Showing posts with label microRNA. Show all posts
Showing posts with label microRNA. Show all posts

December 22, 2013

MicroRNA profile before and after antiviral therapy in liver transplant recipients for hepatitis C virus cirrhosis

Journal of Gastroenterology and Hepatology

Volume 29, Issue 1, pages 121–127, January 2014

Hepatology

Fanni Gelley2, Gergely Zadori2, Balazs Nemes2, Matteo Fassan4,Gabor Lendvai1, Eniko Sarvary2, Attila Doros2,  Zsuzsanna Gerlei2, Peter Nagy3, Zsuzsa Schaff1, Andras Kiss1,*

Article first published online: 19 DEC 2013

DOI: 10.1111/jgh.12362

© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd

Keywords: HCV receptors;  HCV; liver transplantation;  microRNA;  SVR

Abstract

Background and Aim

Management of hepatitis C virus (HCV) recurrence is a major challenge after liver transplantation. Significant dysregulated expression of HCV receptors (i.e. claudin-1, occludin, tetraspanin CD81, scavenger receptor type B1) has been shown recently during HCV infection. This might facilitate hepatocytic entry and reinfection of HCV. MicroRNAs (miRs) play role in the regulation of gene expression. We aimed to characterize miR expression profiles related to HCV infection and antiviral therapy in adult liver transplant recipients, with special emphasis on miRs predicted to target HCV receptors.

Methods

Twenty-eight adult liver transplant recipients were enrolled in the study. Paired biopsies were obtained at the time of HCV recurrence and at the end of antiviral treatment. MiRs for HCV receptors were selected using target prediction software. Expression levels of miR-21, miR-23a miR-34a, miR-96, miR-99a*, miR-122, miR-125b, miR-181a-2*, miR-194, miR-195, miR-217, miR-221, and miR-224 were determined by reverse transcription–quantitative polymerase chain reaction.

Results

miR-99a* and miR-224 expressions were increased in HCV recurrence samples, while miR-21 and miR-194 were decreased in comparison to normal liver tissue. Increased expressions of miR-221, miR-224, and miR-217 were observed in samples taken after antiviral therapy when compared with HCV recurrence samples. High HCV titer at recurrence was associated with higher level of miR-122.

Conclusions

Samples at recurrence of HCV and after antiviral therapy revealed distinct HCV-related miR expression profiles, with significant dysregulation of those miRNAs potentially targeting mRNAs of HCV receptors. In particular, miR-194 and miR-21 might be involved in the regulation of HCV receptor proteins' expression during HCV infection and antiviral therapy.

Source

Roadmap of miR-122-related clinical application from bench to bedside

Expert Opin Investig Drugs. 2013 Dec 20. [Epub ahead of print]

Qiu Z, Dai Y.

Abstract

Introduction: microRNA (miRNA) regulates target gene expression to influence many physiological and pathophysiological processes. The liver-specific miRNA, miR-122, contributes to liver function and plays a very important role in hepatic diseases including the viral hepatitis C (HCV). For this reason, developing an miR-122-related clinical application could be very useful in managing or treating many hepatic disorders. Areas covered: This review introduces the basic concepts of miRNA and miR-122. It also discusses the possibility of miR-122 as a biomarker and summarizes the results of anti-miR-122 treatment from basic research to a Phase IIa clinical trial. Furthermore, the authors discuss the potential opportunities and challenges found in clinical trials with miravirsen. Expert opinion: miR-122 may be a useful biomarker as both a diagnostic and prognostic tool. Furthermore, miravirsen is a novel treatment with great potential for hepatic disease treatment, especially in HCV. However, there is certainly the need for future investigations to better determine whether miR-122 is really specific for liver. It is also important to elucidate whether miR-122 is actually specific for HCV genome and further investigate the therapeutic potential of miravirsen. Only once these studies have been completed can anti-miR-122 treatment potentially enter the clinical practice.

PMID: 24354366 [PubMed - as supplied by publisher]

Source

November 9, 2013

Rosetta Genomics Granted U.S. Patent Allowance for the Use of microRNAs to Treat Liver Cancer

Expands the Company's Patent Portfolio in Oncology Therapeutics

PRINCETON, NJ and REHOVOT, ISRAEL -- (Marketwired) -- 11/07/13 -- Rosetta Genomics Ltd. (NASDAQ: ROSG), a leading developer and provider of microRNA-based molecular diagnostics, announces receipt of a Notice of Allowance from the U.S. Patent and Trademark Office (USPTO) related to U.S. Patent Application No. 13/481,105 titled "Targeting microRNAs for the Treatment of Liver Cancer."

This allowance is for a therapeutic patent that protects a method for treating hepatocellular carcinoma (HCC), or liver cancer, and covers the administration of a compound comprising a modified oligonucleotide that is an anti-miR-222. In addition, various modifications of the nucleotide are claimed. There is an additional claim which refers to the reduction of the levels of serum alpha-fetoprotein or serum des-gamma-carboxyprothrombin in the subject to be treated.

"HCC is the fifth most common cancer in the world and the third leading cause of cancer deaths. Because standard chemotherapy usually has no beneficial outcome on HCC patients, there is significant need for new therapeutic modalities and novel therapeutic targets in order to develop more effective treatments for HCC," said E. Robert Wassman, M.D., Chief Medical Officer of Rosetta Genomics. "Since microRNAs are master regulators of gene expression, their de-regulation can trigger changes that lead to the disease phenotype, and the modulation of their activity can be a key to the development of novel therapies."

"We continue to fortify and protect our global leadership position in microRNA technology with the addition of this valuable patent allowance," commented Kenneth A. Berlin, President and CEO of Rosetta Genomics. "Our solid patent position in microRNAs provides us with the opportunity to license, partner or otherwise derive value from this powerful technology for use in a variety of diagnostic and targeted therapeutics in oncology where there continues to be a large, unmet medical need."

Rosetta Genomics maintains an active intellectual property strategy to protect its leadership position in microRNA technology. Rosetta's portfolio includes 33 issued patents, including 30 in the U.S. In addition, Rosetta has 43 patent applications pending, of which 23 are in the U.S. These applications protect the specific microRNAs used in the Company's products and cover composition of matter, diagnostic applications, therapeutic applications and discovery process applications for microRNAs in humans.

