We determined the effect of attaching palmitate, tocopherol or cholesterol to PS ASOs and their effects on plasma protein binding and on enhancing ASO potency in the muscle of rodents and monkeys. We found that cholesterol ASO conjugates showed 5-fold potency enhancement in the muscle of rodents relative to unconjugated ASOs. However, they were toxic in mice and as a result were not evaluated in the monkey. In contrast, palmitate and tocopherol-conjugated ASOs showed enhanced potency in the skeletal muscle of rodents and modest enhancements in potency in the monkey. Analysis of the plasma-protein binding profiles of the ASO-conjugates by size-exclusion chromatography revealed distinct and species-specific differences in their association with plasma proteins which likely rationalizes their behavior in animals. Overall, our data suggest that modulating binding to plasma proteins can influence ASO activity and distribution to extra-hepatic tissues in a species-dependent manner and sets the stage to identify other strategies to enhance ASO potency in muscle tissues.
Despite recent advances, targeted
delivery of therapeutic oligonucleotide
to extra-hepatic tissues continues to be a challenging endeavor and
efficient ligand–receptor systems need to be identified. To
determine the feasibility of using neurotensin to improve the productive
uptake of antisense oligonucleotides (ASO), we synthesized neurotensin-ASO
conjugates and evaluated their cellular uptake and activity in cells
and in mice. We performed a comprehensive structure–activity
relationship study of the conjugates and determined the influence
of ASO charge, ASO length, peptide charge, linker chemistry and ligand
identity on receptor binding and internalization. We identified a
modified neurotensin peptide capable of improving the cellular uptake
and activity of gapmer ASOs in sortilin expressing cells (sixfold)
and in spinal cord in mice (twofold). Neurotensin conjugation also
improved the potency of morpholino ASO designed to correct splicing
of survival motor neuron pre-mRNA in the cortex and striatum after
intracerebroventricular injection. Neurotensin-mediated targeted delivery
represents a possible approach for enhancing the potency of ASOs with
diverse nucleic acid modifications.
The M2 pyruvate kinase (PKM2) isoform is upregulated in most cancers and plays a crucial role in regulation of the Warburg effect, which is characterized by the preference for aerobic glycolysis over oxidative phosphorylation for energy metabolism. PKM2 is an alternative-splice isoform of the PKM gene and is a potential therapeutic target. Antisense oligonucleotides (ASO) that switch PKM splicing from the cancer-associated PKM2 to the PKM1 isoform have been shown to induce apoptosis in cultured glioblastoma cells when delivered by lipofection. Here, we explore the potential of ASO-based PKM splice switching as a targeted therapy for liver cancer. A more potent lead constrained-ethyl (cEt)/DNA ASO induced PKM splice switching and inhibited the growth of cultured hepatocellular carcinoma (HCC) cells. This PKM isoform switch increased pyruvate-kinase activity and altered glucose metabolism. In an orthotopic HCC xenograft mouse model, the lead ASO and a second ASO targeting a nonoverlapping site inhibited tumor growth. Finally, in a genetic HCC mouse model, a surrogate mouse-specific ASO induced Pkm splice switching and inhibited tumorigenesis, without observable toxicity. These results lay the groundwork for a potential ASO-based splicing therapy for HCC.
Significance:
Antisense oligonucleotides are used to induce a change in PKM isoform usage in hepatocellular carcinoma, reversing the Warburg effect and inhibiting tumorigenesis.
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