USE OF A1CF INHIBITORS FOR TREATING HEPATITIS B VIRUS INFECTION
20230257748 · 2023-08-17
Assignee
Inventors
- Dennis Jul HANSEN (Farum, DK)
- Souphalone Luangsay (Basel, CH)
- Alan James MUELLER-BRECKENRIDGE (Munchenstein, CH)
- Lykke Pedersen (Kobenhavn NV, DK)
- Johanna Marie POSE VICENTE (Birsfelden, CH)
Cpc classification
A61K47/549
HUMAN NECESSITIES
C12N15/113
CHEMISTRY; METALLURGY
International classification
C12N15/113
CHEMISTRY; METALLURGY
A61K48/00
HUMAN NECESSITIES
A61K47/26
HUMAN NECESSITIES
Abstract
The present invention relates to an A1CF inhibitor for use in treatment of an HBV infection, in particular a chronic HBV infection. The invention in particular relates to the use of A1CF inhibitors for destabilizing cccDNA, such as HBV cccDNA. The invention also relates to nucleic acid molecules which are complementary to A1CF and capable of reducing the level of an A1CF mRNA. Also comprised in the present invention is a pharmaceutical composition and its use in the treatment of a HBV infection.
Claims
1. An A1CF (APOBEC1 complementation factor) inhibitor for use in the treatment of Hepatitis B virus (HBV) infection.
2. The A1CF inhibitor for use according to claim 1, wherein the HBV infection is a chronic infection.
3. The A1CF inhibitor for use according to claim 1 or 2, wherein the A1CF inhibitor is capable of reducing the amount of cccDNA (covalently closed circular DNA) in an HBV infected cell.
4. The A1CF inhibitor for use according to any one of claims 1 to 3, wherein said inhibitor is a nucleic acid molecule of 12 to 60 nucleotides in length comprising a contiguous nucleotide sequence of at least 12 nucleotides in length which is at least 95% complementary, such as fully complementary, to a mammalian A1CF target sequence, in particular a human A1CF target sequence, and is capable of reducing the expression of A1CF mRNA in a cell which expresses the A1CF mRNA.
5. The A1CF inhibitor for use according to any one of claims 1 to 4, wherein said inhibitor is selected from the group consisting of a single stranded antisense oligonucleotide, an siRNA and a shRNA.
6. The A1CF inhibitor for use according to any one of claims 1 to 5, wherein the mammalian A1CF target sequence is selected from the group consisting of SEQ ID NOs: 1, 4, 5, 6, 7, 8, 9, 10, and 11.
7. The A1CF inhibitor for use according to any one of claims 4 to 6, wherein the contiguous nucleotide sequence is at least 98% complementary, such as fully complementary, to the target sequence of SEQ ID NO: 1 and SEQ ID NO: 2.
8. The A1CF inhibitor for use according to any one of claims 3 to 7, wherein the amount of cccDNA in the HBV infected cell is reduced by at least 60%.
9. The A1CF inhibitor for use according to any one of claims 4 to 7, wherein the A1CF mRNA is reduced by at least 60%.
10. A nucleic acid molecule of 12 to 30 nucleotides in length comprising a contiguous nucleotides sequence of at least 12 nucleotides which is 90% complementary, such as fully complementary, to a mammalian A1CF target sequence, in particular a human A1CF target sequence, wherein the nucleic acid molecule is capable of inhibiting the expression of A1CF mRNA.
11. The nucleic acid molecule according to claim 10, wherein the contiguous nucleotide sequence is fully complementary to a sequence selected from the group consisting of SEQ ID NOs: 1, 4, 5, 6, 7, 8, 9, 10, and 11.
12. The nucleic acid molecule according to claim 10 or 11, wherein the nucleic acid molecule comprises a contiguous nucleotide sequence of 12 to 25, such as 16 to 20 nucleotides in length.
13. The nucleic acid molecule of any one of claims 10 to 12, wherein the nucleic acid molecule is a RNAi molecule, such as a double stranded siRNA or a shRNA.
14. The nucleic acid molecule of any one of claims 10 to 12, wherein the nucleic acid molecule is a single stranded antisense oligonucleotide.
15. The nucleic acid molecule according to 14, wherein the single stranded antisense oligonucleotide is capable of recruiting RNase H.
16. The nucleic acid molecule according to any one of claims 10 to 15, wherein the nucleic acid molecule comprises one or more 2′ sugar modified nucleosides.
17. The nucleic acid molecule according to claim 16, wherein the one or more 2′ sugar modified nucleosides are independently selected from the group consisting of 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA, 2′-amino-DNA, 2′-fluoro-DNA, arabino nucleic acid (ANA), 2′-fluoro-ANA and LNA nucleosides.
18. The nucleic acid molecule according to any one of claim 16 or 17, wherein the one or more 2′ sugar modified nucleosides are LNA nucleosides.
19. The nucleic acid molecule according to any one of claims 10 to 18, where the contiguous nucleotide sequence comprises at least one phosphorothioate internucleoside linkage.
20. The nucleic acid molecule according to claim 19, wherein all the internucleoside linkages within the contiguous nucleotide sequence are phosphorothioate internucleoside linkages.
21. The nucleic acid molecule according to any one of claims 10 to 20, wherein the nucleic acid molecule, or contiguous nucleotide sequence thereof, comprises a gapmer of formula 5′-F-G-F′-3′, wherein regions F and F′ independently comprise 1-4 2′ sugar modified nucleosides and G is a region between 6 and 18 nucleosides which are capable of recruiting RNase H, such as a region comprising between 6 and 18 DNA nucleosides.
22. A conjugate compound comprising a nucleic acid molecule according to any one of claims 10 to 21 and at least one conjugate moiety covalently attached to said nucleic acid molecule.
23. The conjugate compound of claim 22, wherein the conjugate moiety is or comprises a GalNAc moiety, such as a trivalent GalNAc moiety, for example a GalNAc moiety selected from one or more of the trivalent GalNAc moieties in
24. The conjugate compound of claim 22 or 23, wherein the conjugate compound comprises a physiologically labile linker composed of 2 to 5 linked nucleosides comprising at least two consecutive phosphodiester linkages, wherein the physiologically labile linker is covalently bound at the 5′ or 3′ terminal of the nucleic acid molecule.
25. A pharmaceutically acceptable salt of a nucleic acid molecule according to any one of claims 10 to 21, or a conjugate compound according to any one of claims 22 to 24.
26. A pharmaceutical composition comprising a nucleic acid molecule according to any one of claims 10 to 21, a conjugate compound according to any one of claims 22 to 24, or a pharmaceutically acceptable salt according to claim 25 and a pharmaceutically acceptable excipient.
27. An in vivo or in vitro method for inhibiting A1CF expression in a target cell which is expressing A1CF, said method comprising administering a nucleic acid molecule according to any one of claims 10 to 21, a conjugate compound according to any one of claims 22 to 24, a pharmaceutically acceptable salt according to claim 25, or a pharmaceutical composition according to claim 26 in an effective amount to said cell.
28. A method for treating a disease comprising administering a therapeutically or prophylactically effective amount of a nucleic acid molecule according to any one of claims 10 to 21, a conjugate compound according to any one of claims 22 to 24, a pharmaceutically acceptable salt according to claim 25, or a pharmaceutical composition according to claim 26, to a subject suffering from or susceptible to a disease.
29. A method according to claim 28, wherein the disease is Hepatitis B Virus (HBV) infection, such as a chronic HBV infection.
30. A nucleic acid molecule according any one of claims 10 to 21, a conjugate compound according to any one of claims 22 to 24, a pharmaceutically acceptable salt according to claim 25, or a pharmaceutical composition according to claim 26 for use in medicine.
31. A nucleic acid molecule according any one of claims 10 to 21, a conjugate compound according to any one of claims 22 to 24, a pharmaceutically acceptable salt according to claim 25, or a pharmaceutical composition according to claim 26, for use in the treatment of Hepatitis B Virus (HBV) infection, such as a chronic HBV infection.
32. Use of a nucleic acid molecule according any one of claims 10 to 21, a conjugate compound according to any one of claims 22 to 24, a pharmaceutically acceptable salt according to claim 25, or a pharmaceutical composition according to claim 26, for the preparation of a medicament for the treatment of Hepatitis B Virus (HBV) infection, such as a chronic HBV infection.
Description
BRIEF DESCRIPTION OF FIGURES
[0019]
[0020] The two different diastereoisomers shown in each of
DEFINITIONS
[0021] HBV Infection
[0022] The term “hepatitis B virus infection” or “HBV infection” is commonly known in the art and refers to an infectious disease that is caused by the hepatitis B virus (HBV) and affects the liver. A HBV infection can be an acute or a chronic infection. Chronic hepatitis B virus (CHB) infection is a global disease burden affecting 248 million individuals worldwide. Approximately 686,000 deaths annually are attributed to HBV-related end-stage liver diseases and hepatocellular carcinoma (HCC) (GBD 2013; Schweitzer et al., Lancet. 2015 Oct. 17; 386(10003):1546-55). WHO projected that without expanded intervention, the number of people living with CHB infection will remain at the current high levels for the next 40-50 years, with a cumulative 20 million deaths occurring between 2015 and 2030 (WHO 2016). CHB infection is not a homogenous disease with singular clinical presentation. Infected individuals have progressed through several phases of CHB-associated liver disease in their life; these phases of disease are also the basis for treatment with standard of care (SOC). Current guidelines recommend treating only selected CHB-infected individuals based on three criteria—serum ALT level, HBV DNA level, and severity of liver disease (EASL, 2017). This recommendation was due to the fact that SOC i.e. nucleos(t)ide analogs (NAs) and pegylated interferon-alpha (PEG-IFN), are not curative and must be administered for long periods of time thereby increasing their safety risks. NAs effectively suppress HBV DNA replication; however, they have very limited/no effect on other viral markers. Two hallmarks of HBV infection, hepatitis B surface antigen (HBsAg) and covalently closed circular DNA (cccDNA), are the main targets of novel drugs aiming for HBV cure. In the plasma of CHB individuals, HBsAg subviral (empty) particles outnumber HBV virions by a factor of 103 to 105 (Ganem & Prince, N Engl J Med. 2004 Mar. 11; 350(11):1118-29); its excess is believed to contribute to immunopathogenesis of the disease, including inability of individuals to develop neutralizing anti-HBs antibody, the serological marker observed following resolution of acute HBV infection.
[0023] In some embodiments, the term “HBV infection” refers to “chronic HBV infection”.
[0024] Further, the term encompasses infection with any HBV genotype.
[0025] In some embodiments, the patient to be treated is infected with HBV genotype A.
[0026] In some embodiments, the patient to be treated is infected with HBV genotype B.
[0027] In some embodiments, the patient to be treated is infected with HBV genotype C.
[0028] In some embodiments, the patient to be treated is infected with HBV genotype D.
[0029] In some embodiments, the patient to be treated is infected with HBV genotype E.
[0030] In some embodiments, the patient to be treated is infected with HBV genotype F.
[0031] In some embodiments, the patient to be treated is infected with HBV genotype G.
[0032] In some embodiments, the patient to be treated is infected with HBV genotype H.
[0033] In some embodiments, the patient to be treated is infected with HBV genotype I.
[0034] In some embodiments, the patient to be treated is infected with HBV genotype J.
cccDNA (Covalently Closed Circular DNA)
[0035] cccDNA is the viral genetic template of HBV that resides in the nucleus of infected hepatocytes, where it gives rise to all HBV RNA transcripts needed for productive infection and is responsible for viral persistence during natural course of chronic HBV infection (Locarnini & Zoulim, Antivir Ther. 2010; 15 Suppl 3:3-14. doi: 10.3851/IMP1619). Acting as a viral reservoir, cccDNA is the source of viral rebound after cessation of treatment, necessitating long term, often lifetime treatment. PEG-IFN can only be administered to a small subset of CHB due to its various side effects.
[0036] Consequently, novel therapies that can deliver a complete cure, defined by degradation or elimination of HBV cccDNA, to the majority of CHB patients are highly needed.
Compound
[0037] Herein, the term “compound” means any molecule capable of inhibition A1CF expression or activity. Particular compounds of the invention are nucleic acid molecules, such as RNAi molecules or antisense oligonucleotides according to the invention or any conjugate comprising such a nucleic acid molecule. For example, herein the compound may be a nucleic acid molecule targeting A1CF, in particular an antisense oligonucleotide or a siRNA.
Oligonucleotide
[0038] The term “oligonucleotide” as used herein is defined as it is generally understood by the skilled person as a molecule comprising two or more covalently linked nucleosides. Such covalently bound nucleosides may also be referred to as nucleic acid molecules or oligomers.
[0039] The oligonucleotides referred to in the description and claims are generally therapeutic oligonucleotides below 70 nucleotides in length. The oligonucleotide may be or comprise a single stranded antisense oligonucleotide, or may be another nucleic acid molecule, such as a CRISPR RNA, a siRNA, shRNA, an aptamer, or a ribozyme. Therapeutic oligonucleotide molecules are commonly made in the laboratory by solid-phase chemical synthesis followed by purification and isolation. shRNA's are however often delivered to cells using lentiviral vectors from which they are then transcribed to produce the single stranded RNA that will form a stem loop (hairpin) RNA structure that is capable of interacting with the RNA interference machinery (including the RNA-induced silencing complex (RISC)). In an embodiment of the present invention the shRNA is chemically produced shRNA molecules (not relying on cell based expression from plasmids or viruses). When referring to a sequence of the oligonucleotide, reference is made to the sequence or order of nucleobase moieties, or modifications thereof, of the covalently linked nucleotides or nucleosides. Generally, the oligonucleotide of the invention is man-made, and is chemically synthesized, and is typically purified or isolated. Although in some embodiments the oligonucleotide of the invention is a shRNA transcribed from a vector upon entry into the target cell. The oligonucleotide of the invention may comprise one or more modified nucleosides or nucleotides.
[0040] In some embodiments, the oligonucleotide of the invention comprises or consists of 10 to 70 nucleotides in length, such as from 12 to 60, such as from 13 to 50, such as from 14 to 40, such as from 15 to 30, such as from 16 to 25, such as from 16 to 22, such as from 16 to 20 contiguous nucleotides in length. Accordingly, the oligonucleotide of the present invention, in some embodiments, may have a length of 12 to 25 nucleotides. Alternatively, the oligonucleotide of the present invention, in some embodiments, may have a length of 15 to 22 nucleotides.
[0041] In some embodiments, the oligonucleotide or contiguous nucleotide sequence thereof comprises or consists of 24 or less nucleotides, such as 22, such as 20 or less nucleotides, such as 18 or less nucleotides, such as 14, 15, 16 or 17 nucleotides. It is to be understood that any range given herein includes the range endpoints. Accordingly, if a nucleic acid molecule is said to include from 12 to 25 nucleotides, both 12 and 25 nucleotides are included.
[0042] In some embodiments, the contiguous nucleotide sequence comprises or consists of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 or 22 contiguous nucleotides in length The olignucleotide(s) are for modulating the expression of a target nucleic acid in a mammal. In some embodiments the nucleic acid molecules, such as for siRNAs, shRNAs and antisense oligonucleotides, are typically for inhibiting the expression of a target nucleic acid(s).
[0043] In one embodiment, of the invention oligonucleotide is selected from a RNAi agent, such as a siRNA or shRNA. In another embodiment, the oligonucleotide is a single stranded antisense oligonucleotide, such as a high affinity modified antisense oligonucleotide interacting with RNase H.
[0044] In some embodiments the oligonucleotide of the invention may comprise one or more modified nucleosides or nucleotides, such as 2′ sugar modified nucleosides.
[0045] In some embodiments the oligonucleotide comprises phosphorothioate internucleoside linkages.
[0046] In some embodiments the oligonucleotide may be conjugated to non-nucleosidic moieties (conjugate moieties).
[0047] A library of oligonucleotides is to be understood as a collection of variant oligonucleotides. The purpose of the library of oligonucleotides can vary. In some embodiments, the library of oligonucleotides is composed of oligonucleotides with overlapping nucleobase sequence targeting one or more mammalian A1CF target nucleic acids with the purpose of identifying the most potent sequence within the library of oligonucleotides. In some embodiments, the library of oligonucleotides is a library of oligonucleotide design variants (child nucleic acid molecules) of a parent or ancestral oligonucleotide, wherein the oligonucleotide design variants retaining the core nucleobase sequence of the parent nucleic acid molecule.
Antisense Oligonucleotides
[0048] The term “antisense oligonucleotide” or “ASO” as used herein is defined as oligonucleotides capable of modulating expression of a target gene by hybridizing to a target nucleic acid, in particular to a contiguous sequence on a target nucleic acid. The antisense oligonucleotides are not essentially double stranded and are therefore not siRNAs or shRNAs. Preferably, the antisense oligonucleotides of the present invention are single stranded. It is understood that single stranded oligonucleotides of the present invention can form hairpins or intermolecular duplex structures (duplex between two molecules of the same oligonucleotide), as long as the degree of intra or inter self complementarity is less than 50% across of the full length of the oligonucleotide.
[0049] Advantageously, the single stranded antisense oligonucleotide of the invention does not contain RNA nucleosides, since this will decrease nuclease resistance.
[0050] Advantageously, the oligonucleotide of the invention comprises one or more modified nucleosides or nucleotides, such as 2′ sugar modified nucleosides. Furthermore, it is advantageous that the nucleosides which are not modified are DNA nucleosides.
RNAi Molecules
[0051] Herein, the term “RNA interference (RNAi) molecule” refers to short double-stranded oligonucleotide containing RNA nucleosides and which mediates targeted cleavage of an RNA transcript via the RNA-induced silencing complex (RISC), where they interact with the catalytic RISC component argonaute. The RNAi molecule modulates, e g., inhibits, the expression of the target nucleic acid in a cell, e.g. a cell within a subject. such as a mammalian subject. RNAi molecules includes single stranded RNAi molecules (Lima at al 2012 Cell 150: 883) and double stranded siRNAs, as well as short hairpin RNAs (shRNAs). In some embodiments of the invention, the oligonucleotide of the invention or contiguous nucleotide sequence thereof is a RNAi agent, such as a siRNA.
siRNA
[0052] The term “small interfering ribonucleic acid” or “siRNA” refers to a small interfering ribonucleic acid RNAi molecule. It is a class of double-stranded RNA molecules, also known in the art as short interfering RNA or silencing RNA. siRNAs typically comprise a sense strand (also referred to as a passenger strand) and an antisense strand (also referred to as the guide strand), wherein each strand are of 17 to 30 nucleotides in length, typically 19 to 25 nucleosides in length, wherein the antisense strand is complementary, such as at least 95% complementary, such as fully complementary, to the target nucleic acid (suitably a mature mRNA sequence), and the sense strand is complementary to the antisense strand so that the sense strand and antisense strand form a duplex or duplex region. siRNA strands may form a blunt ended duplex, or advantageously the sense and antisense strand 3′ ends may form a 3′ overhang of e.g. 1, 2 or 3 nucleosides to resemble the product produced by Dicer, which forms the RISC substrate in vivo. Effective extended forms of Dicer substrates have been described in U.S. Pat. Nos. 8,349,809 and 8,513,207, hereby incorporated by reference. In some embodiments, both the sense strand and antisense strand have a 2 nt 3′ overhang. The duplex region may therefore be, for example 17 to 25 nucleotides in length, such as 21 to 23 nucleotide in length.
[0053] Once inside a cell the antisense strand is incorporated into the RISC complex which mediate target degradation or target inhibition of the target nucleic acid. siRNAs typically comprise modified nucleosides in addition to RNA nucleosides. In one embodiment, the siRNA molecule may be chemically modified using modified internucleotide linkages and 2′ sugar modified nucleosides, such as 2′-4′ bicyclic ribose modified nucleosides, including LNA and cET or 2′ substituted modifications like of 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA (MOE), 2′-amino-DNA, 2′-fluoro-DNA, arabino nucleic acid (ANA), 2′-fluoro-ANA. In particular, 2′fluoro, 2′-O-methyl or 2′-O-methoxyethyl may be incorporated into siRNAs.