About Liver Cancer
According to the National Cancer Institute, primary liver and bile duct cancers are the fifth most common cause of cancer death in men and the ninth most common cause of cancer death in women. Over the past two decades, the incidence rates for these cancers have increased in people of all races and in both genders; mortality rates have increased in all groups except Asians/Pacific Islanders. Men are more than twice as likely as women to develop and die from liver and bile duct cancers, and African Americans and Hispanics are almost twice as likely to develop these cancers as whites. Although Hispanics and Asians/Pacific Islanders have lower incidence rates of most types of cancer than whites, they have much higher rates of liver cancer.

Liver cancer is closely associated with hepatitis virus infections. Almost all cases of liver cancer in the United States occur in people who first had cirrhosis, usually resulting from hepatitis B or C infection or from heavy alcohol use. Ingestion of foods contaminated with aflatoxin and obesity may also increase liver cancer risk. Vaccinating for hepatitis B provides long-term protection from hepatitis B infection and has been shown to lower the risk of liver cancer in children, although it is not yet known whether it lowers the risk in adults. There is no standard or routine screening test for liver cancer. Standard treatments for liver cancer include surgery, radiation therapy, chemotherapy, percutaneous ethanol injection and targeted therapy.

About Rosetta Cancer Testing Services
Rosetta Cancer Tests are a series of microRNA-based diagnostic testing services offered by Rosetta Genomics. The Rosetta Cancer Origin Test™ can accurately identify the primary tumor type in primary and metastatic cancer including cancer of unknown or uncertain primary (CUP). Rosetta Mesothelioma Test™ diagnoses mesothelioma, a cancer connected to asbestos exposure. The Rosetta Lung Cancer Test™ accurately identifies the four main subtypes of lung cancer using small amounts of tumor cells. The Rosetta Kidney Cancer Test™ accurately classifies the four most common kidney tumors: clear cell renal cell carcinoma (RCC), papillary RCC, chromophobe RCC and oncocytoma. Rosetta's assays are designed to provide objective diagnostic data; it is the treating physician's responsibility to diagnose and administer the appropriate treatment. In the U.S. alone, Rosetta Genomics estimates that 200,000 patients a year may benefit from the Rosetta Cancer Origin Test™, 60,000 from the Rosetta Mesothelioma Test™, 65,000 from the Rosetta Kidney Cancer Test™ and 226,000 patients from the Rosetta Lung Cancer Test™. The Company's assays are offered directly by Rosetta Genomics in the U.S., and through distributors around the world. For more information, please visit www.rosettagenomics.com. Parties interested in ordering the test can contact Rosetta Genomics at (215) 382-9000 ext. 309.

About Rosetta Genomics
Rosetta develops and commercializes a full range of microRNA-based molecular diagnostics. Founded in 2000, Rosetta's integrative research platform combining bioinformatics and state-of-the-art laboratory processes has led to the discovery of hundreds of biologically validated novel human microRNAs. Building on its strong patent position and proprietary platform technologies, Rosetta is working on the application of these technologies in the development and commercialization of a full range of microRNA-based diagnostic tools. Rosetta's cancer testing services are commercially available through its Philadelphia-based CAP-accredited, CLIA-certified lab. Frost & Sullivan recognized Rosetta Genomics with the 2012 North American Next Generation Diagnostics Entrepreneurial Company of the Year Award.

Forward-Looking Statement Disclaimer
Various statements in this release concerning Rosetta's future expectations, plans and prospects, including without limitation, Rosetta's Cancer of Origin Test™, Rosetta's development or commercialization of molecular diagnostics, the market acceptance of Rosetta's cancer testing services, particularly the Rosetta Cancer Origin Test™, Rosetta's development of personalized medicine products and services, Rosetta licensing, partnering or otherwise deriving value from microRNA technology for use in a variety of diagnostic and targeted therapeutics and Rosetta developing therapeutic products., constitute forward-looking statements for the purposes of the safe harbor provisions under The Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those risks more fully discussed in the "Risk Factors" section of Rosetta's Annual Report on Form 20-F for the year ended December 31, 2012 as filed with the SEC. In addition, any forward-looking statements represent Rosetta's views only as of the date of this release and should not be relied upon as representing its views as of any subsequent date. Rosetta does not assume any obligation to update any forward-looking statements unless required by law.

Company Contact:
Rosetta Genomics
Ken Berlin
President & CEO
(609) 419-9000, ext. 1326
investors@rosettagenomics.com
Investor Contacts:
LHA
Anne Marie Fields
(212) 838-3777
afields@lhai.com
or
Bruce Voss
(310) 691-7100
bvoss@lhai.com

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June 6, 2013

Hepatitis C: The Pace of Progress

Medscape Gastroenterology

Digestive Disease Week (DDW) 2013

William F. Balistreri, MD

Jun 06, 2013

Progress in Treating Hepatitis C Infection

Hello. I am Dr. Bill Balistreri, Professor at Cincinnati Children's Hospital. I am here at Digestive Disease Week (DDW) in Orlando, reporting for Medscape.

A major focus of the research and the state-of-the-art summaries presented here at DDW has been the pace of progress in developing new treatment strategies for hepatitis C. Speakers highlighted the fact that the agents and approaches for treatment of hepatitis C virus (HCV) infection are in constant change and may, in fact, be in for an upgrade.

The standard of care for several years consisted of a combination of pegylated interferon and ribavirin. With advanced understanding of the biology of HCV came the identification of specific proteins involved in its replication and the understanding that these proteins can be targeted by protease and polymerase inhibitors.

Last year, the US Food and Drug Administration approved 2 NS3 protease inhibitors -- telaprevir and boceprevir -- for the treatment of HCV genotype 1 in combination with standard therapy. Clinical trials of the 2 agents showed significantly improved sustained virologic response (SVR) rates in treatment-naive patients. Therefore, the American Association for the Study of Liver Diseases guidelines were altered to recommend triple therapy consisting of a protease inhibitor (either telaprevir or boceprevir) plus peginterferon and ribavirin.

Side Effects Still Bothersome

In studies reported here, several investigators[1-4] have found high response rates with either triple-therapy regimen in treatment-naive patients or in previously treated patients who had relapsed. Triple therapy was generally well tolerated. However, troublesome side effects, including rashes, occurred in many patients. Although there was no difference in discontinuation rates between telaprevir and boceprevir, more patients withdrew because of side effects or intolerance than because of nonresponse to the drug.

These studies also underscored the point that patients must be closely followed to reinforce appropriate adherence to the complex algorithmic triple-therapy approach. Protease inhibitors have greatly enhanced SVR rates. However, these inhibitors are active only against the dominant viral genotype type (type 1) found in North America and Europe. Furthermore, 30%-35% of patients with genotype 1 infection will not have sustained viral repression, and there is the potential for resistance. Protease inhibitor-based triple therapy is also limited by the complex dosing regimens, which require intensive monitoring and side-effect management.

