MODULATION OF INFLAMMATORY RESPONSES BY FACTOR XI

Abstract
Disclosed herein are antisense compounds and methods for modulating Factor XI and modulating an inflammatory disease, disorder or condition in an individual in need thereof. Inflammatory diseases in an individual such as arthritis and colitis can be ameliorated or prevented with the administration of antisense compounds targeted to Factor XI.
Description
SEQUENCE LISTING

The present application is being filed along with a Sequence Listing in electronic format. The Sequence Listing is provided as a file entitled BIOL0109WOSEQ.TXT created Apr. 14, 2010, which is 84 Kb in size. The information in the electronic format of the sequence listing is incorporated herein by reference in its entirety.


FIELD OF THE INVENTION

The present invention provides methods, compounds, and compositions for modulating an inflammatory response by administering a Factor XI modulator to an animal.


BACKGROUND OF THE INVENTION
Factor XI

Factor XI, synthesized in the liver, is a member of the coagulation cascade “intrinsic pathway” which ultimately activates thrombin to prevent blood loss. The intrinsic pathway is triggered by activation of Factor XII to XIIa. Factor XIIa converts Factor XI to Factor XIa, and Factor XIa converts Factor IX to Factor IXa. Factor IXa associates with its cofactor Factor VIIIa to convert Factor X to Factor Xa. Factor Xa associates Factor Va to convert prothrombin (Factor II) to thrombin (Factor IIa).


Factor XI deficiency (also known as plasma thromboplastin antecedent (PTA) deficiency, Rosenthal syndrome and hemophilia C) is an autosomal recessive disease associated with a tendency to bleed. Most patients with Factor XI deficiency do not bleed spontaneously but can bleed seriously after trauma. Low levels of Factor XI can also occur in other disease states, including Noonan syndrome.


Inflammation

Inflammation is a complex biological process of the body in response to an injury or abnormal stimulation caused by a physical, chemical or biological stimulus. Inflammation is a protective process by which the body attempts to remove the injury or stimulus and begins to heal affected tissue in the body.


The inflammatory response to injury or stimulus is characterized by clinical signs of increased redness (rubor), temperature (calor), swelling (tumor), pain (dolor) and/or loss of function (functio laesa) in a tissue. Increased redness and temperature is caused by vasodilation leading to increased blood supply at core body temperature to the inflamed tissue site. Swelling is caused by vascular permeability and accumulation of protein and fluid at the inflamed tissue site. Pain is due to the release of chemicals (e.g. bradykinin) at the inflamed tissue site that stimulate nerve endings. Loss of function may be due to several causes.


Inflammation is now recognized as a type of non-specific immune response to an injury or stimulus. The inflammatory response has a cellular component and an exudative component. In the cellular component, resident macrophages at the site of injury or stimulus initiate the inflammatory response by releasing inflammatory mediators such as TNFalpha, IFNalpha, IL-1, IL-6, IL12, IL-18 and others. Leukocytes are then recruited to move into the inflamed tissue area and perform various functions such as release of additional cellular mediators, phagocytosis, release of enzymatic granules and other functions. The exudative component involves the passage of plasma fluid containing proteins from blood vessels to the inflamed tissue site. Inflammatory mediators such as bradykinin, nitric oxide, and histamine cause blood vessels to become dilated, slow the blood flow in the vessels and increase the blood vessel permeability, allowing the movement of fluid and protein into the tissue. Biochemical cascades are activated in order to propagate the inflammatory response (e.g., complement system in response to infection, fibrinolysis and coagulation systems in response to necrosis due to a burn or trauma, kinin system to sustain inflammation) (Robbins Pathologic Basis of Disease, Philadelphia, W.B Saunders Company).


Inflammation can be acute or chronic. Acute inflammation has a fairly rapid onset, quickly becomes severe and quickly and distinctly clears after a few days to a few weeks. Chronic inflammation can begin rapidly or slowly and tends to persist for weeks, months or years with a vague and indefinite termination. Chronic inflammation can result when an injury or stimulus, or products resulting from its presence, persists at the site of injury or stimulation and the body's immune response is not sufficient to overcome its effects.


Inflammatory responses, although generally helpful to the body to clear an injury or stimulus, can sometimes cause injury to the body. In some cases, a body's immune response inappropriately triggers an inflammatory response where there is no known injury or stimulus to the body. In these cases, categorized as autoimmune diseases, the body attacks its own tissues causing injury to its own tissues.


Treatment to decrease inflammation includes non-steroidal anti-inflammatory drugs (NSAIDS) as well as disease modifying drugs. Many of these drugs have unwanted side effects. For example, with NSAIDS, the most common side effects are nausea, vomiting, diarrhea, constipation, decreased appetite, rash, dizziness, headache, and drowsiness. NSAIDs may also cause fluid retention, leading to edema. The most serious side effects are kidney failure, liver failure, ulcers and prolonged bleeding after an injury or surgery.


Accordingly, there is a need to find alternative treatments for inflammation with more attractive clinical profiles. Little is known about the role of Factor XI in inflammation making it an attractive target for investigation. Antisense technology is emerging as an effective means for reducing the expression of certain gene products and may therefore prove to be uniquely useful in a number of therapeutic, diagnostic, and research applications for the modulation of Factor XI.


SUMMARY OF THE INVENTION

Provided herein are methods, compounds, and compositions for modulating levels of Factor XI mRNA and/or protein in an animal. Provided herein are methods, compounds, and compositions for modulating levels of Factor XI mRNA and/or protein in an animal in order to modulate an inflammatory response in the animal. Also provided herein are methods, compounds, and compositions for administering a therapeutically effective amount of a compound targeting Factor XI to an animal for ameliorating an inflammatory disease in an animal; treating an animal at risk for an inflammatory disease; inhibiting Factor XI expression in an animal suffering from an inflammatory disease; and reducing the risk of inflammatory disease in an animal.


In certain embodiments, Factor XI specific inhibitors modulate (i.e., decrease) levels of Factor XI mRNA and/or protein. In certain embodiments, Factor XI specific inhibitors are nucleic acids, proteins, or small molecules.


In certain embodiments, an animal at risk for an inflammatory disease is treated by administering to the animal a therapeutically effective amount of a compound comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides, wherein the modified oligonucleotide is complementary to a Factor XI nucleic acid as shown in SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274 or a therapeutically effective amount of a compound comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from any one of nucleobase sequences recited in SEQ ID NOs: 15 to 269.


In certain embodiments, an animal having an inflammatory disease is treated by administering to the animal a therapeutically effective amount of a compound comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides, wherein the modified oligonucleotide is complementary to a Factor XI nucleic acid as shown in SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274 or a therapeutically effective amount of a compound comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from any one of nucleobase sequences recited in SEQ ID NOs: 15 to 269 or comprises at least 8 contiguous nucleobases complementary to a target segment or target region as described herein. In certain embodiments the modified oligonucleotide has a nucleobase sequence comprising a contiguous nucleobase portion of a nucleobase sequence selected from any one of nucleobase sequences recited in SEQ ID NOs: 15 to 269 or comprises a contiguous nucleobase portion complementary to a target segment or target region as described herein.


In certain embodiments, modulation can occur in a cell, tissue, organ or organism. In certain embodiments, the cell, tissue or organ is in an animal. In certain embodiments, the animal is a human. In certain embodiments, Factor XI mRNA levels are reduced. In certain embodiments, Factor XI protein levels are reduced. Such reduction can occur in a time-dependent manner or in a dose-dependent manner.


Also provided are methods, compounds, and compositions useful for preventing, treating, and ameliorating diseases, disorders, and conditions related to inflammation. In certain embodiments, such diseases, disorders, and conditions are inflammatory diseases, disorders or conditions.


In certain embodiments, methods of treatment include administering a Factor XI specific inhibitor to an individual in need thereof.


In certain embodiments, the inflammation is not sepsis related. In certain embodiments, the inflammation is not related to infection.


Also provided are compounds and compositions that include a modified oligonucleotide consisting of 12 to 30 linked nucleosides, wherein the modified oligonucleotide is complementary to a Factor XI nucleic acid as shown in SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274. In certain embodiments the modified oligonucleotide has a nucleobase sequence comprising a contiguous nucleobase portion of a nucleobase sequence selected from any one of nucleobase sequences recited in SEQ ID NOs: 15 to 269 or comprises a contiguous nucleobase portion complementary to a target segment or target region as described herein. In certain embodiments, the modified oligonucleotide has a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15-269 or comprises at least 8 contiguous nucleobases complementary to a target segment or target region as described herein.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 displays charts illustrating the effects of antisense oligonucleotide (ASO) inhibition on collagen-induced arthritis (CIA) in mice, as described in Example 11, infra. FIG. 1A displays the effect of ASO treatment on the percentage of mice developing CIA. Factor XI ASO treated mice developed a lower incidence of CIA compared to the untreated and Factor VII treated mice. FIG. 1B displays the effect of ASO treatment on the percentage of arthritis affected paws in mice. Factor XI ASO treated mice developed a lower incidence of affected paws compared to the untreated and Factor VII treated mice.



FIG. 2 displays charts illustrating the effects of antisense oligonucleotide (ASO) inhibition on collagen-induced arthritis (CIA) in mice, as described in Example 11, infra. FIG. 2A displays the effect of ASO treatment on the average number of affected paws in mice. Factor XI ASO treated mice had fewer affected paws on average. FIG. 2B displays the effect of ASO treatment on the arthritis severity in the mice. Factor XI ASO treated mice developed less severe arthritis than the control mice.



FIG. 3 displays a timeline of the effect of CIA incidence in mice with or without ASO treatment, as described in Example 11, infra. Factor XI ASO treated mice developed CIA at a later stage with fewer affected mice.



FIG. 4 displays charts showing the arthritis severity and liver quantities of Factor XI mRNA in collagen induced arthritic mice with or without Factor XI antisense treatment, as described in Example 11, infra. FIG. 4A shows the arthritis severity in the collagen induced arthritic mice after 10 weeks of treatment with Factor XI antisense oligonucleotide ISIS 404071 (F11#1), ISIS 404057 (F11#2) or control oligonucleotide (F11 MM). FIG. 4B shows the effect of the same oligonucleotides on Factor XI mRNA in the liver of the treated mice



FIG. 5 displays charts showing the effect of Factor XI antisense oligonucleotide treatment on organ weight, as described in Example 11, infra. FIG. 5A shows the liver weight of the treated mice as a percent of the body weight of the mice. FIG. 5B shows the spleen weight of the treated mice as a percent of the body weight of the mice.



FIG. 6 displays charts showing the effect of Factor XI antisense oligonucleotide treatment on liver enzymes, as described in Example 11, infra. FIG. 6A shows the ALT level. FIG. 6B shows the AST level.



FIG. 7 displays a timeline and charts illustrating the effect of antisense oligonucleotide (ASO) inhibition on colitis in mice, as described in Example 12, infra. FIG. 7A displays a timeline of the effect of DSS-induced colitis incidence with or without ASO treatment on the body weight of mice. The timeline is a measure of the body weights at different time points as a percentage of the body weight at the start of the study. Factor XI ASO treated mice did not have any significant change in body weight during the study period. FIG. 7B displays the final body weight change compared to the DSS control on day 6. The PBS control mice and Factor VII ASO treated mice had a decrease in body weight. The Factor XI ASO treated mice had no significant change in body weight. FIG. 7C displays the colon length measurements after the treatment period. The PBS control mice and Factor VII ASO treated mice had a decrease in colon length. The Factor XI ASO treated mice had no significant change in colon length.



FIG. 8 displays histological slides of mouse colon tissue stained with hematoxylin and eosin as described in Example 12, infra. FIG. 8A displays mouse colon tissue from control mice injected subcutaneously with PBS only and has normal colon histology appearance. FIG. 8B displays mouse colon tissue from mice treated with DSS to induce colitis. The tissue shows lesions of ulcerative colitis consisting of mucosa ulcers (2-4/animal), diffused neutrophil infiltration throughout the entire colon, submucosa edema and muscularis propria thickening. FIG. 8C displays mouse colon tissue from mice treated with Factor VII ASO and subsequently with DSS to induce colitis and shows the same histology as the DSS control. FIG. 8D displays mouse colon tissue from mice treated with Factor XI and subsequently with DSS to induce colitis and shows significantly milder ulcerative colitis lesions with less mucosa ulcers (>1/animal) compared to the DSS control.



FIG. 9 displays a timeline and chart illustrating the effect of antisense oligonucleotide (ASO) inhibition on colitis in mice, as described in Example 12, infra. FIG. 9A displays the timeline of the effect of treatment with PBS, Factor XI ASO (ISIS 404071), Factor XI ASO (ISIS 404057), or a control ASO (ISIS 421208) on the body weight of DSS-induced colitis mice. The timeline is a measure of the body weights at different time points as a percentage of the body weight at the start of the study. ISIS 404071 treated mice and ISIS 404057 treated mice did not have any significant change in body weight during the study period. FIG. 9B displays the final body weight change compared to the DSS control at the end of the study period on day 7. ISIS 404071 treated mice and ISIS 404057 treated mice did not have any significant change in body weight. Astericks in the chart denote statistically significant changes from the DSS only treated mice.



FIG. 10 displays charts illustrating the effect of antisense oligonucleotide (ASO) inhibition on colitis in mice, as described in Example 12, infra. FIG. 10 displays Factor XI mRNA levels in the liver of mice treated with the following: 1) PBS only as a control; 2) PBS and subsequently with DSS to induce colitis; 3) ISIS 404071 and subsequently with DSS to induce colitis; 4) ISIS 404057 and subsequently with DSS to induce colitis; and 5) with control ASO ISIS 421208 and subsequently with DSS to induce colitis.



FIG. 11 displays a timeline and charts illustrating the dose response effect of Factor XI antisense oligonucleotide (ASO) inhibition on colitis in mice, as described in Example 12, infra. Doses of 10 mg/kg Factor XI ASO, 20 mg/kg Factor XI ASO, 40 mg/kg Factor XI ASO or 40 mg/kg of a control non-Factor XI ASO were administered to DSS-induced colitis mice. FIG. 11A displays the timeline of the effect of treatment with the various doses of Factor XI ASO on body weight in DSS-induced colitis mice. FIG. 11B displays the effect of the various doses of Factor XI ASO on stool softness/diarrhea in the DSS-induced colitis mice. FIG. 11C displays the effect of the various doses of Factor XI ASO on colon lengths in the DSS-induced colitis mice.





DETAILED DESCRIPTION OF THE INVENTION

It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed. Herein, the use of the singular includes the plural unless specifically stated otherwise. As used herein, the use of “or” means “and/or” unless stated otherwise. Furthermore, the use of the term “including” as well as other forms, such as “includes” and “included”, is not limiting. Also, terms such as “element” or “component” encompass both elements and components comprising one unit and elements and components that comprise more than one subunit, unless specifically stated otherwise.


The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter described. All documents, or portions of documents, cited in this application, including, but not limited to, patents, patent applications, articles, books, and treatises, are hereby expressly incorporated by reference for the portions of the document discussed herein, as well as in their entirety.


DEFINITIONS

Unless specific definitions are provided, the nomenclature utilized in connection with, and the procedures and techniques of, analytical chemistry, synthetic organic chemistry, and medicinal and pharmaceutical chemistry described herein are those well known and commonly used in the art. Standard techniques may be used for chemical synthesis, and chemical analysis. Where permitted, all patents, applications, published applications and other publications, GENBANK Accession Numbers and associated sequence information obtainable through databases such as National Center for Biotechnology Information (NCBI) and other data referred to throughout the disclosure herein are incorporated by reference for the portions of the document discussed herein, as well as in their entirety.


Unless otherwise indicated, the following terms have the following meanings:


“2′-O-methoxyethyl” (also 2′-MOE and 2′-O(CH2)2—OCH3) refers to an O-methoxy-ethyl modification of the 2′ position of a furosyl ring. A 2′-O-methoxyethyl modified sugar is a modified sugar.


“2′-O-methoxyethyl nucleotide” means a nucleotide comprising a 2′-O-methoxyethyl modified sugar moiety.


“5-methylcytosine” means a cytosine modified with a methyl group attached to the 5′ position. A 5-methylcytosine is a modified nucleobase.


“Active pharmaceutical agent” means the substance or substances in a pharmaceutical composition that provide a therapeutic benefit when administered to an individual. For example, in certain embodiments an antisense oligonucleotide targeted to Factor XI is an active pharmaceutical agent.


“Active target region” or “target region” means a region to which one or more active antisense compounds is targeted. “Active antisense compounds” means antisense compounds that reduce target nucleic acid levels or protein levels.


“Administered concomitantly” refers to the co-administration of two agents in any manner in which the pharmacological effects of both are manifest in the patient at the same time. Concomitant administration does not require that both agents be administered in a single pharmaceutical composition, in the same dosage form, or by the same route of administration. The effects of both agents need not manifest themselves at the same time. The effects need only be overlapping for a period of time and need not be coextensive.


“Administering” means providing a pharmaceutical agent to an individual, and includes, but is not limited to administering by a medical professional and self-administering.


“Amelioration” refers to a lessening of at least one indicator, sign, or symptom of an associated disease, disorder, or condition. In certain embodiments, amelioration includes a delay or slowing in the progression of one or more indicators of a condition or disease. The severity of indicators may be determined by subjective or objective measures, which are known to those skilled in the art. For example, amelioration of arthritis in collagen-induced arthritic mice can be determined by clinically scoring the amount of arthritis in the mice as described by Marty et al. (J. Clin. Invest 107:631-640 (2001)).


“Animal” refers to a human or non-human animal, including, but not limited to, mice, rats, rabbits, dogs, cats, pigs, and non-human primates, including, but not limited to, monkeys and chimpanzees.


“Antidote compound” refers to a compound capable decreasing the intensity or duration of any antisense activity.


“Antidote oligonucleotide” means an antidote compound comprising an oligonucleotide that is complementary to and capable of hybridizing with an antisense compound.


“Antidote protein” means an antidote compound comprising a peptide.


“Antibody” refers to a molecule characterized by reacting specifically with an antigen in some way, where the antibody and the antigen are each defined in terms of the other. Antibody may refer to a complete antibody molecule or any fragment or region thereof, such as the heavy chain, the light chain, Fab region, and Fc region.


“Antisense activity” means any detectable or measurable activity attributable to the hybridization of an antisense compound to its target nucleic acid. In certain embodiments, antisense activity is a decrease in the amount or expression of a target nucleic acid or protein encoded by such target nucleic acid.


“Antisense compound” means an oligomeric compound that is capable of undergoing hybridization to a target nucleic acid through hydrogen bonding.


“Antisense inhibition” means reduction of target nucleic acid levels or target protein levels in the presence of an antisense compound complementary to a target nucleic acid compared to target nucleic acid levels or target protein levels in the absence of the antisense compound.


“Antisense oligonucleotide” means a single-stranded oligonucleotide having a nucleobase sequence that permits hybridization to a corresponding region or segment of a target nucleic acid.


“Bicyclic sugar” means a furosyl ring modified by the bridging of two non-geminal ring atoms. A bicyclic sugar is a modified sugar.


“Bicyclic nucleic acid” or “BNA” refers to a nucleoside or nucleotide wherein the furanose portion of the nucleoside or nucleotide includes a bridge connecting two carbon atoms on the furanose ring, thereby forming a bicyclic ring system.


“Cap structure” or “terminal cap moiety” means chemical modifications, which have been incorporated at either terminus of an antisense compound.


“Chemically distinct region” refers to a region of an antisense compound that is in some way chemically different than another region of the same antisense compound. For example, a region having 2′-O-methoxyethyl nucleotides is chemically distinct from a region having nucleotides without 2′-O-methoxyethyl modifications.


“Chimeric antisense compound” means an antisense compound that has at least two chemically distinct regions.


“Co-administration” means administration of two or more pharmaceutical agents to an individual. The two or more pharmaceutical agents may be in a single pharmaceutical composition, or may be in separate pharmaceutical compositions. Each of the two or more pharmaceutical agents may be administered through the same or different routes of administration. Co-administration encompasses concomitant, parallel or sequential administration.


“Coagulation factor” means any of factors I, II, III, IV, V, VII, VIII, IX, X, XI, XII, or XIII in the blood coagulation cascade. “Coagulation factor nucleic acid” means any nucleic acid encoding a coagulation factor. For example, in certain embodiments, a coagulation factor nucleic acid includes, without limitation, a DNA sequence encoding a coagulation factor (including genomic DNA comprising introns and exons), an RNA sequence transcribed from DNA encoding a coagulation factor, and an mRNA sequence encoding a coagulation factor. “Coagulation factor mRNA” means an mRNA encoding a coagulation factor protein.


“Complementarity” means the capacity for pairing between nucleobases of a first nucleic acid and a second nucleic acid.


“Contiguous nucleobases” means nucleobases immediately adjacent to each other.


“Diluent” means an ingredient in a composition that lacks pharmacological activity, but is pharmaceutically necessary or desirable. For example, the diluent in an injected composition may be a liquid, e.g. saline solution.


“Disease modifying drug” refers to any agent that modifies the symptoms and/or progression associated with an inflammatory disease, disorder or condition, including autoimmune diseases (e.g. arthritis, colitis or diabetes), trauma or surgery-related disorders, sepsis, allergic inflammation and asthma. DMARDs modify one or more of the symptoms and/or disease progression associated with these diseases, disorders or conditions.


“Dose” means a specified quantity of a pharmaceutical agent provided in a single administration, or in a specified time period. In certain embodiments, a dose may be administered in one, two, or more boluses, tablets, or injections. For example, in certain embodiments where subcutaneous administration is desired, the desired dose requires a volume not easily accommodated by a single injection, therefore, two or more injections may be used to achieve the desired dose. In certain embodiments, the pharmaceutical agent is administered by infusion over an extended period of time or continuously. Doses may be stated as the amount of pharmaceutical agent per hour, day, week, or month.


“Effective amount” means the amount of active pharmaceutical agent sufficient to effectuate a desired physiological outcome in an individual in need of the agent. The effective amount may vary among individuals depending on the health and physical condition of the individual to be treated, the taxonomic group of the individuals to be treated, the formulation of the composition, assessment of the individual's medical condition, and other relevant factors.


“Factor XI”, “FXI”, “Factor 11” and “F11” is used interchangeably herein.


“Factor XI nucleic acid” or “Factor XI nucleic acid” means any nucleic acid encoding Factor XI. For example, in certain embodiments, a Factor XI nucleic acid includes a DNA sequence encoding Factor XI, an RNA sequence transcribed from DNA encoding Factor XI (including genomic DNA comprising introns and exons), and an mRNA sequence encoding Factor XI. “Factor XI mRNA” means an mRNA encoding a Factor XI protein.


“Factor XI specific inhibitor” refers to any agent capable of specifically inhibiting the expression of Factor XI mRNA and/or Factor XI protein at the molecular level. For example, Factor XI specific inhibitors include nucleic acids (including antisense compounds), peptides, antibodies, small molecules, and other agents capable of inhibiting the expression of Factor XI mRNA and/or Factor XI protein. In certain embodiments, by specifically modulating Factor XI mRNA level and/or Factor XI protein expression, Factor XI specific inhibitors may affect components of the inflammatory pathway. Similarly, in certain embodiments, Factor XI specific inhibitors may affect other molecular processes in an animal.


“Factor XI specific inhibitor antidote” means a compound capable of decreasing the effect of a Factor XI specific inhibitor. In certain embodiments, a Factor XI specific inhibitor antidote is selected from a Factor XI peptide; a Factor XI antidote oligonucleotide, including a Factor XI antidote compound complementary to a Factor XI antisense compound; and any compound or protein that affects the intrinsic or extrinsic coagulation pathway.


“Fully complementary” or “100% complementary” means each nucleobase of a first nucleic acid has a complementary nucleobase in a second nucleic acid. In certain embodiments, a first nucleic acid is an antisense compound and a target nucleic acid is a second nucleic acid.


“Gapmer” means a chimeric antisense compound in which an internal region having a plurality of nucleosides that support RNase H cleavage is positioned between external regions having one or more nucleosides, wherein the nucleosides comprising the internal region are chemically distinct from the nucleoside or nucleosides comprising the external regions. The internal region may be referred to as a “gap segment” and the external regions may be referred to as “wing segments.”


“Gap-widened” means a chimeric antisense compound having a gap segment of 12 or more contiguous 2′-deoxynucleosides positioned between and immediately adjacent to 5′ and 3′ wing segments having from one to six nucleosides.


“Hybridization” means the annealing of complementary nucleic acid molecules. In certain embodiments, complementary nucleic acid molecules include an antisense compound and a target nucleic acid.


“Identifying an animal at risk for an inflammatory disease, disorder or condition” means identifying an animal having been diagnosed with an inflammatory disease, disorder or condition or identifying an animal predisposed to develop an inflammatory disease, disorder or condition. Individuals predisposed to develop an inflammatory disease, disorder or condition, for example in individuals with a familial history of colitis or arthritis. Such identification may be accomplished by any method including evaluating an individual's medical history and standard clinical tests or assessments.


“Immediately adjacent” means there are no intervening elements between the immediately adjacent elements.


“Individual” means a human or non-human animal selected for treatment or therapy.


“Inflammatory response” refers to any disease, disorder or condition related to inflammation in an animal. Examples of inflammatory responses include an immune response by the body of the animal to clear the injury or stimulus responsible for initiating the inflammatory response. Alternatively, an inflammatory response can be initiated in the body even when no known injury or stimulus is found such as in autoimmune diseases. Inflammation can be mediated by a Th1 or a Th2 response. Th1 and Th2 responses include production of selective cytokines and cellular migration or recruitment to the inflammatory site. Cell types that can migrate to an inflammatory site include, but are not limited to, eosinophils and macrophages. Th1 cytokines include, but are not limited to IL-1, IL-6, TNFα, INFγ and keratinocyte chemoattractanct (KC). Th2 cytokines include, but are not limited to, IL-4 and IL-5. A decrease in cytokine(s) level or cellular migration can be an indication of decreased inflammation. Accordingly, cytokine level or cellular migration can be a marker for certain types of inflammation such as Th1 or Th2 mediated inflammation.


“Inflammatory disease”, “inflammatory disorder” or “inflammatory condition” means a disease, disorder or condition related to an inflammatory response to injury or stimulus characterized by clinical signs of increased redness (rubor), temperature (calor), swelling (tumor), pain (dolor) and/or loss of function (functio laesa) in a tissue.


“Internucleoside linkage” refers to the chemical bond between nucleosides.


“Linked nucleosides” means adjacent nucleosides which are bonded together.


“Mismatch” or “non-complementary nucleobase” or “MM” refers to the case when a nucleobase of a first nucleic acid is not capable of pairing with the corresponding nucleobase of a second or target nucleic acid.


“Modified internucleoside linkage” refers to a substitution or any change from a naturally occurring internucleoside bond (i.e. a phosphodiester internucleoside bond).


“Modified nucleobase” refers to any nucleobase other than adenine, cytosine, guanine, thymidine, or uracil. An “unmodified nucleobase” means the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C), and uracil (U).


“Modified nucleotide” means a nucleotide having, independently, a modified sugar moiety, modified internucleoside linkage, or modified nucleobase. A “modified nucleoside” means a nucleoside having, independently, a modified sugar moiety or modified nucleobase.


“Modified oligonucleotide” means an oligonucleotide comprising a modified internucleoside linkage, a modified sugar, or a modified nucleobase.


“Modified sugar” refers to a substitution or change from a natural sugar.


“Modulating” refers to changing or adjusting a feature in a cell, tissue, organ or organism. For example, modulating Factor XI mRNA can mean to increase or decrease the level of Factor XI mRNA and/or Factor XI protein in a cell, tissue, organ or organism. Modulating Factor XI mRNA and/or protein can lead to an increase or decrease in an inflammatory response in a cell, tissue, organ or organism. A “modulator” effects the change in the cell, tissue, organ or organism. For example, a Factor XI antisense oligonucleotide can be a modulator that increases or decreases the amount of Factor XI mRNA and/or Factor XI protein in a cell, tissue, organ or organism. “Motif” means the pattern of chemically distinct regions in an antisense compound.


“Naturally occurring internucleoside linkage” means a 3′ to 5′ phosphodiester linkage.


“Natural sugar moiety” means a sugar found in DNA (2′-H) or RNA (2′-OH).


“NSAID” refers to a Non-Steroidal Anti-Inflammatory Drug. NSAIDs reduce inflammatory reactions in a subject but in general do not ameliorate or prevent a disease from occurring or progressing.


“Nucleic acid” refers to molecules composed of monomeric nucleotides. A nucleic acid includes ribonucleic acids (RNA), deoxyribonucleic acids (DNA), single-stranded nucleic acids, double-stranded nucleic acids, small interfering ribonucleic acids (siRNA), and microRNAs (miRNA).


“Nucleobase” means a heterocyclic moiety capable of pairing with a base of another nucleic acid.


“Nucleobase sequence” means the order of contiguous nucleobases independent of any sugar, linkage, or nucleobase modification.


“Nucleoside” means a nucleobase linked to a sugar.


“Nucleotide” means a nucleoside having a phosphate group covalently linked to the sugar portion of the nucleoside.


“Oligomeric compound” or “oligomer” means a polymer of linked monomeric subunits which is capable of hybridizing to at least a region of a nucleic acid molecule.


“Oligonucleotide” means a polymer of linked nucleosides each of which can be modified or unmodified, independent one from another.


“Parenteral administration” means administration through injection or infusion. Parenteral administration includes subcutaneous administration, intravenous administration, intramuscular administration, intraarterial administration, intraperitoneal administration, or intracranial administration, e.g. intrathecal or intracerebroventricular administration.


“Peptide” means a molecule formed by linking at least two amino acids by amide bonds. Peptide refers to polypeptides and proteins.


“Pharmaceutical composition” means a mixture of substances suitable for administering to an individual. For example, a pharmaceutical composition may comprise one or more active pharmaceutical agents and a sterile aqueous solution.


“Pharmaceutically acceptable salts” means physiologically and pharmaceutically acceptable salts of antisense compounds, i.e., salts that retain the desired biological activity of the parent oligonucleotide and do not impart undesired toxicological effects thereto.


“Phosphorothioate linkage” means a linkage between nucleosides where the phosphodiester bond is modified by replacing one of the non-bridging oxygen atoms with a sulfur atom. A phosphorothioate linkage is a modified internucleoside linkage.


“Portion” means a defined number of contiguous (i.e. linked) nucleobases of a nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of a target nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of an antisense compound.


“Prevent” refers to delaying or forestalling the onset, development or progression of a disease, disorder, or condition for a period of time from minutes to indefinitely. Prevent also means reducing risk of developing a disease, disorder, or condition.


“Prodrug” means a therapeutic agent that is prepared in an inactive form that is converted to an active form within the body or cells thereof by the action of endogenous enzymes or other chemicals or conditions.


“Side effects” means physiological responses attributable to a treatment other than the desired effects. In certain embodiments, side effects include injection site reactions, liver function test abnormalities, renal function abnormalities, liver toxicity, renal toxicity, central nervous system abnormalities, myopathies, and malaise. For example, increased aminotransferase levels in serum may indicate liver toxicity or liver function abnormality. For example, increased bilirubin may indicate liver toxicity or liver function abnormality.


“Single-stranded oligonucleotide” means an oligonucleotide which is not hybridized to a complementary strand.


“Specifically hybridizable” refers to an antisense compound having a sufficient degree of complementarity between an antisense oligonucleotide and a target nucleic acid to induce a desired effect, while exhibiting minimal or no effects on non-target nucleic acids under conditions in which specific binding is desired, i.e. under physiological conditions in the case of in vivo assays and therapeutic treatments.


“Targeting” or “targeted” means the process of design and selection of an antisense compound that will specifically hybridize to a target nucleic acid and induce a desired effect.


“Target nucleic acid,” “target RNA,” and “target RNA transcript” all refer to a nucleic acid capable of being targeted by antisense compounds.


“Target segment” means the sequence of nucleotides of a target nucleic acid to which an antisense compound is targeted. “5′ target site” refers to the 5′-most nucleotide of a target segment.


“3′ target site” refers to the 3′-most nucleotide of a target segment.


“Th1 related disease, disorder or condition” means an inflammatory disease, disorder or condition mediated by a Th1 immune response. Examples of Th1 diseases include, but is not limited to, allergic diseases (e.g., allergic rhinitis), autimmune diseases (e.g, multiple sclerosis, arthritis, scleroderma, psoriasis, celiac disease), cardiovascular diseases, colitis, diabetes (e.g., type 1 insulin-dependent diabetes mellitus), hypersensitivities (e.g., Type 4 hypersensitivity), infectious diseases (e.g., viral infection, mycobacterial infection) and posterior uveitis.


“Th2 related disease, disorder or condition” means an inflammatory disease, disorder or condition mediated by a Th2 immune response. Examples of Th2 diseases include, but is not limited to, allergic diseases (e.g, chronic rhinosinusitis), airway hyperresponsiveness, asthma, atopic dermatitis, colitis, endometriosis, infectious diseases (e.g., helminth infection), thyroid disease (e.g., Graves' disease), hypersensitivities (e.g, Types 1, 2 or 3 hypersensitivity) and pancreatitis.


“Th1” or “Th2” responses include production of selective cytokines and cellular migration or recruitment to an inflammatory site. Cell types that can migrate to an inflammatory site include, but are not limited to, eosinophils and macrophages. Accordingly, cytokine level or cellular migration can be a marker for certain types of inflammation such as Th1 or Th2 mediated inflammation. Th1 markers include, but are not limited to cytokines IL-1, IL-6, TNFα, INFγ and keratinocyte chemoattractanct (KC). Th2 markers include, but are not limited to, eosinophil infiltration, mucus production and cytokines IL-4 and IL-5. A decrease in cytokine(s) level or cellular migration can be an indication of decreased inflammation.


“Therapeutically effective amount” means an amount of a pharmaceutical agent that provides a therapeutic benefit to an individual.


“Treat” refers to administering a pharmaceutical composition to an animal in order to effect an alteration or improvement of a disease, disorder, or condition in the animal. In certain embodiments, one or more pharmaceutical compositions can be administered to the animal.


“Unmodified nucleotide” means a nucleotide composed of naturally occurring nucleobases, sugar moieties, and internucleoside linkages. In certain embodiments, an unmodified nucleotide is an RNA nucleotide (i.e. β-D-ribonucleotide) or a DNA nucleotide (i.e. β-D-deoxyribonucleotide).


CERTAIN EMBODIMENTS

In certain embodiments, provided are methods, compounds, and compositions for modulating an inflammatory response by administering the compound to an animal, wherein the compound comprises a Factor XI modulator. Modulation of Factor XI can lead to an increase or decrease of Factor XI mRNA and protein expression in order to increase or decrease an inflammatory response as needed. In certain embodiments, Factor XI inhibition in an animal is reversed by administering a modulator targeting Factor XI. In certain embodiments of the invention, Factor XI is inhibited by the modulator. The Factor XI modulator can be a modified oligonucleotide targeting Factor XI.


In certain embodiments, provided are methods, compounds, and compositions for the treatment, prevention, or amelioration of inflammatory diseases, disorders and conditions associated with Factor XI in an animal in need thereof. In an embodiment, the method for ameliorating an inflammatory disease in an animal comprises administering to the animal a compound targeting Factor XI.


In certain embodiments provided are methods, compounds and compositions for treating an animal at risk for an inflammatory disease, disorder or condition, comprising administering a therapeutically effective amount of a compound targeting Factor XI to the animal at risk.


In certain embodiments, provided are methods, compounds and compositions for inhibiting Factor XI expression in an animal suffering from an inflammatory disease, disorder or condition, comprising administering a compound targeting Factor XI to the animal.


In certain embodiments, provided are methods, compounds and compositions for reducing the risk of inflammatory disease, disorder or condition, in an animal comprising administering a compound targeting Factor XI to the animal.


In certain embodiments, provided is a Factor XI modulator, wherein the Factor XI modulator is a Factor XI specific inhibitor, for use in treating, preventing, or ameliorating an inflammatory response, disease, disorder or condition. In certain embodiments, Factor XI specific inhibitors are nucleic acids (including antisense compounds), peptides, antibodies, small molecules, and other agents capable of inhibiting the expression of Factor XI mRNA and/or Factor XI protein.


In certain embodiments, the inflammatory disease, disorder or condition is a fibrin related inflammatory disease, disorder or condition.


In certain embodiments, the inflammatory disease, disorder or condition is not sepsis or infection related.


In certain embodiments, the inflammatory disease, disorder or condition is Th1 mediated. In certain embodiments, a marker for the Th1 mediated inflammatory disease, disorder or condition is decreased. Markers for Th1 include, but are not limited to cytokines such as IL-1, IL-6, TNF-α or KC. In certain embodiments, the compounds of the invention prevent or ameliorate a Th1 mediated disease. Th1 mediated diseases include, but is not limited to, allergic diseases (e.g., allergic rhinitis), autimmune diseases (e.g, multiple sclerosis, arthritis, scleroderma, psoriasis, celiac disease), cardiovascular diseases, colitis, diabetes (e.g., type 1 insulin-dependent diabetes mellitus), hypersensitivities (e.g., Type 4 hypersensitivity), infectious diseases (e.g., viral infection, mycobacterial infection) and posterior uveitis.


In certain embodiments, the inflammatory disease, disorder or condition is Th2 mediated. In certain embodiments, a marker for the Th2 mediated inflammatory disease, disorder or condition is decreased. Markers for Th2 include, but are not limited to, eosinophil infiltration to the site of inflammation, mucus production and cytokines such as IL-4, IL-5. In certain embodiments, the compounds of the invention prevent or ameliorate a Th2 mediated disease. Th2 mediated diseases include, but is not limited to, allergic diseases (e.g, chronic rhinosinusitis), airway hyperresponsiveness, asthma, atopic dermatitis, colitis, endometriosis, infectious diseases (e.g., helminth infection), thyroid disease (e.g., Graves' disease), hypersensitivities (e.g, Types 1, 2 or 3 hypersensitivity) and pancreatitis.


In certain embodiments, provided are compounds targeted to a Factor XI nucleic acid. In certain embodiments, the Factor XI nucleic acid is any of the sequences set forth in GENBANK Accession No. NM000128.3 (incorporated herein as SEQ ID NO: 1), nucleotides 19598000 to 19624000 of GENBANK Accession No. NT022792.17 (incorporated herein as SEQ ID NO: 2), and GENBANK Accession No. NM028066.1 (incorporated herein as SEQ ID NO: 6), exons 1-15 GENBANK Accession No. NW001118167.1 (incorporated herein as SEQ ID NO: 274).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide. In certain embodiments, the compound of the invention comprises a modified oligonucleotide consisting of 12 to 30 linked nucleosides.


In certain embodiments, the compound of the invention may comprise a modified oligonucleotide comprising a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. In certain embodiments, the compound of the invention may comprise a modified oligonucleotide comprising a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1.


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of a target region as set out below as nucleobase ranges on the target RNA sequence.


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 656 to 676 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 656 to 676 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 665 to 687 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 665 to 687 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 50% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 675 to 704 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 675 to 704 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 50% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 677 to 704 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 677 to 704 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 60% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 678 to 697 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 678 to 697 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 70% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 680 to 703 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 680 to 703 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3 and Example 14).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 683 to 702 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 683 to 702 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 90% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 738 to 759 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 738 to 759 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3 and Example 14).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 738 to 760 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 738 to 760 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 60% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 738 to 762 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 738 to 762 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 45% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1018 to 1042 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1018 to 1042 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1062 to 1089 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1089 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 70% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1062 to 1090 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1090 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 60% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1062 to 1091 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1091 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 20% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1275 to 1301 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1091 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1276 to 1301 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1091 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 14).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1284 to 1308 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1091 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1291 to 1317 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1062 to 1091 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the invention provides a compound comprising a modified oligonucleotide comprising a nucleobase sequence complementary to at least a portion of nucleobases 1275 to 1318 of SEQ ID NO: 1. Said modified oligonucleotide may comprise at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases complementary to an equal length portion of nucleobases 1275 to 1318 of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may comprise a nucleobase sequence 100% complementary to an equal length portion of SEQ ID NO: 1. Said modified oligonucleotide may achieve at least 70% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


Embodiments of the present invention provide compounds comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15 to 241.


Embodiments of the present invention provide compounds comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15 to 269.


Embodiments of the present invention provide compounds comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 242 to 269.


Certain embodiments of the present invention provide compounds comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15 to 269.


Certain embodiments of the present invention provide compounds comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 242 to 269.


In certain embodiments, the modified oligonucleotide comprises at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 nucleobases of a nucleobase sequence selected from ISIS Nos: 22, 31, 32, 34, 36 to 38, 40, 41, 43, 51 to 53, 55, 56, 59, 60, 64, 66, 71, 73, 75, 96, 98 to 103, 105 to 109, 113 to 117, 119, 124, 127, 129, 171, 172, 174, 176, 178, 179, 181 to 197, 199 to 211, and 213 to 232. In certain embodiments, the modified oligonucleotide comprises a nucleobase sequence selected from SEQ ID NOs: 22, 31, 32, 34, 36 to 38, 40, 41, 43, 51 to 53, 55, 56, 59, 60, 64, 66, 71, 73, 75, 96, 98 to 103, 105 to 109, 113 to 117, 119, 124, 127, 129, 171, 172, 174, 176, 178, 179, 181 to 197, 199 to 211, and 213 to 232. In certain embodiments, the modified oligonucleotide consists of a nucleobase sequence selected from SEQ ID NOs: 22, 31, 32, 34, 36 to 38, 40, 41, 43, 51 to 53, 55, 56, 59, 60, 64, 66, 71, 73, 75, 96, 98 to 103, 105 to 109, 113 to 117, 119, 124, 127, 129, 171, 172, 174, 176, 178, 179, 181 to 197, 199 to 211, and 213 to 232. Said modified oligonucleotide may achieve at least 70% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the modified oligonucleotide comprises at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 nucleobases of a nucleobase sequence selected from ISIS Nos: 22, 31, 34, 37, 40, 43, 51 to 53, 60, 98, 100 to 102, 105 to 109, 114, 115, 119, 171, 174, 176, 179, 181, 186, 188 to 193, 195, 196, 199 to 210, and 213 to 232. In certain embodiments, the modified oligonucleotide comprises a nucleobase sequence selected from SEQ ID NOs: 22, 31, 34, 37, 40, 43, 51 to 53, 60, 98, 100 to 102, 105 to 109, 114, 115, 119, 171, 174, 176, 179, 181, 186, 188 to 193, 195, 196, 199 to 210, and 213 to 232. In certain embodiments, the modified oligonucleotide consists of a nucleobase sequence selected from SEQ ID NOs: 22, 31, 34, 37, 40, 43, 51 to 53, 60, 98, 100 to 102, 105 to 109, 114, 115, 119, 171, 174, 176, 179, 181, 186, 188 to 193, 195, 196, 199 to 210, and 213 to 232. Said modified oligonucleotide may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the modified oligonucleotide comprises at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 nucleobases of a nucleobase sequence selected from ISIS Nos: 31, 37, 100, 105, 179, 190 to 193, 196, 202 to 207, 209, 210, 214 to 219, 221 to 224, 226, 227, 229 and 231. In certain embodiments, the modified oligonucleotide comprises a nucleobase sequence selected from SEQ ID NOs: 31, 37, 100, 105, 179, 190 to 193, 196, 202 to 207, 209, 210, 214 to 219, 221 to 224, 226, 227, 229 and 231. In certain embodiments, the modified oligonucleotide consists of a nucleobase sequence selected from SEQ ID NOs: 31, 37, 100, 105, 179, 190 to 193, 196, 202 to 207, 209, 210, 214 to 219, 221 to 224, 226, 227, 229 and 231. Said modified oligonucleotide may achieve at least 90% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 3).


In certain embodiments, the modified oligonucleotide comprises at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 nucleobases of a nucleobase sequence selected from SEQ ID NOs: 34, 52, 53, 114, 115, 190, 213 to 232, 242 to 260, and 262 to 266. In certain embodiments, the modified oligonucleotide comprises a nucleobase sequence selected from SEQ ID NOs: 34, 52, 53, 114, 115, 190, 213 to 232, 242 to 260, and 262 to 266. In certain embodiments, the modified oligonucleotide consists of a nucleobase sequence selected from SEQ ID NOs: 34, 52, 53, 114, 115, 190, 213 to 232, 242 to 260, and 262 to 266. Said modified oligonucleotides may achieve at least 70% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 14).


In certain embodiments, the modified oligonucleotide comprises at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 nucleobases of a nucleobase sequence selected from SEQ ID NOs: 34, 52, 53, 114, 115, 190, 213 to 216, 218 to 226, 243 to 246, 248, 249, 252 to 259, 264 and 265. In certain embodiments, the modified oligonucleotide comprises a nucleobase sequence selected from SEQ ID NOs: 34, 52, 53, 114, 115, 190, 213 to 216, 218 to 226, 243 to 246, 248, 249, 252 to 259, 264 and 265. In certain embodiments, the modified oligonucleotide consists of a nucleobase sequence selected from SEQ ID NOs: 34, 52, 53, 114, 115, 190, 213 to 216, 218 to 226, 243 to 246, 248, 249, 252 to 259, 264 and 265. Said modified oligonucleotides may achieve at least 80% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 14).


In certain embodiments, the modified oligonucleotide comprises at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19 or 20 nucleobases of a nucleobase sequence selected from SEQ ID NOs: 34, 190, 215, 222, 223, 226, 246 and 254. In certain embodiments, the modified oligonucleotide comprises a nucleobase sequence selected from SEQ ID NOs: 34, 190, 215, 222, 223, 226, 246 and 254. In certain embodiments, the modified oligonucleotide consists of a nucleobase sequence selected from SEQ ID NOs: 34, 190, 215, 222, 223, 226, 246 and 254. Said modified oligonucleotides may achieve at least 90% inhibition of human mRNA levels as determined using an RT-PCR assay method, optionally in HepG2 cells (e.g. as described in Example 14).


