGAUGGAGGAUCCG
1279
1663-1681





AD-70619
CAUCCUCCCCGGCAUGCUA
1096
1672-1690
UAGCAUGCCGGGGAGGAUG
1280
1672-1690





AD-70620
CAUGCUCUGCGCAGGGUUA
1097
1684-1702
UAACCCUGCGCAGAGCAUG
1281
1684-1702





AD-70621
AGGGUUCCUCGAGGGCGGA
1098
1696-1714
UCCGCCCUCGAGGAACCCU
1282
1696-1714





AD-70622
GAGGGCGGCACCGAUGCGU
1099
1706-1724
ACGCAUCGGUGCCGCCCUC
1283
1706-1724





AD-70623
GAUGCGUGCCAGGGUGAUU
1100
1718-1736
AAUCACCCUGGCACGCAUC
1284
1718-1736





AD-70624
AGGGUGAUUCCGGAGGCCA
1101
1728-1746
UGGCCUCCGGAAUCACCCU
1285
1728-1746





AD-70625
CGGAGGCCCGCUGGUGUGU
1102
1738-1756
ACACACCAGCGGGCCUCCG
1286
1738-1756





AD-70626
GGUGUGUGAGGACCAAGCU
1103
1750-1768
AGCUUGGUCCUCACACACC
1287
1750-1768





AD-70627
CCAAGCUGCAGAGCGCCGA
1104
1762-1780
UCGGCGCUCUGCAGCUUGG
1288
1762-1780





AD-70628
AGAGCGCCGGCUCACCCUA
1105
1771-1789
UAGGGUGAGCCGGCGCUCU
1289
1771-1789





AD-70629
UCACCCUGCAAGGCAUCAU
1106
1782-1800
AUGAUGCCUUGCAGGGUGA
1290
1782-1800





AD-70630
GGCAUCAUCAGCUGGGGAU
1107
1793-1811
AUCCCCAGCUGAUGAUGCC
1291
1793-1811





AD-70631
CUGGGGAUCGGGCUGUGGU
1108
1804-1822
ACCACAGCCCGAUCCCCAG
1292
1804-1822





AD-70632
UGUGGUGACCGCAACAAGA
1109
1817-1835
UCUUGUUGCGGUCACCACA
1293
1817-1835





AD-70633
CAACAAGCCAGGCGUCUAA
1110
1828-1846
UUAGACGCCUGGCUUGUUG
1294
1828-1846





AD-70634
AGGCGUCUACACCGAUGUA
1111
1837-1855
UACAUCGGUGUAGACGCCU
1295
1837-1855





AD-70635
GAUGUGGCCUACUACCUGA
1112
1850-1868
UCAGGUAGUAGGCCACAUC
1296
1850-1868





AD-70636
UACUACCUGGCCUGGAUCA
1113
1859-1877
UGAUCCAGGCCAGGUAGUA
1297
1859-1877





AD-70637
CUGGAUCCGGGAGCACACA
1114
1870-1888
UGUGUGCUCCCGGAUCCAG
1298
1870-1888





AD-70638
AGCACACCGUUUCCUGAUU
1115
1881-1899
AAUCAGGAAACGGUGUGCU
1299
1881-1899





AD-70639
UCCUGAUUGCUCAGGGACU
1116
1892-1910
AGUCCCUGAGCAAUCAGGA
1300
1892-1910





AD-70640
CAGGGACUCAUCUUUCCCU
1117
1903-1921
AGGGAAAGAUGAGUCCCUG
1301
1903-1921





AD-70641
UUUCCCUCCUUGGUGAUUA
1118
1915-1933
UAAUCACCAAGGAGGGAAA
1302
1915-1933





AD-70642
UGGUGAUUCCGCAGUGAGA
1119
1925-1943
UCUCACUGCGGAAUCACCA
1303
1925-1943





AD-70643
AGUGAGAGAGUGGCUGGGA
1120
1937-1955
UCCCAGCCACUCUCUCACU
1304
1937-1955





AD-70644
GCUGGGGCAUGGAAGGCAA
1121
1949-1967
UUGCCUUCCAUGCCCCAGC
1305
1949-1967





AD-70645
UGGAAGGCAAGAUUGUGUA
1122
1958-1976
UACACAAUCUUGCCUUCCA
1306
1958-1976





AD-70646
UUGUGUCCCAUUCCCCCAA
1123
1970-1988
UUGGGGGAAUGGGACACAA
1307
1970-1988





AD-70647
UCCCCCAGUGCGGCCAGCU
1124
1981-1999
AGCUGGCCGCACUGGGGGA
1308
1981-1999





AD-70648
GCCAGCUCCGCGCCAGGAU
1125
1993-2011
AUCCUGGCGCGGAGCUGGC
1309
1993-2011





AD-70649
GCCAGGAUGGCGCAGGAAA
1126
2004-2022
UUUCCUGCGCCAUCCUGGC
1310
2004-2022





AD-70650
GCAGGAACUCAAUAAAGUA
1127
2015-2033
UACUUUAUUGAGUUCCUGC
1311
2015-2033





AD-70651
AAUAAAGUGCUUUGAAAAU
1128
2025-2043
AUUUUCAAAGCACUUUAUU
1312
2025-2043





AD-70652
UUGAAAAUGCUGAGAAAAA
1129
2036-2054
UUUUUCUCAGCAUUUUCAA
1313
2036-2054
















TABLE 12







F12 Modified Sequences















SEQ

SEQ

SEQ


Duplex

ID
Antisense Sequence
ID
mRNA target
ID


Name
Sense Sequence 5′ to 3′
NO
5′ to 3′
NO
sequence
NO





AD-70653
GACUCCUGGAUAGGCAGCUdTdT
1314
AGCUGCCUAUCCAGGAGUCdTdT
1498
GACUCCUGGAUAGGCAGCU
1682





AD-70654
UAGGCAGCUGGACCAACGAdTdT
1315
UCGUUGGUCCAGCUGCCUAdTdT
1499
UAGGCAGCUGGACCAACGG
1683





AD-70655
ACCAACGGACGGAUGCCAUdTdT
1316
AUGGCAUCCGUCCGUUGGUdTdT
1500
ACCAACGGACGGAUGCCAU
1684





AD-70656
AUGCCAUGAGGGCUCUGCUdTdT
1317
AGCAGAGCCCUCAUGGCAUdTdT
1501
AUGCCAUGAGGGCUCUGCU
1685





AD-70657
GCUCUGCUGCUCCUGGGGUdTdT
1318
ACCCCAGGAGCAGCAGAGCdTdT
1502
GCUCUGCUGCUCCUGGGGU
1686





AD-70658
UCCUGGGGUUCCUGCUGGUdTdT
1319
ACCAGCAGGAACCCCAGGAdTdT
1503
UCCUGGGGUUCCUGCUGGU
1687





AD-70659
CUGCUGGUGAGCUUGGAGUdTdT
1320
ACUCCAAGCUCACCAGCAGdTdT
1504
CUGCUGGUGAGCUUGGAGU
1688





AD-70660
CUUGGAGUCAACACUUUCAdTdT
1321
UGAAAGUGUUGACUCCAAGdTdT
1505
CUUGGAGUCAACACUUUCG
1689





AD-70661
ACUUUCGAUUCCACCUUGAdTdT
1322
UCAAGGUGGAAUCGAAAGUdTdT
1506
ACUUUCGAUUCCACCUUGG
1690





AD-70662
CCACCUUGGGAAGCCCCCAdTdT
1323
UGGGGGCUUCCCAAGGUGGdTdT
1507
CCACCUUGGGAAGCCCCCA
1691





AD-70663
GCCCCCAAGGAGCAUAAGUdTdT
1324
ACUUAUGCUCCUUGGGGGCdTdT
1508
GCCCCCAAGGAGCAUAAGU
1692





AD-70664
CAUAAGUACAAAGCUGAAAdTdT
1325
UUUCAGCUUUGUACUUAUGdTdT
1509
CAUAAGUACAAAGCUGAAG
1693





AD-70665
AAGCUGAAGAGCACACAGUdTdT
1326
ACUGUGUGCUCUUCAGCUUdTdT
1510
AAGCUGAAGAGCACACAGU
1694





AD-70666
ACACAGUCGUUCUCACUGUdTdT
1327
ACAGUGAGAACGACUGUGUdTdT
1511
ACACAGUCGUUCUCACUGU
1695





AD-70667
UUCUCACUGUCACCGGGGAdTdT
1328
UCCCCGGUGACAGUGAGAAdTdT
1512
UUCUCACUGUCACCGGGGA
1696





AD-70668
ACCGGGGAGCCCUGCCACUdTdT
1329
AGUGGCAGGGCUCCCCGGUdTdT
1513
ACCGGGGAGCCCUGCCACU
1697





AD-70669
UGCCACUUCCCCUUCCAGUdTdT
1330
ACUGGAAGGGGAAGUGGCAdTdT
1514
UGCCACUUCCCCUUCCAGU
1698





AD-70670
UUCCAGUACCACCGGCAGAdTdT
1331
UCUGCCGGUGGUACUGGAAdTdT
1515
UUCCAGUACCACCGGCAGC
1699





AD-70671
ACCGGCAGCUGUACCACAAdTdT
1332
UUGUGGUACAGCUGCCGGUdTdT
1516
ACCGGCAGCUGUACCACAA
1700





AD-70672
UACCACAAAUGUACCCACAdTdT
1333
UGUGGGUACAUUUGUGGUAdTdT
1517
UACCACAAAUGUACCCACA
1701





AD-70673
UACCCACAAGGGCCGGCCAdTdT
1334
UGGCCGGCCCUUGUGGGUAdTdT
1518
UACCCACAAGGGCCGGCCA
1702





AD-70674
GCCGGCCAGGCCCUCAGCAdTdT
1335
UGCUGAGGGCCUGGCCGGCdTdT
1519
GCCGGCCAGGCCCUCAGCC
1703





AD-70675
CUCAGCCCUGGUGUGCUAAdTdT
1336
UUAGCACACCAGGGCUGAGdTdT
1520
CUCAGCCCUGGUGUGCUAC
1704





AD-70676
UGUGCUACCACCCCCAACUdTdT
1337
AGUUGGGGGUGGUAGCACAdTdT
1521
UGUGCUACCACCCCCAACU
1705





AD-70677
ACCCCCAACUUUGAUCAGAdTdT
1338
UCUGAUCAAAGUUGGGGGUdTdT
1522
ACCCCCAACUUUGAUCAGG
1706





AD-70678
AUCAGGACCAGCGAUGGGAdTdT
1339
UCCCAUCGCUGGUCCUGAUdTdT
1523
AUCAGGACCAGCGAUGGGG
1707





AD-70679
AGCGAUGGGGAUACUGUUUdTdT
1340
AAACAGUAUCCCCAUCGCUdTdT
1524
AGCGAUGGGGAUACUGUUU
1708





AD-70680
UACUGUUUGGAGCCCAAGAdTdT
1341
UCUUGGGCUCCAAACAGUAdTdT
1525
UACUGUUUGGAGCCCAAGA
1709





AD-70681
CCAAGAAAGUGAAAGACCAdTdT
1342
UGGUCUUUCACUUUCUUGGdTdT
1526
CCAAGAAAGUGAAAGACCA
1710





AD-70682
AAAGACCACUGCAGCAAACdTdT
1343
GUUUGCUGCAGUGGUCUUUdTdT
1527
AAAGACCACUGCAGCAAAC
1711





AD-70683
UGCAGCAAACACAGCCCCUdTdT
1344
AGGGGCUGUGUUUGCUGCAdTdT
1528
UGCAGCAAACACAGCCCCU
1712





AD-70684
AGCCCCUGCCAGAAAGGAAdTdT
1345
UUCCUUUCUGGCAGGGGCUdTdT
1529
AGCCCCUGCCAGAAAGGAG
1713





AD-70685
AGAAAGGAGGGACCUGUGUdTdT
1346
ACACAGGUCCCUCCUUUCUdTdT
1530
AGAAAGGAGGGACCUGUGU
1714





AD-70686
ACCUGUGUGAACAUGCCAAdTdT
1347
UUGGCAUGUUCACACAGGUdTdT
1531
ACCUGUGUGAACAUGCCAA
1715





AD-70687
AUGCCAAGCGGCCCCCACUdTdT
1348
AGUGGGGGCCGCUUGGCAUdTdT
1532
AUGCCAAGCGGCCCCCACU
1716





AD-70688
GCCCCCACUGUCUCUGUCAdTdT
1349
UGACAGAGACAGUGGGGGCdTdT
1533
GCCCCCACUGUCUCUGUCC
1717





AD-70689
CACCUCACUGGAAACCACUdTdT
1350
AGUGGUUUCCAGUGAGGUGdTdT
1534
CACCUCACUGGAAACCACU
1718





AD-70690
AACCACUGCCAGAAAGAGAdTdT
1351
UCUCUUUCUGGCAGUGGUUdTdT
1535
AACCACUGCCAGAAAGAGA
1719





AD-70691
CAGAAAGAGAAGUGCUUUAdTdT
1352
UAAAGCACUUCUCUUUCUGdTdT
1536
CAGAAAGAGAAGUGCUUUG
1720





AD-70692
UGCUUUGAGCCUCAGCUUAdTdT
1353
UAAGCUGAGGCUCAAAGCAdTdT
1537
UGCUUUGAGCCUCAGCUUC
1721





AD-70693
CAGCUUCUCCGGUUUUUCAdTdT
1354
UGAAAAACCGGAGAAGCUGdTdT
1538
CAGCUUCUCCGGUUUUUCC
1722





AD-70694
CGGUUUUUCCACAAGAAUAdTdT
1355
UAUUCUUGUGGAAAAACCGdTdT
1539
CGGUUUUUCCACAAGAAUG
1723





AD-70695
CAAGAAUGAGAUAUGGUAUdTdT