Next-in-Line Antivirals: Simeprevir and Sofosbuvir

The good news is that the guidelines may once again be revised. Preliminary results reported here have documented superior efficacy and tolerability of novel therapeutic strategies based on several new antivirals.

The first is simeprevir, a potent, once-daily oral investigational NS3/4A protease inhibitor that was shown to be effective in treatment of genotype 1 infection both in treatment-naive patients and nonresponders when coadministered with standard therapy (peginterferon and ribavirin).[5,6]

The second agent is sofosbuvir, a nucleotide analog that inhibits NS5B-directed HCV replication, which was also shown to be highly effective. This drug in combination with standard therapy was associated with SVR rates of 90% at 12 weeks post-treatment compared with 58% in placebo-treated patients.[7]

Most reported adverse effects were associated with peginterferon and ribavirin and not with new agents. Thus, these drugs represent an advance in management capable of inducing high sustained response rates with a shorter duration of therapy, better tolerability, and no resistance development, but they still require the addition of interferon to the regimen.

Interferon-Free Treatment: Still Searching

There is a high degree of optimism, however. Important observations presented this week may usher in the next generation of interferon-free treatment of HCV infection. Investigators have documented that several treatment protocols, which did not include interferon, were indeed capable of inducing high SVR rates in patients with chronic HCV.

In one study,[8] 3 direct-acting antiviral agents were administered in combination with ribavirin. These were ABT-450 (a potent NS3 protease inhibitor), ABT-330 (a nonnucleoside NS5B polymerase inhibitor), and ABT-267 (an NS5A inhibitor). The treatment regimen achieved high SVR rates in noncirrhotic treatment-naive patients and previous nonresponders, and the drugs were well tolerated. This preliminary study indicated that 12 weeks of therapy with this combination of 3 direct-acting antivirals and ribavirin may be effective for the treatment of HCV genotype 1 infection.

Other potential combinations of direct-acting antivirals were also discussed. In recently published studies,[9] sofosbuvir combined with ribavirin alone was shown to be effective for hepatitis C genotype 2 and 3 and possibly genotype 1. This regimen offers a low incidence of side effects, a relatively short duration of treatment, and was effective against all genotypes. These advantages may lower the threshold for HCV treatment for both patients and physicians.

A Glimpse of Future Treatments

Speakers here also gave us a glimpse of the future. Second-generation protease inhibitors and small-molecule drugs to inhibit other viral enzymes are being evaluated in clinical studies. Drug cocktails that target multiple HCV enzymes simultaneously may ultimately become the standard of treatment. This has certainly been an effective strategy for the management of infection with HIV.

It was also suggested that future strategies will include unique approaches to the treatment of viral hepatitis. One interesting approach is to use RNA interference. Speakers highlighted a recently reported breakthrough -- the use of a microRNA designed to interfere with HCV replication at the intracellular level.[10] An antisense oligonucleotide microRNA binds highly conserved sites in HCV. The liver-expressed microRNA normally serves to protect HCV. By binding to messenger proteins in liver cells, this agent prevents HCV replication and survival and effectively reduces the viral load.

The antisense nucleotide induced a dose-dependent drop in HCV RNA levels, and the biologic effects lasted for weeks, suggesting that agents of this type can be administered infrequently, possibly at monthly intervals. This study offers proof of concept that a new class of RNA interference drugs is possible. Larger studies will determine the safety and effectiveness of this approach.

Barriers to Care Continue

Presentations here allow us to envision a multifaceted treatment scenario, which uses an antisense oligonucleotide perhaps in combination with other therapeutic agents: small interfering RNAs directed against conserved sequences in the viral protease replication complex or polymerase genes. The bottom line is that these exciting advances in antiviral therapy will lead to significant improvements in response rates and reduced adverse effects.

However, only a minority of HCV-infected patients may benefit because of multiple barriers which have been identified and which impede delivery of HCV therapy.

The study presented here reported perceived barriers to care.[11,12] Most surveyed physicians viewed patient-level barriers as highly significant. These include fear of the side effects and concerns about treatment duration and cost. Another barrier is inadequate case finding, an obstacle that could be overcome by widespread screening.

A report from the Centers for Disease Control and Prevention,[13] released last week, contained updated testing guidelines. The report states that many persons who test positive for hepatitis C do not receive the necessary follow-up to determine whether they require medical care. Therefore, enhanced efforts to improve awareness, education, and specialist availability are needed.

The high prevalence of HCV infection worldwide also should stimulate expanded efforts in primary prevention, including vaccine development, as well as aggressive approaches to secondary and tertiary prevention. These efforts will reduce the burden of chronic liver disease and improve survival.

Thank you for listening. This is Bill Balistreri for Medscape.

Source

May 30, 2013

MicroRNA HCV Therapy Has Big Promise

By Michael Smith, North American Correspondent, MedPage Today

Published: March 27, 2013

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Action Points

  • A nonpharmaceutical approach to hepatitis C (HCV) treatment demonstrated promising efficacy and safety results in an early stage trial.
  • Point out that the antisense oligonucleotide miravirsen, which binds miR-122, had no dose-limiting adverse events and did not appear to give rise to resistance.

A nonpharmaceutical approach to hepatitis C (HCV) treatment demonstrated promising efficacy and safety results in an early stage trial, researchers reported.

Blocking the liver-expressed microRNA-122 (miR-122) led to dose-dependent and persistent declines in HCV, according to Harry Janssen, MD, PhD, of the University Health Network in Toronto, and colleagues.

The antisense oligonucleotide miravirsen, which binds miR-122, had no dose-limiting adverse events and did not appear to give rise to resistance, Janssen and colleagues reported online in the New England Journal of Medicine.

The researchers noted that miR-122 binds to two sites in the HCV genome – an attachment that is essential for the "stability and propagation" of the virus. Miravirsen, in turn, binds to miR-122, making it unavailable to HCV.

Their findings – from a randomized, double blind, placebo-controlled, Phase IIa study – suggest that miravirsen might play a role in treating chronic HCV infection, the researchers concluded.

But exactly what that role is will depend on further study, experts outside the industry-supported study commented.

The results so far are "very exciting," according to Stacey Rizza, MD of the Mayo Clinic in Rochester, Minn.

