POLYNUCLEIC ACID MOLECULES FOR INHIBITING EXPRESSION OF LP(A), PHARMACEUTICAL COMPOSITIONS, AND USES THEREOF

Information

  • Patent Application
  • 20250188464
  • Publication Number
    20250188464
  • Date Filed
    February 07, 2025
    9 months ago
  • Date Published
    June 12, 2025
    5 months ago
Abstract
Disclosed herein are polynucleic acid molecules, pharmaceutical compositions, and methods for suppressing the expression of Lipoprotein(a) (Lp(a)) gene.
Description
SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted electronically in XML format and is hereby incorporated by reference in its entirety. Said XML copy, created on Feb. 6, 2025, is named 61382-712.301_SL.xml and is 2,341,181 bytes in size.


BACKGROUND OF THE DISCLOSURE

The discovery of RNA interference (RNAi) as a cellular mechanism that selectively degrades mRNAs allows for both the targeted manipulation of cellular phenotypes in cell culture and the potential for development of directed therapeutics (Behlke, 2006, Mol. Ther. 13, 644-670; Xie et al., 2006, Drug Discov. Today 11, 67-73).


Lipoprotein(a)(Lp(a)) is a lipoprotein composed of an LDL (low-density lipoprotein) lipid core, apolipoprotein B (apo B), and a unique apolipoprotein, apo(a). Lp(a) is considered one of the most common independent genetically inherited causal risk factors for cardiovascular disease (CVD). Accordingly, there is a need for developing an effective Lp(a) inhibitor. The polynucleic acid molecules, conjugates thereof, and methods described herein satisfy this need and provide related advantages.


INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. To the extent publications and patents or patent applications incorporated by reference contradict the disclosure contained in the specification, the specification is intended to supersede and/or take precedence over any such contradictory material.


SUMMARY OF THE DISCLOSURE

Disclosed herein, in certain aspects, is a polynucleic acid molecule for modulating expression of lipoprotein(a) (Lp(a)) gene, comprising a sense strand and an antisense strand, wherein the antisense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 1-154. In some cases, the sense strand comprises comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 309-462. In some cases, the antisense strand comprises a nucleic acid sequence comprising at least 14, 15, 16, 17, 18, 19, 20, 21, or 22 consecutive sequences of a nucleic acid sequence selected from SEQ ID NOs: 1-154, with no more than 1, 2, 3, or 4 mismatches. In some cases, the sense strand comprises a nucleic acid sequence comprising at least 14, 15, 16, 17, 18, 19, or 20 consecutive sequences from a nucleic acid sequence selected from SEQ ID NOs: 309-462, with no more than 1, 2, 3, or 4 mismatches. In some cases, the sense strand comprises one of SEQ ID NOs: 309-462 and the antisense strand comprises a nucleic acid sequence that is selected from SEQ ID NOs: 1-154


In some cases, the sense strand comprises at least two consecutive modified internucleotide linkages at the 5′ end. In some cases, the antisense strand comprises at least two consecutive modified internucleotide linkages at the 5′ end and/or 3′ end. In some cases, the modified internucleotide linkage is a phosphorothioate linkage. In some cases, the modified internucleotide linkage comprises a stereochemically enriched phosphorothioate internucleotide linkage. In some cases, the modified internucleotide linkage is an SP chiral internucleotide phosphorothioate linkage. In some cases, the polynucleic acid comprises a plurality of modified internucleotide linkages, and at least 1, 2, 3, or 4 of the plurality of modified internucleotide linkages are stereochemically enriched phosphorothioate internucleotide linkages. In some cases, at least one stereochemically enriched phosphorothioate is disposed between two consecutive nucleosides that are two of six 5′ or 3′-terminal nucleosides of the sense strand or the antisense strand. In some cases, the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein n stands for a 2′-O-methyl modified nucleotide, and wherein Nf stands for a 2′-fluoro modified nucleotide.


In some cases, the sense strand or antisense strand is about 19-25, or about 21-23 nucleotides in length.


In some cases, the sense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 463-616. In some cases, the antisense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 155-308. In some cases, the sense strand comprises a sequence selected from a nucleic acid sequence of SEQ ID NOs: 463-616, and the antisense strand comprises a sequence selected from a nucleic acid sequence of SEQ ID NOs: 155-308.


In another aspect, provided herein is polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises:

    • (a) an antisense strand comprising the nucleotide sequence of UAGAUGACCAAGCUUGGCAGGUC (SEQ ID NO: 4) and a sense strand comprising the nucleotide sequence of CCUGCCAAGCUUGGUCAUCUA (SEQ ID NO: 312); (b) an antisense strand comprising the nucleotide sequence of UAUAGAUGACCAAGCUUGGCAGG (SEQ ID NO: 5) and a sense strand comprising the nucleotide sequence of UGCCAAGCUUGGUCAUCUAUA (SEQ ID NO:313); (c) an antisense strand comprising the nucleotide sequence of UCAUAGAUGACCAAGCUUGGCAG (SEQ ID NO: 6) and a sense strand comprising the nucleotide sequence of GCCAAGCUUGGUCAUCUAUGA (SEQ ID NO: 314); (d) an antisense strand comprising the nucleotide sequence of UCGACGGCAGUCCCUUCUGCGUC (SEQ ID NO: 11) and a sense strand comprising the nucleotide sequence of CGCAGAAGGGACUGCCGUCGA (SEQ ID NO: 319); (e) an antisense strand comprising the nucleotide sequence of UUCUAGGCUUGGAACCGGGGUAA (SEQ ID NO: 18) and a sense strand comprising the nucleotide sequence of ACCCCGGUUCCAAGCCUAGAA (SEQ ID NO: 326); (f) an antisense strand comprising the nucleotide sequence of UAGCCUCUAGGCUUGGAACCGGG (SEQ ID NO: 21) and a sense strand comprising the nucleotide sequence of CGGUUCCAAGCCUAGAGGCUA (SEQ ID NO: 329); (g) an antisense strand comprising the nucleotide sequence of UUUACCGUGGUAGCACUCCUGCA (SEQ ID NO: 44) and a sense strand comprising the nucleotide sequence of CAGGAGUGCUACCACGGUAAA (SEQ ID NO: 352): (h) an antisense strand comprising the nucleotide sequence of UUGUCCAUUACCGUGGUAGCACU (SEQ ID NO: 47) and a sense strand comprising the nucleotide sequence of UGCUACCACGGUAAUGGACAA (SEQ ID NO: 355); (i) an antisense strand comprising the nucleotide sequence of UCUCUGUCCAUUACCGUGGUAGC (SEQ ID NO: 49) and a sense strand comprising the nucleotide sequence of UACCACGGUAAUGGACAGAGA (SEQ ID NO: 357); (j) an antisense strand comprising the nucleotide sequence of UAUUGUGUCAGGUUGCAGUACUC (SEQ ID NO: 60) and a sense strand comprising the nucleotide sequence of GUACUGCAACCUGACACAAUA (SEQ ID NO: 368); (k) an antisense strand comprising the nucleotide sequence of UUGCGUCUGAGCAUUGUGUCAGG (SEQ ID NO: 64) and a sense strand comprising the nucleotide sequence of UGACACAAUGCUCAGACGCAA (SEQ ID NO: 372). (l) an antisense strand comprising the nucleotide sequence of UUAACUCUGUCCAUAAUGGUAGU (SEQ ID NO: 88) and a sense strand comprising the nucleotide sequence of UACCAUUAUGGACAGAGUUAA (SEQ ID NO: 396); (m) an antisense strand comprising the nucleotide sequence of UCCAAGCUUGGCAAGUUCUUCCU (SEQ ID NO: 89) and a sense strand comprising the nucleotide sequence of GAAGAACUUGCCAAGCUUGGA (SEQ ID NO: 397); (n) an antisense strand comprising the nucleotide sequence of UAGAUGACCAAGCUUGGCAAGUU (SEQ ID NO: 90) and a sense strand comprising the nucleotide sequence of CUUGCCAAGCUUGGUCAUCUA (SEQ ID NO: 398); or (o) an antisense strand comprising the nucleotide sequence of UGGUCCGACUAUGCUGGUGUGGU (SEQ ID NO: 98) and a sense strand comprising the nucleotide sequence of CACACCAGCAUAGUCGGACCA (SEQ ID NO: 406).


In another aspect, provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises: (a) an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaggsusc (SEQ ID NO: 158) and a sense strand comprising the nucleotide sequence of cscsugccAfaGfcUfuggucaucua (SEQ ID NO: 466); (b) an antisense strand comprising the nucleotide sequence of usAfsuagaUfgaccAfaGfcUfuggcasgsg (SEQ ID NO: 159) and a sense strand comprising the nucleotide sequence of usgsccaaGfcUfuGfgucaucuaua (SEQ ID NO: 467); (c) an antisense strand comprising the nucleotide sequence of usCfsauagAfugacCfaAfgCfuuggcsasg (SEQ ID NO: 160) and a sense strand comprising the nucleotide sequence of gscscaagCfuUfgGfucaucuauga (SEQ ID NO: 468); (d) an antisense strand comprising the nucleotide sequence of usCfsgacgGfcaguCfcCfuUfcugcgsusc (SEQ ID NO: 165) and a sense strand comprising the nucleotide sequence of csgscagaAfgGfgAfcugccgucga (SEQ ID NO: 473); (e) an antisense strand comprising the nucleotide sequence of usUfscuagGfcuugGfaAfcCfggggusasa (SEQ ID NO: 172) and a sense strand comprising the nucleotide sequence of ascscccgGfuUfcCfaagccuagaa (SEQ ID NO: 480); (f) an antisense strand comprising the nucleotide sequence of usAfsgccuCfuaggCfuUfgGfaaccgsgsg (SEQ ID NO: 175) and a sense strand comprising the nucleotide sequence of csgsguucCfaAfgCfcuagaggcua (SEQ ID NO: 483); (g) an antisense strand comprising the nucleotide sequence of usUfsuaccGfugguAfgCfaCfuccugscsa (SEQ ID NO: 198) and a sense strand comprising the nucleotide sequence of csasggagUfgCfuAfccacgguaaa (SEQ ID NO: 506); (h) an antisense strand comprising the nucleotide sequence of usUfsguccAfuuacCfgUfgGfuagcascsu (SEQ ID NO: 201) and a sense strand comprising the nucleotide sequence of usgscuacCfaCfgGfuaauggacaa (SEQ ID NO: 509); (i) an antisense strand comprising the nucleotide sequence of usCfsucugUfccauUfaCfcGfugguasgsc (SEQ ID NO: 203) and a sense strand comprising the nucleotide sequence of usasccacGfgUfaAfuggacagaga (SEQ ID NO: 511); (j) an antisense strand comprising the nucleotide sequence of usAfsuuguGfucagGfuUfgCfaguacsusc (SEQ ID NO: 214) and a sense strand comprising the nucleotide sequence of gsusacugCfaAfcCfugacacaaua (SEQ ID NO: 522); (k) an antisense strand comprising the nucleotide sequence of usUfsgcguCfugagCfaUfuGfugucasgsg (SEQ ID NO: 218) and a sense strand comprising the nucleotide sequence of usgsacacAfaUfgCfucagacgcaa (SEQ ID NO: 526); (l) an antisense strand comprising the nucleotide sequence of usUfsaacuCfugucCfaUfaAfugguasgsu (SEQ ID NO: 242) and a sense strand comprising the nucleotide sequence of usasccauUfaUfgGfacagaguuaa (SEQ ID NO: 550); (m) an antisense strand comprising the nucleotide sequence of usCfscaagCfuuggCfaAfgUfucuucscsu (SEQ ID NO: 243) and a sense strand comprising the nucleotide sequence of gsasagaaCfuUfgCfcaagcuugga (SEQ ID NO: 551); (n) an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaagsusu (SEQ ID NO: 244) and a sense strand comprising the nucleotide sequence of csusugccAfaGfcUfuggucaucua (SEQ ID NO: 552); or (o) an antisense strand comprising the nucleotide sequence of usGfsguccGfacuaUfgCfuGfgugugsgsu (SEQ ID NO: 252) and a sense strand comprising the nucleotide sequence of csascaccAfgCfaUfagucggacca (SEQ ID NO: 560),

    • wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


In another aspect, provided herein is a polynucleic acid molecule conjugate for modulating expression of lipoprotein(a) gene (Lp(a)), wherein the polynucleic acid molecule conjugate comprises a polynucleic acid molecule described herein and an asialoglycoprotein receptor targeting moiety. In some cases, the asialoglycoprotein receptor targeting moiety comprises N-Acetylgalactosamine (GalNAc) or galactose. In some cases, the GalNAc comprises an anomeric carbon bonded to trivalent, tetravalent linker, pentavalent, or hexavalent linker, wherein the anomeric carbon is part of a hemiaminal group.


In some cases, the polynucleic acid molecule and the asialoglycoprotein receptor targeting moiety is coupled via a linker. In some cases, the linker is a cleavable linker. In some cases, the linker comprises formula (IV) below,




embedded image


wherein at least one of Y1 and Y2 is a nucleotide in the polynucleic acid molecule. In some cases, the Y1 is the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule.


In some cases, the linker and the asialoglycoprotein receptor targeting moiety with the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule are shown in Formula (V′), Formula (V″″), Formula (V′″″), or Formula (V″″″):




embedded image




    • wherein Z in formula (V′) is —H, —OH, —O-Methyl, —F, or —O-methoxyethyl and R in formula (V′) is adenine, uracil, guanine, cytosine, thymine, abasic, or others;







embedded image




    • wherein Z in formula (V″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.







embedded image




    • wherein Z in formula (V′″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V′″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others; or







embedded image




    •  wherein Z in formula (V″″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.





In some cases, the linker and the asialoglycoprotein receptor targeting moiety with the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule are shown in Formula (V′):




embedded image


wherein Z in formula (V′) is —H, —OH, —O-Methyl, —F, or —O-methoxyethyl and R in formula (V′) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.


In another aspect, provided herein is a pharmaceutical composition comprising a polynucleic acid molecule described herein or a polynucleic acid molecule conjugate described herein, and a pharmaceutically acceptable excipient. In some cases, the pharmaceutical composition is formulated for parenteral, oral, intranasal, buccal, rectal, transdermal, intravenous, subcutaneous, or intrathecal administration.


In another aspect, provided herein is method of modulating expression of lipoprotein(a) (Lp(a)) gene in a subject in need thereof, comprising: administering to the subject a polynucleic acid molecule described herein, a polynucleic acid molecule conjugate described herein, or a pharmaceutical composition described herein, thereby modulating the expression of Lp(a) gene in the subject in need thereof.


In another aspect, provided herein is a method for treating or preventing a cardiovascular disease or a lipid disorder, comprising: administering to the subject a polynucleic acid molecule described herein, a polynucleic acid molecule conjugate described herein, or a pharmaceutical composition described herein, thereby modulating the expression of Lp(a) gene in the subject in need thereof. In some cases, the cardiovascular disease is coronary artery disease, acute myocardial infarction, asymptomatic carotid atherosclerosis, stroke, atrial fibrillation, hypercholesterolemia, or peripheral artery occlusive disease. In some cases, the lipid disorder is hyperlipidemia or hypercholesterolemia.


In some cases, the polynucleic acid molecule is administered at a dose sufficient to decrease the expression of Lp(a) gene in a cell of said subject or to decrease plasma Lp(a) level of said subject by at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% compared to a control.





BRIEF DESCRIPTION OF THE DRAWINGS

Various aspects of the disclosure are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present disclosure will be obtained by reference to the following detailed description that sets forth illustrative aspects, in which the principles of the disclosure are utilized, and the accompanying drawings below.



FIGS. 1A-1VV show dose responses of siRNA compositions on Lp(a) expression levels in primary human hepatocytes (PHH).



FIG. 2 shows % change in serum Lp(a) level from base line (Day −1) in cynomolgus monkeys.



FIG. 3 shows % change in serum Lp(a) level from base line (Day −1) in cynomolgus monkeys.





DETAILED DESCRIPTION OF THE DISCLOSURE

Lp(a) gene (LPA) is located on chromosome 6q26-q27 is the major gene locus for Lp(a) concentrations in all populations (F. Kronenberg et al., J Intern Med, 273 (1) (2013)). LPA gene is one of the strongest monogenic risk factors for CVD (S. Tsimikas, J Am Coll Cardiol, 69 (6) (2017)). The LPA gene is highly expressed in liver with dramatic decrease as well as increase in Lp(a) observed after liver transplant (A. A. Damluji et al., Journal of clinical lipidology, 10 (2) (2016)).


Lipoprotein (a)(Lp(a)) is a low-density lipoprotein-like particle formed by the association of apolipoprotein (a) (apo(a)) with apolipoprotein B (apo B). The apo(a) protein is covalently linked to apo B in the assembled Lp(a) particle via a disulfide bond. Lp(a) carries atherosclerosis-causing cholesterol and binds atherogenic pro-inflammatory oxidized phospholipids as a preferential carrier of oxidized phospholipids in human plasma, which facilitate inflammation reactions.


The plasma level of Lp(a) is primarily determined by the LPA gene encoding apo(a) (S. Tsimikas, J Am Coll Cardiol, 69 (6) (2017). The Lp(a) level varies between individuals and is directly proportional to CVD risk. Elevated plasma levels of Lp(a) are associated with increased risk for atherosclerosis and its manifestations, which may include hypercholesterolemia (Seed et al., N. Engl. J. Med., 1990, 322, 1494-1499), myocardial infarction (Sandkamp et al., Clin. Chem., 1990, 36, 20-23), and thrombosis (Nowak-Gottl et al., Pediatrics, 1997, 99, E11). Therefore, inhibition of LPA is viewed as a potential therapeutic strategy to treat CVD.


Described herein is a polynucleic acid molecule for modulating expression of Lp(a) gene, comprising a nucleic acid sequence selected from Table 1 or Table 2. In some instances, the polynucleic acid molecule is a single-stranded nucleic acid molecule. In some instances, the polynucleic acid molecule is a double-stranded nucleic acid molecule comprising a sense strand and an antisense strand. Accordingly, provided herein are various target regions of human Lp(a) mRNA the polynucleic acid molecule described herein hybridizes to. The polynucleic acid molecule described herein can be a modified polynucleic acid molecule. For example, the modified polynucleic acid molecule can comprise a 2′-fluoro modified nucleotide, a 2′-O-methyl modified nucleotide, or a modified internucleotide linkage such as a phosphorothioate linkage. In some aspects, provided herein is the polynucleic acid conjugated with a targeting moiety described herein.


Also described herein is a method of modulating expression of Lp(a) mRNA or protein in a subject. Described further herein is a method of modulating LDL and/or cholesterol in a subject in need thereof.


Definition

The singular form “a”, “an”, and “the” include plural references unless the context clearly dictates otherwise. For example, the term “a cell” includes one or more cells, including mixtures thereof. “A and/or B” is used herein to include all of the following alternatives: “A”, “B”, “A or B”, and “A and B.”


Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limit of that range and any other stated or intervening value in that stated range, is encompassed within the disclosure. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges, and are also encompassed within the disclosure, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the disclosure.


Certain ranges are presented herein with numerical values being preceded by the term “about.” The term “about” is used herein to provide literal support for the exact number that it precedes, as well as a number that is near to or approximately the number that the term precedes. In determining whether a number is near to or approximately a specifically recited number, the near or approximating unrecited number may be a number which, in the context in which it is presented, provides the substantial equivalent of the specifically recited number.


“Percent (%) sequence identity” or “Percent (%) identity” with respect to the nucleic acid sequences identified herein is defined as the percentage of nucleic acid in a candidate sequence that are identical with the nucleic acid sequence being compared, after aligning the sequences considering any conservative substitutions as part of the sequence identity.


All ranges disclosed herein also encompass any and all possible sub-ranges and combinations of sub-ranges thereof. Any listed range can be recognized as sufficiently describing and enabling the same range being broken down into at least equal halves, thirds, quarters, fifths, tenths, and so forth. As a non-limiting example, each range discussed herein can be readily broken down into a lower third, middle third and upper third, and the like. As will also be understood by one skilled in the art all language such as “up to,” “at least,” “greater than,” “less than,” and the like include the number recited and refer to ranges which can be subsequently broken down into sub-ranges as discussed above. Finally, as will be understood by one skilled in the art, a range includes each individual member. Thus, for example, a group having 1-3 articles refers to groups having 1, 2, or 3 articles. Similarly, a group having 1-5 articles refers to groups having 1, 2, 3, 4, or 5 articles, and so forth.


Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the polynucleic acid molecules, the polynucleic acid molecule conjugates, the pharmaceutical compositions, the methods and other aspects belong.


As used herein, the term “complementary” indicates a sufficient degree of complementarity between two nucleic acid molecules that bind stably and specifically to avoid nonspecific binding.


As used herein, the term “polynucleic acid” and the term “polynucleotide” are interchangeably used to refer a chain of nucleotides. The term “nucleotide” includes a sequence “G,” “C,” “A,” “T” and “U” each generally stand for a nucleotide that contains guanine, cytosine, adenine, thymidine and uracil as a base. In some instances, the “nucleotide” can refer to a modified nucleotide (e.g., with modified sugar moiety, modified base, modified internucleotide linkage, or combination thereof, including, but not limited to 2′-modified nucleotide, LNA, ENA, BNA, UNA, GNA etc.) In some instances, the “nucleotide” can refer to a modified nucleotide with a non-canonical base (e.g. including, but not limited to, 2-thiouridine, 2-thiothymidine, inosine, 2-aminopurine, 2,6-diaminopurine, dihydrouridine, 4-thiouridine, 4-thiothymidine, 2-thiocytidine).


As used herein, a “subject” can be any mammal, including a human and a non-human primate.


A “subject in need thereof”, refers to a subject having a Lp(a) related disorder or symptoms thereof, including but not limited to, CVD or a lipid disorder, or a subject having an increased risk of developing Lp(a) related disorder or symptoms thereof, including but not limited to, a CVD or lipid disorder relative to the population at large. In some instances, a subject in need thereof has coronary heart disease or atherosclerosis, or symptoms thereof. In some instances, a subject in need thereof has hyperlipidemia or hypercholesterolemia, or symptoms thereof. In some instances, a subject in need thereof is being administered or has been administered a drug different from the polynucleic acid molecules or conjugates disclosed herein, for treating or preventing a CVD or lipid disorder. For example, a subject in need thereof is being administered or has been administered atorvastatin.


The term “condition,” as used herein, includes diseases, disorders, and susceptibilities. In some cases, the condition is an Lp(a) related disorder, atherosclerotic vascular disease, or symptoms thereof. In some cases, the condition is a hypertriglyceridemia or symptoms thereof.


The term “atherosclerosis” or “atherosclerotic vascular disease,” as used herein, refers to a disease in which the inside of an artery narrows due to the buildup of plaque. In some instances, it may result in coronary artery disease, stroke, peripheral artery disease, or kidney problems.


The term “cardiovascular disease” or “CVD” refers to all types of diseases that affect the heart or blood vessels, including coronary heart disease (clogged arteries), which can cause heart attacks, stroke, congenital heart defects and peripheral artery disease. A CVD or symptoms thereof can include myocardial infarction, stroke, atrial fibrillation, or calcific aortic valve stenosis. A CVD or symptoms thereof include cardiac arrest or peripheral arterial disease.


The term “lipid disorder” refers to a disorder or a condition that increase levels of LDLs, triglycerides, or both. For example, the lipid disorder can be hyperlipidemia or hypercholesterolemia.


The term “low-density lipoprotein (LDL),” as used herein, refers to a microscopic blob made up of an outer rim of lipoprotein and a cholesterol center. LDL can have a highly hydrophobic core composed of a polyunsaturated fatty acid known as linoleate and hundreds to thousands esterified and unesterified cholesterol molecules. The core of LDL can also carry triglycerides and other fats and can be surrounded by a shell of phospholipids and unesterified cholesterol.


As used herein, the term “treat,” “treating” or “treatment” of any disease or disorder refers, in one instance, to ameliorating the disease or disorder (i.e., slowing or arresting or reducing the development of the disease or at least one of the clinical symptoms thereof). In another instance, “treat”, “treating” or “treatment” refers to alleviating or ameliorating at least one physical parameter including those which may not be discernible by the patient. In yet another instance, “treat”, “treating” or “treatment” refers to modulating the disease or disorder, either physically, (e.g., stabilization of a discernible symptom), physiologically, (e.g., stabilization of a physical parameter), or both.


The terms “prevent,” “preventing,” and “prevention,” as used herein, refer to a decrease in the occurrence of pathology of a condition in a subject, who does not have, but is at risk of or susceptible to developing a disease or condition. The prevention may be complete, e.g., the total absence of pathology of a condition in a subject. The prevention may also be partial, such that the occurrence of pathology of a condition in a subject is less than that which would have occurred without the present disclosure.


“Administering” and its grammatical equivalents as used herein can refer to providing pharmaceutical compositions described herein to a subject or a patient. Conventional methods, known to those of ordinary skill in the art of medicine, can be used to administer the composition to the subject, depending upon the type of disease to be treated or the site of the disease. For example, the composition can be administered, e.g., orally, parenterally, by inhalation spray, topically, rectally, nasally, buccally, vaginally, via an implanted reservoir, or via infusion. One or more such routes can be employed.


The terms “pharmaceutical composition” and its grammatical equivalents as used herein can refer to a mixture or solution comprising a therapeutically effective amount of an active pharmaceutical ingredient together with one or more pharmaceutically acceptable excipients, carriers, and/or a therapeutic agent to be administered to a subject, e.g., a human in need thereof.


The term “pharmaceutically acceptable” and its grammatical equivalents as used herein can refer to an attribute of a material which is useful in preparing a pharmaceutical composition that is generally safe, non-toxic, and neither biologically nor otherwise undesirable and is acceptable for veterinary as well as human pharmaceutical use. “Pharmaceutically acceptable” can refer a material, such as a carrier or diluent, which does not abrogate the biological activity or properties of the compound, and is relatively nontoxic, i.e., the material may be administered to a subject without causing undesirable biological effects or interacting in a deleterious manner with any of the components of the pharmaceutical composition in which it is contained.


A “pharmaceutically acceptable excipient” refers to an excipient that can be administered to a subject, together with an agent, and which does not destroy the pharmacological activity thereof and is nontoxic when administered in doses sufficient to deliver a therapeutic amount of the agent.


The term “therapeutic agent” can refer to any agent that, when administered to a subject, has a therapeutic, diagnostic, and/or prophylactic effect and/or elicits a desired biological and/or pharmacological effect. Therapeutic agents can also be referred to as “actives” or “active agents.” Such agents include, but are not limited to, cytotoxins, radioactive ions, chemotherapeutic agents, small molecule drugs, proteins, and nucleic acids.


It is appreciated that certain features of the polynucleic acid molecules, and/or polynucleic acid molecule conjugates, pharmaceutical composition comprising the polynucleic acid molecules or the polynucleic acid molecule conjugates, methods and other aspects, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the polynucleic acid molecules, and/or polynucleic acid molecule conjugates, pharmaceutical composition comprising the polynucleic acid molecules or the polynucleic acid molecule conjugates, methods and other aspects, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub-combination. All combinations of the embodiments are specifically embraced by the present disclosure and are disclosed herein just as if each and every combination was individually and explicitly disclosed, to the extent that such combinations embrace operable processes and/or compositions. In addition, all sub-combinations listed in the embodiments describing such variables are also specifically embraced by the present polynucleic acid molecules, and/or polynucleic acid molecule conjugates, pharmaceutical composition comprising the polynucleic acid molecules or the polynucleic acid molecule conjugates, methods and other aspects and are disclosed herein just as if each and every such sub-combination was individually and explicitly disclosed herein.


Polynucleic Acid Molecules
Target Regions of Polynucleic Acid Molecules

Described herein is a polynucleic acid molecule for modulating expression of Lp(a) gene. In some instances, the polynucleic acid molecule is a single-stranded nucleic acid molecule. In some instances, the polynucleic acid molecule is a double-stranded nucleic acid molecule.


In some aspects, the polynucleic acid molecule described herein hybridizes to certain regions of human Lp(a) mRNA. In some instances, the polynucleic acid molecule comprises a sense strand and an antisense strand, and wherein the antisense strand hybridizes to a certain region of Lp(a) mRNA. As used herein, the term “sense strand” can be interchangeably used with the term “passenger strand”, and the term “antisense strand” can be interchangeably used with the term “guide strand”.


In some aspects, the polynucleic acid molecule described herein hybridizes to the 5′ UTR region of human Lp(a) mRNA. In some aspects, the polynucleic acid molecule described herein hybridizes to the coding region of human Lp(a) mRNA. In some aspects, the polynucleic acid molecule described herein hybridizes to the 3′ UTR region of human Lp(a) mRNA. In some aspects, the polynucleic acid molecule described herein hybridizes to a portion of exon 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, or 39 of human Lp(a) mRNA. In some aspects, the polynucleic acid molecule described herein hybridizes to a coding region of human Lp(a) m RNA (NCBI Reference Sequence: NM_005577.4).


In some aspects, the starting position of the binding site of the polynucleic acid molecule described herein on human Lp(a) mRNA (NCBI Reference Sequence: NM_005577.4) is between position 190-210, 250-270; 360-390; 400-450; 460-520, 530-550, 1100-1200, 2600-2700, 2700-2800,2800-2900, 3000-3300; 3300-3600, 3600-4000, 40004200, 4400-4700, 4700-5000, 5000-5200, or 5500-6000.


The starting position of the binding site of the polynucleic acid molecule described herein on human Lp(a) mRNA (NCBI Reference Sequence: NM_005577.4) can be between position 200-210, 380-390, 410-420, 1100-1200, 2700-2800, 3200-3300, or 3300-3400.


The starting position of the binding site of the polynucleic acid molecule described herein on human Lp(a) mRNA (NCBI Reference Sequence: NM_005577.4) can be between position 200-210,250-260, 380-390, 410-430, 430-440, 460-470, 490-500, 500-510, 540-550, 1150-1180, 2650-2700, 2700-2750, 2760-2770, 2850-2900, 3200-3250, 3250-3300, 3300-3310, 3700-3750, 3750-3800, 3950-4000, 4800-4850, 5100-5150, 5500-5550, 5850-5900, or 2750-2800.


Structure of Polynucleic Acid Molecules

Described herein is a polynucleic acid molecule for modulating expression of Lp(a) gene. In some instances, the polynucleic acid molecule is a single-stranded nucleic acid molecule, wherein the single-stranded nucleic acid molecule is reverse complementary to a target region of Lp(a) mRNA.


In some aspects, the polynucleic acid molecule described herein is not 100% complementary to the target region of Lp(a) mRNA. Accordingly, in some instances, the polynucleic acid molecule described herein is about 95% complementary to the target region of Lp(a) mRNA. In some instances, the polynucleic acid molecule described herein is about 90% complementary to the target region of Lp(a) mRNA. In some instances, the polynucleic acid molecule described herein is about 85% complementary to the target region of Lp(a) mRNA. In some instances, the polynucleic acid molecule described herein is about 80% complementary to the target region of Lp(a) mRNA. In some instances, the polynucleic acid molecule described herein is about 75% complementary to the target region of Lp(a) mRNA. In some instances, the polynucleic acid molecule described herein is about 70% complementary to the target region of Lp(a) mRNA.


In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence in Table 1, Table 2 or Table 5. In some instances, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% complementary to a sequence in Table 1, Table 2, or Table 5. In some instances, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% complementary to a nucleic acid sequence selected from SEQ ID NOs: 309-462. In some instances, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% complementary to a nucleic acid sequence selected from SEQ ID NOs: 1-154.


