This page is archived

Links to external sources may no longer work as intended. The content may not represent the latest thinking in this area or the Society’s current position on the topic.

Oligonucleotide therapeutics: challenges and opportunities

08 February 2022 13:00 - 17:00

Read the conference report summarising the event (PDF).

This Royal Society meeting will seek to explore the opportunities and existing challenges of oligonucleotide-based therapies as a platform. Speakers will discuss overcoming barriers in manufacturing and stability of molecules, and the delivery, and efficacy and efficiency of oligonucleotide-based therapies. 

Background

This meeting will bring together key stakeholders from across the sector to highlight the emerging technologies in the field and explore opportunities around the use of oligonucleotides as therapeutic agents, including siRNA, antisense, and aptamers.  

Speakers will also outline some of the key challenges such as targeted delivery, the balance of efficacy and efficiency, and manufacturing that must be addressed if these wide ranging therapeutics are to be successful.

The conference will conclude with a panel discussion on the future of Oligonucleotide therapeutics.

About the conference series

Supported by AstraZeneca, the meeting will form part of the Royal Society’s Transforming our future conferences in the life sciences. These meetings are unique, high-level events that address the scientific and technical challenges of the next decade. Each conference features cutting edge science from industry and academia and brings together leading experts from the scientific community, including regulatory, charity and funding bodies.

Organisers

  • Professor Sarah J Tabrizi FMedSci, Director of UCL Huntington's disease centre, UCL Institute of Neurology, and UK DRI UCL

    Sarah Tabrizi is Professor of Clinical Neurology and joint Head of Dept of Neurodegenerative disease at the UCL Institute of Neurology, Honorary Consultant Neurologist at the National Hospital of Neurology and Neurosurgery, Queen Square, London, and Director of the UCL Huntington’s Disease Centre. Her research focuses on understanding the basic cellular mechanisms of neurodegeneration, in particular Huntington’s disease (HD), and finding effective disease-modifying therapies for HD. She has identified a key role for the innate immune system in the pathogenesis of HD, and leads two major, multidisciplinary research initiatives, TRACK-HD and Track-On HD, aimed at understanding the neurobiology of the neurodegenerative changes in premanifest and early stage HD gene carriers, and is actively working on developing and testing disease-modifying therapies for HD. Sarah is clinical global PI for the world’s first gene silencing trial in HD which started in September 2015, is an elected Fellow of the UK Academy of Medical Sciences. In 2017 she received the Seventh International Leslie Gehry Brenner prize for Innovation in Science awarded by the Hereditary Disease Foundation.

  • Professor Peter Goodfellow FMedSci FRS

    Peter Goodfellow is a geneticist who tracked down the genetic essence of human ‘maleness’. In a high-profile scientific race to find the enigmatic ‘testis-determining factor’ (TDF; also known as sex-determining region Y (SRY) protein), Peter overturned others’ claims by correctly pinpointing the tiny SRY gene on the Y chromosome as the lynchpin of maleness in mammals.

    Peter’s famous work began with his clever use of cell and molecular biology techniques to narrow down a segment of the Y chromosome as the location for the elusive TDF-encoding gene. Subsequently he found the crucial SRY gene and, with others, engineered a female mouse to become male through SRY expression.

    In 1995, Peter won the Louis–Jeantet Prize for this work. The following year he began a decade-long chapter of his career, working in industry. Joining SmithKline Beecham as Head of Discovery, he then became — following a merger — Senior Vice-President of Discovery Research in the newly formed GlaxoSmithKline. Peter is now mostly retired.

  • Dr Shalini Andersson, AstraZeneca

    Shalini is Vice President Oligonucleotide Discovery in BioPharmaceuticals R&D, AstraZeneca. She is a member of the Management Team for Discovery Sciences as well as of the Review Board for drug projects in all therapy areas in BioPharmaceuticals R&D. 

    Shalini is also leading Targeted Drug Delivery within Cardiovascular, Renal and metabolic diseases and several collaborations with academic research groups and biotechs in the nucleic therapeutics field. 