In certain embodiments, the compound of the invention consists of a single-stranded modified oligonucleotide.


In certain embodiments, the modified oligonucleotide consists of 12 to 30 linked nucleosides or 20 linked nucleosides.


In certain embodiments, the nucleobase sequence of the modified oligonucleotide is 100% complementary to a nucleobase sequence of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274.


In certain embodiments, the compound has at least one modified internucleoside linkage. In certain embodiments, the modified internucleoside linkage is a phosphorothioate internucleoside linkage. In certain embodiments, each modified internucleoside linkage is a phosphorothioate internucleoside linkage.


In certain embodiments, the compound has at least one nucleoside comprising a modified sugar. In certain embodiments, at least one modified sugar is a bicyclic sugar. In certain embodiments, at least one modified sugar comprises a 2′-O-methoxyethyl (2′MOE).


In certain embodiments, the compound has at least one nucleoside comprising a modified nucleobase. In certain embodiments, the modified nucleobase is a 5-methylcytosine.


In certain embodiments, the modified oligonucleotide of the compound comprises:


(i) a gap segment consisting of linked deoxynucleosides;


(ii) a 5′ wing segment consisting of linked nucleosides;


(iii) a 3′ wing segment consisting of linked nucleosides, wherein the gap segment is positioned immediately adjacent to and between the 5′ wing segment and the 3′ wing segment and wherein each nucleoside of each wing segment comprises a modified sugar.


In certain embodiments, the modified oligonucleotide of the compound comprises:


(i) a gap segment consisting of ten linked deoxynucleosides;


(ii) a 5′ wing segment consisting of linked nucleosides;


(iii) a 3′ wing segment consisting of linked nucleosides, wherein the gap segment is positioned immediately adjacent to and between the 5′ wing segment and the 3′ wing segment and wherein each nucleoside of each wing segment comprises a modified sugar.


In certain embodiments, the modified oligonucleotide of the compound comprises:


(i) a gap segment consisting of ten linked deoxynucleosides;


(ii) a 5′ wing segment consisting of five linked nucleosides;


(iii) a 3′ wing segment consisting of five linked nucleosides, wherein the gap segment is positioned immediately adjacent to and between the 5′ wing segment and the 3′ wing segment, wherein each nucleoside of each wing segment comprises a 2′-O-methoxyethyl sugar; and wherein each internucleoside linkage is a phosphorothioate linkage.


In certain embodiments, the modified oligonucleotide of the compound comprises:


(i) a gap segment consisting of fourteen linked deoxynucleosides;


(ii) a 5′ wing segment consisting of three linked nucleosides;


(iii) a 3′ wing segment consisting of three linked nucleosides, wherein the gap segment is positioned immediately adjacent to and between the 5′ wing segment and the 3′ wing segment, wherein each nucleoside of each wing segment comprises a 2′-O-methoxyethyl sugar; and wherein each internucleoside linkage is a phosphorothioate linkage.


In certain embodiments, the modified oligonucleotide of the compound comprises:


(i) a gap segment consisting of thirteen linked deoxynucleosides;


(ii) a 5′ wing segment consisting of two linked nucleosides;


(iii) a 3′ wing segment consisting of five linked nucleosides, wherein the gap segment is positioned immediately adjacent to and between the 5′ wing segment and the 3′ wing segment, wherein each nucleoside of each wing segment comprises a 2′-O-methoxyethyl sugar; and wherein each internucleoside linkage is a phosphorothioate linkage.


In certain embodiments, provided are methods, compounds and compositions for treating an animal at risk for an inflammatory disease, disorder or condition or an animal having an inflammatory disease, disorder or condition comprising administering to the animal a therapeutically effective amount of a compound comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides, wherein the modified oligonucleotide is complementary to a Factor XI nucleic acid as shown in SEQ ID NO: 1 or SEQ ID NO: 2.


In certain embodiments, provided are methods, compounds and compositions for treating an animal at risk for an inflammatory disease, disorder or condition or an animal having an inflammatory disease, disorder or condition comprising administering to the animal a therapeutically effective amount of a compound comprising a modified oligonucleotide consisting of 12 to 30 linked nucleosides and having a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from any one of nucleobase sequences recited in SEQ ID NOs: 15 to 269.


In certain embodiments, administration of a Factor XI modulator to an animal does not cause injurious bleeding in the animal or exacerbate a bleeding condition.


In certain embodiments, the animal is pre-treated with one or more Factor XI modulators.


In certain embodiments, the animal is a human.


In certain embodiments, the compounds of the invention treats, prevents or ameliorates an inflammatory response, disease, disorder or condition in an animal. In certain embodiments, the response, disease, disorder or condition is associated with Factor XI. In certain embodiments the inflammatory response, disease, disorder, or condition may include, but is not limited to, or may be due to or associated with arthritis, colitis, fibrosis, allergic inflammation and asthma, cardiovascular disease, diabetes, sepsis, immunoproliferative disease, antiphospholipid syndrome, graft-related diseases and autoimmune diseases, or any combination thereof.


Examples of arthritis include, but are not limited to, rheumatoid arthritis, juvenile rheumatoid arthritis, arthritis uratica, gout, chronic polyarthritis, periarthritis humeroscapularis, cervical arthritis, lumbosacral arthritis, osteoarthritis, psoriatic arthritis, enteropathic arthritis and ankylosing spondylitis.


Examples of colitis include, but are not limited to, ulcerative colitis, Inflammatory Bowel Disease (IBD) and Crohn's Disease.


Examples of graft-related disorders include, but are not limited to, graft versus host disease (GVHD), disorders associated with graft transplantation rejection, chronic rejection, and tissue or cell allografts or xenografts.


Examples of immunoproliferative diseases include, but are not limited to, cancers (e.g., lung cancers) and benign hyperplasias.


Examples of autoimmune diseases include, but are not limited to, lupus (e.g., lupus erythematosus, lupus nephritis), Hashimoto's thyroiditis, primary myxedema, Graves' disease, pernicious anemia, autoimmune atrophic gastritis, Addison's disease, diabetes (e.g. insulin dependent diabetes mellitus, type I diabetes mellitus, type II diabetes mellitus), good pasture's syndrome, myasthenia gravis, pemphigus, Crohn's disease, sympathetic ophthalmia, autoimmune uveitis, multiple sclerosis, autoimmune hemolytic anemia, idiopathic thrombocytopenia, primary biliary cirrhosis, chronic action hepatitis, ulcerative colitis, Sjogren's syndrome, rheumatic diseases (e.g., rheumatoid arthritis), polymyositis, scleroderma, psoriasis, and mixed connective tissue disease.


In certain embodiments, the compounds and compositions are administered to an animal to treat, prevent or ameliorate an inflammatory disease. In certain embodiments, administration to an animal is by a parenteral route. In certain embodiments, the parenteral administration is any of subcutaneous or intravenous administration.


In certain embodiments, the compound is co-administered with one or more second agent(s). In certain embodiments the second agent is a NSAID or a disease modifying drug.


NSAIDS include, but are not limited to, acetyl salicylic acid, choline magnesium salicylate, diflunisal, magnesium salicylate, salsalate, sodium salicylate, diclofenac, etodolac, fenoprofen, flurbiprofen, indomethacin, ketoprofen, ketorolac, meclofenamate, naproxen, nabumetone, phenylbutazone, piroxicam, sulindac, tolmetin, acetaminophen, ibuprofen, Cox-2 inhibitors, meloxicam and tramadol. The compound of the invention and one or more NSAIDS can be administered concomitantly or sequentially.


Examples of disease modifying drugs include, but are not limited to, methotrexate, abatacept, infliximab, cyclophosphamide, azathioprine, corticosteroids, cyclosporin A, aminosalicylates, sulfasalazine, hydroxychloroquine, leflunomide, etanercept, efalizumab, 6-mercapto-purine (6-MP), and tumor necrosis factor-alpha (TNFalpha) or other cytokine blockers or antagonists. The compound of the invention and one or more disease modifying drug can be administered concomitantly or sequentially.


In certain embodiments, a compound or oligonucleotide is in salt form.


In certain embodiments, the compounds or compositions are formulated with a pharmaceutically acceptable carrier or diluent.


In certain embodiments, provided are methods and compounds useful for the treatment, prevention, or amelioration of an inflammatory response or inflammatory disease, disorder, or condition. Factor XI has a sequence as shown in SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274. In certain embodiments, a modified oligonucleotide is used for treating an inflammatory response or inflammatory disease, disorder, or condition. In certain embodiments, the modified oligonucleotide has a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15-269.


In certain embodiments, provided are methods and compounds useful in the manufacture of a medicament for the treatment, prevention, or amelioration of an inflammatory response or inflammatory disease, disorder, or condition. Factor XI has a sequence as shown in SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274. In certain embodiments, a modified oligonucleotide is used in the manufacture of a medicament for treating an inflammatory response or inflammatory disease, disorder, or condition. In certain embodiments, the modified oligonucleotide has a nucleobase sequence comprising a portion of contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15-269 or comprises a portion of nucleobases complementary to a target segment or target region as described herein. In certain embodiments, the modified oligonucleotide has a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15-269 or comprises at least 8 contiguous nucleobases complementary to a target segment or target region as described herein.


In certain embodiments, provided is the use of a Factor XI modulator as described herein in the manufacture of a medicament for treating, ameliorating, or preventing inflammatory diseases, disorders, and conditions associated with Factor XI.


In certain embodiments, provided is a Factor XI modulator as described herein for use in treating, preventing, or ameliorating an inflammatory response or inflammatory disease, disorder, or condition as described herein. The Factor XI modulator can be used in combination therapy with one or more additional agent or therapy as described herein. Agents or therapies can be administered concomitantly or sequentially to an animal.


In certain embodiments, provided is the use of a Factor XI modulator as described herein in the manufacture of a medicament for treating, preventing, or ameliorating an inflammatory disease, disorder or condition as described herein. The Factor XI modulator can be used in combination therapy with one or more additional agent or therapy as described herein. Agents or therapies can be administered concomitantly or sequentially to an animal.


In certain embodiments, provided is a kit for treating, preventing, or ameliorating an inflammatory response, disease, disorder or condition as described herein wherein the kit comprises:


(i) a Factor XI specific inhibitor as described herein; and optionally


(ii) an additional agent or therapy as described herein.


A kit of the present invention may further include instructions for using the kit to treat, prevent, or ameliorate an inflammatory disease, disorder or condition as described herein by combination therapy as described herein.


Antisense Compounds

Oligomeric compounds include, but are not limited to, oligonucleotides, oligonucleosides, oligonucleotide analogs, oligonucleotide mimetics, antisense compounds, antisense oligonucleotides, and siRNAs. An oligomeric compound may be “antisense” to a target nucleic acid, meaning that is capable of undergoing hybridization to a target nucleic acid through hydrogen bonding.


In certain embodiments, an antisense compound has a nucleobase sequence that, when written in the 5′ to 3′ direction, comprises the reverse complement of the target segment of a target nucleic acid to which it is targeted. In certain such embodiments, an antisense oligonucleotide has a nucleobase sequence that, when written in the 5′ to 3′ direction, comprises the reverse complement of the target segment of a target nucleic acid to which it is targeted.


In certain embodiments, an antisense compound targeted to a Factor XI nucleic acid is 12 to 30 subunits in length. In other words, antisense compounds are from 12 to 30 linked subunits. In other embodiments, the antisense compound is 8 to 80, 12 to 50, 15 to 30, 18 to 24, 19 to 22, or 20 linked subunits. In certain such embodiments, the antisense compounds are 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, or 80 linked subunits in length, or a range defined by any two of the above values. In some embodiments the antisense compound is an antisense oligonucleotide, and the linked subunits are nucleotides.


In certain embodiments, a shortened or truncated antisense compound targeted to a Factor XI nucleic acid has a single subunit deleted from the 5′ end (5′ truncation), or alternatively from the 3′ end (3′ truncation). A shortened or truncated antisense compound targeted to a Factor XI nucleic acid may have two subunits deleted from the 5′ end, or alternatively may have two subunits deleted from the 3′ end, of the antisense compound. Alternatively, the deleted nucleosides may be dispersed throughout the antisense compound, for example, in an antisense compound having one nucleoside deleted from the 5′ end and one nucleoside deleted from the 3′ end.


When a single additional subunit is present in a lengthened antisense compound, the additional subunit may be located at the 5′ or 3′ end of the antisense compound. When two or more additional subunits are present, the added subunits may be adjacent to each other, for example, in an antisense compound having two subunits added to the 5′ end (5′ addition), or alternatively to the 3′ end (3′ addition), of the antisense compound. Alternatively, the added subunits may be dispersed throughout the antisense compound, for example, in an antisense compound having one subunit added to the 5′ end and one subunit added to the 3′ end.


It is possible to increase or decrease the length of an antisense compound, such as an antisense oligonucleotide, and/or introduce mismatch bases without eliminating activity. For example, in Woolf et al. (Proc. Natl. Acad. Sci. USA 89:7305-7309, 1992), a series of antisense oligonucleotides 13-25 nucleobases in length were tested for their ability to induce cleavage of a target RNA in an oocyte injection model. Antisense oligonucleotides 25 nucleobases in length with 8 or 11 mismatch bases near the ends of the antisense oligonucleotides were able to direct specific cleavage of the target mRNA, albeit to a lesser extent than the antisense oligonucleotides that contained no mismatches. Similarly, target specific cleavage was achieved using 13 nucleobase antisense oligonucleotides, including those with 1 or 3 mismatches.


Gautschi et al (J. Natl. Cancer Inst. 93:463-471, March 2001) demonstrated the ability of an oligonucleotide having 100% complementarity to the bcl-2 mRNA and having 3 mismatches to the bcl-xL mRNA to reduce the expression of both bcl-2 and bcl-xL in vitro and in vivo. Furthermore, this oligonucleotide demonstrated potent anti-tumor activity in vivo.


Maher and Dolnick (Nuc. Acid. Res. 16:3341-3358, 1988) tested a series of tandem 14 nucleobase antisense oligonucleotides, and a 28 and 42 nucleobase antisense oligonucleotides comprised of the sequence of two or three of the tandem antisense oligonucleotides, respectively, for their ability to arrest translation of human DHFR in a rabbit reticulocyte assay. Each of the three 14 nucleobase antisense oligonucleotides alone was able to inhibit translation, albeit at a more modest level than the 28 or 42 nucleobase antisense oligonucleotides.


Antisense Compound Motifs

In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid have chemically modified subunits arranged in patterns, or motifs, to confer to the antisense compounds properties such as enhanced the inhibitory activity, increased binding affinity for a target nucleic acid, or resistance to degradation by in vivo nucleases.


Chimeric antisense compounds typically contain at least one region modified so as to confer increased resistance to nuclease degradation, increased cellular uptake, increased binding affinity for the target nucleic acid, and/or increased inhibitory activity. A second region of a chimeric antisense compound may optionally serve as a substrate for the cellular endonuclease RNase H, which cleaves the RNA strand of an RNA:DNA duplex.


Antisense compounds having a gapmer motif are considered chimeric antisense compounds. In a gapmer an internal region having a plurality of nucleotides that supports RNaseH cleavage is positioned between external regions having a plurality of nucleotides that are chemically distinct from the nucleosides of the internal region. In the case of an antisense oligonucleotide having a gapmer motif, the gap segment generally serves as the substrate for endonuclease cleavage, while the wing segments comprise modified nucleosides. In certain embodiments, the regions of a gapmer are differentiated by the types of sugar moieties comprising each distinct region. The types of sugar moieties that are used to differentiate the regions of a gapmer may in some embodiments include β-D-ribonucleosides, β-D-deoxyribonucleosides, 2′-modified nucleosides (such 2′-modified nucleosides may include 2′-MOE, and 2′-O—CH3, among others), and bicyclic sugar modified nucleosides (such bicyclic sugar modified nucleosides may include those having a 4′-(CH2)n-O-2′ bridge, where n=1 or n=2). Preferably, each distinct region comprises uniform sugar moieties. The wing-gap-wing motif is frequently described as “X-Y-Z”, where “X” represents the length of the 5′ wing region, “Y” represents the length of the gap region, and “Z” represents the length of the 3′ wing region. As used herein, a gapmer described as “X-Y-Z” has a configuration such that the gap segment is positioned immediately adjacent each of the 5′ wing segment and the 3′ wing segment. Thus, no intervening nucleotides exist between the 5′ wing segment and gap segment, or the gap segment and the 3′ wing segment. Any of the antisense compounds described herein can have a gapmer motif. In some embodiments, X and Z are the same, in other embodiments they are different. In a preferred embodiment, Y is between 8 and 15 nucleotides. X, Y or Z can be any of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30 or more nucleotides. Thus, gapmers of the present invention include, but are not limited to, for example 5-10-5, 4-8-4, 4-12-3, 4-12-4, 3-14-3, 2-13-5, 2-16-2, 1-18-1, 3-10-3, 2-10-2, 1-10-1 or 2-8-2.


In certain embodiments, the antisense compound as a “wingmer” motif, having a wing-gap or gap-wing configuration, i.e. an X-Y or Y-Z configuration as described above for the gapmer configuration. Thus, wingmer configurations of the present invention include, but are not limited to, for example 5-10, 8-4, 4-12, 12-4, 3-14, 16-2, 18-1, 10-3, 2-10, 1-10, 8-2, 2-13, or 5-13.


In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid possess a 5-10-5 gapmer motif.


In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid possess a 3-14-3 gapmer motif.


In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid possess a 2-13-5 gapmer motif.


In certain embodiments, an antisense compound targeted to a Factor XI nucleic acid has a gap-widened motif.


In certain embodiments, a gap-widened antisense oligonucleotide targeted to a Factor XI nucleic acid has a gap segment of fourteen 2′-deoxyribonucleosides positioned immediately adjacent to and between wing segments of three chemically modified nucleosides. In certain embodiments, the chemical modification comprises a 2′-sugar modification. In another embodiment, the chemical modification comprises a 2′-MOE sugar modification.


In certain embodiments, a gap-widened antisense oligonucleotide targeted to a Factor XI nucleic acid has a gap segment of thirteen 2′-deoxyribonucleosides positioned immediately adjacent to and between a 5′ wing segment of two chemically modified nucleosides and a 3′ wing segment of five chemically modified nucleosides. In certain embodiments, the chemical modification comprises a 2′-sugar modification. In another embodiment, the chemical modification comprises a 2′-MOE sugar modification.


Target Nucleic Acids, Target Regions and Nucleotide Sequences

Nucleotide sequences that encode Factor XI include, without limitation, the following: GENBANK® Accession No. NM000128.3, first deposited with GENBANK® on Mar. 24, 1999 incorporated herein as SEQ ID NO: 1; GENBANK® Accession No. NT022792.17, truncated from 19598000 to 19624000, first deposited with GENBANK® on Nov. 29, 2000, and incorporated herein as SEQ ID NO: 2; GENBANK® Accession No. NM028066.1, first deposited with GENBANK® on Jun. 2, 2002, incorporated herein as SEQ ID NO: 6; and exons 1-15 of GENBANK Accession No. NW001118167.1 (incorporated herein as SEQ ID NO: 274).


It is understood that the sequence set forth in each SEQ ID NO in the examples contained herein is independent of any modification to a sugar moiety, an internucleoside linkage, or a nucleobase. As such, antisense compounds defined by a SEQ ID NO may comprise, independently, one or more modifications to a sugar moiety, an internucleoside linkage, or a nucleobase. Antisense compounds described by Isis Number (Isis No) indicate a combination of nucleobase sequence and motif.


In certain embodiments, a target region is a structurally defined region of the target nucleic acid. For example, a target region may encompass a 3′ UTR, a 5′ UTR, an exon, an intron, an exon/intron junction, a coding region, a translation initiation region, translation termination region, or other defined nucleic acid region. The structurally defined regions for Factor XI can be obtained by accession number from sequence databases such as NCBI and such information is incorporated herein by reference. In certain embodiments, a target region may encompass the sequence from a 5′ target site of one target segment within the target region to a 3′ target site of another target segment within the target region.


Targeting includes determination of at least one target segment to which an antisense compound hybridizes, such that a desired effect occurs. In certain embodiments, the desired effect is a reduction in mRNA target nucleic acid levels. In certain embodiments, the desired effect is reduction of levels of protein encoded by the target nucleic acid or a phenotypic change associated with the target nucleic acid.


A target region may contain one or more target segments. Multiple target segments within a target region may be overlapping. Alternatively, they may be non-overlapping. In certain embodiments, target segments within a target region are separated by no more than about 300 nucleotides. In certain embodiments, target segments within a target region are separated by a number of nucleotides that is, is about, is no more than, is no more than about, 250, 200, 150, 100, 90, 80, 70, 60, 50, 40, 30, 20, or 10 nucleotides on the target nucleic acid, or is a range defined by any two of the preceeding values. In certain embodiments, target segments within a target region are separated by no more than, or no more than about, 5 nucleotides on the target nucleic acid. In certain embodiments, target segments are contiguous. Contemplated are target regions defined by a range having a starting nucleic acid that is any of the 5′ target sites or 3′ target sites listed herein.


Suitable target segments may be found within a 5′ UTR, a coding region, a 3′ UTR, an intron, an exon, or an exon/intron junction. Target segments containing a start codon or a stop codon are also suitable target segments. A suitable target segment may specifically exclude a certain structurally defined region such as the start codon or stop codon.


The determination of suitable target segments may include a comparison of the sequence of a target nucleic acid to other sequences throughout the genome. For example, the BLAST algorithm may be used to identify regions of similarity amongst different nucleic acids. This comparison can prevent the selection of antisense compound sequences that may hybridize in a non-specific manner to sequences other than a selected target nucleic acid (i.e., non-target or off-target sequences).


There may be variation in activity (e.g., as defined by percent reduction of target nucleic acid levels) of the antisense compounds within an active target region. In certain embodiments, reductions in Factor XI mRNA levels are indicative of inhibition of Factor XI expression. Reductions in levels of a Factor XI protein are also indicative of inhibition of target mRNA levels. Further, phenotypic changes are indicative of inhibition of Factor XI expression. For example, a prolonged aPTT time can be indicative of inhibition of Factor XI expression. In another example, prolonged aPTT time in conjunction with a normal PT time can be indicative of inhibition of Factor XI expression. In another example, a decreased quantity of Platelet Factor 4 (PF-4) can be indicative of inhibition of Factor XI expression. In another example, reduced formation of inflammation (e.g., in thrombus, asthma, arthritis or colitis formation) can be indicative of inhibition of Factor XI expression. Alternatively, increased time for inflammation formation (e.g, in thrombus, asthma, arthritis or colitis formation) can be indicative of inhibition of Factor XI expression.


Hybridization

In some embodiments, hybridization occurs between an antisense compound disclosed herein and a Factor XI nucleic acid. The most common mechanism of hybridization involves hydrogen bonding (e.g., Watson-Crick, Hoogsteen or reversed Hoogsteen hydrogen bonding) between complementary nucleobases of the nucleic acid molecules.


Hybridization can occur under varying conditions. Stringent conditions are sequence-dependent and are determined by the nature and composition of the nucleic acid molecules to be hybridized.


Methods of determining whether a sequence is specifically hybridizable to a target nucleic acid are well known in the art. In certain embodiments, the antisense compounds provided herein are specifically hybridizable with a Factor XI nucleic acid.


Complementarity

An antisense compound and a target nucleic acid are complementary to each other when a sufficient number of nucleobases of the antisense compound can hydrogen bond with the corresponding nucleobases of the target nucleic acid, such that a desired effect will occur (e.g., antisense inhibition of a target nucleic acid, such as a Factor XI nucleic acid).


Non-complementary nucleobases between an antisense compound and a Factor XI nucleic acid may be tolerated provided that the antisense compound remains able to specifically hybridize to a target nucleic acid. Moreover, an antisense compound may hybridize over one or more segments of a Factor XI nucleic acid such that intervening or adjacent segments are not involved in the hybridization event (e.g., a loop structure, mismatch or hairpin structure).


In certain embodiments, the antisense compounds provided herein, or a specified portion thereof, are, or are at least, 70%, 80%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or 100% complementary to a Factor XI nucleic acid, a target region, target segment, or specified portion thereof. Percent complementarity of an antisense compound with a target nucleic acid can be determined using routine methods.


For example, an antisense compound in which 18 of 20 nucleobases of the antisense compound are complementary to a target region, and would therefore specifically hybridize, would represent 90 percent complementarity. In this example, the remaining noncomplementary nucleobases may be clustered or interspersed with complementary nucleobases and need not be contiguous to each other or to complementary nucleobases. As such, an antisense compound which is 18 nucleobases in length having 4 (four) noncomplementary nucleobases which are flanked by two regions of complete complementarity with the target nucleic acid would have 77.8% overall complementarity with the target nucleic acid and would thus fall within the scope of the present invention. Percent complementarity of an antisense compound with a region of a target nucleic acid can be determined routinely using BLAST programs (basic local alignment search tools) and PowerBLAST programs known in the art (Altschul et al., J. Mol. Biol., 1990, 215, 403 410; Zhang and Madden, Genome Res., 1997, 7, 649 656). Percent homology, sequence identity or complementarity, can be determined by, for example, the Gap program (Wisconsin Sequence Analysis Package, Version 8 for Unix, Genetics Computer Group, University Research Park, Madison Wis.), using default settings, which uses the algorithm of Smith and Waterman (Adv. Appl. Math., 1981, 2, 482 489).


In certain embodiments, the antisense compounds provided herein, or specified portions thereof, are fully complementary (i.e. 100% complementary) to a target nucleic acid, or specified portion thereof. For example, antisense compound may be fully complementary to a Factor XI nucleic acid, or a target region, or a target segment or target sequence thereof. As used herein, “fully complementary” means each nucleobase of an antisense compound is capable of precise base pairing with the corresponding nucleobases of a target nucleic acid. For example, a 20 nucleobase antisense compound is fully complementary to a target sequence that is 400 nucleobases long, so long as there is a corresponding 20 nucleobase portion of the target nucleic acid that is fully complementary to the antisense compound. Fully complementary can also be used in reference to a specified portion of the first and/or the second nucleic acid. For example, a 20 nucleobase portion of a 30 nucleobase antisense compound can be “fully complementary” to a target sequence that is 400 nucleobases long. The 20 nucleobase portion of the 30 nucleobase oligonucleotide is fully complementary to the target sequence if the target sequence has a corresponding 20 nucleobase portion wherein each nucleobase is complementary to the 20 nucleobase portion of the antisense compound. At the same time, the entire 30 nucleobase antisense compound may or may not be fully complementary to the target sequence, depending on whether the remaining 10 nucleobases of the antisense compound are also complementary to the target sequence.


The location of a non-complementary nucleobase may be at the 5′ end or 3′ end of the antisense compound. Alternatively, the non-complementary nucleobase or nucleobases may be at an internal position of the antisense compound. When two or more non-complementary nucleobases are present, they may be contiguous (i.e. linked) or non-contiguous. In one embodiment, a non-complementary nucleobase is located in the wing segment of a gapmer antisense oligonucleotide.


In certain embodiments, antisense compounds that are, or are up to 12, 13, 14, 15, 16, 17, 18, 19, or 20 nucleobases in length comprise no more than 4, no more than 3, no more than 2, or no more than 1 non-complementary nucleobase(s) relative to a target nucleic acid, such as a Factor XI nucleic acid, or specified portion thereof.


In certain embodiments, antisense compounds that are, or are up to 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleobases in length comprise no more than 6, no more than 5, no more than 4, no more than 3, no more than 2, or no more than 1 non-complementary nucleobase(s) relative to a target nucleic acid, such as a Factor XI nucleic acid, or specified portion thereof.


The antisense compounds provided herein also include those which are complementary to a portion of a target nucleic acid. As used herein, “portion” refers to a defined number of contiguous (i.e. linked) nucleobases within a region or segment of a target nucleic acid. A “portion” can also refer to a defined number of contiguous nucleobases of an antisense compound. In certain embodiments, the antisense compounds, are complementary to at least an 8 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 12 nucleobase portion of a target segment. In certain embodiments, the antisense compounds are complementary to at least a 15 nucleobase portion of a target segment. Also contemplated are antisense compounds that are complementary to at least a 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or more nucleobase portion of a target segment, or a range defined by any two of these values.


Identity

The antisense compounds provided herein may also have a defined percent identity to a particular nucleotide sequence, SEQ ID NO, or compound represented by a specific Isis number, or portion thereof. As used herein, an antisense compound is identical to the sequence disclosed herein if it has the same nucleobase pairing ability. For example, a RNA which contains uracil in place of thymidine in a disclosed DNA sequence would be considered identical to the DNA sequence since both uracil and thymidine pair with adenine. Shortened and lengthened versions of the antisense compounds described herein as well as compounds having non-identical bases relative to the antisense compounds provided herein also are contemplated. The non-identical bases may be adjacent to each other or dispersed throughout the antisense compound. Percent identity of an antisense compound is calculated according to the number of bases that have identical base pairing relative to the sequence to which it is being compared.


In certain embodiments, the antisense compounds, or portions thereof, are at least 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, 99% or 100% identical to one or more of the antisense compounds or SEQ ID NOs, or a portion thereof, disclosed herein.


Modifications

A nucleoside is a base-sugar combination. The nucleobase (also known as base) portion of the nucleoside is normally a heterocyclic base moiety. Nucleotides are nucleosides that further include a phosphate group covalently linked to the sugar portion of the nucleoside. For those nucleosides that include a pentofuranosyl sugar, the phosphate group can be linked to the 2′, 3′ or 5′ hydroxyl moiety of the sugar. Oligonucleotides are formed through the covalent linkage of adjacent nucleosides to one another, to form a linear polymeric oligonucleotide. Within the oligonucleotide structure, the phosphate groups are commonly referred to as forming the internucleoside linkages of the oligonucleotide.


Modifications to antisense compounds encompass substitutions or changes to internucleoside linkages, sugar moieties, or nucleobases. Modified antisense compounds are often preferred over native forms because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for nucleic acid target, increased stability in the presence of nucleases, or increased inhibitory activity.


Chemically modified nucleosides may also be employed to increase the binding affinity of a shortened or truncated antisense oligonucleotide for its target nucleic acid. Consequently, comparable results can often be obtained with shorter antisense compounds that have such chemically modified nucleosides.


Modified Internucleoside Linkages

The naturally occurring internucleoside linkage of RNA and DNA is a 3′ to 5′ phosphodiester linkage. Antisense compounds having one or more modified, i.e. non-naturally occurring, internucleoside linkages are often selected over antisense compounds having naturally occurring internucleoside linkages because of desirable properties such as, for example, enhanced cellular uptake, enhanced affinity for target nucleic acids, and increased stability in the presence of nucleases.


Oligonucleotides having modified internucleoside linkages include internucleoside linkages that retain a phosphorus atom as well as internucleoside linkages that do not have a phosphorus atom. Representative phosphorus containing internucleoside linkages include, but are not limited to, phosphodiesters, phosphotriesters, methylphosphonates, phosphoramidate, and phosphorothioates. Methods of preparation of phosphorous-containing and non-phosphorous-containing linkages are well known.


In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid comprise one or more modified internucleoside linkages. In certain embodiments, the modified internucleoside linkages are phosphorothioate linkages. In certain embodiments, each internucleoside linkage of an antisense compound is a phosphorothioate internucleoside linkage.


Modified Sugar Moieties

Antisense compounds of the invention can optionally contain one or more nucleosides wherein the sugar group has been modified. Such sugar modified nucleosides may impart enhanced nuclease stability, increased binding affinity or some other beneficial biological property to the antisense compounds. In certain embodiments, nucleosides comprise a chemically modified ribofuranose ring moieties. Examples of chemically modified ribofuranose rings include without limitation, addition of substitutent groups (including 5′ and 2′ substituent groups, bridging of non-geminal ring atoms to form bicyclic nucleic acids (BNA), replacement of the ribosyl ring oxygen atom with S, N(R), or C(R1)(R)2 (R═H, C1-C12 alkyl or a protecting group) and combinations thereof. Examples of chemically modified sugars include 2′-F-5′-methyl substituted nucleoside (see PCT International Application WO 2008/101157 Published on Aug. 21, 2008 for other disclosed 5′,2′-bis substituted nucleosides) or replacement of the ribosyl ring oxygen atom with S with further substitution at the 2′-position (see published U.S. Patent Application US2005-0130923, published on Jun. 16, 2005) or alternatively 5′-substitution of a BNA (see PCT International Application WO 2007/134181 Published on Nov. 22, 2007 wherein LNA is substituted with for example a 5′-methyl or a 5′-vinyl group).


Examples of nucleosides having modified sugar moieties include without limitation nucleosides comprising 5′-vinyl, 5′-methyl (R or S), 4′-S, 2′-F, 2′-OCH3 and 2′-O(CH2)2OCH3 substituent groups. The substituent at the 2′ position can also be selected from allyl, amino, azido, thio, O-allyl, O—C1-C10 alkyl, OCF3, O(CH2)2SCH3, O(CH2)2-O—N(Rm)(Rn), and O—CH2-C(═O)—N(Rm)(Rn), where each Rm and Rn is, independently, H or substituted or unsubstituted C1-C10 alkyl, O-alkaryl or O-aralkyl, substituted alkyl, alkenyl, alkynyl, alkaryl, aralkyl, SH, SCH3, OCN, Cl, Br, CN, 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 pharmacokinetic properties, or a group for improving the pharmacodynamic properties of an antisense compound, and other substituents having similar properties


Examples of bicyclic nucleic acids (BNAs) include without limitation nucleosides comprising a bridge between the 4′ and the 2′ ribosyl ring atoms. In certain embodiments, antisense compounds provided herein include one or more BNA nucleosides wherein the bridge comprises one of the formulas: 4′-(CH2)-O-2′ (LNA); 4′-(CH2)-S-2; 4′-(CH2)2-O-2′ (ENA); 4′-C(CH3)2-O-2′ (see PCT/US2008/068922); 4′-CH(CH3)-O-2′ and 4′-C—H(CH2OCH3)-O-2′ (see U.S. Pat. No. 7,399,845, issued on Jul. 15, 2008); 4′-CH2-N(OCH3)-2′ (see PCT/US2008/064591); 4′-CH2-O—N(CH3)-2′ (see published U.S. Patent Application US2004-0171570, published Sep. 2, 2004); 4′-CH2-N(R)—O-2′ (see U.S. Pat. No. 7,427,672, issued on Sep. 23, 2008); 4′-CH2-CH(CH3)-2′ (see Chattopadhyaya et al., J. Org. Chem., 2009, 74, 118-134) and 4′-CH2-C—(═CH2)-2′ (see PCT/US2008/066154); and wherein R is, independently, H, C1-C12 alkyl, or a protecting group. Each of the foregoing BNAs include various stereochemical sugar configurations including for example α-L-ribofuranose and β-D-ribofuranose (see PCT international application PCT/DK98/00393, published on Mar. 25, 1999 as WO 99/14226). Previously, α-L-methyleneoxy (4′-CH2—O-2′) BNA's have also been incorporated into antisense oligonucleotides that showed antisense activity (Frieden et al., Nucleic Acids Research, 2003, 21, 6365-6372).


Further reports related to bicyclic nucleosides can be found in published literature (see for example: Srivastava et al., J. Am. Chem. Soc., 2007, 129, 8362-8379; U.S. Pat. Nos. 7,053,207; 6,268,490; 6,770,748; 6,794,499; 7,034,133; and 6,525,191; Elayadi et al., Curr. Opinion Invens. Drugs, 2001, 2, 558-561; Braasch et al., Chem. Biol., 2001, 8, 1-7; and Orum et al., Curr. Opinion Mol. Ther., 2001, 3, 239-243; and U.S. Pat. No. 6,670,461; International applications WO 2004/106356; WO 94/14226; WO 2005/021570; U.S. Patent Publication Nos. US2004-0171570; US2007-0287831; US2008-0039618; U.S. Pat. No. 7,399,845; U.S. patent Ser. Nos. 12/129,154; 60/989,574; 61/026,995; 61/026,998; 61/056,564; 61/086,231; 61/097,787; 61/099,844; PCT International Applications Nos. PCT/US2008/064591; PCT/US2008/066154; PCT/US2008/068922; and Published PCT International Applications WO 2007/134181).


In certain embodiments, bicyclic sugar moieties of BNA nucleosides include, but are not limited to, compounds having at least one bridge between the 4′ and the 2′ position of the pentofuranosyl sugar moiety wherein such bridges independently comprises 1 or from 2 to 4 linked groups independently selected from —[C(Ra)(Rb)]n—, —C(Ra)═C(Rb)—, —C(Ra)═N—, —C(═NRa)—, —C(═S)—, —O—, —Si(Ra)2—, —S(═O)x—, and —N(Ra)—;


wherein:


x is 0, 1, or 2;


n is 1, 2, 3, or 4;


each Ra and Rb is, independently, H, a protecting group, hydroxyl, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C5-C20 aryl, substituted C5-C20 aryl, heterocycle radical, substituted heterocycle radical, heteroaryl, substituted heteroaryl, C5-C7 alicyclic radical, substituted C5-C7 alicyclic radical, halogen, OJ1, NJ1J2, SJ1, N3, COOJ1, acyl (C(═O)—H), substituted acyl, CN, sulfonyl (S(═O)2-J1), or sulfoxyl (S(═O)-J1); and


each J1 and J2 is, independently, H, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C5-C20 aryl, substituted C5-C20 aryl, acyl (C(═O)—H), substituted acyl, a heterocycle radical, a substituted heterocycle radical, C1-C12 aminoalkyl, substituted C1-C12 aminoalkyl or a protecting group.


In certain embodiments, the bridge of a bicyclic sugar moiety is, —[C(Ra)(Rb)]n—, —[C(Ra)(Rb)]n—O—, —C(RaRb)—N(R)—O— or —C(RaRb)—O—N(R)—. In certain embodiments, the bridge is 4′-CH2-2′,4′-(CH2)2-2′,4′-(CH2)3-2′,4′-CH2—O-2′,4′-(CH2)2—O-2′,4′-CH2—O—N(R)-2′ and 4′-CH2—N(R)—O-2′- wherein each R is, independently, H, a protecting group or C1-C12 alkyl.


In certain embodiments, bicyclic nucleosides include, but are not limited to, (A) α-L-Methyleneoxy (4′-CH2—O-2′) BNA, (B) β-D-Methyleneoxy (4′-CH2—O-2′) BNA, (C) Ethyleneoxy (4′-(CH2)2—O-2′) BNA, (D) Aminooxy (4′-CH2—O—N(R)-2′) BNA, (E) Oxyamino (4′-CH2—N(R)—O-2′) BNA, and (F) Methyl(methyleneoxy) (4′-CH(CH3)—O-2′) BNA, (G) Methylene-thio (4′-CH2—S-2′) BNA, (H) Methylene-amino (4′-CH2—N(R)-2′) BNA, (I) Methyl carbocyclic (4′-CH2—CH(CH3)-2′) BNA, and (J) Propylene carbocyclic (4′-(CH2)3-2′) BNA as depicted below.




embedded image


embedded image


wherein Bx is the base moiety and R is independently H, a protecting group or C1-C12 alkyl.


In certain embodiments, bicyclic nucleoside having Formula I:




embedded image


wherein:


Bx is a heterocyclic base moiety;


-Qa-Qb-Qc- is —CH2—N(Rc)—CH2—, —C(═O)—N(Rc)—CH2—, —CH2—O—N(Rc)—, —CH2—N(Rc)—O— or —N(Rc)—O—CH2;


Rc is C1-C12 alkyl or an amino protecting group; and


Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety or a covalent attachment to a support medium.


In certain embodiments, bicyclic nucleoside having Formula II:




embedded image


wherein:


Bx is a heterocyclic base moiety;


Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety or a covalent attachment to a support medium;


Za is C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, substituted C1-C6 alkyl, substituted C2-C6 alkenyl, substituted C2-C6 alkynyl, acyl, substituted acyl, substituted amide, thiol or substituted thio.


In one embodiment, each of the substituted groups is, independently, mono or poly substituted with substituent groups independently selected from halogen, oxo, hydroxyl, OJc, NJcJd, SJc, N3, OC(═X)Jc, and NJeC(═X)NJcJd, wherein each Jc, Jd and Je is, independently, H, C1-C6 alkyl, or substituted C1-C6 alkyl and X is O or NJc.


In certain embodiments, bicyclic nucleoside having Formula III:




embedded image


wherein:


Bx is a heterocyclic base moiety;


Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety or a covalent attachment to a support medium;


Zb is C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, substituted C1-C6 alkyl, substituted C2-C6 alkenyl, substituted C2-C6 alkynyl or substituted acyl (C(═O)—).


In certain embodiments, bicyclic nucleoside having Formula IV:




embedded image


wherein:


Bx is a heterocyclic base moiety;


Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety or a covalent attachment to a support medium;


Rd is C1-C6 alkyl, substituted C1-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, C2-C6 alkynyl or substituted C2-C6 alkynyl;


each qa, qb, qc and qd is, independently, H, halogen, C1-C6 alkyl, substituted C1-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, C2-C6 alkynyl or substituted C2-C6 alkynyl, C1-C6 alkoxyl, substituted C1-C6 alkoxyl, acyl, substituted acyl, C1-C6 aminoalkyl or substituted C1-C6 aminoalkyl;


In certain embodiments, bicyclic nucleoside having Formula V:




embedded image


wherein:


Bx is a heterocyclic base moiety;


Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety or a covalent attachment to a support medium;


qa, qb, qe and qf are each, independently, hydrogen, halogen, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C1-C12 alkoxy, substituted C1-C12 alkoxy, OJj, SJj, SOJj, SO2Jj, NJjJk, N3, CN, C(═O)OJj, C(═O)NJjJk, C(═O)Jj, O—C(═O)NJjJk, N(H)C(═NH)NJjJk, N(H)C(═O)NJjJk or N(H)C(═S)NJjJk;


or qe and qf together are ═C(qg)(qh);


qg and qh are each, independently, H, halogen, C1-C12 alkyl or substituted C1-C12 alkyl.


The synthesis and preparation of the methyleneoxy (4′-CH2—O-2′) BNA monomers adenine, cytosine, guanine, 5-methyl-cytosine, thymine and uracil, along with their oligomerization, and nucleic acid recognition properties have been described (Koshkin et al., Tetrahedron, 1998, 54, 3607-3630). BNAs and preparation thereof are also described in WO 98/39352 and WO 99/14226.


Analogs of methyleneoxy (4′-CH2—O-2′) BNA and 2′-thio-BNAs, have also been prepared (Kumar et al., Bioorg. Med. Chem. Lett., 1998, 8, 2219-2222). Preparation of locked nucleoside analogs comprising oligodeoxyribonucleotide duplexes as substrates for nucleic acid polymerases has also been described (Wengel et al., WO 99/14226). Furthermore, synthesis of 2′-amino-BNA, a novel comformationally restricted high-affinity oligonucleotide analog has been described in the art (Singh et al., Org. Chem., 1998, 63, 10035-10039). In addition, 2′-amino- and 2′-methylamino-BNA's have been prepared and the thermal stability of their duplexes with complementary RNA and DNA strands has been previously reported.


In certain embodiments, bicyclic nucleoside having Formula VI:




embedded image


wherein:


Bx is a heterocyclic base moiety;


Ta and Tb are each, independently H, a hydroxyl protecting group, a conjugate group, a reactive phosphorus group, a phosphorus moiety or a covalent attachment to a support medium;


each qi, qj, qk and ql is, independently, H, halogen, C1-C12 alkyl, substituted C1-C12 alkyl, C2-7


C1-2 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C1-C12 alkoxyl, substituted C1-C12 alkoxyl, OJj, SJj, SOJj, SO2Jj, NJjJk, N3, CN, C(═O)OJj, C(═O)NJjJk, C(═O)Jj, O—C(═O)NJjJk, N(H)C(═NH)NJjJk, N(H)C(═O)NJjJk or N(H)C(═S)NJjJk; and


qi and qi or ql and qk together are ═C(qg)(qh), wherein qg and qh are each, independently, H, halogen, C1-C12 alkyl or substituted C1-C12 alkyl.


One carbocyclic bicyclic nucleoside having a 4′-(CH2)3-2′ bridge and the alkenyl analog bridge 4′-CH═CH—CH2-2′ have been described (Freier et al., Nucleic Acids Research, 1997, 25(22), 4429-4443 and Albaek et al., J. Org. Chem., 2006, 71, 7731-7740). The synthesis and preparation of carbocyclic bicyclic nucleosides along with their oligomerization and biochemical studies have also been described (Srivastava et al., J. Am. Chem. Soc., 2007, 129(26), 8362-8379).


In certain embodiments, nucleosides are modified by replacement of the ribosyl ring with a sugar surrogate. Such modification includes without limitation, replacement of the ribosyl ring with a surrogate ring system (sometimes referred to as DNA analogs) such as a morpholino ring, a cyclohexenyl ring, a cyclohexyl ring or a tetrahydropyranyl ring such as one having one of the formula:




embedded image


Many other bicyclo and tricyclo sugar surrogate ring systems are also know in the art that can be used to modify nucleosides for incorporation into antisense compounds (see for example review article: Leumann, Christian J., Bioorg. Med. Chem., 2002, 10, 841-854)). Such ring systems can undergo various additional substitutions to enhance activity. See for example compounds having Formula VII:




embedded image


wherein independently for each of said at least one tetrahydropyran nucleoside analog of Formula VII:


Bx is a heterocyclic base moiety;


Ta and Tb are each, independently, an internucleoside linking group linking the tetrahydropyran nucleoside analog to the antisense compound or one of Ta and Tb is an internucleoside linking group linking the tetrahydropyran nucleoside analog to the antisense compound and the other of Ta and Tb is H, a hydroxyl protecting group, a linked conjugate group or a 5′ or 3′-terminal group;


q1, q2, q3, q4, q5, q6 and q7 are each independently, H, C1-C6 alkyl, substituted C1-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, C2-C6 alkynyl or substituted C2-C6 alkynyl; and each of R1 and R2 is selected from hydrogen, hydroxyl, halogen, substituted or unsubstituted alkoxy, NJ1J2, SJ1, N3, OC(═X)J1, OC(═X)NJ1J2, NJ3C(═X)NJ1J2 and CN, wherein X is O, S or NJ1 and each J1, J2 and J3 is, independently, H or C1-C6 alkyl.