[0054] In some embodiments, all of the nucleotides of an siRNA sense (passenger) strand may be modified with 2′ sugar modified nucleosides such as LNA (see WO2004/083430, WO2007/085485 for example). In some embodiments, the passenger stand of the siRNA may be discontinuous (see WO2007/107162 for example). The incorporation of thermally destabilizing nucleotides occurring at a seed region of the antisense strand of siRNAs have been reported as useful in reducing off-target activity of siRNAs (see WO2018/098328 for example). Suitably the siRNA comprises a 5′ phosphate group or a 5′-phosphate mimic at the 5′ end of the antisense strand. In some embodiments, the 5′ end of the antisense strand is a RNA nucleoside.
[0055] In one embodiment, the siRNA molecule further comprises at least one phosphorothioate or methylphosphonate internucleoside linkage. The phosphorothioaie or methylphosphonate internucleoside linkage may be at the 3′-terminus one or both strand (e.g., the antisense strand; or the sense strand); or the phosphorothioate or methylphosphonate internucleoside linkage may be at the 5′-terminus of one or both strands (e.g., the antisense strand; or the sense strand); or the phosphorothioate or methylphosphonate internucleoside linkage may be at the both the 5′- and 3′-terminus of one or both strands (e.g., the antisense strand; or the sense strand). In some embodiments, the remaining internucleoside linkages are phosphodiester linkages. In some embodiments, siRNA molecules comprise one or more phosphorothioate internucleoside linkages. In siRNA molecules phosphorothioate internucleoside linkages may reduce or the nuclease cleavage in RICS, it is therefore advantageous that not all internucleoside linkages in the antisense strand are modified.
[0056] The siRNA molecule may further comprise a ligand. In some embodiments, the ligand is conjugated to the 3′ end of the sense strand.
[0057] For biological distribution, siRNAs may be conjugated to a targeting ligand, and/or be formulated into lipid nanoparticles.
[0058] Other aspects of the invention relate to pharmaceutical compositions comprising these dsRNA, such as siRNA molecules suitable for therapeutic use, and methods of inhibiting the expression of the target gene by administering the dsRNA molecules such as siRNAs of the invention, e.g., for the treatment of various disease conditions as disclosed herein.
shRNA
[0059] The term “short hairpin RNA” or “shRNA” refers to molecules that are generally between 40 and 70 nucleotides in length, such as between 45 and 65 nucleotides in length, such as 50 and 60 nucleotides in length and form a stem loop (hairpin) RNA structure which interacts with the endonuclease known as Dicer which is believed to processes dsRNA into 19-23 base pair short interfering RNAs with characteristic two base 3′ overhangs which are then incorporated into an RNA-induced silencing complex (RISC). Upon binding to the appropriate target mRNA, one or more endonucleases within the RISC cleave the target to induce silencing. shRNA oligonucleotides may be chemically modified using modified internucleotide linkages and 2′ sugar modified nucleosides, such as 2′-4′ bicyclic ribose modified nucleosides, including LNA and cET or 2′ substituted modifications like of 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA (MOE), 2′-amino-DNA, 2′-fluoro-DNA, arabino nucleic acid (ANA), 2′-fluoro-ANA.
[0060] In some embodiments, shRNA molecule comprises one or more phosphorothioate internucleoside linkages. In RNAi molecules phosphorothioate internucleoside linkages may reduce or the nuclease cleavage in RICS it is therefore advantageous that not al internucleoside linkages in the stem loop of the shRNA molecule are modified. Phosphorothioate internucleoside linkages can advantageously be placed in the 3′ and/or 5′ end of the stem loop of the shRNA molecule, in particular in the part of the molecule that is not complementary to the target nucleic acid. The region of the shRNA molecule that is complementary to the target nucleic acid may however also be modified in the first 2 to 3 internucleoside linkages in the part that is predicted to become the 3′ and/or 5′ terminal following cleavage by Dicer.
Contiguous Nucleotide Sequence
[0061] The term “contiguous nucleotide sequence” refers to the region of the nucleic acid molecule which is complementary to the target nucleic acid. The term is used interchangeably herein with the term “contiguous nucleobase sequence” and the term “oligonucleotide motif sequence”. In some embodiments, all the nucleotides of the oligonucleotide constitute the contiguous nucleotide sequence. In some embodiments, the contiguous nucleotide sequence is included in the guide strand of an siRNA molecule. In some embodiments, the contiguous nucleotide sequence is the part of an shRNA molecule which is 100% complementary to the target nucleic acid. In some embodiments, the oligonucleotide comprises the contiguous nucleotide sequence, such as a F-G-F′ gapmer region, and may optionally comprise further nucleotide(s), for example a nucleotide linker region which may be used to attach a functional group (e.g. a conjugate group for targeting) to the contiguous nucleotide sequence. The nucleotide linker region may or may not be complementary to the target nucleic acid. In some embodiments, the nucleobase sequence of the antisense oligonucleotide is the contiguous nucleotide sequence. In some embodiments, the contiguous nucleotide sequence is 100% complementary to the target nucleic acid.
Nucleotides and Nucleosides
[0062] Nucleotides and nucleosides are the building blocks of oligonucleotides and polynucleotides, and for the purposes of the present invention include both naturally occurring and non-naturally occurring nucleotides and nucleosides. In nature, nucleotides, such as DNA and RNA nucleotides comprise a ribose sugar moiety, a nucleobase moiety and one or more phosphate groups (which is absent in nucleosides). Nucleosides and nucleotides may also interchangeably be referred to as “units” or “monomers”.
Modified Nucleoside
[0063] The term “modified nucleoside” or “nucleoside modification” as used herein refers to nucleosides modified as compared to the equivalent DNA or RNA nucleoside by the introduction of one or more modifications of the sugar moiety or the (nucleo)base moiety. Advantageously, one or more of the modified nucleoside comprises a modified sugar moiety. The term modified nucleoside may also be used herein interchangeably with the term “nucleoside analogue” or modified “units” or modified “monomers”. Nucleosides with an unmodified DNA or RNA sugar moiety are termed DNA or RNA nucleosides herein. Nucleosides with modifications in the base region of the DNA or RNA nucleoside are still generally termed DNA or RNA if they allow Watson Crick base pairing.
Modified Internucleoside Linkage
[0064] The term “modified internucleoside linkage” is defined as generally understood by the skilled person as linkages other than phosphodiester (PO) linkages, that covalently couples two nucleosides together. The oligonucleotides of the invention may therefore comprise one or more modified internucleoside linkages, such as a one or more phosphorothioate internucleoside linkages, or one or more phosphorodithioate internucleoside linkages.
[0065] With the oligonucleotide of the invention it is advantageous to use phosphorothioate internucleoside linkages.
[0066] Phosphorothioate internucleoside linkages are particularly useful due to nuclease resistance, beneficial pharmacokinetics and ease of manufacture. In some embodiments, at least 50% of the internucleoside linkages in the oligonucleotide, or contiguous nucleotide sequence thereof, are phosphorothioate, such as at least 60%, such as at least 70%, such as at least 75%, such as at least 80% or such as at least 90% of the internucleoside linkages in the oligonucleotide, or contiguous nucleotide sequence thereof, are phosphorothioate. In some embodiments, all of the internucleoside linkages of the oligonucleotide, or contiguous nucleotide sequence thereof, are phosphorothioate.
[0067] In some advantageous embodiments, all the internucleoside linkages of the contiguous nucleotide sequence of the oligonucleotide are phosphorothioate, or all the internucleoside linkages of the oligonucleotide are phosphorothioate linkages.
[0068] It is recognized that, as disclosed in EP 2 742 135, antisense oligonucleotides may comprise other internucleoside linkages (other than phosphodiester and phosphorothioate), for example alkyl phosphonate/methyl phosphonate internucleoside linkages, which according to EP 2 742 135 may for example be tolerated in an otherwise DNA phosphorothioate gap region.
Nucleobase
[0069] The term “nucleobase” includes the purine (e.g. adenine and guanine) and pyrimidine (e.g. uracil, thymine and cytosine) moiety present in nucleosides and nucleotides which form hydrogen bonds in nucleic acid hybridization. In the context of the present invention the term nucleobase also encompasses modified nucleobases which may differ from naturally occurring nucleobases, but are functional during nucleic acid hybridization. In this context “nucleobase” refers to both naturally occurring nucleobases such as adenine, guanine, cytosine, thymidine, uracil, xanthine and hypoxanthine, as well as non-naturally occurring variants. Such variants are for example described in Hirao et al (2012) Accounts of Chemical Research vol 45 page 2055 and Bergstrom (2009) Current Protocols in Nucleic Acid Chemistry Suppl. 37 1.4.1.
[0070] In some embodiments, the nucleobase moiety is modified by changing the purine or pyrimidine into a modified purine or pyrimidine, such as substituted purine or substituted pyrimidine, such as a nucleobased selected from isocytosine, pseudoisocytosine, 5-methyl cytosine, 5-thiozolo-cytosine, 5-propynyl-cytosine, 5-propynyl-uracil, 5-bromouracil 5-thiazolo-uracil, 2-thio-uracil, 2′thio-thymine, inosine, diaminopurine, 6-aminopurine, 2-aminopurine, 2,6-diaminopurine and 2-chloro-6-aminopurine.
[0071] The nucleobase moieties may be indicated by the letter code for each corresponding nucleobase, e.g. A, T, G, C or U, wherein each letter may optionally include modified nucleobases of equivalent function. For example, in the exemplified oligonucleotides, the nucleobase moieties are selected from A, T, G, C, and 5-methyl cytosine. Optionally, for LNA gapmers, 5-methyl cytosine LNA nucleosides may be used.
Modified Oligonucleotide
[0072] The term “modified oligonucleotide” describes an oligonucleotide comprising one or more sugar-modified nucleosides and/or modified internucleoside linkages. The term “chimeric oligonucleotide” is a term that has been used in the literature to describe oligonucleotides comprising modified nucleosides and DNA nucleosides. The antisense oligonucleotide of the invention is advantageously a chimeric oligonucleotide.
Complementarity
[0073] The term “complementarity” or “complementary” describes the capacity for Watson-Crick base-pairing of nucleosides/nucleotides. Watson-Crick base pairs are guanine (G)-cytosine (C) and adenine (A)—thymine (T)/uracil (U). It will be understood that oligonucleotides may comprise nucleosides with modified nucleobases, for example 5-methyl cytosine is often used in place of cytosine, and as such the term complementarity encompasses Watson Crick base-paring between non-modified and modified nucleobases (see for example Hirao et al (2012) Accounts of Chemical Research vol 45 page 2055 and Bergstrom (2009) Current Protocols in Nucleic Acid Chemistry Suppl. 37 1.4.1).
[0074] The term “% complementary” as used herein, refers to the proportion of nucleotides (in percent) of a contiguous nucleotide sequence in a nucleic acid molecule (e.g. oligonucleotide) which across the contiguous nucleotide sequence, are complementary to a reference sequence (e.g. a target sequence or sequence motif). The percentage of complementarity is thus calculated by counting the number of aligned nucleobases that are complementary (from Watson Crick base pair) between the two sequences (when aligned with the target sequence 5′-3′ and the oligonucleotide sequence from 3′-5′), dividing that number by the total number of nucleotides in the oligonucleotide and multiplying by 100. In such a comparison a nucleobase/nucleotide which does not align (form a base pair) is termed a mismatch. Insertions and deletions are not allowed in the calculation of % complementarity of a contiguous nucleotide sequence. It will be understood that in determining complementarity, chemical modifications of the nucleobases are disregarded as long as the functional capacity of the nucleobase to form Watson Crick base pairing is retained (e.g. 5′-methyl cytosine is considered identical to a cytosine for the purpose of calculating % identity).
[0075] The term “fully complementary”, refers to 100% complementarity.
Identity
[0076] The term “Identity” as used herein, refers to the proportion of nucleotides (expressed in percent) of a contiguous nucleotide sequence in a nucleic acid molecule (e.g. oligonucleotide) which across the contiguous nucleotide sequence, are identical to a reference sequence (e.g. a sequence motif). The percentage of identity is thus calculated by counting the number of aligned nucleobases that are identical (a Match) between two sequences (in the contiguous nucleotide sequence of the compound of the invention and in the reference sequence), dividing that number by the total number of nucleotides in the oligonucleotide and multiplying by 100. Therefore, Percentage of Identity=(Matches×100)/Length of aligned region (e.g. the contiguous nucleotide sequence). Insertions and deletions are not allowed in the calculation the percentage of identity of a contiguous nucleotide sequence. It will be understood that in determining identity, chemical modifications of the nucleobases are disregarded as long as the functional capacity of the nucleobase to form Watson Crick base pairing is retained (e.g. 5-methyl cytosine is considered identical to a cytosine for the purpose of calculating % identity).
Hybridization
[0077] The term “hybridizing” or “hybridizes” as used herein is to be understood as two nucleic acid strands (e.g. an oligonucleotide and a target nucleic acid) forming hydrogen bonds between base pairs on opposite strands thereby forming a duplex. The affinity of the binding between two nucleic acid strands is the strength of the hybridization. It is often described in terms of the melting temperature (T.sub.m) defined as the temperature at which half of the oligonucleotides are duplexed with the target nucleic acid. At physiological conditions T.sub.m is not strictly proportional to the affinity (Mergny and Lacroix, 2003, Oligonucleotides 13:515-537). The standard state Gibbs free energy ΔG° is a more accurate representation of binding affinity and is related to the dissociation constant (K.sub.d) of the reaction by ΔG°=−RT ln(K.sub.d), where R is the gas constant and T is the absolute temperature. Therefore, a very low ΔG° of the reaction between an oligonucleotide and the target nucleic acid reflects a strong hybridization between the oligonucleotide and target nucleic acid. ΔG° is the energy associated with a reaction where aqueous concentrations are 1M, the pH is 7, and the temperature is 37° C. The hybridization of oligonucleotides to a target nucleic acid is a spontaneous reaction and for spontaneous reactions ΔG° is less than zero. ΔG° can be measured experimentally, for example, by use of the isothermal titration calorimetry (ITC) method as described in Hansen et al., 1965, Chem. Comm. 36-38 and Holdgate et al., 2005, Drug Discov Today. The skilled person will know that commercial equipment is available for ΔG° measurements. ΔG° can also be estimated numerically by using the nearest neighbor model as described by SantaLucia, 1998, Proc Natl Acad Sci USA, 95: 1460-1465 using appropriately derived thermodynamic parameters described by Sugimoto et al., 1995, Biochemistry 34:11211-11216 and McTigue et al., 2004, Biochemistry 43:5388-5405. In order to have the possibility of modulating its intended nucleic acid target by hybridization, oligonucleotides of the present invention hybridize to a target nucleic acid with estimated ΔG° values below −10 kcal for oligonucleotides that are 10 to 30 nucleotides in length. In some embodiments, the degree or strength of hybridization is measured by the standard state Gibbs free energy ΔG°. The oligonucleotides may hybridize to a target nucleic acid with estimated ΔG° values below −10 kcal, such as below −15 kcal, such as below −20 kcal and such as below −25 kcal for oligonucleotides that are 8 to 30 nucleotides in length. In some embodiments, the oligonucleotides hybridize to a target nucleic acid with an estimated ΔG° value in the range of of −10 to −60 kcal, such as −12 to −40, such as from −15 to −30 kcal or −16 to −27 kcal such as −18 to −25 kcal.
Target Nucleic Acid
[0078] According to the present invention, the target nucleic acid is a nucleic acid which encodes mammalian A1CF and may for example be a gene, a RNA, a mRNA, and pre-mRNA, a mature mRNA or a cDNA sequence. The target may therefore be referred to as A1CF target nucleic acid.
[0079] Suitably, the target nucleic acid encodes an A1CF protein, in particular mammalian A1CF, such as the human A1CF gene encoding pre-mRNA or mRNA sequences provided herein as SEQ ID NO: 1, 4, 5, 6, 7, 8, 9, 10, or 11.
[0080] The therapeutic oligonucleotides of the invention may for example target exon regions of a mammalian A1CF (in particular siRNA and shRNA, but also antisense oligonucleotides), or may for example target any intron region in the A1CF pre-mRNA (in particular antisense oligonucleotides). The human A1CF gene encodes 10 transcript, eight of which are protein coding and therefore potential nucleic acid targets.
[0081] Table 1 lists predicted exon and intron regions of SEQ ID NO: 1, i.e. of the human A1CF pre-mRNA sequence.
TABLE-US-00001 TABLE 1 Exon and intron regions in the human A1CF pre-mRNA. Exonic regions in the Intronic regions in the human A1CF premRNA human A1CF premRNA (SEQ ID NO: 1) (SEQ ID NO: 1) ID start end ID start end E1 1 95 I1 96 21595 E2 21596 21643 I2 21644 22694 E3 22695 22787 I3 22788 25690 E4 25691 25834 I4 25835 34868 E5 34869 35011 I5 35012 41553 E6 41554 41688 I6 41689 43683 E7 43684 43814 I7 43815 49363 E8 49364 49602 I8 49603 57380 E9 57381 57545 I9 57546 65026 E10 65027 65124 I10 65125 69396 E11 69397 69670 I11 69671 71613 E12 71614 71819 I12 71820 74499 E13 74500 74636 I13 74637 75633 E14 75634 75782 I14 75783 78795 E15 78796 86255
[0082] Suitably, the target nucleic acid encodes an A1CF protein, in particular mammalian A1CF, such as human A1CF (See for example Table 2 and Table 3) which provides an overview on the genomic sequences of human, cyno monkey and mouse A1CF (Table 2) and on pre-mRNA sequences for human, monkey and mouse A1CF and for the mature mRNAs for human A1CF (Table 3).
[0083] In some embodiments, the target nucleic acid is selected from the group consisting of SEQ ID NO: 1, 2, 3, 4, 6, 7, 8, 10, and 11, or naturally occurring variants thereof (e.g. sequences encoding a mammalian A1CF).
TABLE-US-00002 TABLE 2 Genome and assembly information for A1CF across species. Genomic coordinates ensembl Species Chr. Strand Start End Assembly gene_id Human 10 Rv 50799409 50885675 GRCh38.p12 ENSG00000148584 Cyno monkey 9 Fwd 85376801 85454053 Macaca_fascicularis_5.0 ENSMFAG00000035948 Mouse 19 Fwd 31868764 31948995 GRCm38.p5 ENSMUSG00000052595 Fwd = forward strand. Rv = reverse strand. The genome coordinates provide the pre-mRNA sequence (genomic sequence).
[0084] If employing the nucleic acid molecule of the invention in research or diagnostics the target nucleic acid may be a cDNA or a synthetic nucleic acid derived from DNA or RNA.
[0085] For in vivo or in vitro application, the therapeutic nucleic acid molecule of the invention is typically capable of inhibiting the expression of the A1CF target nucleic acid in a cell which is expressing the A1CF target nucleic acid. In some embodiments, said cell comprises HBV cccDNA. The contiguous sequence of nucleobases of the nucleic acid molecule of the invention is typically complementary to a conserved region of the A1CF target nucleic acid, as measured across the length of the nucleic acid molecule, optionally with the exception of one or two mismatches, and optionally excluding nucleotide based linker regions which may link the oligonucleotide to an optional functional group such as a conjugate, or other non-complementary terminal nucleotides. The target nucleic acid is a messenger RNA, such as a pre-mRNA which encodes mammalian A1CF protein, such as human A1CF, e.g. the human A1CF pre-mRNA sequence, such as that disclosed as SEQ ID NO: 1, the monkey A1CF pre-mRNA sequence, such as that disclosed as SEQ ID NO: 2, or the mouse A1CF pre-mRNA sequence, such as that disclosed as SEQ ID NO: 3, or a mature A1CF mRNA, such as that a human mature mRNA disclosed as SEQ ID NO: 4, 6, 7, 8, 10, or 11. SEQ ID NOs: 1-13 are DNA sequences—it will be understood that target RNA sequences have uracil (U) bases in place of the thymidine bases (T).