    Shalini received her PhD in 1989 at the University of Linköping, Sweden. Prior to joining AstraZeneca in 1997, she was Associate Professor in Organic and Analytical Chemistry at the University of Linköping, Sweden. She is the author or co-author of over 50 peer reviewed articles and 5 patents. 

    Shalini is member of the Board of Oligonucleotide Therapeutics Society and of the Scientific Advisory Group for Nucleic Acid Therapy Accelerator (UK). 

Schedule

Chair

Professor Sarah J Tabrizi FMedSci, Director of UCL Huntington's disease centre, UCL Institute of Neurology, and UK DRI UCL

13:05 - 13:25 Genetic Based Medicines for Neurological Diseases

Currently there are multiple genetic based medicines being pursued for neurological diseases including antisense technology, gene therapy and gene editing technologies. Antisense oligonucleotides (ASOs are one of the more advanced technologies. ASOs are synthetic, chemical modified nucleic acid analogs designed to bind to RNA by Watson-Crick base paring. Upon binding to the RNA, ASOs modulate the function of the targeted RNA through a variety of mechanisms. Both protein coding, as well as non-coding RNAs, can be targets of ASO based drugs, significantly broadening therapeutic targets for drug discovery compared to small molecules and protein based therapeutics. The approval of nusinersen (Spinraza™) as a treatment for spinal muscular atrophy (SMA) validates the utility of antisense drugs for the treatment of motor neuron diseases. The application of antisense technology as potential therapy for other neurological diseases and neurodevelopmental disorders will be discussed.

Dr C. Frank Bennett, Chief Scientific Officer, Ionis Pharmaceuticals, Carlsbad, CA USA

13:25 - 13:45 Basic science of Oligonucleotides and how chemistry can solve some of the challenges faced

Professor Anastasia Khvorova, University of Massachusetts Medical School

13:45 - 14:05 Challenges and opportunities in targeted delivery and distribution

While oligonucleotide therapies have enormous therapeutic potential, significant challenges in drug delivery to many extra-hepatic cell/tissue types remain. This is particularly the case for neurological and neuromuscular disorders where limited efficacy and poor oligonucleotide delivery to affected tissues including skeletal muscle, cardiac muscle and the central nervous system, represent both major challenges and opportunities. A wide range of delivery technologies are being advanced to address this challenge, including bio-conjugates and nanotechnologies. Current progress and future prospects will be discussed.

Professor Matthew Wood, University of Oxford

14:05 - 14:25 Panel Q&A

Dr C. Frank Bennett, Chief Scientific Officer, Ionis Pharmaceuticals, Carlsbad, CA USA

Professor Anastasia Khvorova, University of Massachusetts Medical School

Professor Matthew Wood, University of Oxford

14:35 - 14:50 Exploring the safety of antisense oligonucleotides

There is an urgent need for increased mechanistic understanding of the events that follow entry of ASOs into cells. One area that has been little explored is the effect that ASOs have on the RNA binding proteome (RBPome). The RBPs have key regulatory functions and post-transcriptional networks are combinatorially controlled by common RBPs, which regulate gene expression via coordination of RNA splicing, mRNA export, stability, localization and translation to maintain homeostasis. In addition, many the ~1000 proteins that have the capacity to bind RNA, are multifunctional, with their activities controlled through RNA binding. Subverting normal cellular RBP function through their interaction with ASOs could have cell-wide impact on: i) key metabolic functions such as the liver in appropriate binding of ASOs to RNA-binding metabolic enzymes could subvert this key regulatory step; ii) cytoplasmic control of gene expression e.g. by competing with endogenous RNA turnover mechanism; iii) the localisation of RNA binding proteins; iv) the response to cell stress e.g. viral infection. We have developed in vitro models capturing cytotoxicity and proinflammatory ASO effects and established detailed in vitro and in vivo safety profiles for a set of reference ASOs. Preliminary data using orthogonal organic phase separation (OOPS) indicate that we can identify differences in RBP binding between ASOs of different properties. By building on our findings from hepatocyte delivery of GalNAc conjugated ASOs and siRNA and using the same set of ASOs for different cell biological/ biochemical assays across selected cell-types, we are generating a large knowledge base to identify desired and undesired properties and mechanisms for efficient and safe uptake of ASOs. In the future these data will be key for optimizing novel delivery approaches, translational and quantitative risk assessment strategies and guide optimization of novel delivery systems from both efficacy and safety perspective. 