In some instances, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% complementary to a sequence in Table 1, Table 2, and Table 5, excluding overhangs. In some instances, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% complementary to a nucleic acid sequence selected from SEQ ID NOs: 309-462, excluding overhangs. In some instances, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% complementary to a nucleic acid sequence selected from SEQ ID NOs: 1-154, excluding overhangs.


In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 14 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 14 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 15 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 15 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 16 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 16 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 17 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 17 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 18 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 18 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 19 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 19 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 20 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 20 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 21 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 21 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 22 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 22 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 with no more than 1, 2, 3, or 4 mismatches.


In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 14 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 15 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 16 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 17 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 18 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 19 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 20 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 21 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 22 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 with no more than 1, 2, 3, or 4 mismatches.


In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 14, 15, 16, 17, 18, 19, 20, 21, or 22 consecutive nucleotides that are complementary to a sequence in Table 1, Table 2, and Table 5 without overhangs with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 14, 15, 16, 17, 18, 19, 20, 21, or 22 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 309-462 without overhangs with no more than 1, 2, 3, or 4 mismatches. In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 14, 15, 16, 17, 18, 19, 20, 21, or 22 consecutive nucleotides that are complementary to a nucleic acid sequence of SEQ ID NO: 1-154 without overhangs with no more than 1, 2, 3, or 4 mismatches.


In some aspects, the polynucleic acid molecule described herein comprises a strand of at least 10, 11, 12, 13, 14, or 15 nucleotides in length. In some aspects, the polynucleic acid molecule described herein comprises a strand of about 15-40, 16-30, 17-30, 18-30, 18-27, 18-25, 18-23, 19-23, 20-23, or 21-23 nucleotides in length. In some aspects, the polynucleic acid molecule described herein comprises a strand of about 15, 16, 17, 18, 19, 20 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a strand of about 21, 22, 23, 24, 25 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a strand of about 26, 27, 28, 29, 30 nucleotides long.


In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of at least 10, 11, 12, 13, 14, or 15 nucleotides in length. In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of about 15-30, 16-30, 17-30, 18-30, 18-27, 18-25, 18-23, 19-23, 20-23, or 21-23 nucleotides in length. In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of about 15, 16, 17, 18, 19, 20 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of about 21, 22, 23, 24, 25 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of about 26, 27, 28, 29, 30 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of about 21 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a single-stranded nucleic acid of about 23 nucleotides long.


In some instances, the polynucleic acid molecule is a double-stranded nucleic acid molecule comprising a sense strand and an antisense strand, and wherein the antisense strand is at least partially reverse complementary to a target region of Lp(a) mRNA.


In some aspects, the antisense strand described herein is not 100% complementary to a target region of Lp(a) mRNA. Accordingly, in some instances, the antisense strand described herein is 100% complementary to a target region of Lp(a) mRNA. In some aspects, the antisense strand described herein is about 95% complementary to a target region of Lp(a) mRNA. In some aspects, the antisense strand described herein is about 90% complementary to a target region of Lp(a) mRNA. In some aspects, the antisense strand described herein is about 85% complementary to a target region of Lp(a) mRNA. In some aspects, the antisense strand described herein is about 80% complementary to a target region of Lp(a) mRNA. In some aspects, the antisense strand described herein is about 75% complementary to a target region of Lp(a) mRNA. In some aspects, the antisense strand described herein is about 70% complementary to a target region of Lp(a) mRNA.


In some aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence in Table 1 or Table 2. In other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% identical to a sequence in Table 1 or Table 2. In some instances, the sense strand described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, or at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs:309-462. In some instances, the antisense strand described herein comprises a nucleic acid sequences that is at least 80%, at least 85%, at least 90%, or at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs:1-154. In some instances, the sense strand described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406. In some instances, the antisense strand described herein comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, identical to a nucleic acid sequence selected from SEQ ID NOs: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98.


In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising 15 consecutive sequences of the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 15 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 15 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet still other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 16 consecutive sequences out of the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 16 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 16 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet still other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 17 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 17 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 17 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 18 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 18 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 18 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 19 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 19 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 19 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 20 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 20 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 20 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 21 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 21 consecutive sequences from SEQ ID NOs: 309-462 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 21 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 22 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 22 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In specific aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 23 consecutive sequences from SEQ ID NOs: 1-154 with no more than 1, 2, 3, or 4 mismatches. In yet other aspects, the polynucleic acid molecule described herein comprises a nucleic acid sequence comprising at least 23 consecutive sequences from the sequences in Table 1 or Table 2 with no more than 1, 2, 3, or 4 mismatches. As used herein, the term “consecutive sequence” refers to a sequence contains a number of consecutive nucleotides from a reference sequence. For example, if a reference sequence is N1N2N3N4N5N6N7, a consecutive sequence can be N1N2N3N4 or N3N4N5N6, but a sequence of N1N3N4N5 or N3N4N7 cannot be a consecutive sequence.


In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 15 consecutive sequences of SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 15 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 16 consecutive sequences of SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2, 3 or 4 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 16 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 17 consecutive sequences of SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 17 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 18 consecutive sequences of SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2 or 3 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 18 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2, 3, or 4 mismatches. In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 19 consecutive sequences of SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2 or 3 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 19 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2 or 3 mismatches. In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 20 consecutive sequences from SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2 or 3 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 20 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2 or 3 mismatches. In some aspects, the sense strand described herein comprises a nucleic acid sequence comprising at least 21 consecutive sequences of SEQ ID NO: 312-314, 319, 326, 329, 352, 355, 357, 368, 372, 396-398, and 406 with no more than 1, 2 or 3 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 21 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2 or 3 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 22 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2 or 3 mismatches. In some aspects, the antisense strand described herein comprises a nucleic acid sequence comprising at least 23 consecutive sequences of SEQ ID NO: 4-6, 11, 18, 21, 44, 47, 49, 60, 64, 88-90, and 98 with no more than 1, 2 or 3 mismatches.


In some aspects, the polynucleic acid molecule described herein comprises a sense and an antisense strand of at least 10, 11, 12, 13, 14, or 15 nucleotides in length. In some aspects, the polynucleic acid molecule described herein comprises a sense and an antisense strand of about 15-30, 16-30, 17-30, 18-30, 18-27, 18-25, 18-23, 19-23, 20-23, or 21-23 nucleotides in length. In some aspects, the polynucleic acid molecule described herein comprises a sense and an antisense strand of about 15, 16, 17, 18, 19, 20 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a sense and an antisense strand of about 21, 22, 23, 24, 25 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a sense and an antisense strand of about 26, 27, 28, 29, 30 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a sense strand of 19 nucleotides long, and an antisense strand of about 21 nucleotides long. In some aspects, the polynucleic acid molecule described herein comprises a sense strand of 21 nucleotides long, and an antisense strand of about 23 nucleotides long.


In some aspects, the sense strand and the antisense strand described herein are reverse complementary to each other and form a duplex with a 3′ overhang on the antisense strand. In some aspects, the sense strand and the antisense strand described herein are reverse complementary to each other and form a duplex with a 5′ overhang on the antisense strand. In some aspects, the sense strand and the antisense strand described herein are reverse complementary to each other and form a duplex with a 3′ overhang on the sense strand. In some aspects, the sense strand and the antisense strand described herein are reverse complementary to each other and form a duplex with a 5′ overhang on the sense strand.


Modifications of Polynucleic Acid Molecules

In some aspects, described herein is the polynucleic acid molecule described herein with modifications. In some aspects, the modifications described herein occurs one or more different structures of the polynucleic acid molecule described herein (e.g., modifications on sugar ring(s), backbone(s), base(s)). In some aspects, the modifications described herein comprise substitutions of one or more nucleotide in the polynucleic acid molecule described herein. In some aspects, different percentages of the polynucleic acid molecule described herein comprise the modifications described herein. In some aspects, different positions of the polynucleic acid molecule described herein comprise the modifications described herein. WO/2018/035380 is herein incorporated by reference in its entirety.


Types of Modifications

In some aspects, the polynucleic acid molecule described herein comprises one or more sugar-modified nucleotide. In some instances, the sugar-modified nucleotide includes a modification at a 2′ hydroxyl group of the ribose moiety. In some instances, the sugar-modified nucleotide includes modification with an H, OR, R, halo, SH, SR, NH2, NHR, NR2, or CN, wherein R is an alkyl moiety. In some aspects, the sugar-modified nucleotide is a 2′-fluoro modified nucleotide. In some aspects, the sugar-modified nucleotide is a 2′-O-methyl modified nucleotide or a 2′-alkoxy modified nucleotide (e.g., 2′-methoxy modified nucleotide). In some instances, 2′ hydroxyl group modification includes 2′-deoxy, 2′-deoxy-2′-fluoro, 2′-O-aminopropyl (2′-O-AP), 2′-O-dimethylaminoethyl (2′-O-DMAOE), 2′-O-dimethylaminopropyl (2′-O-DMAP), 2′-O-dimethylaminoethyloxyethyl (2′-O-DMAEOE), or 2′-O—N-methylacetamido (2′-O-NMA). In some instances, the alkyl moiety comprises a hetero substitution. In some instances, the carbon of the heterocyclic group is substituted by a nitrogen, oxygen or sulfur. In some instances, the heterocyclic substitution includes morpholino, imidazole, and pyrrolidino.


In some instances, 2′ hydroxyl group of the ribose moiety includes a locked or bridged ribose modification (e.g., LNA), an unlocked ribose modification (e.g., UNA), or ethylene nucleic acids (ENA).


In some aspects, the sugar-modified nucleotide is a 2′-amino modified nucleotide. In some aspects, the sugar-modified nucleotide is a 2′-azido modified nucleotide. In some aspects, the sugar-modified nucleotide is a 2′-deoxy modified nucleotide. In some aspects, the sugar-modified nucleotide is a 2′-O-methoxythyl (2′-MOE). In some aspects, the sugar-modified nucleotide is a locked nucleic acid (LNA). In some aspects, the sugar-modified nucleotide is an ethylene-bridged nucleic acid (ENA). In some aspects, the sugar-modified nucleotide is a (S)-constrained ethyl (cEt). In some aspects, the sugar-modified nucleotide is a tricyclo-DNA (tcDNA). In some aspects, the sugar-modified nucleotide is a 2′-NH2 nucleic acid.


In some aspects, the polynucleotide acid molecule described herein comprises one or more sugarphosphate-modified nucleotide. In some aspects, the modified sugarphosphate is phosphorodiamidate morpholino (PMO). In some aspects, the modified sugarphosphate is phosphoramidate. In some aspects, the modified sugarphosphate is thiophosphoramidate. In some aspects, the modified sugarphosphate is peptide nucleic acid (PNA).


In some aspects, the polynucleic acid molecule described herein comprises one or more backbone-modified nucleotide. In some aspects, the modified backbone is phosphorothioate. In some aspects, the modified backbone is methylphosphonate. In some aspects, the modified backbone is guanidinopropyl phosphoramidate. In some aspects, the modified backbone is a mesyl-phosphoramidate (MsPA) linkages. In some instances, the modified backbone comprises one or more of phosphorodithioates, methylphosphonates, 5′-alkylenephosphonates, 5′-methylphosphonate, 3′-alkylene phosphonates, borontrifluoridates, borano phosphate esters and selenophosphates of 3′-5′ linkage or 2′-5′ linkage, phosphotriesters, thionoalkylphosphotriesters, hydrogen phosphonate linkages, alkyl phosphonates, alkylphosphonothioates, arylphosphonothioates, phosphoroselenoates and phosphoramidates.


In some aspects, the modified nucleotide comprises a modified guanine (e.g., inosine) or one or more of any types of unnatural nucleic acids.


In some aspects, the modified backbone is phosphorothioate, and the phosphorothioate is a stereochemically enriched phosphorothioate. In certain aspects, the strand contains at least one stereochemically enriched phosphorothioate. In some aspects, the strand comprises at least 1, 2, 3 stereochemically enriched phosphorothioates. In some aspects, the strand comprises only 1, 2, 3, or 4 stereochemically enriched phosphorothioates. In further aspects, at least one (e.g., one or two) stereochemically enriched phosphorothioate is disposed between two consecutive nucleosides that are two of six 5′-terminal nucleosides of the strand. In yet further aspects, at least one (e.g., one or two) stereochemically enriched phosphorothioate is disposed between two consecutive nucleosides that are two of six 3′-terminal nucleosides of the strand. In still further aspects, one stereochemically enriched phosphorothioate is covalently bonded to the first nucleoside and the second nucleoside from the 5′-end within the strand. In some aspects, one stereochemically enriched phosphorothioate is covalently bonded to the twenty first nucleoside and the twenty second nucleoside from the 5′-end within the strand. In certain aspects, one stereochemically enriched phosphorothioate is covalently bonded to the twenty second nucleoside and the twenty third nucleoside from the 5′-end within the strand. In particular aspects, the stereochemically enriched phosphorothioate has RP stereochemical identity. In certain aspects, the stereochemically enriched phosphorothioate has SP stereochemical identity.


In some aspects, the polynucleotide molecules described herein comprises one or more (e.g., from 1 to 20, from 1 to 10, or from 1 to 5) stereochemically enriched (e.g., internucleoside) phosphorothioates (e.g., having diastereomeric excess of at least 10%, at least 50%, at least 60%, at least 70%, at least 80%, or at least 90%, e.g., up to about 99%, for the P-stereogenic center). The polynucleotide molecules described herein comprises one or more (e.g., from 1 to 20, from 1 to 10, or from 1 to 5; e.g., internucleoside) phosphorodithioates. The phosphorodithioates may be non-P-stereogenic in the polynucleotide molecules described herein. Phosphorothioates and phosphorodithioates may enhance the stability of the polynucleotide molecules described herein to exonuclease activity of serum. Non-P-stereogenic phosphorodithioates may simplify the synthesis of the polynucleotide molecule described herein by reducing the number of possible diastereomers. Typically, the phosphorothioate or phosphorodithioate may connect two contiguous nucleosides within the six 3′-terminal nucleosides and the six 5′-terminal nucleosides of the polynucleotide molecules described herein. In some aspects, the stereochemically enriched phosphorothioate (e.g., RP-enriched phosphorothioate) may be covalently bonded to the first nucleoside(e.g., the 3′-carbon atom of the first nucleoside) and the second nucleoside (e.g., the 5′-carbon atom of the second nucleoside) from the 5′-end of the antisense strand. Additionally or alternatively, the stereochemically enriched phosphorothioate (e.g., SP-enriched phosphorothioate) may be covalently bonded to the 21st nucleoside (e.g., the 3′-carbon atom of the 21st nucleoside) from the 5′-end and the 22nd nucleoside (e.g., the 5′-carbon atom of the 22nd nucleoside) of the antisense strand. Further, additionally or alternatively, the stereochemically enriched phosphorothioate (e.g., SP-enriched phosphorothioate or Rp-enriched phosphorothioate) may be covalently bonded to the 22nd nucleoside (e.g., the 3′-carbon atom of the 22nd nucleoside) and the 23rd nucleoside (e.g., the 5′-carbon atom of the 23rd nucleoside) from the 5′-end of the antisense strand.


Combinations of a 5′ RP-enriched phosphorothioate (e.g., RP-enriched phosphorothioate covalently bonded to the first nucleoside (e.g., the 3′-carbon atom of the first nucleoside) and the second nucleoside (e.g., the 5′-carbon atom of the second nucleoside) from the 5′-end and a 3′ SP-enriched phosphorothioate (e.g., SP-enriched phosphorothioate covalently bonded to the 21st nucleoside (e.g., the 3′-carbon atom of the 21st nucleoside) and the 22nd nucleoside (e.g., the 5′-carbon atom of the 22nd nucleoside) from the 5′-end in an antisense strand can produce superior efficacy and/or duration of action, e.g., as measured by the reduction in the activity of the target relative to a reference guide strand that lacks the combination of a 5′ RP-enriched phosphorothioate and a 3′ SP-enriched phosphorothioate, or a 5′ Rp-enriched phosphorothioate and a 3′ Sp and Rp-enriched phosphorothioate. In some embodiments, the stereochemically enriched phosphorothioate may comprise RpRpSpSp (RpRp at the positions 1 and 2 of the guide strand and SpSp at the positions 21 and 22 of the guide strand) or RpRpSpRp (RpRp at the positions 1 and 2 of the guide strand and SpRp at the positions 21 and 22 of the guide strand). In some aspects, the polynucleotide molecules described herein comprises four stereochemically enriched phosphorothioates: (1) a Rp-enriched phosphorothioate covalently bonded to the 1st nucleoside (e.g., the 3′-carbon atom of the 1st nucleoside) and the 2nd nucleoside (e.g., the 5′-carbon atom of the 2nd nucleoside) from the 5′-end of the antisense strand; (2) a Rp-enriched phosphorothioate covalently bonded to the 2nd nucleoside (e.g., the 3′-carbon atom of the 2nd nucleoside) and the 3rd nucleoside (e.g., the 5′-carbon atom of the 3rd nucleoside) from the 5′-end of the antisense strand; (3) a Sp-enriched phosphorothioate covalently bonded to the 21st nucleoside (e.g., the 3′-carbon atom of the 21st nucleoside) and the 22th nucleoside (e.g., the 5′-carbon atom of the 22th nucleoside) from the 5′-end of the antisense strand; and (4) a Sp-enriched phosphorothioate covalently bonded to the 22th nucleoside (e.g., the 3′-carbon atom of the 22th nucleoside) and the 23rd nucleoside (e.g., the 5′-carbon atom of the 23rd nucleoside) from the 5′-end of the antisense strand. In some aspects, the polynucleotide molecules described herein comprises four stereochemically enriched phosphorothioates: (1) a Rp-enriched phosphorothioate covalently bonded to the 1st nucleoside (e.g., the 3′-carbon atom of the 1st nucleoside) and the 2nd nucleoside (e.g., the 5′-carbon atom of the 2nd nucleoside) from the 5′-end of the antisense strand; (2) a Rp-enriched phosphorothioate covalently bonded to the 2nd nucleoside (e.g., the 3′-carbon atom of the 2nd nucleoside) and the 3rd nucleoside (e.g., the 5′-carbon atom of the 3rd nucleoside) from the 5′-end of the antisense strand; (3) a Sp-enriched phosphorothioate covalently bonded to the 21st nucleoside (e.g., the 3′-carbon atom of the 21st nucleoside) and the 22th nucleoside (e.g., the 5′-carbon atom of the 22th nucleoside) from the 5′-end of the antisense strand; and (4) a Rp-enriched phosphorothioate covalently bonded to the 22th nucleoside (e.g., the 3′-carbon atom of the 22th nucleoside) and the 23rd nucleoside (e.g., the 5′-carbon atom of the 23rd nucleoside) from the 5′-end of the antisense strand.


In some aspects, the polynucleotide molecule described herein comprises one or more purine modification. In some aspects, the purine modification described herein is 2,6-diaminopurine. In some aspects, the purine modification described herein is 3-deaza-adenine. In some aspects, the purine modification described herein is 7-deaza-guanine. In some aspects, the purine modification described herein is 8-azido-adenine.


In some aspects, the polynucleotide molecule described herein comprises one or more pyrimidine modification. In some aspects, the pyrimidine modification described herein is 2-thiothymidine. In some aspects, the pyrimidine modification described herein is 5-carboxamide-uracil. In some aspects, the pyrimidine modification described herein is 5-methyl-cytosine. In some aspects, the pyrimidine modification described herein is 5-ethynyl uracil.


In some cases, the polynucleic acid molecule described herein comprises an abasic substitution. In those cases where a hybridized polynucleotide construct is contemplated for use as siRNA, a reduction of miRNA-like off-target effects is desirable. The inclusion of one or more (e.g., one or two) abasic substitutions in the hybridized polynucleotide constructs may reduce or even eliminate miRNA-like off-target effects, as the abasic substitutions lack nucleobases that are capable of engaging in base-pairing interactions and alleviate steric hindrance. Thus, the polynucleotide molecule disclosed herein may include one or more (e.g., one or two) abasic substitutions. In some aspects, abasic substitution is at the 5th nucleotide from the 5′ end of the antisense strand described herein. In some aspects, abasic substitution is at the 7th nucleotide from the 5′ end of the antisense strand described herein.


When the polynucleotide molecule disclosed herein includes two or more of the abasic substitutions, their structures may be same or different. In certain aspects, a sense strand contains one abasic substitution (e.g., an antisense strand may be free of abasic substitutions). In other aspects, an antisense strand contains one abasic substitution (e.g., a sense strand may be free of abasic substitutions). In yet other aspects, an antisense strand contains one abasic substitution, and a sense strand contains one abasic substitution. In further aspects, a sense strand includes an abasic substitution between a nucleoside number (x) and a nucleoside number (x+1), where x is an integer from 2 to 7. In yet further aspects, an antisense strand includes an abasic substitution between a nucleoside number (x) and a nucleoside number (x+1), where x is an integer from 2 to 7.


The abasic substitution may be of formula (III):




embedded image


where

    • L is a sugar analogue, or is substituted with a heteroacyl from A, U, C, G, or is any other substituted nucleic acid (e.g., locked or unlocked nucleic acid, glycol nucleic acid, etc.);
    • each X4 is independently O or S;
    • each X5 is independently O, S, NH, or a bond;
    • each R9 is independently H, optionally substituted C1-6 alkyl, optionally substituted C2-6 alkenyl, optionally substituted C2-6 alkynyl, optionally substituted (C1-9 heterocyclyl)-C1-6-alkyl, optionally substituted (C6-10 aryl)-C1-6-alkyl, optionally substituted (C3-8 cycloalkyl)-C1-6-alkyl, -LinkA(-T)p, or a conjugation moiety;
    • each LinkA is independently a multivalent linker (e.g., including —C(O)—N(H)—);
    • each T is independently an auxiliary moiety;
    • R10 is a bond to a 3′-carbon atom of a nucleoside (x) in the strand;
    • R11 is a bond to a 5′-oxygen atom of a nucleoside (x+1) in the strand;
    • p is an integer from 1 to 6; and
    • t is an integer from 1 to 6.


In some aspects, the abasic substitution described herein is attached to the antisense strand of the polynucleic acid molecule described herein. In particular aspects, an abasic substitution (e.g., an internucleotide, abasic spacer of formula (III) in which t is 1) may be included in the antisense strand described herein (e.g., within the seed region of the guide strand). In some aspects, an abasic substitution (e.g., an internucleotide, abasic spacer of formula (III) in which t is 1) may be bonded to the 3′ carbon atom of the second, third, fourth, or fifth nucleoside from the 5′-end of the antisense strand described herein. In certain aspects, an abasic substitution (e.g., an internucleotide, abasic spacer of formula (III) in which t is 1) may be bonded to the 3′ carbon atom of the thirteenth, fourteenth, fifteenth, or sixteenth nucleoside from the 5′-end of the antisense strand described herein. In some aspects, an abasic substitution fourth, fifth, sixth, seventh, eighth, and/or ninth nucleoside from the 5′-end of the antisense strand described herein.


The polynucleotide molecule described herein may contain a strand including a seed region including a hypoxanthine nucleobase-containing nucleoside (e.g., inosine).


In certain aspects, the hypoxanthine nucleobase-containing nucleoside is a second nucleoside from the 5′-end in the strand. In further aspects, the hypoxanthine nucleobase-containing nucleoside is a third nucleoside from the 5′-end in the strand. In yet further aspects, the hypoxanthine nucleobase-containing nucleoside is a fourth nucleoside from the 5′-end in the strand. In still further aspects, the hypoxanthine nucleobase-containing nucleoside is a fifth nucleoside from the 5′-end in the strand. In particular aspects, the hypoxanthine nucleobase-containing nucleoside is a sixth nucleoside in the strand. In particular aspects, the hypoxanthine nucleobase-containing nucleoside is a seventh nucleoside in the strand.


The Amount and Location of Modifications

In some aspects, the polynucleotide molecule described herein comprises one or more type of modifications as described above. Accordingly, in some aspects, about 10% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 20% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 30% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 40% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 50% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 60% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 70% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 80% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, about 90% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above. In other aspects, 100% of the nucleotides from the polynucleotide molecule described herein are modified with one or more type of modifications as described above.


In some aspects, the one or more types of modifications described herein occurs in the seed region within the the polynucleotide molecule described herein. In some aspects, the one or more types of modifications described herein occurs at different positions within the polynucleotide molecule described herein. In specific aspects, the one or more types of modifications described herein occurs at 3′ terminal of the polynucleotide molecule described herein. In specific aspects, the one or more types of modifications described herein occurs at 5′ terminal of the polynucleotide molecule described herein. In specific aspects, the one or more types of modifications described herein occurs dispersedly within the polynucleotide molecule described herein. In specific aspects, the one or more types of modifications described herein occurs in clusters within the polynucleotide molecule described herein.


Specific Modification Patterns

In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises about three 2′-fluoro modified nucleotides and about eighteen 2′-O-methyl modified nucleotides, and wherein the antisense strand comprises about five 2′-fluoro modified nucleotides and about eighteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a polynucleic acid modified with a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein n stands for a 2′-O-methyl modified nucleotide, and wherein Nf stands for a 2′-fluoro modified nucleotide. In some aspects, the sense strand comprises ‘5-NfnNfnNfnNfnNfNfNfnNfnNfnNfnNfnNf-3’, wherein the antisense strand comprises ‘5-nNfnNfnNfnNfnNfnnnNfnNfnNfnNfnnn-3’, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the sense strand comprises ‘5-nnnnnnNfnNfNfNfnnnnnnnnnn-3’, wherein the antisense strand comprises ‘5-nNfnnnNfnNfNfnnnnNfnNfnnnnnnn-3’, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the sense strand comprises ‘5-nnnnnnnnNfnNfnnnnnnnnnn-3’, wherein the antisense strand comprises ‘5-nNfnnnnnnnnnNfnNfnnnnnnnnn-3’, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the sense strand comprises ‘5-nnnnnnNfnNfnNfnnnnnnnnnn-3’, wherein the antisense strand comprises ‘5-nNfnnnnnnnnnNfnNfnNfnnnnnnn-3’, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some instances, each modification pattern includes one or more phosphorothioate internucleotide linkages in locations such as between 1st and 2nd nucleotides on 5′ end, between 2nd and 3rd nucleotides on 5′ end, between 1st and 2nd nucleotides on 3′ end, and/or between 2nd and 3rd nucleotides on 3′ end.


In some aspects, the antisense strand comprises 5′-nNfnnnNfnNfNfnnnnNfnNfnnnnnnn-3′, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the antisense strand comprises 5′-nNfnnnNfnnnnnnnNfnNfnnnnnnn-3′, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnnnnnnnnn-3′, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the antisense strand comprises or consists of two 2′-fluoro modified nucleotides at positions 2 and 14, respectively. In some aspects, the antisense strand comprises or consists of three 2′-fluoro modified nucleotides at positions 2, 12, and 14, respectively. In some aspects, the antisense strand comprises or consists of three 2′-fluoro modified nucleotides at positions 2, 14, and 16, respectively. In some aspects, the antisense strand comprises or consists of four 2′-fluoro modified nucleotides at positions 2, 12, 14, and 16, respectively. In some aspects, the antisense strand comprises a 2′-fluoro modified nucleotide at position 6, 7, 8, or 9. In some aspects, the antisense strand comprises a 2′-fluoro modified nucleotide at position 4. In some aspects, the antisense strand does not contain a 2′-fluoro modified nucleotide at position 4.


In some aspects, the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the sense strand comprises 5′-nnnnnnNfnNfNfNfnnnnnnnnnn-3′, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the sense strand comprises 5′-nnnnnnnnNfNfNfnnnnnnnnnn-3′, wherein Nf stands for a 2′-fluoro modified nucleotide, and wherein n stands for a 2′-O-methyl modified nucleotide. In some aspects, the sense strand comprises or consists of two 2′-fluoro modified nucleotides at positions 9 and 11, respectively. In some aspects, the sense strand comprises or consists of three 2′-fluoro modified nucleotides at positions 7, 9 and 11, respectively. In some aspects, the sense strand comprises or consists of three 2′-fluoro modified nucleotides at positions 9, 10 and 11, respectively. In some aspects, the sense strand comprises or consists of four 2′-fluoro modified nucleotides at positions 7, 9, 10 and 11, respectively. In some aspects, the sense strand comprises a 2′-fluoro modified nucleotide at position 8, 12, or 16. In some aspects, the sense strand does not contain a 2′-fluoro modified nucleotide at position 8, 12, or 16.


In some aspects, described herein is a specific modification pattern for the polynucleic acid molecule which is a double-stranded nucleic acid molecule comprising a sense strand and an antisense strand. In some aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 2 from the 5′ end. In some aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 14 from the 5′ end. In some aspects, the antisense strand comprises 2′-fluoro modified nucleotides in positions 2 and 14 from the 5′ end. In some aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 12 from the 5′ end. In some aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 16 from the 5′ end. In other aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 6 from the 5′ end. In other aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 7 from the 5′ end. In other aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 8 from the 5′ end. In other aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 9 from the 5′ end. In other aspects, the antisense strand comprises a 2′-fluoro modified nucleotide in position 4 from the 5′ end.


In some aspects, described herein is a specific modification pattern for the polynucleic acid molecule which is a double-stranded nucleic acid molecule comprising a sense strand and an antisense strand. In some aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 9 from the 5′ end. In some aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 11 from the 5′ end. In some aspects, the sense strand comprises 2′-fluoro modified nucleotides in positions 9 and 11 from the 5′ end. In some aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 7 from the 5′ end. In some aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 10 from the 5′ end. In some aspects, the sense strand comprises 2′-fluoro modified nucleotides in positions 9, 11, and 7 from the 5′ end. the sense strand comprises 2′-fluoro modified nucleotides in positions 9 and 11, and 10 from the 5′ end. the sense strand comprises 2′-fluoro modified nucleotides in positions 9 and 7 from the 5′ end. the sense strand comprises 2′-fluoro modified nucleotides in positions 9 and 10 from the 5′ end. the sense strand comprises 2′-fluoro modified nucleotides in positions 9, 11, 7, and 10 from the 5′ end. In other aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 8 from the 5′ end. In other aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 12 from the 5′ end. In other aspects, the sense strand comprises a 2′-fluoro modified nucleotide in position 16 from the 5′ end.


In some aspects, the sense and antisense strand of the polynucleic acid molecule comprises any combination of two or more 2′-fluoro modified nucleotides at the positions described in the above two paragraphs.


In some aspects, the antisense strand comprises 5′-nNfnnnNfnNfNfnnnnNfnNfnnnnnnn-3′. In some aspects, the antisense strand comprises 5′-nNfnnnNfnnnnnnnNfnNfnnnnnnn-3′. In some aspects, the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnnnnnnnnn-3′. In the modification patterns described above, “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′. In some aspects, the sense strand comprises 5′-nnnnnnNfnNfNfNfnnnnnnnnnn-3′. In some aspects, the sense strand comprises 5′-nnnnnnnnNfNfNfnnnnnnnnnn-3′. In the modification patterns described above, “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern for the polynucleic acid molecule which is a double-stranded nucleic acid molecule comprising a sense strand and an antisense strand, wherein the sense strand comprises about twelve 2′-fluoro modified nucleotides and about nine 2′-O-methyl modified nucleotides, and wherein the antisense strand comprises about nine 2′-fluoro modified nucleotides and about fourteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand is fully modified and comprises twelve 2′-fluoro modified nucleotides, nine 2′-O-methyl modified nucleotides, and wherein the antisense strand is fully modified and comprises nine 2′-fluoro modified nucleotides and fourteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-NfnNfnNfnNfnNfNfNfnNfnNfnNfnNfnNf-3′, wherein the antisense strand comprises 5′-nNfnNfnNfnNfnNfnnnNfnNfnNfnNfnnn-3′, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-NfnNfnNfnNfnNfNfNfnNfnNfnNfnNfnNf-3′, wherein the antisense strand comprises 5′-nNfnNfnNfnNfnNfnnnNfnNfnNfnNfnnn-3′, wherein the sense and/or antisense strand comprises one or more phosphorothioate linkage, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide. In other aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-NfnNfnNfnNfnNfNfNfnNfnNfnNfnNfnNf-3′, wherein the antisense strand comprises 5′-nNfnNfnNfnNfnNfnnnNfnNfnNfnNfnnn-3′, wherein the sense comprises two phosphorothioate linkages, wherein the antisense comprises four phosphorothioate linkages, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand and/or antisense strand is modified as Type I in Table 8.









