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Pharmacokinetics and Proceedings in Clinical Application of Nucleic Acid Therapeutics

期刊

MOLECULAR THERAPY
卷 29, 期 2, 页码 521-539

出版社

CELL PRESS
DOI: 10.1016/j.ymthe.2020.11.008

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  1. EU Consolidator Grant Longheart

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Oligonucleotide therapeutics are a promising class of drugs targeting RNA molecules to revolutionize disease treatment. Through chemical modifications for stability and binding, these drugs show potential in treating neurodegenerative, cardiac, and cancer disorders. With ongoing research and development, these oligonucleotide-based agents are paving the way for next-generation therapeutics.
Oligonucleotide therapeutics are a novel promising class of drugs designed to specifically target either coding or non coding RNA molecules to revolutionize treatment of various diseases. During preclinical development, investigations of the pharmacokinetic characteristics of these oligonucleotide-based drug candidates are essential. Oligonucleotides possess a long history of chemical modifications to enhance their stability and binding affinity, as well as reducing toxicity. Phosphorothioate backbone modifications of oligonucleotides were a hallmark of this development process that greatly enhanced plasma stability and protein binding of these agents. Modifications such as 2'-O-methylation further improved stability, while other modifications of the ribose, such as locked nucleic acid (LNA) modification, significantly increased binding affinity, potency, and tissue half-life. These attributes render oligonucleotide therapeutics able to regulate protein expression in both directions depending on the target RNA. Thus, a growing interest has emerged using these oligonucleotides in the treatment of neurodegenerative and cardiac disorders as well as cancer, since the deregulation of certain coding and non-coding RNAs plays a key role in the development of these diseases. Cutting edge research is being performed in the field of non-coding RNAs, identifying potential therapeutic targets, and developing novel oligonucleotide-based agents that outperform classical drugs. Some of these agents are either in clinical trials showing promising results or are already US Food and Drug Administration (FDA) approved, with more oligonucleotides being developed for therapeutic purposes. This is the advent of mechanism-based next-generation therapeutics for a wide range of diseases.

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