1356
AUACCAUAUCUCAUUCUUGdTdT
1540
CAAGAAUGAGAUAUGGUAU
1724





AD-70696
UAUGGUAUAGAACUGAGCAdTdT
1357
UGCUCAGUUCUAUACCAUAdTdT
1541
UAUGGUAUAGAACUGAGCA
1725





AD-70697
UGAGCAAGCAGCUGUGGCAdTdT
1358
UGCCACAGCUGCUUGCUCAdTdT
1542
UGAGCAAGCAGCUGUGGCC
1726





AD-70698
GCUGUGGCCAGAUGCCAGUdTdT
1359
ACUGGCAUCUGGCCACAGCdTdT
1543
GCUGUGGCCAGAUGCCAGU
1727





AD-70699
AUGCCAGUGCAAGGGUCCUdTdT
1360
AGGACCCUUGCACUGGCAUdTdT
1544
AUGCCAGUGCAAGGGUCCU
1728





AD-70700
AAGGGUCCUGAUGCCCACUdTdT
1361
AGUGGGCAUCAGGACCCUUdTdT
1545
AAGGGUCCUGAUGCCCACU
1729





AD-70701
UGCCCACUGCCAGCGGCUAdTdT
1362
UAGCCGCUGGCAGUGGGCAdTdT
1546
UGCCCACUGCCAGCGGCUG
1730





AD-70702
CGGCUGGCCAGCCAGGCCUdTdT
1363
AGGCCUGGCUGGCCAGCCGdTdT
1547
CGGCUGGCCAGCCAGGCCU
1731





AD-70703
AGCCAGGCCUGCCGCACCAdTdT
1364
UGGUGCGGCAGGCCUGGCUdTdT
1548
AGCCAGGCCUGCCGCACCA
1732





AD-70704
CGCACCAACCCGUGCCUCAdTdT
1365
UGAGGCACGGGUUGGUGCGdTdT
1549
CGCACCAACCCGUGCCUCC
1733





AD-70705
UGCCUCCAUGGGGGUCGCUdTdT
1366
AGCGACCCCCAUGGAGGCAdTdT
1550
UGCCUCCAUGGGGGUCGCU
1734





AD-70706
GGGGUCGCUGCCUAGAGGUdTdT
1367
ACCUCUAGGCAGCGACCCCdTdT
1551
GGGGUCGCUGCCUAGAGGU
1735





AD-70707
CUAGAGGUGGAGGGCCACAdTdT
1368
UGUGGCCCUCCACCUCUAGdTdT
1552
CUAGAGGUGGAGGGCCACC
1736





AD-70708
AGGGCCACCGCCUGUGCCAdTdT
1369
UGGCACAGGCGGUGGCCCUdTdT
1553
AGGGCCACCGCCUGUGCCA
1737





AD-70709
UGUGCCACUGCCCGGUGGAdTdT
1370
UCCACCGGGCAGUGGCACAdTdT
1554
UGUGCCACUGCCCGGUGGG
1738





AD-70710
CGGUGGGCUACACCGGAGAdTdT
1371
UCUCCGGUGUAGCCCACCGdTdT
1555
CGGUGGGCUACACCGGAGC
1739





AD-70711
ACCGGAGCCUUCUGCGACAdTdT
1372
UGUCGCAGAAGGCUCCGGUdTdT
1556
ACCGGAGCCUUCUGCGACG
1740





AD-70712
UUCUGCGACGUGGACACCAdTdT
1373
UGGUGUCCACGUCGCAGAAdTdT
1557
UUCUGCGACGUGGACACCA
1741





AD-70713
GACACCAAGGCAAGCUGCUdTdT
1374
AGCAGCUUGCCUUGGUGUCdTdT
1558
GACACCAAGGCAAGCUGCU
1742





AD-70714
CAAGCUGCUAUGAUGGCCAdTdT
1375
UGGCCAUCAUAGCAGCUUGdTdT
1559
CAAGCUGCUAUGAUGGCCG
1743





AD-70715
GAUGGCCGCGGGCUCAGCUdTdT
1376
AGCUGAGCCCGCGGCCAUCdTdT
1560
GAUGGCCGCGGGCUCAGCU
1744





AD-70716
UCAGCUACCGCGGCCUGGAdTdT
1377
UCCAGGCCGCGGUAGCUGAdTdT
1561
UCAGCUACCGCGGCCUGGC
1745





AD-70717
CGGCCUGGCCAGGACCACAdTdT
1378
UGUGGUCCUGGCCAGGCCGdTdT
1562
CGGCCUGGCCAGGACCACG
1746





AD-70718
AGGACCACGCUCUCGGGUAdTdT
1379
UACCCGAGAGCGUGGUCCUdTdT
1563
AGGACCACGCUCUCGGGUG
1747





AD-70719
UCGGGUGCGCCCUGUCAGAdTdT
1380
UCUGACAGGGCGCACCCGAdTdT
1564
UCGGGUGCGCCCUGUCAGC
1748





AD-70720
CUGUCAGCCGUGGGCCUCAdTdT
1381
UGAGGCCCACGGCUGACAGdTdT
1565
CUGUCAGCCGUGGGCCUCG
1749





AD-70721
UGGGCCUCGGAGGCCACCUdTdT
1382
AGGUGGCCUCCGAGGCCCAdTdT
1566
UGGGCCUCGGAGGCCACCU
1750





AD-70722
CCACCUACCGGAACGUGAAdTdT
1383
UUCACGUUCCGGUAGGUGGdTdT
1567
CCACCUACCGGAACGUGAC
1751





AD-70723
AACGUGACUGCCGAGCAAAdTdT
1384
UUUGCUCGGCAGUCACGUUdTdT
1568
AACGUGACUGCCGAGCAAG
1752





AD-70724
CGAGCAAGCGCGGAACUGAdTdT
1385
UCAGUUCCGCGCUUGCUCGdTdT
1569
CGAGCAAGCGCGGAACUGG
1753





AD-70725
CGGAACUGGGGACUGGGCAdTdT
1386
UGCCCAGUCCCCAGUUCCGdTdT
1570
CGGAACUGGGGACUGGGCG
1754





AD-70726
GACUGGGCGGCCACGCCUUdTdT
1387
AAGGCGUGGCCGCCCAGUCdTdT
1571
GACUGGGCGGCCACGCCUU
1755





AD-70727
ACGCCUUCUGCCGGAACCAdTdT
1388
UGGUUCCGGCAGAAGGCGUdTdT
1572
ACGCCUUCUGCCGGAACCC
1756





AD-70728
CGGAACCCGGACAACGACAdTdT
1389
UGUCGUUGUCCGGGUUCCGdTdT
1573
CGGAACCCGGACAACGACA
1757





AD-70729
AACGACAUCCGCCCGUGGUdTdT
1390
ACCACGGGCGGAUGUCGUUdTdT
1574
AACGACAUCCGCCCGUGGU
1758





AD-70730
GCCCGUGGUGCUUCGUGCUdTdT
1391
AGCACGAAGCACCACGGGCdTdT
1575
GCCCGUGGUGCUUCGUGCU
1759





AD-70731
UUCGUGCUGAACCGCGACAdTdT
1392
UGUCGCGGUUCAGCACGAAdTdT
1576
UUCGUGCUGAACCGCGACC
1760





AD-70732
ACCGCGACCGGCUGAGCUAdTdT
1393
UAGCUCAGCCGGUCGCGGUdTdT
1577
ACCGCGACCGGCUGAGCUG
1761





AD-70733
CUGAGCUGGGAGUACUGCAdTdT
1394
UGCAGUACUCCCAGCUCAGdTdT
1578
CUGAGCUGGGAGUACUGCG
1762





AD-70734
UACUGCGACCUGGCACAGUdTdT
1395
ACUGUGCCAGGUCGCAGUAdTdT
1579
UACUGCGACCUGGCACAGU
1763





AD-70735
UGGCACAGUGCCAGACCCAdTdT
1396
UGGGUCUGGCACUGUGCCAdTdT
1580
UGGCACAGUGCCAGACCCC
1764





AD-70736
AGACCCCAACCCAGGCGGAdTdT
1397
UCCGCCUGGGUUGGGGUCUdTdT
1581
AGACCCCAACCCAGGCGGC
1765





AD-70737
AGGCGGCGCCUCCGACCCAdTdT
1398
UGGGUCGGAGGCGCCGCCUdTdT
1582
AGGCGGCGCCUCCGACCCC
1766





AD-70738
UCCGACCCCGGUGUCCCCUdTdT
1399
AGGGGACACCGGGGUCGGAdTdT
1583
UCCGACCCCGGUGUCCCCU
1767





AD-70739
UGUCCCCUAGGCUUCAUGUdTdT
1400
ACAUGAAGCCUAGGGGACAdTdT
1584
UGUCCCCUAGGCUUCAUGU
1768





AD-70740
UUCAUGUCCCACUCAUGCAdTdT
1401
UGCAUGAGUGGGACAUGAAdTdT
1585
UUCAUGUCCCACUCAUGCC
1769





AD-70741
ACUCAUGCCCGCGCAGCCAdTdT
1402
UGGCUGCGCGGGCAUGAGUdTdT
1586
ACUCAUGCCCGCGCAGCCG
1770





AD-70742
CGCAGCCGGCACCGCCGAAdTdT
1403
UUCGGCGGUGCCGGCUGCGdTdT
1587
CGCAGCCGGCACCGCCGAA
1771





AD-70743
ACCGCCGAAGCCUCAGCCAdTdT
1404
UGGCUGAGGCUUCGGCGGUdTdT
1588
ACCGCCGAAGCCUCAGCCC
1772





AD-70744
UCAGCCCACGACCCGGACAdTdT
1405
UGUCCGGGUCGUGGGCUGAdTdT
1589
UCAGCCCACGACCCGGACC
1773





AD-70745
ACCCGGACCCCGCCUCAGUdTdT
1406
ACUGAGGCGGGGUCCGGGUdTdT
1590
ACCCGGACCCCGCCUCAGU
1774





AD-70562
CCUCAGUCCCAGACCCCGAdTdT
1407
UCGGGGUCUGGGACUGAGGdTdT
1591
CCUCAGUCCCAGACCCCGG
1775





AD-70563
AGACCCCGGGAGCCUUGCAdTdT
1408
UGCAAGGCUCCCGGGGUCUdTdT
1592
AGACCCCGGGAGCCUUGCC
1776





AD-70564
CCUUGCCGGCGAAGCGGGAdTdT
1409
UCCCGCUUCGCCGGCAAGGdTdT
1593
CCUUGCCGGCGAAGCGGGA
1777





AD-70565
AAGCGGGAGCAGCCGCCUUdTdT
1410
AAGGCGGCUGCUCCCGCUUdTdT
1594
AAGCGGGAGCAGCCGCCUU
1778





AD-70566
AGCCGCCUUCCCUGACCAAdTdT
1411
UUGGUCAGGGAAGGCGGCUdTdT
1595
AGCCGCCUUCCCUGACCAG
1779





AD-70567
UGACCAGGAACGGCCCACUdTdT
1412
AGUGGGCCGUUCCUGGUCAdTdT
1596
UGACCAGGAACGGCCCACU
1780





AD-70568
CGGCCCACUGAGCUGCGGAdTdT
1413
UCCGCAGCUCAGUGGGCCGdTdT
1597
CGGCCCACUGAGCUGCGGG
1781





AD-70569
UGCGGGCAGCGGCUCCGCAdTdT
1414
UGCGGAGCCGCUGCCCGCAdTdT
1598
UGCGGGCAGCGGCUCCGCA
1782





AD-70570
CGGCUCCGCAAGAGUCUGUdTdT
1415
ACAGACUCUUGCGGAGCCGdTdT
1599
CGGCUCCGCAAGAGUCUGU
1783





AD-70571
AGUCUGUCUUCGAUGACCAdTdT
1416
UGGUCAUCGAAGACAGACUdTdT
1600
AGUCUGUCUUCGAUGACCC
1784





AD-70572
CGAUGACCCGCGUCGUUGAdTdT
1417
UCAACGACGCGGGUCAUCGdTdT
1601
CGAUGACCCGCGUCGUUGG
1785





AD-70573
UCGUUGGCGGGCUGGUGGAdTdT
1418
UCCACCAGCCCGCCAACGAdTdT
1602
UCGUUGGCGGGCUGGUGGC
1786





AD-70574
UGGUGGCGCUACGCGGGGAdTdT
1419
UCCCCGCGUAGCGCCACCAdTdT
1603
UGGUGGCGCUACGCGGGGC
1787





AD-70575
UACGCGGGGCGCACCCCUAdTdT
1420
UAGGGGUGCGCCCCGCGUAdTdT
1604
UACGCGGGGCGCACCCCUA
1788





AD-70576
ACCCCUACAUCGCCGCGCUdTdT
1421
AGCGCGGCGAUGUAGGGGUdTdT
1605
ACCCCUACAUCGCCGCGCU
1789





AD-70577
GCCGCGCUGUACUGGGGCAdTdT
1422
UGCCCCAGUACAGCGCGGCdTdT
1606
GCCGCGCUGUACUGGGGCC
1790





AD-70578
CUGGGGCCACAGUUUCUGAdTdT
1423
UCAGAAACUGUGGCCCCAGdTdT
1607
CUGGGGCCACAGUUUCUGC
1791





AD-70579
UUUCUGCGCCGGCAGCCUAdTdT
1424
UAGGCUGCCGGCGCAGAAAdTdT
1608
UUUCUGCGCCGGCAGCCUC
1792





AD-70580
CGGCAGCCUCAUCGCCCCAdTdT
1425
UGGGGCGAUGAGGCUGCCGdTdT
1609
CGGCAGCCUCAUCGCCCCC
1793





AD-70581
UCGCCCCCUGCUGGGUGCUdTdT
1426
AGCACCCAGCAGGGGGCGAdTdT
1610
UCGCCCCCUGCUGGGUGCU
1794





AD-70582
UGGGUGCUGACGGCCGCUAdTdT
1427
UAGCGGCCGUCAGCACCCAdTdT
1611
UGGGUGCUGACGGCCGCUC
1795





AD-70583
GCCGCUCACUGCCUGCAGAdTdT
1428
UCUGCAGGCAGUGAGCGGCdTdT
1612
GCCGCUCACUGCCUGCAGG
1796





AD-70584
CUGCAGGACCGGCCCGCAAdTdT
1429
UUGCGGGCCGGUCCUGCAGdTdT
1613
CUGCAGGACCGGCCCGCAC
1797





AD-70585
GGCCCGCACCCGAGGAUCUdTdT
1430