[0086] Further information on exemplary target nucleic acids is provided in Tables 2 and 3.
TABLE-US-00003 TABLE 3 Overview on target nucleic acids. Target Nucleic Acid, Species, Reference Sequence ID A1CF Homo sapiens pre-mRNA SEQ ID NO: 1 A1CF Macaca fascicularis pre-mRNA SEQ ID NO: 2 A1CF Mus musculus pre-mRNA SEQ ID NO: 3 A1CF Homo sapiens mature mRNA, SEQ ID NO: 4 variant 1 (ENST00000374001) A1CF Homo sapiens mature mRNA, SEQ ID NO: 5 variant 2 (ENST00000395489) A1CF Homo sapiens mature mRNA, SEQ ID NO: 6 variant 3 (ENST00000282641) A1CF Homo sapiens mature mRNA, SEQ ID NO: 7 variant 4 (ENST00000395495) A1CF Homo sapiens mature mRNA, SEQ ID NO: 8 variant 5 (ENST00000373997) A1CF Homo sapiens mature mRNA, SEQ ID NO: 9 variant 6 (ENST00000373995) A1CF Homo sapiens mature mRNA, SEQ ID NO: 10 variant 8 (ENST00000373993) A1CF Homo sapiens mature mRNA, SEQ ID NO: 11 variant 9 (ENST00000414883)
[0087] In some embodiments, the target nucleic acid is SEQ ID NO: 1.
[0088] In some embodiments, the target nucleic acid is SEQ ID NO: 2.
[0089] In some embodiments, the target nucleic acid is SEQ ID NO: 3.
[0090] In some embodiments, the target nucleic acid is SEQ ID NO: 4.
[0091] In some embodiments, the target nucleic acid is SEQ ID NO: 5.
[0092] In some embodiments, the target nucleic acid is SEQ ID NO: 6.
[0093] In some embodiments, the target nucleic acid is SEQ ID NO: 7.
[0094] In some embodiments, the target nucleic acid is SEQ ID NO: 8.
[0095] In some embodiments, the target nucleic acid is SEQ ID NO: 9.
[0096] In some embodiments, the target nucleic acid is SEQ ID NO: 10.
[0097] In some embodiments, the target nucleic acid is SEQ ID NO: 11.
Target Sequence
[0098] The term “target sequence” as used herein refers to a sequence of nucleotides present in the target nucleic acid which comprises the nucleobase sequence which is complementary to the oligonucleotide or nucleic acid molecule of the invention. In some embodiments, the target sequence consists of a region on the target nucleic acid with a nucleobase sequence that is complementary to the contiguous nucleotide sequence of the oligonucleotide of the invention. This region of the target nucleic acid may interchangeably be referred to as the target nucleotide sequence, target sequence or target region. In some embodiments, the target sequence is longer than the complementary sequence of a nucleic acid molecule of the invention, and may, for example represent a preferred region of the target nucleic acid which may be targeted by several nucleic acid molecules of the invention.
[0099] In some embodiments, the target sequence is a sequence selected from the group consisting of a human A1CF mRNA exon, such as an A1CF human mRNA exon selected from the group consisting of e1, e2, e3, e4, e5, e6, e7, e8, e9, e10, e11, e12, 13, e14, and e15, (see for example Table 1 above).
[0100] Accordingly, the invention provides for an oligonucleotide, wherein said oligonucleotide comprises a contiguous sequence which is at least 90% complementary, such as fully complementary to an exon region of SEQ ID NO: 1, selected from the group consisting of e1-e15 (see Table 1).
[0101] In some embodiments, the target sequence is a sequence selected from the group consisting of a human A1CFmRNA intron, such as an A1CF human mRNA intron selected from the group consisting of i1, i2, i3, i4, i5, i6, i7, i8, i9, i10, i11, i12, i13, and i14 (see for example Table 1 above).
[0102] Accordingly, the invention provides for an oligonucleotide, wherein said oligonucleotide comprises a contiguous sequence which is at least 90% complementary, such as fully complementary to an intron region of SEQ ID NO: 1, selected from the group consisting of i1-i14 (see Table 1).
[0103] In some embodiments, the target sequence is selected from the group consisting of SEQ ID NO: 12, 13, 14 and 15. In some embodiments, the contiguous nucleotide sequence as referred to herein is at least 90% complementary, such as at least 95% complementary to a target sequence selected from the group consisting of SEQ ID NO: 12, 13, 14 and 15. In some embodiments, the contiguous nucleotide sequence is fully complementary to a target sequence selected from the group consisting of SEQ ID NO: 12, 13, 14 and 15.
[0104] The oligonucleotide of the invention comprises a contiguous nucleotide sequence which is complementary to or hybridizes to a region on the target nucleic acid, such as a target sequence described herein.
[0105] The target nucleic acid sequence to which the therapeutic oligonucleotide is complementary or hybridizes to generally comprises a stretch of contiguous nucleobases of at least 10 nucleotides. The contiguous nucleotide sequence is between 12 to 70 nucleotides, such as 12 to 50, such as 13 to 30, such as 14 to 25, such as 15 to 20, such as 16 to 18 contiguous nucleotides.
[0106] In some embodiments, the oligonucleotide of the present invention targets a region shown in Table 4 or 5.
TABLE-US-00004 TABLE 4 Exemplary target regions Target start SEQ end SEQ region ID NO: 1 ID NO: 1 1A 1 31 2A 33 112 3A 114 137 4A 147 171 5A 196 211 6A 215 238 7A 251 267 8A 269 290 9A 301 388 10A 390 425 11A 428 448 12A 455 470 13A 498 514 14A 516 540 15A 560 594 16A 612 647 17A 671 709 18A 719 777 19A 802 818 20A 833 873 21A 888 929 22A 944 959 23A 963 978 24A 980 998 25A 1023 1057 26A 1103 1132 27A 1146 1171 28A 1175 1201 29A 1203 1303 30A 1305 1330 31A 1333 1351 32A 1353 1435 33A 1450 1473 34A 1481 1512 35A 1515 1538 36A 1540 1559 37A 1562 1588 38A 1591 1613 39A 1615 1649 40A 1634 1648 41A 1678 1723 42A 1725 1741 43A 1742 1788 44A 1803 1848 45A 1856 1871 46A 1873 1887 47A 1896 1941 48A 1943 1961 49A 1970 2010 50A 2012 2034 51A 2038 2053 52A 2072 2098 53A 2137 2164 54A 2160 2179 55A 2181 2211 56A 2213 2230 57A 2232 2264 58A 2266 2308 59A 2310 2357 60A 2374 2392 61A 2394 2413 62A 2419 2437 63A 2439 2454 64A 2471 2524 65A 2526 2554 66A 2556 2576 67A 2581 2597 68A 2599 2620 69A 2646 2737 70A 2739 2754 71A 2766 2786 72A 2788 2822 73A 2823 2882 74A 2884 2951 75A 2953 3051 76A 3053 3067 77A 3070 3118 78A 3121 3166 79A 3179 3196 80A 3200 3215 81A 3257 3278 82A 3279 3300 83A 3334 3366 84A 3354 3368 85A 3391 3412 86A 3392 3410 87A 3400 3420 88A 3414 3430 89A 3435 3452 90A 3435 3450 91A 3465 3480 92A 3473 3508 93A 3473 3502 94A 3477 3500 95A 3477 3499 96A 3487 3501 97A 3520 3535 98A 3520 3538 99A 3540 3591 100A 3593 3620 101A 3655 3711 102A 3717 3735 103A 3737 3761 104A 3773 3802 105A 3804 3829 106A 3838 3860 107A 3862 3878 108A 3880 3899 109A 3926 3965 110A 3973 3987 111A 4001 4021 112A 4023 4039 113A 4051 4086 114A 4094 4108 115A 4121 4154 116A 4191 4242 117A 4244 4294 118A 4397 4416 119A 4442 4475 120A 4442 4459 121A 4505 4529 122A 4514 4529 123A 4515 4529 124A 4542 4556 125A 4544 4561 126A 4563 4577 127A 4585 4599 128A 4603 4623 129A 4627 4643 130A 4687 4706 131A 4721 4746 132A 4756 4770 133A 4772 4812 134A 4814 4845 135A 4847 4886 136A 4896 4934 137A 4950 4978 138A 4980 5003 139A 5006 5022 140A 5057 5079 141A 5109 5154 142A 5177 5192 143A 5194 5216 144A 5235 5249 145A 5264 5315 146A 5317 5353 147A 5369 5387 148A 5389 5409 149A 5411 5425 150A 5434 5491 151A 5505 5523 152A 5525 5551 153A 5565 5581 154A 5628 5644 155A 5674 5689 156A 5730 5750 157A 5755 5778 158A 5780 5810 159A 5812 5864 160A 5869 5889 161A 5891 5915 162A 5952 5971 163A 5986 6020 164A 6128 6164 165A 6166 6187 166A 6192 6215 167A 6240 6257 168A 6259 6283 169A 6331 6392 170A 6394 6423 171A 6434 6470 172A 6472 6497 173A 6499 6533 174A 6535 6556 175A 6558 6593 176A 6612 6631 177A 6631 6647 178A 6649 6671 179A 6673 6719 180A 6730 6746 181A 6804 6833 182A 6835 6853 183A 6895 6915 184A 6917 6931 185A 6933 7001 186A 7017 7042 187A 7059 7074 188A 7076 7096 189A 7098 7115 190A 7129 7151 191A 7153 7181 192A 7197 7260 193A 7262 7280 194A 7296 7421 195A 7463 7483 196A 7489 7509 197A 7525 7539 198A 7533 7548 199A 7550 7567 200A 7569 7590 201A 7607 7629 202A 7624 7638 203A 7640 7660 204A 7648 7674 205A 7663 7682 206A 7680 7707 207A 7696 7717 208A 7719 7737 209A 7739 7778 210A 7778 7795 211A 7780 7795 212A 7845 7898 213A 7900 7916 214A 7918 7938 215A 7940 7960 216A 7971 7990 217A 8003 8046 218A 8058 8075 219A 8086 8173 220A 8201 8218 221A 8220 8252 222A 8278 8314 223A 8322 8340 224A 8357 8372 225A 8389 8414 226A 8416 8432 227A 8446 8472 228A 8504 8526 229A 8528 8543 230A 8570 8587 231A 8603 8637 232A 8665 8687 233A 8689 8722 234A 8773 8793 235A 8795 8814 236A 8836 8851 237A 8854 8906 238A 8921 8993 239A 9019 9047 240A 9053 9101 241A 9103 9121 242A 9123 9159 243A 9171 9185 244A 9187 9211 245A 9213 9229 246A 9231 9249 247A 9251 9276 248A 9282 9326 249A 9374 9390 250A 9407 9426 251A 9460 9476 252A 9507 9525 253A 9535 9590 254A 9607 9628 255A 9636 9683 256A 9685 9703 257A 9705 9733 258A 9735 9818 259A 9820 9837 260A 9839 9896 261A 9898 9915 262A 9917 9939 263A 9960 10000 264A 10002 10020 265A 10031 10066 266A 10082 10166 267A 10208 10228 268A 10230 10257 269A 10259 10278 270A 10289 10321 271A 10325 10340 272A 10355 10369 273A 10374 10396 274A 10406 10421 275A 10459 10510 276A 10512 10573 277A 10592 10610 278A 10612 10635 279A 10658 10714 280A 10716 10764 281A 10770 10818 282A 10820 10838 283A 10858 10873 284A 10905 10928 285A 10930 10949 286A 10959 11037 287A 11045 11077 288A 11084 11107 289A 11109 11125 290A 11135 11190 291A 11207 11256 292A 11269 11314 293A 11316 11334 294A 11336 11366 295A 11388 11445 296A 11472 11496 297A 11507 11542 298A 11567 11598 299A 11613 11648 300A 11664 11685 301A 11687 11740 302A 11748 11802 303A 11810 11840 304A 11842 11861 305A 11863 11878 306A 11885 11914 307A 11922 11940 308A 11944 11975 309A 11978 12009 310A 12011 12029 311A 12032 12053 312A 12070 12101 313A 12107 12126 314A 12132 12162 315A 12165 12180 316A 12240 12256 317A 12270 12292 318A 12309 12346 319A 12348 12367 320A 12381 12403 321A 12412 12428 322A 12442 12456 323A 12446 12467 324A 12492 12512 325A 12501 12517 326A 12532 12560 327A 12548 12563 328A 12549 12563 329A 12557 12571 330A 12575 12593 331A 12594 12611 332A 12599 12635 333A 12619 12633 334A 12639 12657 335A 12640 12656 336A 12645 12701 337A 12645 12659 338A 12668 12683 339A 12702 12721 340A 12703 12721 341A 12704 12722 342A 12705 12723 343A 12706 12724 344A 12707 12725 345A 12708 12726 346A 12709 12727 347A 12710 12728 348A 12711 12729 349A 12711 12730 350A 12715 12732 351A 12735 12795 352A 12815 12835 353A 12857 12873 354A 12875 12900 355A 12902 12937 356A 12972 13033 357A 13035 13056 358A 13090 13123 359A 13173 13219 360A 13245 13275 361A 13301 13316 362A 13318 13342 363A 13344 13400 364A 13402 13433 365A 13455 13547 366A 13566 13580 367A 13582 13607 368A 13614 13628 369A 13622 13667 370A 13669 13694 371A 13716 13757 372A 13759 13804 373A 13806 13840 374A 13863 13897 375A 13899 13917 376A 13919 13934 377A 13936 14008 378A 14010 14049 379A 14086 14100 380A 14103 14118 381A 14124 14163 382A 14174 14258 383A 14288 14319 384A 14367 14412 385A 14422 14447 386A 14463 14480 387A 14483 14546 388A 14548 14574 389A 14626 14641 390A 14643 14668 391A 14673 14691 392A 14747 14767 393A 14783 14803 394A 14820 14841 395A 14849 14871 396A 14862 14877 397A 14899 14927 398A 14956 14974 399A 14982 15007 400A 15017 15055 401A 15057 15087 402A 15089 15104 403A 15104 15138 404A 15141 15180 405A 15196 15239 406A 15241 15265 407A 15273 15291 408A 15293 15318 409A 15325 15363 410A 15365 15385 411A 15392 15424 412A 15426 15460 413A 15462 15476 414A 15478 15501 415A 15521 15570 416A 15573 15587 417A 15598 15631 418A 15649 15664 419A 15665 15690 420A 15721 15753 421A 15755 15782 422A 15784 15838 423A 15840 15857 424A 15859 15880 425A 15885 15928 426A 15930 15949 427A 15977 16020 428A 16022 16039 429A 16041 16120 430A 16131 16145 431A 16162 16199 432A 16210 16234 433A 16240 16283 434A 16299 16345 435A 16371 16391 436A 16393 16408 437A 16435 16481 438A 16483 16520 439A 16522 16540 440A 16535 16552 441A 16554 16574 442A 16581 16645 443A 16647 16672 444A 16701 16744 445A 16746 16761 446A 16763 16793 447A 16795 16818 448A 16820 16853 449A 16856 16874 450A 16884 16914 451A 16916 16946 452A 16948 16968 453A 16970 17043 454A 17046 17077 455A 17095 17116 456A 17119 17157 457A 17171 17189 458A 17213 17233 459A 17272 17320 460A 17322 17338 461A 17340 17356 462A 17358 17385 463A 17389 17446 464A 17448 17483 465A 17485 17506 466A 17584 17604 467A 17606 17638 468A 17659 17676 469A 17687 17741 470A 17743 17758 471A 17760 17777 472A 17779 17794 473A 17807 17826 474A 17836 17862 475A 17880 17910 476A 17914 17930 477A 17932 17956 478A 17958 17976 479A 17978 18005 480A 18009 18052 481A 18054 18075 482A 18102 18128 483A 18150 18201 484A 18203 18240 485A 18242 18279 486A 18331 18354 487A 18351 18365 488A 18374 18406 489A 18404 18419 490A 18408 18439 491A 18441 18471 492A 18473 18524 493A 18526 18566 494A 18568 18617 495A 18624 18640 496A 18642 18658 497A 18648 18697 498A 18699 18763 499A 18723 18739 500A 18777 18792 501A 18808 18825 502A 18827 18850 503A 18858 18920 504A 18923 18974 505A 18976 18993 506A 18995 19058 507A 19060 19087 508A 19089 19180 509A 19254 19273 510A 19292 19308 511A 19326 19350 512A 19352 19395 513A 19410 19488 514A 19507 19530 515A 19559 19585 516A 19587 19607 517A 19614 19632 518A 19634 19678 519A 19688 19739 520A 19741 19783 521A 19807 19821 522A 19859 19876 523A 19878 19908 524A 19910 19949 525A 19951 19969 526A 19972 19997 527A 20022 20044 528A 20046 20069 529A 20088 20106 530A 20108 20140 531A 20142 20169 532A 20174 20216 533A 20242 20259 534A 20271 20304 535A 20427 20448 536A 20436 20458 537A 20446 20460 538A 20481 20499 539A 20512 20531 540A 20540 20555 541A 20555 20569 542A 20557 20572 543A 20600 20619 544A 20631 20645 545A 20638 20655 546A 20647 20661 547A 20683 20716 548A 20719 20738 549A 20747 20766 550A 20780 20796 551A 20784 20805 552A 20837 20868 553A 20839 20856 554A 20870 20895 555A 20883 20900 556A 20912 20932 557A 20930 20966 558A 20936 20954 559A 20970 20987 560A 20986 21000 561A 20990 21022 562A 20998 21014 563A 21006 21020 564A 21008 21022 565A 21010 21030 566A 21018 21040 567A 21018 21035 568A 21065 21105 569A 21107 21135 570A 21139 21154 571A 21161 21224 572A 21233 21258 573A 21266 21293 574A 21295 21328 575A 21330 21357 576A 21373 21393 577A 21395 21434 578A 21436 21454 579A 21456 21522 580A 21529 21580 581A 21582 21612 582A 21652 21666 583A 21667 21685 584A 21671 21685 585A 21720 21738 586A 21740 21754 587A 21763 21800 588A 21811 21839 589A 21837 21877 590A 21902 21942 591A 21944 21960 592A 21975 22012 593A 22014 22032 594A 22049 22089 595A 22110 22143 596A 22145 22159 597A 22161 22188 598A 22190 22210 599A 22229 22260 600A 22275 22334 601A 22360 22406 602A 22408 22422 603A 22424 22440 604A 22442 22472 605A 22491 22531 606A 22559 22579 607A 22584 22677 608A 22695 22734 609A 22736 22765 610A 22767 22787 611A 22812 22826 612A 22849 22864 613A 22866 22886 614A 22933 22998 615A 23014 23046 616A 23082 23101 617A 23114 23146 618A 23168 23190 619A 23192 23225 620A 23286 23309 621A 23314 23422 622A 23419 23440 623A 23424 23438 624A 23428 23464 625A 23475 23499 626A 23505 23522 627A 23505 23526 628A 23505 23520 629A 23541 23561 630A 23549 23572 631A 23549 23571 632A 23575 23592 633A 23624 23648 634A 23650 23672 635A 23678 23699 636A 23685 23699 637A 23779 23794 638A 23921 23939 639A 23966 23997 640A 23993 24027 641A 23994 24008 642A 24029 24046 643A 24053 24068 644A 24095 24109 645A 24103 24163 646A 24103 24133 647A 24198 24218 648A 24201 24218 649A 24223 24240 650A 24258 24272 651A 24274 24294 652A 24356 24370 653A 24364 24394 654A 24423 24438 655A 24454 24474 656A 24454 24495 657A 24457 24474 658A 24497 24530 659A 24532 24555 660A 24562 24576 661A 24578 24604 662A 24617 24662 663A 24665 24698 664A 24697 24725 665A 24727 24746 666A 24777 24815 667A 24818 24835 668A 24843 24880 669A 24904 24924 670A 24926 24944 671A 24954 24970 672A 24995 25014 673A 25044 25059 674A 25061 25080 675A 25082 25098 676A 25108 25129 677A 25131 25193 678A 25226 25251 679A 25276 25296 680A 25368 25383 681A 25397 25412 682A 25414 25436 683A 