"One of the challenges in hepatitis C is always resistance," she told MedPage Today. "These microRNA (inhibitors) are targeting very conserved parts of the hepatitis virus so the chance of resistance is much lower."

But, she cautioned, "It's still very early, we don't know if it's actually going to lead to the outcomes we need it to lead to -- i.e. cure – and we're not sure yet long-term whether this is going to be safe."

Indeed, the long-term safety of the substance may be important, since one of the functions of miR-122 is to act as a tumor suppressor, commented Judy Lieberman, MD, PhD, of Harvard Medical School, and Peter Sarnow, PhD, of Stanford University in Palo Alto, Calif.

But, they concluded in an accompanying editorial in the journal, "pending satisfactory answers to the questions regarding safety," miravirsen or other microRNAs might be useful in a cocktail of anti-HCV agents that would have various targets.

Miravirsen, Janssen and colleagues reported, suppressed HCV in animal studies and showed no adverse events in healthy volunteers. To advance the clinical trials, they enrolled 36 treatment-naïve patients with genotype 1 HCV and randomly assigned them to placebo or one of three doses of miravirsen -- 3, 5, or 7 milligrams per kilogram of body weight.

Patients got five subcutaneous injections over a 29-day period and were followed for 18 weeks.

Miravirsen, they reported, led to dose-dependent reduction in HCV RNA, Specifically, the average maximum drop in HCV RNA (in log10 IU per milliliter) was:

  • 1.2 for patients receiving 3 milligrams per kilogram, a change that was significant (P=0.01).
  • 2.9 for those getting 5 milligrams per kilogram ( P=0.003).
  • 3.0 for patients given 7 milligrams per kilogram, (P=0.002).
  • 0.4 in the placebo group.

During the 14 weeks of follow-up after the end of treatment, HCV was not detected at some points in one patient in the 5-milligram group and in four patients in the 7-milligram group.

Several of those patients had viral rebound, suggesting that 4 weeks of miravirsen is not enough to lead to sustained virological responses, Janssen and colleagues reported.

Only two of the 112 adverse events reported miravirsen patients were above grade 2, the researchers reported, but none was dose limiting.

As well, the researchers reported that they found no mutations in the miR-122 binding sites of the HCV genome that would lead to resistance.

Rizza told MedPage Today that therapy for HCV is advancing rapidly, to the point where investigational all-oral regimens are possible that avoid the standard but difficult-to-take pegylated interferon and ribavirin.

But even those novel regimens may not be useful in all patients, so a therapy like miravirsen is likely to find a role, she said.

The study was supported by Santaris Pharma. Janssen reported financial links with the company as well as with Roche, Merck, Abbott, Anadys, Medtronic, Gilead, and Tibotec. Several authors are employees of Santaris.

Lieberman reported financial links with Alnylam. Sarnow did not report any potential conflicts.

Primary source: New England Journal of Medicine
Source reference:
Janssen HLA, et al "Treatment of HCV infection by targeting microRNA" N Engl J Med 2013; DOI: 10.1056/NEJMoa1209026.

Additional source: New England Journal of Medicine
Source reference:
udy Lieberman,Peter Sarnow "Micromanaging hepatitis C virus" N Engl J Med 2013; DOI: 10.1056/NEJMe1301348.

Source

April 13, 2013

Early Test of Micro-RNA-Targeting Drug Shows Promise Against HCV

Reuters Health Information

Mar 27, 2013

By Gene Emery

NEW YORK (Reuters Health) Mar 27 - The Santaris Pharma drug miravirsen significantly reduced blood levels of hepatitis C virus (HCV) and, in a few cases, kept the virus at undetectable levels 14 weeks after treatment stopped, according to new research funded by the manufacturer.

The study, released online today in the New England Journal of Medicine, was a phase IIa trial that focused on patients with chronic HCV genotype 1 infection and involved a new technique for clearing the virus.

The drug, formerly known by its experimental name SPC3649, blocks the access to microRNA-122 (miR-122), which is active in liver cells and required by the virus to replicate. Similar chunks of microRNA regulate cell activity throughout the body.

When microRNA-122 was blocked, the hepatitis virus couldn't function properly and, in some cases, began to disappear from the blood.

"The reduction in HCV RNA levels was dose-dependent and sustained beyond the administration period for miravirsen," the researchers reported. They said a reduction in HCV RNA of at least 2 log(10) IU/mL occurred in one patient (11%) receiving 3 mg/kg of miravirsen and in six patients each (67%) in the groups receiving 5 or 7 mg, compared to placebo.

"This is a big step forward for hepatitis C but it's a bigger step forward for medicine in general because it's the first study to show that, in humans, blocking microRNA can have good efficacy" with few apparent side effects, said chief author Dr. Harry Janssen of the University of Toronto.

Because cancer, heart, nerve and metabolic diseases may also involve microRNA, he said in a telephone interview from Shanghai, "this study opens up different avenues of treatment for these types of diseases."

Dr. Kenneth Sherman, a hepatitis researcher at the University of Cincinnati College of Medicine who was not involved in the study, told Reuters Health by email that miravirsen "represents an exciting new therapeutic class of drugs for this serious and common liver disease."

"The absence of interactions with other drugs, combined with what appears to be a high barrier to resistance, makes this approach very desirable," he said. Other hepatitis C drugs are being developed, but "these data suggest that miravirsen could play an important role in our future armamentarium against a virus that causes progressive liver disease in millions of people worldwide."

Dr. Janssen's team gave five weekly doses of the drug or placebo to 36 volunteers.

All initially had virus levels ranging from about 5 to 7, using a logarithmic scale. Placebo recipients showed virtually no improvement.

Miravirsen worked better in some volunteers than others, which Dr. Janssen said wasn't surprising.

"The treatment targets the host, not the virus. And in many of these host-targeting treatments you see a heterogeneous response rate," he said.

Of the nine patients who received the lowest dose of 3 mg/kg each week, the five people with the best outcomes also received established treatment with pegylated interferon and ribavirin during the observation period.

At the highest dose of 7 mg/kg, nearly everyone saw some decline in virus levels. Five patients saw their virus levels drop into the undetectable range, but in two of those cases the levels rebounded during the observation period.

Most of those getting 5 mg/kg also had initial reductions and some rebounds. Only one of the nine volunteers in that group ended up with virus levels in the undetectable range.

Taken together, all three treatment groups saw a rebound, with peak effectiveness coming at week seven in the 3 mg/kg group, week 12 in the 5 mg/kg group and weeks eight to 10 for the 7 mg/kg group.

There were no side effects that seemed connected to the treatment.