In certain embodiments, the modified THP nucleosides of Formula VII are provided wherein q1, q2, q3, q4, q5, q6 and q7 are each H (M). In certain embodiments, at least one of q1, q2, q3, q4, q5, q6 and q7 is other than H. In certain embodiments, at least one of q1, q2, q3, q4, q5, q6 and q7 is methyl. In certain embodiments, THP nucleosides of Formula VII are provided wherein one of R1 and R2 is fluoro (K). In certain embodiments, THP nucleosides of Formula VII are provided wherein one of R1 and R2 is methoxyethoxy. In certain embodiments, R1 is fluoro and R2 is H; R1 is H and R2 is fluoro; R1 is methoxy and R2 is H, and R1 is H and R2 is methoxyethoxy. Methods for the preparations of modified sugars are well known to those skilled in the art.


In nucleotides having modified sugar moieties, the nucleobase moieties (natural, modified or a combination thereof) are maintained for hybridization with an appropriate nucleic acid target.


In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid comprise one or more nucleotides having modified sugar moieties. In certain embodiments, the modified sugar moiety is 2′-MOE. In certain embodiments, the 2′-MOE modified nucleotides are arranged in a gapmer motif. In certain embodiments, the modified sugar moiety is a bicyclic nucleoside having a (4′-CH(CH3)—O-2′) bridging group. In certain embodiments, the (4′-CH(CH3)—O-2′) modified nucleotides are arranged throughout the wings of a gapmer motif.


Modified Nucleobases

Nucleobase (or base) modifications or substitutions are structurally distinguishable from, yet functionally interchangeable with, naturally occurring or synthetic unmodified nucleobases. Both natural and modified nucleobases are capable of participating in hydrogen bonding. Such nucleobase modifications may impart nuclease stability, binding affinity or some other beneficial biological property to antisense compounds. Modified nucleobases include synthetic and natural nucleobases such as, for example, 5-methylcytosine (5-me-C). Certain nucleobase substitutions, including 5-methylcytosine substitutions, are particularly useful for increasing the binding affinity of an antisense compound for a target nucleic acid. For example, 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., Antisense Research and Applications, CRC Press, Boca Raton, 1993, pp. 276-278).


Additional unmodified nucleobases include 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 (—C≡C—CH3) uracil and cytosine and other alkynyl derivatives of pyrimidine bases, 6-azo uracil, cytosine and thymine, 5-uracil (pseudouracil), 4-thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioalkyl, 8-hydroxyl and 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, 2-F-adenine, 2-amino-adenine, 8-azaguanine and 8-azaadenine, 7-deazaguanine and 7-deazaadenine and 3-deazaguanine and 3-deazaadenine.


Heterocyclic base moieties may also include those in which the purine or pyrimidine base is replaced with other heterocycles, for example 7-deaza-adenine, 7-deazaguanosine, 2-aminopyridine and 2-pyridone. Nucleobases that are particularly useful for increasing the binding affinity of antisense compounds include 5-substituted pyrimidines, 6-azapyrimidines and N-2, N-6 and O-6 substituted purines, including 2 aminopropyladenine, 5-propynyluracil and 5-propynylcytosine.


In certain embodiments, antisense compounds targeted to a Factor XI nucleic acid comprise one or more modified nucleobases. In certain embodiments, gap-widened antisense oligonucleotides targeted to a Factor XI nucleic acid comprise one or more modified nucleobases. In certain embodiments, the modified nucleobase is 5-methylcytosine. In certain embodiments, each cytosine is a 5-methylcytosine.


Compositions and Methods for Formulating Pharmaceutical Compositions

Antisense oligonucleotides may be admixed with pharmaceutically acceptable active or inert substance for the preparation of pharmaceutical compositions or formulations. Compositions and methods for the formulation of pharmaceutical compositions are dependent upon a number of criteria, including, but not limited to, route of administration, extent of disease, or dose to be administered.


Pharmaceutical compositions comprising antisense compounds encompass any pharmaceutically acceptable salts, esters, or salts of such esters, or any other oligonucleotide which, upon administration to an animal, including a human, is capable of providing (directly or indirectly) the biologically active metabolite or residue thereof. Accordingly, for example, the disclosure is also drawn to pharmaceutically acceptable salts of antisense compounds, prodrugs, pharmaceutically acceptable salts of such prodrugs, and other bioequivalents. Suitable pharmaceutically acceptable salts include, but are not limited to, sodium and potassium salts.


In certain embodiments, one or more modified oligonucleotides of the present invention can be formulated as a prodrug. A prodrug can be produced by modifying a pharmaceutically active compound such that the active compound will be regenerated upon in vivo administration. For example, a prodrug can include the incorporation of additional nucleosides at one or both ends of an antisense compound which are cleaved by endogenous nucleases within the body, to form the active antisense compound. The prodrug can be designed to alter the metabolic stability or the transport characteristics of a drug, to mask side effects or toxicity, to improve the flavor of a drug or to alter other characteristics or properties of a drug. In certain embodiments, upon in vivo administration, a prodrug is chemically converted to the biologically, pharmaceutically or therapeutically more active form of a modified oligonucleotide. In certain embodiments, prodrugs are useful because they are easier to administer than the corresponding active form. For example, in certain instances, a prodrug may be more bioavailable (e.g., through oral administration) than is the corresponding active form. In certain instances, a prodrug may have improved solubility compared to the corresponding active form. In certain embodiments, prodrugs are less water soluble than the corresponding active form. In certain instances, such prodrugs possess superior transmittal across cell membranes, where water solubility is detrimental to mobility. In certain embodiments, a prodrug is an ester. In certain such embodiments, the ester is metabolically hydrolyzed to carboxylic acid upon administration. In certain instances the carboxylic acid containing compound is the corresponding active form. In certain embodiments, a prodrug comprises a short peptide (polyaminoacid) bound to an acid group. In certain of such embodiments, the peptide is cleaved upon administration to form the corresponding active form.


In certain embodiments, a pharmaceutical composition of the present invention is administered in the form of a dosage unit (e.g., tablet, capsule, bolus, etc.). In certain embodiments, such pharmaceutical compositions comprise a modified oligonucleotide in a dose selected from 25 mg, 30 mg, 35 mg, 40 mg, 45 mg, 50 mg, 55 mg, 60 mg, 65 mg, 70 mg, 75 mg, 80 mg, 85 mg, 90 mg, 95 mg, 100 mg, 105 mg, 110 mg, 115 mg, 120 mg, 125 mg, 130 mg, 135 mg, 140 mg, 145 mg, 150 mg, 155 mg, 160 mg, 165 mg, 170 mg, 175 mg, 180 mg, 185 mg, 190 mg, 195 mg, 200 mg, 205 mg, 210 mg, 215 mg, 220 mg, 225 mg, 230 mg, 235 mg, 240 mg, 245 mg, 250 mg, 255 mg, 260 mg, 265 mg, 270 mg, 270 mg, 280 mg, 285 mg, 290 mg, 295 mg, 300 mg, 305 mg, 310 mg, 315 mg, 320 mg, 325 mg, 330 mg, 335 mg, 340 mg, 345 mg, 350 mg, 355 mg, 360 mg, 365 mg, 370 mg, 375 mg, 380 mg, 385 mg, 390 mg, 395 mg, 400 mg, 405 mg, 410 mg, 415 mg, 420 mg, 425 mg, 430 mg, 435 mg, 440 mg, 445 mg, 450 mg, 455 mg, 460 mg, 465 mg, 470 mg, 475 mg, 480 mg, 485 mg, 490 mg, 495 mg, 500 mg, 505 mg, 510 mg, 515 mg, 520 mg, 525 mg, 530 mg, 535 mg, 540 mg, 545 mg, 550 mg, 555 mg, 560 mg, 565 mg, 570 mg, 575 mg, 580 mg, 585 mg, 590 mg, 595 mg, 600 mg, 605 mg, 610 mg, 615 mg, 620 mg, 625 mg, 630 mg, 635 mg, 640 mg, 645 mg, 650 mg, 655 mg, 660 mg, 665 mg, 670 mg, 675 mg, 680 mg, 685 mg, 690 mg, 695 mg, 700 mg, 705 mg, 710 mg, 715 mg, 720 mg, 725 mg, 730 mg, 735 mg, 740 mg, 745 mg, 750 mg, 755 mg, 760 mg, 765 mg, 770 mg, 775 mg, 780 mg, 785 mg, 790 mg, 795 mg, and 800 mg. In certain such embodiments, a pharmaceutical composition of the present invention comprises a dose of modified oligonucleotide selected from 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 500 mg, 600 mg, 700 mg, and 800 mg.


In certain embodiments, a pharmaceutical composition comprises a sterile lyophilized modified oligonucleotide that is reconstituted with a suitable diluent, e.g., sterile water for injection or sterile saline for injection. The reconstituted product is administered as a subcutaneous injection or as an intravenous infusion after dilution into saline. The lyophilized drug product consists of a modified oligonucleotide which has been prepared in water for injection, or in saline for injection, adjusted to pH 7.0-9.0 with acid or base during preparation, and then lyophilized. The lyophilized modified oligonucleotide may be 25-800 mg, or any dose between 25-800 mg as described above, of a modified oligonucleotide. The lyophilized drug product may be packaged in a 2 mL Type I, clear glass vial (ammonium sulfate-treated), stoppered with a bromobutyl rubber closure and sealed with an aluminum FLIP-OFF® overseal.


In certain embodiments, the compositions of the present invention may additionally contain other adjunct components conventionally found in pharmaceutical compositions, at their art-established usage levels. Thus, for example, the compositions may contain additional, compatible, pharmaceutically-active materials such as, for example, antipruritics, astringents, local anesthetics or anti-inflammatory agents, or may 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. 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 oligonucleotide(s) of the formulation.


In certain embodiments, pharmaceutical compositions of the present invention comprise one or more modified oligonucleotides and one or more excipients. In certain such embodiments, excipients are selected from water, salt solutions, alcohol, polyethylene glycols, gelatin, lactose, amylase, magnesium stearate, talc, silicic acid, viscous paraffin, hydroxymethylcellulose and polyvinylpyrrolidone.


In certain embodiments, a pharmaceutical composition of the present invention is prepared using known techniques, including, but not limited to mixing, dissolving, granulating, dragee-making, levigating, emulsifying, encapsulating, entrapping or tabletting processes.


In certain embodiments, the compounds of the invention targeted to a Factor XI nucleic acid can be utilized in pharmaceutical compositions by combining the antisense compound with a suitable pharmaceutically acceptable diluent or carrier. A pharmaceutically acceptable diluent includes, but is not limited to, water, oils, alcohols, or phosphate-buffered saline (PBS). PBS is a diluent suitable for use in compositions to be delivered parenterally. Accordingly, in one embodiment, employed in the methods described herein is a pharmaceutical composition comprising an compound targeted to a Factor XI nucleic acid and a pharmaceutically acceptable diluent. In certain embodiments, the pharmaceutically acceptable diluent is PBS. In certain embodiments, the compound is an antisense oligonucleotide.


In certain embodiments, a pharmaceutical composition of the present invention is a liquid (e.g., a suspension, elixir and/or solution). In certain of such embodiments, a liquid pharmaceutical composition is prepared using ingredients known in the art, including, but not limited to, water, buffered saline, glycols, oils, alcohols, flavoring agents, preservatives, and coloring agents.


In certain embodiments, a pharmaceutical composition of the present invention is a solid (e.g., a powder, tablet, and/or capsule). In certain of such embodiments, a solid pharmaceutical composition comprising one or more oligonucleotides is prepared using ingredients known in the art, including, but not limited to, starches, sugars, diluents, granulating agents, lubricants, binders, and disintegrating agents.


In certain embodiments, a pharmaceutical composition of the present invention is formulated as a depot preparation. Certain such depot preparations are typically longer acting than non-depot preparations. In certain embodiments, such preparations are administered by implantation (for example subcutaneously or intramuscularly) or by intramuscular injection. In certain embodiments, depot preparations are prepared using suitable polymeric or hydrophobic materials (for example an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.


In certain embodiments, a pharmaceutical composition of the present invention comprises a delivery system. Examples of delivery systems include, but are not limited to, liposomes and emulsions. Certain delivery systems are useful for preparing certain pharmaceutical compositions including those comprising hydrophobic compounds. In certain embodiments, certain organic solvents such as dimethylsulfoxide are used.


In certain embodiments, a pharmaceutical composition of the present invention comprises one or more tissue-specific delivery molecules designed to deliver the one or more pharmaceutical agents of the present invention to specific tissues or cell types. For example, in certain embodiments, pharmaceutical compositions include liposomes coated with a tissue-specific antibody.


In certain embodiments, a pharmaceutical composition of the present invention comprises a co-solvent system. Certain of such co-solvent systems comprise, for example, benzyl alcohol, a nonpolar surfactant, a water-miscible organic polymer, and an aqueous phase. In certain embodiments, such co-solvent systems are used for hydrophobic compounds. A non-limiting example of such a co-solvent system is the VPD co-solvent system, which is a solution of absolute ethanol comprising 3% w/v benzyl alcohol, 8% w/v of the nonpolar surfactant Polysorbate 80™ and 65% w/v polyethylene glycol 300. The proportions of such co-solvent systems may be varied considerably without significantly altering their solubility and toxicity characteristics. Furthermore, the identity of co-solvent components may be varied: for example, other surfactants may be used instead of Polysorbate 80™; the fraction size of polyethylene glycol may be varied; other biocompatible polymers may replace polyethylene glycol, e.g., polyvinyl pyrrolidone; and other sugars or polysaccharides may substitute for dextrose.


In certain embodiments, a pharmaceutical composition of the present invention comprises a sustained-release system. A non-limiting example of such a sustained-release system is a semi-permeable matrix of solid hydrophobic polymers. In certain embodiments, sustained-release systems may, depending on their chemical nature, release pharmaceutical agents over a period of hours, days, weeks or months.


In certain embodiments, a pharmaceutical composition of the present invention is prepared for oral administration. In certain of such embodiments, a pharmaceutical composition is formulated by combining one or more compounds comprising a modified oligonucleotide with one or more pharmaceutically acceptable carriers. Certain of such carriers enable pharmaceutical compositions to be formulated as tablets, pills, dragees, capsules, liquids, gels, syrups, slurries, suspensions and the like, for oral ingestion by a subject. In certain embodiments, pharmaceutical compositions for oral use are obtained by mixing oligonucleotide and one or more solid excipient. Suitable excipients include, but are not limited to, fillers, such as sugars, including lactose, sucrose, mannitol, or sorbitol; cellulose preparations such as, for example, maize starch, wheat starch, rice starch, potato starch, gelatin, gum tragacanth, methyl cellulose, hydroxypropylmethyl-cellulose, sodium carboxymethylcellulose, and/or polyvinylpyrrolidone (PVP). In certain embodiments, such a mixture is optionally ground and auxiliaries are optionally added. In certain embodiments, pharmaceutical compositions are formed to obtain tablets or dragee cores. In certain embodiments, disintegrating agents (e.g., cross-linked polyvinyl pyrrolidone, agar, or alginic acid or a salt thereof, such as sodium alginate) are added.


In certain embodiments, dragee cores are provided with coatings. In certain such embodiments, concentrated sugar solutions may be used, which may optionally contain gum arabic, talc, polyvinyl pyrrolidone, carbopol gel, polyethylene glycol, and/or titanium dioxide, lacquer solutions, and suitable organic solvents or solvent mixtures. Dyestuffs or pigments may be added to tablets or dragee coatings.


In certain embodiments, pharmaceutical compositions for oral administration are push-fit capsules made of gelatin. Certain of such push-fit capsules comprise one or more pharmaceutical agents of the present invention in admixture with one or more filler such as lactose, binders such as starches, and/or lubricants such as talc or magnesium stearate and, optionally, stabilizers. In certain embodiments, pharmaceutical compositions for oral administration are soft, sealed capsules made of gelatin and a plasticizer, such as glycerol or sorbitol. In certain soft capsules, one or more pharmaceutical agents of the present invention are be dissolved or suspended in suitable liquids, such as fatty oils, liquid paraffin, or liquid polyethylene glycols. In addition, stabilizers may be added.


In certain embodiments, pharmaceutical compositions are prepared for buccal administration. Certain of such pharmaceutical compositions are tablets or lozenges formulated in conventional manner.


In certain embodiments, a pharmaceutical composition is prepared for administration by injection (e.g., intravenous, subcutaneous, intramuscular, etc.). In certain of such embodiments, a pharmaceutical composition comprises a carrier and is formulated in aqueous solution, such as water or physiologically compatible buffers such as Hanks's solution, Ringer's solution, or physiological saline buffer (e.g., PBS). In certain embodiments, other ingredients are included (e.g., ingredients that aid in solubility or serve as preservatives). In certain embodiments, injectable suspensions are prepared using appropriate liquid carriers, suspending agents and the like. Certain pharmaceutical compositions for injection are presented in unit dosage form, e.g., in ampoules or in multi-dose containers. Certain pharmaceutical compositions for injection are suspensions, solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents. Certain solvents suitable for use in pharmaceutical compositions for injection include, but are not limited to, lipophilic solvents and fatty oils, such as sesame oil, synthetic fatty acid esters, such as ethyl oleate or triglycerides, and liposomes. Aqueous injection suspensions may contain substances that increase the viscosity of the suspension, such as sodium carboxymethyl cellulose, sorbitol, or dextran. Optionally, such suspensions may also contain suitable stabilizers or agents that increase the solubility of the pharmaceutical agents to allow for the preparation of highly concentrated solutions.


In certain embodiments, a pharmaceutical composition is prepared for transmucosal administration. In certain of such embodiments penetrants appropriate to the barrier to be permeated are used in the formulation. Such penetrants are generally known in the art.


In certain embodiments, a pharmaceutical composition is prepared for administration by inhalation. Certain of such pharmaceutical compositions for inhalation are prepared in the form of an aerosol spray in a pressurized pack or a nebulizer. Certain of such pharmaceutical compositions comprise a propellant, e.g., dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas. In certain embodiments using a pressurized aerosol, the dosage unit may be determined with a valve that delivers a metered amount. In certain embodiments, capsules and cartridges for use in an inhaler or insufflator may be formulated. Certain of such formulations comprise a powder mixture of a pharmaceutical agent of the invention and a suitable powder base such as lactose or starch.


In certain embodiments, a pharmaceutical composition is prepared for rectal administration, such as a suppositories or retention enema. Certain of such pharmaceutical compositions comprise known ingredients, such as cocoa butter and/or other glycerides.


In certain embodiments, a pharmaceutical composition is prepared for topical administration. Certain of such pharmaceutical compositions comprise bland moisturizing bases, such as ointments or creams. Exemplary suitable ointment bases include, but are not limited to, petrolatum, petrolatum plus volatile silicones, and lanolin and water in oil emulsions. Exemplary suitable cream bases include, but are not limited to, cold cream and hydrophilic ointment.


In certain embodiments, a pharmaceutical composition of the present invention comprises a modified oligonucleotide in a therapeutically effective amount. In certain embodiments, the therapeutically effective amount is sufficient to prevent, alleviate or ameliorate symptoms of a disease or to prolong the survival of the subject being treated.


Routes of Administration

In certain embodiments, administering to a subject comprises parenteral administration. In certain embodiments, administering to a subject comprises intravenous administration. In certain embodiments, administering to a subject comprises subcutaneous administration.


In certain embodiments, administration includes pulmonary administration. In certain embodiments, pulmonary administration comprises delivery of aerosolized oligonucleotide to the lung of a subject by inhalation. Following inhalation by a subject of aerosolized oligonucleotide, oligonucleotide distributes to cells of both normal and inflamed lung tissue, including alveolar macrophages, eosinophils, epithelium, blood vessel endothelium, and bronchiolar epithelium. A suitable device for the delivery of a pharmaceutical composition comprising a modified oligonucleotide includes, but is not limited to, a standard nebulizer device. Additional suitable devices include dry powder inhalers or metered dose inhalers.


In certain embodiments, pharmaceutical compositions are administered to achieve local rather than systemic exposures. For example, pulmonary administration delivers a pharmaceutical composition to the lung, with minimal systemic exposure.


Additional suitable administration routes include, but are not limited to, oral, rectal, transmucosal, intestinal, enteral, topical, suppository, intrathecal, intraventricular, intraperitoneal, intranasal, intraocular, intramuscular, intramedullary, and intratumoral.


Conjugated Antisense Compounds

In certain embodiments, the compounds of the invention can be covalently linked to one or more moieties or conjugates which enhance the activity, cellular distribution or cellular uptake of the resulting antisense oligonucleotides. Typical conjugate groups include cholesterol moieties and lipid moieties. Additional conjugate groups include carbohydrates, phospholipids, biotin, phenazine, folate, phenanthridine, anthraquinone, acridine, fluoresceins, rhodamines, coumarins, and dyes.


In certain embodiments, antisense compounds can also be modified to have one or more stabilizing groups that are generally attached to one or both termini of antisense compounds to enhance properties such as, for example, nuclease stability. Included in stabilizing groups are cap structures. These terminal modifications protect the antisense compound having terminal nucleic acid from exonuclease degradation, and can help in delivery and/or localization within a cell. The cap can be present at the 5′-terminus (5′-cap), or at the 3′-terminus (3′-cap), or can be present on both termini. Cap structures are well known in the art and include, for example, inverted deoxy abasic caps. Further 3′ and 5′-stabilizing groups that can be used to cap one or both ends of an antisense compound to impart nuclease stability include those disclosed in WO 03/004602 published on Jan. 16, 2003.


Cell Culture and Antisense Compounds Treatment

The effects of antisense compounds on the level, activity or expression of Factor XI nucleic acids can be tested in vitro in a variety of cell types. Cell types used for such analyses are available from commercial vendors (e.g. American Type Culture Collection, Manassus, Va.; Zen-Bio, Inc., Research Triangle Park, N.C.; Clonetics Corporation, Walkersville, Md.) and cells are cultured according to the vendor's instructions using commercially available reagents (e.g. Invitrogen Life Technologies, Carlsbad, Calif.). Illustrative cell types include, but are not limited to, HepG2 cells, Hep3B cells, and primary hepatocytes.


In Vitro Testing of Antisense Oligonucleotides

Described herein are methods for treatment of cells with antisense oligonucleotides, which can be modified appropriately for treatment with other antisense compounds.


In general, cells are treated with antisense oligonucleotides when the cells reach approximately 60-80% confluency in culture.


One reagent commonly used to introduce antisense oligonucleotides into cultured cells includes the cationic lipid transfection reagent LIPOFECTIN® (Invitrogen, Carlsbad, Calif.). Antisense oligonucleotides are mixed with LIPOFECTIN® in OPTI-MEM® 1 (Invitrogen, Carlsbad, Calif.) to achieve the desired final concentration of antisense oligonucleotide and a LIPOFECTIN® concentration that typically ranges 2 to 12 ug/mL per 100 nM antisense oligonucleotide.


Another reagent used to introduce antisense oligonucleotides into cultured cells includes LIPOFECTAMINE® (Invitrogen, Carlsbad, Calif.). Antisense oligonucleotide is mixed with LIPOFECTAMINE® in OPTI-MEM® 1 reduced serum medium (Invitrogen, Carlsbad, Calif.) to achieve the desired concentration of antisense oligonucleotide and a LIPOFECTAMINE® concentration that typically ranges 2 to 12 ug/mL per 100 nM antisense oligonucleotide.


Another technique used to introduce antisense oligonucleotides into cultured cells includes electroporation.


Cells are treated with antisense oligonucleotides by routine methods. Cells are typically harvested 16-24 hours after antisense oligonucleotide treatment, at which time RNA or protein levels of target nucleic acids are measured by methods known in the art and described herein. In general, when treatments are performed in multiple replicates, the data are presented as the average of the replicate treatments.


The concentration of antisense oligonucleotide used varies from cell line to cell line. Methods to determine the optimal antisense oligonucleotide concentration for a particular cell line are well known in the art. Antisense oligonucleotides are typically used at concentrations ranging from 1 nM to 300 nM when transfected with LIPOFECTAMINE®. Antisense oligonucleotides are used at higher concentrations ranging from 625 to 20,000 nM when transfected using electroporation.


RNA Isolation


RNA analysis can be performed on total cellular RNA or poly(A)+ mRNA. Methods of RNA isolation are well known in the art. RNA is prepared using methods well known in the art, for example, using the TRIZOL® Reagent (Invitrogen, Carlsbad, Calif.) according to the manufacturer's recommended protocols.


Analysis of Inhibition of Target Levels or Expression

Inhibition of levels or expression of a Factor XI nucleic acid can be assayed in a variety of ways known in the art. For example, target nucleic acid levels can be quantitated by, e.g., Northern blot analysis, competitive polymerase chain reaction (PCR), or quantitaive real-time PCR. RNA analysis can be performed on total cellular RNA or poly(A)+ mRNA. Methods of RNA isolation are well known in the art. Northern blot analysis is also routine in the art. Quantitative real-time PCR can be conveniently accomplished using the commercially available ABI PRISM® 7600, 7700, or 7900 Sequence Detection System, available from PE-Applied Biosystems, Foster City, Calif. and used according to manufacturer's instructions.


Quantitative Real-Time PCR Analysis of Target RNA Levels

Quantitation of target RNA levels may be accomplished by quantitative real-time PCR using the ABI PRISM® 7600, 7700, or 7900 Sequence Detection System (PE-Applied Biosystems, Foster City, Calif.) according to manufacturer's instructions. Methods of quantitative real-time PCR are well known in the art.


Prior to real-time PCR, the isolated RNA is subjected to a reverse transcriptase (RT) reaction, which produces complementary DNA (cDNA) that is then used as the substrate for the real-time PCR amplification. The RT and real-time PCR reactions are performed sequentially in the same sample well. RT and real-time PCR reagents are obtained from Invitrogen (Carlsbad, Calif.). RT, real-time-PCR reactions are carried out by methods well known to those skilled in the art.


Gene (or RNA) target quantities obtained by real time PCR are normalized using either the expression level of a gene whose expression is constant, such as cyclophilin A or GAPDH, or by quantifying total RNA using RIBOGREEN® (Invitrogen, Inc. Carlsbad, Calif.). Cyclophilin A or GAPDH expression is quantified by real time PCR, by being run simultaneously with the target, multiplexing, or separately. Total RNA is quantified using RIBOGREEN® RNA quantification reagent (Invitrogen, Carlsbad, Calif.). Methods of RNA quantification by RIBOGREEN® are taught in Jones, L. J., et al, (Analytical Biochemistry, 1998, 265, 368-374). A CYTOFLUOR® 4000 instrument (PE Applied Biosystems) is used to measure RIBOGREEN® fluorescence.


Probes and primers are designed to hybridize to a Factor XI nucleic acid. Methods for designing real-time PCR probes and primers are well known in the art, and may include the use of software such as PRIMER EXPRESS® Software (Applied Biosystems, Foster City, Calif.).


The PCR probes have JOE or FAM covalently linked to the 5′ end and TAMRA or MGB covalently linked to the 3′ end, where JOE or FAM is the fluorescent reporter dye and TAMRA or MGB is the quencher dye. In some cell types, primers and probe designed to a sequence from a different species are used to measure expression. For example, a human GAPDH primer and probe set can be used to measure GAPDH expression in monkey-derived cells and cell lines.


Analysis of Protein Levels

Antisense inhibition of Factor XI nucleic acids can be assessed by measuring Factor XI protein levels. Protein levels of Factor XI can be evaluated or quantitated in a variety of ways well known in the art, such as immunoprecipitation, Western blot analysis (immunoblotting), enzyme-linked immunosorbent assay (ELISA), quantitative protein assays, protein activity assays (for example, caspase activity assays), immunohistochemistry, immunocytochemistry or fluorescence-activated cell sorting (FACS). Antibodies directed to a target can be identified and obtained from a variety of sources, such as the MSRS catalog of antibodies (Aerie Corporation, Birmingham, Mich.), or can be prepared via conventional monoclonal or polyclonal antibody generation methods well known in the art. Antibodies useful for the detection of human and rat Factor XI are commercially available.


In Vivo Testing of Antisense Compounds

Antisense compounds, for example, antisense oligonucleotides, are tested in animals to assess their ability to inhibit expression of Factor XI and produce phenotypic changes, such as, prolonged aPTT, prolonged aPTT time in conjunction with a normal PT, decreased quantity of Platelet Factor 4 (PF-4), reduced induction of asthma, reduced formation of arthritis, reduced formation of colitis, increased time for asthma formation, arthritis formation and increased time for colitis formation. Testing may be performed in normal animals, or in experimental disease models. For administration to animals, antisense oligonucleotides are formulated in a pharmaceutically acceptable diluent, such as phosphate-buffered saline. Administration includes parenteral routes of administration, such as intraperitoneal, intravenous, and subcutaneous. In one embodiment, following a period of treatment with antisense oligonucleotides, RNA is isolated from liver tissue and changes in Factor XI nucleic acid expression are measured. Changes in Factor XI protein levels can be measured by determining clot times, e.g. PT and aPTT, using plasma from treated animals, or by measuring the level of inflammation, inflammatory conditions (e.g., asthma, arthritis, colitis) or inflammatory markers (inflammatory cytokines) present in the animal.


Certain Indications

In certain embodiments, the invention provides methods of treating an individual comprising administering one or more pharmaceutical compositions of the present invention. In certain embodiments, the individual has or is at risk for an inflammatory disease, disorder or condition. In certain embodiments, the individual is at risk for an inflammatory disease, disorder or condition as described supra. In certain embodiments the invention provides methods for prophylactically reducing Factor XI expression in an individual. Certain embodiments include treating an individual in need thereof by administering to an individual a therapeutically effective amount of an antisense compound targeted to a Factor XI nucleic acid.


In certain embodiments, administration of a therapeutically effective amount of an antisense compound targeted to a Factor XI nucleic acid is accompanied by monitoring of Factor XI levels in the serum of an individual, to determine an individual's response to administration of the antisense compound. An individual's response to administration of the antisense compound is used by a physician to determine the amount and duration of therapeutic intervention.


In certain embodiments, administration of an antisense compound targeted to a Factor XI nucleic acid results in reduction of Factor XI expression by at least 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 99%, or a range defined by any two of these values. In certain embodiments, administration of an antisense compound targeted to a Factor XI nucleic acid results in a change in a measure of blood clotting as measured by a standard test, for example, but not limited to, activated partial thromboplastin time (aPTT) test, prothrombin time (PT) test, thrombin time (TCT), bleeding time, or D-dimer. Alternatively, a change in inflammation (e.g., asthma, arthritis or colitis levels) can be determined in animal models with inflammation (e.g., induced asthma, arthritis or colitis). In certain embodiments, administration of a Factor XI antisense compound increases the measure by at least 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 99%, or a range defined by any two of these values. In some embodiments, administration of a Factor XI antisense compound decreases the measure by at least 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 99%, or a range defined by any two of these values.


In certain embodiments, pharmaceutical compositions comprising an antisense compound targeted to Factor XI are used for the preparation of a medicament for treating a patient suffering or susceptible to an inflammatory disease, disorder or condition.


Certain Combination Therapies

In certain embodiments, one or more pharmaceutical compositions of the present invention are co-administered with one or more other pharmaceutical agents. In certain embodiments, such one or more other pharmaceutical agents are designed to treat the same disease, disorder, or condition as the one or more pharmaceutical compositions of the present invention. In certain embodiments, such one or more other pharmaceutical agents are designed to treat a different disease, disorder, or condition as the one or more pharmaceutical compositions of the present invention. In certain embodiments, such one or more other pharmaceutical agents are designed to treat an undesired side effect of one or more pharmaceutical compositions of the present invention. In certain embodiments, one or more pharmaceutical compositions of the present invention are co-administered with another pharmaceutical agent to treat an undesired effect of that other pharmaceutical agent. In certain embodiments, one or more pharmaceutical compositions of the present invention are co-administered with another pharmaceutical agent to produce a combinational effect. In certain embodiments, one or more pharmaceutical compositions of the present invention are co-administered with another pharmaceutical agent to produce a synergistic effect.


In certain embodiments, one or more pharmaceutical compositions of the present invention and one or more other pharmaceutical agents are administered at the same time. In certain embodiments, one or more pharmaceutical compositions of the present invention and one or more other pharmaceutical agents are administered at different times. In certain embodiments, one or more pharmaceutical compositions of the present invention and one or more other pharmaceutical agents are prepared together in a single formulation. In certain embodiments, one or more pharmaceutical compositions of the present invention and one or more other pharmaceutical agents are prepared separately.


In certain embodiments, pharmaceutical agents that may be co-administered with a pharmaceutical composition of the present invention include NSAIDS and/or disease modifying drugs as described supra. In certain embodiments, the disease modifying drug is administered prior to administration of a pharmaceutical composition of the present invention. In certain embodiments, the disease modifying drug is administered following administration of a pharmaceutical composition of the present invention. In certain embodiments the disease modifying drugs is administered at the same time as a pharmaceutical composition of the present invention. In certain embodiments the dose of a co-administered disease modifying drugs is the same as the dose that would be administered if the disease modifying drug was administered alone. In certain embodiments the dose of a co-administered disease modifying drug is lower than the dose that would be administered if the disease modifying drugs was administered alone. In certain embodiments the dose of a co-administered disease modifying drug is greater than the dose that would be administered if the disease modifying drugs was administered alone.


In certain embodiments, the co-administration of a second compound enhances the effect of a first compound, such that co-administration of the compounds results in an effect that is greater than the effect of administering the first compound alone. In other embodiments, the co-administration results in effects that are additive of the effects of the compounds when administered alone. In certain embodiments, the co-administration results in effects that are supra-additive of the effects of the compounds when administered alone. In certain embodiments, the first compound is an antisense compound. In certain embodiments, the second compound is an antisense compound.


In certain embodiments, an antidote is administered anytime after the administration of a Factor XI specific inhibitor. In certain embodiments, an antidote is administered anytime after the administration of an antisense oligonucleotide targeting Factor XI. In certain embodiments, the antidote is administered minutes, hours, days, weeks, or months after the administration of an antisense compound targeting Factor XI. In certain embodiments, the antidote is a complementary (e.g. the sense strand) to the antisense compound targeting Factor XI. In certain embodiments, the antidote is a Factor 7, Factor 7a, Factor XI, or Factor XIa protein. In certain embodiments, the Factor 7, Factor 7a, Factor XI, or Factor XIa protein is a human Factor 7, human Factor 7a, human Factor XI, or human Factor XIa protein. In certain embodiments, the Factor 7 protein is NovoSeven.


ADVANTAGES OF THE INVENTION

Provided herein, for the first time, are methods and compositions for the modulation of Factor XI that can treat, prevent and/or ameliorate an inflammatory response. In a particular embodiment, provided are Factor XI oligonucleotides (oligonucleotides targeting a nucleic acid encoding Factor XI protein) to ameliorate an inflammatory condition such as arthritis or colitis.


EXAMPLES
Non-Limiting Disclosure and Incorporation by Reference

While certain compounds, compositions and methods described herein have been described with specificity in accordance with certain embodiments, the following examples serve only to illustrate the compounds described herein and are not intended to limit the same. Each of the references recited in the present application is incorporated herein by reference in its entirety.


Example 1
Antisense Inhibition of Human Factor XI in HepG2 Cells

Antisense oligonucleotides targeted to a Factor XI nucleic acid were tested for their effects on Factor XI mRNA in vitro. Cultured HepG2 cells at a density of 10,000 cells per well were transfected using lipofectin reagent with 75 nM antisense oligonucleotide. After a treatment period of approximately 24 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells.


The chimeric antisense oligonucleotides in Tables 1 and 2 were designed as 5-10-5 MOE gapmers. The gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. Each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. Each gapmer listed in Table 1 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3) and each gapmer listed in Table 2 is targeted to SEQ ID NO: 2 (GENBANK Accession No. NT022792.17, truncated from 19598000 to 19624000).









TABLE 1







Inhibiton of human Factor XI mRNA levels by chimeric antisense


oligonucleotides having 5-10-5 MOE wings and deoxy


gap targeted to SEQ ID NO: 1













Target
Target

%
SEQ


Oligo ID
Start Site
Stop Site
Sequence
inhibition
ID NO















412187
38
57
TTCAAACAAGTGACATACAC
21
15





412188
96
115
TGAGAGAATTGCTTGCTTTC
21
16





412189
106
125
AAATATACCTTGAGAGAATT
8
17





412190
116
135
AGTATGTCAGAAATATACCT
24
18





412191
126
145
TTAAAATCTTAGTATGTCAG
14
19





412192
146
165
CAGCATATTTGTGAAAGTCG
44
20





412193
222
241
TGTGTAGGAAATGGTCACTT
38
21





412194
286
305
TGCAATTCTTAATAAGGGTG
80
22





412195
321
340
AAATCATCCTGAAAAGACCT
22
23





412196
331
350
TGATATAAGAAAATCATCCT
25
24





412197
376
395
ACACATTCACCAGAAACTGA
45
25





412198
550
569
TTCAGGACACAAGTAAACCA
21
26





412199
583
602
TTCACTCTTGGCAGTGTTTC
66
27





412200
612
631
AAGAATACCCAGAAATCGCT
59
28





412201
622
641
CATTGCTTGAAAGAATACCC
66
29





412202
632
651
TTGGTGTGAGCATTGCTTGA
65
30





412203
656
675
AATGTCTTTGTTGCAAGCGC
91
31





412204
676
695
TTCATGTCTAGGTCCACATA
74
32





412205
686
705
GTTTATGCCCTTCATGTCTA
69
33





412206
738
757
CCGTGCATCTTTCTTGGCAT
87
34





412207
764
783
CGTGAAAAAGTGGCAGTGGA
64
35





412208
811
830
AGACAAATGTTACGATGCTC
73
36





412209
821
840
GTGCTTCAGTAGACAAATGT
91
37





412210
896
915
TGCACAGGATTTCAGTGAAA
73
38





412211
906
925
GATTAGAAAGTGCACAGGAT
64
39





412212
1018
1037
CCGGGATGATGAGTGCAGAT
88
40





412213
1028
1047
AAACAAGCAACCGGGATGAT
71
41





412214
1048
1067
TCCTGGGAAAAGAAGGTAAA
58
42





412215
1062
1081
ATTCTTTGGGCCATTCCTGG
81
43





412216
1077
1096
AAAGATTTCTTTGAGATTCT
43
44





412217
1105
1124
AATCCACTCTCAGATGTTTT
47
45





412218
1146
1165
AACCAGAAAGAGCTTTGCTC
27
46





412219
1188
1207
GGCAGAACACTGGGATGCTG
56
47





412220
1204
1223
TGGTAAAATGAAGAATGGCA
58
48





412221
1214
1233
ATCAGTGTCATGGTAAAATG
48
49





412222
1241
1263
AACAATATCCAGTTCTTCTC
5
50





412223
1275
1294
ACAGTTTCTGGCAGGCCTCG
84
51





412224
1285
1304
GCATTGGTGCACAGTTTCTG
87
52





412225
1295
1314
GCAGCGGACGGCATTGGTGC
86
53





412226
1371
1390
TTGAAGAAAGCTTTAAGTAA
17
54





412227
1391
1410
AGTATTTTAGTTGGAGATCC
75
55





412228
1425
1444
ATGTGTATCCAGAGATGCCT
71
56





412229
1456
1475
GTACACTCATTATCCATTTT
64
57





412230
1466
1485
GATTTTGGTGGTACACTCAT
52
58





412231
1476
1495
TCCTGGGCTTGATTTTGGTG
74
59





412232
1513
1532
GGCCACTCACCACGAACAGA
80
60





412233
1555
1574
TGTCTCTGAGTGGGTGAGGT
64
61





412234
1583
1602
GTTTCCAATGATGGAGCCTC
60
62





412235
1593
1612
ATATCCACTGGTTTCCAATG
57
63





412236
1618
1637
CCATAGAAACAGTGAGCGGC
72
64





412237
1628
1647
TGACTCTACCCCATAGAAAC
48
65





412238
1642
1661
CGCAAAATCTTAGGTGACTC
71
66





412239
1673
1692
TTCAGATTGATTTAAAATGC
43
67





412240
1705
1724
TGAACCCCAAAGAAAGATGT
32
68





412241
1715
1734
TATTATTTCTTGAACCCCAA
41
69





412242
1765
1784
AACAAGGCAATATCATACCC
49
70





412243
1775
1794
TTCCAGTTTCAACAAGGCAA
70
71





412244
1822
1841
GAAGGCAGGCATATGGGTCG
53
72





412245
1936
1955
GTCACTAAGGGTATCTTGGC
75
73





412246
1992
2011
AGATCATCTTATGGGTTATT
68
74





412247
2002
2021
TAGCCGGCACAGATCATCTT
75
75





412248
2082
2101
CCAGATGCCAGACCTCATTG
53
76





412249
2195
2214
CATTCACACTGCTTGAGTTT
55
77





412250
2268
2287
TGGCACAGTGAACTCAACAC
63
78





412251
2326
2345
CTAGCATTTTCTTACAAACA
58
79





412252
2450
2469
TTATGGTAATTCTTGGACTC
39
80





412253
2460
2479
AAATATTGCCTTATGGTAAT
20
81





412254
2485
2504
TATCTGCCTATATAGTAATC
16
82





412255
2510
2529
GCCACTACTTGGTTATTTTC
38
83





412256
2564
2583
AACAAATCTATTTATGGTGG
39
84





412257
2622
2641
CTGCAAAATGGTGAAGACTG
57
85





412258
2632
2651
GTGTAGATTCCTGCAAAATG
44
86





412259
2882
2901
TTTTCAGGAAAGTGTATCTT
37
87





412260
2892
2911
CACAAATCATTTTTCAGGAA
27
88





412261
2925
2944
TCCCAAGATATTTTAAATAA
3
89





412262
3168
3187
AATGAGATAAATATTTGCAC
34
90





412263
3224
3243
TGAAAGCTATGTGGTGACAA
33
91





412264
3259
3278
CACACTTGATGAATTGTATA
27
92





413460
101
120
TACCTTGAGAGAATTGCTTG
40
93





413461
111
130
GTCAGAAATATACCTTGAGA
39
94





413462
121
140
ATCTTAGTATGTCAGAAATA
12
95





413463
381
400
GAGTCACACATTCACCAGAA
74
96





413464
627
646
GTGAGCATTGCTTGAAAGAA
42
97





413465
637
656
CTTATTTGGTGTGAGCATTG
80
98





413466
661
680
ACATAAATGTCTTTGTTGCA
79
99





413467
666
685
GGTCCACATAAATGTCTTTG
91
100





413468
671
690
GTCTAGGTCCACATAAATGT
84
101





413469
681
700
TGCCCTTCATGTCTAGGTCC
84
102





413470
692
711
GTTATAGTTTATGCCCTTCA
72
103





413471
816
835
TCAGTAGACAAATGTTACGA
67
104





413472
826
845
TGGGTGTGCTTCAGTAGACA
99
105





413473
911
930
AGCCAGATTAGAAAGTGCAC
80
106





413474
1023
1042
AGCAACCGGGATGATGAGTG
84
107





413475
1053
1072
GCCATTCCTGGGAAAAGAAG
80
108





413476
1067
1086
TTGAGATTCTTTGGGCCATT
88
109





413477
1151
1170
ACTGAAACCAGAAAGAGCTT
54
110





413478
1193
1212
AGAATGGCAGAACACTGGGA
53
111





413479
1209
1228
TGTCATGGTAAAATGAAGAA
40
112





413480
1219
1238
AAGAAATCAGTGTCATGGTA
71
113





413481
1280
1299
GGTGCACAGTTTCTGGCAGG
86
114





413482
1290
1309
GGACGGCATTGGTGCACAGT
85
115





413483
1300
1319
AACTGGCAGCGGACGGCATT
78
116





413484
1430
1449
CCTTAATGTGTATCCAGAGA
74
117





413485
1461
1480
TGGTGGTACACTCATTATCC
68
118





413486
1471
1490
GGCTTGATTTTGGTGGTACA
83
119





413487
1481
1500
AACGATCCTGGGCTTGATTT
57
120





413488
1560
1579
ACAGGTGTCTCTGAGTGGGT
49
121





413489
1588
1607
CACTGGTTTCCAATGATGGA
68
122





413490
1623
1642
CTACCCCATAGAAACAGTGA
57
123





413491
1633
1652
TTAGGTGACTCTACCCCATA
73
124





413492
1647
1666
AGACACGCAAAATCTTAGGT
68
125





413493
1710
1729
TTTCTTGAACCCCAAAGAAA
65
126





413494
1780
1799
GTGGTTTCCAGTTTCAACAA
70
127





413495
1921
1940
TTGGCTTTCTGGAGAGTATT
58
128





413496
1997
2016
GGCACAGATCATCTTATGGG
72
129





413497
2627
2646
GATTCCTGCAAAATGGTGAA
39
130





413498
2637
2656
GCAGAGTGTAGATTCCTGCA
60
131





413499
2887
2906
ATCATTTTTCAGGAAAGTGT
52
132
















TABLE 2







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides having 5-10-5 MOW wings and deoxy


gap targeted to SEQ ID NO: 2













Target
Target

%
SEQ ID


Oligo ID
Start Site
Stop Site
Sequence
inhibition
NO















413500
1658
1677
GTGAGACAAATCAAGACTTC
15
133





413501
2159
2178
TTAGTTTACTGACACTAAGA
23
134





413502
2593
2612
CTGCTTTATGAAAAACCAAC
22
135





413503
3325
3344
ATACCTAGTACAATGTAAAT
29
136





413504
3548
3567
GGCTTGTGTGTGGTCAATAT
54
137





413505
5054
5073
TGGGAAAGCTTTCAATATTC
57
138





413506
6474
6493
ATGGAATTGTGCTTATGAGT
57
139





413507
7590
7609
TTTCAAGCTCAGGATGGGAA
55
140





413508
7905
7924
GTTGGTAAAATGCAACCAAA
64
141





413509
8163
8182
TCAGGACACAAGTAAACCTG
66
142





413510
9197
9216
TGCAAGCTGGAAATAAAAGC
17
143





413511
9621
9640
TGCCAATTTAAAAGTGTAGC
43
144





413512
9800
9819
ATATTTCAAAATCCAGTATG
39
145





413513
9919
9938
TTCTGAATATACAAATTAAT
27
146





413514
9951
9970
TTTACTATGAAAATCTAAAT
5
147





413515
11049
11068
GGTATCCTGAGTGAGATCTA
36
148





413516
11269
11288
CCAGCTATCAGGAAAATTCC
50
149





413517
12165
12184
AAAGCTATTGGAGACTCAGA
51
150





413518
12584
12603
ATGGAATCTCTTCATTTCAT
49
151





413519
12728
12747
ATGGAGACATTCATTTCCAC
59
152





413520
13284
13303
GCTCTGAGAGTTCCAATTCA
52
153





413521
14504
14523
CTGGGAAGGTGAATTTTTAG
62
154





413522
14771
14790
TCAAGAGTCTTCATGCTACC
42
155





413523
15206
15225
TCAGTTTACCTGGGATGCTG
61
156





413524
15670
15689
GACATTATACTCACCATTAT
7
157





413525
15905
15924
GTATAAATGTGTCAAATTAA
43
158





413526
16482
16501
GTAAAGTTTTACCTTAACCT
47
159





413527
17298
17317
CCATAATGAAGAAGGAAGGG
52
160





413528
17757
17776
TTAAGTTACATTGTAGACCA
48
161





413529
18204
18223
TGTGTGGGTCCTGAAATTCT
52
162





413530
18981
19000
ATCTTGTAATTACACACCCC
27
163





413531
19174
19193
GTACACTCTGCAACAGAAGC
47
164





413532
19604
19623
AGGGAATAACATGAAGGCCC
32
165





413533
20936
20955
ATCCAGTTCACCATTGGAGA
48
166





413534
21441
21460
TTTTCCAGAAGAGACTCTTC
31
167





413535
21785
21804
GTCACATTTAAAATTTCCAA
41
168





413536
23422
23441
TTAATATACTGCAGAGAACC
37
169





413537
25893
25912
AGAAATATCCCCAGACAGAG
16
170









Example 2
Dose-Dependent Antisense Inhibition of Human Factor XI in HepG2 Cells

Twelve gapmers, exhibiting over 84 percent or greater in vitro inhibition of human Factor XI, were tested at various doses in HepG2 cells. Cells were plated at a density of 10,000 cells per well and transfected using lipofectin reagent with 9.375 nM, 18.75 nM, 37.5 nM, 75 nM, and 150 nM concentrations of antisense oligonucleotide, as specified in Table 3. After a treatment period of approximately 16 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 (forward sequence: CAGCCTGGAGCATCGTAACA, incorporated herein as SEQ ID NO: 3; reverse sequence: TTTATCGAGCTTCGTTATTCTGGTT, incorporated herein as SEQ ID NO: 4; probe sequence: TTGTCTACTGAAGCACACCCAAACAGGGAX, wherein X is the fluorophore, incorporated herein as SEQ ID NO: 5) was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells. As illustrated in Table 3, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells.