TABLE 8







Nucleotide Modification Patterns








Pattern Name
Pattern





Type I for sense strand
5′-NfsnsNfnNfnNfnNfNfNfnNfnNfnNfnNfnNf-3′


Type I for antisense strand
5′-nsNfsnNfnNfnNfnNfnnnNfnNfnNfnNfnsnsn-3′


Type II for sense strand
5′-nsnsnnnnNfnNfNfNfnnnnnnnnnn-3′


Type II for antisense strand
5′-nsNfsnnnNfnNfNfnnnnNfnNfnnnnnsnsn-3′


Type III for sense strand
5′-nsnsnnnnnnNfnNfnnnnnnnnnn-3′


Type III for antisense strand
5′-nsNfsnnnnnnnnnNfnNfnnnnnnnsnsn-3′


Type IV for sense strand
5′-nsnsnnnnNfnNfnNfnnnnnnnnnn-3′


Type IV for antisense strand
5′-nsNfsnnnnnnnnnNfnNfnNfnnnnnsnsn-3′


Type V for sense strand
5′-nsnsnnnnNfnNfnNfnnnnnnnnnn-3′


Type V for antisense strand
5′-_nsNfsnnnnNfnnnnNfnNfnNfnnnnnsnsn-3′


Type VI for sense strand
5′-nnnnnnNfnNfnNfnnnnnnnnnn-invdN-invdN-3′





Note:


“Nf” stands for a 2′-fluoro modified nucleotide, “n” stands for a 2′-O-methyl modified nucleotide, “s” stands for a 3′-phosphorothioate, “invdN” stands for an inverted deoxy-nucleotide.






In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence of SEQ ID NOs: 309-462, an antisense strand comprises a nucleic acid sequence of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in Type I modification pattern specified in Table 8.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises about four 2′-fluoro modified nucleotides and about seventeen 2′-O-methyl modified nucleotides, and wherein the antisense strand comprises about six 2′-fluoro modified nucleotides and about seventeen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand is fully modified and comprises four 2′-fluoro modified nucleotides, seventeen 2′-O-methyl modified nucleotides, and wherein the antisense strand is fully modified and comprises six 2′-fluoro modified nucleotides and seventeen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfNfNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnNfnNfNfnnnnNfnNfnnnnnnn-3′, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfNfNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnNfnNfNfnnnnNfnNfnnnnnnn-3′, wherein the sense and/or antisense strand comprises one or more phosphorothioate linkage, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide. In other aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfNfNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnNfnNfNfnnnnNfnNfnnnnnnn-3′, wherein the sense comprises two phosphorothioate linkages, wherein the antisense comprises four phosphorothioate linkages, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand and/or antisense strand is modified as Type II in Table 8.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence of SEQ ID NOs: 309-462, and/or an antisense strand comprising a nucleic acid sequence of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in Type II modification pattern specified in Table 8.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises about two 2′-fluoro modified nucleotides and about nineteen 2′-O-methyl modified nucleotides, and wherein the antisense strand comprises about three 2′-fluoro modified nucleotides and about twenty 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand is fully modified and comprises two 2′-fluoro modified nucleotides and nineteen 2′-O-methyl modified nucleotides, and wherein the antisense strand is fully modified and comprises three 2′-fluoro modified nucleotides and twenty 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnnnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnnnnnnNfnNfnnnnnnnnn-3′, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnnnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnnnnnnNfnNfnnnnnnnnn-3′, wherein the sense and/or antisense strand comprises one or more phosphorothioate linkage, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide. In other aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnnnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnnnnnnNfnNfnnnnnnnnn-3′, wherein the sense comprises two phosphorothioate linkages, wherein the antisense comprises four phosphorothioate linkages, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand and/or antisense strand is modified as Type III in Table 8.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence of SEQ ID NOs: 309-462, and/or an antisense strand comprising a nucleic acid sequence of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in Type III modification pattern specified in Table 8.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises about three 2′-fluoro modified nucleotides and about eighteen 2′-O-methyl modified nucleotides, and wherein the antisense strand comprises about four 2′-fluoro modified nucleotides and about nineteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand is fully modified and comprises three 2′-fluoro modified nucleotides, eighteen 2′-O-methyl modified nucleotides, and wherein the antisense strand is fully modified and comprises four 2′-fluoro modified nucleotides, nineteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnnnnnnNfnNfnNfnnnnnnn-3′, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnnnnnnNfnNfnNfnnnnnnn-3′, wherein the sense and/or antisense strand comprises one or more phosphorothioate linkage, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands fora 2′-O-methyl modified nucleotide. In other aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnnnnnnNfnNfnNfnnnnnnn-3′, wherein the sense comprises two phosphorothioate linkages, wherein the antisense comprises four phosphorothioate linkages, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand and/or antisense strand is modified as Type IV in Table 8.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence of SEQ ID NOs: 309-462, and/or an antisense strand comprising a nucleic acid sequence of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in Type IV modification pattern specified in Table 8.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises about three 2′-fluoro modified nucleotides and about eighteen 2′-O-methyl modified nucleotides, and wherein the antisense strand comprises about five 2′-fluoro modified nucleotides and about eighteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand is fully modified and comprises three 2′-fluoro modified nucleotides and eighteen 2′-O-methyl modified nucleotides, and wherein the antisense strand is fully modified and comprises five 2′-fluoro modified nucleotides, eighteen 2′-O-methyl modified nucleotides.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein the sense and/or antisense strand comprises one or more phosphorothioate linkage, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide. In other aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-_nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein the sense comprises two phosphorothioate linkages, wherein the antisense comprises four phosphorothioate linkages, wherein “Nf” stands for a 2′-fluoro modified nucleotide, and wherein “n” stands for a 2′-O-methyl modified nucleotide.


In some aspects, described herein is a specific modification pattern, wherein the sense strand and/or antisense strand is modified as Type V in Table 8.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence of SEQ ID NOs: 309-462, and/or an antisense strand comprising a nucleic acid sequence of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in Type V modification pattern specified in Table 8.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises about three 2′-fluoro modified nucleotides and about eighteen 2′-O-methyl modified nucleotides, with one or more inverted deoxy-nucleotides on the 3′ end as an overhang.


In some aspects, described herein is a specific modification pattern, wherein the sense strand is fully modified and comprises three 2′-fluoro modified nucleotides and eighteen 2′-O-methyl modified nucleotides, with two inverted deoxy-nucleotides on the 3′ end as an overhang.


In some aspects, described herein is a specific modification pattern, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-invdN-invdN-3′, wherein “Nf” stands fora 2′-fluoro modified nucleotide, wherein “n” stands for a 2′-O-methyl modified nucleotide, and “invdN” stands for an inverted deoxy-nucleotide. In some instances, the invdN is an inverted deoxyl-thymine. In some aspects, the linker conjugated with one or more targeting moieties as shown in Formula (IV″ or IV′″) is added to the first nucleic acid on the 5′ end. In some aspects, the linker conjugated with one or more GalNAc as shown in Formula (V″) or (V′″) is added to the first nucleic acid on the 5′ end. In some aspects, the modification pattern comprises one or more phosphorothioate linkages. In some aspects, the modification pattern is shown in Formula (VII). In some aspects, the 5′ end modification known in the art is applied to the one or more inverted nucleotides.




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wherein R is a moiety that corresponds to the sugar modification described herein, in some instances, R is —O-methyl; wherein R′ is thymine, abasic, or others; wherein A is —O or —S; and wherein A′ is —O or —S.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence of SEQ ID NOs: 309-462, and/or an antisense strand comprising a nucleic acid sequence of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in Type VI modification pattern specified in Table 8.


In some aspects, the polynucleotide molecule provided herein comprises a single-stranded nucleic acid comprising a nucleic acid sequence selected from one of SEQ ID NOs: 1-154. In some aspects, the polynucleotide molecule provided herein comprises a single-stranded nucleic acid that is complementary to a nucleic acid sequence selected from SEQ ID NOs: 309-462.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence selected from one of SEQ ID NOs: 309-462 and an antisense strand comprising a nucleic acid sequence selected from one of SEQ ID NOs: 1-154. In other aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence selected from one of SEQ ID NOs: 309-462, an antisense strand comprising a nucleic acid sequence selected from one of SEQ ID NOs: 1-154, and wherein the sense and/or antisense strand is modified in the modification pattern as described herein.


In some aspects, the polynucleotide molecule provided herein comprises a sense strand comprising a nucleic acid sequence selected from one of SEQ ID NOs: 463-616, and an antisense strand comprising a nucleic acid sequence selected from SEQ ID NOs: 155-308.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaggsusc (SEQ ID NO: 158) and a sense strand comprising the nucleotide sequence of cscsugccAfaGfcUfuggucaucua (SEQ ID NO: 466), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usAfsuagaUfgaccAfaGfcUfuggcasgsg (SEQ ID NO: 159) and a sense strand comprising the nucleotide sequence of usgsccaaGfcUfuGfgucaucuaua (SEQ ID NO: 467), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usCfsauagAfugacCfaAfgCfuuggcsasg (SEQ ID NO. 160) and a sense strand comprising the nucleotide sequence of gscscaagCfuUfgGfucaucuauga (SEQ ID NO: 468), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usCfsgacgGfcaguCfcCfuUfcugcgsusc (SEQ ID NO: 165) and a sense strand comprising the nucleotide sequence of csgscagaAfgGfgAfcugccgucga (SEQ ID NO: 473), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usUfscuagGfcuugGfaAfcCfggggusasa (SEQ ID NO: 172) and a sense strand comprising the nucleotide sequence of ascscccgGfuUfcCfaagccuagaa (SEQ ID NO: 480), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “1” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usAfsgccuCfuaggCfuUfgGfaaccgsgsg (SEQ ID NO: 175) and a sense strand comprising the nucleotide sequence of csgsguucCfaAfgCfcuagaggcua (SEQ ID NO: 483), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usUfsuaccGfugguAfgCfaCfuccugscsa (SEQ ID NO: 198) and a sense strand comprising the nucleotide sequence of csasggagUfgCfuAfccacgguaaa (SEQ ID NO: 506), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usUfsguccAfuuacCfgUfgGfuagcascsu (SEQ ID NO: 201) and a sense strand comprising the nucleotide sequence of usgscuacCfaCfgGfuaauggacaa (SEQ ID NO: 509), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usCfsucugUfccauUfaCfcGfugguasgsc (SEQ ID NO: 203) and a sense strand comprising the nucleotide sequence of usasccacGfgUfaAfuggacagaga (SEQ ID NO: 511), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “T” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usAfsuuguGfucagGfuUfgCfaguacsusc (SEQ ID NO: 214) and a sense strand comprising the nucleotide sequence of gsusacugCfaAfcCfugacacaaua (SEQ ID NO: 522), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usUfsgcguCfugagCfaUfuGfugucasgsg (SEQ ID NO: 218) and a sense strand comprising the nucleotide sequence of usgsacacAfaUfgCfucagacgcaa (SEQ ID NO: 526), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usUfsaacuCfugucCfaUfaAfugguasgsu (SEQ ID NO: 242) and a sense strand comprising the nucleotide sequence of usasccauUfaUfgGfacagaguuaa (SEQ ID NO: 550), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usCfscaagCfuuggCfaAfgUfucuucscsu (SEQ ID NO: 243) and a sense strand comprising the nucleotide sequence of gsasagaaCfuUfgCfcaagcuugga (SEQ ID NO: 551), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “C” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “T” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaagsusu (SEQ ID NO: 244) and a sense strand comprising the nucleotide sequence of csusugccAfaGfcUfuggucaucua (SEQ ID NO: 552), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a)(Lp(a)) gene, wherein polynucleic acid molecule an antisense strand comprising the nucleotide sequence of usGfsguccGfacuaUfgCfuGfgugugsgsu (SEQ ID NO: 252) and a sense strand comprising the nucleotide sequence of csascaccAfgCfaUfagucggacca (SEQ ID NO: 560), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a)(Lp(a)) gene, wherein polynucleic acid molecule an antisense strand comprising the nucleotide sequence of usAfsgccuCfuaggCfuUfgGfaaccgsgsg (SEQ ID NO: 175) and a sense strand comprising the nucleotide sequence of csgsguucCfaAfgCfcuagaggcua (SEQ ID NO: 483), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Further provided herein is a polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule an antisense strand comprising the nucleotide sequence of usAfsuuguGfucagGfuUfgCfaguacsusc (SEQ ID NO: 214) and a sense strand comprising the nucleotide sequence of gsusacugCfaAfcCfugacacaaua (SEQ ID NO: 522), wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.




















TABLE 1









Modified




Modified

Position




Unmodified
SEQ
Antisense
SEQ

Unmodified
SEQ
Sense
SEQ
at


Compd
siRNA
Antisense Sequence
ID
Sequence
ID
siRNA
Sense Sequence
ID
Sequence
ID
Human