Problems such as headache and fatigue were experienced by placebo recipients at comparable levels. For example, flu-like symptoms were seen in two patients in the low-dose group, none in the medium-dose group and one in both the high-dose and placebo groups.

No doses were reduced because of side effects.

As seen in previous studies, the drug also produced a gradual and prolonged reduction in cholesterol.

The researchers are currently testing whether it is better to give miravirsen for 12 weeks instead of five.

"All tested strains of HCV depend on miR-122, suggesting that it is a universal HCV Achilles' heel," said Dr. Judy Lieberman of Harvard Medical School and Dr. Peter Sarnow of Sanford University in an online editorial.

Such drugs, alone or in combination, they said, "could provide curative therapy for a large proportion of patients infected with all HCV strains without danger of drug resistance. It could also shorten the treatment time to achieve viral elimination, reduce the rate of relapse, and offer the possibility of interferon-free regimens. Only further clinical trials can determine whether this promise can be met."

SOURCE: http://bit.ly/XfMNEb and http://bit.ly/XfMNEb

N Engl J Med 2013.

Source

January 4, 2012

Gene-Targeting Therapy Shows Promise Against Hepatitis C

Provided by Hep Magazine

November 9, 2011

Miravirsen, a novel injectable drug targeting a “microRNA” known as miR-122 responsible for the accumulation of hepatitis C virus (HCV) in the liver, had long-lasting activity against the virus when used without other medications in a preliminary clinical trial presented Monday, November 7, at the 62nd annual meeting of the American Association for the Study of Liver Diseases (AASLD) in San Francisco.

New clinical data from the early stage Phase II study demonstrate that four out of nine participants treated with the highest dose of miravirsen—7 milligrams per kilogram (mg/kg) of body weight—saw their HCV viral loads decrease to undetectable levels with just four weeks of treatment.

These findings, said study presenter Harry Janssen, MD, PhD, of Erasmus MC University Hospital in Rotterdam, Netherlands, suggest that miravirsen’s unique mechanism-of-action offers a high barrier to viral resistance and the potential for cure, used either alone or with other medications. He also noted that miravirsen was well tolerated in people living with HCV, signaling a possible advantage over today’s standard pegylated interferon–based treatment.

Continue Reading Here ...

January 2, 2012

Hepatitis C virus survives by hijacking liver microRNA: study

January 2, 2012

Viral diseases are still one of the biggest challenges to medical science. Thanks to thousands of years of co-evolution with humans, their ability to harness the biology of their human hosts to survive and thrive makes them very difficult to target with medical treatment

Scientists at the University of North Carolina at Chapel Hill, working with colleagues from the University of Colorado, have shown for the first time how a small RNA molecule that regulates gene expression in human liver cells has been hijacked by the hepatitis C virus to ensure its own survival – helping medical scientists understand why a new antiviral drug appears to be effective against the virus.

MicroRNAs are involved in regulating the expression of genes in cells, usually by blocking the production of key proteins or by destabilizing the messenger RNAs that encode the cell's proteins as it grows and divides. Normally they act by downregulating gene expression. The research team found that the binding of a prominent microRNA in liver cells, called miR-122, to the viral RNA results in its stabilization, promoting efficient replication of the virus genome in the liver and supporting the virus' lifecycle.

"The hepatitis C virus has done two very interesting things with miR-122," says Stanley M. Lemon, MD, professor of medicine and microbiology and immunology and a member of UNC Lineberger Comprehensive Cancer Center and the Center for Translational Immunology.

"First, it has evolved a unique relationship with a key regulator, since miR-122 represents about half of all microRNAs present in the liver. Second, the virus has usurped a process that usually downregulates gene expression to upregulate the stability of its RNA and expression of viral proteins needed for its lifecycle. It's a classic example of how viruses subvert normally beneficial functions of the cell to their own nefarious purposes."

Work by Dr. Lemon and his colleagues in 2005 helped to demonstrate that miR-122 was required for hepatitis C to replicate itself, but the mechanism was not understood. Now the UNC research team has shown how it works, which helps to explain how a new experimental antiviral drug target the virus. The drug, called an "antagomer", binds to miR-122 and sequesters it in the liver and thus destabilizes the viral genome, accelerating its degradation in the liver. Results of the most recent study are published online this week in the journal Proceedings of the National Academy of Sciences.

Hepatitis C is a continuing public health problem, which is difficult to measure because symptoms occur months to years after infection. The Centers for Disease Control and Prevention estimates as many as 4 million people in the United States may be persistently infected with hepatitis C virus, and most do not know they are infected. More than a third of those who are long-term carriers may develop chronic liver disease or liver cancer, a deadly form of cancer that is becoming increasingly common due to the spread of this virus.

Provided by University of North Carolina

Source

December 7, 2010

Serum microRNA Profiles Serve as Novel Biomarkers for HBV Infection and Diagnosis of HBV-Positive Hepatocarcinoma

Cancer Res. 2010 Nov 23. [Epub ahead of print]

Li LM, Hu ZB, Zhou ZX, Chen X, Liu FY, Zhang JF, Shen HB, Zhang CY, Zen K.

Authors' Affiliations: Institute for Virology, State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Department of Epidemiology and Biostatistics, Cancer Center, Nanjing Medical University, and Clinical Laboratory, Nanjing Second Hospital, Nanjing, China; and Department of Virology, University of California School of Public Health, Berkeley, California.

Abstract

Diagnosis of hepatitis B virus (HBV)-positive hepatocellular carcinoma (HCC), particularly HCC independent of cirrhosis etiology, presents a great challenge because of a lack of biomarkers. Here we test the hypothesis that expression profiles of microRNAs (miRNAs) in serum can serve as biomarkers for diagnosis of HBV infection and HBV-positive HCC. We recruited 513 subjects (210 controls and 135 HBV-, 48 hepatitis C virus (HCV)-, and 120 HCC-affected individuals) and employed a strategy of initial screening by Solexa sequencing followed by validation with TaqMan probe-based quantitative reverse transcription-PCR assay. First, because of a close link between chronic hepatitis B and HCC, we compared miRNA expression profiles in HBV serum with that in control serum and successfully obtained 13 miRNAs that were differentially expressed in HBV serum. This 13-miRNA-based biomarker accurately discriminated not only HBV cases from controls and HCV cases, but also HBV-positive HCC cases from control and HBV cases. Second, we directly compared miRNA expressions in HCC serum with those in controls and identified 6 miRNAs that were significantly upregulated in HCC samples. Interestingly, 2 of these miRNAs, miR-375 and miR-92a, were also identified by our first approach as HBV specific. When we employed 3 of these miRNAs (miR-25, miR-375, and let-7f) as biomarkers, we could clearly separate HCC cases from controls, and miR-375 alone had an ROC of 0.96 (specificity: 96%; sensitivity: 100%) in HCC prediction. In conclusion, our study demonstrates for the first time that serum miRNA profiles can serve as novel and noninvasive biomarkers for HBV infection and HBV-positive HCC diagnosis. Cancer Res; 70(23); 1-10. ©2010 AACR.