AGAUCCUCGGGUGCGGGCCdTdT
1614
GGCCCGCACCCGAGGAUCU
1798





AD-70586
CGAGGAUCUGACGGUGGUAdTdT
1431
UACCACCGUCAGAUCCUCGdTdT
1615
CGAGGAUCUGACGGUGGUG
1799





AD-70587
GUGGUGCUCGGCCAGGAAAdTdT
1432
UUUCCUGGCCGAGCACCACdTdT
1616
GUGGUGCUCGGCCAGGAAC
1800





AD-70588
GCCAGGAACGCCGUAACCAdTdT
1433
UGGUUACGGCGUUCCUGGCdTdT
1617
GCCAGGAACGCCGUAACCA
1801





AD-70589
CGUAACCACAGCUGUGAGAdTdT
1434
UCUCACAGCUGUGGUUACGdTdT
1618
CGUAACCACAGCUGUGAGC
1802





AD-70590
UGUGAGCCGUGCCAGACGUdTdT
1435
ACGUCUGGCACGGCUCACAdTdT
1619
UGUGAGCCGUGCCAGACGU
1803





AD-70591
UGCCAGACGUUGGCCGUGAdTdT
1436
UCACGGCCAACGUCUGGCAdTdT
1620
UGCCAGACGUUGGCCGUGC
1804





AD-70592
GCCGUGCGCUCCUACCGCUdTdT
1437
AGCGGUAGGAGCGCACGGCdTdT
1621
GCCGUGCGCUCCUACCGCU
1805





AD-70593
UACCGCUUGCACGAGGCCUdTdT
1438
AGGCCUCGUGCAAGCGGUAdTdT
1622
UACCGCUUGCACGAGGCCU
1806





AD-70594
ACGAGGCCUUCUCGCCCGUdTdT
1439
ACGGGCGAGAAGGCCUCGUdTdT
1623
ACGAGGCCUUCUCGCCCGU
1807





AD-70595
UCGCCCGUCAGCUACCAGAdTdT
1440
UCUGGUAGCUGACGGGCGAdTdT
1624
UCGCCCGUCAGCUACCAGC
1808





AD-70596
CUACCAGCACGACCUGGCUdTdT
1441
AGCCAGGUCGUGCUGGUAGdTdT
1625
CUACCAGCACGACCUGGCU
1809





AD-70597
ACCUGGCUCUGUUGCGCCUdTdT
1442
AGGCGCAACAGAGCCAGGUdTdT
1626
ACCUGGCUCUGUUGCGCCU
1810





AD-70598
UUGCGCCUUCAGGAGGAUAdTdT
1443
UAUCCUCCUGAAGGCGCAAdTdT
1627
UUGCGCCUUCAGGAGGAUG
1811





AD-70599
GAGGAUGCGGACGGCAGCUdTdT
1444
AGCUGCCGUCCGCAUCCUCdTdT
1628
GAGGAUGCGGACGGCAGCU
1812





AD-70600
ACGGCAGCUGCGCGCUCCUdTdT
1445
AGGAGCGCGCAGCUGCCGUdTdT
1629
ACGGCAGCUGCGCGCUCCU
1813





AD-70601
CGCUCCUGUCGCCUUACGUdTdT
1446
ACGUAAGGCGACAGGAGCGdTdT
1630
CGCUCCUGUCGCCUUACGU
1814





AD-70602
CCUUACGUUCAGCCGGUGUdTdT
1447
ACACCGGCUGAACGUAAGGdTdT
1631
CCUUACGUUCAGCCGGUGU
1815





AD-70603
AGCCGGUGUGCCUGCCAAAdTdT
1448
UUUGGCAGGCACACCGGCUdTdT
1632
AGCCGGUGUGCCUGCCAAG
1816





AD-70604
UGCCAAGCGGCGCCGCGCAdTdT
1449
UGCGCGGCGCCGCUUGGCAdTdT
1633
UGCCAAGCGGCGCCGCGCG
1817





AD-70605
GCGCCGCGCGACCCUCCGAdTdT
1450
UCGGAGGGUCGCGCGGCGCdTdT
1634
GCGCCGCGCGACCCUCCGA
1818





AD-70606
CCCUCCGAGACCACGCUCUdTdT
1451
AGAGCGUGGUCUCGGAGGGdTdT
1635
CCCUCCGAGACCACGCUCU
1819





AD-70607
CGCUCUGCCAGGUGGCCGAdTdT
1452
UCGGCCACCUGGCAGAGCGdTdT
1636
CGCUCUGCCAGGUGGCCGG
1820





AD-70608
AGGUGGCCGGCUGGGGCCAdTdT
1453
UGGCCCCAGCCGGCCACCUdTdT
1637
AGGUGGCCGGCUGGGGCCA
1821





AD-70609
UGGGGCCACCAGUUCGAGAdTdT
1454
UCUCGAACUGGUGGCCCCAdTdT
1638
UGGGGCCACCAGUUCGAGG
1822





AD-70610
UUCGAGGGGGCGGAGGAAUdTdT
1455
AUUCCUCCGCCCCCUCGAAdTdT
1639
UUCGAGGGGGCGGAGGAAU
1823





AD-70611
CGGAGGAAUAUGCCAGCUUdTdT
1456
AAGCUGGCAUAUUCCUCCGdTdT
1640
CGGAGGAAUAUGCCAGCUU
1824





AD-70612
CAGCUUCCUGCAGGAGGCAdTdT
1457
UGCCUCCUGCAGGAAGCUGdTdT
1641
CAGCUUCCUGCAGGAGGCG
1825





AD-70613
AGGAGGCGCAGGUACCGUUdTdT
1458
AACGGUACCUGCGCCUCCUdTdT
1642
AGGAGGCGCAGGUACCGUU
1826





AD-70614
AGGUACCGUUCCUCUCCCUdTdT
1459
AGGGAGAGGAACGGUACCUdTdT
1643
AGGUACCGUUCCUCUCCCU
1827





AD-70615
CUCUCCCUGGAGCGCUGCUdTdT
1460
AGCAGCGCUCCAGGGAGAGdTdT
1644
CUCUCCCUGGAGCGCUGCU
1828





AD-70616
CGCUGCUCAGCCCCGGACAdTdT
1461
UGUCCGGGGCUGAGCAGCGdTdT
1645
CGCUGCUCAGCCCCGGACG
1829





AD-70617
CCGGACGUGCACGGAUCCUdTdT
1462
AGGAUCCGUGCACGUCCGGdTdT
1646
CCGGACGUGCACGGAUCCU
1830





AD-70618
CGGAUCCUCCAUCCUCCCAdTdT
1463
UGGGAGGAUGGAGGAUCCGdTdT
1647
CGGAUCCUCCAUCCUCCCC
1831





AD-70619
CAUCCUCCCCGGCAUGCUAdTdT
1464
UAGCAUGCCGGGGAGGAUGdTdT
1648
CAUCCUCCCCGGCAUGCUC
1832





AD-70620
CAUGCUCUGCGCAGGGUUAdTdT
1465
UAACCCUGCGCAGAGCAUGdTdT
1649
CAUGCUCUGCGCAGGGUUC
1833





AD-70621
AGGGUUCCUCGAGGGCGGAdTdT
1466
UCCGCCCUCGAGGAACCCUdTdT
1650
AGGGUUCCUCGAGGGCGGC
1834





AD-70622
GAGGGCGGCACCGAUGCGUdTdT
1467
ACGCAUCGGUGCCGCCCUCdTdT
1651
GAGGGCGGCACCGAUGCGU
1835





AD-70623
GAUGCGUGCCAGGGUGAUUdTdT
1468
AAUCACCCUGGCACGCAUCdTdT
1652
GAUGCGUGCCAGGGUGAUU
1836





AD-70624
AGGGUGAUUCCGGAGGCCAdTdT
1469
UGGCCUCCGGAAUCACCCUdTdT
1653
AGGGUGAUUCCGGAGGCCC
1837





AD-70625
CGGAGGCCCGCUGGUGUGUdTdT
1470
ACACACCAGCGGGCCUCCGdTdT
1654
CGGAGGCCCGCUGGUGUGU
1838





AD-70626
GGUGUGUGAGGACCAAGCUdTdT
1471
AGCUUGGUCCUCACACACCdTdT
1655
GGUGUGUGAGGACCAAGCU
1839





AD-70627
CCAAGCUGCAGAGCGCCGAdTdT
1472
UCGGCGCUCUGCAGCUUGGdTdT
1656
CCAAGCUGCAGAGCGCCGG
1840





AD-70628
AGAGCGCCGGCUCACCCUAdTdT
1473
UAGGGUGAGCCGGCGCUCUdTdT
1657
AGAGCGCCGGCUCACCCUG
1841





AD-70629
UCACCCUGCAAGGCAUCAUdTdT
1474
AUGAUGCCUUGCAGGGUGAdTdT
1658
UCACCCUGCAAGGCAUCAU
1842





AD-70630
GGCAUCAUCAGCUGGGGAUdTdT
1475
AUCCCCAGCUGAUGAUGCCdTdT
1659
GGCAUCAUCAGCUGGGGAU
1843





AD-70631
CUGGGGAUCGGGCUGUGGUdTdT
1476
ACCACAGCCCGAUCCCCAGdTdT
1660
CUGGGGAUCGGGCUGUGGU
1844





AD-70632
UGUGGUGACCGCAACAAGAdTdT
1477
UCUUGUUGCGGUCACCACAdTdT
1661
UGUGGUGACCGCAACAAGC
1845





AD-70633
CAACAAGCCAGGCGUCUAAdTdT
1478
UUAGACGCCUGGCUUGUUGdTdT
1662
CAACAAGCCAGGCGUCUAC
1846





AD-70634
AGGCGUCUACACCGAUGUAdTdT
1479
UACAUCGGUGUAGACGCCUdTdT
1663
AGGCGUCUACACCGAUGUG
1847





AD-70635
GAUGUGGCCUACUACCUGAdTdT
1480
UCAGGUAGUAGGCCACAUCdTdT
1664
GAUGUGGCCUACUACCUGG
1848





AD-70636
UACUACCUGGCCUGGAUCAdTdT
1481
UGAUCCAGGCCAGGUAGUAdTdT
1665
UACUACCUGGCCUGGAUCC
1849





AD-70637
CUGGAUCCGGGAGCACACAdTdT
1482
UGUGUGCUCCCGGAUCCAGdTdT
1666
CUGGAUCCGGGAGCACACC
1850





AD-70638
AGCACACCGUUUCCUGAUUdTdT
1483
AAUCAGGAAACGGUGUGCUdTdT
1667
AGCACACCGUUUCCUGAUU
1851





AD-70639
UCCUGAUUGCUCAGGGACUdTdT
1484
AGUCCCUGAGCAAUCAGGAdTdT
1668
UCCUGAUUGCUCAGGGACU
1852





AD-70640
CAGGGACUCAUCUUUCCCUdTdT
1485
AGGGAAAGAUGAGUCCCUGdTdT
1669
CAGGGACUCAUCUUUCCCU
1853





AD-70641
UUUCCCUCCUUGGUGAUUAdTdT
1486
UAAUCACCAAGGAGGGAAAdTdT
1670
UUUCCCUCCUUGGUGAUUC
1854





AD-70642
UGGUGAUUCCGCAGUGAGAdTdT
1487
UCUCACUGCGGAAUCACCAdTdT
1671
UGGUGAUUCCGCAGUGAGA
1855





AD-70643
AGUGAGAGAGUGGCUGGGAdTdT
1488
UCCCAGCCACUCUCUCACUdTdT
1672
AGUGAGAGAGUGGCUGGGG
1856





AD-70644
GCUGGGGCAUGGAAGGCAAdTdT
1489
UUGCCUUCCAUGCCCCAGCdTdT
1673
GCUGGGGCAUGGAAGGCAA
1857





AD-70645
UGGAAGGCAAGAUUGUGUAdTdT
1490
UACACAAUCUUGCCUUCCAdTdT
1674
UGGAAGGCAAGAUUGUGUC
1858





AD-70646
UUGUGUCCCAUUCCCCCAAdTdT
1491
UUGGGGGAAUGGGACACAAdTdT
1675
UUGUGUCCCAUUCCCCCAG
1859





AD-70647
UCCCCCAGUGCGGCCAGCUdTdT
1492
AGCUGGCCGCACUGGGGGAdTdT
1676
UCCCCCAGUGCGGCCAGCU
1860





AD-70648
GCCAGCUCCGCGCCAGGAUdTdT
1493
AUCCUGGCGCGGAGCUGGCdTdT
1677
GCCAGCUCCGCGCCAGGAU
1861





AD-70649
GCCAGGAUGGCGCAGGAAAdTdT
1494
UUUCCUGCGCCAUCCUGGCdTdT
1678
GCCAGGAUGGCGCAGGAAC
1862





AD-70650
GCAGGAACUCAAUAAAGUAdTdT
1495
UACUUUAUUGAGUUCCUGCdTdT
1679
GCAGGAACUCAAUAAAGUG
1863





AD-70651
AAUAAAGUGCUUUGAAAAUdTdT
1496
AUUUUCAAAGCACUUUAUUdTdT
1680
AAUAAAGUGCUUUGAAAAU
1864





AD-70652
UUGAAAAUGCUGAGAAAAAdTdT
1497
UUUUUCUCAGCAUUUUCAAdTdT
1681
UUGAAAAUGCUGAGAAAAA
1865
















TABLE 13







F12 Single Dose Screen in Hep3b Cells











Duplex Name
AVG
STDEV














AD-70653
75.05
21.99



AD-70654
59.86
17.07



AD-70655
49.58
5.13



AD-70656
42.85
9.76



AD-70657
40.2
6.21



AD-70658
52.43
13.02



AD-70659
34.67
3.33



AD-70660
33.59
8.28



AD-70661
53.13
11.32



AD-70662
61.89
7.76



AD-70663
48.43
6.92



AD-70664
34.42
4.01



AD-70665
33.22
4.21



AD-70666
33.44
5.89



AD-70667
47.6
10.96



AD-70668
125.01
38.32



AD-70669
64.78
12.71



AD-70670
57.49
5.4



AD-70671
30.06
7.8



AD-70672
54.95
2.39



AD-70673
79.79
10.29



AD-70674
88.3
12.07



AD-70675
55.83