ID
ID
(5′→3′)
NO.
(5′→3′)
NO.
ID
(5′→3′)
NO.
(5′→3′)
NO.
Transcript


























SRS-
G-
UCCAAGCUUGGCAGGUCCUUCCU
1

text missing or illegible when filed

155
P-
GAAGGACCUGCCAAGCUUGGA
309

text missing or illegible when filed

463
 198


000023
000023




000023










SRS-
G-
UACCAAGCUUGGCAGGUCCUUCC
2

text missing or illegible when filed

156
P-
AAGGACCUGCCAAGCUUGGUA
310

text missing or illegible when filed

464
 199


000024
000024




000024










SRS-
G-
UAUGACCAAGCUUGGCAGGUCCU
3

text missing or illegible when filed

157
P-
GACCUGCCAAGCUUGGUCAUA
311

text missing or illegible when filed

465
 202


000025
000025




000025










SRS-
G-
UAGAUGACCAAGCUUGGCAGGUC
4

text missing or illegible when filed

158
P-
CCUGCCAAGCUUGGUCAUCUA
312

text missing or illegible when filed

466
 204


000026
000008




000026










SRS-
G
UAUAGAUGACCAAGCUUGGCAGG
5

text missing or illegible when filed

159
P-
UGCCAAGCUUGGUCAUCUAUA
313

text missing or illegible when filed

467
 206


000027
000009




000027










SRS-
G-
UCAUAGAUGACCAAGCUUGGCAG
6

text missing or illegible when filed

160
P-
GCCAAGCUUGGUCAUCUAUGA
314

text missing or illegible when filed

468
 207


000028
000010




000028










SRS-
G-
UAUCAAGCCAGCAUUUGGGUAGU
7

text missing or illegible when filed

161
P-
UACCCAAAUGCUGGCUUGAUA
315

text missing or illegible when filed

469
 260


000029
000026




000029










SRS-
G-
UGUCCCUUCUGCGUCUGAGCAUU
8

text missing or illegible when filed

162
P-
UGCUCAGACGCAGAAGGGACA
316

text missing or illegible when filed

470
 374


000030
000027




000030










SRS-
G-
UCGGCAGUCCCCUCUGCGUCUGA
9

text missing or illegible when filed

163
P-
AGACGCAGAAGGGACUGCCGA
317

text missing or illegible when filed

471
 379


000031
000028




000031










SRS-
G-
UGACGGCAGUCCCUUCUGCGUCU
10

text missing or illegible when filed

164
P-
ACGCAGAAGGGACUGCCGUCA
318

text missing or illegible when filed

472
 381


000032
000029




000032










SRS-
G-
UCGACGGCAGUCCCUUCUGCGUC
11

text missing or illegible when filed

165
P-
CGCAGAAGGGACUGCCGUCGA
319

text missing or illegible when filed

473
 382


000033
000011




000033










SRS-
G-
UGCGACGGCAGUCCCUUCUGCGU
12

text missing or illegible when filed

166
P-
GCAGAAGGGACUGCCGUCGCA
320

text missing or illegible when filed

474
 383


000034
000030




000034










SRS-
G-
UGAACCGGGGUAACAGUCGGAGG
13

text missing or illegible when filed

167
P-
UCCGACUGUUACCCCGGUUCA
321

text missing or illegible when filed

475
 406


000035
000031




000035










SRS-
G-
UGGAACCGGGGUAACAGUCGGAG
14

text missing or illegible when filed

168
P-
CCGACUGUUACCCCGGUUCCA
322

text missing or illegible when filed

476
 407


000036
000032




000036










SRS-
G-
UUGGAACCGGGGUAACAGUCGGA
15

text missing or illegible when filed

169
P-
CGACUGUUACCCCGGUUCCAA
323

text missing or illegible when filed

477
 408


000037
000033




000037










SRS-
G-
UGCUUGGAACCGGGGUAACAGUC
16

text missing or illegible when filed

170
P-
CUGUUACCCCGGUUCCAAGCA
324

text missing or illegible when filed

478
 411


000038
000034




000038










SRS-
G-
UGGCUUGGAACCGGGGUAACAGU
17

text missing or illegible when filed

171
P-
UGUUACCCCGGUUCCAAGCCA
325

text missing or illegible when filed

479
 412


000039
000035




000039










SRS-
G-
UUCUAGGCUUGGAACCGGGGUAA
18

text missing or illegible when filed

172
P-
ACCCCGGUUCCAAGCCUAGAA
326

text missing or illegible when filed

480
 416


000040
000012




000040










SRS-
G-
UCUCUAGGCUUGGAACCGGGGUA
19

text missing or illegible when filed

173
P-
CCCCGGUUCCAAGCCUAGAGA
327

text missing or illegible when filed

481
 417


000041
000036




000041










SRS-
G-
UGCCUCUAGGCUUGGAACCGGGG
20

text missing or illegible when filed

174
P-
CCGGUUCCAAGCCUAGAGGCA
328

text missing or illegible when filed

482
 419


000042
000037




000042










SRS-
G-
UAGCCUCUAGGCUUGGAACCGGG
21

text missing or illegible when filed

175
P-
CGGUUCCAAGCCUAGAGGCUA
329

text missing or illegible when filed

483
 420


000043
000013




000043










SRS-
G-
UGAGCCUCUAGGCUUGGAACCGG
22

text missing or illegible when filed

176
P-
GGUUCCAAGCCUAGAGGCUCA
330

text missing or illegible when filed

484
 423


000044
000038




000044










SRS-
G-
UGAAGGAGCCUCUAGGCUUGGAA
23

text missing or illegible when filed

177
P-
CCAAGCCUAGAGGCUCCUUCA
331

text missing or illegible when filed

485
 425


000045
000039




000045










SRS-
G-
UCGGAAGGAGCCUCUAGGCUUGG
24

text missing or illegible when filed

178
P-
AAGCCUAGAGGCUCCUUCCGA
332

text missing or illegible when filed

486
 427


000046
000040




000046










SRS-
G-
UGUUCGGAAGGAGCCUCUAGGCU
25

text missing or illegible when filed

179
P-
CCUAGAGGCUCCUUCCGAACA
333

text missing or illegible when filed

487
 430


000047
000041




000047










SRS-
G-
UUGCUUGUUCGGAAGGAGCCUCU
26

text missing or illegible when filed

180
P-
AGGCUCCUUCCGAACAAGCAA
334

text missing or illegible when filed

488
 435


000048
000042




000048










SRS-
G-
UGUGCUUGUUCGGAAGGAGCCUC
27

text missing or illegible when filed

181
P-
GGCUCCUUCCGAACAAGCACA
335

text missing or illegible when filed

489
 436


000049
000043




000049










SRS-
G-
UCGGUGCUUGUUCGGAAGGAGCC
28

text missing or illegible when filed

182
P-
CUCCUUCCGAACAAGCACCGA
336

text missing or illegible when filed

490
 438


000050
000044




000050










SRS-
G-
UUCGGUGCUUGUUCGGAAGGAGC
29

text missing or illegible when filed

183
P-
UCCUUCCGAACAAGCACCGAA
337

text missing or illegible when filed

491
 439


000051
000045




000051










SRS-
G-
UCAGUCGGUGCUUGUUCGGAAGG
30

text missing or illegible when filed

184
P-
UUCCGAACAAGCACCGACUGA
338

text missing or illegible when filed

492
 442


000052
000046




000052










SRS-
G-
UUGCUCAGUCGGUGCUUGUUCGG
31

text missing or illegible when filed

185
P-
GAACAAGCACCGACUGAGCAA
339

text missing or illegible when filed

493
 446


000053
000047




000053










SRS-
G-
UUAGCACUCCUGCACCCCAGGCC
32

text missing or illegible when filed

186
P-
CCUGGGGUGCAGGAGUGCUAA
340

text missing or illegible when filed

494
 470


000054
000048




000054










SRS-
G-
UGUAGCACUCCUGCACCCCAGGC
33

text missing or illegible when filed

187
P-
CUGGGGUGCAGGAGUGCUACA
341

text missing or illegible when filed

495
 471


000055
000049




000055










SRS-
G-
UGAUAACUCUGUCCAUUACCAUG
34

text missing or illegible when filed

188
P-
UGGUAAUGGACAGAGUUAUCA
342

text missing or illegible when filed

496
 493


000056
000050




000056










SRS-
G-
UCGAUAACUCUGUCCAUUACCAU
35

text missing or illegible when filed

189
P-
GGUAAUGGACAGAGUUAUCGA
343

text missing or illegible when filed

497
 494


000057
000051




000057










SRS-
G-
UUAUGUGCCUCGAUAACUCUGUC
36

text missing or illegible when filed

190
P-
CAGAGUUAUCGAGGCACAUAA
344

text missing or illegible when filed

498
 503


000058
000052




000058










SRS-
G-
UGUAUGUGCCUCGAUAACUCUGU
37

text missing or illegible when filed

191
P-
AGAGUUAUCGAGGCACAUACA
345

text missing or illegible when filed

499
 504


000059
000053




000059










SRS-
G-
UAGUAUGUGCCUCGAUAACUCUG
38

text missing or illegible when filed

192
P-
GAGUUAUCGAGGCACAUACUA
346

text missing or illegible when filed

500
 505


000060
000054




000060










SRS-
G-
UACAGUGGUGGAGUAUGUGCCUC
39

text missing or illegible when filed

193
P-
GGCACAUACUCCACCACUGUA
347

text missing or illegible when filed

501
 515


000061
000055




000061










SRS-
G-
UACCAAGCUUGGCAGGUUCUUCC
40

text missing or illegible when filed

194
P-
AAGAACCUGCCAAGCUUGGUA
348

text missing or illegible when filed

502
 541


000062
000056




000062










SRS-
G-
UAUGACCAAGCUUGGCAGGUUCU
41

text missing or illegible when filed

195
P-
AACCUGCCAAGCUUGGUCAUA
349

text missing or illegible when filed

503
 544


000063
000057




000063










SRS-
G-
UAGAUGACCAAGCUUGGCAGGUU
42

text missing or illegible when filed

196
P-
CCUGCCAAGCUUGGUCAUCUA
350

text missing or illegible when filed

504
 546


000064
000058




000064










SRS-
G-
UUACCGUGGUAGCACUCCUGCAC
43

text missing or illegible when filed

197
P-
GCAGGAGUGCUACCACGGUAA
351

text missing or illegible when filed

505
1162


000065
000059




000065










SRS-
G-
UUUACCGUGGUAGCACUCCUGCA
44

text missing or illegible when filed

198
P-
CAGGAGUGCUACCACGGUAAA
352

text missing or illegible when filed

506
1163


000066
000014




000066










SRS-
G-
UCAUUACCGUGGUAGCACUCCUG
45

text missing or illegible when filed

199
P-
GGAGUGCUACCACGGUAAUGA
353

text missing or illegible when filed

507
1165


000067
000060




000067










SRS-
G-
UGUCCAUUACCGUGGUAGCACUC
46

text missing or illegible when filed

200
P-
GUGCUACCACGGUAAUGGACA
354

text missing or illegible when filed

508
1168


000068
000061




000068










SRS-
G-
UUGUCCAUUACCGUGGUAGCACU
47

text missing or illegible when filed

201
P-
UGCUACCACGGUAAUGGACAA
355

text missing or illegible when filed

509
1169


000069
000015




000069










SRS-
G-
UUCUGUCCAUUACCGUGGUAGCA
48

text missing or illegible when filed

202
P-
CUACCACGGUAAUGGACAGAA
356

text missing or illegible when filed

510
1171


000070
000062




000070










SRS-
G-
UCUCUGUCCAUUACCGUGGUAGC
49

text missing or illegible when filed

203
P-
UACCACGGUAAUGGACAGAGA
357

text missing or illegible when filed

511
1172


000071
000016




000071










SRS-
G-
UAACUCUGUCCAUUACCGUGGUA
50

text missing or illegible when filed

204
P-
CCACGGUAAUGGACAGAGUUA
358

text missing or illegible when filed

512
1174


000072
000063




000072










SRS-
G-
UGAUAACUCUGUCCAUUACCGUG
51

text missing or illegible when filed

205
P-
CGGUAAUGGACAGAGUUAUCA
359

text missing or illegible when filed

513
1177


000073
000064




000073










SRS-
G-
UCGAUAACUCUGUCCAUUACCGU
52

text missing or illegible when filed

206
P-
GGUAAUGGACAGAGUUAUCGA
360

text missing or illegible when filed

514
1178


000074
000065




000074










SRS-
G-
UACAGGAUCUGGAUUCCUGCAGU
53

text missing or illegible when filed

207
P-
UGCAGGAAUCCAGAUCCUGUA
361

text missing or illegible when filed

515
2684


000075
000066




000075










SRS-
G-
UAAUAAGGGGCUGCCACAGGAUC
54

text missing or illegible when filed

208
P-
UCCUGUGGCAGCCCCUUAUUA
362

text missing or illegible when filed

516
2698


000076
000067




000076










SRS-
G-
UAACAAUAAGGGGCUGCCACAGG
55

text missing or illegible when filed

209
P-
UGUGGCAGCCCCUUAUUGUUA
363

text missing or illegible when filed

517
2701


000077
000068




000077










SRS-
G-
UGUAUAACAAUAAGGGGCUGCCA
56

text missing or illegible when filed

210
P-
GCAGCCCCUUAUUGUUAUACA
364

text missing or illegible when filed

518
2705


000078
000069




000078










SRS-
G-
UCGUAUAACAAUAAGGGGCUGCC
57

text missing or illegible when filed

211
P-
CAGCCCCUUAUUGUUAUACGA
365

text missing or illegible when filed

519
2706


000079
000070




000079










SRS-
G-
UUCGUAUAACAAUAAGGGGCUGC
58

text missing or illegible when filed

212
P-
AGCCCCUUAUUGUUAUACGAA
366

text missing or illegible when filed

520
2707


000080
000071




000080










SRS-
G-
UUGUGUCAGGUUGCAGUACUCCC
59

text missing or illegible when filed

213
P-
GAGUACUGCAACCUGACACAA
367

text missing or illegible when filed

521
2747


000081
000072




000081










SRS-
G-
UAUUGUGUCAGGUUGCAGUACUC
60

text missing or illegible when filed

214
P-
GUACUGCAACCUGACACAAUA
368

text missing or illegible when filed

522
2749


000082
000017




000082










SRS-
G-
UGCAUUGUGUCAGGUUGCAGUAC
61

text missing or illegible when filed

215
P-
ACUGCAACCUGACACAAUGCA
369

text missing or illegible when filed

523
2751


000083
000073




000083










SRS-
G-
UGAGCAUUGUGUCAGGUUGCAGU
62

text missing or illegible when filed

216
P-
UGCAACCUGACACAAUGCUCA
370

text missing or illegible when filed

524
2753


000084
000074




000084










SRS-
G-
UUGAGCAUUGUGUCAGGUUGCAG
63

text missing or illegible when filed

217
P-
GCAACCUGACACAAUGCUCAA
371

text missing or illegible when filed

525
2754


000085
000075




000085










SRS-
G
UUGCGUCUGAGCAUUGUGUCAGG
64

text missing or illegible when filed

218
P-
UGACACAAUGCUCAGACGCAA
372

text missing or illegible when filed

526
2760


000086
000018




000086










SRS-
G-
UUCUGCGUCUGAGCAUUGUGUCA
65

text missing or illegible when filed

219
P-
ACACAAUGCUCAGACGCAGAA
373

text missing or illegible when filed

527
2762


000087
000076




000087










SRS-
G-
UCUUCUGCGUCUGAGCAUUGUGU
66

text missing or illegible when filed

220
P-
ACAAUGCUCAGACGCAGAAGA
374

text missing or illegible when filed

528
2764


000088
000077




000088










SRS-
G-
UGAGCCUCUAGGCUUGGAAUCGG
67

text missing or illegible when filed

221
P-
GAUUCCAAGCCUAGAGGCUCA
375

text missing or illegible when filed

529
2815


000089
000078




000089










SRS-
G-
UUUCAGAAGGAGCCUCUAGGCUU
68

text missing or illegible when filed

222
P-
GCCUAGAGGCUCCUUCUGAAA
376

text missing or illegible when filed

530
2823


000090
000079




000090










SRS-
G-
UUUGCUCAGUUGGUGCUUGUUCA
69

text missing or illegible when filed

223
P-
AACAAGCACCAACUGAGCAAA
377

text missing or illegible when filed

531
2841


000091
000080




000091










SRS-
G-
UCUUUGCUCAGUUGGUGCUUGUU
70

text missing or illegible when filed

224
P-
CAAGCACCAACUGAGCAAAGA
378

text missing or illegible when filed

532
2843


000092
000081




000092










SRS-
G-
UGUGCCCUGAUAACUCUGUCCAU
71

text missing or illegible when filed

225
P-
GGACAGAGUUAUCAAGGCACA
379

text missing or illegible when filed

533
2894


000093
000082




000093










SRS-
G-
UGGAUCUGGAUUUCGGCAGUAGU
72

text missing or illegible when filed

226
P-
UACUGCCGAAAUCCAGAUCCA
380

text missing or illegible when filed

534
3023


000094
000083




000094










SRS-
G-
UUAACACCAAGGGGCUGCCACAG
73

text missing or illegible when filed

227
P-
GUGGCAGCCCCUUGGUGUUAA
381

text missing or illegible when filed

535
3044


000095
000084




000095










SRS-
G-
UGUAUAACACCAAGGGGCUGCCA
74

text missing or illegible when filed

228
P-
GCAGCCCCUUGGUGUUAUACA
382

text missing or illegible when filed

536
3047


000096
000085




000096










SRS-
G-
UUUGUAUAACACCAAGGGGCUGC
75

text missing or illegible when filed

229
P-
AGCCCCUUGGUGUUAUACAAA
383

text missing or illegible when filed

537
3049


000097
000086




000097










SRS-
G-
UGUUGUAUAACACCAAGGGGCUG
76

text missing or illegible when filed

230
P-
GCCCCUUGGUGUUAUACAACA
384

text missing or illegible when filed

538
3050


000098
000087




000098










SRS
G
UUCGUGUCAGGUUGCAGUACUCC
77

text missing or illegible when filed

231
P-
AGUACUGCAACCUGACACGAA
385

text missing or illegible when filed

539
3090


000099
000088




000099










SRS-
G-
UAGCAUCGUGUCAGGUUGCAGUA
78

text missing or illegible when filed

232
P-
CUGCAACCUGACACGAUGCUA
386

text missing or illegible when filed

540
3094


000100
000089




000100










SRS-
G-
UGAGCAUCGUGUCAGGUUGCAGU
79

text missing or illegible when filed

233
P-
UGCAACCUGACACGAUGCUCA
387

text missing or illegible when filed

541
3095


000101
000090




000101










SRS-
G-
UUGAGCAUCGUGUCAGGUUGCAG
80

text missing or illegible when filed

234
P-
GCAACCUGACACGAUGCUCAA
388

text missing or illegible when filed

542
3096


000102
000091




000102










SRS-
G-
UUCUGAGCAUCGUGUCAGGUUGC
81

text missing or illegible when filed

235
P-
AACCUGACACGAUGCUCAGAA
389

text missing or illegible when filed

543
3098


000103
000092




000103










SRS-
G
UAAAGCCUCUAGGCUUGGAGCCA
82

text missing or illegible when filed

236
P-
GCUCCAAGCCUAGAGGCUUUA
390

text missing or illegible when filed

544
3158


000104
000093




000104










SRS-
G-
UCCAUAAUGGUAGUAGCAGUCCU
83

text missing or illegible when filed

237
P-
GACUGCUACUACCAUUAUGGA
391

text missing or illegible when filed

545
3218


000105
000094




000105










SRS-
G-
UUCCAUAAUGGUAGUAGCAGUCC
84

text missing or illegible when filed

238
P-
ACUGCUACUACCAUUAUGGAA
392

text missing or illegible when filed

546
3219


000106
000095




000106










SRS-
G-
UGUCCAUAAUGGUAGUAGCAGUC
85

text missing or illegible when filed

239
P-
CUGCUACUACCAUUAUGGACA
393

text missing or illegible when filed

547
3220


000107
000096




000107










SRS-
G-
UUCUGUCCAUAAUGGUAGUAGCA
86

text missing or illegible when filed

240
P-
CUACUACCAUUAUGGACAGAA
394

text missing or illegible when filed

548
3223


000108
000097




000108










SRS-
G-
UAACUCUGUCCAUAAUGGUAGUA
87

text missing or illegible when filed

241
P-
CUACCAUUAUGGACAGAGUUA
395

text missing or illegible when filed

549
3226


000109
000098




000109










SRS-
G-
UUAACUCUGUCCAUAAUGGUAGU
88

text missing or illegible when filed

242
P-
UACCAUUAUGGACAGAGUUAA
396

text missing or illegible when filed

550
3227


000110
000019




000110










SRS-
G-
UCCAAGCUUGGCAAGUUCUUCCU
89

text missing or illegible when filed

243
P-
GAAGAACUUGCCAAGCUUGGA
397

text missing or illegible when filed

551
3276


000111
000020




000111










SRS-
G-
UAGAUGACCAAGCUUGGCAAGUU
90

text missing or illegible when filed

244
P-
CUUGCCAAGCUUGGUCAUCUA
398

text missing or illegible when filed

552
3282


000112
000021




000112










SRS-
G-
UAUAGAUGACCAAGCUUGGCAAG
91

text missing or illegible when filed

245
P-
UGCCAAGCUUGGUCAUCUAUA
399

text missing or illegible when filed

553
3284


000113
000099




000113










SRS-
G-
UCAUAGAUGACCAAGCUUGGCAA
92

text missing or illegible when filed

246
P-
GCCAAGCUUGGUCAUCUAUGA
400

text missing or illegible when filed

554
3285


000114
000100




000114










SRS-
G-
UACUAUGCUGGUGUGGUGUCAUA
93

text missing or illegible when filed

247
P-
UGACACCACACCAGCAUAGUA
401

text missing or illegible when filed

555
3303


000115
000101




000115










SRS-
G-
UGACUAUGCUGGUGUGGUGUCAU
94

text missing or illegible when filed

248
P-
GACACCACACCAGCAUAGUCA
402

text missing or illegible when filed

556
3304


000116
000102




000116










SRS-
G-
UCGACUAUGCUGGUGUGGUGUCA
95

text missing or illegible when filed

249
P-
ACACCACACCAGCAUAGUCGA
403

text missing or illegible when filed

557
3305


000117
000103




000117










SRS-
G-
UUCCGACUAUGCUGGUGUGGUGU
96

text missing or illegible when filed

250
P-
ACCACACCAGCAUAGUCGGAA
404

text missing or illegible when filed

558
3307


000118
000104




000118










SRS-
G-
UGUCCGACUAUGCUGGUGUGGUG
97

text missing or illegible when filed

251
P-
CCACACCAGCAUAGUCGGACA
405

text missing or illegible when filed

559
3308


000119
000105




000119










SRS-
G-
UGGUCCGACUAUGCUGGUGUGGU
98

text missing or illegible when filed

252
P-
CACACCAGCAUAGUCGGACCA
406

text missing or illegible when filed

560
3309


000120
000022




000120










SRS-
G-
UUUUCUGGGGUCCGACUAUGCUG
99

text missing or illegible when filed

253
P-
GCAUAGUCGGACCCCAGAAAA
407

text missing or illegible when filed

561
3316


000121
000106




000121










SRS-
G-
UUUUUCUGGGGUCCGACUAUGCU
100

text missing or illegible when filed

254
P-
CAUAGUCGGACCCCAGAAAAA
408

text missing or illegible when filed

562
3317


000122
000107




000122










SRS-
G-
UUAGUUUUCUGGGGUCCGACUAU
101

text missing or illegible when filed

255
P-
AGUCGGACCCCAGAAAACUAA
409

text missing or illegible when filed

563
3320


000123
000108




000123










SRS-
G-
UAUCCAUGGUGUAACACCAAGGG
102

text missing or illegible when filed

256
P-
CUUGGUGUUACACCAUGGAUA
410

text missing or illegible when filed

564
3396


000124
000109




000124










SRS-
G-
UGAUCCAUGGUGUAACACCAAGG
103

text missing or illegible when filed

257
P-
UUGGUGUUACACCAUGGAUCA
411

text missing or illegible when filed

565
3397


000125
000110




000125










SRS-
G-
UGGAUCCAUGGUGUAACACCAAG
104

text missing or illegible when filed

258
P-
UGGUGUUACACCAUGGAUCCA
412

text missing or illegible when filed

566
3398


000126
000111




000126










SRS-
G-
UGGGAUCCAUGGUGUAACACCAA
105

text missing or illegible when filed

259
P-
GGUGUUACACCAUGGAUCCCA
413

text missing or illegible when filed

567
3399


000127
000112




000127










SRS-
G-
UUGACACUGGGAUCCAUGGUGUA
106

text missing or illegible when filed

260
P-
CACCAUGGAUCCCAGUGUCAA
414

text missing or illegible when filed

568
3406


000128
000113




000128










SRS-
G-
UCUGACACUGGGAUCCAUGGUGU
107

text missing or illegible when filed

261
P-
ACCAUGGAUCCCAGUGUCAGA
415

text missing or illegible when filed

569
3407


000129
000114




000129










SRS-
G-
UGUUGCAAGGACACUUGAUUCUG
108

text missing or illegible when filed

262
P-
GAAUCAAGUGUCCUUGCAACA
416

text missing or illegible when filed

570
3464


000130
000115




000130










SRS-
G-
UCAUGGUAUAACACCAAGGACUA
109

text missing or illegible when filed

263
P-
GUCCUUGGUGUUAUACCAUGA
417

text missing or illegible when filed

571
3735


000131
000116




000131










SRS-
G-
UUCCAUGGUAUAACACCAAGGAC
110

text missing or illegible when filed

264
P-
CCUUGGUGUUAUACCAUGGAA
418

text missing or illegible when filed

572
3737


000132
000117




000132










SRS-
G-
UAUCCAUGGUAUAACACCAAGGA
111

text missing or illegible when filed

265
P-
CUUGGUGUUAUACCAUGGAUA
419

text missing or illegible when filed

573
3738


000133
000118




000133










SRS-
G-
UGGGAUCCAUGGUAUAACACCAA
112

text missing or illegible when filed

266
P-
GGUGUUAUACCAUGGAUCCCA
420

text missing or illegible when filed

574
3741


000134
000119




000134










SRS-
G-
UGACAUUGUGUCAGGUUGCAGUA
113

text missing or illegible when filed

267
P-
CUGCAACCUGACACAAUGUCA
421

text missing or illegible when filed

575
3778


000135
000120




000135










SRS-
G-
UGGACAUUGUGUCAGGUUGCAGU
114

text missing or illegible when filed

268
P-
UGCAACCUGACACAAUGUCCA
422

text missing or illegible when filed

576
3779


000136
000121




000136










SRS-
G-
UUGGACAUUGUGUCAGGUUGCAG
115

text missing or illegible when filed

269
P-
GCAACCUGACACAAUGUCCAA
423

text missing or illegible when filed

577
3780


000137
000122




000137










SRS-
G-
UCACUGGACAUUGUGUCAGGUUG
116

text missing or illegible when filed

270
P-
ACCUGACACAAUGUCCAGUGA
424

text missing or illegible when filed

578
3783


000138
000123




000138










SRS-
G-
UAUUCUGUCACUGGACAUUGUGU
117

text missing or illegible when filed

271
P-
ACAAUGUCCAGUGACAGAAUA
425

text missing or illegible when filed

579
3790


000139
000124




000139










SRS-
G-
UCACCAUUUGGGUAGUAUUCUGU
118

text missing or illegible when filed

272
P-
AGAAUACUACCCAAAUGGUGA
426

text missing or illegible when filed

580
3991


000140
000125




000140










SRS-
G-
UGUAUAACACCAAGGGCGAAUCU
119

text missing or illegible when filed

273
P-
AUUCGCCCUUGGUGUUAUACA
427

text missing or illegible when filed

581
4049


000141
000126




000141










SRS-
G-
UCAUGGUAUAACACCAAGGGCGA
120

text missing or illegible when filed

274
P-
GCCCUUGGUGUUAUACCAUGA
428

text missing or illegible when filed

582
4053


000142
000127




000142










SRS-
G-
UUCCAUGGUAUAACACCAAGGGC
121

text missing or illegible when filed

275
P-
CCUUGGUGUUAUACCAUGGAA
429

text missing or illegible when filed

583
4055


000143
000128




000143










SRS-
G-
UAUCCAUGGUAUAACACCAAGGG
122

text missing or illegible when filed

276
P-
CUUGGUGUUAUACCAUGGAUA
430

text missing or illegible when filed

584
4056


000144
000129




000144










SRS-
G-
UUGACACUGGGAUCCAUGGUAUA
123

text missing or illegible when filed

277
P-
UACCAUGGAUCCCAGUGUCAA
431

text missing or illegible when filed

585
4066


000145
000130




000145










SRS-
G-
UCUGACACUGGGAUCCAUGGUAU
124

text missing or illegible when filed

278
P-
ACCAUGGAUCCCAGUGUCAGA
432

text missing or illegible when filed

586
4067


000146
000131




000146










SRS-
G-
UGGACCACCGUGGGAGUUGUGAG
125

text missing or illegible when filed

279
P-
CACAACUCCCACGGUGGUCCA
433

text missing or illegible when filed

587
4138


000147
000132




000147










SRS-
G-
UGGGACCACCGUGGGAGUUGUGA
126

text missing or illegible when filed

280
P-
ACAACUCCCACGGUGGUCCCA
434

text missing or illegible when filed

588
4139


000148
000133




000148










SRS-
G-
UUGCUUGGAACUGGGACCACCGU
127

text missing or illegible when filed

281
P-
GGUGGUCCCAGUUCCAAGCAA
435

text missing or illegible when filed

589
4150


000149
000134




000149










SRS-
G-
UAUUCUGUCACUGGACAUCGUGU
128

text missing or illegible when filed

282
P-
ACGAUGUCCAGUGACAGAAUA
436

text missing or illegible when filed

590
4450


000150
000135




000150










SRS-
G-
UGAUGCCAGUGUGGUAUCAUAGA
129

text missing or illegible when filed

283
P-
UAUGAUACCACACUGGCAUCA
437

text missing or illegible when filed

591
4645


000151
000136




000151










SRS-
G-
UUGAUGCCAGUGUGGUAUCAUAG
130

text missing or illegible when filed

284
P-
AUGAUACCACACUGGCAUCAA
438

text missing or illegible when filed

592
4646


000152
000137




000152










SRS-
G-
UGUGUAACACCAGGGUUGUUUCC
131

text missing or illegible when filed

285
P-
AAACAACCCUGGUGUUACACA
439

text missing or illegible when filed

593
4733


000153
000138




000153










SRS-
G-
UAGGACACCUGAUUCUGUUUCUG
132

text missing or illegible when filed

286
P-
GAAACAGAAUCAGGUGUCCUA
440

text missing or illegible when filed

594
4802


000154
000139




000154










SRS-
G-
UUAGGACACCUGAUUCUGUUUCU
133

text missing or illegible when filed

287
P-
AAACAGAAUCAGGUGUCCUAA
441

text missing or illegible when filed

595
4803


000155
000140




000155










SRS-
G-
UUCUAGGACACCUGAUUCUGUUU
134

text missing or illegible when filed

288
P-
ACAGAAUCAGGUGUCCUAGAA
442

text missing or illegible when filed

596
4805


000156
000141




000156










SRS-
G-
UCUCUAGGACACCUGAUUCUGUU
135

text missing or illegible when filed

289
P-
CAGAAUCAGGUGUCCUAGAGA
443

text missing or illegible when filed

597
4806


000157
000142




000157










SRS-
G-
UGUCUCUAGGACACCUGAUUCUG
136

text missing or illegible when filed

290
P-
GAAUCAGGUGUCCUAGAGACA
444

text missing or illegible when filed

598
4808


000158
000143




000158










SRS-
G-
UGGGAGUCUCUAGGACACCUGAU
137

text missing or illegible when filed

291
P-
CAGGUGUCCUAGAGACUCCCA
445

text missing or illegible when filed

599
4812


000159
000144




000159










SRS-
G-
UGGAACAACAGUGGGAGUCUCUA
138

text missing or illegible when filed

292
P-
GAGACUCCCACUGUUGUUCCA
446

text missing or illegible when filed

600
4823


000160
000145




000160










SRS-
G-
UGAAUGUGCCUCGAUAACUCUGG
139

text missing or illegible when filed

293
P-
AGAGUUAUCGAGGCACAUUCA
447

text missing or illegible when filed

601
4926


000161
000146




000161










SRS-
G-
UUGGAUGACCAAGAUUGACAUGU
140

text missing or illegible when filed

294
P-
AUGUCAAUCUUGGUCAUCCAA
448

text missing or illegible when filed

602
4969


000162
000147




000162










SRS-
G-
UAUGGAUGACCAAGAUUGACAUG
141

text missing or illegible when filed

295
P-
UGUCAAUCUUGGUCAUCCAUA
449

text missing or illegible when filed

603
4970


000163
000148




000163










SRS-
G-
UAAAACACCAAGGGOCUGUAUCG
142

text missing or illegible when filed

296
P-
AUACAGGCCCUUGGUGUUUUA
450

text missing or illegible when filed

604
5073


000164
000149




000164










SRS-
G-
UGCAUCGCGUCAGGUUGCAGUAC
143

text missing or illegible when filed

297
P-
ACUGCAACCUGACGCGAUGCA
451

text missing or illegible when filed

605
5121


000165
000150




000165










SRS-
G-
UAGCAUCGCGUCAGGUUGCAGUA
144

text missing or illegible when filed

298
P-
CUGCAACCUGACGCGAUGCUA
452

text missing or illegible when filed

606
5122


000166
000151




000166










SRS-
G-
UGAGCAUCGCGUCAGGUUGCAGU
145

text missing or illegible when filed

299
P-
UGCAACCUGACGCGAUGCUCA
453

text missing or illegible when filed

607
5123


000167
000152




000167










SRS-
G
UUGAGCAUCGCGUCAGGUUGCAG
146

text missing or illegible when filed

300
P-
GCAACCUGACGCGAUGCUCAA
454

text missing or illegible when filed

608
5124


000168
000153




000168










SRS-
G-
UUCUGAGCAUCGCGUCAGGUUGC
147

text missing or illegible when filed

301
P-
AACCUGACGCGAUGCUCAGAA
455

text missing or illegible when filed

609
5126


000169
000154




000169










SRS-
G-
UGUCUGAGCAUCGCGUCAGGUUG
148

text missing or illegible when filed

302
P-
ACCUGACGCGAUGCUCAGACA
456

text missing or illegible when filed

610
5127


000170
000155




000170










SRS-
G-
UUGUCUGAGCAUCGCGUCAGGUU
149

text missing or illegible when filed

303
P-
CCUGACGCGAUGCUCAGACAA
457

text missing or illegible when filed

611
5128


000171
000156




000171










SRS-
G-
UGUGUCUGAGCAUCGCGUCAGGU
150

text missing or illegible when filed

304
P-
CUGACGCGAUGCUCAGACACA
458

text missing or illegible when filed

612
5129


000172
000157




000172










SRS-
G-
UUGUGUCUGAGCAUCGCGUCAGG
151

text missing or illegible when filed

305
P-
UGACGCGAUGCUCAGACACAA
459

text missing or illegible when filed

613
5130


000173
000158




000173










SRS-
G-
UUCUGUGUCUGAGCAUCGCGUCA
152

text missing or illegible when filed

306
P-
ACGCGAUGCUCAGACACAGAA
460

text missing or illegible when filed

614
5132


000174
000159




000174










SRS-
G-
UUACAAUGCUUCCAGGACAUUUC
153

text missing or illegible when filed

307
P-
AAUGUCCUGGAAGCAUUGUAA
461

text missing or illegible when filed

615
5505


000175
000160




000175










SRS-
G-
UCAGUGAUGUAACAUUCAGUCCU
154

text missing or illegible when filed

308
P-
GACUGAAUGUUACAUCACUGA
462

text missing or illegible when filed

616
5866


000176
000161




000176





As used herein, “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate. The “position at human transcript” is defined as the 5′ position of a 21-mer target site in human transcript (NCBI Reference Sequence No: NM_005577.4).


Note that, in some instances, the sense strand sequence is coupled to a targeting moiety (e.g., GalNAc or galactose (e.g., L96)) at the 3′ end of the sense strand.



text missing or illegible when filed indicates data missing or illegible when filed







Conjugation
Targeting Moiety

In certain aspects, the polynucleotide molecule described herein is coupled or conjugated with one or more targeting moieties to form a polynucleotide-targeting moiety conjugate molecule. In some instances, a targeting moiety is selected based on its ability to target the conjugate molecule described herein to a desired cell population, tissue, or an organ selectively or preferably. In some instances, the targeting moiety targets the cell, tissue, or an organ that expresses the corresponding binding partner (e.g., either the corresponding receptor or ligand) of the targeting moiety. For example, the polynucleotide molecule described herein could be targeted to hepatocytes expressing asialoglycoprotein (ASGP-R) by selecting a targeting moiety containing N-acetyl galactosamine (GalNAc) as the targeting moiety. Any suitable GalNAc molecules that are known in the art to be used as a targeting moiety are contemplated. Exemplary GalNAc molecule includes a triantennary GalNAc (e.g., L96). A further example of the targeting moiety is galactose. The targeting moiety can also be a lipid, peptide, or small molecule.


A targeting moiety (i.e., an intracellular targeting moiety) that targets a desired site within the cell (e.g., endoplasmic reticulum, Golgi apparatus, nucleus, or mitochondria) may be included in the hybridized polynucleotide constructs disclosed herein. Non-limiting examples of the intracellular targeting moieties are provided in WO 2015/069932 and in WO 2015/188197; the disclosure of the intracellular targeting moieties in WO 2015/069932 and in WO 2015/188197 is incorporated herein by reference.


The polynucleotide molecule described herein, thus, may include one or more targeting moieties selected from the group consisting of intracellular targeting moieties, extracellular targeting moieties, and combinations thereof. Thus, the inclusion of one or more targeting moieties (e.g., extracellular targeting moieties including targeting moieties independently selected from the group consisting of folate, mannose, N-acetyl galactosamine, and prostate specific membrane antigen) and one or more intracellular targeting moiety (e.g., a moiety targeting endoplasmic reticulum, Golgi apparatus, nucleus, or mitochondria) in the polynucleotide molecule described herein can facilitate the delivery of the polynucleotides to a specific site within the specific cell population. In some aspects, the targeting moiety contains one or more mannose carbohydrates. Mannose targets the mannose receptor, which is a 175 KDa membrane-associated receptor that is expressed on sinusoidal liver cells and antigen presenting cells (e.g., macrophages and dendritic cells). It is a highly effective endocytotic/recycling receptor that binds and internalizes mannosylated pathogens and proteins (Lennartz et. al. J. Biol. Chem. 262:9942-9944, 1987; Taylor et. al. J. Biol. Chem. 265:12156-62, 1990).


Some of the targeting moieties are described herein. In some aspects, the targeting moiety contains or specifically binds to a protein selected from the group including insulin, insulin-like growth factor receptor 1 (IGF1R), IGF2R, insulin-like growth factor (IGF; e.g., IGF 1 or 2), mesenchymal epithelial transition factor receptor (c-met; also known as hepatocyte growth factor receptor (HGFR)), hepatocyte growth factor (HGF), epidermal growth factor receptor (EGFR), epidermal growth factor (EGF), heregulin, fibroblast growth factor receptor (FGFR), platelet-derived growth factor receptor (PDGFR), platelet-derived growth factor (PDGF), vascular endothelial growth factor receptor (VEGFR), vascular endothelial growth factor (VEGF), tumor necrosis factor receptor (TNFR), tumor necrosis factor alpha (TNF-α), TNF-β, folate receptor (FOLR), folate, transferrin, transferrin receptor (TfR), mesothelin, Fc receptor, c-kit receptor, c-kit, an integrin (e.g., an α4 integrin or a β-1 integrin), P-selectin, sphingosine-1-phosphate receptor-1 (S1PR), hyaluronate receptor, leukocyte function antigen-1 (LFA-1), CD4, CD11, CD18, CD20, CD25, CD27, CD52, CD70, CD80, CD85, CD95 (Fas receptor), CD106 (vascular cell adhesion molecule 1 (VCAM1), CD166 (activated leukocyte cell adhesion molecule (ALCAM)), CD178 (Fas ligand), CD253 (TNF-related apoptosis-inducing ligand (TRAIL)), ICOS ligand, CCR2, CXCR3, CCR5, CXCL12 (stromal cell-derived factor 1 (SDF-1)), interleukin 1 (IL-1), IL-Ira, IL-2, IL-3, IL-4, IL-6, IL-7, IL-8, CTLA-4, MART-1, gp100, MAGE-1, ephrin (Eph) receptor, mucosal addressin cell adhesion molecule 1 (MAdCAM-1), carcinoembryonic antigen (CEA), LewisY, MUC-1, epithelial cell adhesion molecule (EpCAM), cancer antigen 125 (CA125), prostate specific membrane antigen (PSMA), TAG-72 antigen, and fragments thereof. In further aspects, the targeting moiety contains erythroblastic leukemia viral oncogene homolog (ErbB) receptor (e.g., ErbB1 receptor; ErbB2 receptor; ErbB3 receptor; and ErbB4 receptor). In some aspects, the targeting moiety contains one or more (e.g., from 1 to 6) N-acetyl galactosamines (GalNAc). In some aspects, the targeting moiety contains one or more (e.g., from 1 to 6) galactose. In certain aspects, the targeting moiety contains one or more (e.g., from 1 to 6) mannoses. In other aspects, the targeting moiety contains a folate ligand. The folate ligand has the structure:




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Certain targeting moieties may include bombesin, gastrin, gastrin-releasing peptide, tumor growth factors (TGF) (e.g., TGF-α or TGF-β), or vaccinia virus growth factor (VVGF). Non-peptidyl targeting moieties can also be used in the targeting moieties and may include, for example, steroids, carbohydrates, vitamins, and lectins. Some targeting moieties may include a polypeptide, such as somatostatin or somatostatin analog (e.g., octreotide or lanreotide), bombesin, or an antibody or antigen-binding fragment thereof. Antibodies may be of any recognized class or subclass, e.g., IgG, IgA, IgM, IgD, or IgE. Typical are those antibodies which fall within the IgG class. The antibodies can be derived from any species according to techniques known in the art. Typically, however, the antibody is of human, murine, or rabbit origin. In addition, the antibody may be polyclonal or monoclonal, but is typically monoclonal. Human or chimeric (e.g., humanized) antibodies may be used in targeting moieties. Targeting moieties may include an antigen-binding fragment of an antibody. Such antibody fragments may include, for example, the Fab′, F(ab′)2, Fv, or Fab fragments, single domain antibody, ScFv, or other antigen-binding fragments. Fc fragments may also be employed in targeting moieties. Such antibody fragments can be prepared, for example, by proteolytic enzyme digestion, for example, by pepsin or papain digestion, reductive alkylation, or recombinant techniques. The materials and methods for preparing antibody fragments are well-known to those skilled in the art. See, e.g., Parham, J. Immunology, 131:2895, 1983; Lamoyi et al., J. Immunological Methods, 56:235, 1983. Other peptides for use as a targeting auxiliary moiety in polynucleotide molecule described herein can be selected from KiSS peptides and analogs, urotensin II peptides and analogs, GnRH I and II peptides and analogs, depreotide, vapreotide, vasoactive intestinal peptide (VIP), cholecystokinin (CCK), RGD-containing peptides, melanocyte-stimulating hormone (MSH) peptide, neurotensin, calcitonin, glutathione, YIGSR (leukocyte-avid peptides, e.g., P483H, which contains the heparin-binding region of platelet factor-4 (PF-4) and a lysine-rich sequence), atrial natriuretic peptide (ANP), β-amyloid peptides, delta-opioid antagonists (such as ITIPP(psi)), annexin-V, endothelin, leukotriene B4 (LTB4), chemotactic peptides (e.g., N-formyl-methionyl-leucyl-phenylalanine-lysine (fMLFK), GP IIb/IIIa receptor antagonists (e.g., DMP444), human neutrophil elastase inhibitor (EPI-HNE-2 and EPI-HNE-4), plasmin inhibitor, antimicrobial peptides, apticide (P280 and P274), thrombospondin receptor (including analogs such as TP-1300), bitistatin, pituitary adenylyl cyclase type I receptor (PAC1), fibrin α-chain, peptides derived from phage display libraries, and conservative substitutions thereof.


One or more (e.g., from 1 to 6) targeting moieties can be linked to MOIETY or to X2 in formula (V′, V″, V′″, V″″, V′″″, V″″″) through -LinkA-.


In some aspects, the targeting moiety includes one or more (e.g., from 1 to 6 or from 1 to 3) asialoglycoprotein receptor ligands (e.g., GalNAc). In some aspects, an asialoglycoprotein receptor ligand (e.g., GalNAc) is attached to -LinkA- through an anomeric carbon (e.g., where the anomeric carbon is the carbon atom in an acetal or a hemiaminal). An asialoglycoprotein receptor ligand (e.g., GalNAc) attached to a linker through a hemiaminal may produce a hybridized polynucleotide construct having superior efficacy in gene silencing as compared to hybridized polynucleotide constructs having the asialoglycoprotein receptor ligand (e.g., GalNAc) attached to a linker through an acetal.


In some aspects, the linker and three asialoglycoprotein receptor targeting moieties, each of which comprises GalNAc, are as shown in Formula (V). In some instances, the conjugate described herein only comprises one asialoglycoprotein receptor targeting moiety, so the conjugate comprises a structure of Formula (V) with any two of the targeting moieties removed. In some instances, the conjugate described herein only comprises two asialoglycoprotein receptor targeting moieties, so the conjugate described herein comprises a structure of Formula (V) with any one of the targeting moieties removed.




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wherein one of Y1 and Y2 is nucleotide, or wherein both Y1 and Y2 are nucleotides and Y1 and Y2 are consecutive or neighboring nucleotides from the polynucleic acid molecule described herein.


In some aspects, the linker and the targeting moieties described herein are conjugated to 3′ end of the sense strand (e.g., as shown in Formula (V′, V″″, V′″″, V″″″)). In some aspects, the linker and the targeting moieties described herein are conjugated to 5′ end of the sense strand (e.g., as shown in Formula (V″) or (V′″)). In some aspects, the linker and the targeting moieties described herein are conjugated to 3′ end of the antisense strand(e.g., as shown in Formula (V′), (V″″), (V′″″), (V″″″)). In some aspects, the linker and the targeting moieties described herein are conjugated to 5′ end of the antisense strand (e.g., as shown in Formula (V″) or (V′″)).




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wherein Z in formula (V′) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V′) is adenine, uracil, guanine, cytosine, thymine, abasic, or others;




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wherein Z in formula (V″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (V′″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V′″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (V″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (V′″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V′″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (V″″″) is a moiety that corresponds to one or the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.


In some instances, the 3′ end of passenger/sense strand from Table 1, Table 2, or Table 5 is conjugated with X2-GalNAc (see Formula (V), (V′), (V″″), (V′″″), (V″″″)). In some instances, the 5′ end of passenger/sense strand from Table 1, Table 2, or Table 5 is conjugated with X2-GalNAc (see Formula (V), (V″), or (V′″)). In some instances, a nucleic acid within passenger/sense strand (not at the 5′ or 3′ end) from Table 1, Table 2, or Table 5 is conjugated with X2-GalNAc (see Formula (V)). In some instances, the 3′ end of guide/antisense strand from Table 1, Table 2, or Table 5 is conjugated with X2-GalNAc (see Formula (V), (V′), (V″″), (V′″″), (V″″″)). In some instances, the 5′ end of guide/antisense strand from Table 1, Table 2, or Table 5 is conjugated with X2-GalNAc (see Formula (V), (V″), or (V′″)). In some instances, a nucleic acid within guide/antisense strand (not at the 5′ or 3′ end) from Table 1, Table 2, or Table 5 is conjugated with X2-GalNAc (see Formula (V)).


In some instances, one or more endosomal escape moieties (e.g., from 1 to 6 or from 1 to 3) can be attached to a polynucleotide construct or a hybridized polynucleotide construct disclosed herein as an auxiliary moiety. Exemplary endosomal escape moieties include chemotherapeutics (e.g., quinolones such as chloroquine); fusogenic lipids (e.g., dioleoylphosphatidyl-ethanolamine (DOPE)); and polymers such as polyethylenimine (PEI); poly(beta-amino ester)s; polypeptides, such as polyarginines (e.g., octaarginine) and polylysines (e.g., octalysine); proton sponges, viral capsids, and peptide transduction domains as described herein. For example, fusogenic peptides can be derived from the M2 protein of influenza A viruses; peptide analogs of the influenza virus hemagglutinin; the HEF protein of the influenza C virus; the transmembrane glycoprotein of filoviruses; the transmembrane glycoprotein of the rabies virus; the transmembrane glycoprotein (G) of the vesicular stomatitis virus; the fusion protein of the Sendai virus; the transmembrane glycoprotein of the Semliki forest virus; the fusion protein of the human respiratory syncytial virus (RSV); the fusion protein of the measles virus; the fusion protein of the Newcastle disease virus; the fusion protein of the visna virus, the fusion protein of murine leukemia virus; the fusion protein of the HTL virus; and the fusion protein of the simian immunodeficiency virus (SIV). Other moieties that can be employed to facilitate endosomal escape are described in Dominska et al., Journal of Cell Science, 123(8):1183-1189, 2010. Specific examples of endosomal escape moieties including moieties suitable for conjugation to the hybridized polynucleotide constructs disclosed herein are provided, e.g., in WO 2015/188197; the disclosure of these endosomal escape moieties is incorporated by reference herein.