PMID: 21098710 [PubMed - as supplied by publisher]

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October 23, 2010

Hepatic microRNA expression is associated with the response to interferon treatment of chronic hepatitis C

Published on: 2010-10-22

HCV infection frequently induces chronic liver diseases. The current standard treatment for chronic hepatitis (CH) C combines pegylated interferon (IFN) and ribavirin, and is less than ideal due to undesirable effects.

MicroRNAs (miRNAs) are endogenous small non-coding RNAs that control gene expression by degrading or suppressing the translation of target mRNAs. In this study we administered the standard combination treatment to CHC patients.

We then examined their miRNA expression profiles in order to identify the miRNAs that were associated with each patient's drug response.

Methods: 99 CHC patients with no anti-viral therapy history were enrolled. The expression level of 470 mature miRNAs found their biopsy specimen, obtained prior to the combination therapy, were quantified using microarray analysis.

The miRNA expression pattern was classified based on the final virological response to the combination therapy. Monte Carlo Cross Validation (MCCV) was used to validate the outcome of the prediction based on the miRNA expression profile.

Results: We found that the expression level of 9 miRNAs were significantly different in the sustained virological response (SVR) and non-responder (NR) groups.

MCCV revealed an accuracy, sensitivity, and specificity of 70.5%, 76.5% and 63.3% in SVR and non-SVR and 70.0%, 67.5%, and 73.7% in relapse (R) and NR, respectively.

Conclusions: The hepatic miRNA expression pattern that exists in CHC patients before combination therapy is associated with their therapeutic outcome. This information can be utilized as a novel biomarker to predict drug response and can also be applied to developing novel anti-viral therapy for CHC patients.

Author: Yoshiki MurakamiMasami TanakaHidenori ToyodaKatsuyuki HayashiMasahiko KurodaAtsushi TajimaKunitada Shimotohno

Credits/Source: BMC Medical Genomics 2010, 3:48

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September 23, 2010

Regulus Therapeutics Secures Additional Patents on microRNA Therapeutics for the Treatment of Hepatitis C Virus (HCV) Infection

Sept. 23, 2010, 8:00 a.m. EDT

-- US and European Patent Offices Grant Claims Covering Use of anti-miR-122 Alone or In Combination with Other HCV Therapeutic Agents --

LA JOLLA, Calif., Sep 23, 2010 (BUSINESS WIRE) -- Regulus Therapeutics Inc. announced today that the European Patent Office (EPO) and United States Patent and Trademark Office (USPTO) have recently granted claims for microRNA-122 therapy in hepatitis C viral (HCV) infections. The EPO issued a Notice of Intent to Grant for an application in the 'Sarnow' patent series (European Patent Application No. 05749437.9) for claims covering the use of an antisense inhibitor of miR-122 for the treatment of HCV infection and related conditions, either alone or in combination with other HCV therapeutic agents. Additionally, the USPTO has recently allowed claims in a continuation application in the Sarnow patent series (US Serial No. 11/953,705), directed to methods of reducing HCV viral genome amount with an antisense inhibitor of miR-122 in combination with other HCV therapeutic agents. The Sarnow patent series, owned by Stanford University and licensed to Regulus, relates to the discovery and development of therapeutic products for HCV infection by inhibiting the liver-specific microRNA known as miR-122.

"We are very pleased that the Sarnow patent estate continues to generate patents worldwide. Notably, the claims capture uses of anti-miR-122 in combination with the therapeutic agents, such as interferon and ribavirin, which comprise the current standard of care for the treatment of HCV infection," said Garry E. Menzel, Ph.D., Executive Vice President Corporate Development and Finance of Regulus.

Regulus controls a broad and dominant patent estate related to microRNA therapeutics, including miR-122 therapeutic agents. These two new patents will further strengthen the Regulus-controlled patent estate surrounding miR-122 compositions and methods of use, which includes but is not limited to:

-- The 'Sarnow' patent claiming the use of anti-miR-122 to inhibit HCV replication (US Patent No. 7,307,067)

-- The 'Esau' patent claiming the use of anti-miRs targeting miR-122 as inhibitory agents (US Patent No. 7,683,036)

-- The 'Tuschl III' patent claiming compositions of matter for miR-122 and complementary oligonucleotides (US Patent No. 7,232,806)

-- The 'Manoharan' patent claiming antagomirs, including antagomirs targeting miR-122 (US Patent No. 7,582,744)

-- A recently granted Regulus-owned European application claiming the use of miR-122 antagonists for reducing cholesterol (EP Application No. 06813949.2)

miR-122 is a liver-expressed microRNA that has been shown to be a critical endogenous "host factor" for the replication of HCV, and anti-miRs targeting miR-122 have been shown to block HCV infection (Jopling et al. (2005) Science 309, 1577-81). In earlier work, scientists at Alnylam Pharmaceuticals and Isis Pharmaceuticals (Regulus' co-founders) demonstrated the ability to antagonize miR-122 in vivo using chemically modified single-stranded anti-miR oligonucleotides. Data from multiple preclinical studies have shown a robust HCV antiviral effect following inhibition of miR-122. Through a collaboration with GlaxoSmithKline, Regulus is developing a microRNA therapeutic targeting miR-122 for the treatment of HCV infection as its most advanced therapeutic program. Regulus plans to identify a clinical development candidate in the fourth quarter of 2010 and file an investigational new drug (IND) application in 2011.