25438 25483 684A 25475 25499 685A 25501 25529 686A 25547 25561 687A 25564 25590 688A 25598 25627 689A 25629 25776 690A 25778 25844 691A 25842 25873 692A 25875 25894 693A 25898 25942 694A 25944 26000 695A 26002 26027 696A 26037 26053 697A 26055 26086 698A 26088 26116 699A 26131 26186 700A 26190 26211 701A 26225 26246 702A 26249 26265 703A 26276 26321 704A 26334 26355 705A 26357 26386 706A 26398 26415 707A 26426 26455 708A 26469 26510 709A 26544 26580 710A 26582 26602 711A 26612 26655 712A 26671 26691 713A 26711 26725 714A 26736 26754 715A 26760 26780 716A 26788 26831 717A 26833 26850 718A 26860 26898 719A 26920 26936 720A 26938 26965 721A 26984 27050 722A 27065 27107 723A 27118 27177 724A 27187 27226 725A 27228 27243 726A 27271 27311 727A 27330 27364 728A 27382 27407 729A 27430 27450 730A 27446 27477 731A 27479 27517 732A 27519 27534 733A 27549 27582 734A 27584 27634 735A 27636 27663 736A 27682 27705 737A 27723 27745 738A 27771 27834 739A 27899 27921 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65173 1641A 65187 65203 1642A 65208 65291 1643A 65293 65322 1644A 65362 65387 1645A 65389 65405 1646A 65407 65462 1647A 65464 65575 1648A 65577 65615 1649A 65626 65640 1650A 65642 65671 1651A 65673 65700 1652A 65702 65723 1653A 65725 65764 1654A 65781 65797 1655A 65806 65823 1656A 65825 65839 1657A 65841 65883 1658A 65896 65939 1659A 65947 66010 1660A 66012 66026 1661A 66038 66058 1662A 66062 66109 1663A 66120 66136 1664A 66131 66214 1665A 66216 66253 1666A 66255 66271 1667A 66273 66306 1668A 66315 66331 1669A 66335 66384 1670A 66409 66426 1671A 66410 66425 1672A 66430 66459 1673A 66470 66492 1674A 66494 66524 1675A 66499 66513 1676A 66501 66515 1677A 66537 66552 1678A 66566 66606 1679A 66619 66638 1680A 66640 66657 1681A 66656 66674 1682A 66677 66693 1683A 66695 66734 1684A 66740 66788 1685A 66790 66828 1686A 66830 66845 1687A 66847 66870 1688A 66872 66892 1689A 66923 66948 1690A 66960 66974 1691A 66973 67017 1692A 67037 67061 1693A 67072 67106 1694A 67108 67150 1695A 67159 67174 1696A 67176 67191 1697A 67189 67218 1698A 67226 67268 1699A 67247 67263 1700A 67298 67322 1701A 67325 67342 1702A 67348 67362 1703A 67399 67429 1704A 67446 67464 1705A 67466 67505 1706A 67507 67524 1707A 67526 67552 1708A 67600 67617 1709A 67618 67634 1710A 67636 67660 1711A 67677 67708 1712A 67710 67744 1713A 67759 67788 1714A 67837 67859 1715A 67861 67884 1716A 67886 67905 1717A 67929 67951 1718A 67956 67993 1719A 67995 68014 1720A 68018 68032 1721A 68034 68048 1722A 68050 68074 1723A 68081 68134 1724A 68144 68215 1725A 68232 68288 1726A 68290 68313 1727A 68315 68358 1728A 68360 68381 1729A 68397 68414 1730A 68416 68434 1731A 68436 68453 1732A 68455 68504 1733A 68536 68562 1734A 68564 68579 1735A 68591 68606 1736A 68655 68706 1737A 68708 68727 1738A 68729 68833 1739A 68909 68957 1740A 68959 68992 1741A 68994 69026 1742A 69038 69058 1743A 69054 69068 1744A 69060 69106 1745A 69108 69135 1746A 69137 69166 1747A 69168 69207 1748A 69209 69224 1749A 69236 69252 1750A 69253 69297 1751A 69299 69318 1752A 69320 69355 1753A 69376 69404 1754A 69406 69464 1755A 69466 69578 1756A 69586 69629 1757A 69631 69663 1758A 69677 69696 1759A 69708 69722 1760A 69724 69760 1761A 69762 69779 1762A 69784 69798 1763A 69800 69822 1764A 69833 69866 1765A 69869 69912 1766A 69921 69957 1767A 69974 69989 1768A 69996 70128 1769A 70131 70166 1770A 70203 70217 1771A 70297 70320 1772A 70322 70361 1773A 70363 70388 1774A 70393 70417 1775A 70419 70438 1776A 70447 70465 1777A 70493 70509 1778A 70517 70541 1779A 70561 70590 1780A 70598 70640 1781A 70669 70688 1782A 70690 70730 1783A 70767 70782 1784A 70784 70800 1785A 70802 70816 1786A 70832 70881 1787A 70885 70906 1788A 70910 70984 1789A 70986 71002 1790A 71004 71018 1791A 71020 71071 1792A 71073 71103 1793A 71105 71135 1794A 71178 71193 1795A 71209 71238 1796A 71240 71265 1797A 71267 71297 1798A 71316 71337 1799A 71407 71438 1800A 71449 71495 1801A 71497 71605 1802A 71607 71709 1803A 71711 71740 1804A 71742 71767 1805A 71769 71785 1806A 71787 71882 1807A 71884 71926 1808A 71920 71945 1809A 71970 71984 1810A 71993 72021 1811A 72039 72109 1812A 72111 72167 1813A 72204 72267 1814A 72295 72333 1815A 72336 72355 1816A 72377 72391 1817A 72393 72411 1818A 72413 72436 1819A 72470 72492 1820A 72494 72556 1821A 72558 72576 1822A 72577 72591 1823A 72598 72640 1824A 72642 72687 1825A 72687 72707 1826A 72735 72793 1827A 72797 72811 1828A 72816 72837 1829A 72843 72879 1830A 72881 72896 1831A 72928 72958 1832A 72974 73027 1833A 73046 73061 1834A 73066 73087 1835A 73099 73122 1836A 73126 73141 1837A 73160 73182 1838A 73193 73221 1839A 73241 73263 1840A 73277 73309 1841A 73311 73330 1842A 73334 73350 1843A 73367 73390 1844A 73403 73438 1845A 73444 73466 1846A 73477 73497 1847A 73503 73537 1848A 73539 73577 1849A 73596 73673 1850A 73675 73691 1851A 73708 73724 1852A 73726 73774 1853A 73776 73800 1854A 73802 73866 1855A 73871 73910 1856A 73935 73969 1857A 73971 73985 1858A 74013 74064 1859A 74076 74097 1860A 74114 74129 1861A 74136 74165 1862A 74167 74186 1863A 74188 74254 1864A 74271 74372 1865A 74374 74388 1866A 74401 74432 1867A 74449 74474 1868A 74476 74516 1869A 74518 74555 1870A 74550 74582 1871A 74614 74680 1872A 74704 74752 1873A 74774 74797 1874A 74802 74856 1875A 74867 74923 1876A 74903 74917 1877A 74937 74951 1878A 74953 74975 1879A 74958 74972 1880A 74969 75003 1881A 74974 74989 1882A 74991 75005 1883A 75023 75039 1884A 75024 75039 1885A 75051 75066 1886A 75080 75098 1887A 75095 75109 1888A 75135 75200 1889A 75189 75203 1890A 75223 75238 1891A 75245 75282 1892A 75293 75310 1893A 75312 75335 1894A 75337 75355 1895A 75364 75394 1896A 75411 75432 1897A 75434 75467 1898A 75481 75512 1899A 75514 75530 1900A 75532 75547 1901A 75572 75651 1902A 75667 75687 1903A 75689 75740 1904A 75739 75760 1905A 75762 75849 1906A 75859 75876 1907A 75885 75900 1908A 75907 75929 1909A 75931 75949 1910A 75951 75973 1911A 75975 76073 1912A 76075 76092 1913A 76094 76110 1914A 76118 76141 1915A 76143 76158 1916A 76160 76176 1917A 76179 76211 1918A 76224 76240 1919A 76247 76267 1920A 76269 76290 1921A 76292 76306 1922A 76308 76335 1923A 76343 76364 1924A 76366 76390 1925A 76392 76409 1926A 76428 76486 1927A 76488 76502 1928A 76519 76539 1929A 76541 76564 1930A 76575 76589 1931A 76606 76620 1932A 76640 76654 1933A 76645 76663 1934A 76653 76678 1935A 76727 76756 1936A 76782 76799 1937A 76805 76819 1938A 76831 76858 1939A 76907 76927 1940A 76942 76985 1941A 76987 77008 1942A 77010 77045 1943A 77056 77085 1944A 77101 77139 1945A 77158 77172 1946A 77174 77197 1947A 77199 77221 1948A 77223 77262 1949A 77267 77281 1950A 77283 77332 1951A 77349 77363 1952A 77383 77465 1953A 77478 77516 1954A 77518 77553 1955A 77555 77579 1956A 77594 77628 1957A 77631 77684 1958A 77686 77715 1959A 77733 77794 1960A 77796 77835 1961A 77854 77875 1962A 77883 77899 1963A 77920 77940 1964A 77942 77963 1965A 77978 77998 1966A 78009 78033 1967A 78035 78075 1968A 78092 78111 1969A 78113 78142 1970A 78144 78176 1971A 78189 78203 1972A 78215 78250 1973A 78267 78298 1974A 78313 78360 1975A 78386 78408 1976A 78410 78449 1977A 78467 78491 1978A 78494 78517 1979A 78519 78552 1980A 78554 78578 1981A 78589 78608 1982A 78620 78657 1983A 78659 78674 1984A 78676 78696 1985A 78719 78769 1986A 78771 78823 1987A 78834 78919 1988A 78921 78938 1989A 78953 78991 1990A 78992 79006 1991A 78992 79007 1992A 81650 81664 1993A 82345 82366 1994A 82358 82372 1995A 82390 82406 1996A 82531 82547 1997A 82535 82550 1998A 83245 83259 1999A 83709 83723 2000A 83901 83918 2001A 85858 85873
[0107] In some embodiments, the target sequence is selected from the group consisting of target regions 1A to 2001A as shown in Table 4 above.
TABLE-US-00005 TABLE 5 Exemplary target regions Target start SEQ end SEQ region ID NO: 1 ID NO: 1 1C 39 60 2C 60 78 3C 2314 2327 4C 2911 2951 5C 3211 3224 6C 4669 4682 7C 4670 4683 8C 5059 5073 9C 5789 5802 10C 6577 6591 11C 7773 7786 12C 8088 8101 13C 8773 8786 14C 11161 11175 15C 11431 11444 16C 12446 12459 17C 12703 12721 18C 12703 12717 19C 12704 12722 20C 12704 12718 21C 12705 12723 22C 12705 12719 23C 12706 12724 24C 2706 12720 25C 12707 12725 26C 12707 12721 27C 12708 12726 28C 12708 12722 29C 12709 12727 30C 12709 12723 31C 12710 12728 32C 12710 12724 33C 12711 12729 34C 12711 12725 35C 12711 12730 36C 12712 12726 37C 12713 12727 38C 12714 12728 39C 12715 12730 40C 12715 12729 41C 12717 12730 42C 12718 12732 43C 13178 13191 44C 15649 15662 45C 15822 15835 46C 15890 15903 47C 16495 16508 48C 19257 19270 49C 19891 19907 50C 22624 22642 51C 22707 22720 52C 25655 25776 53C 25793 25844 54C 25850 25869 55C 27809 27825 56C 28623 28636 57C 29713 29728 58C 29982 30004 59C 30008 30021 60C 30880 30897 61C 30882 30897 62C 30885 30899 63C 30887 30902 64C 30986 30999 65C 31588 31601 66C 31911 31925 67C 31913 31926 68C 32075 32088 69C 32266 32279 70C 33213 33232 71C 35865 35883 72C 35865 35879 73C 35866 35884 74C 35866 35880 75C 35867 35885 76C 35867 35881 77C 35868 35886 78C 35868 35882 79C 35869 35887 80C 35869 35883 81C 35870 35888 82C 35870 35884 83C 35871 35889 84C 35871 35885 85C 35871 35890 86C 35872 35886 87C 35873 35887 88C 35874 35888 89C 35875 35890 90C 35875 35889 91C 35877 35890 92C 35878 35891 93C 38221 38234 94C 38388 38402 95C 38596 38615 96C 38667 38686 97C 39710 39723 98C 41289 41303 99C 41290 41303 100C 41294 41310 101C 41548 41562 102C 41551 41567 103C 41572 41588 104C 41680 41693 105C 42012 42025 106C 42319 42332 107C 43518 43532 108C 43585 43601 109C 43586 43599 110C 43687 43707 111C 43709 43727 112C 43741 43757 113C 43770 43812 114C 44217 44230 115C 45386 45399 116C 45387 45400 117C 46795 46812 118C 49386 49402 119C 49431 49444 120C 49446 49459 121C 49518 49534 122C 49737 49751 123C 49777 49790 124C 50578 50592 125C 52491 52504 126C 57296 57311 127C 57374 57393 128C 57406 57426 129C 57488 57504 130C 57512 57533 131C 59439 59452 132C 59460 59474 133C 60638 60653 134C 60681 60700 135C 60881 60895 136C 61260 61280 137C 62960 62976 138C 64306 64320 139C 65023 65036 140C 65062 65099 141C 65498 65511 142C 65850 65863 143C 66276 66289 144C 67447 67460 145C 67508 67521 146C 67861 67874 147C 69112 69126 148C 69383 69404 149C 69436 69464 150C 69489 69506 151C 69541 69573 152C 69601 69617 153C 69833 69854 154C 70939 70955 155C 71029 71043 156C 71465 71488 157C 71531 71605 158C 71607 71629 159C 71631 71647 160C 71649 71671 161C 71673 71707 162C 71724 71740 163C 71751 71767 164C 71796 71809 165C 72008 72021 166C 72777 72790 167C 73605 73625 168C 74278 74291 169C 74295 74309 170C 74350 74370 171C 74492 74510 172C 74518 74549 173C 74617 74639 174C 75624 75644 175C 78777 78808 176C 78834 78850 177C 78858 78901 178C 78992 79005
[0108] In some embodiments, the target sequence is selected from the group consisting of target regions 10 to 178C as shown in Table 5 above.
Target Cell
[0109] The term a “target cell” as used herein refers to a cell which is expressing the target nucleic acid. For the therapeutic use of the present invention it is advantageous if the target cell is infected with HBV. In some embodiments, the target cell may be in vivo or in vitro. In some embodiments, the target cell is a mammalian cell such as a rodent cell, such as a mouse cell or a rat cell, or a woodchuck cell or a primate cell such as a monkey cell (e.g. a cynomolgus monkey cell) or a human cell.
[0110] In preferred embodiments, the target cell expresses A1CF mRNA, such as the A1CF pre-mRNA or A1CF mature mRNA. The poly A tail of A1CF mRNA is typically disregarded for antisense oligonucleotide targeting.
[0111] Further, the target cell may be a hepatocyte. In one embodiment, the target cell is HBV infected primary human hepatocytes, either derived from HBV infected individuals or from a HBV infected mouse with a humanized liver (PhoenixBio, PXB-mouse).
[0112] In accordance with the present invention, the target cell may be infected with HBV. Further, the target cell may comprise HBV cccDNA. Thus, the target cell preferably comprises A1CF mRNA, such as the A1CF pre-mRNA or A1CF mature mRNA, and HBV cccDNA. In one embodiment, the target cell is a human cell. In one embodiment, the human cell is a hepatocyte.
Naturally Occurring Variant
[0113] The term “naturally occurring variant” refers to variants of A1CF gene or transcripts which originate from the same genetic loci as the target nucleic acid, but may differ for example, by virtue of degeneracy of the genetic code causing a multiplicity of codons encoding the same amino acid, or due to alternative splicing of pre-mRNA, or the presence of polymorphisms, such as single nucleotide polymorphisms (SNPs), and allelic variants. Based on the presence of the sufficient complementary sequence to the oligonucleotide, the oligonucleotide of the invention may therefore target the target nucleic acid and naturally occurring variants thereof.
[0114] In some embodiments, the naturally occurring variants have at least 95% such as at least 98% or at least 99% homology to a mammalian A1CF target nucleic acid, such as a target nucleic acid of SEQ ID NO: 1 and/or SEQ ID NO: 2. In some embodiments, the naturally occurring variants have at least 99% homology to the human A1CF target nucleic acid of SEQ ID NO: 1. In some embodiments, the naturally occurring variants are known polymorphisms.
Inhibition of Expression
[0115] The term “inhibition of expression” as used herein is to be understood as an overall term for an A1CF (APOBEC1 complementation factor) inhibitors ability to inhibit amount or the activity of A1CF in a target cell. Inhibition of expression or activity may be determined by measuring the level of A1CF pre-mRNA or A1CF mRNA, or by measuring the level of A1CF protein or activity in a cell. Inhibition of expression may be determined in vitro or in vivo. Inhibition is determined by reference to a control. It is generally understood that the control is an individual or target cell treated with a saline composition.
[0116] The term “inhibition” or “inhibit” may also be referred to as down-regulate, reduce, suppress, lessen, lower, decrease the expression or activity of A1CF.
[0117] The inhibition of expression of A1CF may occur e.g. by degradation of pre-mRNA or mRNA e.g. using RNase H recruiting oligonucleotides, such as gapmers, or nucleic acid molecules that function via the RNA interference pathway, such as siRNA or shRNA. Alternatively, the inhibitor of the present invention may bind to A1CF polypeptide and inhibit the activity of A1CF or prevent its binding to other molecules.
[0118] In some embodiments, the inhibition of expression of the A1CF target nucleic acid or the activity of A1CF protein results in a decreased amount of HBV cccDNA in the target cell. Preferably, the amount of HBV cccDNA is decreased as compared to a control. In some embodiments, the decrease in amount of HBV cccDNA is at least 20%, at least 30%, as compared to a control. In some embodiments, the amount of cccDNA in an HBV infected cell is reduced by at least 50%, such as 60%, such as 70%, when compared to a control.
[0119] In some embodiments, the inhibition of expression of the A1CF target nucleic acid or the activity of A1CF protein results in a decreased amount of HBV pgRNA in the target cell. Preferably, the amount of HBV pgRNA is decreased as compared to a control. In some embodiments, the decrease in amount of HBV pgRNA is at least 20%, at least 30%, as compared to a control. In some embodiments, the amount of pgRNA in an HBV infected cell is reduced by at least 50%, such as 60%, when compared to a control.
Sugar Modifications
[0120] The oligonucleotide of the invention may comprise one or more nucleosides which have a modified sugar moiety, i.e. a modification of the sugar moiety when compared to the ribose sugar moiety found in DNA and RNA.
[0121] Numerous nucleosides with modification of the ribose sugar moiety have been made, primarily with the aim of improving certain properties of oligonucleotides, such as affinity and/or nuclease resistance.
