Antisense oligonucleotides: the next frontier for treatment of neurological disorders
Abstract
Antisense oligonucleotides (ASOs) were first discovered to influence RNA processing and modulate protein expression over two decades ago; however, progress translating these agents into the clinic has been hampered by inadequate target engagement, insufficient biological activity, and off-target toxic effects. Over the years, novel chemical modifications of ASOs have been employed to address these issues. These modifications, in combination with elucidation of the mechanism of action of ASOs and improved clinical trial design, have provided momentum for the translation of ASO-based strategies into therapies. Many neurological conditions lack an effective treatment; however, as research progressively disentangles the pathogenic mechanisms of these diseases, they provide an ideal platform to test ASO-based strategies. This steady progress reached a pinnacle in the past few years with approvals of ASOs for the treatment of spinal muscular atrophy and Duchenne muscular dystrophy, which represent landmarks in a field in which disease-modifying therapies were virtually non-existent. With the rapid development of improved next-generation ASOs toward clinical application, this technology now holds the potential to have a dramatic effect on the treatment of many neurological conditions in the near future.
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ASOs do not readily cross the blood-brain barrier, which remains a substantial obstacle for their clinical application in treating CNS disorders.
“However, the fact that ASOs do not readily cross the BBB remains one of the substantial obstacles for their clinical application in treating CNS disorders (28, 29).”
From Neurotransmitter-derived lipidoids (NT-lipidoids) for enhanced brain delivery through intravenous injection (2020) · cites this paper as [28]
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- Authors
- Rinaldi, C., & Wood, M. J. A.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Wood, Matthew J. A.
- Venue
- Nature Reviews Neurology
- Published
- 2017-12-01
- Volume
- 14
- Issue
- 1
- Pages
- 9-21
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- OpenAlex
- W2771247031
- Cited by
- 788
- References
- 17
- Citations by year
- 2026: 65 · 2025: 100 · 2024: 124 · 2023: 114 · 2022: 106 · 2021: 101 · 2020: 94 · 2019: 59 · 2018: 24 · 2017: 1
- FWCI
- 4.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (205162/Z/16/Z)
- Parkinson's UK (J-1403)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Interference and Gene Delivery
- Health Sciences › Medicine › Genetics › Neurogenetic and Muscular Disorders Research
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Keywords
- antisense oligonucleotides, neurological disorders, RNA processing, target engagement, off-target toxicity, spinal muscular atrophy, Duchenne muscular dystrophy, disease-modifying therapy, clinical translation
- MeSH terms
- Humans, Nervous System Diseases, Thionucleotides, Oligonucleotides, Antisense
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