About microRNAs

The discovery of microRNA in humans is one of the most exciting scientific breakthroughs in the last decade. microRNAs are small RNA molecules, typically 20 to 25 nucleotides in length that do not encode proteins but instead regulate gene expression. Nearly 700 microRNAs have been identified in the human genome, and more than one-third of all human genes are believed to be regulated by microRNAs. As a single microRNA can regulate entire networks of genes, these new molecules are considered the master regulators of the genome. microRNAs have been shown to play an integral role in numerous biological processes including the immune response, cell-cycle control, metabolism, viral replication, stem cell differentiation and human development. Most microRNAs are conserved across multiple species indicating the evolutionary importance of these molecules as modulators of critical biological pathways. Indeed, microRNA expression or function has been shown to be significantly altered in many disease states, including cancer, heart failure and viral infections. Targeting microRNAs with anti-miRs, antisense oligonucleotide inhibitors of microRNAs, or miR-mimics, double-stranded oligonucleotides to replace microRNA function, opens the possibility of a novel class of therapeutics and a unique approach to treating disease by modulating entire biological pathways. To learn more about microRNAs please visit http://www.regulusrx.com/microrna/microrna-explained.php

About Regulus Therapeutics Inc.

Regulus Therapeutics is a biopharmaceutical company leading the discovery and development of innovative new medicines based on microRNAs. Regulus is targeting microRNAs as a new class of therapeutics by working with a broad network of academic collaborators and leveraging oligonucleotide drug discovery and development expertise from its founding companies Alnylam Pharmaceuticals /quotes/comstock/15*!alny/quotes/nls/alny (ALNY 14.56, -0.11, -0.75%) and Isis Pharmaceuticals /quotes/comstock/15*!isis/quotes/nls/isis (ISIS 8.65, +0.08, +0.93%) . Regulus is advancing microRNA therapeutics towards the clinic in several areas including hepatitis C infection, cardiovascular disease, fibrosis, oncology, immuno-inflammatory diseases, and metabolic diseases. Regulus' intellectual property estate contains both the fundamental and core patents in the field and includes over 600 patents and more than 300 pending patent applications pertaining primarily to chemical modifications of oligonucleotides targeting microRNAs for therapeutic applications. In April 2008, Regulus entered into a major alliance with GlaxoSmithKline to discover and develop microRNA therapeutics for immuno-inflammatory diseases. In February 2010, Regulus entered into a new collaboration with GlaxoSmithKline to develop and commercialize microRNA therapeutics targeting microRNA-122 for the treatment of Hepatitis C Viral infection. In June 2010, sanofi-aventis and Regulus entered into the largest-to-date strategic alliance on microRNA therapeutics focused initially on fibrosis. For more information, visit http://www.regulusrx.com/.

Forward-Looking Statements

This press release includes forward-looking statements regarding the future therapeutic and commercial potential of Regulus' business plans, technologies and intellectual property related to microRNA therapeutics being discovered and developed by Regulus, including the therapeutic potential of targeting microRNA-122. Any statement describing Regulus' goals, expectations, financial or other projections, intentions or beliefs is a forward-looking statement and should be considered an at-risk statement. Such statements are subject to certain risks and uncertainties, particularly those inherent in the process of discovering, developing and commercializing drugs that are safe and effective for use as human therapeutics, and in the endeavor of building a business around such products. Such party's forward-looking statements also involve assumptions that, if they never materialize or prove correct, could cause their results to differ materially from those expressed or implied by such forward-looking statements. Although these forward-looking statements reflect the good faith judgment of the management of Regulus, these statements are based only on facts and factors currently known by Regulus. As a result, you are cautioned not to rely on these forward-looking statements. These and other risks concerning Regulus' programs are described in additional detail in each of Isis' and Alnylam's annual report on Form 10-K for the year ended December 31, 2009 and their most recent quarterly report on Form 10-Q, which are on file with the SEC. Copies of these and other documents are available from either Isis or Alnylam.

SOURCE: Regulus Therapeutics Inc.

Regulus Therapeutics
Zachary Zimmerman, Ph.D., 858-202-6300
busdev@regulus.com
or
Media:
Russo Partners
Heidi Chokeir, Ph.D., 619-528-2217
 
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September 22, 2010

Santaris Pharma A/S Advances miravirsen, the First microRNA-Targeted Drug to Enter Clinical Trials, Into Phase 2 to Treat Patients Infected With Hepatitis C Virus

- Santaris Pharma A/S initiates Phase 2a clinical trial with miravirsen (SPC3649) to assess safety and tolerability in treatment-naive patients with chronic Hepatitis C
 
HOERSHOLM, Denmark and SAN DIEGO, September 22, 2010 /PRNewswire/ -- Santaris Pharma A/S, a clinical-stage biopharmaceutical company focused on the discovery and development of RNA-targeted therapies, today announced that it has advanced miravirsen (SPC3649), the first microRNA-targeted drug to enter clinical trials, into Phase 2 studies to assess the safety and tolerability of the drug in treatment-naive patients infected with the Hepatitis C virus (HCV).
 
Paving the way to conduct the first clinical trials of a microRNA-targeted drug in the United States, Santaris Pharma A/S also received acceptance of its Investigational New Drug (IND) application from the U.S. Food and Drug Administration (FDA). In addition to the United States, the Phase 2a clinical trials will be conducted in the Netherlands, Germany, Poland, Romania, and Slovakia.

The World Health Organization estimates about 3% of the world's population has been infected with HCV and that some 170 million are chronic carriers at risk of developing liver cirrhosis and/or liver cancer(2). Approximately 3-4 million Americans are chronically infected with an estimated 40,000 new infections per year(1). In Europe, there are about 4 million carriers(2). The current standard of care, pegylated interferon in combination with ribavirin, is effective in only about 50% of those treated(1).

Developed using Santaris Pharma A/S proprietary Locked Nucleic Acid (LNA) Drug Platform, miravirsen is a specific inhibitor of miR-122, a liver specific microRNA that the Hepatitis C virus requires for replication. Miravirsen is designed to recognize and sequester miR-122, making it unavailable to the Hepatitis C virus. As a result, the replication of the virus is effectively inhibited and the level of Hepatitis C virus is reduced.

"Advancing miravirsen, the first microRNA-targeted drug to enter clinical trials, into Phase 2 studies in patients with Hepatitis C demonstrates Santaris Pharma A/S leadership in developing RNA-targeted medicines," said Arthur A. Levin, Ph.D., Vice President, Chief Development Officer and President, US Operations. "Receiving IND acceptance from the FDA to conduct the first clinical trials with a microRNA-targeted drug in the United States brings Santaris Pharma A/S one step closer to potentially providing a growing number of patients chronically infected with HCV with a more effective and better tolerated treatment option."

The LNA Drug Platform is the only technology with both mRNA and microRNA targeted drugs in clinical trials, reinforcing the broad utility of the platform. The unique combination of small size and very high affinity, which is only achievable with LNA-based drugs, allows this new class of drugs to potently and specifically inhibit RNA targets in many different tissues without the need for complex delivery vehicles. LNA-based drugs are a promising new type of therapy that enables scientists to develop drugs to attack previously inaccessible pathways.