TABLE 3







Dose-dependent antisense inhibition


of human Factor XI in HepG2 cells














9.375
18.75
37.5
75
150
SEQ



nM
nM
nM
nM
nM
ID No.

















412203
29
15
61
77
82
31


412206
28
44
68
80
89
34


412212
28
45
59
73
88
40


412223
33
48
62
76
81
51


412224
24
45
57
70
81
52


412225
32
42
65
78
73
53


413467
2
35
49
61
47
100


413468
14
34
56
78
75
101


413469
24
33
53
70
84
102


413476
26
44
64
73
82
109


413481
22
38
56
67
83
114


413482
26
39
59
74
82
115









Example 3
Antisense Inhibition of Human Factor XI in HepG2 Cells by Oligonucleotides Designed by Microwalk

Additional gapmers were designed based on the gapmers presented in Table 3. These gapmers were designed by creating gapmers shifted slightly upstream and downstream (i.e. “microwalk”) of the original gapmers from Table 3. Gapmers were also created with various motifs, e.g. 5-10-5 MOE, 3-14-3 MOE, and 2-13-5 MOE. These gapmers were tested in vitro. Cultured HepG2 cells at a density of 10,000 cells per well were transfected using lipofectin reagent with 75 nM antisense oligonucleotide. After a treatment period of approximately 24 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells.


The in vitro inhibition data for the gapmers designed by microwalk were then compared with the in vitro inhibition data for the gapmers from Table 3, as indicated in Tables 4, 5, 6, 7, and 8. The oligonucleotides are displayed according to the region on the human mRNA (GENBANK Accession No. NM000128.3) to which they map.


The chimeric antisense oligonucleotides in Table 4 were designed as 5-10-5 MOE, 3-14-3 MOE, and 2-13-5 MOE gapmers. The first listed gapmers in Table 4 are the original gapmers (see Table 3) from which the remaining gapmers were designed via microwalk and are designated by an asterisk. The 5-10-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. The 3-14-3 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 14 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 3 nucleotides each. The 2-13-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 13 2′-deoxynucleotides. The central gap is flanked on the 5′ end with a wing comprising 2 nucleotides and on the 3′ end with a wing comprising 5 nucleotides. For each of the motifs (5-10-5, 3-14-3, and 2-13-5), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. Each gapmer listed in Table 4 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3).


As shown in Table 4, all of the 5-10-5 MOE gapmers, 3-14-3 MOE gapmers, and 2-13-5 MOE gapmers targeted to the target region beginning at target start site 656 and ending at the target stop site 675 (i.e. nucleobases 656-675) of SEQ ID NO: 1 exhibit at least 20% inhibition of Factor XI mRNA. Many of the gapmers exhibit at least 60% inhibition. Several of the gapmers exhibit at least 80% inhibition, including ISIS numbers: 416806, 416809, 416811, 416814, 416821, 416825, 416826, 416827, 416828, 416868, 416869, 416878, 416879, 416881, 416883, 416890, 416891, 416892, 416893, 416894, 416895, 416896, 416945, 416946, 416969, 416970, 416971, 416972, 416973, 412203, 413467, 413468, and 413469. The following ISIS numbers exhibited at least 90% inhibition: 412203, 413467, 416825, 416826, 416827, 416868, 416878, 416879, 416892, 416893, 416895, 416896, 416945, 416972, and 416973. The following ISIS numbers exhibited at least 95% inhibition: 416878, 416892, 416895, and 416896.









TABLE 4







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides targeted to nucleobases 656 to 704 of SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3.3)














Target
Target

%

SEQ


ISIS No.
Start Site
Stop Site
Sequence (5′ to 3′)
inhibition
Motif
ID No.
















*412203
656
675
AATGTCTTTGTTGCAAGCGC
91
5-10-5
31





*413467
666
685
GGTCCACATAAATGTCTTTG
92
5-10-5
100





*413468
671
690
GTCTAGGTCCACATAAATGT
83
5-10-5
101





*413469
681
700
TGCCCTTCATGTCTAGGTCC
86
5-10-5
102





416868
656
675
AATGTCTTTGTTGCAAGCGC
93
3-14-3
31





416945
656
675
AATGTCTTTGTTGCAAGCGC
94
2-13-5
31





416806
657
676
AAATGTCTTTGTTGCAAGCG
86
5-10-5
171





416869
657
676
AAATGTCTTTGTTGCAAGCG
81
3-14-3
171





416946
657
676
AAATGTCTTTGTTGCAAGCG
86
2-13-5
171





416807
658
677
TAAATGTCTTTGTTGCAAGC
51
5-10-5
172





416870
658
677
TAAATGTCTTTGTTGCAAGC
76
3-14-3
172





416947
658
677
TAAATGTCTTTGTTGCAAGC
62
2-13-5
172





416808
659
678
ATAAATGTCTTTGTTGCAAG
55
5-10-5
173





416871
659
678
ATAAATGTCTTTGTTGCAAG
28
3-14-3
173





416948
659
678
ATAAATGTCTTTGTTGCAAG
62
2-13-5
173





416809
660
679
CATAAATGTCTTTGTTGCAA
86
5-10-5
174





416872
660
679
CATAAATGTCTTTGTTGCAA
20
3-14-3
174





416949
660
679
CATAAATGTCTTTGTTGCAA
64
2-13-5
174





416873
661
680
ACATAAATGTCTTTGTTGCA
51
3-14-3
99





416950
661
680
ACATAAATGTCTTTGTTGCA
71
2-13-5
99





416810
662
681
CACATAAATGTCTTTGTTGC
68
5-10-5
175





416874
662
681
CACATAAATGTCTTTGTTGC
49
3-14-3
175





416951
662
681
CACATAAATGTCTTTGTTGC
48
2-13-5
175





416811
663
682
CCACATAAATGTCTTTGTTG
84
5-10-5
176





416875
663
682
CCACATAAATGTCTTTGTTG
75
3-14-3
176





416952
663
682
CCACATAAATGTCTTTGTTG
51
2-13-5
176





416812
664
68
TCCACATAAATGTCTTTGTT
59
5-10-5
177





416876
664
683
TCCACATAAATGTCTTTGTT
37
3-14-3
177





416953
664
683
TCCACATAAATGTCTTTGTT
45
2-13-5
177





416813
665
684
GTCCACATAAATGTCTTTGT
70
5-10-5
178





416877
665
684
GTCCACATAAATGTCTTTGT
51
3-14-3
178





416954
665
684
GTCCACATAAATGTCTTTGT
61
2-13-5
178





416878
666
685
GGTCCACATAAATGTCTTTG
95
3-14-3
100





416955
666
685
GGTCCACATAAATGTCTTTG
75
2-13-5
100





416814
667
686
AGGTCCACATAAATGTCTTT
83
5-10-5
179





416879
667
686
AGGTCCACATAAATGTCTTT
92
3-14-3
179





416956
667
686
AGGTCCACATAAATGTCTTT
61
2-13-5
179





416815
668
687
TAGGTCCACATAAATGTCTT
63
5-10-5
180





416880
668
687
TAGGTCCACATAAATGTCTT
66
3-14-3
180





416957
668
687
TAGGTCCACATAAATGTCTT
59
2-13-5
180





416816
669
688
CTAGGTCCACATAAATGTCT
79
5-10-5
181





416881
669
688
CTAGGTCCACATAAATGTCT
81
3-14-3
181





416958
669
688
CTAGGTCCACATAAATGTCT
43
2-13-5
181





416817
670
689
TCTAGGTCCACATAAATGTC
74
5-10-5
182





416882
670
689
TCTAGGTCCACATAAATGTC
60
3-14-3
182





416959
670
689
TCTAGGTCCACATAAATGTC
25
2-13-5
182





416883
671
690
GTCTAGGTCCACATAAATGT
82
3-14-3
101





416960
671
690
GTCTAGGTCCACATAAATGT
60
2-13-5
101





416818
672
691
TGTCTAGGTCCACATAAATG
76
5-10-5
183





416884
672
691
TGTCTAGGTCCACATAAATG
69
3-14-3
183





416961
672
691
TGTCTAGGTCCACATAAATG
40
2-13-5
183





416819
673
692
ATGTCTAGGTCCACATAAAT
56
5-10-5
184





416885
673
692
ATGTCTAGGTCCACATAAAT
67
3-14-3
184





416962
673
692
ATGTCTAGGTCCACATAAAT
77
2-13-5
184





416820
674
693
CATGTCTAGGTCCACATAAA
77
5-10-5
185





416886
674
693
CATGTCTAGGTCCACATAAA
74
3-14-3
185





416963
674
693
CATGTCTAGGTCCACATAAA
48
2-13-5
185





416821
675
694
TCATGTCTAGGTCCACATAA
84
5-10-5
186





416964
675
694
TCATGTCTAGGTCCACATAA
69
2-13-5
186





412204
676
695
TTCATGTCTAGGTCCACATA
76
5-10-5
32





416888
676
695
TTCATGTCTAGGTCCACATA
76
3-14-3
32





416965
676
695
TTCATGTCTAGGTCCACATA
53
2-13-5
32





416822
677
696
CTTCATGTCTAGGTCCACAT
76
5-10-5
187





416889
677
696
CTTCATGTCTAGGTCCACAT
60
3-14-3
187





416966
677
696
CTTCATGTCTAGGTCCACAT
64
2-13-5
187





116823
678
697
CCTTCATGTCTAGGTCCACA
77
5-10-5
188





416890
678
697
CCTTCATGTCTAGGTCCACA
87
3-14-3
188





416967
678
697
CCTTCATGTCTAGGTCCACA
75
2-13-5
188





416824
679
698
CCCTTCATGTCTAGGTCCAC
64
5-10-5
189





416891
679
698
CCCTTCATGTCTAGGTCCAC
81
3-14-3
189





416968
679
698
CCCTTCATGTCTAGGTCCAC
73
2-13-5
189





416825
680
699
GCCCTTCATGTCTAGGTCCA
92
5-10-5
190





416892
680
699
GCCCTTCATGTCTAGGTCCA
100
3-14-3
190





416969
680
699
GCCCTTCATGTCTAGGTCCA
80
2-13-5
190





416893
681
700
TGCCCTTCATGTCTAGGTCC
90
3-14-3
102





416970
681
700
TGCCCTTCATGTCTAGGTCC
88
2-13-5
102





416826
682
701
ATGCCCTTCATGTCTAGGTC
94
5-10-5
191





416894
682
701
ATGCCCTTCATGTCTAGGTC
84
3-14-3
191





416971
682
701
ATGCCCTTCATGTCTAGGTC
83
2-13-5
191





416827
683
702
TATGCCCTTCATGTCTAGGT
93
5-10-5
192





416895
683
702
TATGCCCTTCATGTCTAGGT
95
3-14-3
192





416972
683
702
TATGCCCTTCATGTCTAGGT
90
2-13-5
192





416828
684
703
TTATGCCCTTCATGTCTAGG
87
5-10-5
193





416896
684
703
TTATGCCCTTCATGTCTAGG
95
3-14-3
193





416973
684
703
TTATGCCCTTCATGTCTAGG
92
2-13-5
193





416829
685
704
TTTATGCCCTTCATGTCTAG
72
5-10-5
194





416897
685
704
TTTATGCCCTTCATGTCTAG
66
3-14-3
194





416974
685
704
TTTATGCCCTTCATGTCTAG
73
2-13-5
194









The chimeric antisense oligonucleotides in Table 5 were designed as 5-10-5 MOE, 3-14-3 MOE, and 2-13-5 MOE gapmers. The first listed gapmer in Table 5 is the original gapmer (see Table 3) from which the remaining gapmers were designed via microwalk and is designated by an asterisk. The 5-10-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. The 3-14-3 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 14 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 3 nucleotides each. The 2-13-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 13 2′-deoxynucleotides. The central gap is flanked on the 5′ end with a wing comprising 2 nucleotides and on the 3′ end with a wing comprising 5 nucleotides. For each of the motifs (5-10-5, 3-14-3, and 2-13-5), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. Each gapmer listed in Table 5 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3).


As shown in Table 5, all of the 5-10-5 MOE gapmers, 3-14-3 MOE gapmers, and 2-13-5 MOE gapmers targeted to the target region beginning at target start site 738 and ending at the target stop site 762 (i.e. nucleobases 738-762) of SEQ ID NO: 1 exhibit at least 45% inhibition of Factor XI mRNA. Most of the gapmers exhibit at least 60% inhibition. Several of the gapmers exhibit at least 80% inhibition, including ISIS numbers: 412206, 416830, 416831, 416898, 416899, 416900, 416903, 416975, 416976, 416977, and 416980. The following ISIS numbers exhibited at least 90% inhibition: 412206, 416831, and 416900.









TABLE 5







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides targeted to nucleobases 738 to 762 SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3.3)














Target
Target

%

SEQ


ISIS No.
Start Site
Stop Site
Sequence (5′ to 3′)
inhibition
Motif
ID No.
















*412206
738
757
CCGTGCATCTTTCTTGGCAT
93
5-10-5
34





416898
738
757
CCGTGCATCTTTCTTGGCAT
88
3-14-3
34





416975
738
757
CCGTGCATCTTTCTTGGCAT
87
2-13-5
34





416830
739
758
TCCGTGCATCTTTCTTGGCA
81
5-10-5
195





416899
739
758
TCCGTGCATCTTTCTTGGCA
86
3-14-3
195





416976
739
758
TCCGTGCATCTTTCTTGGCA
83
2-13-5
195





416831
740
759
ATCCGTGCATCTTTCTTGGC
91
5-10-5
196





416900
740
759
ATCCGTGCATCTTTCTTGGC
90
3-14-3
196





416977
740
759
ATCCGTGCATCTTTCTTGGC
82
2-13-5
196





416832
741
760
CATCCGTGCATCTTTCTTGG
79
5-10-5
197





416901
741
760
CATCCGTGCATCTTTCTTGG
65
3-14-3
197





416978
741
760
CATCCGTGCATCTTTCTTGG
76
2-13-5
197





416833
742
761
TCATCCGTGCATCTTTCTTG
65
5-10-5
198





416902
742
761
TCATCCGTGCATCTTTCTTG
46
3-14-3
198





416979
742
761
TCATCCGTGCATCTTTCTTG
63
2-13-5
198





416834
743
762
GTCATCCGTGCATCTTTCTT
58
5-10-5
199





416903
743
762
GTCATCCGTGCATCTTTCTT
88
3-14-3
199





416980
743
762
GTCATCCGTGCATCTTTCTT
87
2-13-5
199









The chimeric antisense oligonucleotides in Table 6 were designed as 5-10-5 MOE, 3-14-3 MOE, and 2-13-5 MOE gapmers. The first listed gapmers in Table 6 are the original gapmers (see Table 3) from which the remaining gapmers were designed via microwalk and are designated by an asterisk. The 5-10-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. The 3-14-3 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 14 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 3 nucleotides each. The 2-13-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 13 2′-deoxynucleotides. The central gap is flanked on the 5′ end with a wing comprising 2 nucleotides and on the 3′ end with a wing comprising 5 nucleotides. For each of the motifs (5-10-5, 3-14-3, and 2-13-5), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. Each gapmer listed in Table 6 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3).


As shown in Table 6, all of the 5-10-5 MOE gapmers, 3-14-3 MOE gapmers, and 2-13-5 MOE gapmers targeted to the target region beginning at target start site 1018 and ending at the target stop site 1042 (i.e. nucleobases 1018-1042) of SEQ ID NO: 1 exhibit at least 80% inhibition of Factor XI mRNA. The following ISIS numbers exhibited at least 90% inhibition: 413474, 416837, 416838, 416904, 416907, and 416908.









TABLE 6







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides targeted to nucleobases 1018 to 1042 of SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3.3)














Target
Target

%

SEQ


ISIS No.
Start Site
Stop Site
Sequence (5′ to 3′)
inhibition
Motif
ID No.
















*412212
1018
1037
CCGGGATGATGAGTGCAGAT
89
5-10-5
40





416904
1018
1037
CCGGGATGATGAGTGCAGAT
90
3-14-3
40





416981
1018
1037
CCGGGATGATGAGTGCAGAT
87
2-13-5
40





416835
1019
1038
ACCGGGATGATGAGTGCAGA
83
5-10-5
200





416905
1019
1038
ACCGGGATGATGAGTGCAGA
85
3-14-3
200





416982
1019
1038
ACCGGGATGATGAGTGCAGA
84
2-13-5
200





416836
1020
1039
AACCGGGATGATGAGTGCAG
89
5-10-5
201





416906
1020
1039
AACCGGGATGATGAGTGCAG
88
3-14-3
201





416983
1020
1039
AACCGGGATGATGAGTGCAG
86
2-13-5
201





416837
1021
1040
CAACCGGGATGATGAGTGCA
90
5-10-5
202





416907
1021
1040
CAACCGGGATGATGAGTGCA
90
3-14-3
202





416984
1021
1040
CAACCGGGATGATGAGTGCA
89
2-13-5
202





416838
1022
1041
GCAACCGGGATGATGAGTGC
94
5-10-5
203





416908
1022
1041
GCAACCGGGATGATGAGTGC
98
3-14-3
203





416985
1022
1041
GCAACCGGGATGATGAGTGC
88
2-13-5
203





413474
1023
1042
AGCAACCGGGATGATGAGTG
93
5-10-5
107









The chimeric antisense oligonucleotides in Table 7 were designed as 5-10-5 MOE, 3-14-3 MOE, and 2-13-5 MOE gapmers. The first listed gapmer in Table 7 is the original gapmer (see Table 3) from which the remaining gapmers were designed via microwalk and is designated by an asterisk. The 5-10-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. The 3-14-3 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 14 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 3 nucleotides each. The 2-13-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 13 2′-deoxynucleotides. The central gap is flanked on the 5′ end with a wing comprising 2 nucleotides and on the 3′ end with a wing comprising 5 nucleotides. For each of the motifs (5-10-5, 3-14-3, and 2-13-5), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. Each gapmer listed in Table 7 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3).


As shown in Table 7, all of the 5-10-5 MOE gapmers, 3-14-3 MOE gapmers, and 2-13-5 MOE gapmers targeted to the target region beginning at target start site 1062 and ending at the target stop site 1091 (i.e. nucleobases 1062-1091) of SEQ ID NO: 1 exhibit at least 20% inhibition of Factor XI mRNA. Many of the gapmers exhibit at least 50% inhibition, including: 412215, 413476, 413476, 416839, 416840, 416841, 416842, 416843, 416844, 416845, 416846, 416847, 416909, 416910, 416911, 416912, 416913, 416914, 416915, 416916, 416917, 416918, 416986, 416987, 416988, 416989, 416990, 416991, 416992, 416993, 416994, 416995. The following ISIS numbers exhibited at least 80% inhibition: 412215, 413476, 413476, 416839, 416840, 416841, 416842, 416843, 416844, 416845, 416910, 416911, 416912, 416913, 416914, 416916, 416917, 416986, 416987, 416989, 416991, 416992, 416993, and 416994. The following ISIS numbers exhibited at least 90% inhibition: 413476, 413476, 416842, 416844, 416910, 416911, 416912, 416913, 416916, 416917, and 416993.









TABLE 7







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides targeted to nucleobases 1062 to 1091 of SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3.3)














Target
Target

%

SEQ


ISIS No.
Start Site
Stop Site
Sequence (5′ to 3′)
inhibition
Motif
ID No.
















*413476
1067
1086
TTGAGATTCTTTGGGCCATT
93
5-10-5
109





412215
1062
1081
ATTCTTTGGGCCATTCCTGG
82
5-10-5
43





416909
1062
1081
ATTCTTTGGGCCATTCCTGG
78
3-14-3
43





416986
1062
1081
ATTCTTTGGGCCATTCCTGG
88
2-13-5
43





416839
1063
1082
GATTCTTTGGGCCATTCCTG
89
5-10-5
204





416910
1063
1082
GATTCTTTGGGCCATTCCTG
90
3-14-3
204





416987
1063
1082
GATTCTTTGGGCCATTCCTG
80
2-13-5
204





416840
1064
1083
AGATTCTTTGGGCCATTCCT
85
5-10-5
205





416911
1064
1083
AGATTCTTTGGGCCATTCCT
90
3-14-3
205





416988
1064
1083
AGATTCTTTGGGCCATTCCT
76
2-13-5
205





416841
1065
1084
GAGATTCTTTGGGCCATTCC
87
5-10-5
206





416912
1065
1084
GAGATTCTTTGGGCCATTCC
92
3-14-3
206





416989
1065
1084
GAGATTCTTTGGGCCATTCC
88
2-13-5
206





416842
1066
1085
TGAGATTCTTTGGGCCATTC
94
5-10-5
207





416913
1066
1085
TGAGATTCTTTGGGCCATTC
93
3-14-3
207





416990
1066
1085
TGAGATTCTTTGGGCCATTC
76
2-13-5
207





413476
1067
1086
TTGAGATTCTTTGGGCCATT
93
5-10-5
109





416914
1067
1086
TTGAGATTCTTTGGGCCATT
87
3-14-3
109





416991
1067
1086
TTGAGATTCTTTGGGCCATT
87
2-13-5
109





416843
1068
1087
TTTGAGATTCTTTGGGCCAT
89
5-10-5
208





416915
1068
1087
TTTGAGATTCTTTGGGCCAT
79
3-14-3
208





416992
1068
1087
TTTGAGATTCTTTGGGCCAT
84
2-13-5
208





416844
1069
1088
CTTTGAGATTCTTTGGGCCA
90
5-10-5
209





416916
1069
1088
CTTTGAGATTCTTTGGGCCA
91
3-14-3
209





416993
1069
1088
CTTTGAGATTCTTTGGGCCA
91
2-13-5
209





416845
1070
1089
TCTTTGAGATTCTTTGGGCC
86
5-10-5
210





416917
1070
1089
TCTTTGAGATTCTTTGGGCC
92
3-14-3
210





416994
1070
1089
TCTTTGAGATTCTTTGGGCC
83
2-13-5
210





416846
1071
1090
TTCTTTGAGATTCTTTGGGC
72
5-10-5
211





416918
1071
1090
TTCTTTGAGATTCTTTGGGC
63
3-14-3
211





416995
1071
1090
TTCTTTGAGATTCTTTGGGC
64
2-13-5
211





416847
1072
1091
TTTCTTTGAGATTCTTTGGG
50
5-10-5
212





416919
1072
1091
TTTCTTTGAGATTCTTTGGG
27
3-14-3
212





416996
1072
1091
TTTCTTTGAGATTCTTTGGG
22
2-13-5
212









The chimeric antisense oligonucleotides in Table 8 were designed as 5-10-5 MOE, 3-14-3 MOE, and 2-13-5 MOE gapmers. The first listed gapmers in Table 8 are the original gapmers (see Table 3) from which the remaining gapmers were designed via microwalk and are designated by an asterisk. The 5-10-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. The 3-14-3 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 14 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 3 nucleotides each. The 2-13-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 13 2′-deoxynucleotides. The central gap is flanked on the 5′ end with a wing comprising 2 nucleotides and on the 3′ end with a wing comprising 5 nucleotides. For each of the motifs (5-10-5, 3-14-3, and 2-13-5), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. Each gapmer listed in Table 8 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3).


As shown in Table 8, all of the 5-10-5 MOE gapmers, 3-14-3 MOE gapmers, and 2-13-5 MOE gapmers targeted to the target region beginning at target start site 1275 and ending at the target stop site 1318 (i.e. nucleobases 1275-1318) of SEQ ID NO: 1 exhibit at least 70% inhibition of Factor XI mRNA. Many of the gapmers exhibit at least 80% inhibition, including: 412223, 412224, 412225, 413482, 416848, 416849, 416850, 416851, 416852, 416853, 416854, 416855, 416856, 416857, 416858, 416859, 416860, 416861, 416862, 416863, 416864, 416865, 416866, 416867, 416920, 416921, 416922, 416923, 416924, 416925, 416926, 416927, 416928, 416929, 416930, 416931, 416932, 416933, 416934, 416935, 416936, 416937, 416938, 416939, 416940, 416941, 416942, 416943, 416944, 416997, 416998, 416999, 417000, 417001, 417002, 417003, 417004, 417006, 417007, 417008, 417009, 417010, 417011, 417013, 417014, 417015, 417016, 417017, 417018, 417019, and 417020. The following ISIS numbers exhibited at least 90% inhibition: 412224, 416850, 416853, 416856, 416857, 416858, 416861, 416862, 416864, 416922, 416923, 416924, 416925, 416926, 416928, 416931, 416932, 416933, 416934, 416935, 416937, 416938, 416940, 416941, 416943, 416999, and 417002.









TABLE 8







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides targeted to nucleobases 1275 to 1318 of SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3.3)














Target
Target

%

SEQ


ISIS No.
Start Site
Stop Site
Sequence (5′ to 3′)
inhibition
Motif
ID No.
















*412223
1275
1294
ACAGTTTCTGGCAGGCCTCG
85
5-10-5
51





*412224
1285
1304
GCATTGGTGCACAGTTTCTG
93
5-10-5
52





*413482
1290
1309
GGACGGCATTGGTGCACAGT
89
5-10-5
115





*412225
1295
1314
GCAGCGGACGGCATTGGTGC
86
5-10-5
53





416920
1275
1294
ACAGTTTCTGGCAGGCCTCG
88
3-14-3
51





416997
1275
1295
ACAGTTTCTGGCAGGCCTCG
84
2-13-5
51





416848
1276
1295
CACAGTTTCTGGCAGGCCTC
86
5-10-5
213





416921
1276
1295
CACAGTTTCTGGCAGGCCTC
88
3-14-3
213





416998
1276
1295
CACAGTTTCTGGCAGGCCTC
88
2-13-5
213





416849
1277
1296
GCACAGTTTCTGGCAGGCCT
88
5-10-5
214





416922
1277
1294
GCACAGTTTCTGGCAGGCCT
94
3-14-3
214





416999
1277
1296
GCACAGTTTCTGGCAGGCCT
92
2-13-5
214





416850
1278
1297
TGCACAGTTTCTGGCAGGCC
93
5-10-5
215





416923
1278
1297
TGCACAGTTTCTGGCAGGCC
96
3-14-3
215





417000
1278
1297
TGCACAGTTTCTGGCAGGCC
89
2-13-5
215





416851
1279
1298
GTGCACAGTTTCTGGCAGGC
88
5-10-5
216





416924
1279
1298
GTGCACAGTTTCTGGCAGGC
97
3-14-3
216





417001
1279
1298
GTGCACAGTTTCTGGCAGGC
83
2-13-5
216





416925
1280
1299
GGTGCACAGTTTCTGGCAGG
98
3-14-3
114





417002
1280
1299
GGTGCACAGTTTCTGGCAGG
92
2-13-5
114





416852
1281
1300
TGGTGCACAGTTTCTGGCAG
84
5-10-5
217





416926
1281
1300
TGGTGCACAGTTTCTGGCAG
93
3-14-3
217





417003
1281
1300
TGGTGCACAGTTTCTGGCAG
89
2-13-5
217





416853
1282
1301
TTGGTGCACAGTTTCTGGCA
91
5-10-5
218





416927
1282
1301
TTGGTGCACAGTTTCTGGCA
87
3-14-3
218





417004
1282
1301
TTGGTGCACAGTTTCTGGCA
86
2-13-5
218





416854
1283
1302
ATTGGTGCACAGTTTCTGGC
90
5-10-5
219





416928
1283
1302
ATTGGTGCACAGTTTCTGGC
91
3-14-3
219





417005
1283
1302
ATTGGTGCACAGTTTCTGGC
79
2-13-5
219





416855
1284
1303
CATTGGTGCACAGTTTCTGG
87
5-10-5
220





416929
1284
1303
CATTGGTGCACAGTTTCTGG
83
3-14-3
220





417006
1284
1303
CATTGGTGCACAGTTTCTGG
81
2-13-5
220





416930
1285
1304
GCATTGGTGCACAGTTTCTG
87
3-14-3
52





417007
1285
1304
GCATTGGTGCACAGTTTCTG
82
2-13-5
52





416856
1286
1305
GGCATTGGTGCACAGTTTCT
95
5-10-5
221





416931
1286
1305
GGCATTGGTGCACAGTTTCT
96
3-14-3
221





417008
1286
1305
GGCATTGGTGCACAGTTTCT
82
2-13-5
221





416857
1287
1306
CGGCATTGGTGCACAGTTTC
92
5-10-5
222





416932
1287
1306
CGGCATTGGTGCACAGTTTC
92
3-14-3
222





417009
1287
1306
CGGCATTGGTGCACAGTTTC
85
2-13-5
222





416858
1288
1307
ACGGCATTGGTGCACAGTTT
93
5-10-5
223





416933
1288
1307
ACGGCATTGGTGCACAGTTT
92
3-14-3
223





417010
1288
1307
ACGGCATTGGTGCACAGTTT
81
2-13-5
223





416859
1289
1308
GACGGCATTGGTGCACAGTT
90
5-10-5
224





416934
1289
1308
GACGGCATTGGTGCACAGTT
90
3-14-3
224





417011
1289
1308
GACGGCATTGGTGCACAGTT
86
2-13-5
224





416935
1290
1309
GGACGGCATTGGTGCACAGT
92
3-14-3
115





417012
1290
1309
GGACGGCATTGGTGCACAGT
72
2-13-5
115





416860
1291
1310
CGGACGGCATTGGTGCACAG
88
5-10-5
225





416936
1291
1310
CGGACGGCATTGGTGCACAG
89
3-14-3
225





417013
1291
1310
CGGACGGCATTGGTGCACAG
86
2-13-5
225





416861
1292
1311
GCGGACGGCATTGGTGCACA
92
5-10-5
226





416937
1292
1311
GCGGACGGCATTGGTGCACA
93
3-14-3
226





417014
1292
1311
GCGGACGGCATTGGTGCACA
87
2-13-5
226





416862
1293
1312
AGCGGACGGCATTGGTGCAC
90
5-10-5
227





416938
1293
1312
AGCGGACGGCATTGGTGCAC
90
3-14-3
227





417015
1293
1312
AGCGGACGGCATTGGTGCAC
87
2-13-5
227





416863
1294
1313
CAGCGGACGGCATTGGTGCA
83
5-10-5
228





416939
1294
1313
CAGCGGACGGCATTGGTGCA
88
3-14-3
228





417016
1294
1313
CAGCGGACGGCATTGGTGCA
85
2-13-5
228





416940
1295
1314
GCAGCGGACGGCATTGGTGC
92
3-14-3
53





417017
1295
1314
GCAGCGGACGGCATTGGTGC
82
2-13-5
53





416864
1296
1315
GGCAGCGGACGGCATTGGTG
93
5-10-5
229





416941
1296
1315
GGCAGCGGACGGCATTGGTG
95
3-14-3
229





417018
1296
1315
GGCAGCGGACGGCATTGGTG
82
2-13-5
229





416865
1297
1316
TGGCAGCGGACGGCATTGGT
88
5-10-5
230





416942
1297
1316
TGGCAGCGGACGGCATTGGT
85
3-14-3
230





417019
1297
1316
TGGCAGCGGACGGCATTGGT
84
2-13-5
230





416866
1298
1317
CTGGCAGCGGACGGCATTGG
88
5-10-5
231





416943
1298
1317
CTGGCAGCGGACGGCATTGG
92
3-14-3
231





417020
1298
1317
CTGGCAGCGGACGGCATTGG
84
2-13-5
231





416867
1299
1318
ACTGGCAGCGGACGGCATTG
83
5-10-5
232





416944
1299
1318
ACTGGCAGCGGACGGCATTG
83
3-14-3
232





417021
1299
1318
ACTGGCAGCGGACGGCATTG
74
2-13-5
232









Example 4
Dose-Dependent Antisense Inhibition of Human Factor XI in HepG2 Cells

Gapmers from Example 3 (see Tables 4, 5, 6, 7, and 8), exhibiting in vitro inhibition of human Factor XI, were tested at various doses in HepG2 cells. Cells were plated at a density of 10,000 cells per well and transfected using lipofectin reagent with 9.375 nM, 18.75 nM, 37.5 nM and 75 nM concentrations of antisense oligonucleotide, as specified in Table 9. After a treatment period of approximately 16 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells. As illustrated in Table 9, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells.









TABLE 9







Dose-dependent antisense inhibition of human Factor XI in HepG2


cells via transfection of oligonucleotides with lipofectin














9.375
18.75
37.5
75

SEQ



nM
nM
nM
nM
Motif
ID No.

















412203
33
40
62
74
5-10-5
31


412206
24
47
69
86
5-10-5
34


413467
35
51
62
69
5-10-5
100


413474
29
44
57
67
5-10-5
107


413476
24
58
62
77
5-10-5
109


416825
23
52
73
92
5-10-5
190


416826
8
36
58
84
5-10-5
191


416827
31
42
62
77
5-10-5
192


416838
31
51
64
86
5-10-5
203


416842
18
33
62
71
5-10-5
207


416850
4
30
67
84
5-10-5
215


416856
21
45
58
74
5-10-5
221


416858
0
28
54
82
5-10-5
223


416864
18
43
62
78
5-10-5
229


416878
22
34
60
82
5-10-5
100


416892
16
50
70
85
3-14-3
190


416895
39
57
66
71
3-14-3
192


416896
22
39
57
81
3-14-3
193


416908
36
57
67
76
3-14-3
203


416922
14
25
49
75
3-14-3
214


416923
36
47
60
67
3-14-3
215


416924
25
38
56
59
3-14-3
216


416925
13
38
59
75
3-14-3
114


416926
31
43
63
82
3-14-3
217


416931
44
39
57
71
3-14-3
221


416941
33
54
63
78
3-14-3
229


416945
34
45
62
65
2-13-5
31


416969
17
39
61
76
2-13-5
190


416972
32
40
60
69
2-13-5
192


416973
60
75
85
87
2-13-5
193


416984
26
50
62
81
2-13-5
202


416985
17
30
47
57
2-13-5
203


416989
18
41
62
83
2-13-5
206


416993
15
37
50
68
2-13-5
209


416999
24
37
55
73
2-13-5
214


417000
35
47
58
70
2-13-5
215


417002
35
52
67
70
2-13-5
114


417003
26
44
60
56
2-13-5
217









The gapmers were also transfected via electroporation and their dose dependent inhibition of human Factor XI mRNA was measured. Cells were plated at a density of 20,000 cells per well and transfected via electroporation with 0.7 μM, 2.2 μM, 6.7 μM, and 20 μM concentrations of antisense oligonucleotide, as specified in Table 10. After a treatment period of approximately 16 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells. As illustrated in Table 10, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells.









TABLE 10







Dose-dependent antisense inhibition of human Factor XI in HepG2


cells via transfection of oligonucleotides with electroporation













0.7



SEQ ID



μM
2.2 μM
6.7 μM
20 μM
No.


















412203
11
60
70
91
31



412206
22
39
81
94
34



413467
5
31
65
89
100



413474
0
5
52
81
107



413476
40
69
88
93
109



416825
27
74
92
98
190



416826
2
47
86
82
191



416827
37
68
87
92
192



416838
5
30
55
83
203



416842
0
10
66
92
207



416850
14
25
81
91
215



416856
0
29
47
93
221



416858
5
20
56
86
223



416864
32
65
78
90
229



416878
1
26
75
85
100



416892
14
52
82
92
190



416895
0
62
70
91
192



416896
12
35
81
89
193



416908
7
58
74
89
203



416922
35
51
77
91
214



416923
15
30
60
90
215



416924
22
40
63
70
216



416925
0
40
76
80
114



416926
47
71
91
94
217



416931
7
24
60
82
221



416941
16
38
79
89
229



416945
48
70
81
88
31



416969
25
34
86
92
190



416972
25
30
48
88
192



416973
20
48
86
93
193



416984
43
54
88
90
202



416985
12
48
45
69
203



416989
32
65
88
94
206



416993
22
48
87
92
209



416999
20
42
77
88
214



417000
46
73
76
89
215



417002
32
38
82
91
114



417003
0
34
75
89
217










Example 5
Selection and Confirmation of Effective Dose-Dependent Antisense Inhibition of Human Factor XI in HepG2 Cells

Gapmers exhibiting significant dose-dependent inhibition of human Factor XI in Example 4 were selected and tested at various doses in HepG2 cells. Cells were plated at a density of 10,000 cells per well and transfected using lipofectin reagent with 2.34 nM, 4.69 nM, 9.375 nM, 18.75 nM, 37.5 nM, and 75 nM concentrations of antisense oligonucleotide, as specified in Table 11. After a treatment period of approximately 16 hours, RNA was isolated from the cells and human Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of human Factor XI, relative to untreated control cells. As illustrated in Table 11, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells compared to the control.









TABLE 11







Dose-dependent antisense inhibition of human Factor XI in HepG2


cells via transfection of oligonucleotides with lipofectin
















2.34
4.69
9.375
18.75
37.5
75

SEQ



nM
nM
nM
nM
nM
nM
Motif
ID No.



















416825
4
22
39
57
79
89
5-10-5
190


416826
15
22
32
54
76
90
5-10-5
191


416838
21
37
50
63
74
83
5-10-5
203


416850
24
31
49
55
70
77
5-10-5
215


416858
11
35
46
61
75
77
5-10-5
223


416864
13
34
42
65
68
80
5-10-5
229


416892
14
34
49
70
84
93
3-14-3
190


416925
24
34
45
56
67
72
3-14-3
114


416999
10
26
42
62
72
80
2-13-5
214


417002
17
26
49
61
81
84
2-13-5
114


417003
6
29
48
64
73
82
2-13-5
217









The gapmers were also transfected via electroporation and their dose dependent inhibition of human Factor XI mRNA was measured. Cells were plated at a density of 20,000 cells per well and transfected via electroporation with 625 nM, 1250 nM, 2500 nM, 5,000 nM, 10,000 nM, and 20,000 nM concentrations of antisense oligonucleotide, as specified in Table 12. After a treatment period of approximately 16 hours, RNA was isolated from the cells and human Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of human Factor XI, relative to untreated control cells. As illustrated in Table 12, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells compared to the control.









TABLE 12







Dose-dependent antisense inhibition of human Factor XI in HepG2


cells via transfection of oligonucleotides with electroporation















625
1250
2500
5000
10000
20000
SEQ



nM
nM
nM
nM
nM
nM
ID No.


















416825
69
84
91
94
96
97
190


416826
67
82
89
92
95
97
191


416838
66
79
87
90
93
96
203


416850
69
80
87
90
93
96
215


416858
65
77
87
89
93
93
223


416864
45
74
84
87
92
94
229


416892
66
86
96
97
100
100
190


416925
64
80
88
91
95
96
114


416999
61
82
89
94
94
97
214


417002
59
72
86
90
94
96
114


417003
60
74
86
90
95
95
217









Example 6
Selection and Confirmation of Effective Dose-Dependent Antisense Inhibition of Human Factor XI in Cyno Primary Hepatocytes

Gapmers from Example 4 exhibiting significant dose dependent in vitro inhibition of human Factor XI were also tested at various doses in cynomolgus monkey (cyno) primary hepatocytes. Cells were plated at a density of 35,000 cells per well and transfected via electroporation with 0.74 nM, 2.2 nM, 6.7 nM, 20 nM, 60 nM, and 180 nM concentrations of antisense oligonucleotide, as specified in Table 13. After a treatment period of approximately 16 hours, RNA was isolated from the cells and human Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of human Factor XI, relative to untreated control cells. As illustrated in Table 13, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells compared to the control.









TABLE 13







Dose-dependent antisense inhibition of human


Factor XI in cyno primary hepatocytes















0.74
2.2
6.7
20
60
180
SEQ



nM
nM
nM
nM
nM
nM
ID No.


















416825
5
22
51
61
77
84
190


416826
13
24
34
67
69
71
191


416838
0
0
21
34
48
62
203


416850
2
20
24
65
69
67
215


416858
2
13
22
44
63
68
223


416864
0
1
15
23
47
64
229


416892
20
20
43
62
88
92
190


416925
0
9
1
48
55
76
114


416999
3
40
36
62
67
82
214


417002
32
16
28
38
55
71
114


417003
12
18
19
39
58
74
217









Example 7
Selection and Confirmation of Effective Dose-Dependent Antisense Inhibition of Human Factor XI in HepB3 Cells by Gapmers

Gapmers exhibiting in vitro inhibition of human Factor XI in Example 4 were tested at various doses in human HepB3 cells. Cells were plated at a density of 4,000 cells per well and transfected using lipofectin reagent with 2.3 nM, 4.7 nM, 9.4 nM, 18.75 nM, 37.5 nM, and 75 nM concentrations of antisense oligonucleotide, as specified in Table 14. After a treatment period of approximately 16 hours, RNA was isolated from the cells and human Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells. As illustrated in Table 14, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells compared to the control.









TABLE 14







Dose-dependent antisense inhibition


of human Factor XI in HepB3 cells














ISIS
2.3
4.7
9.4
18.75
37.5
75
SEQ


No.
nM
nM
nM
nM
nM
nM
ID No.

















416825
0
15
34
36
53
59
190


416826
16
28
38
55
64
66
191


416838
23
34
43
59
71
56
203


416850
22
32
43
56
75
60
215


416858
17
34
43
57
74
62
223


416864
24
37
42
66
76
63
229


416892
28
34
50
68
82
72
190


416925
26
33
45
59
72
60
114


416999
19
33
42
60
71
59
214


417002
24
30
46
57
71
65
114


417003
11
28
40
40
63
58
217









The gapmers were also transfected via electroporation and their dose dependent inhibition of human Factor XI mRNA was measured. Cells were plated at a density of 20,000 cells per well and transfected via electroporation with 41.15 nM, 123.457 nM, 370.37 nM, 1111.11 nM, 3333.33 nM, and 10,000 nM concentrations of antisense oligonucleotide, as specified in Table 15. After a treatment period of approximately 16 hours, RNA was isolated from the cells and human Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of human Factor XI, relative to untreated control cells. As illustrated in Table 15, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells compared to the control.









TABLE 15







Dose-dependent antisense inhibition


of human Factor XI in HepB3 cells















41.15
123.457
370.37
1111.11
3333.33
10000
SEQ



nM
nM
nM
nM
nM
nM
ID No.


