14.88



AD-70676
61.99
12.96



AD-70677
50.27
9.84



AD-70678
65.84
10.37



AD-70679
51.1
8.97



AD-70680
64.71
10.54



AD-70681
41.02
6.75



AD-70682
60.65
9.01



AD-70683
96.74
6.29



AD-70684
71.16
13.22



AD-70685
99.97
12.48



AD-70686
45.51
6.21



AD-70687
68.37
5.36



AD-70688
65.68
6.4



AD-70689
63.41
5.72



AD-70690
54.1
7.23



AD-70691
43.79
11.91



AD-70692
51.36
8.64



AD-70693
43.25
7.81



AD-70694
51.13
4.52



AD-70695
47.38
4.76



AD-70696
63.08
3.96



AD-70697
49.53
6.44



AD-70698
56.12
8.22



AD-70699
53.68
4.62



AD-70700
68.45
12.64



AD-70701
94.45
11.32



AD-70702
70.82
8.36



AD-70703
93.79
7.87



AD-70704
35.84
4.09



AD-70705
87.79
5.74



AD-70706
59.21
9.08



AD-70707
64.22
10.1



AD-70708
49.55
3



AD-70709
87.37
7.17



AD-70710
76.54
11.55



AD-70711
62.4
4.69



AD-70712
80.45
8.12



AD-70713
76.68
16.28



AD-70714
61.92
15.07



AD-70715
85.76
8.24



AD-70716
97.67
8.1



AD-70717
70.83
2.72



AD-70718
50.19
9.69



AD-70719
77.23
4.82



AD-70720
69.02
6.52



AD-70721
84.91
12.03



AD-70722
42.64
6.44



AD-70723
56.77
6.73



AD-70724
50.28
7.37



AD-70725
73.06
14.77



AD-70726
69.29
8.43



AD-70727
68.98
5.88



AD-70728
59.51
5.26



AD-70729
77.31
11.18



AD-70730
48.22
9.04



AD-70731
63.52
3.78



AD-70732
60.89
6.26



AD-70733
55.56
13.83



AD-70734
110.37
7.09



AD-70735
70.96
1.41



AD-70736
72.71
4.28



AD-70737
66.94
4.75



AD-70738
104.61
9.8



AD-70739
87.48
8.44



AD-70740
69.08
9.31



AD-70741
67.82
3.49



AD-70742
92.93
14.66



AD-70743
59.32
9.95



AD-70744
81.97
6.05



AD-70745
54.96
7.81



AD-70562
46.21
8.44



AD-70563
44.88
5.69



AD-70564
67.82
20.32



AD-70565
52.32
12.39



AD-70566
53.22
10.43



AD-70567
46.28
10.21



AD-70568
41.84
3.91



AD-70569
46.27
10.51



AD-70570
37.31
7.6



AD-70571
55.84
13.93



AD-70572
64.38
6.03



AD-70573
75.03
17.72



AD-70574
61.2
7.6



AD-70575
55.54
18.99



AD-70576
48.67
7.52



AD-70577
34.12
10.23



AD-70578
56.62
6.22



AD-70579
58.22
17.32



AD-70580
64.99
8.66



AD-70581
86.55
15.76



AD-70582
72.76
11.98



AD-70583
47.99
20.51



AD-70584
54
14.12



AD-70585
43.72
6.69



AD-70586
55.96
12.05



AD-70587
64.82
18.43



AD-70588
66.06
13.08



AD-70589
56.65
10.27



AD-70590
77.82
4.75



AD-70591
68.65
9.93



AD-70592
37.1
9.84



AD-70593
50.14
17.24



AD-70594
50.16
13.61



AD-70595
60.63
13.54



AD-70596
80.78
12.29



AD-70597
60.74
21.94



AD-70598
70.51
8.48



AD-70599
67.75
7.59



AD-70600
68.09
31.51



AD-70601
53.28
21.16



AD-70602
44.03
10.56



AD-70603
87.08
40.51



AD-70604
69.39
9.62



AD-70605
86.92
27.74



AD-70606
62.19
7.28



AD-70607
67.55
19.57



AD-70608
98.46
10.23



AD-70609
77.67
10.72



AD-70610
108.45
21.97



AD-70611
73.02
19.12



AD-70612
97.49
26.26



AD-70613
65.22
19.24



AD-70614
96.69
21.51



AD-70615
76.53
7.96



AD-70616
69.73
12.06



AD-70617
58.38
10.85



AD-70618
73.89
22.5



AD-70619
85.32
25.92



AD-70620
72.03
33.04



AD-70621
83.22
24.59



AD-70622
108.98
14.93



AD-70623
71.28
32.49



AD-70624
67.8
25.27



AD-70625
52.08
10.91



AD-70626
40.94
13.75



AD-70627
33.55
3.35



AD-70628
52.37
10.46



AD-70629
53.46
4.07



AD-70630
47
8.42



AD-70631
64.51
42.23



AD-70632
30.66
4.32



AD-70633
33.64
12.21



AD-70634
65.42
6.92



AD-70635
45.84
6.76



AD-70636
47.83
6.63



AD-70637
64.39
8.42



AD-70638
38.91
8.35



AD-70639
40.87
7.79



AD-70640
50.87
13.34



AD-70641
49.64
5.85



AD-70642
44.04
8.02



AD-70643
61.04
11.12



AD-70644
50.03
9.07



AD-70645
67.35
28.98



AD-70646
50.93
6



AD-70647
83.29
5.96



AD-70648
53.57
15.44



AD-70649
46.35
8.99



AD-70650
52.06
7.83



AD-70651
64.65
9.04



AD-70652
100.8
9.21









Example 6. In Vivo F12 Silencing in Mustard Oil-Induced Vascular Permeability Mouse Model

As discussed above, AD-67244 was the most efficacious agent targeting an F12 gene that was tested, resulting in robust, dose-dependent reduction of F12 mRNA and plasma F12 protein in wild-type mice, and normalization of vascular permeability in a bradykinin-induced vascular leakage mouse model of HAE (the ACE-inhibitor-induced mouse model).


The in vivo efficacy of AD-67244 was also assessed in a second mouse model of HAE. In particular, the ability of AD-67244 to rescue mustard oil-induced vascular permeability in C1-INH deficient mice was determined by subcutaneously administering CD-1 female mice (n=10/group) a single 3 mg/kg, 0.5 mg/kg, or 0.1 mg/kg dose of AD-67244 in combination with a single 10 mg/kg dose of a double stranded RNA agent targeting C1-INH at day −7. On Day 0, Evans Blue dye (30 mg/kg) was injected into the tail vein of the animals and a 5% solution of mustard oil was topically applied to the right ear of each animal (the left ear was left untreated and served as a control). Thirty minutes later, the animals were sacrificed, each ear was collected for dye extravasation to determine vascular permeability, and livers were collected for F12 and C1-INH mRNA measurements.


As shown in FIG. 3A, administration of a single 3 mg/kg, 0.5 mg/kg, or 0.1 mg/kg dose of AD-67244 normalized vascular permeability in these mice and, as shown in FIG. 3B, this administration resulted in robust, dose-dependent reduction of F12 mRNA in the livers of these animals. The level of C1-INH in the livers of these animals was less than 0.01% of the level of C1-INH in the livers of the control group administered. These data demonstrate that AD-67244 can mitigate excess bradykinin stimulation.


Example 7. In Vivo F12 Silencing in Non-Human Primates

To determine the efficacy of AD-67244 in non-human primates, female Cynomolgus monkeys (n=3 per group) were subcutaneously administered a single 3 mg/kg, 1 mg/kg, 0.3 mg/kg, or 0.1 mg/kg dose of AD-67244. The level of Cynomolgus F12 μlasma protein levels was measured by ELISA at days −5, −3, −1, 3, 7, 10, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77, 84, 91, 98, 112, 126, and 140 post-dose. FIG. 4 demonstrates that administration of a single 0.3 mg/kg dose of AD-67244 resulted in greater than 85% reduction in F12 protein. FIG. 11 also demonstrates that this reduction in F12 protein was durable with greater than 70% and 50% reduction at 2 and 3 months post-dose, respectively.


Example 8. Effect of 5′ Modification of AD-67244 on Potency in Mice

The effect of modifying the 5′ antisense phosphate of AD-67244 with a vinylphosphate (VP) on the potency of the agent was determined in mice. Wild-type mice (n=3/group) were administered a single 0.5 mg/kg dose of either AD-67244 (sense: 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO: 1866); antisense: 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO: 1867); ALN-F12) or AD-74841 (sense: 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO: 1868); antisense: 5′-VP-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO: 1869); ALN-F12-VP). The plasma level of F12 protein was determined by ELISA at days 0, 3, 7, 15, and 21 post-dose. FIG. 4 demonstrates that 5′ modification of the antisense phosphate group with a vinylphosphate moderately increased the potency of AD-67244.