One or more endosomal escape moieties (e.g., from 1 to 6 or from 1 to 3) can be attached to a MOIETY or X2 in formula (V′, V″, V′″, V″″, V′″″, or V″″″) through -LinkA-, as described herein.


One or more cell penetrating peptides (CPP) (e.g., from 1 to 6 or from 1 to 3) can be attached to a polynucleotide construct or a hybridized polynucleotide construct disclosed herein as an auxiliary moiety. The CPP can be linked to the hybridized polynucleotide bioreversibly through a disulfide linkage, as disclosed herein. Thus, upon delivery to a cell, the CPP can be cleaved intracellularly, e.g., by an intracellular enzyme(e.g., protein disulfide isomerase, thioredoxin, or a thioesterase) and thereby release the polynucleotide.


CPPs are known in the art (e.g., TAT or Arg8) (Snyder and Dowdy, 2005, Expert Opin. Drug Deliv. 2, 43-51). Specific examples of CPPs including moieties suitable for conjugation to the hybridized polynucleotide constructs disclosed herein are provided, e.g., in WO 2015/188197; the disclosure of these CPPs is incorporated by reference herein.


CPPs are positively charged peptides that are capable of facilitating the delivery of biological cargo to a cell. It is believed that the cationic charge of the CPPs is essential for their function. Moreover, the transduction of these proteins does not appear to be affected by cell type, and these proteins can efficiently transduce nearly all cells in culture with no apparent toxicity (Nagahara et al., Nat. Med. 4:1449-52, 1998). In addition to full-length proteins, CPPs have also been used successfully to induce the intracellular uptake of DNA (Abu-Amer, supra), antisense polynucleotides (Astriab-Fisher et al., Pharm. Res, 19:744-54, 2002), small molecules (Polyakov et al., Bioconjug. Chem. 11.762-71, 2000) and even inorganic 40 nm iron particles (Dodd et al., J. Immunol. Methods 256:89-105, 2001; Wunderbaldinger et al., Bioconjug. Chem. 13:264-8, 2002; Lewin et al., Nat. Biotechnol. 18:410-4, 2000; Josephson et al., Bioconjug. Chem. 10:186-91, 1999) suggesting that there is considerable flexibility in particle size in this process.


In one case, a CPP useful in the methods and compositions as described herein includes a peptide featuring substantial alpha-helicity. It has been discovered that transfection is optimized when the CPP exhibits significant alpha-helicity. In another case, the CPP includes a sequence containing basic amino acid residues that are substantially aligned along at least one face of the peptide. A CPP described herein may be a naturally occurring peptide or a synthetic peptide.


One or more cell penetrating peptides (e.g., from 1 to 6 or from 1 to 3) can be attached to a MOIETY or X2 in formula (I) through -LinkA-, as described herein.


The polynucleotide constructs and the hybridized polynucleotide constructs disclosed herein can also include covalently attached neutral polymer-based auxiliary moieties. Neutral polymers include poly(C1-6 alkylene oxide), e.g., poly(ethylene glycol) and poly(propylene glycol) and copolymers thereof, e.g., di- and triblock copolymers. Other examples of polymers include esterified poly(acrylic acid), esterified poly(glutamic acid), esterified poly(aspartic acid), poly(vinyl alcohol), poly(ethylene-co-vinyl alcohol), poly(N-vinyl pyrrolidone), poly(ethyloxazoline), poly(alkylacrylates), poly(acrylamide), poly(N-alkylacrylamides), poly(N-acryloylmorpholine), poly(lactic acid), poly(glycolic acid), poly(dioxanone), poly(caprolactone), styrene-maleic acid anhydride copolymer, poly(L-lactide-co-glycolide) copolymer, divinyl ether-maleic anhydride copolymer, N-(2-hydroxypropyl)methacrylamide copolymer (HMPA), polyurethane, N-isopropylacrylamide polymers, and poly(N,N-dialkylacrylamides). Exemplary polymer auxiliary moieties may have molecular weights of less than 100, 300, 500, 1000, or 5000 Da (e.g., greater than 100 Da). Other polymers are known in the art.


One or more polymers (e.g., from 1 to 6 or from 1 to 3) can be attached to a MOIETY or X2 in formula (V′, V″, V′″, V″″, V′″″, V″″″) through -LinkA-, as described herein.


Conjugation Linkers

In some aspects, the polynucleic acid molecules described herein comprises a sense or antisense strand bonded to at least one group of formula (I)




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    • or a salt thereof, or a stereoisomer thereof,

    • where

    • each X1 is independently O or S;

    • each X2 is independently O, S, NH, or a bond;

    • MOIETY is optionally substituted C2-10 alkane-tetrayl or a group -M1-M2-M3-, wherein each M1 and each M3 is independently absent or optionally substituted C1-6 alkylene, and M2 is optionally substituted C3-9 heterocycle-tetrayl, optionally substituted C6-10 arene-tetrayl, or optionally substituted C3-8 cycloalkane-tetrayl;

    • each R1 and each R2 is independently H, optionally substituted C1-6 alkyl, optionally substituted C2-16 heteroalkyl, a conjugation moiety, or -LinkA(-T)p, provided that at least one R or at least one R2 is a conjugation moiety or -LinkA(-T)p;

    • each R3 is independently H, optionally substituted C1-16 alkyl, optionally substituted C2-16 heteroalkyl, optionally substituted C2-16 alkenyl, optionally substituted C2-16 alkynyl, optionally substituted (C1-9 heterocyclyl)-C1-6-alkyl, optionally substituted (C6-10 aryl)-C1-6-alkyl, optionally substituted (C3-8 cycloalkyl)-C1-6-alkyl, a conjugation moiety, or -LinkA(-T)p;

    • R4 is H, optionally substituted C1-6 alkyl, -LinkA(-T)p, or -Sol;

    • each LinkA is independently a multivalent linker (e.g., including —C(O)—N(H)— (e.g., at least one multivalent linker including —C(O)—N(H)— bonded to T));

    • each T is independently an auxiliary moiety;

    • Sol is solid support;

    • m is an integer from 1 to 6;

    • each n is independently 0 or 1;

    • each p is independently an integer from 1 to 6; and

    • q is an integer from 0 to 3.





The at least one group of formula (I) may be bonded to a 5′-terminus, 3′-terminus, internucleoside phosphate, internucleoside phosphorothioate, or internucleoside phosphorodithioate of the polynucleotide. When the at least one group of formula (I) is bonded to the internucleoside phosphate, internucleoside phosphorothioate, or internucleoside phosphorodithioate, q is 0. The polynucleotide construct contains no more than one Sol.


Group -LinkA- can include from 0 to 3 multivalent monomers (e.g., optionally substituted C1-6 alkane-triyl, optionally substituted C1-6 alkane-tetrayl, or trivalent nitrogen atom) and one or more divalent monomers (e.g., from 1 to 40), where each divalent monomer is independently optionally substituted C1-6 alkylene; optionally substituted C2-6 alkenylene; optionally substituted C2-6 alkynylene; optionally substituted C3-8 cycloalkylene; optionally substituted C3-8 cycloalkenylene; optionally substituted C6-14 arylene; optionally substituted C1-9 heteroarylene having 1 to 4 heteroatoms selected from N, O, and S; optionally substituted C1-9 heterocyclylene having 1 to 4 heteroatoms selected from N, O, and S; imino; optionally substituted N; O; or S(O)m, wherein m is 0, 1, or 2. In some aspects, each monomer is independently optionally substituted C1-6 alkylene; optionally substituted C3-8 cycloalkylene; optionally substituted C3-8 cycloalkenylene; optionally substituted C6-14 arylene; optionally substituted C1-9 heteroarylene having 1 to 4 heteroatoms selected from N, O, and S; optionally substituted C1-9 heterocyclylene having 1 to 4 heteroatoms selected from N, O, and S; imino; optionally substituted N; O; or S(O)m, where m is 0, 1, or 2 (e.g., m is 2). In certain aspects, each monomer is independently optionally substituted C1-6 alkylene; optionally substituted C3-8 cycloalkylene; optionally substituted C3-8 cycloalkenylene; optionally substituted C6-14 arylene; optionally substituted C1-9 heteroarylene having 1 to 4 heteroatoms selected from N, O, and S; optionally substituted C1-9 heterocyclylene having 1 to 4 heteroatoms selected from N, O, and S; optionally substituted N; O; or S(O)m, where m is 0, 1, or 2 (e.g., m is 2). The non-bioreversible linker connecting the auxiliary moiety to the conjugating moiety or to the reaction product thereof can include from 2 to 500 (e.g., from 2 to 300 or from 2 to 200) of such monomers. Group -LinkA- may include a poly(alkylene oxide) (e.g., polyethylene oxide, polypropylene oxide, poly(trimethylene oxide), polybutylene oxide, poly(tetramethylene oxide), and diblock or triblock co-polymers thereof). In some aspects, the non-bioreversible linker includes polyethylene oxide (e.g., poly(ethylene oxide) having a molecular weight of less than 1 kDa).


Group -LinkA(-T)p in formula (I) may be prepared by a process described in the sections below. In some instances, -LinkA(-T)p is of formula (II):





-Q1-Q2([-Q3-Q4-Q5]s-Q6-T)p,   (II)

    • where
    • each s is independently an integer from 0 to 20 (e.g., from 0 to 10), where the repeating units are the same or different;
    • Q1 is a conjugation linker (e.g., [-Q3-Q4-Q5]s-QC-, where QC is optionally substituted C2-12 heteroalkylene (e.g., a heteroalkylene containing —C(O)—N(H)—, —N(H)—C(O)—, —S(O)2—N(H)—, or —N(H)—S(O)2—), optionally substituted C1-12 thioheterocyclylene




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optionally substituted C1-12 heterocyclylene (e.g., 1,2,3-triazole-1,4-diyl or




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cyclobut-3-ene-1,2-dione-3,4-diyl, or pyrid-2-yl hydrazone);

    • Q2 is a linear group (e.g., [-Q3-Q4-Q5-]s—), if p is 1, or a branched group (e.g., [-Q3-Q4-Q5]s-Q7([-Q3-Q4-Q5]s-(Q7)p1)p2, where p1 is 0 or 1, p2 is 0, 1, 2, or 3), if p is an integer from 2 to 6;
    • each Q3 and each Q6 is independently absent, —CO—, —NH—, —O—, —S—, —SO2—, —OC(O)—, —COO—, —NHC(O)—, —C(O)NH—, —CH2—, —CH2NH—, —NHCH2—, —CH2O—, or —OCH2—;
    • each Q4 is independently absent, optionally substituted C1-12 alkylene, optionally substituted C2-12 alkenylene, optionally substituted C2-12 alkynylene, optionally substituted C2-12 heteroalkylene, optionally substituted C6-10 arylene, optionally substituted C1-9 heteroarylene, or optionally substituted C1-9 heterocyclylene;
    • each Q5 is independently absent, —CO—, —NH—, —O—, —S—, —SO2—, —CH2—, —C(O)O—, —OC(O)—, —C(O)NH—, —NH—C(O)—, —NH—CH(Ra)—C(O)—, or —C(O)—CH(Ra)—NH—;
    • each Q7 is independently optionally substituted C1-6, alkane-triyl, optionally substituted C1-6 alkane-tetrayl, optionally substituted C2-6 heteroalkane-triyl, or optionally substituted C2-6 heteroalkane-tetrayl; and
    • each Ra is independently H or an amino acid side chain;
    • provided that at least one of Q3, Q4, and Q5 is present.


In some aspects, each Q4 is independently absent, optionally substituted C1-12 alkylene, optionally substituted C2-12 alkenylene, optionally substituted C2-12 alkynylene, optionally substituted C2-12 heteroalkylene, or optionally substituted C1-9 heterocyclylene. In certain aspects, s is 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20.


Thus, in formula (II), LinkA may include a single branching point, if each p1 is 0, or multiple branching points, if at least one p1 is 1.


In formula (II), Q1 may be —O-QL-QC-, where QL is optionally substituted C2-12 heteroalkylene, optionally substituted C1-12 alkylene, or -(optionally substituted C1-6 alkylene)-(optionally substituted C6-10 arylene)-. In some aspects, QL is optionally substituted C2-12 heteroalkylene or optionally substituted C1-12 alkylene. In formula (II), QC may be:




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In formula (II), Q2 may be a linear group of formula [-Q3-Q4-Q5]-, where Q3, Q4, and Q5 are as defined for formula (II). Alternatively, Q2 may be a branched group [-Q3-Q4-Q5]s-Q7([-Q3-Q4-Q5]s-(Q7)p1)p2, where each Q7 is independently optionally substituted C1-6 alkane-triyl, optionally substituted C1-6 alkane-tetrayl, optionally substituted C2-6 heteroalkane-triyl, or optionally substituted C2-6 heteroalkane-tetrayl;

    • where
    • p1 is 0 or 1;
    • p2 is 0, 1, 2, or 3;
    • where,
      • when p1 is 0, LinkA is a trivalent or tetravalent linker, and,
      • when p1 is 1, LinkA is a tetravalent, pentavalent, or hexavalent linker.


In certain aspects, p1 is 0.


In some aspects, Q7 is:




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Compounds that may be used in the preparation of group -LinkA(-T)p in formula (I) are described herein as well as in WO 2015/188197. Non-limiting examples of -LinkA include:




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    • where

    • R18 is a bond to MOIETY,

    • each R19 is independently a bond to auxiliary moiety,

    • each m5 is independently an integer from 1 to 20,

    • each m6 is independently an integer from 1 to 10,

    • m7 is an integer from 1 to 6, and

    • each X6 is independently O or S.





In formula (II), when the conjugation linker is of formula [-Q3-Q4-Q5]s-QC-, -Q2([-Q3-Q4-Q5]s-Q6-T)p may be:




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    • where

    • R20 is a bond to QC in Q1,

    • each R19 is independently a bond to an auxiliary moiety,

    • each m5 is independently an integer from 1 to 20,

    • each m6 is independently an integer from 1 to 10,

    • m7 is an integer from 1 to 6, and

    • each X6 is independently O or S.





In some aspects, the linker described herein is cleavable. In some aspects, the linker described herein is non-cleavable.


In some aspects, the polynucleic acid molecule described herein comprises a sense or antisense strand bonded to at least one group of formula (IV),




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wherein at least one of Y1 and Y2 is a nucleotide from the polynucleic acid molecule.


In some instances, the Y1 is the last nucleotide on the 3′-terminus or the first nucleotide on the 5′ terminus of one of the strands of the polynucleic acid molecule. In some instances, the Y1 is the last nucleotide on the 3′-terminus or the first nucleotide on the 5′ terminus of the sense strand of the polynucleic acid molecule. In some instances, the Y1 is the last nucleotide on the 3′-terminus or the first nucleotide on the 5′ terminus of the sense strand of the polynucleic acid molecule, and the Y2 is a 3-hydroxy-propoxy group. In some instances, the Y2 is the first nucleotide on the 5′-terminus or the last nucleotide on the 3′-terminus of one of the strands of the polynucleic acid molecule. In some instances, the Y2 is the first nucleotide on the 5′-terminus or the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule. In some instances, the Y2 is the first nucleotide or the last nucleotide on the 3′-terminus on the 5′-terminus of the sense strand of the polynucleic acid molecule, and the Y1 is a 3-hydroxy-propoxy group. In other instances, the Y1 and Y2 are two consecutive nucleotides in one of the strands of the polynucleic acid molecule.


In some aspects, the targeting moiety described herein is conjugated to 3′ end of the sense strand (e.g., formula (IV′) or (IV″″)). In some aspects, the targeting moiety described herein is conjugated to 5′ end of the sense strand (e.g., formula (IV″) or (IV′″)). In some aspects, the targeting moiety described herein is conjugated to 3′ end of the antisense strand (e.g., formula (IV′) or(IV″″)). In some aspects, the targeting moiety described herein is conjugated to 5′ end of the antisense strand (e.g., formula (IV″) or (IV′″)).




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wherein Z in formula (IV′) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (IV′) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (IV″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (IV″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (IV′″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (IV′″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




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wherein Z in formula (IV″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (IV″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.


Pharmaceutical Compositions

Delivery of the polynucleotide molecules described herein can be achieved by contacting a cell with the polynucleotide molecules using a variety of methods. In particular aspects, the polynucleotide molecule described herein is formulated with various excipients, vehicles, and carriers, as described more fully elsewhere herein.


A pharmaceutical composition described herein can be prepared to include a hybridized polynucleotide construct disclosed herein, into a form suitable for administration to a subject using carriers, excipients, and vehicles. Frequently used excipients include magnesium carbonate, titanium dioxide, lactose, mannitol and other sugars, talc, milk protein, gelatin, starch, vitamins, cellulose and its derivatives, animal and vegetable oils, polyethylene glycols and solvents, such as sterile water, alcohols, glycerol, and polyhydric alcohols. Intravenous vehicles include fluid and nutrient replenishers. Preservatives include antimicrobial, anti-oxidants, chelating agents, and inert gases. Other pharmaceutically acceptable vehicles include aqueous solutions, non-toxic excipients, including salts, preservatives, buffers and the like, as described, for instance, in Remington: The Science and Practice of Pharmacy, 21st Ed., Gennaro, Ed., Lippencott Williams & Wilkins (2005), and The United States Pharmacopeia: The National Formulary (USP 36 NF31), published in 2013. The pH and exact concentration of the various components of the pharmaceutical composition are adjusted according to routine skills in the art. See Goodman and Gilman's, The Pharmacological Basis for Therapeutics.


The pharmaceutical compositions described herein may be administered locally or systemically. The therapeutically effective amounts will vary according to factors, such as the degree of infection in a subject, the age, sex, and weight of the individual. Dosage regimes can be adjusted to provide the optimum therapeutic response. For example, several divided doses can be administered daily or the dose can be proportionally reduced as indicated by the exigencies of the therapeutic situation.


The pharmaceutical composition can be administered in a convenient manner, such as by injection (e.g., subcutaneous, intravenous, intraorbital, and the like), oral administration, ophthalmic application, inhalation, topical application, or rectal administration. Depending on the route of administration, the pharmaceutical composition can be coated with a material to protect the pharmaceutical composition from the action of enzymes, acids, and other natural conditions that may inactivate the pharmaceutical composition. The pharmaceutical composition can also be administered parenterally or intraperitoneally. Dispersions can also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof, and in oils. Under ordinary conditions of storage and use, these preparations may contain a preservative to prevent the growth of microorganisms.


Pharmaceutical compositions suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. The composition will typically be sterile and fluid to the extent that easy syringability exists. Typically the composition will be stable under the conditions of manufacture and storage and preserved against the contaminating action of microorganisms, such as bacteria and fungi. The vehicle can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size, in the case of dispersion, and by the use of surfactants. Prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like. In many cases, isotonic agents, for example, sugars, polyalcohols, such as mannitol, sorbitol, or sodium chloride are used in the composition. Prolonged absorption of the injectable compositions can be brought about by including in the composition an agent that delays absorption, for example, aluminum monostearate and gelatin.


Sterile injectable solutions can be prepared by incorporating the pharmaceutical composition in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating the pharmaceutical composition into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above.


It is especially advantageous to formulate parenteral compositions in dosage unit form for ease of administration and uniformity of dosage. Dosage unit form as used herein, refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of pharmaceutical composition is calculated to produce the desired therapeutic effect in association with the required pharmaceutical vehicle. The specification for the dosage unit forms is related to the characteristics of the pharmaceutical composition and the particular therapeutic effect to be achieve. The principal pharmaceutical composition is compounded for convenient and effective administration in effective amounts with a suitable pharmaceutically acceptable vehicle in an acceptable dosage unit. In the case of compositions containing supplementary active ingredients, the dosages are determined by reference to the usual dose and manner of administration of the ingredients.


The pharmaceutical composition can be orally administered, for example, in a carrier, e.g., in an enteric-coated unit dosage form. The pharmaceutical composition and other ingredients can also be enclosed in a hard or soft-shell gelatin capsule or compressed into tablets. For oral therapeutic administration, the pharmaceutical composition can be incorporated with excipients and used in the form of ingestible tablets, troches, capsules, pills, wafers, and the like. Such compositions and preparations should contain at least 1% by weight of active compound. The percentage of the compositions and preparations can, of course, be varied and can conveniently be between about 5% to about 80% of the weight of the unit. The tablets, troches, pills, capsules, and the like can also contain the following: a binder, such as gum tragacanth, acacia, corn starch, or gelatin; excipients such as dicalcium phosphate: a disintegrating agent, such as corn starch, potato starch, alginic acid, and the like; a lubricant, such as magnesium stearate; and a sweetening agent, such as sucrose, lactose or saccharin, or a flavoring agent such as peppermint, oil of wintergreen, or cherry flavoring. When the dosage unit form is a capsule, it can contain, in addition to materials of the above type, a liquid carrier. Various other materials can be present as coatings or to otherwise modify the physical form of the dosage unit. For instance, tablets, pills, or capsules can be coated with shellac, sugar, or both. A syrup or elixir can contain the agent, sucrose as a sweetening agent, methyl and propylparabens as preservatives, a dye, and flavoring, such as cherry or orange flavor. Any material used in preparing any dosage unit form should be of pharmaceutically acceptable purity and substantially non-toxic in the amounts employed. In addition, the pharmaceutical composition can be incorporated into sustained-release preparations and formulations.


The pharmaceutical composition described herein may comprise one or more permeation enhancer that facilitates bioavailability of the polynucleotide molecule described herein. WO 2000/67798, Muranishi, 1990, Crit. Rev. Ther. Drug Carrier Systems, 7, 1, Lee et al., 1991, Crit. Rev. Ther. Drug Carrier Systems, 8, 91 are herein incorporated by reference in its entirety. In some aspects, the permeation enhancer is intestinal. In some aspects, the permeation enhancer is transdermal. In some aspects, the permeation enhancer is to facilitate crossing the brain-blood barrier. In some aspects, the permeation enhancer improves the permeability in the oral, nasal, buccal, pulmonary, vaginal, or corneal delivery model. In some aspects, the permeation enhancer is a fatty acid or a derivative thereof. In some aspects, the permeation enhancer is a surfactant or a derivative thereof. In some aspects, the permeation enhancer is a bile salt or a derivative thereof. In some aspects, the permeation enhancer is a chelating agent or a derivative thereof. In some aspects, the permeation enhancer is a non-chelating non-surfactant or a derivative thereof. In some aspects, the permeation enhancer is an ester or a derivative thereof. In some aspects, the permeation enhancer is an ether or a derivative thereof. In some aspects, the permeation enhancer is arachidonic acid, undecanoic acid, oleic acid, lauric acid, caprylic acid, capric acid, myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein, dilaurin, glyceryl 1-monocaprate, 1-dodecylazacycloheptan-2-one, an acylcarnitine, an acylcholine, or a monoglyceride, a diglyceride or a pharmaceutically acceptable salt thereof. In one specific aspect, the permeation enhancer is sodium caprate (C10). In some aspects, the permeation enhancer is chenodeoxycholic acid (CDCA), ursodeoxychenodeoxycholic acid (UDCA), cholic acid, dehydrocholic acid, deoxycholic acid, glucholic acid, glycholic acid, glycodeoxycholic acid, taurocholic acid taurodeoxycholic acid, sodium tauro-24,25-dihydro-fusidate or sodium glycodihydrofusidate. In some aspects, the permeation enhancer is polyoxyethylene-9-lauryl ether, or polyoxyethylene-20-cetyl ether.


For the polynucleotide molecule described herein, suitable pharmaceutically acceptable salts include (i) salts formed with cations such as sodium, potassium, ammonium, magnesium, calcium, polyamines such as spermine and spermidine, etc.; (ii) acid addition salts formed with inorganic acids, for example hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, and the like; and (iii) salts formed with organic acids such as, for example, acetic acid, oxalic acid, tartaric acid, succinic acid, maleic acid, fumaric acid, gluconic acid, citric acid, malic acid, ascorbic acid, benzoic acid, tannic acid, palmitic acid, alginic acid, polyglutamic acid, naphthalenesulfonic acid, methanesulfonic acid, p-toluenesulfonic acid, naphthalenedisulfonic acid, polygalacturonic acid, and the like.


While the hybridized polynucleotide constructs described herein may not require the use of excipients for delivery to the target cell, the use of excipients may be advantageous in some aspects. Thus, for delivery to the target cell, the hybridized polynucleotide molecule described herein can non-covalently bind an excipient to form a complex. The excipient can be used to alter biodistribution after delivery, to enhance uptake, to increase half-life or stability of the strands in the hybridized polynucleotide constructs (e.g., improve nuclease resistance), and/or to increase targeting to a particular cell or tissue type.


Exemplary excipients include a condensing agent (e.g., an agent capable of attracting or binding a nucleic acid through ionic or electrostatic interactions); a fusogenic agent (e.g., an agent capable of fusing and/or being transported through a cell membrane); a protein to target a particular cell or tissue type (e.g., thyrotropin, melanotropin, lectin, glycoprotein, surfactant protein A, or any other protein); a lipid; a lipopolysaccharide; a lipid micelle or a liposome (e.g., formed from phospholipids, such as phosphotidylcholine, fatty acids, glycolipids, ceramides, glycerides, cholesterols, or any combination thereof); a nanoparticle (e.g., silica, lipid, carbohydrate, or other pharmaceutically-acceptable polymer nanoparticle); a polyplex formed from cationic polymers and an anionic agent (e.g., a CRO), where exemplary cationic polymers include polyamines (e.g., polylysine, polyarginine, polyamidoamine, and polyethylene imine); cholesterol; a dendrimer (e.g., a polyamidoamine (PAMAM) dendrimer); a serum protein (e.g., human serum albumin (HSA) or low-density lipoprotein (LDL)); a carbohydrate (e.g., dextran, pullulan, chitin, chitosan, inulin, cyclodextrin, or hyaluronic acid); a lipid; a synthetic polymer, (e.g., polylysine (PLL), polyethylenimine, poly-L-aspartic acid, poly-L-glutamic acid, styrene-maleic acid anhydride copolymer, poly(L-lactide-co-glycolic) copolymer, divinyl ether-maleic anhydride copolymer, N-(2-hydroxypropyl)methacrylamide copolymer (HMPA), polyethylene glycol (PEG), polyvinyl alcohol (PVA), polyurethane, poly(2-ethylacrylic acid), N-isopropylacrylamide polymer, pseudopeptide-polyamine, peptidomimetic polyamine, or polyamine); a cationic moiety (e.g., cationic lipid, cationic porphyrin, quaternary salt of a polyamine, or alpha helical peptide); a multivalent sugar (e.g., multivalent lactose, multivalent galactose, N-acetyl-galactosamine, N-acetyl-glucosamine, multivalent mannose, or multivalent fucose); a vitamin (e.g., vitamin A, vitamin E, vitamin K, vitamin B, folic acid, vitamin B12, riboflavin, biotin, or pyridoxal); a cofactor; or a drug to disrupt cellular cytoskeleton to increase uptake (e.g., taxol, vincristine, vinblastine, cytochalasin, nocodazole, japlakinolide, latrunculin A, phalloidin, swinholide A, indanocine, or myoservin).


Other therapeutic agents as described herein may be included in a pharmaceutical composition described herein in combination with a polynucleotide molecule described herein.


Methods of Treatment

In some aspects, described herein is a method of modulating expression of Lp(a) gene in a subject, comprising: administering to the subject a polynucleic acid molecule described herein, a polynucleic acid molecule conjugate described herein, or a pharmaceutical composition described herein, thereby modulating the expression of Lp(a) gene in the subject.


In some aspects, the method described herein reduces expression of Lp(a) gene (e.g., expression of Lp(a) mRNA) in a subject by about or at least 10% compared to a control. The term “control” as used herein refers to a subject or a cell receiving no treatment or placebo. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 20% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 30% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 40% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 50% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 60% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 70% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 80% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about or at least 90% compared to a control. In some aspects, the method described herein reduces expression of Lp(a) gene in a subject by about 100% compared to a control.


In some aspects, the method described herein achieves an IC50 value of about 5 nM. In some aspects, the method described herein achieves an IC50 value of about 10 nM. In some aspects, the method described herein achieves an IC50 value of about 15 nM. In some aspects, the method described herein achieves an IC50 value of about 20 nM. In some aspects, the method described herein achieves an IC50 value of about 25 nM. In some aspects, the method described herein achieves an IC50 value of about 30 nM. In some aspects, the method described herein achieves an IC50 value of about 35 nM. In some aspects, the method described herein achieves an IC50 value of about 40 nM. In some aspects, the method described herein achieves an IC50 value of about 45 nM. In some aspects, the method described herein achieves an IC50 value of about 50 nM. In some aspects, the method described herein achieves an IC50 value of about 55 nM. In some aspects, the method described herein achieves an IC50 value of about 60 nM. In some aspects, the method described herein achieves an IC50 value of about 65 nM. In some aspects, the method described herein achieves an IC50 value of about 70 nM. In some aspects, the method described herein achieves an IC50 value of about 75 nM. In some aspects, the method described herein achieves an IC50 value of about 80 nM. In some aspects, the method described herein achieves an IC50 value of about 85 nM. In some aspects, the method described herein achieves an IC50 value of about 90 nM. In some aspects, the method described herein achieves an IC50 value of about 95 nM. In some aspects, the method described herein achieves an IC50 value of about 100 nM.


In some aspects, the method described herein achieves an IC50 value of about 1 μM. In some aspects, the method described herein achieves an IC50 value of about 1.1 μM. In some aspects, the method described herein achieves an IC50 value of about 1.2 μM. In some aspects, the method described herein achieves an IC50 value of about 1.3 μM. In some aspects, the method described herein achieves an IC50 value of about 1.4 μM. In some aspects, the method described herein achieves an IC50 value of about 1.5 μM. In some aspects, the method described herein achieves an IC50 value of about 2 μM. In some aspects, the method described herein achieves an IC50 value of about 4 μM. In some aspects, the method described herein achieves an IC50 value of about 6 μM. In some aspects, the method described herein achieves an IC50 value of about 8 μM. In some aspects, the method described herein achieves an IC50 value of about 10 μM. In some aspects, the method described herein achieves an IC50 value of about 12 μM. In some aspects, the method described herein achieves an IC50 value of about 13 μM. In some aspects, the method described herein achieves an IC50 value of about 14 μM. In some aspects, the method described herein achieves an IC50 value of about 15 μM. In some aspects, the method described herein achieves an IC50 value of about 30 μM. In some aspects, the method described herein achieves an IC50 value of about 35 μM. In some aspects, the method described herein achieves an IC50 value of about 40 μM. In some aspects, the method described herein achieves an IC50 value of about 50 μM. In some aspects, the method described herein achieves an IC50 value of about 60 μM. In some aspects, the method described herein achieves an IC50 value of about 80 PM. In some aspects, the method described herein achieves an IC50 value of about 100 μM. In some aspects, the method described herein achieves an IC50 value of about 120 μM. In some aspects, the method described herein achieves an IC50 value of about 160 μM.


In some aspects, described herein is a method of modulating plasma Lp(a) level in a subject in need thereof, comprising administering to the subject a polynucleic acid molecule described herein, a polynucleic acid molecule conjugate described herein, or a pharmaceutical composition described herein, wherein the polynucleic acid molecule described herein, the polynucleic acid molecule conjugate described herein, or the pharmaceutical composition described herein reduces the plasma Lp(a) level in the subject.


In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 10% compared to a control (e.g., untreated subject or a subject before the treatment). In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 20% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 30% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 40% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 50% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 60% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 70% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 80% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about or at least 90% compared to a control. In some aspects, the method described herein reduces plasma Lp(a) level in a subject by about 100% compared to a control.