416825
32
40
48
75
90
92
190


416826
0
0
34
61
87
92
191


416838
12
9
28
40
77
88
203


416850
26
38
51
73
90
95
215


416858
23
45
52
64
87
92
223


416864
4
3
6
35
75
87
229


416892
9
12
28
65
89
98
190


416925
27
39
50
73
88
96
114


416999
31
45
62
78
94
97
214


417002
19
0
31
47
86
93
114


417003
31
0
15
43
84
92
217









Example 8
Antisense Inhibition of Murine Factor XI in Primary Mouse Hepatocytes

Chimeric antisense oligonucleotides targeting murine Factor XI were designed as 5-10-5 MOE gapmers targeting murine Factor XI (GENBANK Accession No. NM028066.1, incorporated herein as SEQ ID NO: 6). The gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. Each nucleotide in each wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gaper are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. The antisense oligonucleotides were evaluated for their ability to reduce murine Factor XI mRNA in primary mouse hepatocytes.


Primary mouse hepatocytes were treated with 6.25 nM, 12.5 nM, 25 nM, 50 nM, 100 nM, and 200 nM of antisense oligonucleotides for a period of approximately 24 hours. RNA was isolated from the cells and murine Factor XI mRNA levels were measured by quantitative real-time PCR. Murine Factor XI primer probe set RTS 2898 (forward sequence ACATGACAGGCGCGATCTCT, incorporated herein as SEQ ID NO: 7; reverse sequence TCTAGGTTCACGTACACATCTTTGC, incorporated herein as SEQ ID NO: 8; probe sequence TTCCTTCAAGCAATGCCCTCAGCAATX, incorporated herein as SEQ ID NO: 9) was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content as measured by RIBOGREEN®. Several of the murine antisense oligonucleotides reduced Factor XI mRNA levels in a dose-dependent manner.


Example 9
Cross-Reactive Antisense Inhibition of Murine Factor XI in Primary Mouse Hepatocytes

Antisense oligonucleotides targeted to a murine Factor XI nucleic acid were tested for their effects on Factor XI mRNA in vitro. Cultured primary mouse hepatocytes at a density of 10,000 cells per well were treated with 100 nM antisense oligonucleotide. After a treatment period of approximately 24 hours, RNA was isolated from the cells and mouse Factor XI mRNA levels were measured by quantitative real-time PCR. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN®. Results are presented as percent inhibition of Factor XI, relative to untreated control cells.


The chimeric antisense oligonucleotides in Tables 16 were designed as 5-10-5 MOE gapmers. The gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of 10 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleotides each. Each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Mouse target start site” indicates the 5′-most nucleotide to which the gapmer is targeted. “Mouse target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted. All the mouse oligonucleotides listed show cross-reactivity between the mouse Factor XI mRNA (GENBANK Accession No. NM028066.1), incorporated herein as SEQ ID NO: 6 and the human Factor XI mRNA (GENBANK Accession No. NM000128.3), incorporated herein as SEQ ID NO: 1. “Human Target Start Site” indicates the 5′-most nucleotide in the human mRNA (GENBANK Accession No. NM000128.3) to which the antisense oligonucleotide is targeted. “Human Target Stop Site” indicates the 3′-most nucleotide in the human mRNA (GENBANK Accession No. NM000128.3) to which the antisense oligonucleotide is targeted. “Number of mismatches” indicates the mismatches between the mouse oligonucleotide and the human mRNA sequence.









TABLE 16







Inhibition of mouse Factor XI mRNA levels by chimeric antisense oligonucleotides


having 5-10-5 MOE wings and deoxy gap targeted to SEQ ID NO: 1 and SEQ ID NO: 6
















Mouse
Mouse



Human
Human




Target
Target

SEQ
SEQ
Target
Target
No. of


ISIS No
Start Site
Stop Site
Sequence (5′ to 3′)
ID No.
ID No.
Start Site
Stop Site
Mismatches


















404050
379
398
TGCTTGAAGGAATATCCAGA
82
233
619
638
2





404054
448
467
TAGTTCATGCCCTTCATGTC
45
234
688
707
1





404055
453
472
TGTTATAGTTCATGCCCTTC
27
235
693
712
1





404066
686
705
AATGTCCCTGATACAAGCCA
37
236
926
945
1





404067
691
710
GGGAAAATGTCCCTGATACA
39
237
931
950
1





404083
1299
1318
TGTGCAGAGTCACCTGCCAT
47
238
1533
1552
2





404087
1466
1485
TTCTTGAACCCTGAAGAAAG
29
239
1709
1728
2





404089
1477
1496
TGAATTATCATTTCTTGAAC
6
240
1720
1739
2





404090
1483
1502
TGATCATGAATTATCATTTC
42
241
1726
1745
2









Example 10
In Vivo Antisense Inhibition of Murine Factor XI

Several antisense oligonucleotides targeted to murine Factor XI mRNA (GENBANK Accession No. NM028066.1, incorporated herein as SEQ ID NO: 6) showing statistically significant dose-dependent inhibition from the in vitro study were evaluated in vivo. BALB/c mice were treated with ISIS 404057 (TCCTGGCATTCTCGAGCATT, target start site 487, incorporated herein as SEQ ID NO: 10) and ISIS 404071 (TGGTAATCCACTTTCAGAGG, target start site 869, incorporated herein as SEQ ID NO: 11).


Treatment

BALB/c mice were injected with 5 mg/kg, 10 mg/kg, 25 mg/kg, or 50 mg/kg of ISIS 404057 or ISIS 404071 twice a week for 3 weeks. A control group of mice was injected with phosphate buffered saline (PBS) twice a week for 3 weeks. Mice were sacrificed 5 days after receiving the last dose. Whole liver was harvested for RNA analysis and plasma was collected for protein analysis.


RNA Analysis

RNA was extracted from liver tissue for real-time PCR analysis of Factor XI. As shown in Table 17, the antisense oligonucleotides achieved dose-dependent reduction of murine Factor XI over the PBS control. Results are presented as percent inhibition of Factor XI, relative to control.









TABLE 17







Dose-dependent antisense inhibition of murine Factor XI mRNA


in BALB/c mice











%



mg/kg
inhibition













404057
5
40



10
64



25
85



50
95


404071
5
72



10
82



25
93



50
96









Protein Analysis

As shown in Table 18, treatment with ISIS 404071 resulted in a significant dose-dependent reduction of Factor XI protein. Results are presented as percent inhibition of Factor XI, relative to PBS control.









TABLE 18







Dose-dependent inhibition of murine Factor XI protein by ISIS 404071


in BALB/c mice










Dose in
%



mg/kg
Inhibition














5
39



10
67



25
89



50
96










Example 11
In Vivo Effect of Antisense Inhibition of Murine Factor XI on Collagen-Induced Arthritis

The effect of inhibition of Factor XI and its role in fibrin accumulation in the joints leading to joint inflammation and rheumatoid arthritis was evaluated in a murine collagen-induced arthritis (CIA) model. Administration of collagen to animals is a well known method to induce arthritis and has been previously described by Trentham et al. (J Exp Med, 146:857-68, 1977), Courtenay et al. (Nature, 283:666-668, 1980), Cathcart et al. (Lab Invest, 54:26-31, 1986), Wooley (Methods Enzymol 162:361-373, 1988) and Holmdahl et al. (Arthritis Rheum 29:106, 1986). Arthritis induced in mice administered collagen can be visually assessed and clinically scored as described by Marty et al. (J Clin Invest, 107:631-640, 2001) where 1 point is given for each swollen digit except the thumb (maximum, 4), 1 point is given for the tarsal or carpal joint, and 1 point is given for the metatarsal or metacarpal joint with a maximum score of 6 for a hindpaw and 5 for a forepaw. Each paw was graded individually, the cumulative clinical arthritic score per mouse reaching a maximum of 22 points


ISIS 404071 (TGGTAATCCACTTTCAGAGG, incorporated herein as SEQ ID NO: 11) is a chimeric antisense oligonucleotide designed as a 5-10-5 MOE gapmer targeting murine Factor XI (GENBANK Accession No. NM028066.1, incorporated herein as SEQ ID NO: 6; oligonucleotide target site starting at position 869). The gapmer is 20 nucleotides in length, wherein the central gap segment is comprised of 10 consecutive 2′-deoxynucleosides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleosides each. Each nucleoside in each wing segment has a 2′-MOE modification. The internucleoside linkages throughout the gapmer are phosphorothioate (P═S) internucleoside linkages. All cytidine residues throughout the gapmer are 5′ methylcytidines.


ISIS 403102 (CCATAGAACAGCTTCACAGG, incorporated herein as SEQ ID NO: 275) is a chimeric antisense oligonucleotide designed as a 5-10-5 MOE gapmer targeting murine Factor VII. The gapmer is 20 nucleotides in length, wherein the central gap segment is comprised of 10 consecutive 2′-deoxynucleosides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleosides each. Each nucleoside in each wing segment has a 2′-MOE modification. The internucleoside linkages throughout the gapmer are phosphorothioate (P═S) internucleoside linkages. All cytidine residues throughout the gapmer are 5′ methylcytidines.


ISIS 421208 (TCGGAAGC GACTCTTATATG, incorporated herein AS SEQ ID NO: 14), a control oligonucleotide for ISIS 404071 with 8 mismatches (MM), was used as a control. ISIS 421208 is a chimeric antisense oligonucleotide designed as a 5-10-5 MOE gapmer targeting murine Factor XI (GENBANK Accession No. NM028066.1, incorporated herein as SEQ ID NO: 6; oligonucleotide target site starting at position 869). The gapmer is 20 nucleotides in length, wherein the central gap segment is comprised of 10 consecutive 2′-deoxynucleosides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleosides each. Each nucleoside in each wing segment has a 2′-MOE modification. The internucleoside linkages throughout the gapmer are phosphorothioate (P═S) internucleoside linkages. All cytidine residues throughout the gapmer are 5′ methylcytidines.


ISIS 404057 (TCCTGGCATT CTCGAGCATT, incorporated herein as SEQ ID NO: 10) is a chimeric antisense oligonucleotide designed as a 5-10-5 MOE gapmer targeting murine Factor XI (GENBANK Accession No. NM028066.1, incorporated herein as SEQ ID NO: 6; oligonucleotide target site starting at position 487). The gapmer is 20 nucleotides in length, wherein the central gap segment is comprised of 10 consecutive 2′-deoxynucleosides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising 5 nucleosides each. Each nucleoside in each wing segment has a 2′-MOE modification. The internucleoside linkages throughout the gapmer are phosphorothioate (P═S) internucleoside linkages. All cytidine residues throughout the gapmer are 5′ methylcytidines.


Male DBA/1J mice were obtained from The Jackson Laboratory (Bar Harbor, Me.).


Arthritis Study A: Effect of Factor XI Inhibition (ISIS 404071) on Arthritis

The effect of inhibiting Factor XI with ISIS 404071 and its role in ameliorating arthritis was evaluated in a collagen-induced arthritis (CIA) model.


Male DBA/1J mice were separated in groups and treated as shown in Table 19.









TABLE 19







Summary of Mice Study Groups









Group (N)
ASO
CIA





1. (15)
None
No


2. (15)
None
Yes


3. (15)
F7 (403102) 20 mpk
Yes


4. (15)
F11 (404071) 20 mpk
Yes









In a group of 15 DBA/1J mice, 20 mg/kg of ISIS 404071 was injected subcutaneously twice a week for 12 weeks. One control group of 15 mice was injected with 20 mg/kg of ISIS 403102 twice a week for 12 weeks. Two control groups of 15 mice each were injected with PBS twice a week for 12 weeks. Two weeks after the first oligonucleotide dose, type II bovine collagen (Chondrex Inc, Redmond, Wash.) was mixed with complete Freund's adjuvant, homogenized on ice and the emulsion, containing 100 μg of collagen, was injected subcutaneously at the base of the tail in the Factor XI group, the Factor VII group and one of the PBS control groups. A booster injection containing 100 μg collagen type II in incomplete Freund's adjuvant was injected subcutaneously at the base of the tail at a different injection site on day 21 after the first collagen injection in these groups.


Starting 35 days from the first collagen injection, mice in all groups were examined daily for the visual appearance of arthritis, such as swelling and stiffness, in peripheral joints. The results are presented in Table 20 (expressed as a percentage of the PBS control) and in FIGS. 1-3.









TABLE 20







Clinical Effects of Antisense Oligonucleotide Treatment on CIA











Collagen-





treated
ISIS 404071-
ISIS 403102-



control
treated
treated
















% of CIA
64
13
54



% of paws
36
3
19



affected



Average no. of
2
1
1



paws affected



Clinical severity
8
1
4



of CIA










‘Incidence of CIA’ refers to the percentage of mice in each group that had CIA at day 40. The ‘percentage of paws affected’ refers to the percentage of paws out of a total of 60 paws in each group of mice that were affected with arthritis. ‘Average number of affected paws’ refers to the number of affected paws in mice that were diagnosed to have arthritis. The ‘clinical severity of CIA’ was scored as described by Marty et al. (J Clin Invest, 107:631-640, 2001) and as follows: 1 point for each swollen digit except the thumb (maximum, 4), 1 point for the tarsal or carpal joint, and 1 point for the metatarsal or metacarpal joint with a maximum score of 6 for a hindpaw and 5 for a forepaw. Each paw was graded individually, the cumulative clinical arthritic score per mouse reaching a maximum of 22 points.


As shown in Table 20 and FIGS. 1-3, treatment with ISIS 404071 was observed to significantly inhibit the incidence of CIA.


Arthritis Study B: Effect of Factor XI Inhibition (ISIS 404071 and ISIS 404057) on Arthritis

The effect of inhibiting Factor XI with ISIS 404071 or ISIS 404057 and their role in ameliorating arthritis was evaluated in a collagen-induced arthritis model.


Male DBA/1J mice were separated in groups and treated as shown in Table 21.









TABLE 21







Summary of Mice Study Groups









Group (N)
ASO
CIA





1. (20)
None
No


2. (20)
None
Yes


3. (20)
F11 (404071) 20 mpk
Yes


4. (20)
F11 (404057) 20 mpk
Yes


5. (20)
F11 MM (421208) 20 mpk
Yes









In a group of 20 DBA/1J mice, 20 mg/kg of ISIS 404071 were injected subcutaneously twice a week for ten weeks. In a second group of 20 DBA/1J mice, 20 mg/kg of ISIS 404057 were injected subcutaneously twice a week for ten weeks. In a third control group of 20 DBA/1J mice, 20 mg/kg of ISIS 421208 were injected subcutaneously twice a week for ten weeks. Two control groups of 20 mice each were injected with PBS twice a week for ten weeks.


Two and a half weeks after the first oligonucleotide dose, type II bovine collagen in complete Freund's adjuvant was injected subcutaneously at the base of the tail in all the experimental groups and one PBS control group. A booster injection containing 100 μg collagen type II in incomplete Freund's adjuvant was injected subcutaneously at the base of the tail at a different injection site on day 21 after the first collagen injection in these groups.


Mice in all groups were examined daily after day 30 after the first collagen injection for the visual appearance of arthritis in peripheral joints. The effects of Factor XI antisense oligonucleotide treatment at the end of the study are shown in Table 22 and FIGS. 4-6. The results in Table 22 are expressed as percent change compared to the PBS control except for the liver and spleen weight.









TABLE 22







Effects of Antisense Oligonucleotide Treatment on CIA











Collagen-treated
ISIS 404071-
ISIS 421208-



control
treated
treated














% of CIA
100%
64%
81%


% of paws affected
 67%
20%
45%


Average no. of paws
2.5
0.82
1.7


affected


Clinical severity of CIA
10.3
4.6
7.75


Liver Weight
5.56% 
6.089%  
6.14%  


as a % of Body Weight


Spleen Weight
0.608
0.759
0.718


as a % of Body Weight


Liver ALT
42.25
56.6
70.06


Liver AST
97.3
86.75
165.12









Treatment of collagen-induced arthritic mice with Factor XI antisense oligonucleotide ISIS 404071 significantly decreased the amount of arthritis assessed in the mice compared to untreated mice (Table 22 and FIG. 4A). Treatment of collagen-induced arthritic mice with Factor XI antisense oligonucleotide ISIS 404057 did not affect the amount of arthritis assessed in the mice compared to untreated mice. The difference between the effective of the two Factor XI antisense oligonucleotides may be related to the relative effectiveness of each oligonucleotide in inhibiting Factor XI mRNA as shown in FIG. 4B. The lack of Factor XI inhibition by ISIS 404057 correlated with the lack of arthritis inhibition in the mice.


In summary, this example shows for the first time known to the inventors that Factor XI plays a role in arthritis and that treatment of an animal with a Factor XI inhibitor will ameliorate arthritis in the animal. Treatment with a Factor XI inhibitor is also shown to reduce the risk and progression of arthritis in an animal.


Example 12
In Vivo Effect of Antisense Inhibition of Murine Factor XI on DSS-Induced Colitis

The effect of antisense oligonucleotide inhibition of Factor XI and its role in ameliorating colitis was evaluated in a dextran sulfate sodium (DSS)-induced colitis model. Administration of DSS to animals is a well known method to induce colitis and has been previously described by Okayasu et al. (Gastroenterology, 1990, 98:694-702), Cooper et al. (Lab Invest, 1993, 69:238-249) and Dieleman et al. (Clin Exp Immunol, 1998, 114:385-391).


Colitis in humans has symptoms that can include persistent diarrhea (loose, watery, or frequent bowel movements), crampy abdominal pain, fever, rectal bleeding, loss of appetite and weight loss. Pathological changes in colitis can include changes to the colon such as colon shortening (Gore, 1992, AJR, 158:59-61), formation of inflammatory lesions, diffused neutrophil infiltration, submucosa edema and muscularis propria thickening.


Antisense oligonucleotides targeting Factor XI were described in Example 11, supra. Swiss Webb mice were from Charles River Laboratories (Wilmington, Mass.).


Colitis Study A: Effect of Factor XI Inhibition (ISIS 404071) on Colitis

The effect of inhibiting Factor XI with ISIS 404071 and its role in ameliorating colitis was evaluated in a dextran sulfate sodium (DSS)-induced colitis model.


Female Swiss Webb mice were separated in groups and treated as shown in Table 23.









TABLE 23







Summary of Mice Study Groups









Group (N)
ASO
DSS





1. (8)
None
No


2. (8)
None
Yes


3. (8)
F7 (403102) 20 mpk
Yes


4. (8)
F11 (404071) 20 mpk
Yes









In groups of 8 Swiss Webb mice, 20 mg/kg of ISIS 404071 or ISIS 403102 were injected subcutaneously twice a week for 3 weeks. Two control groups of 8 mice each were injected with PBS twice a week for 3 weeks. After the oligonucleotide treatments, 4% DSS in water was administered ad libitum for 6 days to the experimental groups and one PBS control group.


Mice in all groups were weighed at day 0. Mice were sacrificed at the end of the study on day 7 after DSS was administered and their body weights and colon lengths were measured. Results are presented in Table 24 (expressed as a percentage of the PBS control) and FIG. 7.









TABLE 24







Effect of Factor XI inhibition on the DSS-induced colitis model on day 7











DSS-treated
ISIS 404071
ISIS 403102



control
treated
treated
















Body weight
−6
−2
−7



change



Colon length
−27
−13
−34



change










Colon length was assessed in the DSS-induced colitis mice. Treatment with Factor XI oligonucleotide decreased the amount of colon shortening symptomatic of colitis.


Mouse colon tissue from a mouse (DSS induced) ulcer colitis model treated with Factor VII or XI oligonucleotide was studied to determine the amount of inflammation present.


The mice were sacrificed using sodium pentobarbital (160 mg/kg). Colon sections, divided into three equal segments, cut lengthwise, and fixed in 10% neutral-buffered formalin, paraffin-embedded, sectioned at 4 μm, and stained with hematoxylin and eosin for light microscopic examination. The slides were reviewed microscopically by a pathologist and assigned a histological severity score for intestinal inflammation as shown in FIG. 8 and Table 25. The amount of inflammation in 8C (Factor VII treated) and 8D (Factor XI treated) were compared to the negative control in 8A (no inflammation) and the positive control in 8B (maximal inflammation) to determine the severity of inflammation.









TABLE 25







Colon tissue histopathology severity scores















Severity



Group
Treatment
ASO/Target
Score







1 (FIG. 5A)
None
None




2 (FIG. 5B)
DSS
None
++++



3 (FIG. 5C)
DSS
FVII
++++



4 (FIG. 5D)
DSS
FXI
+










Multi-lesion colitis was observed in DSS treated colons (FIG. 8B) compared to colons not treated with DSS (FIG. 8A). The colon in FIG. 8C was treated with the control oligonucleotide ISIS 403102 targeting Factor VII and exhibits lesions similar in appearance to the DSS treated colon in FIG. 8B. The colon in FIG. 8D was treated with ISIS 404071 and exhibits significantly fewer mucosa ulcerative lesions than the colon in FIG. 8B or 8C.


Colitis Study B: Effect of Factor XI Inhibition (ISIS 404071 and ISIS 404057) on Colitis

The effect of inhibiting Factor XI with ISIS 404071 and ISIS 404057 and their roles in ameliorating colitis was evaluated in a dextran sulfate sodium (DSS)-induced colitis model.


Swiss Webb mice were separated in groups and treated as shown in Table 26.









TABLE 26







Summary of Mice Study Groups









Group (N)
ASO
DSS





1. (8)
None
No


2. (8)
None
Yes


3. (8)
F11 (404071) 20 mpk
Yes


4. (8)
F11 (404057) 20 mpk
Yes


5. (8)
F11 MM (421208) 20 mpk
Yes









In a first group of 8 Swiss Webb mice, 20 mg/kg of ISIS 404071 was injected subcutaneously twice a week for 3 weeks. In a second group of 8 Swiss Webb mice, 20 mg/kg of ISIS 404057 was subcutaneously injected twice a week for 3 weeks. In a third control group of 8 Swiss Webb mice, 20 mg/kg of ISISI 421208 was injected subcutaneously twice a week for 3 weeks. Two control groups of 8 mice each were injected with PBS twice a week for 3 weeks. After the oligonucleotide treatment, 4% DSS in water was administered ad libitum for 6 days to all the experimental groups and one PBS control group.


Mice in all groups were weighed at day 0 and daily after administration of DSS. Mice were sacrificed at the end of the study on day 7 after DSS was administered, their livers and colons were harvested for RNA analysis, and their body weights and colon lengths were measured.


The effect of the antisense oligonucleotides on weight change and body colon length is shown in Table 27 and FIG. 9.


RT-PCR analysis of Factor XI mRNA was performed. As presented in Table 27 and FIG. 10, antisense oligonucleotides targeting Factor XI achieved statistically significant dose-dependent reduction of murine Factor XI over the PBS control in the liver. All the measurements are normalized to cyclophilin.









TABLE 27







Effects of Factor XI Inhibition on DSS-Induced Colitis on Day 7












DSS control
ISIS 404071
ISIS 404057
ISIS 421208















Liver Factor
+150
−75
−50
+25


XI mRNA


Colon length
−33
−11
−11
−33


Body weight
−12
−10
−16
−10









All the results in Table 27 are expressed as percent change compared to the PBS control.


Colitis Study C: Effect of Factor XI Inhibition (ISIS 404071) on Colitis

A third study on colitis using Factor XI oligonucleotide (ISIS 404071, SEQ ID NO: 11) was conducted. The study was performed essentially as described earlier in this example. A stool softness/diarrhea study was conducted. After seven days, control mice not administered DSS did not have diarrhea, mice administered DSS produced diarrhea and mice administered Factor XI oligonucleotide produced normal to soft stool but no diarrhea.


P-selectin has been implicated in exacerbating colitis and ablation of P-selectin has been found to ameriolate colitis (Gironella, M. et al., J. Leukoc. Biol. 2002. 72: 56-64). The effect of antisense inhibition of Factor XI on serum P-selectin levels was evaluated in this study. DSS administration led to increase in P-selectin levels which was reduced by treatment with ISIS 404071. The results are presented in Table 28.









TABLE 28







Effects of Factor XI Inhibition on P-selectin levels in the serum









P-selectin (ng/mL)














Control
86



DSS control
106



ISIS 404071
83










Colitis Study D: Effect of Various Doses of Factor XI Inhibition (ISIS 404071) on Colitis

The effect of inhibiting Factor XI with various doses of ISIS 404071 in ameliorating colitis was evaluated in a dextran sulfate sodium (DSS)-induced colitis model.


Female Swiss Webb mice were separated in groups and treated as shown in Table 29.









TABLE 29







Summary of Mice Study Groups









Group (N)
ASO
DSS





1. (8)
None
No


2. (8)
None
Yes


3. (8)
F11 (404071) 40 mpk
Yes


4. (8)
F11 (404071) 20 mpk
Yes


5. (8)
F11 (404071) 10 mpk
Yes









In a first group of 8 Swiss Webb mice, 10 mg/kg of ISIS 404071 was injected subcutaneously twice a week for 3 weeks. In a second group of 8 Swiss Webb mice, 20 mg/kg of ISIS 404057 was subcutaneously injected twice a week for 3 weeks. In a third control group of 8 Swiss Webb mice, 40 mg/kg of ISISI 404057 was injected subcutaneously twice a week for 3 weeks. Two control groups of 8 mice each were injected with PBS twice a week for 3 weeks. After the oligonucleotide treatment, 4% DSS in water was administered ad libitum for 7 days to all the experimental groups and one PBS control group.


Mice in all groups were weighed at day 0 and daily starting on day 3 after administration of DSS as shown in FIG. 11A. The stool softness/diarrhea of the mice was analyzed on day 7 after DSS was administered as shown in FIG. 11B. Mice were sacrificed at the end of the study on day 7 after DSS was administered and their colon lengths were measured as shown in FIG. 11C.


The antisense oligonucleotide showed statistically significant dose effects on body weights and diarrhea scores (FIGS. 11A and 11B). Although the various doses of oligonucleotide did not show a statistical significant effect between the various doses on colon length, administration of any of the three doses significantly improved the colon length when compared to placebo as shown in FIG. 11C.


Mice with dextran sodium sulfate (DSS)-induced colitis have elevated level of thrombin-antithrombin (TAT) complexes in blood (Anthoni, C. et al., J. Exp. Med. 204: 1595-1601, 2007) that is also observed in patients with ulcerative colitis (Kume, K. et al., Intern Med. 2007. 46: 1323-9). The effect of antisense inhibition of Factor XI on TAT levels in the colon was evaluated (Thrombi-Anti-Thrombin III complex, Siemens Healthcare Diagnostics, Deerfield, Ill.) and the results are presented in Table 30. As demonstrated, DSS administration increased TAT levels, which were decreased in a dose-dependent manner by treatment with ISIS 404071.


Plasma levels of soluble CD40 ligand (CD40L) are known to be elevated in cases of inflammatory bowel disease (Ludwiczek, O. et al., Int. J. Colorectal Disease. 2003. 18: 142-147) and may be considered a marker of intestinal inflammation. The effect of antisense inhibition of Factor XI on CD40L levels in the plasma was evaluated (Bender Medsystems, Vienna, Austria; eBioscience, San Diego, Calif.) and the results are presented in Table 31. As demonstrated, DSS administration increased CD40L levels, which were decreased by treatment with ISIS 404071.


Observations on experimental models and humans with ulcerative colitis suggest a pathogenetic role of the kallikrein-kinin system in inflammatory bowel diseases (Devani, M. et al., Digestive and Liver Disease. 2005. 37: 665-673). The effect of antisense inhibition of Factor XI on kinin levels in the colon was evaluated (Phoenix Pharmaceuticals, Burlingame, Calif.) and the results are presented in Table 32. As demonstrated, DSS administration increased bradykinin levels, which were decreased by treatment with ISIS 404071.









TABLE 30







TAT levels in colon of mice groups










Group


TAT levels


(N)
ASO
DSS
(ng/mg protein)













1. (8)
None
No
0.03


2. (8)
None
Yes
2.57


3. (8)
F11 (404071) 40 mpk
Yes
0.75


4. (8)
F11 (404071) 20 mpk
Yes
0.65


5. (8)
F11 (404071) 10 mpk
Yes
1.79
















TABLE 31







CD40L levels in colon of mice groups













CD40L levels


Group (N)
ASO
DSS
(ng/mg protein)













1. (8)
None
No
0.67


2. (8)
None
Yes
0.39


3. (8)
F11 (404071) 40 mpk
Yes
0.39


4. (8)
F11 (404071) 20 mpk
Yes
0.26


5. (8)
F11 (404071) 10 mpk
Yes
0.19
















TABLE 32







Bradykinin levels in colon of mice groups













Bradykinin levels


Group (N)
ASO
DSS
(ng/mg protein)













1. (8)
None
No
0.00


2. (8)
None
Yes
0.09


3. (8)
F11 (404071) 40 mpk
Yes
0.02


4. (8)
F11 (404071) 20 mpk
Yes
0.00


5. (8)
F11 (404071) 10 mpk
Yes
0.03









In summary, this example shows that Factor XI oligonucleotide treatment significantly ameliorated DSS induced ulcerative colitis in an animal. Treatment with a Factor XI inhibitor is also shown to reduce the risk and progression of colitis in an animal.


Colitis Study E: to Determine if Native Human Factor XI Protein can Reverse the Effect of Factor XI Inhibition (ISIS 404071) in a Colitis Model.

The efficacy of human factor XI protein in reversing the effect of inhibiting Factor XI with ISIS 404071 was evaluated in a dextran sulfate sodium (DSS)-induced colitis model.


Female Swiss Webb mice were separated in groups and treated as shown in Table 33.









TABLE 33







Summary of Mice Study Groups













Human


Group (N)
ASO
DSS
recombinant FXI





1. (8)
None
No
0


2. (8)
None
Yes
0


3. (8)
F11 (404071) 40 mpk
Yes
0


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day









Two groups 8 Swiss Webb mice were dosed with 40 mg/kg of ISIS 404071 injected subcutaneously twice a week for 3 weeks. Two control groups of 8 Swiss Webb mice were dosed with PBS subcutaneously twice a week for 3 weeks. Both the ASO treated groups and one of the control groups were then given 4% DSS in distilled water for 7 days ad libitum. One of the ASO and DSS treated groups was also given intravenous injections of 20 μg of recombinant human Factor XI protein (Haematologic Technologies Inc.) for 7 consecutive days, starting the day before DSS treatment. Mice were sacrificed at the end of the study on day 7 after DSS was administered.


The effect of antisense inhibition by ISIS 404071 on Factor XI mRNA levels is presented in Table 34. Factor XI levels are significantly decreased in mice treated with ISIS 404071 alone compared to the untreated PBS control.


Mice in all groups were weighed at day 0 and at the end of the study. The results are presented in Table 35 and demonstrate the weight change in the different groups over the time of the study. Mice were sacrificed at the end of the study on day 7 after DSS was administered and their colon lengths were measured. The results are presented in Table 36 and demonstrate that the increase in colon length due to treatment with ISIS 404071 is eliminated by administration of the recombinant Factor XI protein. The stool softness/diarrhea of the mice was analyzed on day 7 after DSS was administered and the score is presented in Table 37. The amelioration of diarrhea in mice treated with ISIS 404071 is eliminated on addition of recombinant Factor XI protein.


Mice with dextran sodium sulfate (DSS)-induced colitis have elevated level of thrombin-antithrombin (TAT) complexes in blood (Anthoni, C. et al., J. Exp. Med. 204: 1595-1601, 2007) and is also observed in patients with ulcerative colitis (Kume, K. et al., Intern Med. 2007. 46: 1323-9). The effect of antisense inhibition of Factor XI on TAT levels in the colon was evaluated (Siemens Healthcare Diagnostics, Deerfield, Ill.) at the end of the study on day 7 after DSS was administered and the results are presented in Table 38. As demonstrated, DSS administration increased TAT levels, which were decreased by treatment with ISIS 404071. Administration of recombinant Factor XI protein caused a near restoration of TAT levels to that of the DSS treated mice.


Plasma levels of soluble CD40 ligand (CD40L) are known to be elevated in cases of inflammatory bowel disease (Ludwiczek, O. et al., Int. J. Colorectal Disease. 2003. 18: 142-147) and may be considered a marker of intestinal inflammation. The effect of antisense inhibition of Factor XI on CD40L levels in the plasma was evaluated at the end of the study on day 7 after DSS was administered and the results are presented in Table 39. CD40L levels in plasma were measured by commercially available ELISA kits (Bender MedSystems, Vienna, Austria, eBioscience, San Diego, Calif.) according to the manufacture's protocols. As demonstrated, DSS administration increased CD40L levels, which were decreased by treatment with ISIS 404071. Administration of recombinant Factor XI protein caused a restoration of CD40L levels to that of the DSS treated mice.


Observations on experimental models and humans with ulcerative colitis suggest a pathogenetic role of the kallikrein-kinin system in inflammatory bowel diseases (Devani, M. et al., Digestive and Liver Disease. 2005. 37: 665-673). The effect of antisense inhibition of Factor XI on kinin levels in the colon was evaluated (Phoenix Pharmaceuticals, Burlingame, Calif.) at the end of the study on day 7 after DSS was administered and the results are presented in Table 40. As demonstrated, DSS administration increased bradykinin levels, which were decreased by treatment with ISIS 404071. Administration of recombinant Factor XI protein caused a restoration of bradykinin levels to that of the DSS treated mice.


The cytokine levels of IFN-γ, IL-10, IL-12, IL-1β, IL-2, IL-4, IL-5, TNF-α, and keratinocyte chemoattractant (KC) were measured in the colon of the mice groups at the end of the study on day 7 after DSS was administered. Colons were homogenized on ice in PBS supplemented with protease inhibitors (Sigma, St. Louis, Mo.) and extracted with rotation at 4° C. for 1 hour. After removal of insoluble material by centrifugation, colon homogenates were used for the cytokine analysis by multiplex ELISA (Mouse TH1/TH2 9-Plex Ultra-Sensitive Kit, Meso Scale Discovery, Gaithersburg, Md.) according to the manufacture's protocol. Cytokine levels in colon extracts were normalized to the protein concentration measured by protein assay kit (BioRad, Hercules, Calif.). The cytokine level results are presented in Table 41. The levels of pro-inflammatory cytokines, IFN-γ, IL-1β, IL-10, IL-2, IL-5, TNF-α, and KC were elevated by DSS administration, and were decreased by treatment with ISIS 404071. Administration of recombinant Factor XI protein caused a restoration of cytokine levels to that of the DSS treated mice.


In summary, this example shows that antisense treatment of DSS induced ulcerative colitis in an animal ameliorated the ulcerative colitis and decreased certain proinflammatory cytokines such as Th1 cytokines INF-γ, IL-10, TNF-α and KC. Additionally, proinflammatory cytokines such as Th2 cytokines IL-4 and IL-5 were decreased compared to untreated mice. This example also shows that human Factor XI protein treatment can successfully reverse the effect of antisense treatment of DSS induced ulcerative colitis in an animal. Therefore, recombinant human Factor XI protein may serve as an antidote for ISIS 404071 treatment.









TABLE 34







Antisense inhibition by ISIS 404071 and recovery of Factor XI levels by


recombinant Factor XI protein compared to untreated PBS control














Human






recombinant
%


Group (N)
ASO
DSS
FXI
inhibition














2. (8)
None
Yes
0
0


3. (8)
F11 (404071) 40 mpk
Yes
0
82


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
83
















TABLE 35







Weight change (%) in mice groups














Human






recombinant
Weight


Group (N)
ASO
DSS
FXI
change














1. (8)
None
No
0
+1.1


2. (8)
None
Yes
0
−0.4


3. (8)
F11 (404071) 40 mpk
Yes
0
+1.8


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
+0.3
















TABLE 36







Colon length in mice groups














Human
Colon





recombinant
length


Group (N)
ASO
DSS
FXI
(cm)














1. (8)
None
No
 0
11.3


2. (8)
None
Yes
 0
7.9


3. (8)
F11 (404071) 40 mpk
Yes
 0
9.9


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
7.3
















TABLE 37







Stool analysis in mice groups














Human






recombinant
Diarrhea


Group (N)
ASO
DSS
FXI
score





1. (8)
None
No
 0
0.0


2. (8)
None
Yes
 0
2.7


3. (8)
F11 (404071) 40 mpk
Yes
 0
0.5


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
2.0
















TABLE 38







Thrombin-antithrombin (TAT) levels in mice groups














Human
TAT levels


Group


recombinant
(ng/mg


(N)
ASO
DSS
FXI
protein)





1. (8)
None
No
 0
0.2


2. (8)
None
Yes
 0
1.5


3. (8)
F11 (404071) 40 mpk
Yes
 0
0.1


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
0.8
















TABLE 39







CD40L plasma levels in mice groups














Human
CD40L





recombinant
levels


Group (N)
ASO
DSS
FXI
(ng/mL)





1. (8)
None
No
 0
1.2


2. (8)
None
Yes
 0
1.8


3. (8)
F11 (404071) 40 mpk
Yes
 0
1.5


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
1.6
















TABLE 40







Bradykinin levels in the colons of mice groups














Human
Bradykinin


Group


recombinant
levels


(N)
ASO
DSS
FXI
(ng/mg)





1. (8)
None
No
 0
0.0


2. (8)
None
Yes
 0
0.4


3. (8)
F11 (404071) 40 mpk
Yes
 0
0.1


4. (8)
F11 (404071) 40 mpk
Yes
20 ug/mouse/day
0.3
















TABLE 41







Cytokine levels (pg/mg) in the colons of mice groups



















Group














(N)
ASO
DSS
rFXI
IFN-γ
IL-10
IL-12
IL-1β
IL-2
IL-4
IL-5
TNF-α
KC






















1. (8)
None
No
 0
0.08
2.3
47
5
0.08
0.004
0.04
0.09
9


2. (8)
None
Yes
 0
6.65
7.1
63
150
0.32
0.020
0.13
0.77
56


3. (8)
404071
Yes
 0
1.10
4.7
64
50
0.11
0.012
0.04
0.24
27


4. (8)
404071
Yes
20 ug/day
4.51
5.8
96
103
0.28
0.004
0.17
0.91
62









Colitis Study F: Effect of ISIS 404071 on Colitis

The effect of inhibiting Factor XI with ISIS 404071 in ameliorating colitis was evaluated in a dextran sulfate sodium (DSS)-induced colitis model.


Female Swiss Webb mice were separated in groups and treated as shown in Table 42.









TABLE 42







Summary of Mice Study Groups









Group (N)
ASO
DSS





1. (8)
None
No


2. (8)
None
Yes


3. (8)
F11 (404071) 50 mpk
Yes









In a first group of 8 Swiss Webb mice, 50 mg/kg of ISIS 404071 was injected subcutaneously twice a week for 3 weeks. Two control groups of 8 mice each were injected with PBS twice a week for 3 weeks. After the oligonucleotide treatment, 4% DSS in water was administered ad libitum for 7 days to the experimental group and one PBS control group. Mice were sacrificed at the end of the study on day 7 after DSS was administered.


Mice in all groups were weighed at day 0 and daily for 7 days after administration of DSS. The weight of the mice at day 0 and 7 are shown in Table 43. The stool softness/diarrhea of the mice was analyzed for seven days after DSS was administered as shown in Table 44. Mice were sacrificed at the end of the study on day 7 after DSS was administered and their colon lengths and weight were measured as shown in Table 45.


The antisense oligonucleotide showed statistically significant dose effects on diarrhea scores and colon length (Tables 44 and 45). ISIS 404071 did not significantly affect body weight when compared to placebo as shown in Table 43.


The mRNA levels of cytokines IL-1, IL-6, IL-10, IL-12, IL-17 and TNF-α were measured in the colon of the mice groups at the end of the study on day 7 after DSS was administered. Colons were homogenized on ice in PBS supplemented with protease inhibitors (Sigma, St. Louis, Mo.) and extracted with rotation at 4° C. for 1 hour. After removal of insoluble material by centrifugation, colon homogenates were used for the cytokine analysis by multiplex ELISA (Meso Scale Discovery, Gaithersburg, Md.) according to the manufacture's protocol. Cytokine levels in colon extracts were normalized to the protein concentration measured by protein assay kit (BioRad, Hercules, Calif.). The results are presented in Table 46. The levels of pro-inflammatory cytokines, including Th1 cytokines IL-1 and IL-6, elevated by DSS administration were decreased by treatment with ISIS 404071. GATA-3 is a transcription factor and has been shown to promote secretion of cytokines IL-4, IL-5 and IL-13 from Th2 cells. The effect of antisense oligonucleotide on GATA-3 is presented in Table 46.


Plasma levels of aminotransferases (ALT and AST), blood urea nitrogen (BUN), creatinine (CREAT), cholesterol (CHOL) and total bilirubin (TBIL) were measured after treatment and are shown in Table 47.


The effect of antisense inhibition in the liver and colon levels of Factor XI mRNA after treatment by ISIS 404071 is presented in Table 48 (as a percent of the PBS treated control).


In summary, this example shows that Factor XI oligonucleotide treatment significantly ameliorated DSS induced ulcerative colitis in an animal. Treatment with a Factor XI inhibitor is also shown to reduce the risk and progression of colitis in an animal. Treatment with a Factor XI inhibitor also decreased Th1 cytokines IL-1 and IL-6









TABLE 43







Body weight (grams) change after treatment










Weight
Weight



(day 0)
(day 7)















PBS
28.3
29.6



DSS control
26.8
23.1



ISIS 404071
28
24.7

















TABLE 44







Stool scores after treatment with ISIS 404071














Day 3
Day 4
Day 5
Day 6
Day 7
Day 8

















PBS
0
0
0
0
0
0


DSS
0
0
1
1
1.63
2.5


ISIS
0
0.25
1
1
1
2


404071
















TABLE 45







Colon length and weight after treatment










Length
Weight



(cm)
(mg)















PBS
10.8
293.8



DSS control
5.9
276.4



ISIS 404071
7.8
339.3

















TABLE 46







Cytokine mRNA levels (as a % of PBS treated animals)


in the colon after treatment with ISIS 404071















IL-1
IL-6
IL-10
IL-12
IL-17
TNF-α
GATA-3


















PBS
100
100
100
100
100
100
100


DSS
3312
1515
103
244
1478
520
445


ISIS
1189
1056
202
234
787
1127
359


404071
















TABLE 47







Plasma levels of ALT, AST, BUN, CREAT, CHOL


and TBIL after treatment with ISIS 404071














ALT
AST
BUN
CREAT
CHOL
TBIL



(U/L)
(U/L)
(mg/dl)
(mg/dl)
(mg/dl)
(mg/dl)

















PBS
166
207.6
35.2
0.048
105.6
0.25


DSS control
56.8
192.9
31.6
0.089
175.8
0.29


ISIS 404071
133.6
339.3
29.5
−0.003
170.3
0.7
















TABLE 48







Factor XI mRNA levels in the liver and colon after treatment with


ISIS 404071 compared to PBS treatment










Liver
Colon



(% of normal)
(% of normal)















PBS
100
100



DSS control
256
166



ISIS 404071
24
148










Example 13
In Vivo Effect of Antisense Inhibition of Murine Factor XI on an Ova-Induced Asthma Model

The effect of antisense oligonucleotide inhibition of Factor XI and its role in ameliorating asthma was evaluated in an OVA/alum-induced asthma model. Administration of ovalbumin to animals is a well known method to induce colitis and has been previously described by Henderson et al. (J. Exp. Med., 1996, 184: 1483-1494).


Asthma in humans has symptoms that can include wheezing, dyspnea, non-productive coughing, chest tightness and pain, rapid heart rate and sweating. During asthma attacks or exacerbation of asthma, there is inflammation in the lung tissue, constriction of the smooth muscle cells of the bronchi, blockade of airways and difficulty in breathing (Fanta, C. H. N. Engl. J. Med. 2009. 360: 1002-1014).


Antisense oligonucleotides targeting Factor XI were described in Example 11, supra.


Treatment

BALB/c mice (available from Charles River Laboratories, Wilmington, Mass.) were maintained on a 12-hour light/dark cycle and fed ad libitum Teklad lab chow (Harlan Laboratories, Indianapolis, Ind.). Animals were acclimated for at least 7 days in the research facility before initiation of the experiment. Antisense oligonucleotides (ASOs) were prepared in PBS and sterilized by filtering through a 0.2 micron filter. Oligonucleotides were dissolved in 0.9% PBS for injection.


The mice were divided into four treatment groups of 5 mice each. One group received subcutaneous injections of ISIS 404071 at a dose of 50 mg/kg twice a week for 4 weeks. One group of mice received subcutaneous injections of control oligonucleotide, ISIS 421208, which is a mismatch oligonucleotide sequence of ISIS 404071, at a dose of 50 mg/kg twice a week for 4 weeks. Two groups of mice received subcutaneous injections of PBS twice a week for 4 weeks. One PBS group remained untreated and served as the control group. The second PBS group and both the oligonucleotide treated groups were injected with OVA/alum on days 0 and 14 and nebulized with OVA in PBS on days 24, 25, and 26. The first OVA application served to sensitize the mice against OVA while the second was a challenge application to provoke an asthmatic reaction. Two days following the final dose, the mice were euthanized, bronchial lavage (BAL) was collected and analyses done.


Bronchial asthma, even in its mild form, is characterized by local infiltration and activation of inflammatory and immunoeffector cells, including T lymphocytes, macrophages, eosinophils, and mast cells (Smith D. L. et al., Am. Rev. Respir. Dis. 1993. 148: 523-532). The effect of treatment with ISIS 404071 on bronchoalveolar lavage (BAL) eosinophil recruitment was assessed. BAL cells were stained with hemotoxylin and eosin (H&E). The results are presented in Table 49 as a percentage of total cells in BAL. The data demonstrates that treatment with ISIS 404071 decreased the eosinophil recruitment.