Example 9. Synthesis and In Vitro Screening of F12 siRNA Duplexes

Additional iRNA agents targeting F12, e.g., targeting about nucleotides 2000-2060 of SEQ ID NO:9, were designed, synsthesized, and screened for in vitro efficacy, as described above. A detailed list of the additional unmodified F12 sense and antisense strand sequences is shown in Table 14. A detailed list of the additional modified F12 sense and antisense strand sequences is shown in Table 15. Table 16 provides the results of a single dose screen in Hep3b cells transfected with the indicated additional F12 iRNAs. Data are expressed as percent of mRNA remaining relative to AD-1955.









TABLE 14







F12 Unmodified Sequences















SEQ


SEQ





ID
Range in SEQ

ID
Range in SEQ


Duplex Name
Sense Sequence 5′ to 3′
NO
ID NO: 9
Antisense Sequence 5′ to 3′
NO
ID NO: 9





AD-70649.2
GCCAGGAUGGCGCAGGAAA
1870
2004-2022
UUUCCUGCGCCAUCCUGGC
1908
2004-2022





AD-75921.1
CCAGGAUGGCGCAGGAACU
1871
2005-2023
AGUUCCUGCGCCAUCCUGG
1909
2005-2023





AD-75920.1
CAGGAUGGCGCAGGAACUA
1872
2006-2024
UAGUUCCUGCGCCAUCCUG
1910
2006-2024





AD-75919.1
AGGAUGGCGCAGGAACUCA
1873
2007-2025
UGAGUUCCUGCGCCAUCCU
1911
2007-2025





AD-75918.1
GGAUGGCGCAGGAACUCAA
1874
2008-2026
UUGAGUUCCUGCGCCAUCC
1912
2008-2026





AD-75917.1
GAUGGCGCAGGAACUCAAU
1875
2009-2027
AUUGAGUUCCUGCGCCAUC
1913
2009-2027





AD-75916.1
AUGGCGCAGGAACUCAAUA
1876
2010-2028
UAUUGAGUUCCUGCGCCAU
1914
2010-2028





AD-75915.1
UGGCGCAGGAACUCAAUAA
1877
2011-2029
UUAUUGAGUUCCUGCGCCA
1915
2011-2029





AD-75914.1
GGCGCAGGAACUCAAUAAA
1878
2012-2030
UUUAUUGAGUUCCUGCGCC
1916
2012-2030





AD-75913.1
GCGCAGGAACUCAAUAAAA
1879
2013-2031
UUUUAUUGAGUUCCUGCGC
1917
2013-2031





AD-75912.1
CGCAGGAACUCAAUAAAGU
1880
2014-2032
ACUUUAUUGAGUUCCUGCG
1918
2014-2032





AD-70650.2
GCAGGAACUCAAUAAAGUA
1881
2015-2033
UACUUUAUUGAGUUCCUGC
1919
2015-2033





AD-75911.1
CAGGAACUCAAUAAAGUGA
1882
2016-2034
UCACUUUAUUGAGUUCCUG
1920
2016-2034





AD-75910.1
AGGAACUCAAUAAAGUGCU
1883
2017-2035
AGCACUUUAUUGAGUUCCU
1921
2017-2035





AD-75909.1
GGAACUCAAUAAAGUGCUU
1884
2018-2036
AAGCACUUUAUUGAGUUCC
1922
2018-2036





AD-75908.1
GAACUCAAUAAAGUGCUUU
1885
2019-2037
AAAGCACUUUAUUGAGUUC
1923
2019-2037





AD-75907.1
AACUCAAUAAAGUGCUUUA
1886
2020-2038
UAAAGCACUUUAUUGAGUU
1924
2020-2038





AD-75906.1
ACUCAAUAAAGUGCUUUGA
1887
2021-2039
UCAAAGCACUUUAUUGAGU
1925
2021-2039





AD-75922.1
UCAAUAAAGUGCUUUGAAA
1888
2023-2041
UUUCAAAGCACUUUAUUGA
1926
2023-2041





AD-75923.1
CAAUAAAGUGCUUUGAAAA
1889
2024-2042
UUUUCAAAGCACUUUAUUG
1927
2024-2042





AD-70651.2
AAUAAAGUGCUUUGAAAAU
1890
2025-2043
AUUUUCAAAGCACUUUAUU
1928
2025-2043





AD-75924.1
AUAAAGUGCUUUGAAAAUA
1891
2026-2044
UAUUUUCAAAGCACUUUAU
1929
2026-2044





AD-75925.1
UAAAGUGCUUUGAAAAUGA
1892
2027-2045
UCAUUUUCAAAGCACUUUA
1930
2027-2045





AD-75926.1
AAAGUGCUUUGAAAAUGCU
1893
2028-2046
AGCAUUUUCAAAGCACUUU
1931
2028-2046





AD-75927.1
AAGUGCUUUGAAAAUGCUA
1894
2029-2047
UAGCAUUUUCAAAGCACUU
1932
2029-2047





AD-75928.1
AGUGCUUUGAAAAUGCUGA
1895
2030-2048
UCAGCAUUUUCAAAGCACU
1933
2030-2048





AD-75929.1
GUGCUUUGAAAAUGCUGAA
1896
2031-2049
UUCAGCAUUUUCAAAGCAC
1934
2031-2049





AD-75930.1
UGCUUUGAAAAUGCUGAGA
1897
2032-2050
UCUCAGCAUUUUCAAAGCA
1935
2032-2050





AD-75931.1
GCUUUGAAAAUGCUGAGAA
1898
2033-2051
UUCUCAGCAUUUUCAAAGC
1936
2033-2051





AD-75932.1
CUUUGAAAAUGCUGAGAAA
1899
2034-2052
UUUCUCAGCAUUUUCAAAG
1937
2034-2052





AD-75933.1
UUUGAAAAUGCUGAGAAAA
1900
2035-2053
UUUUCUCAGCAUUUUCAAA
1938
2035-2053





AD-70652.2
UUGAAAAUGCUGAGAAAAA
1901
2036-2054
UUUUUCUCAGCAUUUUCAA
1939
2036-2054





AD-75934.1
UGAAAAUGCUGAGAAAAAA
1902
2037-2055
UUUUUUCUCAGCAUUUUCA
1940
2037-2055





AD-75935.1
GAAAAUGCUGAGAAAAAAA
1903
2038-2056
UUUUUUUCUCAGCAUUUUC
1941
2038-2056





AD-75936.1
AAAAUGCUGAGAAAAAAAA
1904
2039-2057
UUUUUUUUCUCAGCAUUUU
1942
2039-2057





AD-75937.1
AAAUGCUGAGAAAAAAAAA
1905
2040-2058
UUUUUUUUUCUCAGCAUUU
1943
2040-2058





AD-75938.1
AAUGCUGAGAAAAAAAAAA
1906
2041-2059
UUUUUUUUUUCUCAGCAUU
1944
2041-2059





AD-75939.1
AUGCUGAGAAAAAAAAAAA
1907
2042-2060
UUUUUUUUUUUCUCAGCAU
1945
2042-2060
















TABLE 15







F12 Modified Sequences
















SEQ

SEQ

SEQ
mRNA target


Duplex

ID
Antisense Sequence
ID
mRNA target sequence
ID
site in SEQ


Name
Sense Sequence 5′ to 3′
NO
5′ to 3′
NO
5′ to 3′
NO
ID NO: 9





AD-70649
GCCAGGAUGGCGCAGGAAAdTdT
1946
UUUCCUGCGCCAUCCUGGCdTdT
1984
GCCAGGAUGGCGCAGGAAC
2022
2004-2022





AD-75921
CCAGGAUGGCGCAGGAACUdTdT
1947
AGUUCCUGCGCCAUCCUGGdTdT
1985
CCAGGAUGGCGCAGGAACU
2023
2005-2023





AD-75920
CAGGAUGGCGCAGGAACUAdTdT
1948
UAGUUCCUGCGCCAUCCUGdTdT
1986
CAGGAUGGCGCAGGAACUC
2024
2006-2024





AD-75919
AGGAUGGCGCAGGAACUCAdTdT
1949
UGAGUUCCUGCGCCAUCCUdTdT
1987
AGGAUGGCGCAGGAACUCA
2025
2007-2025





AD-75918
GGAUGGCGCAGGAACUCAAdTdT
1950
UUGAGUUCCUGCGCCAUCCdTdT
1988
GGAUGGCGCAGGAACUCAA
2026
2008-2026





AD-75917
GAUGGCGCAGGAACUCAAUdTdT
1951
AUUGAGUUCCUGCGCCAUCdTdT
1989
GAUGGCGCAGGAACUCAAU
2027
2009-2027





AD-75916
AUGGCGCAGGAACUCAAUAdTdT
1952
UAUUGAGUUCCUGCGCCAUdTdT
1990
AUGGCGCAGGAACUCAAUA
2028
2010-2028





AD-75915
UGGCGCAGGAACUCAAUAAdTdT
1953
UUAUUGAGUUCCUGCGCCAdTdT
1991
UGGCGCAGGAACUCAAUAA
2029
2011-2029





AD-75914
GGCGCAGGAACUCAAUAAAdTdT
1954
UUUAUUGAGUUCCUGCGCCdTdT
1992
GGCGCAGGAACUCAAUAAA
2030
2012-2030





AD-75913
GCGCAGGAACUCAAUAAAAdTdT
1955
UUUUAUUGAGUUCCUGCGCdTdT
1993
GCGCAGGAACUCAAUAAAG
2031
2013-2031





AD-75912
CGCAGGAACUCAAUAAAGUdTdT
1956
ACUUUAUUGAGUUCCUGCGdTdT
1994
CGCAGGAACUCAAUAAAGU
2032
2014-2032





AD-70650
GCAGGAACUCAAUAAAGUAdTdT
1957
UACUUUAUUGAGUUCCUGCdTdT
1995
GCAGGAACUCAAUAAAGUG
2033
2015-2033





AD-75911
CAGGAACUCAAUAAAGUGAdTdT
1958
UCACUUUAUUGAGUUCCUGdTdT
1996
CAGGAACUCAAUAAAGUGC
2034
2016-2034





AD-75910
AGGAACUCAAUAAAGUGCUdTdT
1959
AGCACUUUAUUGAGUUCCUdTdT
1997
AGGAACUCAAUAAAGUGCU
2035
2017-2035





AD-75909
GGAACUCAAUAAAGUGCUUdTdT
1960
AAGCACUUUAUUGAGUUCCdTdT
1998
GGAACUCAAUAAAGUGCUU
2036
2018-2036





AD-75908
GAACUCAAUAAAGUGCUUUdTdT
1961
AAAGCACUUUAUUGAGUUCdTdT
1999
GAACUCAAUAAAGUGCUUU
2037
2019-2037





AD-75907
AACUCAAUAAAGUGCUUUAdTdT
1962
UAAAGCACUUUAUUGAGUUdTdT
2000
AACUCAAUAAAGUGCUUUG
2038
2020-2038





AD-75906
ACUCAAUAAAGUGCUUUGAdTdT
1963
UCAAAGCACUUUAUUGAGUdTdT
2001
ACUCAAUAAAGUGCUUUGA
2039
2021-2039





AD-75922
UCAAUAAAGUGCUUUGAAAdTdT
1964
UUUCAAAGCACUUUAUUGAdTdT
2002
UCAAUAAAGUGCUUUGAAA
2040
2023-2041





AD-75923
CAAUAAAGUGCUUUGAAAAdTdT
1965
UUUUCAAAGCACUUUAUUGdTdT
2003
CAAUAAAGUGCUUUGAAAA
2041
2024-2042





AD-70651
AAUAAAGUGCUUUGAAAAUdTdT
1966
AUUUUCAAAGCACUUUAUUdTdT
2004
AAUAAAGUGCUUUGAAAAU
2042
2025-2043





AD-75924
AUAAAGUGCUUUGAAAAUAdTdT
1967
UAUUUUCAAAGCACUUUAUdTdT
2005
AUAAAGUGCUUUGAAAAUG
2043
2026-2044





AD-75925
UAAAGUGCUUUGAAAAUGAdTdT
1968
UCAUUUUCAAAGCACUUUAdTdT
2006
UAAAGUGCUUUGAAAAUGC
2044
2027-2045





AD-75926
AAAGUGCUUUGAAAAUGCUdTdT
1969
AGCAUUUUCAAAGCACUUUdTdT
2007
AAAGUGCUUUGAAAAUGCU
2045
2028-2046





AD-75927
AAGUGCUUUGAAAAUGCUAdTdT
1970
UAGCAUUUUCAAAGCACUUdTdT
2008
AAGUGCUUUGAAAAUGCUG
2046
2029-2047





AD-75928
AGUGCUUUGAAAAUGCUGAdTdT
1971
UCAGCAUUUUCAAAGCACUdTdT
2009
AGUGCUUUGAAAAUGCUGA
2047
2030-2048





AD-75929
GUGCUUUGAAAAUGCUGAAdTdT
1972
UUCAGCAUUUUCAAAGCACdTdT
2010
GUGCUUUGAAAAUGCUGAG
2048
2031-2049





AD-75930
UGCUUUGAAAAUGCUGAGAdTdT
1973
UCUCAGCAUUUUCAAAGCAdTdT
2011
UGCUUUGAAAAUGCUGAGA
2049
2032-2050





AD-75931
GCUUUGAAAAUGCUGAGAAdTdT
1974
UUCUCAGCAUUUUCAAAGCdTdT
2012
GCUUUGAAAAUGCUGAGAA
2050
2033-2051





AD-75932
CUUUGAAAAUGCUGAGAAAdTdT
1975
UUUCUCAGCAUUUUCAAAGdTdT
2013
CUUUGAAAAUGCUGAGAAA
2051
2034-2052





AD-75933
UUUGAAAAUGCUGAGAAAAdTdT
1976
UUUUCUCAGCAUUUUCAAAdTdT
2014
UUUGAAAAUGCUGAGAAAA
2052
2035-2053





AD-70652
UUGAAAAUGCUGAGAAAAAdTdT