In some aspects, described herein is a method for treating or preventing a Lp(a) related disorder or symptoms thereof, cardiovascular disease or a lipid disorder, comprising administering to the subject a polynucleic acid molecule as disclosed herein, a polynucleic acid molecule conjugate as disclosed herein, or a pharmaceutical composition as disclosed herein.


In some aspects, the Lp(a) related disorder or cardiovascular disease includes coronary artery disease, acute myocardial infarction, asymptomatic carotid atherosclerosis, stroke, atrial fibrillation, or peripheral artery occlusive disease. In some aspects, the cardiovascular disease is hypercholesterolemia. In some aspects, the cardiovascular disease is myocardial infarction. In some aspects, the cardiovascular disease is the stroke. In some aspects, the cardiovascular disease is calcific aortic valve stenosis. In some aspects, the cardiovascular disease is cardiac arrest. In some aspects, the cardiovascular disease is peripheral arterial disease. In some aspects, the lipid disorder is hyperlipidemia or hypercholesterolemia.


Combination Therapy

In some instances, the methods as disclosed herein comprises administering a polynucleic acid molecule as disclosed herein, a polynucleic acid molecule conjugate as disclosed herein, or a pharmaceutical composition as disclosed herein to a subject (e.g., a human patient) who is on a therapeutic regime for the treatment of Lp(a) related disorder or CVD at the time of, or just prior to, administration of the polynucleic acid molecule as disclosed herein, a polynucleic acid molecule conjugate as disclosed herein, or a pharmaceutical composition as disclosed herein. For example, a patient who has previously been diagnosed with atherosclerosis may have been prescribed and is taking a stable therapeutic regimen of another drug prior to and/or concurrent with administration of a polynucleic acid molecule as disclosed herein, a polynucleic acid molecule conjugate as disclosed herein, or a pharmaceutical composition as disclosed herein. The prior or concurrent therapeutic regimen can comprise, for example, (1) an agent which induces a cellular depletion of cholesterol synthesis by inhibiting 3-hydroxy-3-methylglutaryl (HMG)-coenzyme A (CoA) reductase, such as a statin (e.g., cerivastatin, atorvastatin, simvastatin, pitavastatin, rosuvastatin, fluvastatin, lovastatin, pravastatin, etc.); (2) an agent which inhibits cholesterol uptake and or bile acid re-absorption; (3) an agent which increase lipoprotein catabolism (such as niacin); and/or (4) activators of the LXR transcription factor that plays a role in cholesterol elimination such as 22-hydroxycholesterol.


Patient Population

The methods disclosed herein are useful for reducing plasma Lp(a) levels in subjects that exhibit an elevated level of plasma Lp(a). The subject can be human or non-human primates. In some instances, the subject is otherwise healthy except for exhibiting elevated serum Lp(a). For example, the subject may not exhibit any other risk factor of cardiovascular, thrombotic or other diseases or disorders at the time of treatment. In other instances, however, the subject is selected on the basis of being diagnosed with, or at risk of developing, a disease or disorder that is caused by or correlated with elevated plasma Lp(a). For instance, at the time of, or prior to administration of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein, the subject may be diagnosed with or identified as being at risk of developing a cardiovascular disease or disorder, such as, e.g., coronary artery disease, acute myocardial infarction, asymptomatic carotid atherosclerosis, stroke, atrial fibrillation, peripheral artery occlusive disease, etc. The cardiovascular disease or disorder, in some instances, is hypercholesterolemia. For example, a subject may be selected for treatment with the methods as disclosed herein if the subject is diagnosed with or identified as being at risk of developing a hypercholesterolemia condition such as, e.g., heterozygous Familial Hypercholesterolemia (heFH), homozygous Familial Hypercholesterolemia (hoFH), as well as incidences of hypercholesterolemia that are distinct from Familial Hypercholesterolemia (nonFH). The subject may be diagnosed with or identified as being at risk of developing a lipid disease or disorder, such as, e.g., hyperlipidemia and hypercholesterolemia.


In some instances, at the time of, or prior to administration of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein, the subject may be diagnosed with or identified as being at risk of developing a thrombotic occlusive disease or disorder, such as, e.g., pulmonary embolism, central retinal vein occlusion, etc. The patient can be selected on the basis of being diagnosed with or at risk of developing a combination of two or more of the abovementioned diseases or disorders. For example, at the time of, or prior to administration of the pharmaceutical composition of the present invention, the subject may be diagnosed with or identified as being at risk of developing coronary artery disease and pulmonary embolism. Other diagnostic combinations (e.g., atherosclerosis and central retinal vein occlusion, heFH and stroke, etc.) are also included in the definition of the patient populations that are treatable by the methods as disclosed herein.


In some instances, the subject to be treated with the methods as disclosed herein is selected on the basis of one or more factors selected from the group consisting of age (e.g., older than 40, 45, 50, 55, 60, 65, 70, 75, or 80 years), race, gender (male or female), exercise habits (e.g., regular exerciser, non-exerciser), other preexisting medical conditions (e.g., type-II diabetes, high blood pressure, etc.), and current medication status (e.g., currently taking statins (e.g., cerivastatin, atorvastatin, simvastatin, pitavastatin, rosuvastatin, fluvastatin, lovastatin, pravastatin, etc.), beta blockers, niacin, etc.). The present disclosure also provides methods for reducing plasma Lp(a) levels in patients who are intolerant of, non-responsive to, or inadequately responsive to conventional statin therapy. Potential patients can be selected/screened on the basis of one or more of these factors (e.g., by questionnaire, diagnostic evaluation, etc.) before being treated with the methods as disclosed herein.


Dosage

The amount of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein administered to a subject according to the methods as disclosed herein is, generally, a therapeutically effective amount. As used herein, the term “therapeutically effective amount” refers to a dose of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein that results in a detectable reduction in plasma Lp(a). For example, a therapeutically effective amount of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein includes, for example, an amount of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein that causes a reduction of at least 1%, 2%, 5%, 10%, 15%, 20%, 25%, 30%, 40%, 50%, or more in plasma Lp(a) levels when administered to a subject. In some instances, a therapeutically effective amount of the polynucleic acid molecule as disclosed herein can a dose that can cause a reduction of at least 1%, 2%, 5%, 10%, 15%, 20%, 25%, 30%, 40%, 50%, or more in Lp(a) mRNA levels when administered to a subject.


Regimens

The polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein can be administered to a subject over a defined time course. The methods disclosed herein can comprise sequentially administering to a subject multiple doses of the polynucleic acid molecule as disclosed herein, the polynucleic acid molecule conjugate as disclosed herein, or the pharmaceutical composition as disclosed herein. As used herein, “sequentially administering” means that each dose of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition is administered to the subject at a different point in time, e.g., on different days separated by a predetermined interval (e.g., hours, days, weeks or months). The present disclosure provides methods which comprise sequentially administering to the patient a single initial dose of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition, followed by one or more secondary doses of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition, and optionally followed by one or more tertiary doses of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition.


The terms “initial dose,” “secondary doses,” and “tertiary doses,” refer to the temporal sequence of administration of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition. Thus, the “initial dose” is the dose which is administered at the beginning of the treatment regimen (also referred to as the “baseline dose”); the “secondary doses” are the doses which are administered after the initial dose; and the “tertiary doses” are the doses which are administered after the secondary doses. The initial, secondary, and tertiary doses can all contain the same amount of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition, but will generally differ from one another in terms of frequency of administration. In some instances, the amount of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition contained in the initial, secondary and/or tertiary doses will vary from one another (e.g., adjusted up or down as appropriate) during the course of treatment.


In some instances, each secondary and/or tertiary dose is administered 1 to 30 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, or more) days after the immediately preceding dose. The phrase “the immediately preceding dose,” as used herein, means, in a sequence of multiple administrations, the dose of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition which is administered to a patient prior to the administration of the very next dose in the sequence with no intervening doses.


The methods as disclosed herein can comprise administering to a patient any number of secondary and/or tertiary doses of the polynucleic acid molecule, the polynucleic acid molecule conjugate, or the pharmaceutical composition. For example, in some instances, only a single secondary dose is administered to the patient. In other instances, two or more (e.g., 2, 3, 4, 5, 6, 7, 8, or more) secondary doses are administered to the patient. In some instances, only a single tertiary dose is administered to the patient. In other instances, two or more (e.g., 2, 3, 4, 5, 6, 7, 8, or more) tertiary doses are administered to the patient.


Where multiple secondary doses are administered, each secondary dose can be administered at the same frequency as the other secondary doses. For example, each secondary dose may be administered to the patient 1 to 29 days after the immediately preceding dose. Similarly, where multiple tertiary doses are administered, each tertiary dose may be administered at the same frequency as the other tertiary doses. For example, each tertiary dose may be administered to the patient 1 to 60 days after the immediately preceding dose. Alternatively, the frequency at which the secondary and/or tertiary doses are administered to a patient can vary over the course of the treatment regimen. The frequency of administration may also be adjusted during the course of treatment by a physician depending on the needs of the individual patient following clinical examination.


Exemplary Embodiments

Embodiment 1. A polynucleic acid molecule for modulating expression of lipoprotein(a) (Lp(a)) gene, comprising a nucleic acid sequence that is at least 80%, at least 85%, at least 90% identical to a nucleic acid sequence selected from Table 1, Table 2, or Table 5.


Embodiment 2. The polynucleic acid molecule of embodiment 1, wherein the polynucleic acid molecule comprises a nucleic acid sequence selected from Table 1, Table 2, or Table 5.


Embodiment 3. The polynucleic acid molecule of any one of embodiments 1-2, wherein the polynucleic acid molecule is a single-stranded nucleic acid molecule.


Embodiment 4. The polynucleic acid molecule of embodiment 3, wherein the single-stranded nucleic acid molecule comprises at least 14, 15, 16, 17, 18 consecutive nucleotides that am complementary to a nucleic acid sequence selected from SEQ ID NOs: 309-462, with no more than 1, 2, 3, 4 mismatches.


Embodiment 5. The polynucleic acid molecule of embodiment 3, wherein the single-stranded nucleic acid molecule comprises at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 1-154.


Embodiment 6. The polynucleic acid molecule of embodiment 1 or 2, wherein the polynucleic acid molecule is a double-stranded nucleic acid molecule comprising a sense strand and an antisense strand.


Embodiment 7. The polynucleic acid molecule of embodiment 5, wherein the sense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 309-462.


Embodiment 8. The polynucleic acid molecule of embodiment 5 or embodiment 6, wherein the antisense strand comprises comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 1-154.


Embodiment 9. The polynucleic acid molecule of embodiment 5, wherein the sense strand comprises a nucleic acid sequence comprising at least 14, 15, 16, 17, 18, 19, or 20 consecutive sequences from a nucleic acid sequence selected from SEQ ID NOs: 309-462, with no more than 1, 2, 3, or 4 mismatches.


Embodiment 10. The polynucleic acid molecule of embodiment 6, wherein the antisense strand comprises a nucleic acid sequence comprising at least 14, 15, 16, 17, 18, 19, 20, 21, or 22 consecutive sequences of a nucleic acid sequence selected from SEQ ID NOs: 1-154, with no more than 1, 2, 3, or 4 mismatches.


Embodiment 11. The polynucleic acid molecule of any one of embodiments 6-10, wherein the sense strand comprises a nucleic acid sequence selected from SEQ ID NOs: 309-462 and the antisense strand comprises a nucleic acid sequence selected from SEQ ID NOs: 1-154.


Embodiment 12. The polynucleic acid molecule of any one of embodiments 1-11, wherein the polynucleic acid molecule comprises (1) a 2′-fluoro modified nucleotide; (2) a 2′-O-methyl modified nucleotide; or (3) a modified internucleotide linkage.


Embodiment 13. The polynucleic acid molecule of any one of embodiments 6-12, wherein the sense strand comprises at least two consecutive modified internucleotide linkages at the 5′ end.


Embodiment 14. The polynucleic acid molecule of any one of embodiments 6-13, wherein the antisense strand comprises at least two consecutive modified internucleotide linkages at the 5′ end and/or 3′ end.


Embodiment 15. The polynucleic acid molecule of any one of embodiments 6-14, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein n stands for a 2′-O-methyl modified nucleotide, and wherein Nf stands for a 2′-fluoro modified nucleotide.


Embodiment 16. The polynucleic acid molecule of any one of embodiments 12-15, wherein the modified internucleotide linkage is a phosphorothioate linkage.


Embodiment 17. The polynucleic acid molecule of embodiment 16, wherein the modified internucleotide linkage comprises a stereochemically enriched phosphorothioate internucleotide linkage.


Embodiment 18. The polynucleic acid molecule of any one of embodiments 12-17, wherein the modified internucleotide linkage is an SP chiral internucleotide phosphorothioate linkage.


Embodiment 19. The polynucleic acid molecule of embodiment 18, wherein the polynucleic acid comprises a plurality of modified internucleotide linkages, and at least 1, 2, 3, or 4 of the plurality of modified internucleotide linkages are stereochemically enriched phosphorothioate internucleotide linkages.


Embodiment 20. The polynucleic acid molecule of embodiment 19, wherein the stereochemically enriched phosphorothioate internucleotide linkages comprise both R- and S-isomers.


Embodiment 21. The polynucleic acid molecule of embodiment 19 or 20, wherein the at least one stereochemically enriched phosphorothioate is disposed between two consecutive nucleosides that are two of six 5′ or 3′-terminal nucleosides of the sense strand or the antisense strand.


Embodiment 22. The polynucleic acid molecule of any one of embodiments 6-21, wherein the sense strand or antisense strand is 19-25, or 21-23 nucleotides in length.


Embodiment 23. The polynucleic acid molecule of embodiments 1-5, wherein the polynucleic acid molecule is 19-25 or 21-23 nucleotides in length.


Embodiment 24. The polynucleic acid molecule of any one of embodiments 1-23, wherein the sense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 463-616.


Embodiment 25. The polynucleic acid molecule of any one of embodiments 1-24, wherein the antisense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 155-308.


Embodiment 26. The polynucleic acid molecule of any one of embodiments 1-25, wherein the sense strand comprises a sequence selected from a nucleic acid sequence of SEQ ID NOs: 463-616, and the antisense strand comprises a sequence selected from a nucleic acid sequence of SEQ ID NOs: 155-308.


Embodiment 27. A polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises:

    • (a) an antisense strand comprising the nucleotide sequence of UAGAUGACCAAGCUUGGCAGGUC (SEQ ID NO: 4) and a sense strand comprising the nucleotide sequence of CCUGCCAAGCUUGGUCAUCUA (SEQ ID NO: 312);
    • (b) an antisense strand comprising the nucleotide sequence of UAUAGAUGACCAAGCUUGGCAGG (SEQ ID NO: 5) and a sense strand comprising the nucleotide sequence of UGCCAAGCUUGGUCAUCUAUA (SEQ ID NO:313);
    • (c) an antisense strand comprising the nucleotide sequence of UCAUAGAUGACCAAGCUUGGCAG (SEQ ID NO: 6) and a sense strand comprising the nucleotide sequence of GCCAAGCUUGGUCAUCUAUGA (SEQ ID NO: 314);
    • (d) an antisense strand comprising the nucleotide sequence of UCGACGGCAGUCCCUUCUGCGUC (SEQ ID NO: 11) and a sense strand comprising the nucleotide sequence of CGCAGAAGGGACUGCCGUCGA (SEQ ID NO: 319);
    • (e) an antisense strand comprising the nucleotide sequence of UUCUAGGCUUGGAACCGGGGUAA (SEQ ID NO: 18) and a sense strand comprising the nucleotide sequence of ACCCCGGUUCCAAGCCUAGAA (SEQ ID NO: 326);
    • (f) an antisense strand comprising the nucleotide sequence of UAGCCUCUAGGCUUGGAACCGGG (SEQ ID NO: 21) and a sense strand comprising the nucleotide sequence of CGGUUCCAAGCCUAGAGGCUA (SEQ ID NO: 329);
    • (g) an antisense strand comprising the nucleotide sequence of UUUACCGUGGUAGCACUCCUGCA (SEQ ID NO: 44) and a sense strand comprising the nucleotide sequence of CAGGAGUGCUACCACGGUAAA (SEQ ID NO: 352);
    • (h) an antisense strand comprising the nucleotide sequence of UUGUCCAUUACCGUGGUAGCACU (SEQ ID NO: 47) and a sense strand comprising the nucleotide sequence of UGCUACCACGGUAAUGGACAA (SEQ ID NO: 355);
    • (i) an antisense strand comprising the nucleotide sequence of UCUCUGUCCAUUACCGUGGUAGC (SEQ ID NO: 49) and a sense strand comprising the nucleotide sequence of UACCACGGUAAUGGACAGAGA (SEQ ID NO: 357);
    • (j) an antisense strand comprising the nucleotide sequence of UAUUGUGUCAGGUUGCAGUACUC (SEQ ID NO: 60) and a sense strand comprising the nucleotide sequence of GUACUGCAACCUGACACAAUA (SEQ ID NO: 368);
    • (k) an antisense strand comprising the nucleotide sequence of UUGCGUCUGAGCAUUGUGUCAGG (SEQ ID NO: 64) and a sense strand comprising the nucleotide sequence of UGACACAAUGCUCAGACGCAA (SEQ ID NO: 372);
    • (l) an antisense strand comprising the nucleotide sequence of UUAACUCUGUCCAUAAUGGUAGU (SEQ ID NO: 88) and a sense strand comprising the nucleotide sequence of UACCAUUAUGGACAGAGUUAA (SEQ ID NO: 396);
    • (m) an antisense strand comprising the nucleotide sequence of UCCAAGCUUGGCAAGUUCUUCCU (SEQ ID NO: 89) and a sense strand comprising the nucleotide sequence of GAAGAACUUGCCAAGCUUGGA (SEQ ID NO: 397);
    • (n) an antisense strand comprising the nucleotide sequence of UAGAUGACCAAGCUUGGCAAGUU (SEQ ID NO: 90) and a sense strand comprising the nucleotide sequence of CUUGCCAAGCUUGGUCAUCUA (SEQ ID NO: 398); or
    • (o) an antisense strand comprising the nucleotide sequence of UGGUCCGACUAUGCUGGUGUGGU (SEQ ID NO: 98) and a sense strand comprising the nucleotide sequence of CACACCAGCAUAGUCGGACCA (SEQ ID NO: 406).


Embodiment 28. A polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises:

    • (a) an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaggsusc (SEQ ID NO: 158) and a sense strand comprising the nucleotide sequence of cscsugccAfaGfcUfuggucaucua (SEQ ID NO: 466);
    • (b) an antisense strand comprising the nucleotide sequence of usAfsuagaUfgaccAfaGfcUfuggcasgsg (SEQ ID NO: 159) and a sense strand comprising the nucleotide sequence of usgsccaaGfcUfuGfgucaucuaua (SEQ ID NO: 467);
    • (c) an antisense strand comprising the nucleotide sequence of usCfsauagAfugacCfaAfgCfuuggcsasg (SEQ ID NO: 160) and a sense strand comprising the nucleotide sequence of gscscaagCfuUfgGfucaucuauga (SEQ ID NO: 468);
    • (d) an antisense strand comprising the nucleotide sequence of usCfsgacgGfcaguCfcCfuUfcugcgsusc (SEQ ID NO: 165) and a sense strand comprising the nucleotide sequence of csgscagaAfgGfgAfcugccgucga (SEQ ID NO: 473);
    • (e) an antisense strand comprising the nucleotide sequence of usUfscuagGfcuugGfaAfcCfggggusasa (SEQ ID NO: 172) and a sense strand comprising the nucleotide sequence of ascscccgGfuUfcCfaagccuagaa (SEQ ID NO: 480);
    • (f) an antisense strand comprising the nucleotide sequence of usAfsgccuCfuaggCfuUfgGfaaccgsgsg (SEQ ID NO: 175) and a sense strand comprising the nucleotide sequence of csgsguucCfaAfgCfcuagaggcua (SEQ ID NO: 483);
    • (g) an antisense strand comprising the nucleotide sequence of usUfsuaccGfugguAfgCfaCfuccugscsa (SEQ ID NO: 198) and a sense strand comprising the nucleotide sequence of csasggagUfgCfuAfccacgguaaa (SEQ ID NO: 506);
    • (h) an antisense strand comprising the nucleotide sequence of usUfsguccAfuuacCfgUfgGfuagcascsu (SEQ ID NO: 201) and a sense strand comprising the nucleotide sequence of usgscuacCfaCfgGfuaauggacaa (SEQ ID NO: 509);
    • (i) an antisense strand comprising the nucleotide sequence of usCfsucugUfccauUfaCfcGfugguasgsc (SEQ ID NO: 203) and a sense strand comprising the nucleotide sequence of usasccacGfgUfaAfuggacagaga (SEQ ID NO: 511);
    • (j) an antisense strand comprising the nucleotide sequence of usAfsuuguGfucagGfuUfgCfaguacsusc (SEQ ID NO: 214) and a sense strand comprising the nucleotide sequence of gsusacugCfaAfcCfugacacaaua (SEQ ID NO: 522);
    • (k) an antisense strand comprising the nucleotide sequence of usUfsgcguCfugagCfaUfuGfugucasgsg (SEQ ID NO: 218) and a sense strand comprising the nucleotide sequence of usgsacacAfaUfgCfucagacgcaa (SEQ ID NO: 526);
    • (l) an antisense strand comprising the nucleotide sequence of usUfsaacuCfugucCfaUfaAfugguasgsu (SEQ ID NO: 242) and a sense strand comprising the nucleotide sequence of usasccauUfaUfgGfacagaguuaa (SEQ ID NO: 550);
    • (m) an antisense strand comprising the nucleotide sequence of usCfscaagCfuuggCfaAfgUfucuucscsu (SEQ ID NO: 243) and a sense strand comprising the nucleotide sequence of gsasagaaCfuUfgCfcaagcuugga (SEQ ID NO: 551);
    • (n) an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaagsusu (SEQ ID NO: 244) and a sense strand comprising the nucleotide sequence of csusugccAfaGfcUfuggucaucua (SEQ ID NO: 552); or
    • (o) an antisense strand comprising the nucleotide sequence of usGfsguccGfacuaUfgCfuGfgugugsgsu (SEQ ID NO: 252) and a sense strand comprising the nucleotide sequence of csascaccAfgCfaUfagucggacca (SEQ ID NO: 560),
    • wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.


Embodiment 29. A polynucleic acid molecule conjugate for modulating expression of lipoprotein(a) gene (Lp(a)), wherein the polynucleic acid molecule conjugate comprises a polynucleic acid molecule of any one of embodiments 1-23 and an asialoglycoprotein receptor targeting moiety.


Embodiment 30. The polynucleic acid molecule conjugate of embodiment 29, wherein the asialoglycoprotein receptor targeting moiety comprises N-Acetylgalactosamine (GalNAc) or galactose.


Embodiment 31. The polynucleic acid molecule conjugate of any one of embodiments 29-30, wherein the polynucleic acid molecule and the asialoglycoprotein receptor targeting moiety is coupled via a linker.


Embodiment 32. The polynucleic acid molecule conjugate of embodiment 31, wherein the linker is a cleavable linker.


Embodiment 33. The polynucleic acid molecule conjugate of any one of embodiments 30-31, wherein the GalNAc comprises an anomeric carbon bonded to trivalent, tetravalent linker, pentavalent, or hexavalent linker, wherein the anomeric carbon is part of a hemiaminal group.


Embodiment 34. The polynucleic acid molecule conjugate of any one of embodiments 31-33, wherein the linker comprises formula (IV) below,




embedded image


wherein at least one of Y1 and Y2 is a nucleotide in the polynucleic acid molecule.


Embodiment 35. The polynucleic acid molecule conjugate of embodiment 34, wherein the Y1 is the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule.


Embodiment 36. The polynucleic acid molecule conjugate of any one of embodiments 31-35, wherein the linker and the asialoglycoprotein receptor targeting moiety with the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule are shown in Formula (V′), Formula (V″″), Formula (V′″″), or Formula (V″″″):




embedded image


wherein Z in formula (V′) is —H, —OH, —O-Methyl, —F, or —O-methoxyethyl and R in formula (V′) is adenine, uracil, guanine, cytosine, thymine, abasic, or others;




embedded image


wherein Z in formula (V″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.




embedded image


wherein Z in formula (V′″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V′″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others; or




embedded image


wherein Z in formula (V″″″) is a moiety that corresponds to one of the sugar modifications described herein (e.g., —H, —OH, —O-Methyl, —F, or —O-methoxyethyl) and R in formula (V″″″) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.


Embodiment 37. The polynucleic acid molecule conjugate of embodiment 36, wherein the linker and the asialoglycoprotein receptor targeting moiety with the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule are shown in Formula (V′):




embedded image


wherein Z in formula (V′) is —H, —OH, —O-Methyl, —F, or —O-methoxyethyl and R in formula (V′) is adenine, uracil, guanine, cytosine, thymine, abasic, or others.


Embodiment 38. A pharmaceutical composition comprising a polynucleic acid molecule of any one of embodiments 1-28 or a polynucleic acid molecule conjugate of any one of embodiments 29-37, and a pharmaceutically acceptable excipient.


Embodiment 39. The pharmaceutical composition of embodiment 38, wherein the pharmaceutical composition is formulated as a nanoparticle formulation.


Embodiment 40. The pharmaceutical composition of embodiment 38 or embodiment 39, wherein the pharmaceutical composition is formulated for parenteral, oral, intranasal, buccal, rectal, transdermal, intravenous, subcutaneous, or intrathecal administration.


Embodiment 41. A method of modulating expression of lipoprotein(a) (Lp(a)) gene in a subject in need thereof, comprising:

    • administering to the subject a polynucleic acid molecule of any one of embodiments 1-28, a polynucleic acid molecule conjugate of any one of embodiments 29-37, or a pharmaceutical composition of any one of embodiments 38-40, thereby modulating the expression of Lp(a) gene in the subject in need thereof.


Embodiment 42. A method for treating or preventing a cardiovascular disease or a lipid disorder, comprising

    • administering to the subject a polynucleic acid molecule of any one of embodiments 1-28, a polynucleic acid molecule conjugate of any one of embodiments 29-37, or a pharmaceutical composition of any one of embodiments 38-40, thereby modulating the expression of Lp(a) gene in the subject in need thereof.


Embodiment 43. The method of embodiment 41 or 42, wherein the polynucleic acid molecule is administered at a dose sufficient to decrease the expression of Lp(a) gene in a cell of said subject by at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% compared to a control.


Embodiment 44. The method of embodiment 41 or 42, wherein the polynucleic acid molecule is administered at a dose sufficient to decrease plasma Lp(a) level of said subject by at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% compared to a control.


Embodiment 45. The method of any one of embodiments 41-44, wherein the polynucleic acid molecule is administered in at least two doses comprising an initial dose and a secondary dose.


Embodiment 46. The method of embodiment 45, wherein the secondary dose is administered 1 to 30 days after the initial dose is administered.


Embodiment 47. The method of any one of embodiments 42-46, wherein the cardiovascular disease is coronary artery disease, acute myocardial infarction, asymptomatic carotid atherosclerosis, stroke, atrial fibrillation, or peripheral artery occlusive disease.


Embodiment 48. The method of any one of embodiments 42-46, wherein the lipid disorder is hyperlipidemia or hypercholesterolemia.


EXAMPLES

These examples are provided for illustrative purposes only and not to limit the scope of the claims provided herein.


Example 1—In Vitro Efficacy of siRNAs Targeting Lp(a) in Primary Human Hepatocytes (PHH)

Primary human hepatocytes were thawed and plated on collagen-coated 96-well plates at a density of 9×104 cells per well. Hepatocytes were treated with conjugated siRNAs in the absence of transfection reagents (free uptake). Cells were treated with siRNAs with a concentrations at 10 μM or 0.5 μM. Untreated PHHs were used as negative control. An siRNA targeting an unrelated gene (Ahsa1) was also used as a negative control. Cells were incubated at 37° C., 5% CO2 for 48 h. At the end of the incubation period, the cells were lysed, and the relative expression of the target gene was measured by branched DNA (bDNA) assay and normalized to a house-keeping gene using standard protocols.


The modifications of the sense and antisense strands of the siRNAs tested are listed in Table 1. Note that each of the sense strand sequences was coupled to a GalNac-L96 at its 3′ end. The in vitro potency data of the siRNAs is provided in Table 3.


Forty-eight (48) Lp(a) siRNAs were selected for dose response relationship according to standard dose response curve protocol. The doses tested include 10.0, 3.33, 1.11, 0.37, 0.12, 0.04, 0.01, 0.005, 0.002, and 0.001 μM of the siRNA. The siRNAs were purified to at least approximately 85%.


A summary of the dose response curve data is provided in Table 4. The dose response curves are provided in FIGS. 1A-1VV.


Example 2—Testing Lp(a) siRNAs in Non-Human Primates

Fifteen (15) Lp(a) siRNAs (denoted as “SRS-000008” to “SRS-000022” from Table 2) were tested in a non-human primate study. For each siRNA, the 3′ end of the passenger/sense strand was conjugated with a GalNAc via X2 (see Formula (V′)). The Lp(a) siRNAs had sequences which were cross reactive with the cynomolgus monkey LPA gene. Male cynomolgus monkeys (n=4 per treatment group/siRNA) were administered a single 3 mg/kg subcutaneous injection of Lp(a) siRNA constructs SRS-000008 through SRS-000022. Animals were fasted overnight prior to collection of blood samples on day-1 (pre-dose) and on, days 3, 7, 10, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77, and 84. Lp(a) circulating protein levels in all serum samples were analyzed using an Lp(a) ELISA assay (Abcam, catalog #ab212165).


Formulation Preparation

Preparation of siRNAs was conducted on the dosing day under aseptic conditions at room temperature. The siRNAs were dissolved with sodium chloride and swirled or stirred until fully dissolved. The solution was filtered with a 0.22 μM sterile filter and the solution was collected in a sterile container. The formulation was stored at 2-8° C. The siRNAs were dissolved by the appropriate amount of vehicle to get the concentration of 10 mg/mL as the dosing formulations, respectively. On the day of dosing, siRNA formulations were stored at 2-8° C. for dosing. The dosing procedure was finished within 6 hours.


Animals

Cynomolgus monkeys were used in the study. Animals were housed in a group of 5 or less of the same dose level in stainless steel cages, and in an environmentally monitored, well-ventilated room (Conventional grade) maintained at a temperature of 18° C.-26° C. and a relative humidity of 40%-70%. Fluorescent lighting provided illumination approximately 12 hours per day.


Experimental Design

To obtain groups that were comparable by body weight in the same sex, all monkeys were randomly assigned to respective treatment groups using a computer-generated randomization procedure. The body weights required for randomization were obtained on Day −5 (5 days prior to the first dosing). After randomization, monkeys were assigned to one of the treatment groups.


Each monkey in each group was given an siRNA formulation via subcutaneous injection with single or multipoint on skin of on the hindlimb and/or neck and back using a suitable disposable syringe and supporting needle. The hair around the injection site was shaved prior to dosing, and each injection point received no more than 2 mL. Doses were calculated based upon the most currently scheduled body weight.


Blood samples for lipoprotein A (Lp(a)) serum concentration detection were collected via forelimb or hindlimb subcutaneous vein. Monkeys were fasted overnight prior to blood collection for Lp(a) serum concentration evaluation.


