Hypoxia is a common hallmark of human
disease that is characterized
by abnormally low oxygen levels in the body. While the effects of
hypoxia on many small molecule-based drugs are known, its effects
on several classes of next-generation medications including messenger
RNA therapies warrant further study. Here, we provide an efficacy-
and mechanism-driven study that details how hypoxia impacts the cellular
response to mRNA therapies delivered using 4 different chemistries
of lipid nanoparticles (LNPs, the frontrunner class of drug delivery
vehicles for translational mRNA therapy utilized in the Moderna and
Pfizer/BioNTech COVID-19 vaccines). Specifically, our work provides
a comparative analysis as to how various states of oxygenation impact
LNP-delivered mRNA expression, cellular association, endosomal escape,
and intracellular ATP concentrations following treatment with 4 different
LNPs across 3 different cell lines. In brief, we first identify that
hypoxic cells express less LNP-delivered mRNA into protein than normoxic
cells. Next, we identify generalizable cellular reoxygenation protocols
that can reverse the negative effects that hypoxia imparts on LNP-delivered
mRNA expression. Finally, mechanistic studies that utilize fluorescence-activated
cell sorting, confocal microscopy, and enzyme inhibition reveal that
decreases in mRNA expression correlate with decreases in intracellular
ATP (rather than with differences in mRNA LNP uptake pathways). In
presenting this data, we hope that our work provides a comprehensive
efficacy and mechanism-driven study that explores the impact of differential
oxygenation on LNP-delivered mRNA expression while simultaneously
establishing fundamental criteria that may one day be useful for the
development of mRNA drugs to treat hypoxia-associated disease.