Cited by 227RNA Interference and Gene DeliveryDNA and Nucleic Acid ChemistryVirus-based gene therapy research

The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index; 49 of the 67 sources its claims cite were checked for support.

A divalent siRNA chemical scaffold for potent and sustained modulation of gene expression throughout the central nervous system

Open access

Abstract

Sustained silencing of gene expression throughout the brain using small interfering RNAs (siRNAs) has not been achieved. Here we describe an siRNA architecture, divalent siRNA (di-siRNA), that supports potent, sustained gene silencing in the central nervous system (CNS) of mice and nonhuman primates following a single injection into the cerebrospinal fluid. Di-siRNAs are composed of two fully chemically modified, phosphorothioate-containing siRNAs connected by a linker. In mice, di-siRNAs induced the potent silencing of huntingtin, the causative gene in Huntington’s disease, reducing messenger RNA and protein throughout the brain. Silencing persisted for at least 6 months, with the degree of gene silencing correlating to levels of guide strand tissue accumulation. In cynomolgus macaques, a bolus injection of di-siRNA showed substantial distribution and robust silencing throughout the brain and spinal cord without detectable toxicity and with minimal off-target effects. This siRNA design may enable RNA interference-based gene silencing in the CNS for the treatment of neurological disorders. A divalent siRNA architecture enables sustained silencing of gene expression in deep regions of the brain.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

A divalent siRNA scaffold (Di-siRNA) composed of two fully chemically modified, phosphorothioate-containing siRNAs linked by tetra-ethylene glycol supports broad CNS distribution and sustained gene silencing after a single CSF injection. In mice and non-human primates, Di-siRNA targeting huntingtin produced potent, widespread HTT silencing with minimal detectable toxicity or off-target effects.

Key findings

  • In mice, a single ICV injection of 475 µg Di-siRNAHTT silenced HTT protein below detection throughout the brain; silencing was greater for protein (>99%) than mRNA (~70%), and >80% protein silencing persisted at four months, with effects exceeding six months in some regions.
  • Guide strand accumulation declined slowly: 2–7 µg/g at one month, 0.8–2.5 µg/g at four months, and 0.2–1.8 µg/g at six months; estimated protein silencing IC50 was ~0.5 µg/g and IC90 ~2 µg/g.
  • In Cynomolgus macaques, a single 25 mg ICV dose yielded 1–9 µg/g guide strand at one month and potent HTT silencing: >90% in cortex, >80% in hippocampus, ~50–85% in caudate, and ~40–70% in putamen; spinal cord accumulation was 4–7 µg/g with significant HTT mRNA silencing.
  • Safety assessments in mice and NHPs showed no detectable toxicity: no DARPP32 loss, only minor Iba-1 changes (<1.5-fold), transient Gfap activation at one month in high-dose mice, no MRI or blood chemistry changes in NHPs, and RNA-seq found 52 differentially expressed genes at 1% FDR, with only two potential off-target genes (APOLD1 ~40% down, ANLN ~20% down).

Methods

  • Di-siRNAs were synthesized as two fully 2′-F/2′-OMe-modified asymmetric siRNAs with ~40% phosphorothioate content, linked at their 3′ ends through a tetra-ethylene glycol linker; guide strand concentration defined dosing.
  • Mice (FVB/NJ or BACHD-ΔN17 females) received intra-striatal or ICV injections; Cynomolgus macaques received a single 25 mg ICV infusion via MRI/CT-guided cannula.
  • Guide strand accumulation was quantified by PNA hybridization/HPLC; mRNA by Quantigene, protein by western blot/WES, distribution by fluorescence microscopy, and transcriptome effects by RNA-seq with DESeq2 and gene ontology analysis.

Limitations

  • The paper states that the mechanism of phosphorothioate-mediated uptake and retention is not fully understood, and it is unclear whether the minimal off-target effects are specific to CNS regions, NHPs, or these compounds because no other genome-wide NHP off-target data are available for comparison.
  • The paper states that further investigations are required to detect changes in small RNA function, that it is unclear whether non-selective or SNP-selective HTT silencing is a better therapeutic strategy, and that further evaluation in established disease models is necessary.
  • Evident from the text: NHP efficacy was assessed at one month after a single dose, so long-term durability in primates was projected from mouse accumulation data rather than directly measured; behavioral or functional outcomes were not reported.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41587-019-0205-0

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

79 Own result · 21 Own interpretation · 20 Partly supported · 8 No full text of the sources · 5 Supported · 3 Own method · 2 Mixed support · 2 Couldn’t confirm · 2 Sources not found · 2 No basis given · 1 Supported so far · 1 Not checked yet · accuracy not yet measured

Show all 88 claims

  • Probably not a substantial claim. 24
  • It may state two separate claims as one. 43
58 of 58
  • The paper relies on this without support.