Samples of whole blood were added into centrifuge tubes coated with separation gel and coagulator, and stored temporarily and transferred at room temperature. The blood samples were handled within 2 hours and centrifuged at 1500 g for 10 minutes at room temperature. After the centrifugation, the serum was aliquoted into 2 new tubes and transferred into newly labeled centrifuge tubes. All samples were stored equal to or below −20° C. and avoided repeated freeze-thaws. Watson LIMS 7.5 system was used to manage the samples. ELISA kits (Catalog number: ab212165; Manufacturer: Abcam) were used for Lp(a) serum concentration analysis.


Data Analysis

Lp(a) serum concentrations were determined from serum samples collected on day −1 (pre-dose) and days 3, 7, 10, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77, and 84 using an ELISA assay (Abcam, catalog #ab212165). Results for each individual animal were expressed as the % change of circulating Lp(a) protein relative to the pre-dose (day-1) timepoint. The mean % change for each treatment group along with standard deviation was presented in Table 6 and plotted in FIG. 2.


Example 3—Testing Lp(a) siRNAs in Non-Human Primates

In a similar study described in example 2, four Lp(a) siRNAs, SRS-000013, SRS-000016, SRS-000017, and SRS-000018 were tested in cynomolgus monkeys. For each siRNA, the 3′ end of the passenger/sense strand was conjugated with a GalNAc via X2 (see Formula (V′)). The Lp(a) siRNAs had sequences which were cross reactive with the cynomolgus monkey LPA gene. Male cynomolgus monkeys (n=4 per treatment group/siRNA) were administered a single 1 mg/kg subcutaneous injection of each Lp(a) siRNA. Animals were fasted overnight prior to collection of blood samples on day −1 (pre-dose) and on days 3, 7, 10, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77, and 85. Additional blood samples were collected on days 98, 105, 112, 119, 126, 133, and 140 for SRS-000016 and SRS-000018 treated groups. Lp(a) circulating protein levels in all serum samples were analyzed using an Lp(a) ELISA assay (Abcam, catalog #ab212165). Results for each individual animal were expressed as the % change of circulating Lp(a) protein relative to the pre-dose (day −1) timepoint. The mean % change for each treatment group along with standard deviation was presented in Table 7 and plotted in FIG. 3.


While preferred aspects of the present disclosure have been shown and described herein, it will be obvious to those skilled in the art that such aspects are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the disclosure. It should be understood that various alternatives to the aspects of the disclosure described herein may be employed in practicing the disclosure. It is intended that the following claims define the scope of the disclosure and that methods and structures within the scope of these claims and their equivalents be covered thereby




















TABLE 2









Modified




Modified

Position




Unmodified
SEQ
Antisense
SEQ

Unmodified
SEQ
Sense
SEQ
at


Compd
siRNA
Antisense Sequence
ID
Sequence
ID
siRNA
Sense Sequence
ID
Sequence
ID
Human


ID
ID
(5′→3′)
NO.
(5′→3′)
NO.
ID
(5′→3′)
NO.
(5′→3′)
NO.
Transcript







SRS-
G-
UAGAUGACCAAGCUUGGCAG
 4

text missing or illegible when filed

158
P-
CCUGCCAAGCUUGGUCAUC
312

text missing or illegible when filed

466
 204


000008
000008
GUC



000008
UA









SRS-
G-
UAUAGAUGACCAAGCUUGGC
 5

text missing or illegible when filed

159
P-
UGCCAAGCUUGGUCAUCUA
313

text missing or illegible when filed

467
 206


000009
000009
AGG



000009
UA









SRS-
G-
UCAUAGAUGACCAAGCUUGG
 6

text missing or illegible when filed

160
P-
GCCAAGCUUGGUCAUCUAU
314

text missing or illegible when filed

468
 207


000010
000010
CAG



000010
GA









SRS-
G-
UCGACGGCAGUCCCUUCUGC
11

text missing or illegible when filed

165
P-
CGCAGAAGGGACUGCCGUC
319

text missing or illegible when filed

473
 382


000011
000011
GUC



000011
GA









SRS-
G-
UUCUAGGCUUGGAACCGGGG
18

text missing or illegible when filed

172
P-
ACCCCGGUUCCAAGCCUAG
326

text missing or illegible when filed

480
 416


000012
000012
UAA



000012
AA









SRS-
G-
UAGCCUCUAGGCUUGGAACC
21

text missing or illegible when filed

175
P-
CGGUUCCAAGCCUAGAGGC
329

text missing or illegible when filed

483
 420


000013
000013
GGG



000013
UA









SRS-
G-
UUUACCGUGGUAGCACUCCU
44

text missing or illegible when filed

198
P-
CAGGAGUGCUACCACGGUA
352

text missing or illegible when filed

506
1163


000014
000014
GCA



000014
AA









SRS-
G-
UUGUCCAUUACCGUGGUAGC
47

text missing or illegible when filed

201
P-
UGCUACCACGGUAAUGGAC
355

text missing or illegible when filed

509
1169


000015
000015
ACU



000015
AA









SRS-
G-
UCUCUGUCCAUUACCGUGGU
49

text missing or illegible when filed

203
P-
UACCACGGUAAUGGACAGA
357

text missing or illegible when filed

511
1172


000016
000016
AGC



000016
GA









SRS-
G-
UAUUGUGUCAGGUUGCAGUA
60

text missing or illegible when filed

214
P-
GUACUGCAACCUGACACAA
368

text missing or illegible when filed

522
2749


000017
000017
CUC



000017
UA









SRS-
G-
UUGCGUCUGAGCAUUGUGUC
64

text missing or illegible when filed

218
P-
UGACACAAUGCUCAGACGC
372

text missing or illegible when filed

526
2760


000018
000018
AGG



000018
AA









SRS-
G-
UUAACUCUGUCCAUAAUGGU
88

text missing or illegible when filed

242
P-
UACCAUUAUGGACAGAGUU
396

text missing or illegible when filed

550
3227


000019
000019
AGU



000019
AA









SRS-
G-
UCCAAGCUUGGCAAGUUCUU
89

text missing or illegible when filed

243
P-
GAAGAACUUGCCAAGCUUG
397

text missing or illegible when filed

551
3276


000020
000020
CCU



000020
GA









SRS-
G-
UAGAUGACCAAGCUUGGCAA
90

text missing or illegible when filed

244
P-
CUUGCCAAGCUUGGUCAUC
398

text missing or illegible when filed

552
3282


000021
000021
GUU



000021
UA









SRS-
G-
UGGUCCGACUAUGCUGGUGU
98

text missing or illegible when filed

252
P-
CACACCAGCAUAGUCGGAC
406

text missing or illegible when filed

560
3309


000022
000022
GGU



000022
CA





As used herein, “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate, “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate, “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate, “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate, “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methylunidine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate. The “position at human transcript” is defined as the 5′ position of a 21-mer target site in human transcript (NCBI Reference Sequence No: NM_005577.4). Each modified sense sequence is coupled to a targeting moiety (e.g., GalNAc or galactose) at its 3′ end via a linker (e.g., Formula V′, V′′′′, V′′′′′, or V′′′′′′)



text missing or illegible when filed indicates data missing or illegible when filed














TABLE 3







siRNA efficacy in primary human hepatocytes (PHH)











10 μM
0.5 μM














MV

MV





quadruplicates

quadruplicates

Position of



[% residual
SD
[% residual
SD
21mer Sense


Compd ID
target mRNA]
quadruplicates
target mRNA]
quadruplicates
Strand















Untreated
118
8
94
10
n/a


SRS-000023
98
10
87
3
198


SRS-000024
85
11
79
4
199


SRS-000025
100
2
83
6
202


SRS-000026
73
6
63
5
204


SRS-000027
82
14
85
1
206


SRS-000028
66
11
68
4
207


SRS-000029
78
6
70
3
260


SRS-000030
97
9
83
6
374


SRS-000031
107
10
91
6
379


SRS-000032
100
9
80
10
381


Untreated
102
10
94
6
n/a


Control
96
15
86
6
n/a


(Ahsa1)


SRS-000033
82
13
79
6
382


SRS-000034
96
17
79
3
383


SRS-000035
94
12
76
3
406


SRS-000036
92
6
92
11
407


SRS-000037
94
5
81
7
408


SRS-000038
93
2
82
6
411


SRS-000039
87
3
74
4
412


SRS-000040
73
11
75
1
416


SRS-000041
91
9
86
5
417


SRS-000042
93
8
85
2
419


untreated
96
3
90
5
n/a


untreated
100
9
102
2
n/a


SRS-000043
69
5
80
3
420


SRS-000044
81
6
89
3
421


SRS-000045
82
11
87
6
425


SRS-000046
86
9
97
7
427


SRS-000047
83
11
91
10
430


SRS-000048
95
14
99
6
435


SRS-000049
90
3
80
27
436


SRS-000050
70
31
97
4
438


SRS-000051
88
9
94
10
439


SRS-000052
85
5
94
8
442


untreated
96
8
96
6
n/a


Control
105
1
117
5
n/a


(Ahsa1)


SRS-000053
97
8
98
2
446


SRS-000054
67
4
89
1
470


SRS-000055
82
3
94
5
471


SRS-000056
77
6
87
3
493


SRS-000057
69
8
82
4
494


SRS-000058
63
7
73
3
503


SRS-000059
100
5
99
8
504


SRS-000060
100
6
103
8
505


SRS-000061
99
8
98
2
515


SRS-000062
86
4
89
3
541


untreated
100
3
85
8
n/a


untreated
89
7
102
3
n/a


SRS-000063
80
6
92
5
544


SRS-000064
63
10
69
4
546


SRS-000065
71
4
89
9
1162


SRS-000066
66
4
83
3
1163


SRS-000067
65
4
96
31
1165


SRS-000068
87
5
93
5
1168


SRS-000069
67
3
82
11
1169


SRS-000070
92
6
91
5
1171


SRS-000071
69
3
79
6
1172


SRS-000072
86
3
89
5
1174


untreated
93
11
100
7
n/a


Control
94
7
118
14
n/a


(Ahsa1)


SRS-000073
66
1
76
5
1177


SRS-000074
62
2
77
5
1178


SRS-000075
76
2
89
6
2684


SRS-000076
83
2
98
4
2698


SRS-000077
87
5
102
5
2701


SRS-000078
78
9
89
6
2705


SRS-000079
81
2
92
34
2706


SRS-000080
90
8
99
11
2707


SRS-000081
90
3
91
9
2747


SRS-000082
70
4
82
8
2749


untreated
95
2
91
7
n/a


untreated
101
7
109
11
n/a


SRS-000083
89
4
95
10
2751


SRS-000084
84
19
98
9
2753


SRS-000085
85
6
102
8
2754


SRS-000086
78
2
78
7
2760


SRS-000089
81
7
90
7
2815


SRS-000090
85
6
92
5
2823


SRS-000091
83
6
88
5
2841


SRS-000092
96
3
101
3
2843


SRS-000093
80
7
76
4
2894


SRS-000094
91
6
96
1
3023


untreated
101
7
96
4
n/a


Control
108
5
94
7
n/a


(Ahsa1)


SRS-000095
86
4
78
3
3044


SRS-000096
92
8
86
4
3047


SRS-000097
87
7
91
9
3049


SRS-000098
92
7
86
5
3050


SRS-000099
90
3
92
7
3090


SRS-000100
92
4
93
5
3094


SRS-000101
97
8
93
7
3095


SRS-000102
92
5
93
4
3096


SRS-000103
99
6
100
7
3098


SRS-000104
97
7
106
3
3158


untreated
90
20
101
9
n/a


untreated
97
10
144
64
n/a


SRS-000105
83
5
88
7
3218


SRS-000106
79
5
84
15
3219


SRS-000107
82
7
77
5
3220


SRS-000108
82
8
78
6
3223


SRS-000109
83
7
79
10
3226


SRS-000110
66
7
73
18
3227


SRS-000111
70
5
71
8
3276


SRS-000112
56
7
56
13
3282


SRS-000113
56
1
60
2
3284


SRS-000114
48
3
57
3
3285


untreated
91
9
77
2
n/a


Control
108
5
95
1
n/a


(Ahsa1)


SRS-000115
97
6
82
6
3303


SRS-000116
93
9
89
10
3304


SRS-000117
89
7
83
9
3305


SRS-000118
91
5
77
7
3307


SRS-000119
89
4
75
4
3308


SRS-000120
79
4
77
4
3309


SRS-000121
95
5
79
6
3316


SRS-000122
94
9
84
5
3317


SRS-000123
91
10
78
2
3320


SRS-000124
97
13
82
10
3396


untreated
104
13
83
6
n/a


untreated
99
6
99
3
n/a


SRS-000125
96
7
91
5
3397


SRS-000126
93
11
90
7
3398


SRS-000127
91
12
87
4
3399


SRS-000128
93
10
86
5
3406


SRS-000129
91
7
90
2
3407


SRS-000130
91
9
88
7
3464


SRS-000131
88
12
92
6
3735


SRS-000132
91
13
85
5
3737


SRS-000133
77
2
84
5
3738


SRS-000134
85
10
81
3
3741


untreated
97
7
89
5
n/a


Control
108
4
105
5
n/a


(Ahsa1)


SRS-000135
94
4
89
11
3778


SRS-000136
90
2
94
9
3779


SRS-000137
89
3
90
5
3780


SRS-000138
88
5
86
5
3783


SRS-000139
94
9
86
4
3790


SRS-000140
80
6
82
6
3991


SRS-000141
90
4
91
5
4049


SRS-000142
92
2
83
9
4053


SRS-000143
96
2
75
17
4055


SRS-000144
94
11
85
12
4056


untreated
96
9
95
10
n/a


untreated
101
3
94
3
n/a


SRS-000145
99
9
90
9
4066


SRS-000146
91
12
78
5
4067


SRS-000147
93
7
75
4
4138


SRS-000148
91
14
80
3
4139


SRS-000149
95
12
80
4
4150


SRS-000150
93
14
70
5
4450


SRS-000151
96
12
74
3
4645


SRS-000152
97
9
73
4
4646


SRS-000153
100
12
73
2
4733


SRS-000154
104
10
70
2
4802


untreated
103
5
77
3
n/a


Control
97
6
110
17
n/a


(Ahsa1)


SRS-000155
81
15
83
8
4803


SRS-000156
83
2
110
42
4805


SRS-000157
84
5
82
10
4806


SRS-000158
87
2
76
5
4808


SRS-000159
83
3
75
6
4812


SRS-000160
84
7
79
7
4823


SRS-000161
89
3
75
10
4926


SRS-000162
89
2
80
10
4969


SRS-000163
90
4
84
14
4970


SRS-000164
97
14
86
14
5073


untreated
99
8
96
12
n/a


untreated
121
18
102
7
n/a


SRS-000165
106
5
98
2
5121


SRS-000166
101
9
92
4
5122


SRS-000167
96
9
92
6
5123


SRS-000168
82
1
78
10
5124


SRS-000169
104
7
91
7
5126


SRS-000170
95
10
81
13
5127


SRS-000171
100
10
92
8
5128


SRS-000172
96
6
86
11
5129


SRS-000173
92
8
79
5
5130


SRS-000174
100
5
87
8
5132


untreated
101
5
84
10
n/a


Control
92
14
117
11
n/a


(Ahsa1)


SRS-000175
75
8
81
10
5505


SRS-000176
76
6
92
7
5866


SRS-000087
85
5
88
3
2762


SRS-000088
81
3
90
3
2764


untreated
86
8
97
4
n/a





MV: meanvalue.


SD: standard deviation.


The “position of 21mer sense strand” is defined as the 5′ position of a 21-mer sense strand target site in human transcript (NCBI Reference Sequence No: NM_005577.4)













TABLE 4







Dose Response Curve in Primary Human Hepatocyte












Transcript Start






Site (5′ pos of

MV quadruplicates



21mer Sense
dose
[% residual
SD


Compd ID
Strand)
[μM]
target mRNA]
quadruplicates














SRS-000026
204
Mock
99
8




10.0
40
8




3.33
44
4




1.11
56
3




0.37
63
9




0.12
65
3




0.04
68
7




0.01
75
3




0.005
73
2




0.002
79
4




0.001
86
4










Control (Ahsa1)
1.11 μM
95
2













Mock
101
9


SRS-000027
206
10.0
51
4




3.33
54
4




1.11
59
7




0.37
70
7




0.12
79
6




0.04
88
4




0.01
93
9




0.005
92
3




0.002
95
13




0.001
102
10




Mock
105
15




Mock
97
5


SRS-000028
207
10.0
51
2




3.33
55
4




1.11
63
9




0.37
58
5




0.12
68
5




0.04
94
3




0.01
90
8




0.005
83
5




0.002
94
9




0.001
93
4










Control (Ahsa1)
1.11 μM
99
6













Mock
105
2


SRS-000029
260
10.0
59
7




3.33
60
4




1.11
75
11




0.37
70
4




0.12
75
2




0.04
82
4




0.01
86
6




0.005
82
5




0.002
88
3




0.001
87
4




Mock
100
10




Mock
98
11


SRS-000033
382
10.0
89
11




3.33
82
4




1.11
90
9




0.37
92
7




0.12
88
12




0.04
91
10




0.01
97
6




0.005
97
9




0.002
90
11




0.001
97
5










Control (Ahsa1)
1.11 μM
99
9













Mock
102
3


SRS-000040
416
10.0
78
7




3.33
81
6




1.11
87
4




0.37
87
3




0.12
90
5




0.04
111
23




0.01
99
2




0.005
100
7




0.002
96
13




0.001
102
6




Mock
101
6




Mock
100
4


SRS-000043
420
10.0
75
6




3.33
74
2




1.11
76
3




0.37
83
5




0.12
78
4




0.04
87
9




0.01
89
5




0.005
88
5




0.002
94
7




0.001
92
3










Control (Ahsa1)
1.11 μM
102
5













Mock
100
5


SRS-000044
421
10.0
73
4




3.33
74
2




1.11
84
5




0.37
83
7




0.12
79
4




0.04
82
7




0.01
81
3




0.005
88
8




0.002
93
4




0.001
93
3




Mock
99
6




Mock
89
8


SRS-000045
425
10.0
74
8




3.33
74
8




1.11
79
9




0.37
81
13




0.12
80
12




0.04
85
18




0.01
87
6




0.005
85
10




0.002
97
10




0.001
87
6










Control (Ahsa1)
1.11 μM
99
6













Mock
106
19


SRS-000050
438
10.0
84
10




3.33
84
6




1.11
93
7




0.37
86
7




0.12
93
8




0.04
89
7




0.01
101
11




0.005
95
3




0.002
105
2




0.001
101
9




Mock
107
8




Mock
101
5


SRS-000054
470
10.0
61
4




3.33
64
6




1.11
73
4




0.37
78
5




0.12
80
4




0.04
88
5




0.01
90
7




0.005
88
4




0.002
95
10




0.001
90
8










Control (Ahsa1)
1.11 μM
102
11













Mock
95
7


SRS-000056
493
10.0
57
3




3.33
60
2




1.11
73
7




0.37
76
6




0.12
78
7




0.04
85
4




0.01
94
10




0.005
92
8




0.002
98
8




0.001
99
13




Mock
102
4




Mock
102
7


SRS-000057
494
10.0
58
2




3.33
56
2




1.11
64
5




0.37
71
7




0.12
75
8




0.04
87
7




0.01
91
8




0.005
89
2




0.002
98
2




0.001
101
5










Control (Ahsa1)
1.11 μM
101
3













Mock
98
4


SRS-000058
503
10.0
71
2




3.33
73
6




1.11
67
9




0.37
71
7




0.12
67
6




0.04
69
3




0.01
73
5




0.005
74
3




0.002
79
7




0.001
85
13




Mock
98
10




Mock
107
6


SRS-000064
546
10.0
46
2




3.33
50
2




1.11
58
3




0.37
63
4




0.12
69
5




0.04
72
2




0.01
77
2




0.005
74
4




0.002
82
2




0.001
90
2










Control (Ahsa1)
1.11 μM
92
6













Mock
108
4


SRS-000065
1162
10.0
99
14




3.33
76
2




1.11
104
4




0.37
100
4




0.12
104
8




0.04
97
8




0.01
96
10




0.005
99
8




0.002
103
8




0.001
102
6




Mock
93
6




Mock
101
10


SRS-000066
1163
10.0
71
4




3.33
72
5




1.11
86
9




0.37
81
8




0.12
92
9




0.04
96
11




0.01
95
7




0.005
89
8




0.002
91
6




0.001
94
7










Control (Ahsa1)
1.11 μM
97
3











SRS-000067
1165
10.0
81
5




3.33
79
8




1.11
95
5




0.37
88
8




0.12
97
6




0.04
93
4




0.01
102
9




0.005
92
7




0.002
103
5




0.001
101
7




Mock
98
4




Mock
106
1


SRS-000069
1169
10.0
81
1




3.33
77
2




1.11
80
5




0.37
82
4




0.12
81
4




0.04
84
8




0.01
85
4




0.005
81
3




0.002
87
3




0.001
88
3










Control (Ahsa1)
1.11 μM
93
5













Mock
102
6


SRS-000071
1172
10.0
87
9




3.33
85
3




1.11
92
9




0.37
87
4




0.12
92
5




0.04
93
6




0.01
85
4




0.005
93
5




0.002
87
7




0.001
93
4




Mock
98
5




Mock
99
12


SRS-000073
1177
10.0
55
5




3.33
58
3




1.11
71
4




0.37
75
3




0.12
76
3




0.04
80
5




0.01
80
6




0.005
84
7




0.002
96
6




0.001
100
9










Control (Ahsa1)
1.11 μM
100
8













Mock
104
7


SRS-000074
1178
10.0
49
2




3.33
55
3




1.11
62
8




0.37
70
2




0.12
74
2




0.04
81
2




0.01
88
9




0.005
88
5




0.002
98
9




0.001
102
3




Mock
97
3




Mock
96
8


SRS-000075
2684
10.0
84
9




3.33
87
8




1.11
96
11




0.37
93
6




0.12
98
9




0.04
93
5




0.01
96
4




0.005
96
3




0.002
96
5




0.001
95
3










Control (Ahsa1)
1.11 μM
98
3













Mock
111
2


SRS-000078
2705
10.0
88
1




3.33
89
8




1.11
96
4




0.37
92
4




0.12
107
11




0.04
107
16




0.01
86
4




0.005
91
11




0.002
94
3




0.001
96
3




Mock
95
8




Mock
88
6


SRS-000079
2706
10.0
58
1




3.33
57
2




1.11
59
5




0.37
64
3




0.12
64
3




0.04
73
7




0.01
67
6




0.005
68
3




0.002
75
4




0.001
80
5










Control (Ahsa1)
1.11 μM
88
13













Mock
125
12


SRS-000082
2749
10.0
77
13




3.33
71
11




1.11
80
13




0.37
77
14




0.12
77
10




0.04
80
9




0.01
87
14




0.005
80
10




0.002
85
14




0.001
94
8




Mock
100
14




Mock
90
21


SRS-000086
2760
10.0
71
16




3.33
56
6




1.11
69
12




0.37
60
5




0.12
56
5




0.04
57
3




0.01
58
7




0.005
58
6




0.002
61
3




0.001
72
3










Control (Ahsa1)
1.11 μM
109
27













Mock
99
4


SRS-000093
2894
10.0
61
4




3.33
57
5




1.11
60
9




0.37
67
2




0.12
75
2




0.04
73
5




0.01
75
9




0.005
77
3




0.002
84
4




0.001
81
9




Mock
103
10




Mock
98
4


SRS-000106
3219
10.0
87
9




3.33
90
19




1.11
102
11




0.37
87
7




0.12
83
9




0.04
84
9




0.01
92
12




0.005
79
13




0.002
82
7




0.001
85
6










Control (Ahsa1)
1.11 μM
100
9













Mock
99
19


SRS-000107
3220
10.0
85
5




3.33
97
5




1.11
100
9




0.37
94
4




0.12
93
7




0.04
91
5




0.01
94
8




0.005
88
11




0.002
95
12




0.001
96
13




Mock
103
6




Mock
88
15


SRS-000108
3223
10.0
83
11




3.33
84
6




1.11
84
5




0.37
55
20




0.12
73
4




0.04
67
6




0.01
84
8




0.005
68
11




0.002
82
6




0.001
100
8










Control (Ahsa1)
1.11 μM
95
8













Mock
109
2


SRS-000109
3226
10.0
94
7




3.33
86
17




1.11
83
14




0.37
92
16




0.12
80
9




0.04
80
11




0.01
81
15




0.005
74
17




0.002
84
6




0.001
91
6




Mock
108
9




Mock
92
8


SRS-000110
3227
10.0
66
4




3.33
62
3




1.11
67
1




0.37
58
11




0.12
68
3




0.04
79
6




0.01
84
9




0.005
82
11




0.002
88
7




0.001
94
4










Control (Ahsa1)
1.11 μM
101
4













Mock
107
9


SRS-000111
3276
10.0
83
3




3.33
82
2




1.11
90
6




0.37
85
2




0.12
79
3




0.04
82
3




0.01
87
5




0.005
84
7




0.002
93
8




0.001
96
4




Mock
100
8




Mock
92
4


SRS-000112
3282
10.0
48
5




3.33
53
9




1.11
52
4




0.37
53
7




0.12
54
3




0.04
58
5




0.01
68
6




0.005
66
4




0.002
75
4




0.001
82
5










Control (Ahsa1)
1.11 μM
100
3













Mock
91
5


SRS-000113
3284
10.0
55
6




3.33
63
4




1.11
84
7




0.37
79
1




0.12
76
3




0.04
81
2




0.01
87
4




0.005
85
6




0.002
88
7




0.001
93
4




Mock
95
5




Mock
93
6


SRS-000114
3285
10.0
41
2




3.33
42
2




1.11
47
5




0.37
60
3




0.12
67
5




0.04
74
2




0.01
85
6




0.005
75
6




0.002
88
5




0.001
92
8










Control (Ahsa1)
1.11 μM
99
6













Mock
107
10


SRS-000120
3309
10.0
90
7




3.33
87
7




1.11
88
7




0.37
93
6




0.12
87
9




0.04
94
5




0.01
97
7




0.005
86
2




0.002
96
10




0.001
93
5




Mock
77
52




Mock
94
8


SRS-000133
3738
10.0
82
5




3.33
71
4




1.11
83
4




0.37
84
9




0.12
87
4




0.04
86
0




0.01
91
9




0.005
86
6




0.002
95
5




0.001
102
3










Control (Ahsa1)
1.11 μM
106
10













Mock
103
5


SRS-000134
3741
10.0
97
2




3.33
95
6




1.11
103
8




0.37
98
7




0.12
102
5




0.04
100
8




0.01
105
11




0.005
103
12




0.002
104
17




0.001
111
6




Mock
97
14




Mock
103
4


SRS-000135
3778
10.0
90
9




3.33
87
10




1.11
91
7




0.37
106
23




0.12
93
5




0.04
89
4




0.01
85
24




0.005
91
5




0.002
97
6




0.001
95
6










Control (Ahsa1)
1.11 μM
94
4













Mock
105
12


SRS-000140
3991
10.0
81
8




3.33
77
3




1.11
87
11




0.37
85
8




0.12
87
5




0.04
90
4




0.01
105
14




0.005
93
1




0.002
100
5




0.001
99
4




Mock
98
3




Mock
114
17


SRS-000155
4803
10.0
77
12




3.33
77
4




1.11
86
8




0.37
83
4




0.12
78
3




0.04
80
8




0.01
84
2




0.005
85
8




0.002
89
3




0.001
91
4










Control (Ahsa1)
1.11 μM
90
2













Mock
104
6


SRS-000168
5124
10.0
65
3




3.33
63
4




1.11
82
17




0.37
74
5




0.12
72
8




0.04
74
8




0.01
86
8




0.005
83
3




0.002
88
9




0.001
90
4




Mock
92
8




Mock
97
4


SRS-000175
5505
10.0
85
6




3.33
88
7




1.11
85
11




0.37
82
7




0.12
81
10




0.04
87
14




0.01
91
7




0.005
88
8




0.002
89
7




0.001
92
4










Control (Ahsa1)
1.11 μM
102
4













Mock
96
14


SRS-000176
5866
10.0
96
4




3.33
95
5




1.11
101
8




0.37
93
18




0.12
96
4




0.04
96
5




0.01
103
4




0.005
99
3




0.002
100
3




0.001
101
6




Mock
106
9




Mock
92
7


SRS-000087
2762
10.0
89
6




3.33
77
4




1.11
96
18




0.37
81
3




0.12
76
6




0.04
69
4




0.01
83
13




0.005
72
5




0.002
79
7




0.001
86
3










Control (Ahsa1)
1.11 μM
94
4













Mock
108
15


SRS-000088
2764
10.0
94
8




3.33
86
13




1.11
99
8




0.37
95
7




0.12
95
17




0.04
99
14




0.01
105
7




0.005
97
12




0.002
99
15




0.001
97
10




Control
106
6





MV: mean value.


SD: standard deviation.