[0122] Such modifications include those where the ribose ring structure is modified, e.g. by replacement with a hexose ring (HNA), or a bicyclic ring, which typically have a biradical bridge between the C2 and C4 carbons on the ribose ring (LNA), or an unlinked ribose ring which typically lacks a bond between the C2 and C3 carbons (e.g. UNA). Other sugar modified nucleosides include, for example, bicyclohexose nucleic acids (WO2011/017521) or tricyclic nucleic acids (WO2013/154798). Modified nucleosides also include nucleosides where the sugar moiety is replaced with a non-sugar moiety, for example in the case of peptide nucleic acids (PNA), or morpholino nucleic acids.
[0123] Sugar modifications also include modifications made via altering the substituent groups on the ribose ring to groups other than hydrogen, or the 2′-OH group naturally found in DNA and RNA nucleosides. Substituents may, for example be introduced at the 2′, 3′, 4′ or 5′ positions.
High Affinity Modified Nucleosides
[0124] A high affinity modified nucleoside is a modified nucleotide which, when incorporated into the oligonucleotide enhances the affinity of the oligonucleotide for its complementary target, for example as measured by the melting temperature (T.sub.m). A high affinity modified nucleoside of the present invention preferably result in an increase in melting temperature in the range of +0.5 to +12° C., more preferably in the range of +1.5 to +10° C. and most preferably in the range of +3 to +8° C. per modified nucleoside. Numerous high affinity modified nucleosides are known in the art and include for example, many 2′ substituted nucleosides as well as locked nucleic acids (LNA) (see e.g. Freier & Altmann; Nucl. Acid Res., 1997, 25, 4429-4443 and Uhlmann; Curr. Opinion in Drug Development, 2000, 3(2), 293-213).
2′ Sugar Modified Nucleosides
[0125] A 2′ sugar modified nucleoside is a nucleoside which has a substituent other than H or —OH at the 2′ position (2′ substituted nucleoside) or comprises a 2′ linked biradical capable of forming a bridge between the 2′ carbon and a second carbon in the ribose ring, such as LNA (2′-4′ biradical bridged) nucleosides.
[0126] Indeed, much focus has been spent on developing 2′ sugar substituted nucleosides, and numerous 2′ substituted nucleosides have been found to have beneficial properties when incorporated into oligonucleotides. For example, the 2′ modified sugar may provide enhanced binding affinity and/or increased nuclease resistance to the oligonucleotide. Examples of 2′ substituted modified nucleosides are 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA (MOE), 2′-amino-DNA, 2′-Fluoro-RNA, and 2′-F-ANA nucleoside. For further examples, please see e.g. Freier & Altmann; Nucl. Acid Res., 1997, 25, 4429-4443 and Uhlmann; Curr. Opinion in Drug Development, 2000, 3(2), 293-213, and Deleavey and Damha, Chemistry and Biology 2012, 19, 937. Below are illustrations of some 2′ substituted modified nucleosides.
##STR00001##
[0127] In relation to the present invention 2′ substituted sugar modified nucleosides does not include 2′ bridged nucleosides like LNA.
Locked Nucleic Acid Nucleosides (LNA Nucleoside)
[0128] A “LNA nucleoside” is a 2′-sugar modified nucleoside which comprises a biradical linking the C2′ and C4′ of the ribose sugar ring of said nucleoside (also referred to as a “2′-4′ bridge”), which restricts or locks the conformation of the ribose ring. These nucleosides are also termed bridged nucleic acid or bicyclic nucleic acid (BNA) in the literature. The locking of the conformation of the ribose is associated with an enhanced affinity of hybridization (duplex stabilization) when the LNA is incorporated into an oligonucleotide for a complementary RNA or DNA molecule. This can be routinely determined by measuring the melting temperature of the oligonucleotide/complement duplex.
[0129] Non limiting, exemplary LNA nucleosides are disclosed in WO 99/014226, WO 00/66604, WO 98/039352, WO 2004/046160, WO 00/047599, WO 2007/134181, WO 2010/077578, WO 2010/036698, WO 2007/090071, WO 2009/006478, WO 2011/156202, WO 2008/154401, WO 2009/067647, WO 2008/150729, Morita et al., Bioorganic & Med. Chem. Lett. 12, 73-76, Seth et al. J. Org. Chem. 2010, Vol 75(5) pp. 1569-81, Mitsuoka et al., Nucleic Acids Research 2009, 37(4), 1225-1238, and Wan and Seth, J. Medical Chemistry 2016, 59, 9645-9667.
[0130] Particular examples of LNA nucleosides of the invention are presented in Scheme 1 (wherein B is as defined above).
##STR00002##
[0131] Particular LNA nucleosides are beta-D-oxy-LNA, 6′-methyl-beta-D-oxy LNA such as (S)-6′-methyl-beta-D-oxy-LNA (ScET) and ENA.
RNase H Activity and Recruitment
[0132] The RNase H activity of an antisense oligonucleotide refers to its ability to recruit RNase H when in a duplex with a complementary RNA molecule. WO01/23613 provides in vitro methods for determining RNase H activity, which may be used to determine the ability to recruit RNase H. Typically an oligonucleotide is deemed capable of recruiting RNase H if it, when provided with a complementary target nucleic acid sequence, has an initial rate, as measured in pmol/l/min, of at least 5%, such as at least 10% or more than 20% of the of the initial rate determined when using a oligonucleotide having the same base sequence as the modified oligonucleotide being tested, but containing only DNA monomers with phosphorothioate linkages between all monomers in the oligonucleotide, and using the methodology provided by Example 91-95 of WO 01/23613 (hereby incorporated by reference). For use in determining RNase H activity, recombinant human RNase H1 is available from Creative Biomart® (Recombinant Human RNase H1 fused with His tag expressed in E. coli).
Gapmer
[0133] The antisense oligonucleotide of the invention, or contiguous nucleotide sequence thereof, may be a gapmer, also termed gapmer oligonucleotide or gapmer designs. The antisense gapmers are commonly used to inhibit a target nucleic acid via RNase H mediated degradation. A gapmer oligonucleotide comprises at least three distinct structural regions a 5′-flank, a gap and a 3′-flank, F-G-F′ in the ‘5->3’ orientation. The “gap” region (G) comprises a stretch of contiguous DNA nucleotides which enable the oligonucleotide to recruit RNase H. The gap region is flanked by a 5′ flanking region (F) comprising one or more sugar modified nucleosides, advantageously high affinity sugar modified nucleosides, and by a 3′ flanking region (F′) comprising one or more sugar modified nucleosides, advantageously high affinity sugar modified nucleosides. The one or more sugar modified nucleosides in region F and F′ enhance the affinity of the oligonucleotide for the target nucleic acid (i.e. are affinity enhancing sugar modified nucleosides). In some embodiments, the one or more sugar modified nucleosides in region F and F′ are 2′ sugar modified nucleosides, such as high affinity 2′ sugar modifications, such as independently selected from LNA and 2′-MOE.
[0134] In a gapmer design, the 5′ and 3′ most nucleosides of the gap region are DNA nucleosides, and are positioned adjacent to a sugar modified nucleoside of the 5′ (F) or 3′ (F′) region respectively. The flanks may further be defined by having at least one sugar modified nucleoside at the end most distant from the gap region, i.e. at the 5′ end of the 5′ flank and at the 3′ end of the 3′ flank.
[0135] Regions F-G-F′ form a contiguous nucleotide sequence. Antisense oligonucleotides of the invention, or the contiguous nucleotide sequence thereof, may comprise a gapmer region of formula F-G-F′.
[0136] The overall length of the gapmer design F-G-F′ may be, for example 12 to 32 nucleosides, such as 13 to 24, such as 14 to 22 nucleosides, such as from 15 to 20, such as 16 to 18 nucleosides.
[0137] By way of example, the gapmer oligonucleotide of the present invention can be represented by the following formulae:
F.sub.1-8-G.sub.5-18-F′.sub.1-8, such as
F.sub.1-8-G.sub.7-18-F′.sub.2-8
with the proviso that the overall length of the gapmer regions F-G-F′ is at least 12, such as at least 14 nucleotides in length.
[0138] In an aspect of the invention, the antisense oligonucleotide or contiguous nucleotide sequence thereof consists of or comprises a gapmer of formula 5′-F-G-F′-3′, where region F and F′ independently comprise or consist of 1-8 nucleosides, of which 1-4 are 2′ sugar modified and defines the 5′ and 3′ end of the F and F′ region, and G is a region between 6 and 18 nucleosides which are capable of recruiting RNase H. In some embodiments, the G region consists of DNA nucleosides.
[0139] In some embodiments, region F and F′ independently consists of or comprises a contiguous sequence of sugar modified nucleosides. In some embodiments, the sugar modified nucleosides of region F may be independently selected from 2′-O-alkyl-RNA units, 2′-O-methyl-RNA, 2′-amino-DNA units, 2′-fluoro-DNA units, 2′-alkoxy-RNA, MOE units, LNA units, arabino nucleic acid (ANA) units and 2′-fluoro-ANA units.
[0140] In some embodiments, region F and F′ independently comprises both LNA and a 2′-substituted sugar modified nucleotide (mixed wing design). In some embodiments, the 2′-substituted sugar modified nucleotide is independently selected from the group consisting of 2′-O-alkyl-RNA units, 2′-O-methyl-RNA, 2′-amino-DNA units, 2′-fluoro-DNA units, 2′-alkoxy-RNA, MOE units, arabino nucleic acid (ANA) units and 2′-fluoro-ANA units.
[0141] In some embodiments, all the modified nucleosides of region F and F′ are LNA nucleosides, such as independently selected from beta-D-oxy LNA, ENA or ScET nucleosides, wherein region F or F′, or F and F′ may optionally comprise DNA nucleosides. In some embodiments, all the modified nucleosides of region F and F′ are beta-D-oxy LNA nucleosides, wherein region F or F′, or F and F′ may optionally comprise DNA nucleosides. In such embodiments, the flanking region F or F′, or both F and F′ comprise at least three nucleosides, wherein the 5′ and 3′ most nucleosides of the F and/or F′ region are LNA nucleosides.
LNA Gapmer
[0142] An LNA gapmer is a gapmer wherein either one or both of region F and F′ comprises or consists of LNA nucleosides. A beta-D-oxy gapmer is a gapmer wherein either one or both of region F and F′ comprises or consists of beta-D-oxy LNA nucleosides.
[0143] In some embodiments, the LNA gapmer is of formula: [LNA].sub.1-5-[region G].sub.6-18-[LNA].sub.1-5, wherein region G is as defined in the Gapmer region G definition.
MOE Gapmers
[0144] A MOE gapmers is a gapmer wherein regions F and F′ consist of MOE nucleosides. In some embodiments, the MOE gapmer is of design [MOE].sub.1-8-[Region G].sub.5-16-[MOE].sub.1-8, such as [MOE].sub.2-7-[Region G].sub.6-14-[MOE].sub.2-7, such as [MOE].sub.3-6-[Region G].sub.8-12-[MOE].sub.3-8, such as [MOE].sub.5-[Region G].sub.10-[MOE].sub.5 wherein region G is as defined in the Gapmer definition. MOE gapmers with a 5-10-5 design (MOE-DNA-MOE) have been widely used in the art.
Region D′ or D″ in an Oligonucleotide
[0145] The oligonucleotide of the invention may in some embodiments comprise or consist of the contiguous nucleotide sequence of the oligonucleotide which is complementary to the target nucleic acid, such as a gapmer region F-G-F′, and further 5′ and/or 3′ nucleosides. The further 5′ and/or 3′ nucleosides may or may not be fully complementary to the target nucleic acid. Such further 5′ and/or 3′ nucleosides may be referred to as region D′ and D″ herein.
[0146] The addition of region D′ or D″ may be used for the purpose of joining the contiguous nucleotide sequence, such as the gapmer, to a conjugate moiety or another functional group. When used for joining the contiguous nucleotide sequence with a conjugate moiety is can serve as a biocleavable linker. Alternatively, it may be used to provide exonucleoase protection or for ease of synthesis or manufacture.
[0147] Region D′ and D″ can be attached to the 5′ end of region F or the 3′ end of region F′, respectively to generate designs of the following formulas D′-F-G-F′, F-G-F′-D″ or D′-F-G-F′-D″. In this instance the F-G-F′ is the gapmer portion of the oligonucleotide and region D′ or D″ constitute a separate part of the oligonucleotide.
[0148] Region D′ or D″ may independently comprise or consist of 1, 2, 3, 4 or 5 additional nucleotides, which may be complementary or non-complementary to the target nucleic acid. The nucleotide adjacent to the F or F′ region is not a sugar-modified nucleotide, such as a DNA or RNA or base modified versions of these. The D′ or D″ region may serve as a nuclease susceptible biocleavable linker (see definition of linkers). In some embodiments, the additional 5′ and/or 3′ end nucleotides are linked with phosphodiester linkages, and are DNA or RNA. Nucleotide based biocleavable linkers suitable for use as region D′ or D″ are disclosed in WO2014/076195, which include by way of example a phosphodiester linked DNA dinucleotide. The use of biocleavable linkers in poly-oligonucleotide constructs is disclosed in WO2015/113922, where they are used to link multiple antisense constructs (e.g. gapmer regions) within a single oligonucleotide.
[0149] In one embodiment, the oligonucleotide of the invention comprises a region D′ and/or D″ in addition to the contiguous nucleotide sequence which constitutes the gapmer.
[0150] In some embodiments, the oligonucleotide of the present invention can be represented by the following formulae:
F-G-F′; in particular F.sub.1-8-G.sub.5-18-F′.sub.2-8
D′-F-G-F′, in particular D′.sub.1-3-F.sub.1-8-G.sub.5-18-F′.sub.2-8
F-G-F′-D″, in particular F.sub.1-8-G.sub.5-18-F′.sub.2-8-D″.sub.1-3
D′-F-G-F′-D″, in particular D′.sub.1-3-F.sub.1-8-G.sub.5-18-F′.sub.2-8-D″.sub.1-3
[0151] In some embodiments, the internucleoside linkage positioned between region D′ and region F is a phosphodiester linkage. In some embodiments, the internucleoside linkage positioned between region F′ and region D″ is a phosphodiester linkage.
Conjugate
[0152] The term “conjugate” as used herein refers to an oligonucleotide which is covalently linked to a non-nucleotide moiety (conjugate moiety or region C or third region). The conjugate moiety may be covalently linked to the antisense oligonucleotide, optionally via a linker group, such as region D′ or D″.
[0153] Oligonucleotide conjugates and their synthesis have been reported in comprehensive reviews by Manoharan in Antisense Drug Technology, Principles, Strategies, and Applications, S. T. Crooke, ed., Ch. 16, Marcel Dekker, Inc., 2001 and Manoharan, Antisense and Nucleic Acid Drug Development, 2002, 12, 103, each of which is incorporated herein by reference in its entirety.
[0154] In some embodiments, the non-nucleotide moiety (conjugate moiety) is selected from the group consisting of carbohydrates (e.g. galactose or N-acetylgalactosamine (GalNAc)), cell surface receptor ligands, drug substances, hormones, lipophilic substances, polymers, proteins (e.g. antibodies), peptides, toxins (e.g. bacterial toxins), vitamins, viral proteins (e.g. capsids) or combinations thereof.
[0155] Exemplary conjugate moieties are those capable of binding to the asialoglycoprotein receptor (ASGPR). In particular, tri-valent N-acetylgalactosamine conjugate moieties are suitable for binding to the ASGPR, see for example WO 2014/076196, WO 2014/207232 and WO 2014/179620 (hereby incorporated by reference). Such conjugates serve to enhance uptake of the oligonucleotide to the liver.
Linkers
[0156] A linkage or linker is a connection between two atoms that links one chemical group or segment of interest to another chemical group or segment of interest via one or more covalent bonds. Conjugate moieties can be attached to the oligonucleotide directly or through a linking moiety (e.g. linker or tether). Linkers serve to covalently connect a third region, e.g. a conjugate moiety (region C), to a first region, e.g. an oligonucleotide or contiguous nucleotide sequence complementary to the target nucleic acid (region A).
[0157] In some embodiments of the invention the conjugate or oligonucleotide conjugate of the invention may optionally, comprise a linker region (second region or region B and/or region Y) which is positioned between the oligonucleotide or contiguous nucleotide sequence complementary to the target nucleic acid (region A or first region) and the conjugate moiety (region C or third region).
[0158] Region B refers to biocleavable linkers comprising or consisting of a physiologically labile bond that is cleavable under conditions normally encountered or analogous to those encountered within a mammalian body. Conditions under which physiologically labile linkers undergo chemical transformation (e.g., cleavage) include chemical conditions such as pH, temperature, oxidative or reductive conditions or agents, and salt concentration found in or analogous to those encountered in mammalian cells. Mammalian intracellular conditions also include the presence of enzymatic activity normally present in a mammalian cell such as from proteolytic enzymes or hydrolytic enzymes or nucleases. In one embodiment, the biocleavable linker is susceptible to S1 nuclease cleavage. In a preferred embodiment the nuclease susceptible linker comprises between 1 and 5 nucleosides, such as 1, 2, 3, 4 or 5 nucleosides, more preferably between 2 and 4 nucleosides and most preferably 2 or 3 linked nucleosides comprising at least two consecutive phosphodiester linkages, such as at least 3 or 4 or 5 consecutive phosphodiester linkages. Preferably the nucleosides are DNA or RNA. Phosphodiester containing biocleavable linkers are described in more detail in WO 2014/076195 (hereby incorporated by reference).
[0159] Region Y refers to linkers that are not necessarily biocleavable but primarily serve to covalently connect a conjugate moiety (region C or third region), to an oligonucleotide (region A or first region). The region Y linkers may comprise a chain structure or an oligomer of repeating units such as ethylene glycol, amino acid units or amino alkyl groups The oligonucleotide conjugates of the present invention can be constructed of the following regional elements A-C, A-B-C, A-B-Y-C, A-Y-B-C or A-Y-C. In some embodiments, the linker (region Y) is an amino alkyl, such as a C2-C36 amino alkyl group, including, for example C6 to C12 amino alkyl groups. some embodiments the linker (region Y) is a C6 amino alkyl group.
Treatment
[0160] The term “treatment” as used herein refers to both treatment of an existing disease (e.g. a disease or disorder as herein referred to), or prevention of a disease, i.e. prophylaxis. It will therefore be recognized that treatment as referred to herein may, in some embodiments, be prophylactic. Prophylactic can be understood as preventing an HBV infection from turning into a chronic HBV infection or the prevention of severe liver diseases such as liver cirrhosis and hepatocellular carcinoma caused by a chronic HBV infection.
Patient
[0161] For the purposes of the present invention the “subject” (or “patient”) may be a vertebrate. In context of the present invention, the term “subject” includes both humans and other animals, particularly mammals, and other organisms. Thus, the herein provided means and methods are applicable to both human therapy and veterinary applications. Preferably, the subject is a mammal. More preferably the subject is human.
[0162] As described elsewhere herein, the patient to be treated may suffers from HBV infection, such as chronic HBV infection. In some embodiments, the patient suffering from HBV infection may suffer from hepatocellular carcinoma (HCC). In some embodiments, the patient suffering from HBV infection does not suffer from hepatocellular carcinoma.
DETAILED DESCRIPTION OF THE INVENTION
[0163] HBV cccDNA in infected hepatocytes is responsible for persistent chronic infection and reactivation, being the template for all viral subgenomic transcripts and pre-genomic RNA (pgRNA) to ensure both newly synthesized viral progeny and cccDNA pool replenishment via intracellular nucleocapsid recycling. In the context of the present invention it was for the first time shown that A1CF is associated with cccDNA stability. This knowledge allows for the opportunity to destabilize cccDNA in HBV infected subjects which in turn opens the opportunity for a complete cure of chronically infected HBV patients.