    Sustained silencing of gene expression in deep regions of the brain using siRNAs has not been achieved.

    “Sustained silencing of gene expression in deep regions of the brain using small interfering RNAs (siRNAs) has not been achieved.”
  • The paper relies on this without support.

    An outstanding challenge is developing chemical architectures of oligonucleotides that permit robust, productive, and safe delivery to a particular target tissue.

    “An outstanding challenge is developing chemical architectures of oligonucleotides that permit robust, productive, and safe delivery to a particular target tissue.”
  • The paper relies on this without support.

    Rodent systemic distribution is generally predictive of large mammal distribution, but this is not necessarily the case for the CNS.

    “Rodent systemic distribution is generally predictive of large mammal distribution. However, this is not necessarily the case for the CNS.”
  • The paper relies on this without support.

    The siRNA-targeting region in the HTT sequence is equivalent in Cynomolgus macaque, mouse, and human.

    “whose siRNA-targeting region in the HTT sequence is equivalent to that in mouse and human.”
  • The paper relies on this without support.

    The chemical architecture of an siRNA determines pharmacokinetics and tissue delivery, but the base sequence of the oligonucleotide determines its target.

    “The chemical architecture of an siRNA determines pharmacokinetics and tissue delivery, but the base sequence of the oligonucleotide determines its target.”
  • The paper relies on this without support.

    Loss of DARPP32 indicates neuronal death.

    “Loss of DARPP32 indicates neuronal death.”
  • The paper relies on this without support.

    The cortex and striatum are the two brain regions primarily affected in HD.

    “The cortex and striatum are the two brain regions primarily affected in HD.”
  • The paper relies on this without support.

    Substantially lower accumulation is sufficient for target silencing.

    “Substantially lower accumulation is sufficient for target silencing”
  • The paper relies on this without support.

    The relationship between tissue accumulation and duration of silencing observed in mice holds in NHPs.

    “Given the level of accumulation in cortex and hippocampus, silencing is expected to last 6–9 months in these regions, and as long as 2–4 months in the caudate and putamen.”
9 of 9

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Citations

Cites

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Metadata

Authors
Alterman, J. F., Godinho, B. M. D. C., Hassler, M. R., Ferguson, C. M., Echeverria, D., Sapp, E., Haraszti, R. A., Coles, A. H., Conroy, F., Miller, R., Roux, L., Yan, P., Knox, E. G., Turanov, A. A., King, R. M., Gernoux, G., Mueller, C., Gray-Edwards, H. L., Moser, R. P., Bishop, N. C., Jaber, S. M., Gounis, M. J., Sena-Esteves, M., Pai, A. A., DiFiglia, M., Aronin, N., & Khvorova, A.
Affiliations
  • University of Massachusetts Chan Medical School (US)
  • Massachusetts General Hospital (US)
  • Worcester Polytechnic Institute (US)
Corresponding author
Khvorova, Anastasia
Venue
Nature Biotechnology
Published
2019-08
Volume
37
Issue
8
Pages
884-894
ISSN
  • 0733-222X (ISSN-L)
  • 1087-0156
  • 1546-1696
OpenAlex
W2965851198
Cited by
227
References
49
Citations by year
2026: 35 · 2025: 37 · 2024: 42 · 2023: 32 · 2022: 33 · 2021: 24 · 2020: 21 · 2019: 3
FWCI
5.80
Type
journal article
Language
en
Open access
Locations
  • Nature Biotechnology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (submittedVersion)
  • PubMed Central (submittedVersion)
  • The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
Funders
  • CHDI Foundation (A-6119)
  • Alzheimer's Drug Discovery Foundation (20170101)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Interference and Gene Delivery
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › DNA and Nucleic Acid Chemistry
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
Keywords
central nervous system, cerebrospinal fluid injection, chemically modified siRNA, Huntington's disease, non-human primates, neurological disorders
MeSH terms
Huntingtin Protein, Animals, Central Nervous System, Gene Expression Regulation, Mutation, RNA, Messenger, RNA, Small Interfering, Mice

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