Small interfering RNA: Discovery, pharmacology and clinical development—An introductory review

Post‐transcriptional gene silencing targets and degrades mRNA transcripts, silencing the expression of specific genes. RNA interference technology, using synthetic structurally well‐defined short double‐stranded RNA (small interfering RNA [siRNA]), has advanced rapidly in recent years. This introduc...

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Vydáno v:British journal of pharmacology Ročník 180; číslo 21; s. 2697 - 2720
Hlavní autoři: Ranasinghe, Priyanga, Addison, Melisande L., Dear, James W., Webb, David J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: London Blackwell Publishing Ltd 01.11.2023
Témata:
Amyloidosis
Bioavailability
Chemical modification
Gene expression
Gene silencing
Genetic disorders
Hypercholesterolemia
Hyperoxaluria
Immune response
Liver
Nuclease
Patient compliance
Pharmacodynamics
Pharmacokinetics
Porphyria
Primary hyperoxaluria
RNA-mediated interference
siRNA
Transthyretin
ISSN:0007-1188, 1476-5381, 1476-5381
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Shrnutí:Post‐transcriptional gene silencing targets and degrades mRNA transcripts, silencing the expression of specific genes. RNA interference technology, using synthetic structurally well‐defined short double‐stranded RNA (small interfering RNA [siRNA]), has advanced rapidly in recent years. This introductory review describes the utility of siRNA, by exploring the underpinning biology, pharmacology, recent advances and clinical developments, alongside potential limitations and ongoing challenges. Mediated by the RNA‐induced silencing complex, siRNAs bind to specific complementary mRNAs, which are subsequently degraded. siRNA therapy offers advantages over other therapeutic approaches, including ability of specifically designed siRNAs to potentially target any mRNA and improved patient adherence through infrequent administration associated with a very long duration of action. Key pharmacokinetic and pharmacodynamic challenges include targeted administration, poor tissue penetration, nuclease inactivation, rapid renal elimination, immune activation and off‐target effects. These have been overcome by chemical modification of siRNA and/or by utilising a range of delivery systems, increasing bioavailability and stability to allow successful clinical translation. Patisiran (hereditary transthyretin‐mediated amyloidosis) was the first licensed siRNA, followed by givosiran (acute hepatic porphyria), lumasiran (primary hyperoxaluria type 1) and inclisiran (familial hypercholesterolaemia), which all use N ‐acetylgalactosamine (GalNAc) linkage for effective liver‐directed delivery. Others are currently under development for indications varying from rare genetic diseases to common chronic non‐communicable diseases (hypertension, cancer). Technological advances are paving the way for broader clinical use. Ongoing challenges remain in targeting organs beyond the liver and reaching special sites (e.g., brain). By overcoming these barriers, siRNA therapy has the potential to substantially widen its therapeutic impact.
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ISSN:0007-1188
1476-5381
1476-5381
DOI:10.1111/bph.15972