1977
UUUUUCUCAGCAUUUUCAAdTdT
2015
UUGAAAAUGCUGAGAAAAA
2053
2036-2054





AD-75934
UGAAAAUGCUGAGAAAAAAdTdT
1978
UUUUUUCUCAGCAUUUUCAdTdT
2016
UGAAAAUGCUGAGAAAAAA
2054
2037-2055





AD-75935
GAAAAUGCUGAGAAAAAAAdTdT
1979
UUUUUUUCUCAGCAUUUUCdTdT
2017
GAAAAUGCUGAGAAAAAAA
2055
2038-2056





AD-75936
AAAAUGCUGAGAAAAAAAAdTdT
1980
UUUUUUUUCUCAGCAUUUUdTdT
2018
AAAAUGCUGAGAAAAAAAA
2056
2039-2057





AD-75937
AAAUGCUGAGAAAAAAAAAdTdT
1981
UUUUUUUUUCUCAGCAUUUdTdT
2019
AAAUGCUGAGAAAAAAAAA
2057
2040-2058





AD-75938
AAUGCUGAGAAAAAAAAAAdTdT
1982
UUUUUUUUUUCUCAGCAUUdTdT
2020
AAUGCUGAGAAAAAAAAAA
2058
2041-2059





AD-75939
AUGCUGAGAAAAAAAAAAAdTdT
1983
UUUUUUUUUUUCUCAGCAUdTdT
2021
AUGCUGAGAAAAAAAAAAA
2059
2042-2060
















TABLE 16







F12 Single Dose Screen in Hep3b Cells












10
10
0.1
0.1


Duplex ID
nM_AVG
nM_SD
nM_AVG
nM_SD














AD-70649.2
28.65
6.26
41.38
9.60


AD-75921.1
29.32
7.31
41.14
10.86


AD-75920.1
30.91
5.90
45.92
15.18


AD-75919.1
32.12
14.45
66.98
17.31


AD-75918.1
28.51
14.34
57.71
21.51


AD-75917.1
22.80
1.02
33.45
5.13


AD-75916.1
27.48
7.88
34.62
6.73


AD-75915.1
50.58
28.39
56.95
39.88


AD-75914.1
28.22
5.74
54.70
9.80


AD-75913.1
38.35
11.58
32.08
9.74


AD-75912.1
27.06
9.92
39.41
14.48


AD-70650.2
31.86
12.64
40.42
11.08


AD-75911.1
28.50
5.83
53.54
9.61


AD-75910.1
34.12
6.44
47.93
22.85


AD-75909.1
35.13
13.76
51.88
42.23


AD-75908.1
38.17
7.67
66.18
59.34


AD-75907.1
40.80
20.27
62.36
20.96


AD-75906.1
49.29
8.64
58.20
26.56


AD-75922.1
25.51
3.58
45.53
20.00


AD-75923.1
49.08
13.60
49.27
11.54


AD-70651.2
55.60
32.34
94.24
39.01


AD-75924.1
46.27
14.11
53.33
11.68


AD-75925.1
37.21
8.81
46.28
17.48


AD-75926.1
27.13
6.82
39.29
8.19


AD-75927.1
47.80
14.67
62.71
21.77


AD-75928.1
34.40
6.27
70.89
29.90


AD-75929.1
43.65
16.80
54.91
4.67


AD-75930.1
72.67
33.09
81.86
17.63


AD-75931.1
85.60
17.39
88.98
12.61


AD-75932.1
46.69
3.04
68.57
12.35


AD-75933.1
75.04
4.59
97.52
8.55


AD-70652.2
104.50
12.08
84.12
4.74


AD-75934.1
83.25
19.97
82.77
10.51


AD-75935.1
65.87
3.46
84.47
11.66


AD-75936.1
97.74
3.66
93.48
10.33


AD-75937.1
112.45
30.62
98.91
29.75


AD-75938.1
125.12
33.83
110.47
33.87


AD-75939.1
112.95
24.79
93.19
18.21









Example 10. Evaluation of 5′-End Modifications of F12 siRNA Duplexes

Additional iRNA agents targeting F12 comprising a nucleotide comprising a 5′-phosphate mimic, i.e., a vinyl phosphate, were designed, synthesized, and screened for in vitro efficacy, as described above. Agents comprising the same unmodified and modified nucleotide sequences of these agents but without the 5′-antisense strand vinyl phosphate modification were also designed, synthesized and screened, as described above. A detailed list of all of these additional unmodified F12 sense and antisense strand sequences is shown in Table 17. A detailed list of all of these additional modified F12 sense and antisense strand sequences is shown in Table 18. Table 19 provides the results of a single dose screen in primary mouse hepatocytes cells transfected with the indicated F12 dsRNA agents.


The in vivo efficacy of a subset of these compounds was also assessed by subcutaneously administering wild-type mice a single 0.5 mg/kg dose of an agent and determining the level of F12 protein in the plasma of the animals at days 3, 7, and 15 post-dose. FIG. 6 depicts the results of these assays and demonstrates that the addition of a 5′vinyl phosphate to the antisense strands has a moderate effect on the in vivo efficacy of the indicated agents.









TABLE 17







F12 Unmodified F12 Sequences














SEQ

SEQ



Duplex

ID

ID
Range in SEQ


Name
Sense Sequence 5′ to 3′
NO
Antisense Sequence 5′ to 3′
NO
ID NO: 9





AD-73610
GGAGCCCAAGAAAGUGAAAGA
2060
UCUUUCACUUUCUUGGGCUCCAA
2105
299-321





AD-73633
GGAGCCCAAGAAAGUGAAAGA
2061
UCUUUCACUUUCUUGGGCUCCAA
2106
299-321





AD-73604
GAGCCCAAGAAAGUGAAAGAA
2062
UUCUUUCACUUUCUUGGGCUCCA
2107
300-322





AD-73627
GAGCCCAAGAAAGUGAAAGAA
2063
UUCUUUCACUUUCUUGGGCUCCA
2108
300-322





AD-73595
GCCCAAGAAAGUGAAAGACCA
2064
UGGUCUUUCACUUUCUUGGGCUC
2109
302-324





AD-73617
GCCCAAGAAAGUGAAAGACCA
2065
UGGUCUUUCACUUUCUUGGGCUC
2110
302-324





AD-73606
CCCAAGAAAGUGAAAGACCAA
2066
UUGGUCUUUCACUUUCUUGGGCU
2111
303-325





AD-73629
CCCAAGAAAGUGAAAGACCAA
2067
UUGGUCUUUCACUUUCUUGGGCU
2112
303-325





AD-73609
AAAGAGAAAUGCUUUGAGCCA
2068
UGGCUCAAAGCAUUUCUCUUUCU
2113
426-448





AD-73632
AAAGAGAAAUGCUUUGAGCCA
2069
UGGCUCAAAGCAUUUCUCUUUCU
2114
426-448





AD-73599
AAGAGAAAUGCUUUGAGCCUA
2070
UAGGCUCAAAGCAUUUCUCUUUC
2115
427-449





AD-73621
AAGAGAAAUGCUUUGAGCCUA
2071
UAGGCUCAAAGCAUUUCUCUUUC
2116
427-449





AD-73597
AGAGAAAUGCUUUGAGCCUCA
2072
UGAGGCUCAAAGCAUUUCUCUUU
2117
428-450





AD-73619
AGAGAAAUGCUUUGAGCCUCA
2073
UGAGGCUCAAAGCAUUUCUCUUU
2118
428-450





AD-73596
GAGAAAUGCUUUGAGCCUCAA
2074
UUGAGGCUCAAAGCAUUUCUCUU
2119
429-451





AD-73618
GAGAAAUGCUUUGAGCCUCAA
2075
UUGAGGCUCAAAGCAUUUCUCUU
2120
429-451





AD-73614
AGAAAUGCUUUGAGCCUCAGA
2076
UCUGAGGCUCAAAGCAUUUCUCU
2121
430-452





AD-73637
AGAAAUGCUUUGAGCCUCAGA
2077
UCUGAGGCUCAAAGCAUUUCUCU
2122
430-452





AD-73611
AAAUGCUUUGAGCCUCAGCUA
2078
UAGCUGAGGCUCAAAGCAUUUCU
2123
432-454





AD-73634
AAAUGCUUUGAGCCUCAGCUA
2079
UAGCUGAGGCUCAAAGCAUUUCU
2124
432-454





AD-73605
AUGCUUUGAGCCUCAGCUUCA
2080
UGAAGCUGAGGCUCAAAGCAUUU
2125
434-456





AD-73628
AUGCUUUGAGCCUCAGCUUCA
2081
UGAAGCUGAGGCUCAAAGCAUUU
2126
434-456





AD-73601
UGCUUUGAGCCUCAGCUUCUA
2082
UAGAAGCUGAGGCUCAAAGCAUU
2127
435-457





AD-73624
UGCUUUGAGCCUCAGCUUCUA
2083
UAGAAGCUGAGGCUCAAAGCAUU
2128
435-457





AD-73613
GCUUUGAGCCUCAGCUUCUCA
2084
UGAGAAGCUGAGGCUCAAAGCAU
2129
436-458





AD-73636
GCUUUGAGCCUCAGCUUCUCA
2085
UGAGAAGCUGAGGCUCAAAGCAU
2130
436-458





AD-73616
ACUCCACCUUCCUGCAGGAGA
2086
UCUCCUGCAGGAAGGUGGAGUAU
2131
1522-1544





AD-73639
ACUCCACCUUCCUGCAGGAGA
2087
UCUCCUGCAGGAAGGUGGAGUAU
2132
1522-1544





AD-73603
CACAGAAACUCAAUAAAGUGA
2088
UCACUUUAUUGAGUUUCUGUGCC
2133
1927-1949





AD-73626
CACAGAAACUCAAUAAAGUGA
2089
UCACUUUAUUGAGUUUCUGUGCC
2134
1927-1949





AD-73607
ACAGAAACUCAAUAAAGUGCA
2090
UGCACUUUAUUGAGUUUCUGUGC
2135
1928-1950





AD-73630
ACAGAAACUCAAUAAAGUGCA
2091
UGCACUUUAUUGAGUUUCUGUGC
2136
1928-1950





AD-73600
CAGAAACUCAAUAAAGUGCUA
2092
UAGCACUUUAUUGAGUUUCUGUG
2137
1929-1951





AD-73622
CAGAAACUCAAUAAAGUGCUA
2093
UAGCACUUUAUUGAGUUUCUGUG
2138
1929-1951





AD-73615
AGAAACUCAAUAAAGUGCUUA
2094
UAAGCACUUUAUUGAGUUUCUGU
2139
1930-1952





AD-73638
AGAAACUCAAUAAAGUGCUUA
2095
UAAGCACUUUAUUGAGUUUCUGU
2140
1930-1952





AD-73598
GAAACUCAAUAAAGUGCUUUA
2096
UAAAGCACUUUAUUGAGUUUCUG
2141
1931-1953





AD-73620
GAAACUCAAUAAAGUGCUUUA
2097
UAAAGCACUUUAUUGAGUUUCUG
2142
1931-1953





AD-73602
AAACUCAAUAAAGUGCUUUGA
2098
UCAAAGCACUUUAUUGAGUUUCU
2143
1932-1954





AD-73625
AAACUCAAUAAAGUGCUUUGA
2099
UCAAAGCACUUUAUUGAGUUUCU
2144
1932-1954





AD-73608
ACUCAAUAAAGUGCUUUGAAA
2100
UUUCAAAGCACUUUAUUGAGUUU
2145
1934-1956





AD-73631
ACUCAAUAAAGUGCUUUGAAA
2101
UUUCAAAGCACUUUAUUGAGUUU
2146
1934-1956





AD-73612
UCAAUAAAGUGCUUUGAAAAA
2102
UUUUUCAAAGCACUUUAUUGAGU
2147
1936-1958





AD-73635
UCAAUAAAGUGCUUUGAAAAA
2103
UUUUUCAAAGCACUUUAUUGAGU
2148
1936-1958





AD-73623
AACUCAAUAAAGUGCUUUGAA
2104
UUCAAAGCACUUUAUUGAGUUUC
2149
1933-1955





AD-74838
AAUAAAGUGCUUUGAAAACGA
2333
UCGUUUUCAAAGCACUUUAUUGA
2335
1938-1960





AD-74842
AAUAAAGUGCUUUGAAAACGA
2334
UCGUUUUCAAAGCACUUUAUUGA
2336
1938-1960
















TABLE 18





Modified F12 Sequences





















SEQ

SEQ


Duplex

ID

ID


Name
Sense Sequence 5′ to 3′
NO
Antisense Sequence 5′ to 3′
NO





AD-73610
gsgsagccCfaAfGfAfaagugaaagaL96
2150
usCfsuuuCfaCfUfuucuUfgGfgcuccsasa
2195