Lung sections were stained with periodic acid shift (PAS) base stain that stains mucus, which is produced during asthma attacks (Rogers, D. F. Curr. Opin Pharmacol. 2004. 4: 241-250). The number of airways containing mucus as a percentage of the total airways in the lungs was evaluated. The data is presented in Table 50 and indicates that treatment with ISIS 404071 decreased mucus production in the lungs









TABLE 49







BAL eosinophil recruitment after treatment









Eosinophils



(%)














PBS
0



OVA control
48



ISIS 404071
32



ISIS 421208
51

















TABLE 50







Mucus production after treatment









% airways














PBS
0



OVA control
58



ISIS 404071
34



ISIS 421208
49











In summary, this example shows that Factor XI oligonucleotide treatment significantly ameliorated OVA-induced asthma in an animal. Treatment with a Factor XI inhibitor is also shown to reduce the risk and progression of asthma in an animal.


Example 14
Antisense Inhibition of Human Factor XI in HepG2 Cells by Oligonucleotides Designed by Microwalk

Additional gapmers were designed based on ISIS 416850 and ISIS 416858 (see Table 8 above). These gapmers were shifted slightly upstream and downstream (i.e. “microwalk”) of ISIS 416850 and ISIS 416858. The microwalk gapmers were designed with either 5-8-5 MOE or 6-8-6 MOE motifs.


These microwalk gapmers were tested in vitro. Cultured HepG2 cells at a density of 20,000 cells per well were transfected using electroporation with 8,000 nM antisense oligonucleotide. After a treatment period of approximately 24 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN. Results are presented as percent inhibition of Factor XI, relative to untreated control cells.


ISIS 416850 and ISIS 416858, as well as selected gapmers from Tables 1 and 8 (i.e., ISIS 412206, ISIS 412223, ISIS 412224, ISIS 412225, ISIS 413481, ISIS 413482, ISIS 416825, ISIS 416848, ISIS 416849, ISIS 416850, ISIS 416851, ISIS 416852, ISIS 416853, ISIS 416854, ISIS 416855, ISIS 416856, ISIS 416857, ISIS 416858, ISIS 416859, ISIS 416860, ISIS 416861, ISIS 416862, ISIS 416863, ISIS 416864, ISIS 416865, ISIS 416866, and ISIS 416867) were retested in vitro along with the microwalk gapmers under the same condition as described above.


The chimeric antisense oligonucleotides in Table 51 were designed as 5-10-5 MOE, 5-8-5 and 6-8-6 MOE gapmers. The first two listed gapmers in Table 51 are the original gapmers (ISIS 416850 and ISIS 416858) from which ISIS 445493-445543 were designed via microwalk, and are designated by an asterisk. The 5-10-5 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of ten 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising five nucleotides each. The 5-8-5 gapmers are 18 nucleotides in length, wherein the central gap segment is comprised of eight 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising five nucleotides each. The 6-8-6 gapmers are 20 nucleotides in length, wherein the central gap segment is comprised of eight 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising six nucleotides each. For each of the motifs (5-10-5, 5-8-5 and 6-8-6), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Human Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted in the human sequence. “Human Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted in the human sequence. Each gapmer listed in Table 51 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3). Each gapmer is Table 51 is also fully cross-reactive with the rhesus monkey Factor XI gene sequence, designated herein as SEQ ID NO: 274 (exons 1-15 GENBANK Accession No. NW001118167.1). ‘Rhesus monkey start site’ indicates the 5′-most nucleotide to which the gapmer is targeted in the rhesus monkey sequence. ‘Rhesus monkey stop site’ indicates the 3′-most nucleotide to which the gapmer is targeted to the rhesus monkey sequence.


As shown in Table 51, all of the microwalk designed gapmers targeted to the target region beginning at the target start site 1275 and ending at the target stop site 1317 (i.e. nucleobases 1275-1317) of SEQ ID NO: 1 exhibited at least 60% inhibition of Factor XI mRNA. Similarly, all of the re-tested gapmers from Tables 1 and 8 exhibited at least 60% inhibition.


Several of the gapmers exhibited at least 70% inhibition, including ISIS numbers: ISIS 412206, 412224, 412225, 413481, 413482, 416825, 416848, 416849, 416850, 416851, 416852, 416853, 416854, 416855, 416856, 416857, 416858, 416859, 416860, 416861, 416862, 416863, 416864, 416865, 416866, 416867, 445494, 445495, 445496, 445497, 445498, 445499, 445500, 445501, 445502, 445503, 445504, 445505, 445506, 445507, 445508, 445509, 445510, 445511, 445512, 445513, 445514, 445515, 445516, 445517, 445518, 445519, 445520, 445521, 445522, 445523, 445524, 445525, 445526, 445527, 445528, 445529, 445530, 445531, 445532, 445533, 445534, 445535, 445536, 445537, 455538, 445539, 445540, 445541, 445542, and 445543.


Several of the gapmers exhibited at least 80% inhibition, including ISIS numbers: ISIS 412206, 412224, 412225, 413481, 413482, 416825, 416848, 416849, 416850, 416851, 416852, 416853, 416854, 416855, 416856, 416857, 416858, 416859, 416860, 416861, 416862, 416863, 416864, 416865, 416866, 416867, 445494, 445495, 445496, 445497, 445498, 445500, 445501, 445502, 445503, 445504, 445505, 445506, 445507, 445508, 445509, 445510, 445513, 445514, 445519, 445520, 445521, 445522, 445525, 445526, 445529, 445530, 445531, 445532, 445533, 445534, 445535, 445536, 455538, 445541, and 445542.


Several of the gapmers exhibited at least 90% inhibition, including ISIS numbers: ISIS 412206, 416825, 416850, 416857, 416858, 416861, 445522, and 445531.









TABLE 51







Inhibition of human Factor XI mRNA levels by chimeric antisense


oligonucleotides targeted to SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3)
















Human
Human



SEQ
rhesus
Rhesus



Start
Stop

Percent

ID
monkey
monkey


ISIS No.
Site
Site
Sequence (5′ to 3′)
inhibition
Motif
No.
Start Site
Stop Site


















*416850
1278
1297
TGCACAGTTTCTGGCAG
91
5/10/2005
215
1277
1296





GCC










*416858
1288
1307
ACGGCATTGGTGCACAG
90
5/10/2005
223
1287
1306





TTT










416825
680
699
GCCCTTCATGTCTAGGT
90
5/10/2005
190
679
698





CCA










412206
738
757
CCGTGCATCTTTCTTGG
91
5/10/2005
34
737
756





CAT










412223
1275
1294
ACAGTTTCTGGCAGGCC
62
5/10/2005
51
1274
1293





TCG










445493
1275
1294
ACAGTTTCTGGCAGGCC
69
6/8/2006
51
1274
1293





TCG










445518
1275
1292
AGTTTCTGGCAGGCCTC
75
5/8/2005
242
1274
1291





G










416848
1276
1295
CACAGTTTCTGGCAGGC
87
5/10/2005
213
1275
1294





CTC










445494
1276
1295
CACAGTTTCTGGCAGGC
85
6/8/2006
213
1275
1294





CTC










445519
1276
1293
CAGTTTCTGGCAGGCCT
81
5/8/2005
243
1275
1292





C










416849
1277
1296
GCACAGTTTCTGGCAGG
88
5/10/2005
214
1276
1295





CCT










445495
1277
1296
GCACAGTTTCTGGCAGG
89
6/8/2006
214
1276
1295





CCT










445520
1277
1294
ACAGTTTCTGGCAGGCC
82
5/8/2005
244
1276
1293





T










445496
1278
1297
TGCACAGTTTCTGGCAG
87
6/8/2006
215
1277
1296





GCC










445521
1278
1295
CACAGTTTCTGGCAGGC
87
5/8/2005
245
1277
1294





C










416851
1279
1298
GTGCACAGTTTCTGGCA
89
5/10/2005
216
1278
1297





GGC










445497
1279
1298
GTGCACAGTTTCTGGCA
81
6/8/2006
216
1278
1297





GGC










445522
1279
1296
GCACAGTTTCTGGCAGG
91
5/8/2005
246
1278
1295





C










413481
1280
1299
GGTGCACAGTTTCTGGC
82
5/10/2005
114
1279
1298





AGG










445498
1280
1299
GGTGCACAGTTTCTGGC
83
6/8/2006
114
1279
1298





AGG










445523
1280
1297
TGCACAGTTTCTGGCAG
73
5/8/2005
267
1279
1296





G










416852
1281
1300
TGGTGCACAGTTTCTGG
87
5/10/2005
217
1280
1299





CAG










445499
1281
1300
TGGTGCACAGTTTCTGG
75
6/8/2006
217
1280
1299





CAG










445524
1281
1298
GTGCACAGTTTCTGGCA
75
5/8/2005
247
1280
1297





G










416853
1282
1301
TTGGTGCACAGTTTCTG
84
5/10/2005
218
1281
1300





GCA










445500
1282
1301
TTGGTGCACAGTTTCTG
81
6/8/2006
218
1281
1300





GCA










445525
1282
1299
GGTGCACAGTTTCTGGC
85
5/8/2005
248
1281
1298





A










416854
1283
1302
ATTGGTGCACAGTTTCT
86
5/10/2005
219
1282
1301





GGC










445501
1283
1302
ATTGGTGCACAGTTTCT
83
6/8/2006
219
1282
1301





GGC










445526
1283
1300
TGGTGCACAGTTTCTGG
81
5/8/2005
249
1282
1299





C










416855
1284
1303
CATTGGTGCACAGTTTC
85
5/10/2005
220
1283
1302





TGG










445502
1284
1303
CATTGGTGCACAGTTTC
83
6/8/2006
220
1283
1302





TGG










445527
1284
1301
TTGGTGCACAGTTTCTG
70
5/8/2005
250
1283
1300





G










412224
1285
1304
GCATTGGTGCACAGTTT
84
5/10/200
552
1284
1303





CTG










445503
1285
1304
GCATTGGTGCACAGTTT
89
6/8/200
652
1284
1303





CTG










445528
1285
1302
ATTGGTGCACAGTTTCT
73
5/8/2005
251
1284
1301





G










416856
1286
1305
GGCATTGGTGCACAGTT
84
5/10/2005
221
1285
1304





TCT










445504
1286
1305
GGCATTGGTGCACAGTT
87
6/8/2006
221
1285
1304





TCT










445529
1286
1303
CATTGGTGCACAGTTTC
85
5/8/2005
252
1285
1302





T










416857
1287
1306
CGGCATTGGTGCACAGT
91
5/10/2005
222
1286
1305





TTC










445505
1287
1306
CGGCATTGGTGCACAGT
89
6/8/2006
222
1286
1305





TTC










445530
1287
1304
GCATTGGTGCACAGTTT
83
5/8/2005
253
1286
1303





C










445506
1288
1307
ACGGCATTGGTGCACAG
86
6/8/2006
223
1287
1306





TTT










445531
1288
1305
GGCATTGGTGCACAGTT
90
5/8/2005
254
1287
1304





T










416859
1289
1308
GACGGCATTGGTGCACA
85
5/10/2005
224
1288
1307





GTT










445507
1289
1308
GACGGCATTGGTGCACA
85
6/8/2006
224
1288
1307





GTT










445532
1289
1306
CGGCATTGGTGCACAGT
89
5/8/2005
255
1288
1305





T










413482
1290
1309
GGACGGCATTGGTGCAC
88
5/10/2005
115
1289
1308





AGT










445508
1290
1309
GGACGGCATTGGTGCAC
81
6/8/2006
115
1289
1308





AGT










445533
1290
1307
ACGGCATTGGTGCACAG
87
5/8/2005
256
1289
1306





T










416860
1291
1310
CGGACGGCATTGGTGCA
89
5/10/2005
225
1290
1309





CAG










445509
1291
1310
CGGACGGCATTGGTGCA
84
6/8/2006
225
1290
1309





CAG










445534
1291
1308
GACGGCATTGGTGCACA
82
5/8/2005
257
1290
1307





G










416861
1292
1311
GCGGACGGCATTGGTGC
90
5/10/2005
226
1291
1310





ACA










445510
1292
1311
GCGGACGGCATTGGTGC
88
6/8/2006
226
1291
1310





ACA










445535
1292
1309
GGACGGCATTGGTGCAC
83
5/8/2005
258
1291
1308





A










416862
1293
1312
AGCGGACGGCATTGGTG
89
5/10/2005
227
1292
1311





CAC










445511
1293
1312
AGCGGACGGCATTGGTG
77
6/8/2006
227
1292
1311





CAC










445536
1293
1310
CGGACGGCATTGGTGCA
82
5/8/2005
259
1292
1309





C










416863
1294
1313
CAGCGGACGGCATTGGT
86
5/10/2005
228
1293
1312





GCA










445512
1294
1313
CAGCGGACGGCATTGGT
79
6/8/2006
228
1293
1312





GCA










445537
1294
1311
GCGGACGGCATTGGTGC
78
5/8/2005
260
1293
1310





A










412225
1295
1314
GCAGCGGACGGCATTGG
86
5/10/2005
53
1294
1313





TGC










445513
1295
1314
GCAGCGGACGGCATTGG
85
6/8/2006
53
1294
1313





TGC










445538
1295
1312
AGCGGACGGCATTGGTG
80
5/8/2005
261
1294
1311





C










416864
1296
1315
GGCAGCGGACGGCATTG
88
5/10/2005
229
1295
1314





GTG










445514
1296
1315
GGCAGCGGACGGCATTG
81
6/8/2006
229
1295
1314





GTG










445539
1296
1313
CAGCGGACGGCATTGGT
79
5/8/2005
262
1295
1312





G










416865
1297
1316
TGGCAGCGGACGGCATT
86
5/10/2005
230
1296
1315





GGT










445515
1297
1316
TGGCAGCGGACGGCATT
75
6/8/2006
230
1296
1315





GGT










445540
1297
1314
GCAGCGGACGGCATTGG
74
5/8/2005
263
1296
1313





T










416866
1298
1317
CTGGCAGCGGACGGCAT
84
5/10/2005
231
1297
1316





TGG










445516
1298
1317
CTGGCAGCGGACGGCAT
79
6/8/2006
231
1297
1316





TGG










445541
1298
1315
GGCAGCGGACGGCATTG
80
5/8/2005
264
1297
1314





G










416867
1299
1318
ACTGGCAGCGGACGGCA
85
5/10/2005
232
1298
1317





TTG










445517
1299
1318
ACTGGCAGCGGACGGCA
74
6/8/2006
232
1298
1317





TTG










445542
1299
1316
TGGCAGCGGACGGCATT
83
5/8/2005
265
1298
1315





G










445543
1300
1317
CTGGCAGCGGACGGCAT
74
5/8/2005
266
1299
1316





T









Example 15
Dose-Dependent Antisense Inhibition of Human Factor XI in HepG2 Cells

Gapmers from Example 14 exhibiting in vitro inhibition of human Factor XI were tested at various doses in HepG2 cells. Cells were plated at a density of 20,000 cells per well and transfected using electroporation with 123.46 nM, 370.37 nM, 1,111.11 nM, 3,333.33 nM and 10,000 nM concentrations of antisense oligonucleotide, as specified in Table 52. After a treatment period of approximately 16 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN. Results are presented as percent inhibition of Factor XI, relative to untreated control cells. As illustrated in Table 52, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells.


The half maximal inhibitory concentration (IC50) of each oligonucleotide was calculated by plotting the concentrations of antisense oligonucleotides used versus the percent inhibition of Factor XI mRNA expression achieved at each concentration, and noting the concentration of antisense oligonucleotide at which 50% inhibition of Factor XI mRNA expression was achieved compared to the PBS control. IC50 values are presented in Table 52.









TABLE 52







Dose-dependent antisense inhibition of human Factor XI in HepG2


cells via transfection of oligonucleotides using electroporation













ISIS
123.47
370.37
1,111.11
3,333.33
10,000.0
IC50


No.
nM
nM
nM
nM
nM
(μM)
















416849
5
5
26
57
68
2.7


416850
0
12
36
74
73
2.8


416851
13
35
36
64
72
1.5


416856
12
23
35
59
83
1.6


416857
2
20
35
62
72
2.3


416858
0
27
36
64
70
2.2


416860
0
28
39
41
40
n.d.


416861
0
15
27
66
80
2.0


445498
3
1
27
50
58
4.8


445503
0
0
22
36
60
5.9


445504
8
20
38
53
68
2.7


445505
12
30
39
59
77
1.8


445522
0
0
44
63
74
2.9


445531
8
16
52
61
77
1.8


445532
5
12
39
60
70
2.0





n.d. = no data






Example 16
Dose-Dependent Antisense Inhibition of Human Factor XI in HepG2 Cells by Oligonucleotides Designed by Microwalk

Additional gapmers were designed based on ISIS 416850 and ISIS 416858 (see Table 8 above). These gapmers are shifted slightly upstream and downstream (i.e. microwalk) of ISIS 416850 and ISIS 416858. Gapmers designed by microwalk have 3-8-3 MOE, 4-8-4 MOE, 2-10-2 MOE, 3-10-3 MOE, or 4-10-4 MOE motifs.


These gapmers were tested at various doses in HepG2 cells. Cells were plated at a density of 20,000 cells per well and transfected using electroporation with 375 nM, 750 nM, 1,500 nM, 3,000 nM, 6,000 nM and 12,000 nM concentrations of antisense oligonucleotide, as specified in Table 54. After a treatment period of approximately 16 hours, RNA was isolated from the cells and Factor XI mRNA levels were measured by quantitative real-time PCR. Human Factor XI primer probe set RTS 2966 was used to measure mRNA levels. Factor XI mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN. Results are presented as percent inhibition of Factor XI, relative to untreated control cells.


ISIS 416850, ISIS 416858, ISIS 445522, and ISIS 445531 (see Table 52 above) were re-tested in vitro along with the microwalk gapmers under the same conditions described above.


The chimeric antisense oligonucleotides in Table 53 were designed as 3-8-3 MOE, 4-8-4 MOE, 2-10-2 MOE, 3-10-3 MOE, or 4-10-4 MOE gapmers. The 3-8-3 gapmer is 14 nucleotides in length, wherein the central gap segment is comprised of eight 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising three nucleotides each. The 4-8-4 gapmer is 16 nucleotides in length, wherein the central gap segment is comprised of eight 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising four nucleotides each. The 2-10-2 gapmer is 14 nucleotides in length, wherein the central gap segment is comprised of ten 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising two nucleotides each. The 3-10-3 gapmer is 16 nucleotides in length, wherein the central gap segment is comprised of ten 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising three nucleotides each. The 4-10-4 gapmer is 18 nucleotides in length, wherein the central gap segment is comprised of ten 2′-deoxynucleotides and is flanked on both sides (in the 5′ and 3′ directions) by wings comprising four nucleotides each. For each of the motifs (3-8-3, 4-8-4, 2-10-2, 3-10-3, and 4-10-4), each nucleotide in the 5′ wing segment and each nucleotide in the 3′ wing segment has a 2′-MOE modification. The internucleoside linkages throughout each gapmer are phosphorothioate (P═S) linkages. All cytidine residues throughout each gapmer are 5-methylcytidines. “Human Target start site” indicates the 5′-most nucleotide to which the gapmer is targeted in the human sequence. “Human Target stop site” indicates the 3′-most nucleotide to which the gapmer is targeted in the human sequence. Each gapmer listed in Table 53 is targeted to SEQ ID NO: 1 (GENBANK Accession No. NM000128.3). Each gapmer is Table 53 is also fully cross-reactive with the rhesus monkey Factor XI gene sequence, designated herein as SEQ ID NO: 274 (exons 1-15 GENBANK Accession No. NW001118167.1). ‘Rhesus monkey start site’ indicates the 5′-most nucleotide to which the gapmer is targeted in the rhesus monkey sequence. ‘Rhesus monkey stop site’ indicates the 3′-most nucleotide to which the gapmer is targeted to the rhesus monkey sequence.









TABLE 53







Chimeric antisense oligonucleotides targeted to SEQ ID NO: 1


(GENBANK Accession No. NM_000128.3)


and designed by microwalk of ISIS 416850 and ISIS 416858















Human
Human



Rhesus
Rhesus



Target
Target


SEQ
monkey
monkey


ISIS No.
Start Site
Stop Site
Sequence (5′ to 3′)
Motif
ID No.
Start Site
Stop Site





449707
1280
1295
CACAGTTTCTGGCAGG
4-8-4
268
1279
1294





449708
1281
1294
 ACAGTTTCTGGCAG
3-8-3
269
1280
1293





449709
1279
1296
GCACAGTTTCTGGCAGGC
4-10-4
246
1278
1295





449710
1280
1295
 CACAGTTTCTGGCAGG
3-10-3
268
1279
1294





449711
1281
1294
  ACAGTTTCTGGCAG
2-10-2
269
1280
1293









Dose-response inhibition data is given in Table 54. As illustrated in Table 54, Factor XI mRNA levels were reduced in a dose-dependent manner in antisense oligonucleotide treated cells. The IC50 of each antisense oligonucleotide was also calculated and presented in Table 54. The first two listed gapmers in Table 54 are the original gapmers (ISIS 416850 and ISIS 416858) from which the remaining gapmers were designed via microwalk and are designated by an asterisk.









TABLE 54







Dose-dependent antisense inhibition of human Factor XI in HepG2


cells via transfection of oligonucleotides using electroporation














ISIS
375
750
1,500
3,000
6,000
12,000
IC50


No.
nM
nM
nM
nM
nM
nM
(μM)

















*416850
40
59
69
87
90
95
0.56


*416858
31
35
78
85
90
93
0.83


445522
59
71
83
82
81
92
n.d.


445531
44
64
78
86
91
93
0.44


449707
7
35
63
73
85
91
1.26


449708
0
0
22
33
61
85
4.46


449709
52
71
80
87
92
95
0.38


449710
2
21
52
70
82
87
1.59


449711
6
14
1
7
32
52
11.04 





n.d. = no data






Example 17
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in CD1 Mice

CD1 mice were treated with ISIS antisense oligonucleotides targeting human Factor XI and evaluated for changes in the levels of various metabolic markers.


Treatment

Groups of five CD1 mice each were injected subcutaneously twice a week for 2, 4, or 6 weeks with 50 mg/kg of ISIS 416825, ISIS 416826, ISIS 416838, ISIS 416850, ISIS 416858, ISIS 416864, ISIS 416892, ISIS 416925, ISIS 416999, ISIS 417002, or ISIS 417003. A control group of five mice was injected subcutaneously with PBS for 2 weeks. All experimental groups (i.e. ASO treated mice at 2, 4, 6 weeks) were compared to the control group (i.e. PBS, 2 weeks).


Three days after the last dose was administered to all groups, the mice were sacrificed. Organ weights were measured and blood was collected for further analysis.


Organ Weight

Liver, spleen, and kidney weights were measured at the end of the study, and are presented in Tables 55, 56, and 57 as a percent of the PBS control, normalized to body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS controls were selected for further studies.









TABLE 55







Percent change in liver weight of CD1 mice after antisense


oligonucleotide treatment












ISIS






No.
2 weeks
4 weeks
6 weeks
















416825
+5
+22
+13



416826
+10
+32
+33



416838
+8
−6
0



416850
+5
+3
+6



416858
+7
+1
+10



416864
−2
+2
−5



416925
+14
+14
+33



416999
+13
+30
+47



417002
+14
+8
+35



416892
+35
+88
+95



417003
+8
+42
+32

















TABLE 56







Percent change in spleen weight of CD1 mice after antisense


oligonucleotide treatment












ISIS






No.
2 weeks
4 weeks
6 weeks
















416825
−12
+19
+21



416826
−12
−5
+22



416838
+21
−8
+9



416850
−4
+6
+48



416858
−2
+8
+28



416864
−10
−2
−6



416925
−7
+33
+78



416999
+7
+22
+38



417002
+29
+26
+108



416892
+24
+30
+65



417003
+12
+101
+98

















TABLE 57







Percent change in kidney weight of CD1 mice after antisense


oligonucleotide treatment












ISIS






No.
2 weeks
4 weeks
6 weeks
















416825
−12
−12
−11



416826
−13
−7
−22



416838
−2
−12
−8



416850
−10
−12
−11



416858
+1
−18
−10



416864
−4
−9
−15



416925
−4
−14
−2



416999
−9
−6
−7



417002
+3
−5
−2



416892
+2
−3
+19



417003
−9
−2
−1










Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Measurements of alanine transaminase (ALT) and aspartate transaminase (AST) are expressed in IU/L and the results are presented in Tables 58 and 59. Plasma levels of bilirubin and albumin were also measured using the same clinical chemistry analyzer and expressed in mg/dL. The results are presented in Tables 60 and 61. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Those antisense oligonucleotides which did not increase levels of bilirubin more than two-fold of the control levels were selected for further studies.









TABLE 58







Effect of antisense oligonucleotide treatment on ALT (IU/L) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
36
n.d.
n.d.



ISIS 416825
64
314
507



ISIS 416826
182
126
1954



ISIS 416838
61
41
141



ISIS 416850
67
58
102



ISIS 416858
190
57
216



ISIS 416864
44
33
92



ISIS 416925
160
284
1284



ISIS 416999
61
160
1302



ISIS 417002
71
138
2579



ISIS 416892
66
1526
1939



ISIS 417003
192
362
2214







n.d. = no data













TABLE 59







Effect of antisense oligonucleotide treatment on AST (IU/L) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
68
n.d.
n.d.



ISIS 416825
82
239
301



ISIS 416826
274
156
1411



ISIS 416838
106
73
107



ISIS 416850
72
88
97



ISIS 416858
236
108
178



ISIS 416864
58
46
101



ISIS 416925
144
206
712



ISIS 416999
113
130
671



ISIS 417002
96
87
1166



ISIS 416892
121
1347
1443



ISIS 417003
152
249
839







n.d. = no data













TABLE 60







Effect of antisense oligonucleotide treatment on


bilirubin (mg/dL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
0.28
n.d.
n.d.



ISIS 416825
0.41
0.69
0.29



ISIS 416826
0.39
0.20
0.37



ISIS 416838
0.57
0.24
0.20



ISIS 416850
0.46
0.23
0.22



ISIS 416858
0.57
0.24
0.16



ISIS 416864
0.40
0.26
0.22



ISIS 416925
0.45
0.25
0.25



ISIS 416999
0.48
0.18
0.28



ISIS 417002
0.50
0.25
0.29



ISIS 416892
0.38
2.99
0.50



ISIS 417003
0.33
0.15
0.24







n.d. = no data













TABLE 61







Effect of antisense oligonucleotide treatment on


albumin (mg/dL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
3.7
n.d.
n.d.



ISIS 416825
3.6
3.4
3.5



ISIS 416826
3.3
3.4
3.4



ISIS 416838
3.5
3.8
3.6



ISIS 416850
3.6
3.5
3.1



ISIS 416858
3.4
3.5
2.8



ISIS 416864
3.5
3.6
3.5



ISIS 416925
3.5
3.5
3.2



ISIS 416999
3.4
3.3
3.2



ISIS 417002
3.2
3.4
3.4



ISIS 416892
3.2
4.0
4.4



ISIS 417003
3.4
3.4
3.2







n.d. = no data






Kidney Function

To evaluate the effect of ISIS oligonucleotides on kidney function, plasma concentrations of blood urea nitrogen (BUN) and creatinine were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Tables 62 and 63, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies.









TABLE 62







Effect of antisense oligonucleotide treatment on


BUN (mg/dL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
30
n.d.
n.d.



ISIS 416825
29
35
31



ISIS 416826
24
34
27



ISIS 416838
25
38
30



ISIS 416850
25
30
23



ISIS 416858
21
29
19



ISIS 416864
22
31
28



ISIS 416925
21
30
17



ISIS 416999
22
27
22



ISIS 417002
19
23
19



ISIS 416892
19
28
23



ISIS 417003
23
26
24







n.d. = no data













TABLE 63







Effect of antisense oligonucleotide treatment on


creatinine (mg/dL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
0.14
n.d.
n.d.



ISIS 416825
0.14
0.21
0.17



ISIS 416826
0.15
0.20
0.15



ISIS 416838
0.09
0.27
0.14



ISIS 416850
0.13
0.22
0.19



ISIS 416858
0.13
0.23
0.10



ISIS 416864
0.11
0.22
0.16



ISIS 416925
0.12
0.25
0.13



ISIS 416999
0.07
0.18
0.13



ISIS 417002
0.06
0.16
0.10



ISIS 416892
0.11
0.20
0.17



ISIS 417003
0.17
0.24
0.18







n.d. = no data






Hematology Assays

Blood obtained from all mice groups were sent to Antech Diagnostics for hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) measurements and analyses, as well as measurements of the various blood cells, such as WBC (neutrophils, lymphocytes, and monocytes), RBC, and platelets, and total hemoglobin content. The results are presented in Tables 64-74. Percentages given in the tables indicate the percent of total blood cell count. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and/or an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 64







Effect of antisense oligonucleotide treatment on HCT (%) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
50
n.d.
n.d.



ISIS 416825
49
46
40



ISIS 416826
47
41
37



ISIS 416838
42
44
39



ISIS 416850
44
44
38



ISIS 416858
50
45
46



ISIS 416864
50
45
42



ISIS 416925
51
47
47



ISIS 416999
51
42
40



ISIS 417002
44
44
51



ISIS 416892
48
42
45



ISIS 417003
48
41
43







n.d. = no data













TABLE 65







Effect of antisense oligonucleotide treatment on MCV (fL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
61
n.d.
n.d.



ISIS 416825
58
53
51



ISIS 416826
56
52
53



ISIS 416838
56
54
48



ISIS 416850
57
51
50



ISIS 416858
59
51
50



ISIS 416864
57
52
51



ISIS 416925
61
52
47



ISIS 416999
60
49
48



ISIS 417002
61
50
52



ISIS 416892
59
49
53



ISIS 417003
60
48
45







n.d. = no data













TABLE 66







Effect of antisense oligonucleotide treatment on MCH (pg) in CD1 mice












ISIS No.
2 weeks
4 weeks
6 weeks







PBS
18
n.d.
n.d.



ISIS 416825
17
16
15



ISIS 416826
17
16
16



ISIS 416838
17
17
15



ISIS 416850
17
16
15



ISIS 416858
17
16
15



ISIS 416864
18
16
16



ISIS 416925
17
16
15



ISIS 416999
17
16
15



ISIS 417002
17
16
16



ISIS 416892
18
16
16



ISIS 417003
17
16
16







n.d. = no data













TABLE 67







Effect of antisense oligonucleotide treatment on MCHC (%) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
30
n.d.
n.d.



ISIS 416825
29
31
31



ISIS 416826
29
31
30



ISIS 416838
30
31
32



ISIS 416850
30
31
31



ISIS 416858
30
32
31



ISIS 416864
31
31
31



ISIS 416925
30
32
32



ISIS 416999
27
32
31



ISIS 417002
29
32
31



ISIS 416892
30
32
30



ISIS 417003
29
32
33







n.d. = no data













TABLE 68







Effect of antisense oligonucleotide treatment on WBC


count (cells/nL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
6
n.d.
n.d.



ISIS 416825
8
8
6



ISIS 416826
5
6
8



ISIS 416838
4
6
5



ISIS 416850
4
5
5



ISIS 416858
6
7
4



ISIS 416864
7
6
5



ISIS 416925
6
6
11



ISIS 416999
4
9
7



ISIS 417002
8
8
16



ISIS 416892
5
8
9



ISIS 417003
7
9
10







n.d. = no data













TABLE 69







Effect of antisense oligonucleotide treatment on RBC


count (cells/pL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
8
n.d.
n.d.



ISIS 416825
9
9
8



ISIS 416826
8
8
7



ISIS 416838
8
8
8



ISIS 416850
8
9
8



ISIS 416858
9
9
9



ISIS 416864
9
9
8



ISIS 416925
9
9
10



ISIS 416999
9
9
8



ISIS 417002
9
9
10



ISIS 416892
7
9
9



ISIS 417003
8
9
10







n.d. = no data













TABLE 70







Effect of antisense oligonucleotide treatment on neutrophil


count (%) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
16
n.d.
n.d.



ISIS 416825
15
43
23



ISIS 416826
26
33
23



ISIS 416838
19
33
31



ISIS 416850
15
21
16



ISIS 416858
14
24
27



ISIS 416864
13
27
20



ISIS 416925
12
39
33



ISIS 416999
12
25
22



ISIS 417002
14
31
36



ISIS 416892
19
43
28



ISIS 417003
10
39
24







n.d. = no data













TABLE 71







Effect of antisense oligonucleotide treatment on lymphocyte


count (%) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
81
n.d.
n.d.



ISIS 416825
82
53
71



ISIS 416826
70
61
67



ISIS 416838
76
64
60



ISIS 416850
82
73
76



ISIS 416858
83
73
65



ISIS 416864
84
71
74



ISIS 416925
86
58
57



ISIS 416999
86
72
69



ISIS 417002
83
64
51



ISIS 416892
79
52
64



ISIS 417003
86
54
66







n.d. = no data













TABLE 72







Effect of antisense oligonucleotide treatment on monocyte


count (%) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
3
n.d.
n.d.



ISIS 416825
2
5
4



ISIS 416826
3
5
8



ISIS 416838
2
2
6



ISIS 416850
3
6
6



ISIS 416858
2
3
7



ISIS 416864
2
2
5



ISIS 416925
2
4
8



ISIS 416999
2
4
8



ISIS 417002
3
4
12 



ISIS 416892
3
6
7



ISIS 417003
2
6
8







n.d. = no data













TABLE 73







Effect of antisense oligonucleotide treatment on platelet


count (cells/nL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
2126
n.d.
n.d.



ISIS 416825
1689
1229
942



ISIS 416826
1498
970
645



ISIS 416838
1376
1547
1229



ISIS 416850
1264
1302
1211



ISIS 416858
2480
1364
1371



ISIS 416864
1924
1556
933



ISIS 416925
1509
1359
1211



ISIS 416999
1621
1219
1057



ISIS 417002
1864
1245
1211



ISIS 416892
1687
636
1004



ISIS 417003
1309
773
922







n.d. = no data













TABLE 74







Effect of antisense oligonucleotide treatment on hemoglobin


content (g/dL) in CD1 mice











2 weeks
4 weeks
6 weeks
















PBS
15.1
n.d.
n.d.



ISIS 416825
14.5
14.1
12.1



ISIS 416826
13.4
12.8
11.0



ISIS 416838
12.4
13.6
12.6



ISIS 416850
13.1
13.5
11.6



ISIS 416858
14.8
14.2
14.1



ISIS 416864
15.2
13.9
13.0



ISIS 416925
14.9
14.8
15.3



ISIS 416999
14.2
13.3
12.8



ISIS 417002
14.7
14.0
15.7



ISIS 416892
13.0
13.5
13.1



ISIS 417003
13.7
13.4
14.0







n.d. = no data






Example 18
Measurement of Half-Life of Antisense Oligonucleotide in CD1 Mice Liver

CD1 mice were treated with ISIS antisense oligonucleotides targeting human Factor XI and the oligonucleotide half-life as well as the elapsed time for oligonucleotide degradation and elimination from the liver was evaluated.


Treatment

Groups of fifteen CD1 mice each were injected subcutaneously twice per week for 2 weeks with 50 mg/kg of ISIS 416825, ISIS 416826, ISIS 416838, ISIS 416850, ISIS 416858, ISIS 416864, ISIS 416892, ISIS 416925, ISIS 416999, ISIS 417002, or ISIS 417003. Five mice from each group were sacrificed 3 days, 28 days and 56 days following the final dose. Livers were harvested for analysis.


Measurement of Oligonucleotide Concentration

The concentration of the full-length oligonucleotide as well as the total oligonucleotide concentration (including the degraded form) was measured. The method used is a modification of previously published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a phenol-chloroform (liquid-liquid) extraction followed by a solid phase extraction. An internal standard (ISIS 355868, a 27-mer 2′-O-methoxyethyl modified phosphorothioate oligonucleotide, GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 270) was added prior to extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of quantitation (LLOQ) of approximately 1.14 μg/g. Half-lives were then calculated using WinNonlin software (PHARSIGHT).


The results are presented in Tables 75 and 76, expressed as μg liver tissue. The half-life of each oligonucleotide is presented in Table 77.









TABLE 75







Full-length oligonucleotide concentration (μg/g) in the liver of CD1 mice











ISIS No.
Motif
day 3
day 28
day 56














416825
5-10-5
151
52
7


416826
5-10-5
186
48
8


416838
5-10-5
170
46
10


416850
5-10-5
238
93
51


416858
5-10-5
199
102
18


416864
5-10-5
146
38
25


416999
2-13-5
175
26
0


417002
2-13-5
119
24
1


417003
2-13-5
245
42
4


416925
3-14-3
167
39
5


416892
3-14-3
135
31
6
















TABLE 76







Total oligonucleotide concentration (μg/g) in the liver of CD1 mice











ISIS No.
Motif
day 3
day 28
day 56














416825
5-10-5
187
90
39


416826
5-10-5
212
61
12


416838
5-10-5
216
98
56


416850
5-10-5
295
157
143


416858
5-10-5
273
185
56


416864
5-10-5
216
86
112


416999
2-13-5
232
51
0


417002
2-13-5
206
36
1


417003
2-13-5
353
74
4


416925
3-14-3
280
72
8


416892
3-14-3
195
54
6
















TABLE 77







Half-life of antisense oligonucleotides in the liver of CD1 mice











Half-life


ISIS No.
Motif
(days)












416825
5-10-5
16


416826
5-10-5
13


416838
5-10-5
13


416850
5-10-5
18


416858
5-10-5
26


416864
5-10-5
13


416999
2-13-5
9


417002
2-13-5
11


417003
2-13-5
10


416925
3-14-3
12


416892
3-14-3
12









Example 19
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in Sprague-Dawley Rats

Sprague-Dawley rats were treated with ISIS antisense oligonucleotides targeting human Factor XI and evaluated for changes in the levels of various metabolic markers.


Treatment

Groups of four Sprague Dawley rats each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 416825, ISIS 416826, ISIS 416838, ISIS 416850, ISIS 416858, ISIS 416848, ISIS 416864, ISIS 416892, ISIS 416925, ISIS 416999, ISIS 417002, or ISIS 417003. A control group of four Sprague Dawley rats was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and throughout the treatment period. Urine samples were taken before the start of treatment. Three days after the last dose, urine samples were taken and the rats were sacrificed. Organ weights were measured and blood was collected for further analysis.


Body Weight and Organ Weight

Body weights of the rats were measured at the onset of the study and subsequently twice per week. The body weights are presented in Table 78 and are expressed as a percent change over the weights taken at the start of the study. Liver, spleen, and kidney weights were measured at the end of the study and are presented in Table 78 as a percent of the saline control normalized to body weight. Those antisense oligonucleotides which did not affect more than a six-fold increase in liver and spleen weight above the PBS control were selected for further studies.









TABLE 78







Percent change in organ weight of Sprague Dawley rats after


antisense oligonucleotide treatment











ISIS



Body


No.
Liver
Spleen
Kidney
weight














416825
+20
+245
+25
−18


416826
+81
+537
+44
−40


416838
+8
+212
−0.5
−23


416850
+23
+354
+47
−33


416858
+8
+187
+5
−21


416864
+16
+204
+16
−24


416925
+44
+371
+48
−32


416999
+51
+405
+71
−37


417002
+27
+446
+63
−29


416892
+38
+151
+32
−39


417003
+51
+522
+25
−40









Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Measurements of alanine transaminase (ALT) and aspartate transaminase (AST) are expressed in IU/L and the results are presented in Table 79. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin and albumin were also measured with the same clinical analyzer and the results are also presented in Table 79, expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 79







Effect of antisense oligonucleotide treatment on metabolic markers


in the liver of Sprague-Dawley rats












ALT
AST
Bilirubin
Albumin



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)

















PBS
9
5
20
2



ISIS 416825
89
17
4
2



ISIS 416826
611
104
115
6



ISIS 416838
5
2
4
2



ISIS 416850
80
5
1
4



ISIS 416858
13
4
4
2



ISIS 416864
471
68
3
4



ISIS 416925
102
20
13
5



ISIS 416999
92
28
54
5



ISIS 417002
44
11
12
3



ISIS 416892
113
183
1
8



ISIS 417003
138
23
50
6










Kidney Function

To evaluate the effect of kidney function, plasma concentrations of blood urea nitrogen (BUN) and creatinine were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Table 80, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies. The ratio of urine protein to creatinine in total urine samples was also calculated before and after antisense oligonucleotide treatment and is presented in Table 81. Those antisense oligonucleotides which did not affect more than a five-fold increase in urine protein/creatinine ratios compared to the PBS control were selected for further studies.









TABLE 80







Effect of antisense oligonucleotide treatment on metabolic markers


in the kidney of Sprague-Dawley rats










BUN
Creatinine















PBS
4
8



ISIS 416825
7
17



ISIS 416826
25
6



ISIS 416838
4
5



ISIS 416850
5
7



ISIS 416858
8
4



ISIS 416864
5
6



ISIS 416925
7
5



ISIS 416999
2
4



ISIS 417002
11
1



ISIS 416892
188
1



ISIS 417003
9
9

















TABLE 81







Effect of antisense oligonucleotide treatment on urine protein/creatinine


ratio in Sprague Dawley rats










Before
After













PBS
1.2
1.3


416825
1.1
5.4


416826
1.0
11.4


416838
1.2
3.7


416850
1.0
4.0


416858
0.9
4.4


416864
1.2
4.0


416925
1.0
4.3


416999
1.3
9.1


417002
1.0
2.4


416892
0.8
21.3


417003
0.9
4.8









Hematology Assays

Blood obtained from all rat groups were sent to Antech Diagnostics for hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCV), and mean corpuscular hemoglobin concentration (MCHC) measurements and analyses, as well as measurements of various blood cells, such as WBC (neutrophils, lymphocytes and monocytes), RBC, and platelets as well as hemoglobin content. The results are presented in Tables 82 and 83. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 82







Effect of antisense oligonucleotide treatment


on blood cell count in Sprague-Dawley rats
















Neutro-
Lym-
Mono-




WBC
RBC
phils
phocytes
cytes
Platelets



(/nL)
(/pL)
(%)
(%)
(%)
(103/μL)

















PBS
21
6
37
7
26
18


ISIS 416825
22
2
25
3
15
6


ISIS 416826
7
5
30
5
7
11


ISIS 416838
13
4
17
3
6
27


ISIS 416850
16
7
48
8
11
26


ISIS 416858
28
2
20
3
10
19


ISIS 416864
15
4
26
2
29
12


ISIS 416925
24
6
20
4
23
8


ISIS 416999
12
5
23
3
20
12


ISIS 417002
23
5
22
4
25
7


ISIS 416892
68
12
92
18
58
66


ISIS 417003
83
11
17
3
6
19
















TABLE 83







Effect of antisense oligonucleotide treatment on hematologic


factors (% control) in Sprague-Dawley rats













Hemoglobin
HCT
MCV
MCH
MCHC



(g/dL)
(%)
(fL)
(pg)
(%)
















PBS
6
4
6
2
4


ISIS 416825
2
2
4
2
4


ISIS 416826
7
7
6
3
4


ISIS 416838
2
5
4
2
5


ISIS 416850
4
5
3
4
2


ISIS 416858
2
3
2
2
1


ISIS 416864
4
2
4
2
4


ISIS 416925
6
8
5
2
4


ISIS 416999
6
5
2
3
1


ISIS 417002
5
7
7
3
5


ISIS 416892
14
13
1
2
0


ISIS 417003
11
8
6
4
4









Example 20
Measurement of Half-Life of Antisense Oligonucleotide in Sprague-Dawley Rat Liver and Kidney

Sprague Dawley rats were treated with ISIS antisense oligonucleotides targeting human Factor XI and the oligonucleotide half-life as well as the elapsed time for oligonucleotide degradation and elimination from the liver and kidney was evaluated.


Treatment

Groups of four Sprague Dawley rats each were injected subcutaneously twice a week for 2 weeks with 20 mg/kg of ISIS416825, ISIS 416826, ISIS 416838, ISIS 416850, ISIS 416858, ISIS 416864, ISIS 416892, ISIS 416925, ISIS 416999, ISIS 417002, or ISIS 417003. Three days after the last dose, the rats were sacrificed and livers and kidneys were collected for analysis.


Measurement of Oligonucleotide Concentration

The concentration of the full-length oligonucleotide as well as the total oligonucleotide concentration (including the degraded form) was measured. The method used is a modification of previously published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a phenol-chloroform (liquid-liquid) extraction followed by a solid phase extraction. An internal standard (ISIS 355868, a 27-mer 2′-O-methoxyethyl modified phosphorothioate oligonucleotide, GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 270) was added prior to extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of quantitation (LLOQ) of approximately 1.14 μg/g. The results are presented in Tables 84 and 85, expressed as μg/g liver or kidney tissue. Half-lives were then calculated using WinNonlin software (PHARSIGHT) and presented in Table 86.









TABLE 84







Full-length oligonucleotide concentration (μg/g) in the liver and


kidney of Sprague-Dawley rats












ISIS No.
Motif
Kidney
Liver







416825
5-10-5
632
236



416826
5-10-5
641
178



416838
5-10-5
439
171



416850
5-10-5
259
292



416858
5-10-5
575
255



416864
5-10-5
317
130



416999
2-13-5
358
267



417002
2-13-5
291
118



417003
2-13-5
355
199



416925
3-14-3
318
165



416892
3-14-3
351
215

















TABLE 85







Total oligonucleotide concentration (μg/g) in the liver and


kidney of Sprague-Dawley rats












ISIS No.
Motif
Kidney
Liver







416825
5-10-5
845
278



416826
5-10-5
775
214



416838
5-10-5
623
207



416850
5-10-5
352
346



416858
5-10-5
818
308



416864
5-10-5
516
209



416999
2-13-5
524
329



417002
2-13-5
490
183



417003
2-13-5
504
248



416925
3-14-3
642
267



416892
3-14-3
608
316

















TABLE 86







Half-life (days) of ISIS oligonucleotides in the liver and


kidney of Sprague-Dawley rats









ISIS No.
Motif
Half-life












416825
5-10-5
16


416826
5-10-5
13


416838
5-10-5
13


416850
5-10-5
18


416858
5-10-5
26


416864
5-10-5
13


416999
2-13-5
9


417002
2-13-5
11


417003
2-13-5
10


416925
3-14-3
12


416892
3-14-3
12









Example 21
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in CD1 Mice

CD1 mice were treated with ISIS antisense oligonucleotides targeting human Factor XI and evaluated for changes in the levels of various metabolic markers.