[0164] One aspect of the present invention is an A1CF inhibitor for use in the treatment and/or prevention of Hepatitis B virus (HBV) infection, in particular a chronic HBV infection.
[0165] The A1CF inhibitor can for example be a small molecule that specifically binds to A1CF protein, wherein said inhibitor prevents or reduces binding of A1CF protein to cccDNA.
[0166] An embodiment of the invention is an A1CF inhibitor which is capable of reducing the amount of cccDNA and/or pgRNA in an infected cell, such as an HBV infected cell.
[0167] In a further embodiment, the A1CF inhibitor is capable of reducing HBsAg and/or HBeAg in vivo in an HBV infected individual.
A1CF Inhibitors for Use in Treatment of HBV
[0168] Without being bound by theory, it is believed that A1CF is involved in the stabilization of the cccDNA in the cell nucleus, either via direct or indirect binding to the cccDNA, and by preventing the binding/association of A1CF with cccDNA, the cccDNA is destabilized and becomes prone to degradation. One embodiment of the invention is therefore an A1CF inhibitor which interacts with the A1CF protein, and prevents or reduces its binding/association to cccDNA.
[0169] In some embodiments of the present invention, the inhibitor is an antibody, antibody fragment or a small molecule compound. In some embodiments, the inhibitor may be an antibody, antibody fragment or a small molecule that specifically binds to the A1CF protein, such as the A1CF protein encoded by SEQ ID NO: 1, 4, 5, 6, 7, 8, 9, 10 or 11.
Nucleic Acid Molecules of the Invention
[0170] Therapeutic nucleic acid molecules are potentially excellent A1CF inhibitors since they can target the A1CF transcript and promote its degradation either via the RNA interference pathway or via RNase H cleavage. Alternatively, oligonucleotides such as aptamers can also act as inhibitors of A1CF protein interactions.
[0171] One aspect of the present invention is an A1CF targeting nucleic acid molecule for use in treatment and/or prevention of Hepatitis B virus (HBV) infection. Such a nucleic acid molecule can be selected from the group consisting of a single stranded antisense oligonucleotide, an siRNA, and a shRNA.
[0172] The present section describes novel nucleic acid molecules suitable for use in treatment and/or prevention of Hepatitis B virus (HBV) infection.
[0173] The nucleic acid molecules of the present invention are capable of inhibiting expression of A1CF mRNA and/or protein in vitro and in vivo. The inhibition is achieved by hybridizing an oligonucleotide to a target nucleic acid encoding A1CF. The target nucleic acid may be a mammalian A1CF sequence. In some embodiments, the target nucleic acid may be a human A1CF pre-mRNA sequence such as the sequence of SEQ ID NO: 1 or a human mature A1CF mRNA sequence selected from SEQ ID NO: 4 to 11. In some embodiments, the target nucleic acid may be a cynomolgus monkey A1CF sequence such as the sequence of SEQ ID NO: 2.
[0174] In some embodiments, the nucleic acid molecule of the invention is capable of modulating the expression of the target by inhibiting or down-regulating it. Preferably, such modulation produces an inhibition of expression of at least 20% compared to the normal expression level of the target, more preferably at least 30%, at least 40%, or at least 50%, inhibition compared to the normal expression level of the target. In some embodiments, the nucleic acid molecule of the invention may be capable of inhibiting expression levels of A1CF mRNA by at least 50% or 60% in vitro by transfecting 25 nM nucleic acid molecule into PXB-PHH cells, this range of target reduction is advantageous in terms of selecting nucleic acid molecules with good correlation to the cccDNA reduction. Suitably, the examples provide assays which may be used to measure A1CF mRNA inhibition (e.g. example 1 and the “Materials and Methods” section). A1CF inhibition is triggered by the hybridization between a contiguous nucleotide sequence of the oligonucleotide, such as the guide strand of a siRNA or gapmer region of an antisense oligonucleotide, and the target nucleic acid. In some embodiments, the nucleic acid molecule of the invention comprises mismatches between the oligonucleotide and the target nucleic acid. Despite mismatches hybridization to the target nucleic acid may still be sufficient to show a desired inhibition of A1CF expression. Reduced binding affinity resulting from mismatches may advantageously be compensated by increased number of nucleotides in the oligonucleotide complementary to the target nucleic acid and/or an increased number of modified nucleosides capable of increasing the binding affinity to the target, such as 2′ sugar modified nucleosides, including LNA, present within the oligonucleotide sequence.
[0175] An aspect of the present invention relates to a nucleic acid molecule of 12 to 60 nucleotides in length, which comprises a contiguous nucleotide sequence of at least 12 nucleotides in length, such as at least 12 to 30 nucleotides in length, which is at least 95% complementary, such as fully complementary, to a mammalian A1CF target nucleic acid, in particular a human A1CF nucleic acid. These nucleic acid molecules are capable of inhibiting the expression of A1CF mRNA and/or protein.
[0176] An aspect of the invention relates to a nucleic acid molecule of 12 to 30 nucleotides in length, comprising a contiguous nucleotide sequence of at least 12 nucleotides, such as 12 to 30 nucleotides in length which is at least 90% complementary, such as fully complementary, to a mammalian A1CF target sequence.
[0177] A further aspect of the present invention relates to a nucleic acid molecule according to the invention comprising a contiguous nucleotide sequence of 14 to 22 nucleotides in length with at least 90% complementary, such as fully complementary, to the target sequence of SEQ ID NO: 1.
[0178] In some embodiments, the nucleic acid molecule comprises a contiguous sequence of 12 to 30 nucleotides in length, which is at least 90% complementary, such as at least 91%, such as at least 92%, such as at least 93%, such as at least 94%, such as at least 95%, such as at least 96%, such as at least 97%, such as at least 98%, or 100% complementary with a region of the target nucleic acid or a target sequence.
[0179] It is advantageous if the oligonucleotide, or contiguous nucleotide sequence thereof is fully complementary (100% complementary) to a region of the target sequence, or in some embodiments may comprise one or two mismatches between the oligonucleotide and the target sequence.
[0180] In some embodiments, the oligonucleotide sequence is 100% complementary to a region of the target sequence of SEQ ID NO: 1 and/or SEQ ID NO: 4, 5, 6, 7, 8, 9, 10 and/or 11.
[0181] In some embodiments, the nucleic acid molecule or the contiguous nucleotide sequence of the invention is at least 90% or 95% complementary, such as fully (or 100%) complementary, to the target nucleic acid of SEQ ID NO: 1 and/or 2.
[0182] In some embodiments, the oligonucleotide or the contiguous nucleotide sequence of the invention is at least 90% or 95% complementary, such as fully (or 100%) complementary, to the target nucleic acid of SEQ ID NO: 2 and/or SEQ ID NO: 4, 5, 6, 7, 8, 9 10 and/or 11.
[0183] In some embodiments, the oligonucleotide or the contiguous nucleotide sequence of the invention is at least 90% or 95% complementary, such as fully (or 100%) complementary, to the target nucleic acid of SEQ ID NO: 1 and/or SEQ ID NO: 2 and/or SEQ ID NO: 3.
[0184] In some embodiments, the contiguous sequence of the nucleic acid molecule of the present invention is least 90% complementary, such as fully complementary to a region of SEQ ID NO: 1, selected from the group consisting of target regions 1A to 2001A as shown in Table 4.
[0185] In some embodiments, the contiguous sequence of the nucleic acid molecule of the present invention is least 90% complementary, such as fully complementary to a region of SEQ ID NO: 1, selected from the group consisting of target regions 10 to 178C as shown in Table 5.
[0186] In some embodiments, the nucleic acid molecule of the invention comprises or consists of 12 to 60 nucleotides in length, such as from 13 to 50, such as from 14 to 35, such as 15 to 30, such as from 16 to 22 contiguous nucleotides in length. In a preferred embodiment, the nucleic acid molecule comprises or consists of 15, 16, 17, 18, 19, 20, 21 or 22 nucleotides in length.
[0187] In some embodiments, the contiguous nucleotide sequence of the nucleic acid molecule which is complementary to the target nucleic acids comprises or consists of 12 to 30, such as from 13 to 25, such as from 15 to 23, such as from 16 to 22, contiguous nucleotides in length.
[0188] In some embodiments, the oligonucleotide is selected from the group consisting of an antisense oligonucleotide, an siRNA and a shRNA.
[0189] In some embodiments, the contiguous nucleotide sequence of the siRNA or shRNA which is complementary to the target sequence comprises or consists of 18 to 28, such as from 19 to 26, such as from 20 to 24, such as from 21 to 23, contiguous nucleotides in length.
[0190] In some embodiments, the contiguous nucleotide sequence of the antisense oligonucleotide which is complementary to the target nucleic acids comprises or consists of 12 to 22, such as from 14 to 20, such as from 16 to 20, such as from 15 to 18, such as from 16 to 18, such as from 16, 17, 18, 19 or 20 contiguous nucleotides in length.
[0191] In some embodiments, the oligonucleotide or contiguous nucleotide sequence comprises or consists of a sequence selected from the group consisting of sequences listed in Table 6 (Materials and Methods section).
[0192] It is understood that the contiguous oligonucleotide sequence (motif sequence) can be modified to, for example, increase nuclease resistance and/or binding affinity to the target nucleic acid.
[0193] The pattern in which the modified nucleosides (such as high affinity modified nucleosides) are incorporated into the oligonucleotide sequence is generally termed oligonucleotide design.
[0194] The nucleic acid molecule of the invention may be designed with modified nucleosides and RNA nucleosides (in particular for siRNA and shRNA molecules) or DNA nucleosides (in particular for single stranded antisense oligonucleotides).
[0195] In advantageous embodiments, the nucleic acid molecule or contiguous nucleotide sequence comprises one or more sugar modified nucleosides, such as 2′ sugar modified nucleosides, such as comprise one or more 2′ sugar modified nucleoside independently selected from the group consisting of 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA, 2′-amino-DNA, 2′-fluoro-DNA, arabino nucleic acid (ANA), 2′-fluoro-ANA and LNA nucleosides.
[0196] It is advantageous if one or more of the modified nucleoside(s) is a locked nucleic acid (LNA).
[0197] In some embodiments the contiguous nucleotide sequence comprises LNA nucleosides.
[0198] In some embodiments the contiguous nucleotide sequence comprises LNA nucleosides and DNA nucleosides.
[0199] In some embodiments the contiguous nucleotide sequence comprises 2′-O-methoxyethyl (2′MOE) nucleosides.
[0200] In some embodiments the contiguous nucleotide sequence comprises 2′-O-methoxyethyl (2′MOE) nucleosides and DNA nucleosides.
[0201] Advantageously, the 3′ most nucleoside of the antisense oligonucleotide, or contiguous nucleotide sequence thereof is a 2′sugar modified nucleoside.
[0202] In a further embodiment the nucleic acid molecule comprises at least one modified internucleoside linkage. Suitable internucleoside modifications are described in the “Definitions” section under “Modified internucleoside linkage”.
[0203] Advantageously, the oligonucleotide comprises at least one modified internucleoside linkage, such as phosphorothioate or phosphorodithioate.
[0204] In some embodiments, at least one internucleoside linkage in the contiguous nucleotide sequence is a phosphodiester internucleoside linkages.
[0205] It is advantageous if at least 2 to 3 internucleoside linkages at the 5′ or 3′ end of the oligonucleotide are phosphorothioate internucleoside linkages.
[0206] For single stranded antisense oligonucleotides it is advantageous if at least 75%, such as all, the internucleoside linkages within the contiguous nucleotide sequence are phosphorothioate internucleoside linkages. In some embodiments all the internucleotide linkages in the contiguous sequence of the single stranded antisense oligonucleotide are phosphorothioate linkages.
[0207] In an advantageous embodiment of the invention the antisense oligonucleotide of the invention is capable of recruiting RNase H, such as RNase H1. An advantageous structural design is a gapmer design as described in the “Definitions” section under for example “Gapmer”, “LNA Gapmer” and “MOE gapmer”. In the present invention it is advantageous if the antisense oligonucleotide of the invention is a gapmer with an F-G-F′ design.
[0208] In all instances the F-G-F′ design may further include region D′ and/or D″ as described in the “Definitions” section under “Region D′ or D” in an oligonucleotide”.
[0209] In a further aspect, of the invention the nucleic acid molecules, such as the antisense oligonucleotide, siRNA or shRNA, of the invention can be targeted directly to the liver by covalently attaching them to a conjugate moiety capable of binding to the asialoglycoprotein receptor (ASGPr), such as divalent or trivalent GalNAc cluster.
Conjugates
[0210] Since HBV infection primarily affects the hepatocytes in the liver it is advantageous to conjugate the A1CF inhibitor to a conjugate moiety that will increase the delivery of the inhibitor to the liver compared to the unconjugated inhibitor. In one embodiment, liver targeting moieties are selected from moieties comprising cholesterol or other lipids or conjugate moieties capable of binding to the asialoglycoprotein receptor (ASGPR).
[0211] In some embodiments, the invention provides a conjugate comprising a nucleic acid molecule of the invention covalently attached to a conjugate moiety.
[0212] The asialoglycoprotein receptor (ASGPR) conjugate moiety comprises one or more carbohydrate moieties capable of binding to the asialoglycoprotein receptor (ASPGR targeting moieties) with affinity equal to or greater than that of galactose. The affinities of numerous galactose derivatives for the asialoglycoprotein receptor have been studied (see for example: Jobst, S. T. and Drickamer, K. JB. C. 1996, 271, 6686) or are readily determined using methods typical in the art.
[0213] In one embodiment, the conjugate moiety comprises at least one asialoglycoprotein receptor targeting moiety selected from group consisting of galactose, galactosamine, N-formyl-galactosamine, N-acetylgalactosamine, N-propionyl-galactosamine, N-n-butanoyl-galactosamine and N-isobutanoylgalactosamine. Advantageously, the asialoglycoprotein receptor targeting moiety is N-acetylgalactosamine (GalNAc).
[0214] To generate the ASGPR conjugate moiety the ASPGR targeting moieties (preferably GalNAc) can be attached to a conjugate scaffold. Generally, the ASPGR targeting moieties can be at the same end of the scaffold. In one embodiment, the conjugate moiety consists of two to four terminal GalNAc moieties linked to a spacer which links each GalNAc moiety to a brancher molecule that can be conjugated to the antisense oligonucleotide.
[0215] In a further embodiment, the conjugate moiety is mono-valent, di-valent, tri-valent or tetra-valent with respect to asialoglycoprotein receptor targeting moieties. Advantageously, the asialoglycoprotein receptor targeting moiety comprises N-acetylgalactosamine (GalNAc) moieties.
[0216] GalNAc conjugate moieties can include, for example, those described in WO 2014/179620 and WO 2016/055601 and PCT/EP2017/059080 (hereby incorporated by reference), as well as small peptides with GalNAc moieties attached such as Tyr-Glu-Glu-(aminohexyl GalNAc)3 (YEE(ahGalNAc)3; a glycotripeptide that binds to asialoglycoprotein receptor on hepatocytes, see, e.g., Duff, et al., Methods Enzymol, 2000, 313, 297); lysine-based galactose clusters (e.g., L3G4; Biessen, et al., Cardovasc. Med., 1999, 214); and cholane-based galactose clusters (e.g., carbohydrate recognition motif for asialoglycoprotein receptor).
[0217] The ASGPR conjugate moiety, in particular a trivalent GalNAc conjugate moiety, may be attached to the 3′- or 5′-end of the oligonucleotide using methods known in the art. In one embodiment, the ASGPR conjugate moiety is linked to the 5′-end of the oligonucleotide.
[0218] In one embodiment, the conjugate moiety is a tri-valent N-acetylgalactosamine (GalNAc), such as those shown in
Method of Manufacture
[0219] In a further aspect, the invention provides methods for manufacturing the oligonucleotides of the invention comprising reacting nucleotide units and thereby forming covalently linked contiguous nucleotide units comprised in the oligonucleotide. Preferably, the method uses phophoramidite chemistry (see for example Caruthers et al, 1987, Methods in Enzymology vol. 154, pages 287-313). In a further embodiment the method further comprises reacting the contiguous nucleotide sequence with a conjugating moiety (ligand) to covalently attach the conjugate moiety to the oligonucleotide. In a further aspect, a method is provided for manufacturing the composition of the invention, comprising mixing the oligonucleotide or conjugated oligonucleotide of the invention with a pharmaceutically acceptable diluent, solvent, carrier, salt and/or adjuvant.
Pharmaceutical Salt
[0220] The compounds according to the present invention may exist in the form of their pharmaceutically acceptable salts. The term “pharmaceutically acceptable salt” refers to conventional acid-addition salts or base-addition salts that retain the biological effectiveness and properties of the compounds of the present invention.
[0221] In a further aspect, the invention provides a pharmaceutically acceptable salt of the nucleic acid molecules or a conjugate thereof, such as a pharmaceutically acceptable sodium salt, ammonium salt or potassium salt.
Pharmaceutical Composition
[0222] In a further aspect, the invention provides pharmaceutical compositions comprising any of the compounds of the invention, in particular the aforementioned nucleic acid molecules and/or nucleic acid molecule conjugates or salts thereof and a pharmaceutically acceptable diluent, carrier, salt and/or adjuvant. A pharmaceutically acceptable diluent includes phosphate-buffered saline (PBS) and pharmaceutically acceptable salts include, but are not limited to, sodium and potassium salts. In some embodiments the pharmaceutically acceptable diluent is sterile phosphate buffered saline. In some embodiments, the nucleic acid molecule is used in the pharmaceutically acceptable diluent at a concentration of 50 to 300 μM solution.
[0223] Suitable formulations for use in the present invention are found in Remington's Pharmaceutical Sciences, Mack Publishing Company, Philadelphia, Pa., 17th ed., 1985. For a brief review of methods for drug delivery, see, e.g., Langer (Science 249:1527-1533, 1990). WO 2007/031091 provides further suitable and preferred examples of pharmaceutically acceptable diluents, carriers and adjuvants (hereby incorporated by reference). Suitable dosages, formulations, administration routes, compositions, dosage forms, combinations with other therapeutic agents, pro-drug formulations are also provided in WO2007/031091.
[0224] In some embodiments, the nucleic acid molecule or the nucleic acid molecule conjugates of the invention, or pharmaceutically acceptable salt thereof is in a solid form, such as a powder, such as a lyophilized powder.
[0225] Compounds, nucleic acid molecules or nucleic acid molecule conjugates of the invention may be mixed with pharmaceutically acceptable active or inert substances for the preparation of pharmaceutical compositions or formulations. Compositions and methods for the formulation of pharmaceutical compositions are dependent upon a number of criteria, including, but not limited to, route of administration, extent of disease, or dose to be administered.
[0226] These compositions may be sterilized by conventional sterilization techniques, or may be sterile filtered. The resulting aqueous solutions may be packaged for use as is, or lyophilized, the lyophilized preparation being combined with a sterile aqueous carrier prior to administration. The pH of the preparations typically will be between 3 and 11, more preferably between 5 and 9 or between 6 and 8, and most preferably between 7 and 8, such as 7 to 7.5. The resulting compositions in solid form may be packaged in multiple single dose units, each containing a fixed amount of the above-mentioned agent or agents, such as in a sealed package of tablets or capsules. The composition in solid form can also be packaged in a container for a flexible quantity, such as in a squeezable tube designed for a topically applicable cream or ointment.
[0227] In some embodiments, the nucleic acid molecule or nucleic acid molecule conjugate of the invention is a prodrug. In particular with respect to nucleic acid molecule conjugates the conjugate moiety is cleaved off the nucleic acid molecule once the prodrug is delivered to the site of action, e.g. the target cell.
