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Article ; Online: Splice-Modulating Antisense Oligonucleotides as Therapeutics for Inherited Metabolic Diseases.

Chen, Suxiang / Heendeniya, Saumya Nishanga / Le, Bao T / Rahimizadeh, Kamal / Rabiee, Navid / Zahra, Qurat Ul Ain / Veedu, Rakesh N

BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy

2024  Volume 38, Issue 2, Page(s) 177–203

Abstract: The last decade (2013-2023) has seen unprecedented successes in the clinical translation of therapeutic antisense oligonucleotides (ASOs). Eight such molecules have been granted marketing approval by the United States Food and Drug Administration (US FDA) ...

Abstract The last decade (2013-2023) has seen unprecedented successes in the clinical translation of therapeutic antisense oligonucleotides (ASOs). Eight such molecules have been granted marketing approval by the United States Food and Drug Administration (US FDA) during the decade, after the first ASO drug, fomivirsen, was approved much earlier, in 1998. Splice-modulating ASOs have also been developed for the therapy of inborn errors of metabolism (IEMs), due to their ability to redirect aberrant splicing caused by mutations, thus recovering the expression of normal transcripts, and correcting the deficiency of functional proteins. The feasibility of treating IEM patients with splice-switching ASOs has been supported by FDA permission (2018) of the first "N-of-1" study of milasen, an investigational ASO drug for Batten disease. Although for IEM, owing to the rarity of individual disease and/or pathogenic mutation, only a low number of patients may be treated by ASOs that specifically suppress the aberrant splicing pattern of mutant precursor mRNA (pre-mRNA), splice-switching ASOs represent superior individualized molecular therapeutics for IEM. In this work, we first summarize the ASO technology with respect to its mechanisms of action, chemical modifications of nucleotides, and rational design of modified oligonucleotides; following that, we precisely provide a review of the current understanding of developing splice-modulating ASO-based therapeutics for IEM. In the concluding section, we suggest potential ways to improve and/or optimize the development of ASOs targeting IEM.
MeSH term(s) Humans ; Metabolic Diseases/drug therapy ; Metabolic Diseases/genetics ; Oligonucleotides, Antisense/therapeutic use ; United States
Chemical Substances Oligonucleotides, Antisense
Language English
Publishing date 2024-01-22
Publishing country New Zealand
Document type Review ; Journal Article
ZDB-ID 1364202-9
ISSN 1179-190X ; 1173-8804
ISSN (online) 1179-190X
ISSN 1173-8804
DOI 10.1007/s40259-024-00644-7
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