AD-73633
gsgsagccCfaAfGfAfaagugaaagaL96
2151
PusCfsuuuCfaCfUfuucuUfgGfgcuccsasa
2196





AD-73604
gsasgcccAfaGfAfAfagugaaagaaL96
2152
usUfscuuUfcAfCfuuucUfuGfggcucscsa
2197





AD-73627
gsasgcccAfaGfAfAfagugaaagaaL96
2153
PusUfscuuUfcAfCfuuucUfuGfggcucscsa
2198





AD-73595
gscsccaaGfaAfAfGfugaaagaccaL96
2154
usGfsgucUfuUfCfacuuUfcUfugggcsusc
2199





AD-73617
gscsccaaGfaAfAfGfugaaagaccaL96
2155
PusGfsgucUfuUfCfacuuUfcUfugggcsusc
2200





AD-73606
cscscaagAfaAfGfUfgaaagaccaaL96
2156
usUfsgguCfuUfUfcacuUfuCfuugggscsu
2201





AD-73629
cscscaagAfaAfGfUfgaaagaccaaL96
2157
PusUfsgguCfuUfUfcacuUfuCfuugggscsu
2202





AD-73609
asasagagAfaAfUfGfcuuugagccaL96
2158
usGfsgcuCfaAfAfgcauUfuCfucuuuscsu
2203





AD-73632
asasagagAfaAfUfGfcuuugagccaL96
2159
PusGfsgcuCfaAfAfgcauUfuCfucuuuscsu
2204





AD-73599
asasgagaAfaUfGfCfuuugagccuaL96
2160
usAfsggcUfcAfAfagcaUfuUfcucuususc
2205





AD-73621
asasgagaAfaUfGfCfuuugagccuaL96
2161
PusAfsggcUfcAfAfagcaUfuUfcucuususc
2206





AD-73597
asgsagaaAfuGfCfUfuugagccucaL96
2162
usGfsaggCfuCfAfaagcAfuUfucucususu
2207





AD-73619
asgsagaaAfuGfCfUfuugagccucaL96
2163
PusGfsaggCfuCfAfaagcAfuUfucucususu
2208





AD-73596
gsasgaaaUfgCfUfUfugagccucaaL96
2164
usUfsgagGfcUfCfaaagCfaUfuucucsusu
2209





AD-73618
gsasgaaaUfgCfUfUfugagccucaaL96
2165
PusUfsgagGfcUfCfaaagCfaUfuucucsusu
2210





AD-73614
asgsaaauGfcUfUfUfgagccucagaL96
2166
usCfsugaGfgCfUfcaaaGfcAfuuucuscsu
2211





AD-73637
asgsaaauGfcUfUfUfgagccucagaL96
2167
PusCfsugaGfgCfUfcaaaGfcAfuuucuscsu
2212





AD-73611
asasaugcUfuUfGfAfgccucagcuaL96
2168
usAfsgcuGfaGfGfcucaAfaGfcauuuscsu
2213





AD-73634
asasaugcUfuUfGfAfgccucagcuaL96
2169
PusAfsgcuGfaGfGfcucaAfaGfcauuuscsu
2214





AD-73605
asusgcuuUfgAfGfCfcucagcuucaL96
2170
usGfsaagCfuGfAfggcuCfaAfagcaususu
2215





AD-73628
asusgcuuUfgAfGfCfcucagcuucaL96
2171
PusGfsaagCfuGfAfggcuCfaAfagcaususu
2216





AD-73601
usgscuuuGfaGfCfCfucagcuucuaL96
2172
usAfsgaaGfcUfGfaggcUfcAfaagcasusu
2217





AD-73624
usgscuuuGfaGfCfCfucagcuucuaL96
2173
PusAfsgaaGfcUfGfaggcUfcAfaagcasusu
2218





AD-73613
gscsuuugAfgCfCfUfcagcuucucaL96
2174
usGfsagaAfgCfUfgaggCfuCfaaagcsasu
2219





AD-73636
gscsuuugAfgCfCfUfcagcuucucaL96
2175
PusGfsagaAfgCfUfgaggCfuCfaaagcsasu
2220





AD-73616
ascsuccaCfcUfUfCfcugcaggagaL96
2176
usCfsuccUfgCfAfggaaGfgUfggagusasu
2221





AD-73639
ascsuccaCfcUfUfCfcugcaggagaL96
2177
PusCfsuccUfgCfAfggaaGfgUfggagusasu
2222





AD-73603
csascagaAfaCfUfCfaauaaagugaL96
2178
usCfsacuUfuAfUfugagUfuUfcugugscsc
2223





AD-73626
csascagaAfaCfUfCfaauaaagugaL96
2179
PusCfsacuUfuAfUfugagUfuUfcugugscsc
2224





AD-73607
ascsagaaAfcUfCfAfauaaagugcaL96
2180
usGfscacUfuUfAfuugaGfuUfucugusgsc
2225





AD-73630
ascsagaaAfcUfCfAfauaaagugcaL96
2181
PusGfscacUfuUfAfuugaGfuUfucugusgsc
2226





AD-73600
csasgaaaCfuCfAfAfuaaagugcuaL96
2182
usAfsgcaCfuUTUfauugAfgUfuucugsusg
2227





AD-73622
csasgaaaCfuCfAfAfuaaagugcuaL96
2183
PusAfsgcaCfuUfUfauugAfgUfuucugsusg
2228





AD-73615
asgsaaacUfcAfAfUfaaagugcuuaL96
2184
usAfsagcAfcUfUfuauuGfaGfuuucusgsu
2229





AD-73638
asgsaaacUfcAfAfUfaaagugcuuaL96
2185
PusAfsagcAfcUfUfuauuGfaGfuuucusgsu
2230





AD-73598
gsasaacuCfaAfUfAfaagugcuuuaL96
2186
usAfsaagCfaCfUfuuauUfgAfguuucsusg
2231





AD-73620
gsasaacuCfaAfUfAfaagugcuuuaL96
2187
PusAfsaagCfaCfUfuuauUfgAfguuucsusg
2232





AD-73602
asasacucAfaUfAfAfagugcuuugaL96
2188
usCfsaaaGfcAfCfuuuaUfuGfaguuuscsu
2233





AD-73625
asasacucAfaUfAfAfagugcuuugaL96
2189
PusCfsaaaGfcAfCfuuuaUfuGfaguuuscsu
2234





AD-73608
ascsucaaUfaAfAfGfugcuuugaaaL96
2190
usUfsucaAfaGfCfacuuUfaUfugagususu
2235





AD-73631
ascsucaaUfaAfAfGfugcuuugaaaL96
2191
PusUfsucaAfaGfCfacuuUfaUfugagususu
2236





AD-73612
uscsaauaAfaGfUfGfcuuugaaaaaL96
2192
usUfsuuuCfaAfAfgcacUfuUfauugasgsu
2237





AD-73635
uscsaauaAfaGfUfGfcuuugaaaaaL96
2193
PusUfsuuuCfaAfAfgcacUfuUfauugasgsu
2238





AD-73623
asascucaAfuAfAfAfgugcuuugaaL96
2194
PusUfscaaAfgCfAfcuuuAfuUfgaguususc
2239





AD-74838
asasuaaaGfuGfCfUfuugaaaacgaL96
2337
usCfsguuUfuCfAfaagcAfcUfuuauusgsa
2339





AD-74842
asasuaaaGfuGfCfUfuugaaaacgaL96
2338
PusCfsguuUfuCfAfaagcAfcUfuuauusgsa
2340