Administration
[0228] The compounds, nucleic acid molecules or nucleic acid molecule conjugates or pharmaceutical compositions of the present invention may be administered topically or enterally or parenterally (such as, intravenous, subcutaneous, or intra-muscular).
[0229] In a preferred embodiment, the oligonucleotide or pharmaceutical compositions of the present invention are administered by a parenteral route including intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion. In one embodiment, the active nucleic acid molecule or nucleic acid molecule conjugate is administered intravenously. In another embodiment, the active nucleic acid molecule or nucleic acid molecule conjugate is administered subcutaneously.
[0230] In some embodiments, the nucleic acid molecule, nucleic acid molecule conjugate or pharmaceutical composition of the invention is administered at a dose of 0.1-15 mg/kg, such as from 0.2-10 mg/kg, such as from 0.25-5 mg/kg. The administration can be once a week, every second week, every third week or even once a month.
[0231] The invention also provides for the use of the nucleic acid molecule or nucleic acid molecule conjugate of the invention as described for the manufacture of a medicament wherein the medicament is in a dosage form for subcutaneous administration.
Combination Therapies
[0232] In some embodiments the inhibitor of the present invention such as the nucleic acid molecule, nucleic acid molecule conjugate or pharmaceutical composition of the invention is for use in a combination treatment with another therapeutic agent. The therapeutic agent can for example be the standard of care for the diseases or disorders described above.
[0233] By way of example, the nucleic acid molecule or the nucleic acid molecule conjugate of the present invention may be used in combination with other actives, such as oligonucleotide-based antivirals—such as sequence specific oligonucleotide-based antivirals—acting either through antisense (including other LNA oligomers), siRNAs (such as ARC520), aptamers, morpholinos or any other antiviral, nucleotide sequence-dependent mode of action.
[0234] By way of further example, the nucleic acid molecule or the nucleic acid molecule conjugate of the present invention may be used in combination with other actives, such as immune stimulatory antiviral compounds, such as interferon (e.g. pegylated interferon alpha), TLR7 agonists (e.g. GS-9620), or therapeutic vaccines.
[0235] By way of further example, the nucleic acid molecule or the nucleic acid molecule conjugate of the present invention may be used in combination with other actives, such as small molecules, with antiviral activity. These other actives could be, for example, nucleoside/nucleotide inhibitors (e.g. entecavir or tenofovir disoproxil fumarate), encapsidation inhibitors, entry inhibitors (e.g. Myrcludex B).
[0236] In certain embodiments, the additional therapeutic agent may be an HBV agent, a Hepatitis C virus (HCV) agent, a chemotherapeutic agent, an antibiotic, an analgesic, a nonsteroidal anti-inflammatory (NSAID) agent, an antifungal agent, an antiparasitic agent, an anti-nausea agent, an anti-diarrheal agent, or an immunosuppressant agent.
[0237] In particular, related embodiments, the additional HBV agent may be interferon alpha-2b, interferon alpha-2a, and interferon alphacon-1 (pegylated and unpegylated), ribavirin; an HBV RNA replication inhibitor; a second antisense oligomer; an HBV therapeutic vaccine; an HBV prophylactic vaccine; lamivudine (3TC); entecavir (ETV); tenofovir diisoproxil fumarate (TDF); telbivudine (LdT); adefovir; or an HBV antibody therapy (monoclonal or polyclonal).
[0238] In other particular related embodiments, the additional HCV agent may be interferon alpha-2b, interferon alpha-2a, and interferon alphacon-1 (pegylated and unpegylated); ribavirin; pegasys; an HCV RNA replication inhibitor (e.g., ViroPharma's VP50406 series); an HCV antisense agent; an HCV therapeutic vaccine; an HCV protease inhibitor; an HCV helicase inhibitor; or an HCV monoclonal or polyclonal antibody therapy.
Applications
[0239] The nucleic acid molecules of the invention may be utilized as research reagents for, for example, diagnostics, therapeutics and prophylaxis.
[0240] In research, such nucleic acid molecules may be used to specifically modulate the synthesis of A1CF protein in cells (e.g. in vitro cell cultures) and experimental animals thereby facilitating functional analysis of the target or an appraisal of its usefulness as a target for therapeutic intervention. Typically, the target modulation is achieved by degrading or inhibiting the mRNA producing the protein, thereby preventing protein formation or by degrading or inhibiting a modulator of the gene or mRNA producing the protein.
[0241] If employing the nucleic acid molecules of the invention in research or diagnostics the target nucleic acid may be a cDNA or a synthetic nucleic acid derived from DNA or RNA.
[0242] Also encompassed by the present invention is an in vivo or in vitro method for modulating A1CF expression in a target cell which is expressing A1CF, said method comprising administering a nucleic acid molecule, conjugate compound or pharmaceutical composition of the invention in an effective amount to said cell.
[0243] In some embodiments, the target cell, is a mammalian cell in particular a human cell. The target cell may be an in vitro cell culture or an in vivo cell forming part of a tissue in a mammal. In preferred embodiments, the target cell is present in the liver. The target cell may be a hepatocyte.
[0244] One aspect of the present invention is related the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the invention for use as a medicament.
[0245] In an aspect of the invention, the A1CF inhibitor, such as a nucleic acid molecule, conjugate compound or pharmaceutical composition of the invention is capable of reducing the cccDNA level in HBV infected cells and thereby inhibiting HBV infection. In particular, the antisense oligonucleotide is capable of affecting one or more of the following parameters i) reducing cccDNA and/or ii) reducing pgRNA and/or iii) reducing HBV DNA and/or iv) reducing HBV viral antigens in an infected cell.
[0246] For example, a nucleic acid molecule that inhibits HBV infection may reduce i) the cccDNA levels in an infected cell by at least 40% such as 50%, 60% or 70% reduction compared to controls; or ii) the level of pgRNA by at least 40% such as 50%, 60% or 70% reduction compared to controls. The controls may be untreated cells or animals, or cells or animals treated with an appropriate control.
[0247] Inhibition of HBV infection may be measured in vitro using HBV infected primary human hepatocytes or in vivo using humanized hepatocytes PXB mouse model (available at PhoenixBio, see also Kakuni et al 2014 Int. J. Mol. Sci. 15:58-74). Inhibition of secretion of HBsAg and/or HBeAg may be measured by ELISA, e.g. by using the CLIA ELISA Kit (Autobio Diagnostic) according to the manufacturers' instructions. Reduction of intracellular cccDNA or HBV mRNA and pgRNA may be measured by qPCR, e.g. as described in the Materials and Methods section. Further methods for evaluating whether a test compound inhibits HBV infection are measuring secretion of HBV DNA by qPCR e.g. as described in WO 2015/173208 or using Northern Blot; in-situ hybridization, or immuno-fluorescence.
[0248] Due to the reduction of A1CF levels the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the present invention can be used to inhibit development of or in the treatment of HBV infection. In particular, through the destabilization and reduction of the cccDNA, the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the present invention more efficiently inhibits development of or treats a chronic HBV infection as compared to a compound that only reduces secretion of HBsAg.
[0249] Accordingly, one aspect of the present invention is related to use of an A1CF inhibitor, such as the nucleic acid molecule, conjugate compounds or pharmaceutical compositions of the invention to reduce cccDNA and/or pgRNA in an HBV infected individual.
[0250] A further aspect of the invention relates to the use of an A1CF inhibitor, such as the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the invention to inhibit development of or treat a chronic HBV infection.
[0251] A further aspect of the invention relates to the use of A1CF inhibitor, such as the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the invention to reduce the infectiousness of a HBV infected person. In a particular aspect of the invention, the A1CF inhibitor, such as the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the invention inhibits development of a chronic HBV infection.
[0252] The subject to be treated with the A1CF inhibitor, such as the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the invention (or which prophylactically receives nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the present invention) is preferably a human, more preferably a human patient who is HBsAg positive and/or HBeAg positive, even more preferably a human patient that is HBsAg positive and HBeAg positive.
[0253] Accordingly, the present invention relates to a method of treating a HBV infection, wherein the method comprises administering an effective amount of A1CF inhibitor, such as the nucleic acid molecules, conjugate compounds or pharmaceutical compositions of the invention. The present invention further relates to a method of preventing liver cirrhosis and hepatocellular carcinoma caused by a chronic HBV infection. In one embodiment, the A1CF inhibitors of the present invention is not intended for the treatment of hepatocellular carcinoma, only its prevention.
[0254] The invention also provides for the use of a A1CF inhibitor, such as nucleic acid molecule, a conjugate compound or a pharmaceutical composition of the invention for the manufacture of a medicament, in particular a medicament for use in the treatment of HBV infection or chronic HBV infection or reduction of the infectiousness of a HBV infected person. In preferred embodiments, the medicament is manufactured in a dosage form for subcutaneous administration.
[0255] The invention also provides for the use of a nucleic acid molecule, a conjugate compound, the pharmaceutical composition of the invention for the manufacture of a medicament wherein the medicament is in a dosage form for intravenous administration.
[0256] The A1CF inhibitor, such as the nucleic acid molecule, conjugate or the pharmaceutical composition of the invention may be used in a combination therapy. For example, the nucleic acid molecule, conjugate or the pharmaceutical composition of the invention may be combined with other anti-HBV agents such as interferon alpha-2b, interferon alpha-2a, and interferon alphacon-1 (pegylated and unpegylated), ribavirin, lamivudine (3TC), entecavir, tenofovir, telbivudine (LdT), adefovir, or other emerging anti-HBV agents such as a HBV RNA replication inhibitor, a HBsAg secretion inhibitor, a HBV capsid inhibitor, an antisense oligomer (e.g. as described in WO2012/145697, WO 2014/179629 and WO2017/216390), a siRNA (e.g. described in WO 2005/014806, WO 2012/024170, WO 2012/2055362, WO 2013/003520, WO 2013/159109, WO 2017/027350 and WO2017/015175), a HBV therapeutic vaccine, a HBV prophylactic vaccine, a HBV antibody therapy (monoclonal or polyclonal), or TLR 2, 3, 7, 8 or 9 agonists for the treatment and/or prophylaxis of HBV.
Embodiments of the Invention
[0257] The following embodiments of the present invention may be used in combination with any other embodiments described herein. The definitions and explanations provided herein above, in particular in the sections “SUMMARY OF INVENTION”, “DEFINITIONS” and DETAILED DESCRIPTION OF THE INVENTION″ apply mutatis mutandis to the following. [0258] 1. An A1CF inhibitor for use in the in the treatment and/or prevention of Hepatitis B virus (HBV) infection. [0259] 2. The A1CF inhibitor for the use of embodiment 1, wherein the A1CF inhibitor is administered in an effective amount. [0260] 3. The A1CF inhibitor for the use of embodiment 1 or 2, wherein the HBV infection is a chronic infection. [0261] 4. The A1CF inhibitor for the use of embodiments 1 to 3, wherein the A1CF inhibitor is capable of reducing the amount of cccDNA and/or pgRNA in an infected cell. [0262] 5. The A1CF inhibitor for the use of any one of embodiments 1 to 4, wherein the A1CF inhibitor prevents or reduces the association of A1CF protein to cccDNA. [0263] 6. A1CF inhibitor for the use of embodiment 5, wherein said inhibitor is a small molecule that specifically binds to A1CF protein, wherein said inhibitor prevents or reduces association of A1CF protein to cccDNA. [0264] 7. A1CF inhibitor for the use of embodiment 6, wherein the A1CF protein is encoded by SEQ ID NO: 4, 5, 6, 7, 8, 9, 10 or 11. [0265] 8. The A1CF inhibitor for the use of any one of embodiments 1 to 7, wherein said inhibitor is a nucleic acid molecule of 12-60 nucleotides in length comprising or consisting of a contiguous nucleotide sequence of at least 12 nucleotides in length which is at least 90% complementary to a mammalian A1CF target nucleic acid. [0266] 9. The A1CF inhibitor for the use of embodiment 8, which is capable of reducing the level of the mammalian A1CF target nucleic acid. [0267] 10. The A1CF inhibitor for the use of embodiment 8 or 9, wherein the mammalian A1CF target nucleic acid is RNA. [0268] 11. The A1CF inhibitor for the use of embodiment 10, wherein the RNA is pre-mRNA. [0269] 12. The A1CF inhibitor for the use of any one of embodiments 8 to 11, wherein the nucleic acid molecule is selected from the group consisting of antisense oligonucleotide, siRNA and shRNA. [0270] 13. The A1CF inhibitor for the use of embodiment 12, wherein the nucleic acid molecule is a single stranded antisense oligonucleotide or a double stranded siRNA. [0271] 14. The A1CF inhibitor for the use of any one of embodiments 8 to 13, wherein the mammalian A1CF target nucleic acid is selected from the group consisting of SEQ ID NO: 1, 4, 5, 6, 7, 8, 9, 10 and 11. [0272] 15. The A1CF inhibitor for the use of any one of embodiments 8 to 13, wherein the contiguous nucleotide sequence of the nucleic acid molecule is at least 98% complementary, such as fully complementary, to the target nucleic acid of SEQ ID NO: 1 and SEQ ID NO: 2. [0273] 16. The A1CF inhibitor for the use of any one of embodiments 8 to 13, wherein the contiguous nucleotide sequence of the nucleic acid molecule is at least 98% complementary, such as fully complementary, to the target nucleic acid of SEQ ID NO: 1 and SEQ ID NO: 2 and SEQ ID NO: 3. [0274] 17. The A1CF inhibitor for the use of any one of embodiments 1 to 16, wherein the amount of cccDNA in an HBV infected cell is reduced by at least 50%, such as 60%, when compared to a control. [0275] 18. The A1CF inhibitor for the use of any one of embodiments 1 to 16, wherein the amount of pgRNA in an HBV infected cell is reduced by at least 50%, such as 60%, when compared to a control. [0276] 19. The A1CF inhibitor for the use of any one of embodiments 8 to 18, wherein the amount of mammalian A1CF target nucleic acid is reduced by at least 50%, such as 60% when compared to a control. [0277] 20. A nucleic acid molecule of 12 to 60 nucleotides in length which comprises or consists of a contiguous nucleotide sequence of 12 to 30 nucleotides in length wherein the contiguous nucleotide sequence is at least 90% complementary, such as 95%, such as 98%, such as fully complementary, to a mammalian A1CF target nucleic acid. [0278] 21. The nucleic acid molecule of embodiment 20, wherein the nucleic acid molecule is chemically produced. [0279] 22. The nucleic acid molecule of embodiment 20 or 21, wherein the mammalian A1CF target nucleic acid is selected from the group consisting of SEQ ID NO: 1, 4, 5, 6, 7, 8, 9, 10 and 11. [0280] 23. The nucleic acid molecule of embodiment 20 or 21, wherein the contiguous nucleotide sequence is at least 98% complementary, such as fully complementary to the target nucleic acid of SEQ ID NO: 1 and SEQ ID NO: 2. [0281] 24. The nucleic acid molecule of embodiment 20 or 21, wherein the contiguous nucleotide sequence is fully complementary to the target nucleic acid of SEQ ID NO: 1 and SEQ ID NO: 2 and SEQ ID NO: 3. [0282] 25. The nucleic acid molecule of any one of embodiments 20 to 23, wherein the nucleic acid molecule is 12 to 30 nucleotides in length. [0283] 26. The nucleic acid molecule of any one of embodiments 20 to 25, wherein the nucleic acid molecule is a RNAi molecule, such as a double stranded siRNA or shRNA. [0284] 27. The nucleic acid molecule of any one of embodiments 20 to 25, wherein the nucleic acid molecule is a single stranded antisense oligonucleotide. [0285] 28. The nucleic acid molecule of any one of embodiments 20 to 27, wherein the contiguous nucleotide sequence is fully complementary to a target nucleic acid sequence selected from Table 4 or Table 5. [0286] 29. The nucleic acid molecule of any one of embodiments 20 to 28, which is capable of hybridizing to a target nucleic acid of SEQ ID NO: 1 and SEQ ID NO: 2 with a ΔG° below −15 kcal. [0287] 30. The nucleic acid molecule of any one of embodiments 20 to 29, wherein the contiguous nucleotide sequence comprises or consists of at least 14 contiguous nucleotides, particularly 15, 16, 17, 18, 19, 20, 21, or 22 contiguous nucleotides. [0288] 31. The nucleic acid molecule of any one of embodiments 20 to 29, wherein the contiguous nucleotide sequence comprises or consists of from 14 to 22 nucleotides. [0289] 32. The nucleic acid molecule of embodiment 31, wherein the contiguous nucleotide sequence comprises or consists of 16 to 20 nucleotides. [0290] 33. The nucleic acid molecule of any one of embodiments 20 to 32, wherein the nucleic acid molecule comprises or consists of 14 to 25 nucleotides in length. [0291] 34. The nucleic acid molecule of embodiment 33, wherein the nucleic acid molecule comprises or consists of at least one oligonucleotide strand of 16 to 22 nucleotides in length. [0292] 35. The nucleic acid molecule of any one of embodiment 20 to 34, wherein the contiguous nucleotide sequence is fully complementary to a target sequence selected from the group consisting of SEQ ID NO: 12, 13, 14, and 15. [0293] 36. The nucleic acid molecule of any one of embodiments 20 to 35, wherein the contiguous nucleotide sequence has zero to three mismatches compared to the mammalian A1CF target nucleic acid it is complementary to. [0294] 37. The nucleic acid molecule of embodiment 36, wherein the contiguous nucleotide sequence has one mismatch compared to the mammalian A1CF target nucleic acid. [0295] 38. The nucleic acid molecule of embodiment 36, wherein the contiguous nucleotide sequence has two mismatches compared to the mammalian A1CF target nucleic acid. [0296] 39. The nucleic acid molecule of embodiment 36, wherein the contiguous nucleotide sequence is fully complementary to the mammalian A1CF target nucleic acid. [0297] 40. The nucleic acid molecule of any one of embodiments 20 to 39, comprising one or more modified nucleosides. [0298] 41. The nucleic acid molecule of embodiment 40, wherein the one or more modified nucleosides are high-affinity modified nucleosides. [0299] 42. The nucleic acid molecule of embodiment 40 or 41, wherein the one or more modified nucleosides are 2′ sugar modified nucleosides. [0300] 43. The nucleic acid molecule of embodiment 42, wherein the one or more 2′ sugar modified nucleosides are independently selected from the group consisting of 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA, 2′-amino-DNA, 2′-fluoro-DNA, 2′-fluoro-ANA and LNA nucleosides. [0301] 44. The nucleic acid molecule of any one of embodiments 40 to 43, wherein the one or more modified nucleosides are LNA nucleosides. [0302] 45. The nucleic acid molecule of embodiment 44, wherein the modified LNA nucleosides are selected from the group consisting of oxy-LNA, amino-LNA, thio-LNA, cET, and ENA. [0303] 46. The nucleic acid molecule of embodiment 44 or 45, wherein the modified LNA nucleosides are oxy-LNA with the following 2′-4′ bridge —O—CH.sub.2—. [0304] 47. The nucleic acid molecule of embodiment 46, wherein the oxy-LNA is beta-D-oxy-LNA. [0305] 48. The nucleic acid molecule of embodiment 44 or 45, wherein the modified LNA nucleosides are cET with the following 2′-4′ bridge —O—CH(CH.sub.3)—. [0306] 49. The nucleic acid molecule of embodiment 48, wherein the cET is (S)cET, i.e. 6′(S)methyl-beta-D-oxy-LNA. [0307] 50. The nucleic acid molecule of embodiment 44 or 45, wherein the LNA is ENA, with the following 2′-4′ bridge —O—CH.sub.2—CH.sub.2—. [0308] 51. The nucleic acid molecule of any one of embodiments 20 to 50, wherein the nucleic acid molecule comprises at least one modified internucleoside linkage. [0309] 52. The nucleic acid molecule of embodiment 51, wherein the at least one modified internucleoside linkage is a phosphorothioate internucleoside linkage. [0310] 53. The nucleic acid molecule of any one of embodiments 20 to 52, wherein the nucleic acid molecule is an antisense oligonucleotide capable of recruiting RNase H. [0311] 54. The nucleic acid molecule of embodiment 53, wherein the antisense oligonucleotide or the contiguous nucleotide sequence is a gapmer. [0312] 55. The nucleic acid molecule of embodiment 54, wherein the antisense oligonucleotide or contiguous nucleotide sequence thereof consists of or comprises a gapmer of formula 5′-F-G-F′-3′, where region F and F′ independently comprise or consist of 1-4 2′ sugar modified nucleosides and G is a region between 6 and 18 nucleosides which are capable of recruiting RNase H. [0313] 56. The nucleic acid molecule of embodiment 55, wherein the 1-4 2′ sugar modified nucleosides are independently selected from the group consisting of 2′-O-alkyl-RNA, 2′-O-methyl-RNA, 2′-alkoxy-RNA, 2′-O-methoxyethyl-RNA, 2′-amino-DNA, 2′-fluoro-DNA, arabino nucleic acid (ANA), 2′-fluoro-ANA and LNA nucleosides. [0314] 57. The nucleic acid molecule of embodiment 55 or 56, wherein one or more of the 1-4 2′ sugar modified nucleosides in region F and F′ are LNA nucleosides. [0315] 58. The nucleic acid molecule of embodiment 57, wherein all the 2′ sugar modified nucleosides in region F and F′ are LNA nucleosides. [0316] 59. The nucleic acid molecule of any one of embodiments 56 to 58, wherein the LNA nucleosides are selected from beta-D-oxy-LNA, alpha-L-oxy-LNA, beta-D-amino-LNA, alpha-L-amino-LNA, beta-D-thio-LNA, alpha-L-thio-LNA, (S)cET, (R)cET beta-D-ENA and alpha-L-ENA. [0317] 60. The nucleic acid molecule of any one of embodiments 56 to 59, wherein region F and F′ consist of identical LNA nucleosides. [0318] 61. The nucleic acid molecule of any one of embodiments 56 to 60, wherein all the 2′ sugar modified nucleosides in region F and F′ are oxy-LNA nucleosides. [0319] 62. The nucleic acid molecule of any one of embodiments 55 to 61, wherein the nucleosides in region G are DNA nucleosides. [0320] 63. The nucleic acid molecule of embodiment 62, wherein region G consists of at least 75% DNA nucleosides. [0321] 64. The nucleic acid molecule of embodiment 63, where all the nucleosides in region G are DNA nucleosides. [0322] 65. A conjugate compound comprising a nucleic acid molecule according to any one of embodiments 20 to 64, and at least one conjugate moiety covalently attached to said nucleic acid molecule. [0323] 66. The conjugate compound of embodiment 65, wherein the nucleic acid molecule is a double stranded siRNA and the conjugate moiety is covalently attached to the sense strand of the siRNA. [0324] 67. The conjugate compound of embodiment 65 or 66, wherein the conjugate moiety is selected from carbohydrates, cell surface receptor ligands, drug substances, hormones, lipophilic substances, polymers, proteins, peptides, toxins, vitamins, viral proteins or combinations thereof. [0325] 68. The conjugate compound of any one of embodiments 65 to 67, wherein the conjugate moiety is capable of binding to the asialoglycoprotein receptor. [0326] 69. The conjugate compound of embodiment 68, wherein the conjugate moiety comprises at least one asialoglycoprotein receptor targeting moiety selected from group consisting of galactose, galactosamine, N-formyl-galactosamine, N-acetylgalactosamine, N-propionyl-galactosamine, N-n-butanoyl-galactosamine and N-isobutanoylgalactosamine. [0327] 70. The conjugate compound of embodiment 69, wherein the asialoglycoprotein receptor targeting moiety is N-acetylgalactosamine (GalNAc). [0328] 71. The conjugate compound of embodiment 69 or 70, wherein the conjugate moiety is mono-valent, di-valent, tri-valent or tetra-valent with respect to asialoglycoprotein receptor targeting moieties. [0329] 72. The conjugate compound of embodiment 71, wherein the conjugate moiety consists of two to four terminal GalNAc moieties and a spacer linking each GalNAc moiety to a brancher molecule that can be conjugated to the antisense compound. [0330] 73. The conjugate compound of embodiment 72, wherein the spacer is a PEG spacer. [0331] 74. The conjugate compound of any one of embodiments 68 to 73, wherein the conjugate moiety is a GalNAc moiety, such as a tri-valent N-acetylgalactosamine (GalNAc) moiety. [0332] 75. The conjugate compound of any one of embodiments 68 to 74, wherein the conjugate moiety is selected from one of the trivalent GalNAc moieties in
[0355] The invention will now be illustrated by the following examples which have no limiting character.