Dr Ritwick Sawarkar, MRC Investigator, MRC Toxicology Unit, University of Cambridge.

14:50 - 15:05 Living in the World of RNA Therapeutics

Synthetic small interfering RNAs (siRNAs) are potent inhibitors of gene expression; these agents act through the natural RNA interference (RNAi) pathway. After the demonstration of twenty years of mammalian RNAi in cells, four drugs impacting patients globally that act through the RNAi pathway have been approved.  To deliver therapeutic siRNAs into liver hepatocytes, Alnylam has developed a three-pronged approach involving chemical modification of siRNAs, lipid nanoparticle (LNP) formulation of siRNAs for intravenous administration, and trivalent N-acetylgalactosamine (GalNAc) conjugation to siRNAs for subcutaneous administration. 

The LNP strategy with a partially chemically modified siRNA resulted in the first RNAi therapeutic, ONPATTRO®(patisiran), approved in 2018 is used to treat polyneuropathy in patients with hereditary ATTR amyloidosis.  The approval of ONPATTRO paved the way for a whole new class of RNA-based medicines and further validated LNP platform-based delivery of nucleic acids for human therapeutics including mRNA-based vaccines. 

In 2019 the human therapeutic utility of the the asialoglycoprotein (ASGPR) receptor-GalNAc ligand pair for delivery of nucleic acids for the first-time was fully realized by Alnylam. By combining the chemical modifications of oligonucleotides contributing to various flavors of Enhanced Stabilization Chemistry (ESC, Advanced ESC and ESC+) along with the triantennary N-acetylgalactosamine (GalNAc) ligand, Alnylam enabled human therapeutic applications of hepatocyte-targeting GalNAc-conjugated oligonucleotides. This delivery platform has revolutionized the RNA-based therapeutics field. Three GalNAc-conjugated RNAi therapeutics have been approved so far: GIVLAARI® (givosiran, 2019) for treating acute hepatic porphyria, the only drug available to treat this disease, OXLUMO® (lumasiran, 2020, 2021) for the treatment of primary hyperoxaluria type 1 in both adult and pediatric populations, and Leqvio (inclisiran, 2020) for treatment of a highly prevalent global disease hypercholesterolemia. Several other GalNAc-conjugated siRNAs are being evaluated. 

The next frontier is treatment of diseases of extra-hepatic tissues such as the central nervous system and the eye, and potential delivery platforms are currently being evaluated at Alnylam.

Dr Muthiah Manoharan, Alnylam Pharmaceuticals, Cambridge, Massachusetts, USA

15:05 - 15:20 Building partnerships: an introduction to the MRC/UKRI Nucleic Acid Therapy Accelerator

The Nucleic Acid Therapy Accelerator (NATA) is a newly founded MRC funded research initiative based on the Harwell Research Campus with a mission to accelerate the development of nucleic acid therapeutics, building partnerships with industry and academia from around the world.

NATA is uniquely placed to establish novel expertise and build partnerships to advance the development of nucleic acid therapeutics for the treatment of both rare and common diseases. Our mission is to provide access to expertise and infrastructure that will establish NATA and the UK as an international centre of excellence for nucleic acid-based therapies.

Professor Nick Lench, Executive Director, NATA

15:20 - 15:35 Regulatory paths for oligotherapeutics

Dr David R Jones

15:35 - 15:50 Q&A panel

Chair

Dr Annemieke Aartsma-Rus, Professor of translational genetics, Department of Human Genetics, Leiden University Medical Center

Dr Steve Hood, GSK

Dr Muthiah Manoharan, Alnylam Pharmaceuticals, Cambridge, Massachusetts, USA

Dr Annemieke Aartsma-Rus, Professor of translational genetics, Department of Human Genetics, Leiden University Medical Center