SEQ




Duplex

ID




Name
mRNA target sequence
NO







AD-73610
UUGGAGCCCAAGAAAGUGAAAGA
2240







AD-73633
UUGGAGCCCAAGAAAGUGAAAGA
2241







AD-73604
UGGAGCCCAAGAAAGUGAAAGAC
2242







AD-73627
UGGAGCCCAAGAAAGUGAAAGAC
2243







AD-73595
GAGCCCAAGAAAGUGAAAGACCA
2244







AD-73617
GAGCCCAAGAAAGUGAAAGACCA
2245







AD-73606
AGCCCAAGAAAGUGAAAGACCAU
2246







AD-73629
AGCCCAAGAAAGUGAAAGACCAU
2247







AD-73609
AGAAAGAGAAAUGCUUUGAGCCU
2248







AD-73632
AGAAAGAGAAAUGCUUUGAGCCU
2249







AD-73599
GAAAGAGAAAUGCUUUGAGCCUC
2250







AD-73621
GAAAGAGAAAUGCUUUGAGCCUC
2251







AD-73597
AAAGAGAAAUGCUUUGAGCCUCA
2252







AD-73619
AAAGAGAAAUGCUUUGAGCCUCA
2253







AD-73596
AAGAGAAAUGCUUUGAGCCUCAG
2254







AD-73618
AAGAGAAAUGCUUUGAGCCUCAG
2255







AD-73614
AGAGAAAUGCUUUGAGCCUCAGC
2256







AD-73637
AGAGAAAUGCUUUGAGCCUCAGC
2257







AD-73611
AGAAAUGCUUUGAGCCUCAGCUU
2258







AD-73634
AGAAAUGCUUUGAGCCUCAGCUU
2259







AD-73605
AAAUGCUUUGAGCCUCAGCUUCU
2260







AD-73628
AAAUGCUUUGAGCCUCAGCUUCU
2261







AD-73601
AAUGCUUUGAGCCUCAGCUUCUC
2262







AD-73624
AAUGCUUUGAGCCUCAGCUUCUC
2263







AD-73613
AUGCUUUGAGCCUCAGCUUCUCA
2264







AD-73636
AUGCUUUGAGCCUCAGCUUCUCA
2265







AD-73616
AUACUCCACCUUCCUGCAGGAGG
2266







AD-73639
AUACUCCACCUUCCUGCAGGAGG
2267







AD-73603
GGCACAGAAACUCAAUAAAGUGC
2268







AD-73626
GGCACAGAAACUCAAUAAAGUGC
2269







AD-73607
GCACAGAAACUCAAUAAAGUGCU
2270







AD-73630
GCACAGAAACUCAAUAAAGUGCU
2271







AD-73600
CACAGAAACUCAAUAAAGUGCUU
2272







AD-73622
CACAGAAACUCAAUAAAGUGCUU
2273







AD-73615
ACAGAAACUCAAUAAAGUGCUUU
2274







AD-73638
ACAGAAACUCAAUAAAGUGCUUU
2275







AD-73598
CAGAAACUCAAUAAAGUGCUUUG
2276







AD-73620
CAGAAACUCAAUAAAGUGCUUUG
2277







AD-73602
AGAAACUCAAUAAAGUGCUUUGA
2278







AD-73625
AGAAACUCAAUAAAGUGCUUUGA
2279







AD-73608
AAACUCAAUAAAGUGCUUUGAAA
2280







AD-73631
AAACUCAAUAAAGUGCUUUGAAA
2281







AD-73612
ACUCAAUAAAGUGCUUUGAAAAC
2282







AD-73635
ACUCAAUAAAGUGCUUUGAAAAC
2283







AD-73623
GAAACUCAAUAAAGUGCUUUGAA
2284







AD-74838
UCAAUAAAGUGCUUUGAAAACGA
2341







AD-74842
UCAAUAAAGUGCUUUGAAAACGA
2342
















TABLE 19







F12 Single Dose Screen in Primary Mouse Hepatocytes










Activity













10 nM

0.1 nM*














Duplex ID
Avg
SD
Avg
SD
















AD-67244
7.5
2.3
69.5
4.6



AD-73610
46.8
14.1
104.7
10.1



AD-73633
18.0
6.8
69.2
13.3



AD-73604
21.0
6.3
100.3
10.0



AD-73627
10.5
3.2
55.5
5.7



AD-73595
29.0
7.6
96.1
4.8



AD-73617
12.4
4.9
66.1
10.5



AD-73606
11.8
3.6
93.2
4.1



AD-73629
14.9
4.6
57.8
6.4



AD-73609
35.2
4.7
89.6
5.0



AD-73632
3.3
0.6
46.5
8.0



AD-73599
11.7
2.2
84.4
10.9



AD-73621
5.9
1.7
34.8
4.4



AD-73597
9.4
1.8
60.6
3.0



AD-73619
5.0
1.7
21.0
7.4



AD-73596
7.3
3.1
53.2
10.9



AD-73618
4.6
2.4
29.4
8.2



AD-73614
24.0
8.8
96.0
4.8



AD-73637
7.1
2.2
47.3
6.9



AD-73611
17.3
3.8
92.5
4.0



AD-73634
7.1
3.5
54.5
12.5



AD-73605
10.2
2.1
88.7
6.0



AD-73628
5.7
0.4
23.5
8.1



AD-73601
6.4
2.4
67.4
9.9



AD-73624
3.0
0.5
28.0
5.9



AD-73613
16.4
5.3
92.6
8.8



AD-73636
4.8
1.5
22.5
7.2



AD-73616
99.7
8.0
97.3
3.2



AD-73639
35.5
4.8
100.3
6.7



AD-73603
12.8
5.0
87.7
7.2



AD-73626
2.2
0.8
19.8
4.3



AD-73607
17.4
5.6
90.0
6.4



AD-73630
3.9
1.2
25.0
7.3



AD-73600
2.7
1.5
24.9
4.9



AD-73622
1.5
0.2
16.2
2.3



AD-73615
7.6
3.6
51.9
4.8



AD-73638
3.7
1.5
17.6
5.6



AD-73598
2.0
0.5
18.7
7.5



AD-73620
2.0
0.3
9.5
3.4



AD-73602
4.4
1.9
48.7
8.4



AD-73625
3.3
1.4
9.8
2.0



AD-73608
5.5
1.3
65.4
10.7



AD-73631
2.1
0.4
11.1
1.9



AD-73612
5.4
1.4
49.1
7.3



AD-73635
3.5
0.7
13.0
2.5



AD-73623
2.5
0.4
7.2
1.2









Example 11. AD-67244 Inhibits Venous Thrombosis and Arterial Thrombosis And Does Not Inhibit Hemostasis

Using a mouse model of large vein thrombosis, the in vivo efficacy of AD-67244 to inhibit platelet deposition and fibrin deposition was assessed. The venous electrolytic injury mouse model induces formation of thrombi in large vessels in the presence of continuous blood flow and is an art-recognized relevant animal model of clinical deep vein thrombosis (DVT) formation (e.g., versus mechanical occlusion or stenosis to cause thrombosis). See, Cooley et al., (2005) Thromb Haemost. 94 (3):498-503, Cooley BC, (2011) Arterioscler Thromb Vase Biol. 31 (6):1351-1356 and Diaz et al., (2012) Arterioscler Thromb Vase Biol. 32(3):556-562.


Mice (n=8/group) were subcutaneously administered a single 0.3 mg/kg, 0.75 mg/kg, or 10 mg/kg dose of AD-67244 or PBS as a control. On Day 10 post-dose, animals were anesthetized and administered fluorescent anti-fibrin and anti-platelet antibodies. The femoral vein was exposed, and electrolytic injuries were induced on the surface of the vein. Intra-vital fluorescence quantitation of platelet and fibrin accumulation through 60 minutes was measured. Subsequent to the procedure, animals were sacrificed and liver samples collected for mRNA isolation and quantification, as described above.


As shown in FIGS. 7A and 7B, administration of all doses of AD-67244 significantly inhibited platelet (FIG. 7A) deposition and fibrin deposition (FIG. 7B) at the site of injury. FIG. 7C demonstrates that, at all doses tested, the effect of a single dose of AD-67244 on F12 mRNA expression was durable and F12 mRNA levels remained below about 50% on Day 10 post-dose. Real-time images of fibrin and platelet deposition in control mice and mice administered a single dose of 10 mg/kg of AD-67244 are shown in FIGS. 8A and 8B, respectively, and shown that both fibrin and platelet deposition at the site of injury are significantly inhibited.


The in vivo efficacy of AD-67244 to inhibit arterial thrombosis was also assessed using a well-known mouse model. Specifically, ferric chloride (FeCl3) induced vascular injury is a widely used model of occlusive thrombosis that reports platelet activation and aggregation in the context of a closed vascular system. This model is based on redox-induced endothelial cell injury, which is simple and sensitive to both anticoagulant and anti-platelets drugs. The time required for the development of a thrombus that occludes blood flow gives a quantitative measure of vascular injury, platelet activation and aggregation that is relevant to thrombotic diseases.


Mice (n=8/group) were subcutaneously administered a single 10 mg/kg dose of AD-67244 or PBS as a control. On Day 10 post-dose, animals were anesthetized and the carotid artery was exposed. A thrombus was induced by touching the corner of a piece of filter paper soaked in a 20% FeCl3 solution to the surface of the carotid artery. The filter paper was then removed and the time required for the development of a thrombus that occluded blood flow was measured. Subsequent to the procedure, animals were sacrificed and liver samples collected for mRNA isolation and quantification, as described above.



FIG. 9A demonstrates that the time to occlusion in mice administered a single 10 mg/kg dose of AD-67244 is not significantly different that the time to occlusion in mice administered PBS. FIG. 9B demonstrates that at Day 10 post-dose there was greater than a 97% knockdown of F12 mRNA.


As discussed above, AD-67244 effectively inhibits platelet and fibrin deposition. AD-67244 also inhibits both venous and arterial thrombus formation. Accordingly, in order to determine whether the anti-thrombotic effect of AD-67244 increases bleeding risk by impairing hemostasis, two well-known mouse models of hemostasis were used; the saphenous vein bleeding mouse model and the mouse tail tip transection model.


In the saphenous vein bleeding model, mice (n=8) were administered a single subcutaneous 10 mg/kg dose of AD-67244 or PBS control (n=8). At Day 10 post-dose, the right saphenous vein of the mice was transected and blood was gently wicked away until hemostasis occurred. The clot was then removed to restart bleeding and the blood was again wicked away until hemostasis re-occured. Clot disruption was repeated after every incidence of hemostasis for 30 minutes. The time required for each hemostasis was measured.


As demonstrated in FIG. 10A, administration of AD-67244 did not inhibit hemostasis as compared to administration of PBS.


In the tail tip transection model, mice (n=8) were administered a single subcutaneous 10 mg/kg dose of AD-67244, PBS control (n=8), or 300 U/kg heparin At Day 10 post-dose, the tail was transected 1-5 mm from the tip and bleeding from the tail tip was monitored until cessation. The time to hemostasis or blood flow cessation was monitored. As demonstrated in FIG. 10B, unlike heparin administration, administration of AD-67244 did not inhibit hemostasis.


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) agent that inhibits the expression of F12 for use in treating a subject having a contact activation pathway-associated disease, wherein the dsRNA agent comprises a sense strand and an antisense strand forming a double stranded region, wherein the antisense strand comprises at least 15 contiguous nucleotides differing b no more than 3 nucleotides from the nucleotide sequence of
  • 2. (canceled)
  • 3. (canceled)
  • 4. The dsRNA agent of claim 1, wherein the subject is a human.
  • 5. The dsRNA agent of claim 1, wherein the contact activation pathway-associated disease is selected from the group consisting of thrombophilia, hereditary angioedema (HAE), Flectcher Factor Deficiency, or essential hypertension.
  • 6. The dsRNA agent of claim 1, wherein the administration of the dsRNA agent to the subject decreases platelet deposition in the subject; and/or decreases fibrin deposition in the subject.
  • 7. (canceled)
  • 8. The dsRNA agent of claim 1, wherein the dsRNA is suitable for administration to the subject at a dose of about 0.01 mg/kg to about 10 mg/kg or about 0.5 mg/kg to about 50 mg/kg.
  • 9. The dsRNA agent of claim 1, wherein the dsRNA agent is suitable for subcutaneous administration to the subject.
  • 10. (canceled)
  • 11. The dsRNA agent of claim 1, wherein each strand is no more than 30 nucleotides in length.
  • 12. The dsRNA agent of claim 1, wherein the dsRNA agent comprises at least one nucleotide modification.
  • 13. The dsRNA agent of claim 12, wherein substantially all of the nucleotides of the dsRNA agent comprise a nucleotide modification.
  • 14. The dsRNA agent of claim 12, wherein the nucleotide modification is selected from the group consisting of a deoxy-nucleotide modification, a 3′-terminal deoxy-thymine (dT) nucleotide modification, a 2′—O-methyl nucleotide modification, a 2′-fluoro nucleotide modification, a 2′-deoxy nucleotide modification, a locked nucleotide modification, an unlocked nucleotide modification, a conformationally restricted nucleotide modification, a constrained ethyl nucleotide modification, an abasic nucleotide modification, a 2′-amino nucleotide modification, a 2′—O-allyl-nucleotide modification, 2′-C-alkyl nucleotide modification, 2′-hydroxly-nucleotide modification, a 2′-methoxyethyl nucleotide modification, a 2′—O-alkyl-nucleotide modification, a morpholino nucleotide modification, a phosphoramidate modification, a non-natural base comprising nucleotide modification, a tetrahydropyran nucleotide modification, a 1,5-anhydrohexitol nucleotide modification, a cyclohexenyl nucleotide modification, a nucleotide comprising a phosphorothioate group modification, a nucleotide comprising a methylphosphonate group modification, a nucleotide comprising a 5′-phosphate modification, and a nucleotide comprising a 5′-phosphate mimic modification.
  • 15. The dsRNA agent of claim 1, wherein the dsRNA agent further comprises at least one phosphorothioate internucleotide linkage.
  • 16. The dsRNA agent of claim 1, wherein at least one strand of the dsRNA agent comprises a 3′ overhang of at least 1 nucleotide.
  • 17. The dsRNA agent of claim 1, wherein the dsRNA agent further comprises a ligand.
  • 18. The dsRNA agent of claim 17, wherein the ligand is conjugated to the 3′ end of the sense strand of the dsRNA agent.
  • 19. The dsRNA agent of claim 17, wherein the ligand is an N-acetylgalactosamine (GalNAc) derivative through a monovalent, a bivalent, or a trivalent branched linker.
  • 20. The dsRNA agent of claim 19, wherein the N-acetylgalactosamine (GalNAc) derivative is
  • 21. The dsRNA agent of claim 20, wherein the dsRNA is conjugated to the ligand as shown in the following schematic
  • 22. The dsRNA agent of claim 21, wherein X is O.
  • 23. The dsRNA agent of claim 1, wherein the dsRNA agent comprises a sense strand comprising the nucleotide sequence of 5′-AACUCAAUAAAGUGCUUUGAA-3′ (SEQ ID NO:891), and an antisense strand comprising the nucleotide sequence of 5′-UUCAAAGCACUUUAUUGAGUUUC-3′ (SEQ ID NO:899).
  • 24. The dsRNA agent of claim 23, wherein the dsRNA agent comprises a sense strand comprising the sequence of 5′-asascucaAfuAfAfAfgugcuuugaa-3′ (SEQ ID NO:907) and an antisense strand comprising the sequence of 5′-usUfscaaAfgCfAfcuuuAfuUfgaguususc-3′ (SEQ ID NO:915), and wherein a, c, g, and u are 2′—O-methyl (2′—OMe) A, C, G, and U; Af, Cf, Gf, and Uf are 2′-fluoro A, C, G, and U; and s is a phosphorothioate linkage.
  • 25. (canceled)
RELATED APPLICATIONS

The present application is a continuation of U.S. patent application Ser. No. 17/487,019, filed on Sep. 28, 2021, which is a continuation of U.S. patent application Ser. No. 16/621,754, filed on Dec. 12, 2019, which is a 35 U.S.C. § 371 national stage filing of International Application No. PCT/US2018/040967, filed on Jul. 6, 2018, which in turn claims the benefit of priority to U.S. Provisional Patent Application No. 62/529,664, filed on Jul. 7, 2017. The entire contents of each of the foregoing applications are incorporated herein by reference. The present application is related to U.S. Provisional Patent Application No. 62/157,890, filed on May 6, 2015, U.S. Provisional Patent Application No. 62/260,887, filed on Nov. 30, 2015, U.S. Provisional Patent Application No. 62/266,958, filed on Dec. 14, 2015, and International Application No. PCT/US2016/030876, filed on May 5, 2016. The entire contents of each of the foregoing applications are incorporated herein by reference.

Provisional Applications (1)
Number Date Country
62529664 Jul 2017 US
Continuations (2)
Number Date Country
Parent 17487019 Sep 2021 US
Child 18234952 US
Parent 16621754 Dec 2019 US
Child 17487019 US