The “Transcript Start Site” is defined as the 5′ position of a 21-mer sense strand target site in human transcript (NCBI Reference Sequence No: NM_005577.4)













TABLE 5







Final dose responses in primary human hepatocyte



























Transcript













Start
MV max





Modified
SEQ

Modified 
SEQ


Site 
KD at




siRNA
Antisense Sequence
ID
siRNA
Sense Sequence
ID
IC50
IC80
in NM_
highest
SD max


Compd ID
ID
(5′→3′)
NO.
ID
(5′→3′)
NO.
(μM)
(μM)
005577.4
dose
KD





SRS-000026
G-000008

text missing or illegible when filed

158
P-000026

text missing or illegible when filed

466
   2.046722
  127.9168
204
60.20508
 7.820476





SRS-000027
G-000009

text missing or illegible when filed

159
P-000027

text missing or illegible when filed

467
  12.28532
#N/A
206
48.55853
 3.722845





SRS-000028
G-000010

text missing or illegible when filed

160
P-000028

text missing or illegible when filed

468
  13.86981
#N/A
207
48.81948
 2.262899





SRS-000029
G-000026

text missing or illegible when filed

161
P-000029

text missing or illegible when filed

469
  49.46417
 4399.698
260
41.22481
 7.184138





SRS-000033
G-000011

text missing or illegible when filed

165
P-000033

text missing or illegible when filed

473
#N/A
#N/A
382
10.80257
10.65991





SRS-000040
G-000012

text missing or illegible when filed

172
P-000040

text missing or illegible when filed

480
#N/A
#N/A
416
22.43361
 6.593784





SRS-000043
G-000013

text missing or illegible when filed

175
P-000043

text missing or illegible when filed

483
#N/A
#N/A
420
25.05174
 6.339611





SRS-000044
G-000038

text missing or illegible when filed

176
P-000044

text missing or illegible when filed

484
#N/A
#N/A
421
27.05507
 3.55983





SRS-000045
G-000039

text missing or illegible when filed

177
P-000045

text missing or illegible when filed

485
#N/A
#N/A
425
25.79898
 7.67276





SRS-000050
G-000044

text missing or illegible when filed

182
P-000050

text missing or illegible when filed

490
#N/A
#N/A
438
16.28757
 9.523407





SRS-000054
G-000048

text missing or illegible when filed

186
P-000054

text missing or illegible when filed

494
  39.77935
 1302.725
470
38.88559
 3.700684





SRS-000056
G-000050

text missing or illegible when filed

188
P-000056

text missing or illegible when filed

496
  61.08738
#N/A
493
43.48794
 2.714998





SRS-000057
G-000051

text missing or illegible when filed

189
P-000057

text missing or illegible when filed

497
#N/A
#N/A
494
41.58673
 1.838853





SRS-000058
G-000052

text missing or illegible when filed

190
P-000058

text missing or illegible when filed

498
#N/A
#N/A
503
28.61084
 2.377041





SRS-000064
G-000058

text missing or illegible when filed

196
P-000064

text missing or illegible when filed

504
   4.327232
  961.917
546
54.44387
 2.479078





SRS-000065
G-000059

text missing or illegible when filed

197
P-000065

text missing or illegible when filed

505
#N/A
#N/A
1162
 1.002411
13.93118





SRS-000066
G-000014

text missing or illegible when filed

198
P-000066

text missing or illegible when filed

506
 123.3882
 1424.798
1163
29.36707
 4.073732





SRS-000067
G-000060

text missing or illegible when filed

199
P-000067

text missing or illegible when filed

507
#N/A
#N/A
1165
18.72208
 5.49196





SRS-000069
G-000015

text missing or illegible when filed

201
P-000069

text missing or illegible when filed

509
#N/A
#N/A
1169
19.26548
 1.456436





SRS-000071
G-000016

text missing or illegible when filed

203
P-000071

text missing or illegible when filed

511
#N/A
#N/A
1172
13.3161
 8.604597





SRS-000073
G-000064

text missing or illegible when filed

205
P-000073

text missing or illegible when filed

513
  35.23821
#N/A
1177
45.02429
 4.735237





SRS-000074
G-000065

text missing or illegible when filed

206
P-000074

text missing or illegible when filed

514
   9.343352
#N/A
1178
51.44863
 1.590263





SRS-000075
G-000066

text missing or illegible when filed

207
P-000075

text missing or illegible when filed

515
4491.018
56880.83
2684
16.44153
 9.013653





SRS-000078
G-000069

text missing or illegible when filed

210
P-000078

text missing or illegible when filed

518
#N/A
#N/A
2705
12.1747
 1.347575





SRS-000079
G-000070

text missing or illegible when filed

211
P-000079

text missing or illegible when filed

519
#N/A
#N/A
2706
41.82359
 0.808165





SRS-000082
G-000017

text missing or illegible when filed

214
P-000082

text missing or illegible when filed

522
#N/A
#N/A
2749
23.07176
13.12197





SRS-000086
G-000018

text missing or illegible when filed

218
P-000086

text missing or illegible when filed

526
#N/A
#N/A
2760
29.35791
15.60843





SRS-000087
G-000076

text missing or illegible when filed

219
P-000087

text missing or illegible when filed

527
#N/A
#N/A
2762
10.5034
 6.168005





SRS-000088
G-000077

text missing or illegible when filed

220
P-000088

text missing or illegible when filed

528
#N/A
#N/A
2764
 5.712127
 7.947043





SRS-000093
G-000082

text missing or illegible when filed

225
P-000093

text missing or illegible when filed

533
 163.9122
#N/A
2894
39.04343
 3.861572





SRS-000106
G-000095

text missing or illegible when filed

238
P-000106

text missing or illegible when filed

546
#N/A
#N/A
3219
13.31607
 9.205419





SRS-000107
G-000096

text missing or illegible when filed

239
P-000107

text missing or illegible when filed

547
#N/A
#N/A
3220
14.80472
 4.612617





SRS-000108
G-000097

text missing or illegible when filed

240
P-000108

text missing or illegible when filed

548
#N/A
#N/A
3223
16.80029
11.10403





SRS-000109
G-000098

text missing or illegible when filed

241
P-000109

text missing or illegible when filed

549
#N/A
#N/A
3226
 6.153194
 7.498487





SRS-000110
G-000019

text missing or illegible when filed

242
P-000110

text missing or illegible when filed

550
#N/A
#N/A
3227
33.61694
 3.644445





SRS-000111
G-000020

text missing or illegible when filed

243
P-000111

text missing or illegible when filed

551
#N/A
#N/A
3276
17.35972
 2.580181





SRS-000112
G-000021

text missing or illegible when filed

244
P-000112

text missing or illegible when filed

552
   8.297705
#N/A
3282
51.59325
 4.521415





SRS-000113
G-000099

text missing or illegible when filed

245
P-000113

text missing or illegible when filed

553
  33.84077
659.9335
3284
45.41711
 6.175907





SRS-000114
G-000100

text missing or illegible when filed

246
P-000114

text missing or illegible when filed

554
   1.349305
11004.53
3285
58.87523
 2.300955





SRS-000120
G-000022

text missing or illegible when filed

252
P-000120

text missing or illegible when filed

560
#N/A
#N/A
3309
10.24371
 7.209576





SRS-000133
G-000118

text missing or illegible when filed

265
P-000133

text missing or illegible when filed

573
#N/A
#N/A
3738
17.57087
 5.286225





SRS-000134
G-000119

text missing or illegible when filed

266
P-000134

text missing or illegible when filed

574
#N/A
#N/A
3741
 2.983854
 2.420011





SRS-000135
G-000120

text missing or illegible when filed

267
P-000135

text missing or illegible when filed

575
#N/A
#N/A
3778
 9.608682
 8.804995





SRS-000140
G-000125

text missing or illegible when filed

272
P-000140

text missing or illegible when filed

580
#N/A
#N/A
3991
19.11657
 7.678151





SRS-000155
G-000140

text missing or illegible when filed

287
P-000155

text missing or illegible when filed

595
#N/A
#N/A
4803
23.19757
11.52321





SRS-000168
G-000153

text missing or illegible when filed

300
P-000168

text missing or illegible when filed

608
#N/A
#N/A
5124
34.5264
 2.589133





SRS-000175
G-000160

text missing or illegible when filed

307
P-000175

text missing or illegible when filed

615
#N/A
#N/A
5505
15.05201
 6.295908





SRS-000176
G-000161

text missing or illegible when filed

308
P-000176

text missing or illegible when filed

616
#N/A
#N/A
5866
 3.802795
 3.789188





As used herein, “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; ″Cf′ refers to 2′ -fluorocytidine-3′-phosphate, “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′- fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate; “T” refers to 5-methyluridine-3′-phosphate; “1” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothicate. The “Transcript Start Site in NM_005577.4” is defined as the 5′ position of a 21-mer target site in human transcript (NCBI Reference Sequence No: NM_0055774).


Note that the sense strand sequenceis coupled to a targeting moiety (e.g., GalNAc or galactose) at the 3′ end of the sense strand. MV: mean value. SD: standard deviation.



text missing or illegible when filed indicates data missing or illegible when filed














TABLE 6





% Change in Cynomolgus Monkey Circulating LP(a) Serum Concentration Following Single 3 mg/kg Dose

















SRS ID






















SRS-
SRS-
SRS-
SRS-
SRS-
SRS-
SRS-
SRS-






000008
000009
000010
000011
000012
000013
000014
000015









Position of 21mer Sense Strand






















204
206
207
382
416
420
1163
1169





% Change
Study
−1
Avg
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0


in Cyno
Day

StDev
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0


Serum

3
Avg
−12.9
−8.9
−1.7
−4.5
−11.9
−11.9
−5.3
8.8


Lipoprotein


StDev
10.8
8.6
20.6
15.0
16.0
12.6
60.4
9.8


A

7
Avg
−49.7
−15.7
−40.0
−19.2
−24.8
−15.2
−18.7
−26.6


concentration


StDev
5.3
7.9
10.3
18.0
10.7
14.7
46.4
12.5


from

10
Avg
−67.5
−6.3
−63.9
−16.4
−31.6
−39.9
−22.5
−43.0


Baseline


StDev
8.4
10.1
10.7
14.6
8.5
8.8
43.0
8.3


(Day −1)

14
Avg
−87.3
−31.8
−84.6
−35.8
−57.2
−63.2
−31.2
−68.1





StDev
4.4
5.3
4.5
4.4
6.1
7.1
48.1
4.8




21
Avg
−98.9
−46.8
−98.7
−43.8
−71.0
−83.6
−47.5
−80.7





StDev
2.2
9.9
2.7
10.3
7.3
3.1
37.1
5.1




28
Avg
−100.0
−43.2
−100.0
−37.5
−77.4
−89.4
−47.0
−90.2





StDev
0.0
14.8
0.0
16.5
5.2
3.5
44.4
7.0




35
Avg
−100.0
−57.9
−100.0
−23.0
−76.5
−91.2
−55.0
−92.2





StDev
0.0
17.9
0.0
11.8
6.4
3.1
35.3
5.6




42
Avg
−100.0
−58.4
−100.0
−31.6
−82.1
−97.5
−64.8
−94.1





StDey
0.0
14.9
0.0
7.6
7.2
3.0
16.2
4.2




49
Avg
−100.0
−61.7
−100.0
−40.5
−83.9
−97.3
−65.5
−92.6





StDev
0.0
27.7
0.0
7.2
8.0
3.2
15.9
5.1




56
Avg
−100.0
−51.1
−100.0
−40.4
−81.4
−95.7
−60.4
−91.9





StDev
0.0
13.9
0.0
5.5
9.7
3.2
16.3
5.8




63
Avg
−100.0
−39.5
−100.0
−33.5
−81.4
−94.2
−57.0
−91.0





StDev
0.0
19.4
0.0
18.1
8.9
4.3
20.0
6.7




70
Avg
−100.0
−37.0
−100.0
−37.3
−81.3
−93.7
−58.4
−89.6





StDev
0.0
21.8
0.0
8.1
11.6
5.9
18.9
7.8




77
Avg
−100.0
−46.1
−100.0
−27.7
−78.0
−93.6
−55.6
−67.0





StDev
0.0
38.8
0.0
6.2
14.3
4.5
13.0
42.5




84
Avg
−100.0
−32.3
−100.0
−20.7
−77.6
−90.5
−52.0
−86.1





StDev
0.0
24.0
0.0
14.5
13.4
7.6
14.4
10.8












SRS ID























SRS-
SRS-
SRS-
SRS-
SRS-
SRS-
SRS-







000016
000017
000018
000019
000020
000021
000022









Position of 21mer Sense Strand























1172
2749
2760
3227
3276
3282
3309







% Change
Study
−1
Avg
0.0
0.0
0.0
0.0
0.0
0.0
0.0



in Cyno
Day

StDev
0.0
0.0
0.0
0.0
0.0
0.0
0.0



Serum

3
Avg
0.2
−4.9
12.8
26.2
−0.1
7.3
22.3



Lipoprotein


StDev
20.8
22.8
31.6
26.6
11.6
17.1
16.8



A

7
Avg
−27.7
−35.1
−17.0
25.0
−3.1
−30.7
25.9



concentration


StDev
16.3
15.5
15.2
20.3
22.1
15.2
13.6



from

10
Avg
−45.9
−54.9
−51.9
−4.1
−30.8
−63.6
16.1



Baseline


StDev
11.4
7.4
10.8
9.2
19.1
7.9
23.2



(Day −1)

14
Avg
−73.8
−74.6
−78.9
−22.7
−51.3
−84.7
1.8






StDev
3.1
7.6
15.0
19.5
13.7
4.1
18.2





21
Avg
−87.6
−87.1
−90.1
−48.7
−65.7
−99.0
−16.6






StDev
1.2
3.8
7.2
10.8
12.8
2.0
14.2





28
Avg
−92.6
−89.7
−94.9
−53.9
−80.3
−100.0
−22.5






StDev
2.4
3.9
4.3
17.0
13.3
0.0
15.4





35
Avg
−95.2
−91.4
−96.5
−59.1
−83.4
−100.0
−17.0






StDev
1.3
3.1
3.1
11.1
11.2
0.0
20.9





42
Avg
−96.7
−93.0
−97.5
−71.8
−86.3
−100.0
−23.4






StDey
2.2
3.9
3.1
20.0
9.7
0.0
11.2





49
Avg
−98.5
−92.0
−97.4
−59.7
−81.8
−100.0
−24.0






StDev
2.0
3.8
3.2
6.2
12.8
0.0
11.1





56
Avg
−98.1
−91.3
−98.5
−46.6
−86.9
−100.0
−26.7






StDev
2.3
3.7
1.9
16.7
9.9
0.0
11.1





63
Avg
−98.3
−89.2
−96.5
−50.5
−85.7
−100.0
−25.0






StDev
2.3
5.4
3.5
12.9
10.3
0.0
9.1





70
Avg
−97.6
−91.2
−95.3
−45.1
−82.3
−100.0
−9.9






StDev
1.7
4.0
4.2
14.4
14.8
0.0
17.8





77
Avg
−96.5
−88.2
−94.2
−40.8
−81.9
−95.3
−6.8






StDev
2.6
5.0
5.3
12.1
13.9
9.4
31.3





84
Avg
−96.0
−86.6
−93.8
−31.8
−78.0
−93.7
−13.9






StDev
1.2
5.0
4.6
13.1
17.6
12.5
24.9

















TABLE 7







% Change in Cynomolgus Monkey Circulating LP(a)


Serum Concentration Following Single 1 mg/kg Dose


% Change in Cyno Serum Lipoprotein A Concentration


from Baseline (Day −1)









SRS ID












SRS-
SRS-
SRS-
SRS-



000013
000016
000017
000018









Position of 21mer Sense Strand












420
1172
2749
2760















Study Day
Avg
StDev
Avg
StDev
Avg
StDev
Avg
StDev


















−1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0


3
8.5
2.7
0.5
13.0
7.6
6.7
−4.5
16.9


7
−11.5
9.9
−13.2
25.0
−22.8
5.4
−26.1
12.2


10
−28.2
8.3
−37.0
20.1
−41.0
6.4
−43.5
8.4


14
−46.2
4.9
−59.4
16.4
−58.3
4.3
−63.4
5.2


21
−65.3
26.5
−83.1
7.9
−85.6
3.2
−87.0
2.8


28
−81.8
5.7
−88.9
3.4
−87.0
5.2
−91.6
1.6


35
−79.9
2.6
−88.4
3.5
−83.5
7.3
−91.1
3.5


42
−76.6
6.3
−89.3
3.6
−84.1
6.3
−91.1
4.1


49
−75.8
10.0
−90.3
3.7
−84.3
5.5
−92.3
3.6


56
−67.9
15.9
−90.6
3.9
−80.2
7.4
−91.0
4.4


63
−70.9
13.6
−90.3
3.7
−78.0
6.8
−90.7
3.1


70
−63.9
18.9
−90.2
3.7
−69.1
8.6
−86.6
4.5


77
−62.6
18.8
−89.9
3.6
−71.1
6.2
−87.7
3.3


85
−62.2
12.7
−90.0
3.6
−67.1
8.2
−84.0
4.6


98
NA
NA
−88.0
3.9
NA
NA
−74.6
8.9


105
NA
NA
−88.5
4.4
NA
NA
−75.2
10.5


112
NA
NA
−86.6
4.7
NA
NA
−66.9
13.8


119
NA
NA
−84.1
6.1
NA
NA
−63.1
15.5


126
NA
NA
−80.3
9.2
NA
NA
−63.6
13.1


133
NA
NA
−79.8
10.2
NA
NA
−61.3
13.4


140
NA
NA
−79.9
10.7
NA
NA
−60.1
11.8








Claims
  • 1. A polynucleic acid molecule for modulating expression of lipoprotein(a) (Lp(a)) gene, comprising a sense strand and an antisense strand, wherein the antisense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 1-154.
  • 2. The polynucleic acid of claim 1, wherein the sense strand comprises comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% identical to a nucleic acid sequence selected from SEQ ID NOs: 309-462.
  • 3. The polynucleic acid molecule of any one of claims 1-2, wherein the antisense strand comprises a nucleic acid sequence comprising at least 14, 15, 16, 17, 18, 19, 20, 21, or 22 consecutive sequences of a nucleic acid sequence selected from SEQ ID NOs: 1-154, with no more than 1, 2, 3, or 4 mismatches.
  • 4. The polynucleic acid molecule of any one of claims 1-3, wherein the sense strand comprises a nucleic acid sequence comprising at least 14, 15, 16, 17, 18, 19, or 20 consecutive sequences from a nucleic acid sequence selected from SEQ ID NOs: 309-462, with no more than 1, 2, 3, or 4 mismatches.
  • 5. The polynucleic acid molecule of any one of claims 1-4, wherein the sense strand comprises one of SEQ ID NOs: 309-462 and the antisense strand comprises a nucleic acid sequence that is selected from SEQ ID NOs: 1-154.
  • 6. The polynucleic acid molecule of any one of claims 1-5, wherein the sense strand comprises at least two consecutive modified internucleotide linkages at the 5′ end.
  • 7. The polynucleic acid molecule of any one of claims 1-6, wherein the antisense strand comprises at least two consecutive modified internucleotide linkages at the 5′ end and/or 3′ end.
  • 8. The polynucleic acid molecule of any one of claims 6-7, wherein the modified internucleotide linkage is a phosphorothioate linkage.
  • 9. The polynucleic acid molecule of claim 8, wherein the modified internucleotide linkage comprises a stereochemically enriched phosphorothioate internucleotide linkage.
  • 10. The polynucleic acid molecule of any one of claims 8-9, wherein the modified internucleotide linkage is an SP chiral internucleotide phosphorothioate linkage.
  • 11. The polynucleic acid molecule of claim 10, wherein the polynucleic acid comprises a plurality of modified internucleotide linkages, and at least 1, 2, 3, or 4 of the plurality of modified internucleotide linkages are stereochemically enriched phosphorothioate internucleotide linkages.
  • 12. The polynucleic acid molecule of any one of claims 9-11, wherein at least one stereochemically enriched phosphorothioate is disposed between two consecutive nucleosides that are two of six 5′ or 3′-terminal nucleosides of the sense strand or the antisense strand.
  • 13. The polynucleic acid molecule of any one of claims 1-12, wherein the sense strand comprises 5′-nnnnnnNfnNfnNfnnnnnnnnnn-3′, wherein the antisense strand comprises 5′-nNfnnnnNfnnnnNfnNfnNfnnnnnnn-3′, wherein n stands for a 2′-O-methyl modified nucleotide, and wherein Nf stands for a 2′-fluoro modified nucleotide.
  • 14. The polynucleic acid molecule of any one of claims 1-13, wherein the sense strand or antisense strand is about 19-25, or about 21-23 nucleotides in length.
  • 15. The polynucleic acid molecule of any one of preceding claims, wherein the sense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 463-616.
  • 16. The polynucleic acid molecule of any one of preceding claims, wherein the antisense strand comprises a nucleic acid sequence that is at least 80%, at least 85%, at least 90%, at least 95% identical to a nucleic acid sequence selected from SEQ ID NOs: 155-308.
  • 17. The polynucleic acid molecule of any one of preceding claims, wherein the sense strand comprises a sequence selected from a nucleic acid sequence of SEQ ID NOs: 463-616, and the antisense strand comprises a sequence selected from a nucleic acid sequence of SEQ ID NOs: 155-308.
  • 18. A polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises: (a) an antisense strand comprising the nucleotide sequence of UAGAUGACCAAGCUUGGCAGGUC (SEQ ID NO: 4) and a sense strand comprising the nucleotide sequence of CCUGCCAAGCUUGGUCAUCUA (SEQ ID NO: 312);(b) an antisense strand comprising the nucleotide sequence of UAUAGAUGACCAAGCUUGGCAGG (SEQ ID NO: 5) and a sense strand comprising the nucleotide sequence of UGCCAAGCUUGGUCAUCUAUA (SEQ ID NO:313);(c) an antisense strand comprising the nucleotide sequence of UCAUAGAUGACCAAGCUUGGCAG (SEQ ID NO: 6) and a sense strand comprising the nucleotide sequence of GCCAAGCUUGGUCAUCUAUGA (SEQ ID NO: 314);(d) an antisense strand comprising the nucleotide sequence of UCGACGGCAGUCCCUUCUGCGUC (SEQ ID NO: 11) and a sense strand comprising the nucleotide sequence of CGCAGAAGGGACUGCCGUCGA (SEQ ID NO: 319);(e) an antisense strand comprising the nucleotide sequence of UUCUAGGCUUGGAACCGGGGUAA (SEQ ID NO: 18) and a sense strand comprising the nucleotide sequence of ACCCCGGUUCCAAGCCUAGAA (SEQ ID NO: 326);(f) an antisense strand comprising the nucleotide sequence of UAGCCUCUAGGCUUGGAACCGGG (SEQ ID NO: 21) and a sense strand comprising the nucleotide sequence of CGGUUCCAAGCCUAGAGGCUA (SEQ ID NO: 329);(g) an antisense strand comprising the nucleotide sequence of UUUACCGUGGUAGCACUCCUGCA (SEQ ID NO: 44) and a sense strand comprising the nucleotide sequence of CAGGAGUGCUACCACGGUAAA (SEQ ID NO: 352);(h) an antisense strand comprising the nucleotide sequence of UUGUCCAUUACCGUGGUAGCACU (SEQ ID NO: 47) and a sense strand comprising the nucleotide sequence of UGCUACCACGGUAAUGGACAA (SEQ ID NO: 355);(i) an antisense strand comprising the nucleotide sequence of UCUCUGUCCAUUACCGUGGUAGC (SEQ ID NO: 49) and a sense strand comprising the nucleotide sequence of UACCACGGUAAUGGACAGAGA (SEQ ID NO: 357);(j) an antisense strand comprising the nucleotide sequence of UAUUGUGUCAGGUUGCAGUACUC (SEQ ID NO: 60) and a sense strand comprising the nucleotide sequence of GUACUGCAACCUGACACAAUA (SEQ ID NO: 368);(k) an antisense strand comprising the nucleotide sequence of UUGCGUCUGAGCAUUGUGUCAGG (SEQ ID NO: 64) and a sense strand comprising the nucleotide sequence of UGACACAAUGCUCAGACGCAA (SEQ ID NO: 372);(l) an antisense strand comprising the nucleotide sequence of UUAACUCUGUCCAUAAUGGUAGU (SEQ ID NO: 88) and a sense strand comprising the nucleotide sequence of UACCAUUAUGGACAGAGUUAA (SEQ ID NO: 396);(m) an antisense strand comprising the nucleotide sequence of UCCAAGCUUGGCAAGUUCUUCCU (SEQ ID NO: 89) and a sense strand comprising the nucleotide sequence of GAAGAACUUGCCAAGCUUGGA (SEQ ID NO: 397);(n) an antisense strand comprising the nucleotide sequence of UAGAUGACCAAGCUUGGCAAGUU (SEQ ID NO: 90) and a sense strand comprising the nucleotide sequence of CUUGCCAAGCUUGGUCAUCUA (SEQ ID NO: 398); or(o) an antisense strand comprising the nucleotide sequence of UGGUCCGACUAUGCUGGUGUGGU (SEQ ID NO: 98) and a sense strand comprising the nucleotide sequence of CACACCAGCAUAGUCGGACCA (SEQ ID NO: 406).
  • 19. A polynucleic acid molecule for modulating expression of Lipoprotein(a) (Lp(a)) gene, wherein polynucleic acid molecule comprises: (a) an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaggsusc (SEQ ID NO: 158) and a sense strand comprising the nucleotide sequence of cscsugccAfaGfcUfuggucaucua (SEQ ID NO: 466);(b) an antisense strand comprising the nucleotide sequence of usAfsuagaUfgaccAfaGfcUfuggcasgsg (SEQ ID NO: 159) and a sense strand comprising the nucleotide sequence of usgsccaaGfcUfuGfgucaucuaua (SEQ ID NO: 467);(c) an antisense strand comprising the nucleotide sequence of usCfsauagAfugacCfaAfgCfuuggcsasg (SEQ ID NO: 160) and a sense strand comprising the nucleotide sequence of gscscaagCfuUfgGfucaucuauga (SEQ ID NO: 468);(d) an antisense strand comprising the nucleotide sequence of usCfsgacgGfcaguCfcCfuUfcugcgsusc (SEQ ID NO: 165) and a sense strand comprising the nucleotide sequence of csgscagaAfgGfgAfcugccgucga (SEQ ID NO: 473);(e) an antisense strand comprising the nucleotide sequence of usUfscuagGfcuugGfaAfcCfggggusasa (SEQ ID NO: 172) and a sense strand comprising the nucleotide sequence of ascscccgGfuUfcCfaagccuagaa (SEQ ID NO: 480);(f) an antisense strand comprising the nucleotide sequence of usAfsgccuCfuaggCfuUfgGfaaccgsgsg (SEQ ID NO: 175) and a sense strand comprising the nucleotide sequence of csgsguucCfaAfgCfcuagaggcua (SEQ ID NO: 483);(g) an antisense strand comprising the nucleotide sequence of usUfsuaccGfugguAfgCfaCfuccugscsa (SEQ ID NO: 198) and a sense strand comprising the nucleotide sequence of csasggagUfgCfuAfccacgguaaa (SEQ ID NO: 506);(h) an antisense strand comprising the nucleotide sequence of usUfsguccAfuuacCfgUfgGfuagcascsu (SEQ ID NO: 201) and a sense strand comprising the nucleotide sequence of usgscuacCfaCfgGfuaauggacaa (SEQ ID NO: 509);(i) an antisense strand comprising the nucleotide sequence of usCfsucugUfccauUfaCfcGfugguasgsc (SEQ ID NO: 203) and a sense strand comprising the nucleotide sequence of usasccacGfgUfaAfuggacagaga (SEQ ID NO: 511);(j) an antisense strand comprising the nucleotide sequence of usAfsuuguGfucagGfuUfgCfaguacsusc (SEQ ID NO: 214) and a sense strand comprising the nucleotide sequence of gsusacugCfaAfcCfugacacaaua (SEQ ID NO: 522);(k) an antisense strand comprising the nucleotide sequence of usUfsgcguCfugagCfaUfuGfugucasgsg (SEQ ID NO: 218) and a sense strand comprising the nucleotide sequence of usgsacacAfaUfgCfucagacgcaa (SEQ ID NO: 526);(l) an antisense strand comprising the nucleotide sequence of usUfsaacuCfugucCfaUfaAfugguasgsu (SEQ ID NO: 242) and a sense strand comprising the nucleotide sequence of usasccauUfaUfgGfacagaguuaa (SEQ ID NO: 550);(m) an antisense strand comprising the nucleotide sequence of usCfscaagCfuuggCfaAfgUfucuucscsu (SEQ ID NO: 243) and a sense strand comprising the nucleotide sequence of gsasagaaCfuUfgCfcaagcuugga (SEQ ID NO: 551);(n) an antisense strand comprising the nucleotide sequence of usAfsgaugAfccaaGfcUfuGfgcaagsusu (SEQ ID NO: 244) and a sense strand comprising the nucleotide sequence of csusugccAfaGfcUfuggucaucua (SEQ ID NO: 552); or(o) an antisense strand comprising the nucleotide sequence of usGfsguccGfacuaUfgCfuGfgugugsgsu (SEQ ID NO: 252) and a sense strand comprising the nucleotide sequence of csascaccAfgCfaUfagucggacca (SEQ ID NO: 560),wherein “A” refers to adenosine-3′-phosphate; “a” refers to 2′-O-methyladenosine-3′-phosphate; “Af” refers to 2′-fluoroadenosine-3′-phosphate; “C” refers to cytidine-3′-phosphate; “c” refers to 2′-O-methylcytidine-3′-phosphate; “Cf” refers to 2′-fluorocytidine-3′-phosphate; “G” refers to guanosine-3′-phosphate; “g” refers to 2′-O-methylguanosine-3′-phosphate; “Gf” refers to 2′-fluoroguanosine-3′-phosphate; “U” refers to uridine-3′-phosphate; “u” refers to 2′-O-methyluridine-3′-phosphate; “Uf” refers to 2′-fluorouridine-3′-phosphate: “T” refers to 5-methyluridine-3′-phosphate; “t” refers to 2′-O-methyl-5-methyluridine-3′-phosphate; “Tf” refers to 2′-fluoro-5-methyluridine-3′-phosphate; “s” refers to 3′-phosphorothioate.
  • 20. A polynucleic acid molecule conjugate for modulating expression of lipoprotein(a) gene (Lp(a)), wherein the polynucleic acid molecule conjugate comprises a polynucleic acid molecule of any one of claims [0221]-19 and an asialoglycoprotein receptor targeting moiety.
  • 21. The polynucleic acid molecule conjugate of claim 20, wherein the asialoglycoprotein receptor targeting moiety comprises N-Acetylgalactosamine (GalNAc) or galactose.
  • 22. The polynucleic acid molecule conjugate of one of claims 20-21, wherein the polynucleic acid molecule and the asialoglycoprotein receptor targeting moiety is coupled via a linker.
  • 23. The polynucleic acid molecule conjugate of claim 22, wherein the linker is a cleavable linker.
  • 24. The polynucleic acid molecule conjugate of any one of claims 21-23, wherein the GalNAc comprises an anomeric carbon bonded to trivalent, tetravalent linker, pentavalent, or hexavalent linker, wherein the anomeric carbon is part of a hemiaminal group.
  • 25. The polynucleic acid molecule conjugate of any one of claims 22-24, wherein the linker comprises formula (IV) below,
  • 26. The polynucleic acid molecule conjugate of claim 25, wherein the Y1 is the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule.
  • 27. The polynucleic acid molecule conjugate of any one of claims 22-26, wherein the linker and the asialoglycoprotein receptor targeting moiety with the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule are shown in Formula (V′), Formula (V″″), Formula (V′∝″), or Formula (V″″″):
  • 28. The polynucleic acid molecule conjugate of claim 27, wherein the linker and the asialoglycoprotein receptor targeting moiety with the last nucleotide on the 3′-terminus of the sense strand of the polynucleic acid molecule are shown in Formula (V′):
  • 29. A pharmaceutical composition comprising a polynucleic acid molecule of any one of claims [0221]-19 or a polynucleic acid molecule conjugate of any one of claims 20-28, and a pharmaceutically acceptable excipient.
  • 30. The pharmaceutical composition of claim 29, wherein the pharmaceutical composition is formulated for parenteral, oral, intranasal, buccal, rectal, transdermal, intravenous, subcutaneous, or intrathecal administration.
  • 31. A method of modulating expression of lipoprotein(a)(Lp(a)) gene in a subject in need thereof, comprising: administering to the subject a polynucleic acid molecule of any one of claims 1-19, a polynucleic acid molecule conjugate of any one of claim s 20-28, or a pharmaceutical composition of any one of claims 29-30, thereby modulating the expression of Lp(a) gene in the subject in need thereof.
  • 32. A method for treating or preventing a cardiovascular disease or a lipid disorder, comprising administering to the subject a polynucleic acid molecule of any one of claims 1-19, a polynucleic acid molecule conjugate of any one of claims 20-28, or a pharmaceutical composition of any one of claims 29-30, thereby modulating the expression of Lp(a) gene in the subject in need thereof.
  • 33. The method of any one of claims 31-32, wherein the polynucleic acid molecule is administered at a dose sufficient to decrease the expression of Lp(a) gene in a cell of said subject or to decrease plasma Lp(a) level of said subject by at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, or 90% compared to a control.
  • 34. The method of any one of claims 32-33, wherein the cardiovascular disease is coronary artery disease, acute myocardial infarction, asymptomatic carotid atherosclerosis, stroke, atrial fibrillation, hypercholesterolemia, or peripheral artery occlusive disease.
  • 35. The method of any one of claims 32-33, wherein the lipid disorder is hyperlipidemia or hypercholesterolemia.
CROSS-REFERENCES

This application is a continuation of International Application No. PCT/US2023/030019, filed Aug. 10, 2023, which claims the benefit of U.S. Provisional Application No. 63/371,167, filed on Aug. 11, 2022, and U.S. Provisional Application No. 63/449,914, filed on Mar. 3, 2023, each of which is incorporated herein by reference in its entirety.

Provisional Applications (2)
Number Date Country
63449914 Mar 2023 US
63371167 Aug 2022 US
Continuations (1)
Number Date Country
Parent PCT/US2023/030019 Aug 2023 WO
Child 19048756 US