Treatment

Groups of five CD1 mice each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 412223, ISIS 412224, ISIS 412225, ISIS 413481, ISIS 413482, ISIS 416848, ISIS 416849, ISIS 416850, ISIS 416851, ISIS 416852, ISIS 416853, ISIS 416854, ISIS 416855, ISIS 416856, ISIS 416857, ISIS 416858, ISIS 416859, ISIS 416860, ISIS 416861, ISIS 416862, ISIS 416863, ISIS 416864, ISIS 416865, ISIS 416866, or ISIS 416867. A control group of ten CD1 mice was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and throughout the treatment period. Three days after the last dose, the mice were sacrificed, organ weights were measured, and blood was collected for further analysis.


Body Weight and Organ Weights

Body weight was measured at the onset of the study and subsequently twice per week. The body weights of the mice are presented in Table 87 and are expressed increase in grams over the PBS control weight taken before the start of treatment. Liver, spleen, and kidney weights were measured at the end of the study, and are also presented in Table 87 as percentage of the body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS control were selected for further studies.









TABLE 87







Change in body and organ weights of CD1 mice after antisense


oligonucleotide treatment















body



Liver
Kidney
Spleen
weight



(%)
(%)
(%)
(g)

















PBS
5
1.5
0.3
7



ISIS 416850
6
1.6
0.4
12



ISIS 416858
7
1.6
0.6
12



ISIS 416864
5
1.6
0.3
12



ISIS 412223
6
1.5
0.4
12



ISIS 412224
6
1.6
0.5
10



ISIS 412225
6
1.5
0.4
10



ISIS 413481
6
1.5
0.5
9



ISIS 413482
6
1.6
0.5
11



ISIS 416848
6
1.5
0.4
11



ISIS 416849
8
1.5
0.4
8



ISIS 416851
7
1.5
0.5
11



ISIS 416852
6
1.5
0.4
10



ISIS 416853
8
1.5
0.7
13



ISIS 416854
7
1.2
0.4
13



ISIS 416855
8
1.4
0.6
12



ISIS 416856
6
1.4
0.4
10



ISIS 416857
7
1.6
0.5
10



ISIS 416859
6
1.5
0.4
10



ISIS 416860
6
1.4
0.4
10



ISIS 416861
5
1.3
0.4
9



ISIS 416862
6
1.5
0.4
10



ISIS 416863
5
1.5
0.4
9



ISIS 416865
6
1.5
0.4
8



ISIS 416866
5
1.6
0.4
10



ISIS 416867
5
1.4
0.4
9










Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Measurements of alanine transaminase (ALT) and aspartate transaminase (AST) are expressed in IU/L and the results are presented in Table 88. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin, cholesterol and albumin were also measured using the same clinical chemistry analyzer and are presented in Table 88 expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 88







Effect of antisense oligonucleotide treatment on metabolic markers


in the liver of CD1 mice













ALT
AST
Bilirubin
Albumin
Cholesterol



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)
(mg/dL)
















PBS
32
68
0.25
3.7
135


ISIS 416850
75
99
0.21
3.5
142


ISIS 416858
640
547
0.28
4.4
181


ISIS 416864
36
67
0.19
2.6
152


ISIS 412223
60
125
0.20
3.0
117


ISIS 412224
214
183
0.19
3.4
114


ISIS 412225
40
69
0.23
3.3
128


ISIS 413481
85
143
0.18
3.2
153


ISIS 413482
54
77
0.24
3.0
138


ISIS 416848
153
153
0.19
3.1
151


ISIS 416849
1056
582
0.22
2.5
109


ISIS 416851
47
76
0.19
3.1
106


ISIS 416852
49
91
0.16
4.9
125


ISIS 416853
1023
1087
0.25
3.1
164


ISIS 416854
1613
1140
0.21
5.5
199


ISIS 416855
786
580
0.25
4.2
162


ISIS 416856
130
129
0.23
5.2
109


ISIS 416857
370
269
0.22
3.7
94


ISIS 416859
214
293
0.20
4.2
160


ISIS 416860
189
160
0.23
3.5
152


ISIS 416861
38
85
0.27
4.3
133


ISIS 416862
225
172
0.36
3.9
103


ISIS 416863
41
101
0.24
3.6
118


ISIS 416865
383
262
0.27
4.1
95


ISIS 416866
36
120
0.29
4.3
113


ISIS 416867
45
82
0.21
3.3
144









Kidney Function

To evaluate the effect of ISIS oligonucleotides on kidney function, plasma concentrations of blood urea nitrogen (BUN) were measured using an automated clinical chemistry analyzer and results are presented in Table 89 expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies.









TABLE 89







Effect of antisense oligonucleotide treatment on BUN levels (mg/dL)


in the kidney of CD1 mice









BUN














PBS
22



ISIS 416850
24



ISIS 416858
23



ISIS 416864
24



ISIS 412223
28



ISIS 412224
29



ISIS 412225
23



ISIS 413481
23



ISIS 413482
27



ISIS 416848
23



ISIS 416849
23



ISIS 416851
21



ISIS 416852
21



ISIS 416853
22



ISIS 416854
27



ISIS 416855
23



ISIS 416856
21



ISIS 416857
17



ISIS 416859
18



ISIS 416860
25



ISIS 416861
23



ISIS 416862
21



ISIS 416863
22



ISIS 416865
20



ISIS 416866
22



ISIS 416867
20










Hematology Assays

Blood obtained from all the mice groups were sent to Antech Diagnostics for hematocrit (HCT) measurements, as well as measurements of various blood cells, such as WBC (neutrophils, lymphocytes, and monocytes), RBC, and platelets, as well as total hemoglobin content analysis. The results are presented in Tables 90 and 91. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 90







Effect of antisense oligonucleotide treatment on hematologic


factors in CD1 mice












RBC
Hemoglobin
HCT
WBC



(106/μL)
(g/dL)
(%)
(103/μL)















PBS
10
15
51
7


ISIS 416850
10
15
49
5


ISIS 416858
9
14
50
8


ISIS 416864
10
15
52
5


ISIS 412223
9
15
48
7


ISIS 412224
10
15
50
9


ISIS 412225
9
15
50
7


ISIS 413481
9
13
45
7


ISIS 413482
10
15
50
8


ISIS 416848
9
14
47
7


ISIS 416849
9
14
48
9


ISIS 416851
9
14
47
6


ISIS 416852
9
14
49
5


ISIS 416853
11
17
56
8


ISIS 416854
9
13
43
12


ISIS 416855
9
14
50
6


ISIS 416856
9
14
47
5


ISIS 416857
10
15
53
6


ISIS 416859
10
15
49
6


ISIS 416860
10
15
51
7


ISIS 416861
9
14
48
7


ISIS 416862
9
14
49
6


ISIS 416863
9
14
48
7


ISIS 416865
9
14
50
7


ISIS 416866
9
15
51
6


ISIS 416867
10
14
47
8
















TABLE 91







Effect of antisense oligonucleotide treatment on blood cell count in


CD1 mice












Neutrophil
Lymphocyte
Monocytes
Platelets



(cells/μL)
(cells/μL)
(cells/μL)
(103/μL)















PBS
1023
6082
205
940


ISIS 416850
1144
4004
156
916


ISIS 416858
2229
5480
248
782


ISIS 416864
973
3921
141
750


ISIS 412223
1756
4599
200
862


ISIS 412224
2107
6284
195
647


ISIS 412225
1547
4969
293
574


ISIS 413481
1904
4329
204
841


ISIS 413482
1958
5584
275
818


ISIS 416848
1264
5268
180
953


ISIS 416849
1522
6967
253
744


ISIS 416851
1619
4162
194
984


ISIS 416852
1241
3646
189
903


ISIS 416853
2040
5184
225
801


ISIS 416854
2082
9375
455
1060


ISIS 416855
1443
4236
263
784


ISIS 416856
1292
3622
151
753


ISIS 416857
1334
3697
215
603


ISIS 416859
1561
4363
229
826


ISIS 416860
1291
4889
161
937


ISIS 416861
1122
5119
219
836


ISIS 416862
1118
4445
174
1007


ISIS 416863
1330
5617
226
1131


ISIS 416865
1227
5148
315
872


ISIS 416866
1201
4621
211
1045


ISIS 416867
1404
6078
188
1006









Example 22
Measurement of Half-Life of Antisense Oligonucleotide in CD1 Mouse Liver

Fifteen antisense oligonucleotides which had been evaluated in CD1 mice (Example 21) were further evaluated. CD1 mice were treated with ISIS antisense oligonucleotides and the oligonucleotide half-life as well the elapsed time for oligonucleotide degradation and elimination in the liver was evaluated.


Treatment

Groups of fifteen CD1 mice each were injected subcutaneously twice per week for 2 weeks with 50 mg/kg of ISIS 412223, ISIS 412225, ISIS 413481, ISIS 413482, ISIS 416851, ISIS 416852, ISIS 416856, ISIS 416860, ISIS 416861, ISIS 416863, ISIS 416866, ISIS 416867, ISIS 412224, ISIS 416848 or ISIS 416859. Five mice from each group were sacrificed 3 days, 28 days, and 56 days after the last dose, livers were collected for analysis.


Measurement of Oligonucleotide Concentration

The concentration of the full-length oligonucleotide was measured. The method used is a modification of previously published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a phenol-chloroform (liquid-liquid) extraction followed by a solid phase extraction. An internal standard (ISIS 355868, a 27-mer 2′-O-methoxyethyl modified phosphorothioate oligonucleotide, GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 270) was added prior to extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of quantitation (LLOQ) of approximately 1.14 μg/g. The results are presented in Table 92 expressed as μg/g liver tissue. The half-life of each oligonucleotide was also presented in Table 92.









TABLE 92







Full-length oligonucleotide concentration and half-life in the liver of


CD1 mice

















Half-Life


ISIS No
Motif
day 3
day 28
day 56
(days)















412223
5-10-5
276
127
52
21.9


412224
5-10-5
287
111
31
16.6


412225
5-10-5
279
91
47
20.7


413481
5-10-5
185
94
31
20.6


413482
5-10-5
262
95
40
19.5


416848
5-10-5
326
147
68
23.5


416851
5-10-5
319
147
68
23.8


416852
5-10-5
306
145
83
28.4


416856
5-10-5
313
115
46
19.2


416859
5-10-5
380
156
55
19.0


416860
5-10-5
216
96
36
20.6


416861
5-10-5
175
59
39
24.5


416863
5-10-5
311
101
48
19.8


416866
5-10-5
246
87
25
16.0


416867
5-10-5
246
87
35
18.9









Example 23
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in Sprague-Dawley Rats

Fifteen antisense oligonucleotides which had been evaluated in CD1 mice (Example 21) were further evaluated in Sprague-Dawley rats for changes in the levels of various metabolic markers.


Treatment

Groups of four Sprague Dawley rats each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 412223, ISIS 412224, ISIS 412225, ISIS 413481, ISIS 413482, ISIS 416848, ISIS 416851, ISIS 416852, ISIS 416856, ISIS 416859, ISIS 416860, ISIS 416861, ISIS 416863, ISIS 416866, or ISIS 416867. A control group of four Sprague Dawley rats was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and throughout the treatment period. Three days after the last dose, urine samples were collected and the rats were then sacrificed, organ weights were measured, and blood was collected for further analysis.


Body Weight and Organ Weights

The body weights of the rats were measured at the onset of the study and subsequently twice per week. The body weights are presented in Table 93 and are expressed as increase in grams over the PBS control weight taken before the start of treatment. Liver, spleen and kidney weights were measured at the end of the study, and are also presented in Table 93 as a percentage of the body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS control were selected for further studies.









TABLE 93







Change in body and organ weights of Sprague Dawley rats after antisense


oligonucleotide treatment












Body
Liver
Kidney
Spleen



weight (g)
(%)
(%)
(%)

















PBS
179
4
0.9
0.2



ISIS 412223
126
5
1.0
0.5



ISIS 412224
165
5
1.0
0.5



ISIS 412225
184
4
1.0
0.5



ISIS 413481
147
5
0.9
0.3



ISIS 413482
158
5
1.0
0.6



ISIS 416848
117
5
1.1
0.8



ISIS 416851
169
5
0.9
0.3



ISIS 416852
152
5
1.0
0.4



ISIS 416856
156
5
1.0
0.4



ISIS 416859
128
4
1.0
0.4



ISIS 416860
123
5
1.0
0.5



ISIS 416861
182
5
0.9
0.3



ISIS 416863
197
5
1.0
0.4



ISIS 416866
171
5
1.0
0.5



ISIS 416867
129
5
1.0
0.5










Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Measurements of alanine transaminase (ALT) and aspartate transaminase (AST) are expressed in IU/L and the results are presented in Table 94. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin and albumin were also measured using the same clinical chemistry analyzer and results are presented in Table 94 and expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 94







Effect of antisense oligonucleotide treatment on metabolic markers in


the liver of Sprague-Dawley rats












ALT
AST
Bilirubin
Albumin



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)

















PBS
42
71
0.13
4



ISIS 412223
85
180
0.14
5



ISIS 412224
84
132
0.12
4



ISIS 412225
48
108
0.15
5



ISIS 413481
54
80
0.22
4



ISIS 413482
59
157
0.14
4



ISIS 416848
89
236
0.14
3



ISIS 416851
64
91
0.14
4



ISIS 416852
49
87
0.15
4



ISIS 416856
123
222
0.13
4



ISIS 416859
114
206
0.21
5



ISIS 416860
70
157
0.15
4



ISIS 416861
89
154
0.15
5



ISIS 416863
47
78
0.13
4



ISIS 416866
41
78
0.16
4



ISIS 416867
47
126
0.17
4










Kidney Function

To evaluate the effect of ISIS oligonucleotides on the kidney function, plasma concentrations of blood urea nitrogen (BUN) and creatinine were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Table 95, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies. The total urine protein and ratio of urine protein to creatinine in total urine samples after antisense oligonucleotide treatment was calculated and is also presented in Table 95. Those antisense oligonucleotides which did not affect more than a five-fold increase in urine protein/creatinine ratios compared to the PBS control were selected for further studies.









TABLE 95







Effect of antisense oligonucleotide treatment on metabolic markers in the


kidney of Sprague-Dawley rats














Total






urine
Urine



BUN
Creatinine
protein
protein/creatinine



(mg/dL)
(mg/dL)
(mg/dL)
ratio















PBS
19
38
60
1.7


ISIS 412223
24
46
224
4.6


ISIS 412224
24
44
171
3.8


ISIS 412225
23
58
209
4.0


ISIS 413481
26
45
148
3.6


ISIS 413482
23
34
157
4.8


ISIS 416848
26
64
231
3.9


ISIS 416851
24
70
286
4.0


ISIS 416852
25
60
189
3.0


ISIS 416856
23
48
128
2.7


ISIS 416859
24
44
144
3.3


ISIS 416860
23
58
242
4.6


ISIS 416861
22
39
205
5.1


ISIS 416863
29
73
269
3.8


ISIS 416866
22
85
486
6.2


ISIS 416867
22
70
217
3.1









Hematology Assays

Blood obtained from all rat groups were sent to Antech Diagnostics for hematocrit (HCT) measurements, as well as measurements of the various blood cells, such as WBC (neutrophils and lymphocytes), RBC, and platelets, and total hemoglobin content. The results are presented in Tables 96 and 97. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 96







Effect of antisense oligonucleotide treatment on hematologic factors in


Sprague-Dawley rats












RBC
Hemoglobin

WBC



(106/mL)
(g/dL)
HCT (%)
(103/mL)















PBS
6.9
13.2
42
9


ISIS 412223
7.2
13.1
41
20


ISIS 412224
7.4
13.4
42
20


ISIS 412225
7.4
13.4
42
15


ISIS 413481
7.5
14.2
43
14


ISIS 413482
7.1
13.2
40
13


ISIS 416848
6.0
11.1
35
17


ISIS 416851
7.4
13.7
42
11


ISIS 416852
7.2
13.4
42
13


ISIS 416856
7.7
14.1
43
19


ISIS 416859
7.8
14.0
45
16


ISIS 416860
7.8
14.1
45
17


ISIS 416861
7.7
14.6
45
15


ISIS 416863
7.6
14.1
45
17


ISIS 416866
7.8
14.0
44
20


ISIS 416867
7.8
14.0
45
14
















TABLE 97







Effect of antisense oligonucleotide treatment on blood cell count in


Sprague-Dawley rats











Neutrophil
Lymphocyte
Platelets



(/mL)
(/mL)
(103/mL)
















PBS
988
7307
485



ISIS 412223
1826
16990
567



ISIS 412224
1865
16807
685



ISIS 412225
1499
13204
673



ISIS 413481
1046
12707
552



ISIS 413482
1125
11430
641



ISIS 416848
1874
14316
384



ISIS 416851
1001
9911
734



ISIS 416852
836
11956
632



ISIS 416856
3280
14328
740



ISIS 416859
1414
14323
853



ISIS 416860
1841
13986
669



ISIS 416861
1813
12865
1008



ISIS 416863
1720
14669
674



ISIS 416866
1916
16834
900



ISIS 416867
3044
10405
705










Example 24
Measurement of Half-Life of Antisense Oligonucleotide in the Liver and Kidney of Sprague-Dawley Rats

Sprague Dawley rats were treated with ISIS antisense oligonucleotides targeting human Factor XI and the oligonucleotide half-life as well as the elapsed time for oligonucleotide degradation and elimination from the liver and kidney was evaluated.


Treatment

Groups of four Sprague Dawley rats each were injected subcutaneously twice per week for 2 weeks with 20 mg/kg of ISIS 412223, ISIS 412224, ISIS 412225, ISIS 413481, ISIS 413482, ISIS 416848, ISIS 416851, ISIS 416852, ISIS 416856, ISIS 416859, ISIS 416860, ISIS 416861, ISIS 416863, ISIS 416866, or ISIS 416867. Three days after the last dose, the rats were sacrificed, and livers and kidneys were harvested.


Measurement of Oligonucleotide Concentration

The concentration of the full-length oligonucleotide as well as the total oligonucleotide concentration (including the degraded form) was measured. The method used is a modification of previously published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a phenol-chloroform (liquid-liquid) extraction followed by a solid phase extraction. An internal standard (ISIS 355868, a 27-mer 2′-O-methoxyethyl modified phosphorothioate oligonucleotide, GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 270) was added prior to extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of quantitation (LLOQ) of approximately 1.14 μg/g. The results are presented in Tables 98 and 99, expressed as μg/g liver or kidney tissue. Half-lives were then calculated using WinNonlin software (PHARSIGHT) and presented in Table 100.









TABLE 98







Full-length oligonucleotide concentration (μg/g) in the liver and kidney


of Sprague-Dawley rats










ISIS No
Motif
Kidney
Liver













412223
5-10-5
551
97


412224
5-10-5
487
107


412225
5-10-5
202
119


413481
5-10-5
594
135


413482
5-10-5
241
95


416848
5-10-5
488
130


416851
5-10-5
264
193


416852
5-10-5
399
108


416856
5-10-5
378
84


416859
5-10-5
253
117


416860
5-10-5
247
94


416861
5-10-5
187
159


416863
5-10-5
239
82


416866
5-10-5
210
98


416867
5-10-5
201
112
















TABLE 99







Total oligonucleotide concentration (μg/g) in the liver and kidney of


Sprague-Dawley rats










ISIS No
Motif
Kidney
Liver













412223
5-10-5
395
86


412224
5-10-5
292
78


412225
5-10-5
189
117


413481
5-10-5
366
96


413482
5-10-5
217
91


416848
5-10-5
414
115


416851
5-10-5
204
178


416852
5-10-5
304
87


416856
5-10-5
313
80


416859
5-10-5
209
112


416860
5-10-5
151
76


416861
5-10-5
165
144


416863
5-10-5
203
79


416866
5-10-5
145
85


416867
5-10-5
157
98
















TABLE 100







Half-life (days) of ISIS oligonucleotides in the liver and kidney of


Sprague-Dawley rats









ISIS No
Motif
Half-life












412223
5-10-5
22


412224
5-10-5
17


412225
5-10-5
21


413481
5-10-5
21


413482
5-10-5
20


416848
5-10-5
24


416851
5-10-5
24


416852
5-10-5
28


416856
5-10-5
19


416859
5-10-5
19


416860
5-10-5
21


416861
5-10-5
25


416863
5-10-5
20


416866
5-10-5
16


416867
5-10-5
19









Example 25
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in CD1 Mice

ISIS oligonucleotides with 6-8-6 MOE and 5-8-5 MOE motifs targeting human Factor XI were administered in CD1 mice evaluated for changes in the levels of various metabolic markers.


Treatment

Groups of five CD1 mice each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 416850, ISIS 445498, ISIS 445503, ISIS 445504, ISIS 445505, ISIS 445509, ISIS 445513, ISIS 445522, ISIS 445530, ISIS 445531 or ISIS 445532. A control group of five CD1 mice was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and at the end of the treatment period. Three days after the last dose, the mice were sacrificed, organ weights were measured, and blood was collected for further analysis.


Body Weight and Organ Weight

The body weight changes in the mice are presented in Table 101 and are expressed increase in grams over the PBS control weight taken before the start of treatment. Liver, spleen and kidney weights were measured at the end of the study, and are also presented in Table 101 as percentage of the body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS control were selected for further studies.









TABLE 101







Change in body and organ weights of CD1 mice after antisense


oligonucleotide treatment












Body
Liver
Kidney
Spleen



weight (g)
(%)
(%)
(%)

















PBS
10
5
1.6
0.3



ISIS 416850
11
6
1.5
0.4



ISIS 445498
10
6
1.6
0.5



ISIS 445503
9
8
1.4
0.6



ISIS 445504
11
6
1.6
0.4



ISIS 445505
12
6
1.5
0.5



ISIS 445509
10
6
1.6
0.5



ISIS 445513
9
5
1.6
0.4



ISIS 445522
11
6
1.7
0.4



ISIS 445530
11
6
1.5
0.5



ISIS 445531
10
6
1.5
0.5



ISIS 445532
10
6
1.6
0.4










Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Measurements of alanine transaminase (ALT) and aspartate transaminase (AST) are expressed in IU/L and the results are presented in Table 102. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin and albumin were also measured and results are also presented in Table 102 and expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 102







Effect of antisense oligonucleotide treatment on metabolic markers in the


liver of CD1 mice












ALT
AST
Bilirubin
Albumin



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)

















PBS
34
49
0.23
3.6



ISIS 416850
90
115
0.20
3.2



ISIS 445498
66
102
0.24
3.4



ISIS 445503
1314
852
0.28
3.4



ISIS 445504
71
107
0.17
3.4



ISIS 445505
116
153
0.18
3.2



ISIS 445509
80
117
0.17
3.1



ISIS 445513
37
84
0.22
3.1



ISIS 445522
51
110
0.19
3.4



ISIS 445530
104
136
0.18
3.2



ISIS 445531
60
127
0.16
3.2



ISIS 445532
395
360
0.20
2.9










Kidney Function

To evaluate the effect of ISIS oligonucleotides on kidney function, plasma concentrations of blood urea nitrogen (BUN) were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Table 103, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies.









TABLE 103







Effect of antisense oligonucleotide treatment on BUN levels (mg/dL) in


the kidney of CD1 mice









BUN














PBS
29



ISIS 416850
28



ISIS 445498
28



ISIS 445503
29



ISIS 445504
29



ISIS 445505
29



ISIS 445509
29



ISIS 445513
27



ISIS 445522
28



ISIS 445530
26



ISIS 445531
27



ISIS 445532
23










Hematology Assays

Blood obtained from all mice groups were sent to Antech Diagnostics for hematocrit (HCT) measurements, as well as measurements of the various blood cells, such as WBC (neutrophils and lymphocytes), RBC, and platelets, and total hemoglobin content. The results are presented in Tables 104 and 105. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 104







Effect of antisense oligonucleotide treatment on hematologic factors in


CD1 mice












RBC
Hemoglobin
HCT
WBC



(106/mL)
(g/dL)
(%)
(103/mL)

















PBS
9.6
15.0
51
6



ISIS 416850
9.8
14.8
50
6



ISIS 445498
9.4
13.9
47
5



ISIS 445503
9.2
13.6
46
8



ISIS 445504
9.6
14.7
49
5



ISIS 445505
9.6
14.6
49
5



ISIS 445509
10.2
15.3
51
5



ISIS 445513,
9.8
15.0
50
7



ISIS 445522
9.7
14.6
49
5



ISIS 445530
10.0
15.1
50
7



ISIS 445531
9.4
14.5
48
9



ISIS 445532
9.7
14.8
48
7

















TABLE 105







Effect of antisense oligonucleotide treatment on blood cell count in


CD1 mice











Neutrophil
Lymphocyte
Platelets



(/mL)
(/mL)
(103/mL)
















PBS
1356
4166
749



ISIS 416850
1314
4710
614



ISIS 445498
1197
3241
802



ISIS 445503
1475
6436
309



ISIS 445504
959
3578
826



ISIS 445505
818
3447
725



ISIS 445509
1104
3758
1085



ISIS 445513
959
5523
942



ISIS 445522
698
3997
1005



ISIS 445530
930
5488
849



ISIS 445531
2341
6125
996



ISIS 445532
1116
5490
689










Example 26
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in Sprague-Dawley Rats

Eight antisense oligonucleotides which had been evaluated in CD1 mice (Example 25) were further evaluated in Sprague-Dawley rats for changes in the levels of various metabolic markers.


Treatment

Groups of four Sprague Dawley rats each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 445498, ISIS 445504, ISIS 445505, ISIS 445509, ISIS 445513, ISIS 445522, ISIS 445530 or ISIS 445531. A control group of Sprague Dawley rats was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and throughout the treatment period. Three days after the last dose, urine samples were collected and the rats were then sacrificed, organ weights were measured, and blood was collected for further analysis.


Body Weight and Organ Weight

The body weights of the rats were measured at the onset of the study and subsequently twice per week. The body weights are presented in Table 106 and are expressed as percent increase over the PBS control weight taken before the start of treatment. Liver, spleen and kidney weights were measured at the end of the study, and are also presented in Table 106 as a percentage of the body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS control were selected for further studies.









TABLE 106







Change in body and organ weights of Sprague Dawley rats after antisense


oligonucleotide treatment (%)












Body






weight
Liver
Spleen
Kidney

















ISIS 445498
−17
+26
+107
−10



ISIS 445504
−15
+22
+116
+6



ISIS 445505
−21
+12
+146
+2



ISIS 445509
−17
+16
+252
+3



ISIS 445513
−13
+25
+194
+15



ISIS 445522
−13
+26
+184
+19



ISIS 445530
−7
+24
+99
+4



ISIS 445531
−10
+17
+89
+4










Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Plasma concentrations of ALT (alanine transaminase) and AST (aspartate transaminase) were measured and the results are presented in Table 107 expressed in IU/L. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin and albumin were also measured using the same clinical chemistry analyzer; results are presented in Table 107 and expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 107







Effect of antisense oligonucleotide treatment on metabolic markers in the


liver of Sprague-Dawley rats












ALT
AST
Bilirubin
Albumin



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)

















PBS
102
36
0.13
3.7



ISIS 445498
417
124
0.14
3.7



ISIS 445504
206
86
0.11
3.5



ISIS 445505
356
243
0.15
3.6



ISIS 445509
676
291
0.14
3.5



ISIS 445513
214
91
0.15
3.5



ISIS 445522
240
138
0.47
3.6



ISIS 445530
116
56
0.11
3.7



ISIS 445531
272
137
0.12
3.7










Kidney Function

To evaluate the effect of ISIS oligonucleotides on kidney function, plasma concentrations of blood urea nitrogen (BUN) and creatinine were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Table 108, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies. The total urine protein and ratio of urine protein to creatinine in total urine samples after antisense oligonucleotide treatment was calculated and is also presented in Table 108. Those antisense oligonucleotides which did not affect more than a five-fold increase in urine protein/creatinine ratios compared to the PBS control were selected for further studies.









TABLE 108







Effect of antisense oligonucleotide treatment on metabolic markers in the


kidney of Sprague-Dawley rats













Urine



BUN
Creatinine
protein/creatinine



(mg/dL)
(mg/dL)
ratio
















PBS
18
0.4
1.4



ISIS 445498
25
0.5
3.1



ISIS 445504
26
0.4
4.3



ISIS 445505
24
0.4
3.8



ISIS 445509
27
0.5
4.0



ISIS 445513
24
0.4
4.6



ISIS 445522
25
0.4
6.4



ISIS 445530
22
0.4
4.2



ISIS 445531
23
0.4
3.4










Hematology Assays

Blood obtained from all rat groups were sent to Antech Diagnostics for hematocrit (HCT) measurements, as well as measurements of the various blood cells, such as WBC (neutrophils, lymphocytes, and monocytes), RBC, and platelets, and total hemoglobin content. The results are presented in Tables 109 and 110. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 109







Effect of antisense oligonucleotide treatment on hematologic factors in


Sprague-Dawley rats












RBC
Hemoglobin
HCT
WBC



(/pL)
(g/dL)
(%)
(/nL)

















PBS
8.8
16.0
55
13



ISIS 445498
8.5
14.7
49
13



ISIS 445504
8.9
14.7
50
16



ISIS 445505
9.1
15.0
50
21



ISIS 445509
8.4
14.1
47
17



ISIS 445513
7.8
13.0
44
17



ISIS 445522
7.7
13.6
47
18



ISIS 445530
8.9
14.7
50
12



ISIS 445531
8.8
14.8
50
13

















TABLE 110







Effect of antisense oligonucleotide treatment on blood cell count in


Sprague-Dawley rats












Neutrophil
Lymphocyte
Monocytes
Platelets



(%)
(%)
(%)
(/nL)















PBS
14
82
2.0
1007


ISIS 445498
9
89
2.0
1061


ISIS 445504
10
87
2.0
776


ISIS 445505
10
87
2.5
1089


ISIS 445509
11
84
3.8
1115


ISIS 445513
14
82
3.5
1051


ISIS 445522
13
84
2.8
1334


ISIS 445530
11
87
2.0
1249


ISIS 445531
10
86
2.8
1023









Example 27
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in CD1 Mice

ISIS oligonucleotides with 4-8-4 MOE, 3-8-3 MOE, 2-10-2 MOE, 3-10-3 MOE, and 4-10-4


MOE motifs targeting human Factor XI were administered in CD1 mice evaluated for changes in the levels of various metabolic markers.


Treatment

Groups of five CD1 mice each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 449707, ISIS 449708, ISIS 449409, ISIS 449710, or ISIS 449711. A control group of five CD1 mice was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and at the end of the treatment period. Three days after the last dose, the mice were sacrificed, organ weights were measured, and blood was collected for further analysis.


Body Weight and Organ Weight

The body weights of the mice taken at the end of the study are presented in Table 111 and are expressed in grams. Liver, spleen and kidney weights were also measured at the end of the study and are also presented in Table 111 as percentage of the body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS control were selected for further studies.









TABLE 111







Change in body and organ weights of CD1 mice after antisense


oligonucleotide treatment












Body






weight
Liver
Spleen
Kidney



(g)
(%)
(%)
(%)

















PBS
39






ISIS 449707
42
+11
+63
−5



ISIS 449708
40
+17
+66
0



ISIS 449709
40
+15
+62
−14



ISIS 449710
42
+6
+43
−7



ISIS 449711
42
+18
+63
−12










Liver Function

To evaluate the effect of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Plasma concentrations of ALT (alanine transaminase) and AST (aspartate transaminase) were measured and the results are presented in Table 112 expressed in IU/L. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin and albumin were also measured using the same clinical chemistry analyzer and results are presented in Table 112 and expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 112







Effect of antisense oligonucleotide treatment on metabolic markers in the


liver of CD1 mice












ALT
AST
Bilirubin
Albumin



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)

















PBS
39
52
0.22
3.2



ISIS 449707
41
62
0.19
2.3



ISIS 449708
66
103
0.17
2.8



ISIS 449709
62
83
0.18
2.8



ISIS 449710
43
95
0.18
2.8



ISIS 449711
52
83
0.22
2.8










Kidney Function

To evaluate the effect of ISIS oligonucleotides on kidney function, plasma concentrations of blood urea nitrogen (BUN) and creatinine were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Table 113, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies.









TABLE 113







Effect of antisense oligonucleotide treatment on metabolic markers


(mg/dL) in the kidney of CD1 mice










BUN
Creatinine















PBS
28
0.3



ISIS 449707
27
0.2



ISIS 449708
28
0.2



ISIS 449709
34
0.3



ISIS 449710
29
0.2



ISIS 449711
26
0.2










Hematology Assays

Blood obtained from all mice groups were sent to Antech Diagnostics for hematocrit (HCT), measurements, as well as measurements of the various blood cells, such as WBC (neutrophils, lymphocytes, and monocytes), RBC, and platelets, and total hemoglobin content. The results are presented in Tables 114 and 115. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 114







Effect of antisense oligonucleotide treatment on hematologic factors in


CD1 mice












RBC
Hemoglobin
Hematocrit
WBC



(/pL)
(g/dL)
(%)
(/nL)

















PBS
9.8
14.6
54
6



ISIS 449707
8.4
12.4
45
6



ISIS 449708
9.2
13.2
48
7



ISIS 449709
9.2
13.2
49
5



ISIS 449710
9.1
13.5
48
7



ISIS 449711
9.0
13.3
48
6

















TABLE 115







Effect of antisense oligonucleotide treatment on blood cell count in CD1


mice












Neutrophils
Lymphocytes
Monocytes
Platelets



(%)
(%)
(%)
(/nL)















PBS
15
80
3
1383


ISIS 449707
11
85
3
1386


ISIS 449708
17
77
5
1395


ISIS 449709
19
76
4
1447


ISIS 449710
15
81
3
1245


ISIS 449711
15
79
6
1225









Example 28
Tolerability of Antisense Oligonucleotides Targeting Human Factor XI in Sprague-Dawley Rats

Five antisense oligonucleotides which had been evaluated in CD1 mice (Example 27) were further evaluated in Sprague-Dawley rats for changes in the levels of various metabolic markers.


Treatment

Groups of four Sprague Dawley rats each were injected subcutaneously twice per week for 6 weeks with 50 mg/kg of ISIS 449707, ISIS 449708, ISIS 449709, ISIS 449710, or ISIS 449711. A control group of four Sprague Dawley rats was injected subcutaneously with PBS twice per week for 6 weeks. Body weight measurements were taken before and throughout the treatment period. Three days after the last dose, urine samples were collected and the rats were then sacrificed, organ weights were measured, and blood was collected for further analysis.


Body Weight and Organ Weight

The body weights of the rats were measured at the onset of the study and at the end of the study. The body weight changes are presented in Table 116 and are expressed as increase in grams over the PBS control weight taken before the start of treatment. Liver, spleen and kidney weights were measured at the end of the study, and are also presented in Table 116 as a percentage of the body weight. Those antisense oligonucleotides which did not affect more than six-fold increases in liver and spleen weight above the PBS control were selected for further studies.









TABLE 116







Change in body and organ weights of Sprague Dawley rats after antisense


oligonucleotide treatment












Body






weight
Liver
Spleen
Kidney



(g)
(%)
(%)
(%)

















PBS
478






ISIS 449707
352
+41
+400
+80



ISIS 449708
382
+31
+259
+40



ISIS 449709
376
 +8
+231
+19



ISIS 449710
344
+82
+302
+50



ISIS 449711
362
+52
+327
+72










Liver Function

To evaluate the impact of ISIS oligonucleotides on hepatic function, plasma concentrations of ALT and AST were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Plasma concentrations of alanine transaminase (ALT) and aspartate transaminase (AST) were measured and the results are presented in Table 117 expressed in IU/L. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin and albumin were also measured and results are presented in Table 117 and expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies.









TABLE 117







Effect of antisense oligonucleotide treatment on metabolic markers in the


liver of Sprague-Dawley rats












ALT
AST
Bilirubin
Albumin



(IU/L)
(IU/L)
(mg/dL)
(mg/dL)

















PBS
41
107
0.1
3.4



ISIS 449707
61
199
0.2
3.1



ISIS 449708
25
90
0.1
3.2



ISIS 449709
63
126
0.2
3.1



ISIS 449710
36
211
0.1
2.9



ISIS 449711
32
163
0.1
2.9










Kidney Function

To evaluate the impact of ISIS oligonucleotides on kidney function, plasma concentrations of BUN and creatinine were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Results are presented in Table 118, expressed in mg/dL. Those antisense oligonucleotides which did not affect more than a two-fold increase in BUN levels compared to the PBS control were selected for further studies. The total urine protein and ratio of urine protein to creatinine in total urine samples after antisense oligonucleotide treatment was calculated and is also presented in Table 118. Those antisense oligonucleotides which did not affect more than a five-fold increase in urine protein/creatinine ratios compared to the PBS control were selected for further studies.









TABLE 118







Effect of antisense oligonucleotide treatment on metabolic markers in the


kidney of Sprague-Dawley rats













Urine



BUN
Creatinine
protein/creatinine



(mg/dL)
(mg/dL)
ratio
















PBS
22
0.4
1.5



ISIS 449707
24
0.4
3.2



ISIS 449708
24
0.4
5.7



ISIS 449709
24
0.4
3.4



ISIS 449710
29
0.3
5.9



ISIS 449711
28
0.4
7.3










Hematology Assays

Blood obtained from all rat groups were sent to Antech Diagnostics for hematocrit (HCT) measurements, as well as measurements of the various blood cells, such as WBC (neutrophils, lymphocytes, and monocytes), RBC, and platelets, and total hemoglobin content. The results are presented in Tables 119 and 120. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies.









TABLE 119







Effect of antisense oligonucleotide treatment on hematologic factors in


Sprague-Dawley rats












RBC
Hemoglobin
Hematocrit
WBC



(/pL)
(g/dL)
(%)
(/nL)

















PBS
8.2
15.1
50
16



ISIS 449707
6.0
12.0
40
20



ISIS 449708
6.6
12.2
40
22



ISIS 449709
6.9
12.6
41
14



ISIS 449710
6.3
12.5
41
13



ISIS 449711
6.4
12.6
43
13

















TABLE 120







Effect of antisense oligonucleotide treatment on blood cell count in


Sprague-Dawley rats












Neutrophils
Lymphocytes
Monocytes
Platelets



(%)
(%)
(%)
(/nL)















PBS
12
84
2
1004


ISIS 449707
6
91
2
722


ISIS 449708
6
92
2
925


ISIS 449709
5
91
3
631


ISIS 449710
6
91
2
509


ISIS 449711
7
90
2
919









Example 29
Dose-Dependent Pharmacologic Effect of Antisense Oligonucleotides Targeting Human Factor XI in Cynomolgus Monkeys

Several antisense oligonucleotides were tested in cynomolgus monkeys to determine the pharmacologic effects of the oligonucleotides on Factor XI activity, anticoagulation and bleeding times, liver and kidney distributions, and tolerability. All the ISIS oligonucleotides used in this study target human Factor XI mRNA and are also fully cross-reactive with the rhesus monkey gene sequence (see Table 51). It is expected that the rhesus monkey ISIS oligonucleotides are fully cross-reactive with the cynomolgus monkey gene sequence as well. At the time the study was undertaken, the cynomolgus monkey genomic sequence was not available in the National Center for Biotechnology Information (NCBI) database; therefore, cross-reactivity with the cynomolgus monkey gene sequence could not be confirmed.


Treatment

Groups, each consisting of two male and three female monkeys, were injected subcutaneously with ISIS 416838, ISIS 416850, ISIS 416858, ISIS 416864, or ISIS 417002 in escalating doses. Antisense oligonucleotide was administered to the monkeys at 5 mg/kg three times per a week for week 1; 5 mg/kg twice per week for weeks 2 and 3; 10 mg/kg three times per week for week 4; 10 mg/kg twice per week for weeks 5 and 6; 25 mg/kg three times per week for week 7; and 25 mg/kg twice per week for weeks 8, 9, 10, 11, and 12. One control group, consisting of two male and three female monkeys, was injected subcutaneously with PBS according to the same dosing regimen. An additional experimental group, consisting of two male and three female monkeys, was injected subcutaneously with ISIS 416850 in a chronic, lower dose regimen. Antisense oligonucleotide was administered to the monkeys at 5 mg/kg three times per week for week 1; 5 mg/kg twice per week for week 2 and 3; 10 mg/kg three times per week for week 4; and 10 mg/kg twice per week for weeks 5 to 12. Body weights were measured weekly. Blood samples were collected 14 days and 5 days before the start of treatment and subsequently once per week for Factor XI protein activity analysis in plasma and measurement of various hematologic factors. On day 85, the monkeys were euthanized by exsanguination while under deep anesthesia, and organs harvested for further analysis.


RNA Analysis

On day 85, RNA was extracted from liver tissue for real-time PCR analysis of Factor XI using primer probe set LTS00301 (forward primer sequence ACACGCATTAAAAAGAGCAAAGC, designated herein as SEQ ID NO 271; reverse primer sequence CAGTGTCATGGTAAAATGAAGAATGG, designated herein as SEQ ID NO: 272; and probe sequence TGCAGGCACAGCATCCCAGTGTTCTX, wherein X is a fluorphore, designated herein as SEQ ID NO. 273). Results are presented as percent inhibition of Factor XI, relative to PBS control. As shown in Table 121, treatment with ISIS oligonucleotides resulted in significant reduction of Factor XI mRNA in comparison to the PBS control.









TABLE 121







Inhibition of Factor XI mRNA in the cynomolgus monkey liver relative to


the PBS control











%



ISIS No
inhibition







416838
37



416850
84



416858
90



416864
44



417002
57










Protein Analysis

Plasma samples from all monkey groups taken on different days were analyzed by a sandwich-style ELISA assay (Affinity Biologicals Inc.) using an affinity-purified polyclonal anti-Factor XI antibody as the capture antibody and a peroxidase-conjugated polyclonal anti-Factor XI antibody as the detecting antibody. Monkey plasma was diluted 1:50 for the assay. Peroxidase activity was expressed by incubation with the substrate o-phenylenediamine. The color produced was quantified using a microplate reader at 490 nm and was considered to be proportional to the concentration of Factor XI in the samples.


The results are presented in Table 122, expressed as percentage reduction relative to that of the PBS control. Treatment with ISIS 416850 and ISIS 416858 resulted in a time-dependent decrease in protein levels.









TABLE 122







Inhibition of Factor XI protein in the cynomolgus


monkey liver relative to the PBS control














ISIS
ISIS
ISIS
ISIS
ISIS
ISIS


Days
416838
416850
416858
416864
417002
416850*
















−14
0
0
0
0
0
0


−5
0
0
0
5
0
1


8
3
8
6
7
0
6


15
4
4
16
9
4
13


22
5
11
23
7
2
12


29
8
15
28
10
8
20


36
11
17
35
9
8
22


43
5
23
39
9
9
24


50
8
42
49
10
13
30


57
10
49
60
7
24
34


64
11
55
68
5
26
37


71
12
57
71
10
30
41


78
10
63
73
9
22
42


85
10
64
78
8
23
34









Body and Organ Weights

Body weights were taken once weekly throughout the dosing regimen. The measurements of each group are given in Table 123 expressed in grams. The results indicate that treatment with the antisense oligonucleotides did not cause any adverse changes in the health of the animals, which may have resulted in a significant alteration in weight compared to the PBS control. Organ weights were taken after the animals were euthanized and livers, kidneys and spleens were harvested and weighed. The results are presented in Table 124 and also show no significant alteration in weights compared to the PBS control, except for ISIS 416858, which shows increase in spleen weight. The ISIS oligonucleotide, ISIS 416850, given with the chronic dose regimen is distinguished from the other oligonucleotides with an asterisk (*).









TABLE 123







Weekly measurements of body weights


(g) of cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS


day
PBS
416838
416850
416858
416864
417002
416850*

















1
2780
2720
2572
2912
2890
2640
2665


8
2615
2592
2430
2740
2784
2523
2579


15
2678
2642
2474
2760
2817
2571
2607


22
2715
2702
2514
2800
2857
2617
2661


29
2717
2689
2515
2763
2863
2622
2667


36
2738
2708
2545
2584
3327
2631
2656


43
2742
2700
2544
2607
3355
2630
2670


50
2764
2731
2613
2646
3408
2652
2679


57
2763
2737
2629
2617
3387
2654
n.d.


64
2781
2746
2642
2618
3384
2598
n.d.


71
2945
2869
2769
2865
2942
2727
n.d.


78
2815
2766
2660
2713
2822
2570
n.d.





n.d. = no data













TABLE 124







Organ weights (g) of cynomolgus monkeys after antisense oligonucleotide


treatment











Liver
Spleen
Kidney
















PBS
46
4
11



ISIS 416838
63
5
12



ISIS 416580
64
4
16



ISIS 416858
60
12
13



ISIS 416864
53
5
14



ISIS 417002
51
5
15










Liver Function

To evaluate the impact of ISIS oligonucleotides on hepatic function, plasma concentrations of transaminases were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Plasma concentrations of ALT (alanine transaminase) and AST (aspartate transaminase) were measured and the results are presented in Tables 125 and 126 expressed in IU/L. Those antisense oligonucleotides which did not affect an increase in ALT/AST levels above seven-fold of control levels were selected for further studies. Plasma levels of bilirubin were also measured and results are presented in Table 127 expressed in mg/dL. Those antisense oligonucleotides which did not affect an increase in levels of bilirubin more than two-fold of the control levels by antisense oligonucleotide treatment were selected for further studies. The ISIS oligonucleotide, ISIS 416850, given with the chronic dose regimen is distinguished from the other oligonucleotides with an asterisk (*).