EXAMPLES
Materials and Methods
[0356] siRNA Sequences and Compounds
TABLE-US-00006 TABLE 6 Human A1CF sequences targeted by the individual components of the siRNA pool SEQ ID Position on NO: A1CF target sequence SEQ ID NO: 1 Exon 12 GUGGACAACUGCCGAUUAU 49395-49413 8 13 CUGAAGGUGUUGUCGAUGU 49477-49495 8 14 CAACAGAGCCAUUAUCCGA 69636-69654 11 15 AGACGUAUGCAGCCGAAUA 75681-75699 14
[0357] The pool of siRNA (ON-TARGETplus SMART pool siRNA Cat. No. LU-013576-02-0005, Dharmacon) contains four individual siRNA molecules targeting the sequences listed in the above table.
TABLE-US-00007 TABLE 7 Control compounds SEQ Sequence ID Name Supplier Order number 5′ to 3′ sense strand NO Non-targeting Dharmacon #D-001810-01- UGGUUUACAUGUCGACUAA 16 negative control 05 siRNA#1 Hbx positive GA life Custom made GCACUUCGCUUCACCUCUG 17 control science
Oligonucleotide Synthesis
[0358] Oligonucleotide synthesis is generally known in the art. Below is a protocol which may be applied. The oligonucleotides of the present invention may have been produced by slightly varying methods in terms of apparatus, support and concentrations used.
[0359] Oligonucleotides are synthesized on uridine universal supports using the phosphoramidite approach on an Oligomaker 48 at 1 μmol scale. At the end of the synthesis, the oligonucleotides are cleaved from the solid support using aqueous ammonia for 5-16 hours at 60° C. The oligonucleotides are purified by reverse phase HPLC (RP-HPLC) or by solid phase extractions and characterized by UPLC, and the molecular mass is further confirmed by ESI-MS.
Elongation of the oligonucleotide:
[0360] The coupling of β-cyanoethyl-phosphoramidites (DNA-A(Bz), DNA-G(ibu), DNA-C(Bz), DNA-T, LNA-5-methyl-C(Bz), LNA-A(Bz), LNA-G(dmf), or LNA-T) is performed by using a solution of 0.1 M of the 5′-O-DMT-protected amidite in acetonitrile and DCI (4,5-dicyanoimidazole) in acetonitrile (0.25 M) as activator. For the final cycle a phosphoramidite with desired modifications can be used, e.g. a C6 linker for attaching a conjugate group or a conjugate group as such. Thiolation for introduction of phosphorthioate linkages is carried out by using xanthane hydride (0.01 M in acetonitrile/pyridine 9:1). Phosphordiester linkages can be introduced using 0.02 M iodine in THF/Pyridine/water 7:2:1. The rest of the reagents are the ones typically used for oligonucleotide synthesis.
[0361] For post solid phase synthesis conjugation a commercially available C6 aminolinker phorphoramidite can be used in the last cycle of the solid phase synthesis and after deprotection and cleavage from the solid support the aminolinked deprotected oligonucleotide is isolated. The conjugates are introduced via activation of the functional group using standard synthesis methods.
Purification by RP-HPLC:
[0362] The crude compounds are purified by preparative RP-HPLC on a Phenomenex Jupiter® C18 10 μm 150×10 mm column. 0.1 M ammonium acetate pH 8 and acetonitrile is used as buffers at a flow rate of 5 mL/min. The collected fractions are lyophilized to give the purified compound typically as a white solid.
Abbreviations
[0363] DCI: 4,5-Dicyanoimidazole
[0364] DCM: Dichloromethane
[0365] DMF: Dimethylformamide
[0366] DMT: 4,4′-Dimethoxytrityl
[0367] THF: Tetrahydrofurane
[0368] Bz: Benzoyl
[0369] Ibu: Isobutyryl
[0370] RP-HPLC: Reverse phase high performance liquid chromatography
T.SUB.m .Assay:
[0371] Oligonucleotide and RNA target (phosphate linked, PO) duplexes are diluted to 3 mM in 500 ml RNase-free water and mixed with 500 ml 2×T.sub.m-buffer (200 mM NaCl, 0.2 mM EDTA, 20 mM Na-phosphate, pH 7.0). The solution is heated to 95° C. for 3 min and then allowed to anneal in room temperature for 30 min. The duplex melting temperatures (T.sub.m) are measured on a Lambda 40 UV/VIS Spectrophotometer equipped with a Peltier temperature programmer PTP6 using PE Templab software (Perkin Elmer). The temperature is ramped up from 20° C. to 95° C. and then down to 25° C., recording absorption at 260 nm. First derivative and the local maximums of both the melting and annealing are used to assess the duplex T.sub.m.
[0372] Clonal growth medium (dHCGM). dHCGM is a DMEM medium containing 100 U/ml Penicillin, 100 μg/ml Streptomycin, 20 mM Hepes, 44 mM NaHCO.sub.3, 15 μg/ml L-proline, 0.25 μg/ml insulin, 50 nM Dexamethazone, 5 ng/ml EGF, 0.1 mM Asc-2P, 2% DMSO and 10% FBS (Ishida et al., 2015). Cells were cultured at 37° C. incubator in a humidified atmosphere with 5% CO.sub.2. Culture medium was replaced 24 h post-plating and every 2 days until harvest.
HBV Infected PHH Cells
[0373] Fresh primary human hepatocytes (PHH) were provided by PhoenixBio, Higashi-Hiroshima City, Japan (PXB-cells also described in Ishida et al 2015 Am J Pathol. 185(5):1275-85) in 70,000 cells/well in 96-well plate format.
[0374] Upon arrival the PHH were infected with an MOI of 2GE using HepG2 2.2.15-derived HBV (batch Z12) by incubating the PHH cells with HBV in 4% (v/v) PEG in PHH medium for 16 hours. The cells were then washed three times with PBS and cultured a humidified atmosphere with 5% CO.sub.2 in fresh PHH medium consisting of DMEM (GIBCO, Cat #21885) supplemented with 10% (v/v) heat-inactivated fetal bovine serum (GI BCO, Cat #10082), 2% (v/v) DMSO, 1% (v/v) Penicillin/Streptomycin (GIBCO, Cat #15140-148), 20 mM HEPES (GIBCO, Cat #15630-080), 44 mM NaHCO.sub.3(Wako, Cat #195-14515), 15 μg/ml L-proline (MP-Biomedicals, Cat #0219472825), 0.25 μg/ml Insulin (Sigma, Cat #11882), 50 nM Dexamethasone (Sigma, Cat #D8893), 5 ng/ml EGF (Sigma, Cat #E9644), and 0.1 mM L-Ascorbic acid 2-phosphate (Wako, Cat #013-12061). Cells were cultured at 37° C. incubator in a humidified atmosphere with 5% CO.sub.2. Culture medium was replaced 24 hours post-plating and three times a week until harvest.
siRNA Transfection
[0375] Four days post-infection the cells were transfected with the A1CF siRNA pool (see Table 6) in triplicates. No drug controls (NDC), negative control siRNA and HBx siRNA were included as controls (see Table 7).
[0376] Per well a transfection mixture was prepared with 2 μl of either negative control siRNA (stock concentration 1 μM), A1CF siRNA pool (stock concentration 1 μM), HBx control siRNA (stock concentration 0.12 μM) or H.sub.2O (NDC) with 18.2 μl OptiMEM® (Thermo Fisher Scientific Reduced Serum media) and 0.6 μl Lipofectamine® RNAiMAX Transfection Reagent (Thermofisher Scientific catalog No. 13778). The transfection mixture was mixed and incubated at room temperature 5 minutes prior to transfection. Prior to transfection, the medium was removed from the PHH cells and replaced by 100 μl/well William's E Medium+GlutaMAX™ (Gibco, #32551) supplemented with HepaRG supplement without P/S (Biopredic International, #ADD711C). 20 μl of transfection mix was added to each well yielding a final concentration of 16 nM for the negative control siRNA or A1CF siRNA pool, or 1.92 nM for the HBx control siRNA and the plates gently rocked before placing into the incubator. The medium was replaced with PHH medium after 6 hours. The siRNA treatment was repeated on day 6 post-infection as described above. On day 8 post-infection the supernatants were harvested and stored at −20° C. HBsAg and HBeAg can be determined from the supernatants if desired.
[0377] Measurement of HBV antigen expressionHBV antigen expression and secretion can be measured in the collected supernatants if desired. The HBV propagation parameters, HBsAg and HBeAg levels, are measured using CLIA ELISA Kits (Autobio Diagnostic #CL0310-2, #CL0312-2), according to the manufacturer's protocol. Briefly, 25 μL of supernatant per well is transferred to the respective antibody coated microtiter plate and 25 μL of enzyme conjugate reagent is added. The plate is incubated for 60 min on a shaker at room temperature before the wells are washed five times with washing buffer using an automatic washer. 25 μL of substrate A and B were added to each well. The plates are incubated on a shaker for 10 min at room temperature before luminescence is measured using an EnVision® luminescence reader (Perkin Elmer).
Cell Viability Measurements
[0378] The cell viability was measured on the supernatant free cells by the Cell Counting Kit −8 (CCK8 from Sigma Aldrich, #96992). For the measurement the CCK8 reagent was diluted 1:10 in normal culture medium and 100 μl/well added to the cells. After 1 h incubation in the incubator 80 μl of the supernatants were transferred to a clear flat bottom 96 well plate and read the absorbance at 450 nm. Absorbance values were normalized to the NDC which was set to 100% to calculate the relative cell viabilities.
[0379] Cell viability measurements are used to confirm that any reduction in the viral parameters is not the cause of cell death, the closer the value is to 100% the lower the toxicity.
qRT-PCR for cccDNA and HBV DNA Quantification
[0380] Following cell viability determination the cells were washed with PBS once and then lysed with 50 μl/well lysis solution from the TaqMan® Gene Expression Cells-to-CT™ Kit (Thermo Fisher Scientific, #AM1729) and stored at −80° C.
[0381] Prior to the cccDNA qPCR analysis, a fraction of the cell lysate was digested with T5 enzyme (15 U/4 μL cell lysate; New England Biolabs, #M0363L). Digestion was done at 37° C. for 30 min.
[0382] For the quantification of cccDNA for each reaction 2 μl T5-digested cell lysate, 0.5 μl 20×cccDNA_DANDRI Taqman primer/probe (Life Technologies, custom #AI1RW7N, FAM-dye listed in the Table below), 5 μl TaqMan® Fast Advanced Master Mix (Applied Biosystems, #4444557) and 2.5 μl DEPC-treated water were used. Technical triplicates were run for each sample.
TABLE-US-00008 Primer name Sequence SEQ ID CCCDNA_DANDRI_F CCGTGTGCACTTCGCTTCA 18 CCCDNA_DANDRI_R GCACAGCTTGGAGGCTTGA 19 CCCDNA_DANDRI_M 5′-[6FAM]CATGGAGACCACCGTGAACGCCC[BHQ1]-3′ 20
[0383] For quantification of intra-cellular HBV DNA and the normalization control, human hemoglobin beta (HBB), for each reaction 2 μl undigested cell lysate, 0.5 μl 20×HBV Taqman primer/probe (Life Technologies, #Pa03453406_s1, FAM-dye), 0.5 μl 20×HBB Taqman® primer/probe (Life Technologies, #Hs00758889_s1, VIC-dye), 5 μl TaqMan® Fast Advanced Master Mix (Applied Biosystems, #4444557) and 2 μl DEPC-treated water were used. Technical triplicates were run for each sample.
[0384] The qRT-PCR was run on the QuantStudio™ K12 Flex with standard settings for the fast heating block (95° C. for 20 seconds, then 40 cycles with 95° C. for 1 second and 60° C. for 20 seconds).
[0385] Any outliers were removed from the data set by excluding values with more than 0.9 difference to the median Ct of all 9 biological & technical replicates for each sample. Fold changes for cccDNA and total HBV DNA were determined from the Ct values via the 2.sup.−ddCT method, and normalized to the HBB as housekeeping gene. The expression levels are presented as % of the average no drug control samples (i.e. the lower the value the larger the inhibition/reduction).
Real-Time PCR for Measuring A1CF mRNA Expression
[0386] For quantification of A1CF RNA levels and the normalization control, GUS B, the TaqMan® RNA-to-Ct™ 1-Step Kit (Life Technologies, #4392656) was used. For each reaction 2 μl undigested cell lysate, 0.5 μl 20×A1CF Taqman primer/probe (Life Technologies, #Hs00205840_m1, FAM-dye), 0.5 μl 20×GUS B Taqman primer/probe (Life Technologies, #Hs00939627_m1, VIC-dye), 5 μl 2×TaqMan® RT-PCR Mix, 0.25 μl 40×TaqMan® RT Enzyme Mix and 1.75 μl DEPC-treated water were used. Technical triplicates were run for each sample and minus RT controls included to evaluate potential amplification due to DNA present.
[0387] The qRT-PCR was run on the QuantStudio™ K12 Flex with 48 C for 15 min, 95° C. for 10 min, then 40 cycles with 95° C. for 15 seconds and 60 C for 60 seconds.
[0388] The A1CF mRNA expression levels were analyzed using the comparative cycle threshold 2-ΔΔCt method normalized to the reference gene GUS B and to non-transfected cells. Primers used for GUS B RNA and target mRNA quantification are listed in Table 8. The expression levels are presented as % of the average no drug control samples (i.e. the lower the value the larger the inhibition/reduction).
TABLE-US-00009 TABLE 8 GUS B and A1CF mRNA qPCR primers (Thermo Fisher Scientific) A1CF primers Hs00205840_m1 Housekeeping gene primers Hs00939627_m1
Example 1: Measurement of the Reduction of A1CF mRNA, HBV Intracellular DNA and cccDNA in HBV Infected PHH Cells Resulting from siRNA Treatment
[0389] In the following experiment, the effect of A1CF knock-down on the HBV parameters, HBV DNA and cccDNA, was tested.
[0390] HBV infected PHH cells were treated with the pool of siRNAs from Dharmacon (LU-013576-02-0005, see Table 6) as described in the Materials and Methods section “siRNA transfection”.
[0391] Following the 4 days-treatment, A1CF mRNA, cccDNA and intracellular HBV DNA were measured by qPCR as described in the Materials and Methods section “Real-time PCR for measuring A1CF mRNA Expression” and “qRT-PCR for cccDNA and HBV DNA quantification”. The results are shown in Table 9 as % of the average no drug control samples (i.e. the lower the value the larger the inhibition/reduction).
TABLE-US-00010 TABLE 9 Effect on HBV parameters following knockdown of A1CF with pool of siRNA. Values are given as average of biological and technical triplicates. HBV A1CF intracellular mRNA* DNA cccDNA Treatment Mean SD Mean SD Mean SD A1CF siRNA 39 6 40 15 24 3 HBx positive ND ND 56 30 94 60 control siRNA negative ND ND 94 37 109 63 control ND = not determined
[0392] From this it can be seen that the A1CF siRNA pool is capable of reducing A1CF mRNA, cccDNA as well as HBV DNA quite efficiently. The positive control reduced intracellular HBV DNA as expected but had no effect on cccDNA.