TABLE 125







Effect of antisense oligonucleotide treatment on


ALT (IU/L) in the liver of cynomolgus monkeys














Days









before/after

ISIS
ISIS
ISIS
ISIS
ISIS
ISIS


treatment
PBS
416838
416850
416858
416864
417002
416850*

















−14
57
76
54
47
54
61
80


22
39
36
41
28
37
36
42


43
36
35
43
36
36
35
41


64
38
40
60
47
43
42
n.d.


85
34
41
75
50
43
116
n.d.





n.d. = no data













TABLE 126







Effect of antisense oligonucleotide treatment on


AST (IU/L) in the liver of cynomolgus monkeys














Days









before/after

ISIS
ISIS
ISIS
ISIS
ISIS
ISIS


treatment
PBS
416838
416850
416858
416864
417002
416850*

















−14
71
139
81
58
76
114
100


22
43
39
45
38
41
44
39


43
38
32
50
39
40
42
40


64
35
33
56
50
46
37
n.d.


85
41
30
82.
49
56
50
n.d.





n.d. = no data













TABLE 127







Effect of antisense oligonucleotide treatment on bilirubin


(mg/dL) in the liver of cynomolgus monkeys














Days









before/after

ISIS
ISIS
ISIS
ISIS
ISIS
ISIS


treatment
PBS
416838
416850
416858
416864
417002
416850*

















−14
0.24
0.26
0.21
0.27
0.31
0.26
0.28


22
0.16
0.17
0.13
0.18
0.22
0.20
0.19


43
0.17
0.17
0.13
0.14
0.17
0.21
0.18


64
0.19
0.15
0.14
0.12
0.16
0.14
n.d.


85
0.20
0.13
0.14
0.14
0.17
0.12
n.d.





n.d. = no data






Kidney Function

To evaluate the impact of ISIS oligonucleotides on kidney function, urine samples were collected. The ratio of urine protein to creatinine in urine samples after antisense oligonucleotide treatment was calculated and is presented in Table 128. Those antisense oligonucleotides which did not affect more than a five-fold increase in urine protein/creatinine ratios compared to the PBS control were selected for further studies.









TABLE 128







Effect of antisense oligonucleotide treatment on urine protein to creatinine


ratio in cynomolgus monkeys










Day 80
Day 84















PBS
0.09
0.10



ISIS 416838
0.13
0.13



ISIS 416850
0.09
0.12



ISIS 416858
0.10
0.07



ISIS 416864
0.36
0.34



ISIS 417002
0.18
0.24










Measurement of Oligonucleotide Concentration

The concentration of the full-length oligonucleotide as well as the elapsed time oligonucleotide degradation and elimination from the liver and kidney were evaluated. The method used is a modification of previously published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a phenol-chloroform (liquid-liquid) extraction followed by a solid phase extraction. An internal standard (ISIS 355868, a 27-mer 2′-O-methoxyethyl modified phosphorothioate oligonucleotide, GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 270) was added prior to extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of quantitation (LLOQ) of approximately 1.14 μg/g. Half-lives were then calculated using WinNonlin software (PHARSIGHT). The results are presented in Tables 129 and 130, expressed as μg/g liver or kidney tissue.









TABLE 129







Full-length oligonucleotide concentration (μg/g) in the liver and kidney of


cynomolgus monkeys









ISIS No.
Kidney
Liver





416838
1339
1087


416850
2845
1225


416858
1772
1061


416864
2093
1275


417002
2162
1248
















TABLE 130







Total oligonucleotide concentration (μg/g) in the liver and kidney of


cynomolgus monkeys









ISIS No.
Kidney
Liver





416838
1980
1544


416850
3988
1558


416858
2483
1504


416864
3522
1967


417002
3462
1757









Hematology Assays

Blood obtained from all monkey groups were sent to Korea Institute of Toxicology (KIT) for HCT, MCV, MCH, and MCHC analysis, as well as measurements of the various blood cells, such as WBC (neutrophils, lymphocytes, monocytes, eosinophils, basophils, reticulocytes), RBC, platelets and total hemoglobin content. The results are presented in Tables 131-144. Those antisense oligonucleotides which did not affect a decrease in platelet count of more than 50% and an increase in monocyte count of more than three-fold were selected for further studies. The ISIS oligonucleotide, ISIS 416850, given with the chronic dose regimen is distinguished from the other oligonucleotides with an asterisk (*).









TABLE 131







Effect of antisense oligonucleotide treatment on WBC


count (×103/μL) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
14
12
13
14
13
13
15


day −5
13
12
13
14
13
14
15


day 8
10
10
10
12
11
10
13


day 15
10
10
9
11
10
10
16


day 22
12
11
10
11
10
10
15


day 29
11
11
11
12
10
10
14


day 36
10
10
10
12
10
11
16


day 43
10
10
9
11
10
10
15


day 50
12
11
11
13
12
13
15


day 57
11
12
11
13
12
12
n.d.


day 64
11
13
11
12
11
11
n.d.


day 71
15
15
15
13
14
12
n.d.


day 78
10
11
12
11
11
9
n.d.


day 85
10
12
15
11
12
10
n.d.





n.d. = no data













TABLE 132







Effect of antisense oligonucleotide treatment on RBC


count (×106/μL) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
5.7
5.6
5.3
5.6
5.5
5.6
5.5


day −5
5.7
5.6
5.5
5.6
5.6
5.6
5.5


day 8
5.7
5.7
5.4
5.6
5.7
5.6
5.5


day 15
5.6
5.6
5.3
5.4
5.7
5.4
5.3


day 22
5.5
5.4
5
5.3
5.3
5.2
5.1


day 29
5.6
5.3
4.9
5.3
5.3
5.2
5.2


day 36
5.7
5.5
5.3
5.5
5.6
5.4
5.3


day 43
5.7
5.6
5.2
5.5
5.5
5.4
5.2


day 50
5.8
5.5
5.2
5.5
5.6
5.4
5.3


day 57
5.7
5.5
5.2
5.6
5.5
4.9
n.d.


day 64
5.8
5.6
5.4
5.7
5.6
5.4
n.d.


day 71
5.6
5.5
5.4
5.6
5.6
5.5
n.d.


day 78
5.6
5.4
5.3
5.4
5.3
5.4
n.d.


day 85
5.6
5.5
5.5
5.5
5.4
5.4
n.d.





n.d. = no data













TABLE 133







Effect of antisense oligonucleotide treatment


on hemoglobin (g/dL) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
13.2
12.9
12.4
13.2
12.7
13.0
12.8


day −5
13.1
13.1
12.7
13.2
13.0
13.2
12.8


day 8
13.1
12.9
12.4
12.8
12.7
12.8
12.5


day 15
12.9
12.9
12.1
12.6
12.8
12.3
12.2


day 22
12.7
12.5
11.6
12.4
12.1
12.1
11.7


day 29
12.8
12.4
11.5
12.3
12.1
12.0
12.0


day 36
13.0
12.8
12.2
12.6
12.5
12.5
12.3


day 43
12.9
12.7
11.8
12.4
12.2
12.3
11.8


day 50
12.6
12.3
11.8
12.2
12.1
12.3
11.9


day 57
13.1
12.6
12.1
12.7
12.3
11.3
n.d.


day 64
13.1
12.6
12.3
12.8
12.1
12.2
n.d.


day 71
12.9
12.7
12.3
12.7
12.2
12.5
n.d.


day 78
13.0
12.5
12.2
12.4
11.9
12.4
n.d.


day 85
13.2
12.4
12.7
11.9
12.3
12.2
n.d.





n.d. = no data













TABLE 134







Effect of antisense oligonucleotide treatment


on hematocrit (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
46
42
41
43
43
44
44


day −5
44
42
43
42
44
45
43


day 8
44
43
43
43
44
44
43


day 15
44
42
40
40
42
40
40


day 22
45
43
41
41
42
41
40


day 29
46
43
41
41
43
42
42


day 36
46
43
42
40
42
42
41


day 43
46
43
40
40
42
41
40


day 50
48
44
42
41
44
43
42


day 57
46
43
42
41
42
38
n.d.


day 64
47
44
43
42
42
41
n.d.


day 71
46
44
43
42
44
43
n.d.


day 78
43
41
41
39
39
40
n.d.


day 85
43
42
42
39
40
41
n.d.





n.d. = no data













TABLE 135







Effect of antisense oligonucleotide treatment


on MCV (fL) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
81
77
78
77
79
79
81


day −5
78
76
77
75
79
80
78


day 8
77
77
80
77
78
79
79


day 15
78
75
76
74
74
76
75


day 22
84
80
83
77
79
79
79


day 29
83
81
83
78
80
81
82


day 36
81
78
80
75
76
78
76


day 43
80
78
79
74
77
77
77


day 50
84
80
83
76
79
80
80


day 57
82
79
80
74
77
80
n.d.


day 64
81
79
79
73
75
76
n.d.


day 71
84
80
80
75
79
78
n.d.


day 78
78
76
79
72
74
75
n.d.


day 85
77
77
77
72
74
76
n.d.





n.d. = no data













TABLE 136







Effect of antisense oligonucleotide treatment


on MCH (pg) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
23
23
23
24
23
24
24


day −5
23
23
23
23
23
24
23


day 8
23
23
23
23
23
23
23


day 15
23
23
23
23
23
23
23


day 22
23
23
24
24
23
23
23


day 29
23
23
23
23
23
23
23


day 36
23
23
23
23
23
23
23


day 43
23
23
23
23
22
23
23


day 50
22
23
23
23
22
23
23


day 57
23
23
23
22
23
23
n.d.


Day 64
23
23
22
22
23
22
n.d.


Day 71
23
23
23
22
23
23
n.d.


Day 78
23
23
23
23
23
23
n.d.


Day 85
23
23
22
22
23
23
n.d.





n.d. = no data













TABLE 137







Effect of antisense oligonucleotide treatment


on MCHC (g/dL) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
29
30
30
31
29
30
29


day −5
30
31
30
31
29
30
30


day 8
30
30
29
30
29
29
29


day 15
30
31
30
31
30
31
30


day 22
28
29
28
30
29
29
29


day 29
28
29
28
30
29
29
28


day 36
28
30
29
31
30
30
30


day 43
28
30
29
31
29
30
30


day 50
26
28
28
30
28
29
29


day 57
29
29
29
31
29
29
n.d.


day 64
28
29
29
30
29
30
n.d.


day 71
28
29
28
30
28
29
n.d.


day 78
30
30
29
32
30
31
n.d.


day 85
31
30
30
31
30
30
n.d.





n.d. = no data













TABLE 138







Effect of antisense oligonucleotide treatment on platelet


count (×103/μL) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
349
377
528
419
434
442
387


day −5
405
425
573
463
456
466
434


day 8
365
387
548
391
438
435
401


day 15
375
387
559
400
439
410
396


day 22
294
319
466
316
364
377
347


day 29
311
337
475
336
397
410
370


day 36
326
370
505
371
428
415
379


day 43
336
365
490
342
351
393
391


day 50
379
372
487
331
419
389
351


day 57
345
371
528
333
409
403
n.d.


day 64
329
358
496
295
383
436
n.d.


day 71
322
365
465
286
394
490
n.d.


day 78
309
348
449
262
366
432
n.d.


day 85
356
344
458
267
387
418
n.d.





n.d. = no data













TABLE 139







Effect of antisense oligonucleotide treatment


on reticulocytes (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
1.4
1.0
1.7
1.0
0.9
0.9
1.1


day −5
1.0
0.9
1.2
0.9
0.9
0.8
0.8


day 8
1.0
1.2
1.2
1.2
0.8
1.1
1.1


day 15
1.5
1.2
1.9
1.6
0.8
1.1
1.0


day 22
1.2
1.2
1.9
1.3
0.9
1.2
1.0


day 29
1.6
1.6
2.5
1.5
1.3
1.6
1.4


day 36
1.7
1.6
2.2
1.6
1.3
1.3
1.3


day 43
1.3
1.2
1.6
1.3
1.1
1.1
1.0


day 50
1.6
1.6
2.7
1.5
1.3
1.6
1.2


day 57
1.8
1.5
2.0
1.4
1.0
4.6
n.d.


day 64
1.3
1.3
1.7
1.0
0.8
1.3
n.d.


day 71
1.6
1.3
1.8
1.3
1.0
1.3
n.d.


day 78
1.5
1.4
1.8
1.2
1.2
1.3
n.d.


day 85
1.5
1.5
2.3
1.3
1.5
1.4
n.d.





n.d. = no data













TABLE 140







Effect of antisense oligonucleotide treatment


on neutrophils (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
40
36
49
37
53
43
48


day −5
37
35
52
46
51
43
53


day 8
54
42
57
51
52
46
53


day 15
49
43
58
54
59
57
73


day 22
41
37
57
47
59
55
64


day 29
44
36
53
43
44
45
42


day 36
37
39
57
47
58
61
72


day 43
40
30
50
45
57
57
61


day 50
36
31
45
46
49
61
62


day 57
41
32
49
44
57
54
n.d.


day 64
40
30
41
37
49
55
n.d.


day 71
38
28
27
26
42
34
n.d.


day 78
42
35
42
39
48
51
n.d.


day 85
30
22
60
40
39
36
n.d.





n.d. = no data













TABLE 141







Effect of antisense oligonucleotide treatment


on lymphocytes (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
54
59
47
58
42
53
47


day −5
56
59
43
49
44
53
43


day 8
43
54
39
45
45
50
44


day 15
47
53
38
43
38
40
24


day 22
54
59
39
49
37
41
33


day 29
51
59
43
51
51
50
53


day 36
58
57
39
49
38
35
26


day 43
55
65
45
51
39
39
36


day 50
59
64
49
48
46
34
35


day 57
55
63
45
51
39
40
n.d.


day 64
56
64
53
56
46
39
n.d.


day 71
56
65
61
66
52
59
n.d.


day 78
53
60
51
54
46
41
n.d.


day 85
63
72
34
52
54
56
n.d.





n.d. = no data













TABLE 142







Effect of antisense oligonucleotide treatment


on eosinophils (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
1.3
0.6
1.0
0.7
1.0
0.3
0.5


day −5
1.5
0.6
1.6
1.3
0.9
0.3
0.7


day 8
0.9
0.4
1.1
0.3
0.7
0.2
0.5


day 15
0.7
0.3
1.0
0.3
0.5
0.1
0.2


day 22
0.9
0.5
0.7
0.6
0.9
0.3
0.5


day 29
0.9
0.3
1.2
0.6
0.9
0.3
0.8


day 36
0.9
0.5
1.7
0.4
0.6
0.2
0.4


day 43
0.9
0.6
1.2
0.3
0.6
0.2
0.4


day 50
1.2
0.8
1.2
0.4
0.7
0.1
0.3


day 57
0.7
0.6
1.0
0.3
0.4
0.2
n.d.


day 64
1.0
0.7
1.3
0.4
0.7
0.2
n.d.


day 71
1.6
0.8
1.8
0.9
1.1
0.3
n.d.


day 78
1.0
0.9
1.0
0.5
1.2
0.1
n.d.


day 85
1.3
1.5
1.2
0.6
1.6
0.2
n.d.





n.d. = no data













TABLE 143







Effect of antisense oligonucleotide treatment


on monocytes (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
3.3
3.1
2.3
2.8
2.8
3.0
2.9


day −5
3.8
3.6
2.8
2.8
3.3
3.2
2.4


day 8
2.3
2.5
1.8
2.7
2.1
3.3
1.8


day 15
2.7
2.4
2.0
2.2
2.4
2.3
1.5


day 22
3.4
2.9
2.4
2.8
2.8
3.1
1.9


day 29
3.3
3.2
2.7
3.8
3.4
3.5
2.7


day 36
3.1
2.5
2.1
2.9
2.3
2.6
1.5


day 43
3.5
3.3
2.6
3.1
2.1
2.8
1.8


day 50
2.6
3.2
3.7
4.6
2.9
3.1
1.8


day 57
2.6
3.2
n.d. 3.2
3.8
2.4
3.6
n.d.


day 64
2.6
3.5
n.d. 3.5
4.4
2.8
4.0
n.d.


day 71
3.4
4.3
n.d. 4.7
4.9
3.7
4.7
n.d.


day 78
3.3
3.6
n.d. 4.5
4.9
3.7
4.7
n.d.


day 85
4.4
3.7
n.d. 3.5
6.1
3.7
5.3
n.d.





n.d. = no data













TABLE 144







Effect of antisense oligonucleotide treatment


on basophils (%) in cynomolgus monkeys
















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS



PBS
416838
416850
416858
416864
417002
416850*


















day −14
0.3
0.2
0.2
0.3
0.2
0.3
0.2


day −5
0.3
0.3
0.2
0.3
0.2
0.3
0.3


day 8
0.2
0.2
0.2
0.3
0.2
0.3
0.3


day 15
0.3
0.3
0.2
0.2
0.2
0.2
0.2


day 22
0.2
0.2
0.2
0.2
0.2
0.2
0.1


day 29
0.3
0.2
0.2
0.2
0.3
0.2
0.3


day 36
0.3
0.4
0.3
0.3
0.3
0.2
0.1


day 43
0.3
0.4
0.3
0.3
0.4
0.3
0.2


day 50
0.4
0.3
0.3
0.4
0.4
0.3
0.2


day 57
0.2
0.3
0.4
0.2
0.3
0.3
n.d.


day 64
0.3
0.4
0.4
0.4
0.4
0.2
n.d.


day 71
0.2
0.5
0.3
0.4
0.4
0.3
n.d.


day 78
0.2
0.4
0.3
0.4
0.3
0.3
n.d.


day 85
0.3
0.3
0.3
0.3
0.4
0.3
n.d.





n.d. = no data






Cytokine and Chemokine Assays

Blood samples obtained from the monkey groups treated with PBS, ISIS 416850 and ISIS 416858 administered in the escalating dose regimen were sent to Pierce Biotechnology (Woburn, Mass.) for measurement of chemokine and cytokine levels. Levels of IL-1β, IL-6, IFN-γ, and TNF-α were measured using the respective primate antibodies and levels of IL-8, MIP-1α, MCP-1, MIP-1β and RANTES were measured using the respective cross-reacting human antibodies. Measurements were taken 14 days before the start of treatment and on day 85, when the monkeys were euthanized. The results are presented in Tables 145 and 146.









TABLE 145







Effect of antisense oligonucleotide treatment on cytokine/chemokine


levels (pg/mL) in cynomolgus monkeys on day −14

















IL-1β
IL-6
IFN-γ
TNF-α
IL-8
MIP-1α
MCP-1
MIP-1β
RANTES




















PBS
16
10
114
7
816
54
1015
118
72423


ISIS 416850
3
30
126
14
1659
28
1384
137
75335


ISIS 416858
5
9
60
9
1552
36
1252
122
112253
















TABLE 146







Effect of antisense oligonucleotide treatment on cytokine/chemokine


levels (pg/mL) in cynomolgus monkeys on day 85

















IL-1β
IL-6
IFN-γ
TNF-α
IL-8
MIP-1α
MCP-1
MIP-1β
RANTES




















PBS
7
4
102
34
87
23
442
74
84430


ISIS 416850
13
17
18
27
172
41
2330
216
83981


ISIS 416858
5
25
18
45
303
41
1752
221
125511









Example 30
Pharmacologic Effect of Antisense Oligonucleotides Targeting Human Factor XI in Cynomolgus Monkeys

Several antisense oligonucleotides chosen from the rodent tolerability studies (Examples 25-28) were tested in cynomolgus monkeys to determine their pharmacologic effects, relative efficacy on Factor XI activity and tolerability in a cynomolgus monkey model. The antisense oligonucleotides were also compared to ISIS 416850 and ISIS 416858 selected from the monkey study described earlier (Example 29). All the ISIS oligonucleotides used in this study target human Factor XI mRNA and are also fully cross-reactive with the rhesus monkey gene sequence (see Tables 51 and 53). It is expected that the rhesus monkey ISIS oligonucleotides are fully cross-reactive with the cynomolgus monkey gene sequence as well. At the time the study was undertaken, the cynomolgus monkey genomic sequence was not available in the National Center for Biotechnology Information (NCBI) database; therefore, cross-reactivity with the cynomolgus monkey gene sequence could not be confirmed.


Treatment

Groups, each consisting of two male and two female monkeys, were injected subcutaneously with 25 mg/kg of ISIS 416850, ISIS 449709, ISIS 445522, ISIS 449710, ISIS 449707, ISIS 449711, ISIS 449708, 416858 and ISIS 445531. Antisense oligonucleotide was administered to the monkeys at 25 mg/kg three times per week for week 1 and 25 mg/kg twice per week for weeks 2 to 8. A control group, consisting of two male and two female monkeys was injected subcutaneously with PBS according to the same dosing regimen. Body weights were taken 14 days and 7 days before the start of treatment and were then measured weekly throughout the treatment period. Blood samples were collected 14 days and 5 days before the start of treatment and subsequently several times during the dosing regimen for measurement of various hematologic factors. On day 55, the monkeys were euthanized by exsanguination while under deep anesthesia, and organs harvested for further analysis.


RNA Analysis

On day 55, RNA was extracted from liver tissue for real-time PCR analysis of Factor XI using primer probe set LTS00301. Results are presented as percent inhibition of Factor XI, relative to PBS control. As shown in Table 147, treatment with ISIS 416850, ISIS 449709, ISIS 445522, ISIS 449710, ISIS 449707, ISIS 449708, ISIS 416858 and ISIS 445531 resulted in significant reduction of Factor XI mRNA in comparison to the PBS control.









TABLE 147







Inhibition of Factor XI mRNA in the cynomolgus monkey liver relative


to the PBS control











%



Oligo ID
inhibition














416850
68



449709
69



445522
89



449710
52



449707
47



449711
0



449708
46



416858
89



445531
66










Protein Analysis

Plasma samples from all monkey groups taken on different days were analyzed by a sandwich-style ELISA assay (Affinity Biologicals Inc.) using an affinity-purified polyclonal anti-Factor XI antibody as the capture antibody and a peroxidase-conjugated polyclonal anti-Factor XI antibody as the detecting antibody. Monkey plasma was diluted 1:50 for the assay. Peroxidase activity was expressed by incubation with the substrate o-phenylenediamine. The color produced was quantified using a microplate reader at 490 nm and was considered to be proportional to the concentration of Factor XI in the samples.


The results are presented in Table 148, expressed as percentage reduction relative to that of the PBS control. Treatment with ISIS 416850, ISIS 449709, ISIS 445522, and ISIS 416858 resulted in a time-dependent decrease in protein levels.









TABLE 148







Inhibition of Factor XI protein in the cynomolgus monkey liver relative to the PBS control

















ISIS No.
Day −14
Day −5
Day 10
Day 17
Day 24
Day 31
Day 38
Day 45
Day 52
Day 55




















416850
0
0
20
31
38
52
51
53
53
58


449709
1
0
27
35
44
45
46
48
47
50


445522
2
0
36
50
61
70
73
77
80
82


449710
1
0
10
14
17
25
20
23
4
24


449707
0
0
16
19
21
29
28
35
29
32


449711
0
1
5
3
6
9
2
4
3
5


449708
1
0
7
15
3
14
9
2
6
6


416858
4
0
36
49
62
68
74
79
81
81


445531
0
1
9
22
23
27
29
32
32
37









Body and Organ Weights

Body weights of each group are given in Table 149 expressed in grams. The results indicate that treatment with the antisense oligonucleotides did not cause any adverse changes in the health of the animals, which may have resulted in a significant alteration in weight compared to the PBS control. Organ weights were taken after the animals were euthanized on day 55, and livers, kidneys and spleens were harvested. The results are presented in Table 150 expressed as a percentage of the body weight and also show no significant alteration in weights compared to the PBS control, with the exception of ISIS 449711, which caused increase in spleen weight.









TABLE 149







Weekly measurements of body weights (g) of cynomolgus monkeys



















ISIS
ISIS
ISIS
ISIS
ISIS
ISIS
ISIS
ISIS
ISIS


Days
PBS
416850
449709
445522
449710
449707
449711
449708
416858
445531




















−14
2069
2061
2044
2050
2097
2072
2049
2096
2073
2079


−7
2107
2074
2093
2042
2114
2083
2105
2163
2092
2092


1
2131
2083
2112
2047
2131
2107
2123
2130
2115
2125


8
2186
2072
2075
2094
2120
2088
2123
2148
2149
2119


15
2201
2147
2085
2092
2145
2120
2103
2125
2162
2109


22
2206
2139
2117
2114
2177
2142
2171
2110
2188
2143


29
2204
2159
2068
2125
2149
2155
2203
2095
2196
2148


36
2246
2136
2064
2121
2180
2158
2227
2100
2210
2191


43
2304
2186
2106
2142
2227
2197
2251
2125
2238
2233


50
2274
2143
2147
2127
2201
2185
2227
2076
2225
2197
















TABLE 150







Organ weights (g) of cynomolgus monkeys after antisense oligonucleotide


treatment











Liver
Spleen
Kidney
















PBS
2.3
0.16
0.48



ISIS 416850
2.5
0.17
0.51



ISIS 449709
2.6
0.21
0.57



ISIS 445522
2.6
0.23
0.55



ISIS 449710
2.6
0.24
0.58



ISIS 449707
2.5
0.24
0.53



ISIS 449711
2.6
0.32
0.54



ISIS 449708
2.6
0.19
0.60



ISIS 416858
2.6
0.24
0.47



ISIS 445531
2.8
0.24
0.49










Liver Function

To evaluate the impact of ISIS oligonucleotides on hepatic function, plasma concentrations of ALT and AST were measured using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.). Plasma concentrations of alanine transaminase (ALT) and aspartate transaminase (AST) were measured and the results are presented in Tables 151 and 152 expressed in IU/L. Plasma levels of bilirubin were also measured and results are presented in Table 153 expressed in mg/dL. As observed in Tables 151-153, there were no significant increases in any of the liver metabolic markers after antisense oligonucleotide treatment.









TABLE 151







Effect of antisense oligonucleotide treatment on ALT (IU/L) in the liver of


cynomolgus monkeys












Day −14
Day −5
Day 31
Day 55

















PBS
57
55
53
57



ISIS 416850
48
42
45
55



ISIS 449709
73
77
65
102



ISIS 445522
43
45
40
60



ISIS 449710
37
42
37
45



ISIS 449707
54
56
52
63



ISIS 449711
49
137
48
54



ISIS 449708
48
54
44
46



ISIS 416858
43
66
46
58



ISIS 445531
84
73
57
73

















TABLE 152







Effect of antisense oligonucleotide treatment on AST (IU/L) in the liver of


cynomolgus monkeys












Day −14
Day −5
Day 31
Day 55

















PBS
65
45
44
47



ISIS 416850
62
45
46
57



ISIS 449709
62
51
45
71



ISIS 445522
62
47
46
79



ISIS 449710
52
38
37
64



ISIS 449707
64
53
50
52



ISIS 449711
58
78
47
47



ISIS 449708
74
53
56
50



ISIS 416858
64
100
60
69



ISIS 445531
78
46
47
49

















TABLE 153







Effect of antisense oligonucleotide treatment on bilirubin (mg/dL) in the


liver of cynomolgus monkeys












Day −14
Day −5
Day 31
Day 55

















PBS
0.25
0.20
0.20
0.17



ISIS 416850
0.26
0.22
0.26
0.17



ISIS 449709
0.24
0.19
0.15
0.18



ISIS 445522
0.24
0.20
0.14
0.18



ISIS 449710
0.24
0.19
0.15
0.22



ISIS 449707
0.27
0.19
0.13
0.16



ISIS 449711
0.23
0.16
0.13
0.13



ISIS 449708
0.27
0.21
0.14
0.14



ISIS 416858
0.25
0.23
0.16
0.16



ISIS 445531
0.22
0.18
0.13
0.11










Kidney Function

To evaluate the impact of ISIS oligonucleotides on kidney function, urine samples were collected on different days. BUN levels were measured at various time points using an automated clinical chemistry analyzer (Hitachi Olympus AU400e, Melville, N.Y.) and the results are presented in Table 154. The ratio of urine protein to creatinine in urine samples after antisense oligonucleotide treatment was also calculated for day 49 and results are presented in Table 155. As observed in Tables 154 and 155, there were no significant increases in any of the kidney metabolic markers after antisense oligonucleotide treatment.









TABLE 154







Effect of antisense oligonucleotide treatment on BUN levels (mg/dL) in


cynomolgus monkeys












Day −14
Day −5
Day 31
Day 55

















PBS
22
21
22
22



ISIS 416850
24
23
21
26



ISIS 449709
22
21
20
28



ISIS 445522
23
22
22
22



ISIS 449710
19
19
19
23



ISIS 449707
25
21
21
20



ISIS 449711
26
22
20
23



ISIS 449708
25
23
23
23



ISIS 416858
25
24
23
24



ISIS 445531
22
18
20
22

















TABLE 155







Effect of antisense oligonucleotide treatment on urine protein to creatinine


ratio in cynomolgus monkeys









Urine



protein/creatinine



ratio














PBS
0.02



ISIS 416850
0.08



ISIS 449709
0.05



ISIS 445522
0.01



ISIS 449710
0.00



ISIS 449707
0.03



ISIS 449711
0.01



ISIS 449708
0.00



ISIS 416858
0.05



ISIS 445531
0.08










Hematology Assays

Blood obtained from all the monkey groups on different days were sent to Korea Institute of Toxicology (KIT) for HCT, MCV, MCH, and MCHC measurements, as well as measurements of the various blood cells, such as WBC (neutrophils and monocytes), RBC and platelets, as well as total hemoglobin content. The results are presented in Tables 156-165.









TABLE 156







Effect of antisense oligonucleotide treatment


on HCT (%) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
40
42
43
43
41
40


ISIS 416850
41
44
42
42
42
40


ISIS 449709
41
42
43
42
41
40


ISIS 445522
42
42
41
43
41
39


ISIS 449710
41
44
43
44
43
41


ISIS 449707
40
43
42
43
43
42


ISIS 449711
41
41
42
39
39
38


ISIS 449708
41
44
44
43
44
42


ISIS 416858
41
44
43
43
41
39


ISIS 445531
41
42
43
41
41
41
















TABLE 157







Effect of antisense oligonucleotide treatment on platelet


count (×100/μL) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
361
441
352
329
356
408


ISIS 416850
462
517
467
507
453
396


ISIS 449709
456
481
449
471
418
441


ISIS 445522
433
512
521
425
403
333


ISIS 449710
411
463
382
422
313
360


ISIS 449707
383
464
408
408
424
399


ISIS 449711
410
431
325
309
257
259


ISIS 449708
387
517
444
378
381
348


ISIS 416858
369
433
358
289
287
257


ISIS 445531
379
416
380
376
345
319
















TABLE 158







Effect of antisense oligonucleotide treatment


on neutrophils (%) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
81
84
75
75
91
118


ISIS 416850
88
109
95
100
85
108


ISIS 449709
73
101
89
81
77
115


ISIS 445522
61
84
81
66
69
125


ISIS 449710
93
86
80
94
97
132


ISIS 449707
85
106
80
89
89
98


ISIS 449711
64
71
52
58
45
70


ISIS 449708
73
84
61
57
61
75


ISIS 416858
65
84
54
54
61
73


ISIS 445531
60
80
85
116
93
91
















TABLE 159







Effect of antisense oligonucleotide treatment


on monocytes (%) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
1.9
2.8
3.1
2.8
3.9
2.2


ISIS 416850
1.9
2.9
3.2
3.7
3.8
3.4


ISIS 449709
4.0
2.0
3.0
2.8
3.6
3.4


ISIS 445522
2.1
2.3
3.6
3.9
4.4
3.0


ISIS 449710
1.3
2.0
2.5
2.4
3.4
1.6


ISIS 449707
1.3
2.3
3.2
4.2
4.0
4.8


ISIS 449711
1.2
2.3
5.9
6.9
7.6
7.8


ISIS 449708
1.7
2.6
5.4
5.8
7.0
6.2


ISIS 416858
2.0
2.7
4.0
4.7
4.6
4.6


ISIS 445531
1.3
2.2
3.4
4.1
4.4
4.1
















TABLE 160







Effect of antisense oligonucleotide treatment on


hemoglobin content (g/dL) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
12.3
12.5
12.9
12.7
12.4
12.1


ISIS 416850
13.0
13.5
13.3
13.1
13.1
12.7


ISIS 449709
12.8
12.8
13.2
13.1
12.6
12.5


ISIS 445522
13.3
12.7
12.7
12.9
12.6
12.0


ISIS 449710
13.0
13.2
13.4
13.1
13.0
12.7


ISIS 449707
12.7
12.8
12.7
12.7
12.9
12.6


ISIS 449711
12.7
12.7
12.5
11.8
11.5
11.3


ISIS 449708
13.0
13.2
13.5
13.0
13.3
13.0


ISIS 416858
12.8
13.0
13.0
12.8
12.3
12.0


ISIS 445531
12.6
12.6
12.7
12.3
12.0
12.1
















TABLE 161







Effect of antisense oligonucleotide treatment on WBC


count (×103/μL) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
10
10
11
12
11
12


ISIS 416850
12
13
11
12
12
10


ISIS 449709
11
10
11
11
11
10


ISIS 445522
10
9
11
13
10
11


ISIS 449710
11
11
12
12
11
15


ISIS 449707
13
11
12
11
12
8


ISIS 449711
13
12
10
9
9
7


ISIS 449708
14
10
11
11
10
10


ISIS 416858
10
11
10
9
8
9


ISIS 445531
20
15
17
17
20
15
















TABLE 162







Effect of antisense oligonucleotide treatment on RBC


count (×106/μL) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
5.6
5.6
5.8
5.8
5.6
5.5


ISIS 416850
5.5
5.7
5.6
5.6
5.7
5.6


ISIS 449709
5.8
5.8
5.9
5.9
5.7
5.7


ISIS 445522
5.9
5.6
5.6
5.8
5.7
5.4


ISIS 449710
5.6
5.8
5.8
5.8
5.7
5.6


ISIS 449707
5.7
5.8
5.7
5.7
5.9
5.8


ISIS 449711
5.6
5.7
5.6
5.4
5.4
5.3


ISIS 449708
5.7
5.9
5.9
5.8
6.0
5.8


ISIS 416858
5.5
5.5
5.6
5.6
5.5
5.3


ISIS 445531
5.7
5.7
5.8
5.6
5.5
5.6
















TABLE 163







Effect of antisense oligonucleotide treatment


on MCV (fL) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
72
74
75
73
73
73


ISIS 416850
74
77
76
75
75
73


ISIS 449709
72
74
73
73
71
71


ISIS 445522
72
74
74
75
73
72


ISIS 449710
75
77
75
75
75
73


ISIS 449707
71
75
74
74
73
73


ISIS 449711
73
74
75
73
73
73


ISIS 449708
73
75
75
75
74
74


ISIS 416858
75
79
78
76
75
75


ISIS 445531
72
74
75
75
75
74
















TABLE 164







Effect of antisense oligonucleotide treatment


on MCH (pg) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
22.1
22.4
22.3
22.1
22.0
22.0


ISIS 416850
23.7
23.7
23.7
23.3
22.7
22.9


ISIS 449709
22.4
22.3
22.5
22.2
21.0
22.0


ISIS 445522
22.6
22.5
22.8
22.4
22.4
22.2


ISIS 449710
23.0
22.8
23.1
22.6
21.8
22.7


ISIS 449707
22.2
22.2
22.1
22.1
22.6
21.9


ISIS 449711
22.6
22.7
22.2
22.1
21.7
21.3


ISIS 449708
22.9
22.7
22.9
22.7
22.2
22.5


ISIS 416858
23.2
23.5
23.1
23.0
22.2
22.8


ISIS 445531
22.2
22.2
22.1
22.0
21.6
21.7
















TABLE 165







Effect of antisense oligonucleotide treatment


on MCHC (g/dL) in cynomolgus monkeys














Day −14
Day −5
Day 17
Day 31
Day 45
Day 55

















PBS
30.8
30.0
30.1
29.9
30.3
30.2


ISIS 416850
32.0
30.7
31.3
31.0
31.0
30.9


ISIS 449709
31.4
30.3
30.7
30.7
31.1
31.2


ISIS 445522
31.4
30.4
30.9
30.0
30.7
31.0


ISIS 449710
31.2
29.7
30.7
30.1
30.4
31.1


ISIS 449707
31.4
29.8
30.0
29.8
29.8
30.0


ISIS 449711
31.0
30.7
29.9
29.8
29.6
29.5


ISIS 449708
31.4
30.2
30.7
29.9
30.6
31.8


ISIS 416858
31.1
29.8
29.9
31.0
30.3
30.4


ISIS 445531
30.9
30.0
29.5
29.7
29.0
29.6









Cytokine and Chemokine Assays

Blood samples obtained from all monkey groups were sent to Pierce Biotechnology (Woburn, Mass.) for measurements of chemokine and cytokine levels. Levels of IL-1β, IL-6, IFN-γ, and TNF-α were measured using the respective primate antibodies and levels of IL-8, MIP-1α, MCP-1, MIP-10 and RANTES were measured using the respective cross-reacting human antibodies. Measurements were taken 14 days before the start of treatment and on day 55, when the monkeys were euthanized. The results are presented in Tables 166 and 167.









TABLE 166







Effect of antisense oligonucleotide treatment on cytokine/chemokine


levels (pg/mL) in cynomolgus monkeys on day −14

















IL-1β
IL-6
IFN-γ
TNF-α
IL-8
MIP-1α
MCP-1
MIP-1β
RANTES




















PBS
350
3
314
32
82
27
277
8
297


ISIS 416850
215
1
115
4
45
14
434
31
4560


ISIS 449409
137
1
37
9
34
13
290
14
2471


ISIS 445522
188
5
172
16
32
22
297
27
3477


ISIS 449710
271
7
1115
72
29
20
409
18
1215


ISIS 449707
115
1
34
6
106
16
294
13
3014


ISIS 449711
79
2
29
6
156
20
264
24
3687


ISIS 449708
35
1
27
12
184
11
361
19
11666


ISIS 416858
103
0
32
4
224
11
328
37
6521


ISIS 445531
101
2
68
9
83
25
317
22
7825
















TABLE 167







Effect of antisense oligonucleotide treatment on cytokine/chemokine


levels (pg/mL) in cynomolgus monkeys on day 55

















IL-1β
IL-6
IFN-γ
TNF-α
IL-8
MIP-1α
MCP-1
MIP-1β
RANTES




















PBS
453
3
232
191
68
21
237
34
775


ISIS 416850
106
1
19
16
620
17
887
50
27503


ISIS 449409
181
0
25
8
254
17
507
47
8958


ISIS 445522
341
2
83
18
100
22
592
63
16154


ISIS 449710
286
2
176
26
348
27
474
53
22656


ISIS 449707
97
1
24
16
48
12
264
49
1193


ISIS 449711
146
7
22
31
110
17
469
91
3029


ISIS 449708
131
0
18
17
85
23
409
128
4561


ISIS 416858
28
1
9
15
167
11
512
47
5925


ISIS 445531
155
1
15
16
293
12
339
84
5935









Example 31
Measurement of Viscosity of Isis Antisense Oligonucleotides Targeting Human Factor XI

The viscosity of antisense oligonucleotides targeting human Factor XI was measured with the aim of screening out antisense oligonucleotides which have a viscosity more than 40 cP at a concentration of 165-185 mg/mL.


ISIS oligonucleotides (32-35 mg) were weighed into a glass vial, 120 μL of water was added and the antisense oligonucleotide was dissolved into solution by heating the vial at 50° C. Part of (75 μL) the pre-heated sample was pipetted to a micro-viscometer (Cambridge). The temperature of the micro-viscometter was set to 25° C. and the viscosity of the sample was measured. Another part (20 μL) of the pre-heated sample was pipetted into 10 mL of water for UV reading at 260 nM at 85° C. (Cary UV instrument). The results are presented in Table 168.









TABLE 168







Viscosity and concentration of ISIS antisense


oligonucleotides targeting human Factor XI










Viscosity
Concentration


ISIS No.
(cP)
(mg/mL)












412223
8
163


412224
98
186


412225
>100
162


413481
23
144


413482
16.
172


416848
6
158


416850
67
152


416851
26
187


416852
29
169


416856
18
175


416858
10
166


416859
10
161


416860
>100
154


416861
14
110


416863
9
165


416866
>100
166


416867
8
168


445498
21
157


445504
20
139


445505
9
155


445509
>100
167


445513
34
167


445522
63
173


445522
58
174


445530
25
177


445531
15
155


445531
20
179


449707
7
166


449708
9
188


449709
65
171


449710
7
186


449711
6
209


451541
10
168








Claims
  • 1. A method for modulating an inflammatory response by administering a compound to an animal, wherein the compound comprises a Factor XI modulator and whereby the inflammatory response is modulated in the animal.
  • 2. The method of claim 1, wherein the Factor XI modulator is a modified oligonucleotide targeting Factor XI.
  • 3. A method for ameliorating or reducing the risk of an inflammatory disease, disorder or condition in an animal, or for treating an animal at risk for an inflammatory disease, disorder or condition, comprising administering a compound targeting Factor XI to the animal, wherein the compound administered to the animal ameliorates or reduces the risk of the inflammatory disease, disorder or condition in the animal, or treats the animal at risk for the inflammatory disease, disorder or condition.
  • 4. (canceled)
  • 5. A method for inhibiting Factor XI expression in an animal suffering from an inflammatory disease, disorder or condition, comprising administering a compound targeting Factor XI to the animal, wherein the compound administered to the animal inhibits Factor XI expression in the animal suffering from the inflammatory disease, disorder or condition.
  • 6. (canceled)
  • 7. The method of claim 1, wherein Factor XI has a sequence as shown in SEQ ID NO: 1 or SEQ ID NO: 2.
  • 8. The method of claim 3, wherein the compound targeting Factor XI is a modified oligonucleotide.
  • 9. The method of claim 8, wherein the modified oligonucleotide has a nucleobase sequence comprising at least 8 contiguous nucleobases of a nucleobase sequence selected from among the nucleobase sequences recited in SEQ ID NOs: 15-269.
  • 10. The method of claim 9, wherein the nucleobase sequence of the modified oligonucleotide is 80% complementary to a nucleobase sequence of SEQ ID NO: 1, SEQ ID NO: 2, SEQ ID NO: 6 or SEQ ID NO: 274.
  • 11. The method of claim 8, wherein the modified oligonucleotide consists of a single-stranded modified oligonucleotide.
  • 12. The method of claim 8, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides or wherein the modified oligonucleotide consists of 20 linked nucleosides.
  • 13. (canceled)
  • 14. The method of claim 12, wherein at least one internucleoside linkage is a modified internucleoside linkage, wherein at least one nucleoside comprises a modified sugar and/or wherein at least one nucleoside comprises a modified nucleobase.
  • 15. The method of claim 14, wherein each modified internucleoside linkage is a phosphorothioate internucleoside linkage.
  • 16. (canceled)
  • 17. The method of claim 14, wherein at least one modified sugar is a bicyclic sugar or a 2′-O-methoxyethyl.
  • 18.-19. (canceled)
  • 20. The method of claim 14, wherein the modified nucleobase is a 5-methylcytosine.
  • 21. The method of claim 8, wherein the modified oligonucleotide comprises: (a) a gap segment consisting of linked deoxynucleosides;(b) a 5′ wing segment consisting of linked nucleosides;(c) a 3′ wing segment consisting of linked nucleosides;
  • 22. The method of claim 8, wherein the modified oligonucleotide comprises: (a) a gap segment consisting of ten linked deoxynucleosides;(b) a 5′ wing segment consisting of five linked nucleosides;(c) a 3′ wing segment consisting of five linked nucleosides;
  • 23.-28. (canceled)
  • 29. The method of claim 1, wherein the animal is a human.
  • 30. The method of claim 3, wherein the inflammatory disease is arthritis, colitis, diabetes, sepsis, allergic inflammation, asthma, immunoproliferative disease, antiphospholipid syndrome or graft-related disorder, and/or an autoimmune disease.
  • 31. (canceled)
  • 32. The method of claim 30, wherein the arthritis is selected from rheumatoid arthritis, juvenile rheumatoid arthritis, arthritis uratica, gout, chronic polyarthritis, periarthritis humeroscapularis, cervical arthritis, lumbosacral arthritis, osteoarthritis, psoriatic arthritis, enteropathic arthritis and ankylosing spondylitis and wherein the colitis is selected from ulcerative colitis, Inflammatory Bowel Disease (IBD) and Crohn's Disease.
  • 33. (canceled)
  • 34. The method of claim 3, wherein the inflammatory disease disorder or condition is Th1 mediated and/or Th2 mediated.
  • 35. The method of claim 34, wherein a marker for the Th1 mediated and/or Th2 mediated inflammatory disease, disorder or condition is decreased.
  • 36. The method of claim 35, wherein the marker for Th1 is any of the cytokines IL-1, IL-6, INF-γ, TNF-α or KC.
  • 37.-38. (canceled)
  • 39. The method of claim 35, wherein the marker for Th2 is any of IL-4, IL-5, eosinophil infiltration or mucus production.
  • 40.-41. (canceled)
  • 42. The method of claim 1, further comprising a second agent.
  • 43. (canceled)
  • 44. The method of claim 1, wherein the compound is a salt form.
  • 45. The method of claim 1, further comprising a pharmaceutically acceptable carrier or diluent.
  • 46.-49. (canceled)
Priority Claims (1)
Number Date Country Kind
PCT/US2009/006092 Oct 2009 US national
PCT Information
Filing Document Filing Date Country Kind 371c Date
PCT/US10/31311 4/15/2010 WO 00 12/15/2011
Provisional Applications (1)
Number Date Country
61169701 Apr 2009 US