"Using our LNA Drug Platform to advance the first microRNA-targeted therapy into human clinical trials was certainly a scientific breakthrough," said Henrik Oerum, Ph.D., Vice President and Chief Scientific Officer of Santaris Pharma A/S. "We are extremely pleased with the results of the Phase I trials and excited to progress miravirsen into Phase 2 clinical trials. Because of its unique mechanism of action and tolerability profile, miravirsen has the potential to be an effective treatment option for patients with HCV."

The randomized, double-blind, placebo-controlled, ascending multiple-dose Phase 2a study will assess the safety and tolerability of miravirsen and is designed to enroll up to 55 treatment-naïve patients with chronic Hepatitis C virus genotype 1 infection. Secondary endpoints include pharmacokinetics of miravirsen and its effect on viral load. Miravirsen will be given as subcutaneous injections weekly or every other week for four weeks.

Data from Phase 1 clinical studies with miravirsen in healthy volunteers show that the drug is well tolerated. A recent study published in Science demonstrated that miravirsen successfully inhibited miR-122 and dramatically reduced Hepatitis C virus in the liver and in the bloodstream in chimpanzees chronically infected with the Hepatitis C virus(3). Miravirsen provided continued efficacy in the animals up to several months after the treatment period with no adverse events and no evidence of viral rebound or resistance.

In addition to miravirsen, Santaris Pharma A/S has a robust product pipeline targeting mRNAs and microRNAs both internally as well as in partnerships and collaborations with miRagen Therapeutics (cardiovascular diseases), Shire plc (rare genetic disorders), Pfizer (undisclosed therapeutic areas), GlaxoSmithKline (viral disease) and Enzon Pharmaceuticals (oncology).

About microRNAs

MicroRNAs have emerged as an important class of small RNAs encoded in the genome. They act to control the expression of sets of genes and entire pathways and are thus thought of as master regulators of gene expression. Recent studies have demonstrated that microRNAs are associated with many disease processes. Because they are single molecular entities that dictate the expression of fundamental regulatory pathways, microRNAs represent potential drug targets for controlling many biologic and disease processes.

About Locked Nucleic Acid (LNA) Drug Platform

The LNA Drug Platform and Drug Discovery Engine developed by Santaris Pharma A/S combines the Company's proprietary LNA chemistry with its highly specialized and targeted drug development capabilities to rapidly deliver potent single-stranded LNA-based drug candidates against RNA targets, both mRNA and microRNA, for a range of diseases including metabolic disorders, infectious and inflammatory diseases, cancer and rare genetic disorders. The LNA Drug Platform overcomes the limitations of earlier antisense and siRNA technologies to deliver potent single-stranded LNA-based drug candidates across a multitude of disease states. The unique combination of small size and very high affinity, which is only achievable with LNA-based drugs, allows this new class of drugs to potently and specifically inhibit RNA targets in many different tissues without the need for complex delivery vehicles. LNA-based drugs are a promising new type of therapy that enables scientists to develop drugs to attack previously inaccessible clinical pathways. The most important features of LNA-based drugs include excellent specificity, providing optimal targeting; increased affinity to targets providing improved potency; and strong pharmacology upon systemic delivery without complicated delivery vehicles.

About Santaris Pharma A/S

Santaris Pharma A/S is a privately held clinical-stage biopharmaceutical company focused on the discovery and development of RNA-targeted therapies. The Locked Nucleic Acid (LNA) Drug Platform and Drug Discovery Engine developed by Santaris Pharma A/S combine the Company's proprietary LNA chemistry with its highly specialized and targeted drug development capabilities to rapidly deliver potent single-stranded LNA-based drug candidates across a multitude of disease states. The Company's research and development activities focus on infectious diseases and metabolic disorders, while partnerships with major pharmaceutical companies include a range of therapeutic areas including cancer, cardiovascular disease, infectious and inflammatory diseases, and rare genetic disorders. The Company has strategic partnerships with miRagen Therapeutics, Shire plc, Pfizer, GlaxoSmithKline, and Enzon Pharmaceuticals. As part of its broad patent estate, the Company holds exclusive worldwide rights to all therapeutic uses of LNA. Santaris Pharma A/S, founded in 2003, is headquartered in Denmark with operations in the United States. Please visit http://www.santaris.com/ for more information.

(1) American Association for the Study of Liver Diseases -http://www.aasld.org/patients/Pages/LiverFastFactsHepC.aspx

(2) World Health Organization - http://www.who.int/csr/disease/hepatitis/Hepc.pdf

(3) Science. 2010 Jan 8; 327(5962):198-201. Epub 2009 Dec 3

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August 15, 2010

Cancer’s little helpers

Home / August 28th, 2010; Vol.178 #5 / Feature

Tiny pieces of RNA may turn cells to the dark side
 
By Tina Hesman Saey
August 28th, 2010; Vol.178 #5 (p. 18)
 
When tiny hairpin-shaped molecules act up, they don’t rebel loner-style like James Dean. Instead they take on the persona of Darth Vader, crushing proteins under their command and turning acquaintances to the dark side as well. In this case, though, the fight is for control not of the universe, but of the body. And a dark-side victory could end in cancer.
 
No one would have predicted a decade ago that these microRNAs, as the hairpins are called, were involved in cancer, because no one even knew that they existed in people. Mere snippets of RNA — DNA’s underappreciated cousin — these micromolecules are about 22 chemical letters long. But their size belies their power.

When on their best behavior, the molecules are competent and capable managers of the protein-building process that keeps a cell humming in perfect harmony. But when microRNAs go rogue, the results can be disastrous.

New research is revealing just how important these newly discovered molecules are. An imbalance of micro​RNAs can cause cancer by encouraging runaway cell growth or by dampening a cell’s defenses, and can also make the disease more stubborn. But just as Darth Vader never completely lost the young Jedi Anakin Skywalker within him, even bad microRNAs may have good in them yet. Some scientists think that therapies aimed at soothing riled-up microRNAs may help cure the very cancers that the molecules help cause.

Most of the discoveries linking microRNAs and cancer have come in the past five years. “This is extremely rapid progression,” says Curtis Harris, chief of the human carcinogenesis lab at the National Cancer Institute, based in Bethesda, Md.

Micro middle managers

The realization that such small molecules could play a big role in disease was late in coming, says Carlo Croce of Ohio State University in Columbus. “In the beginning there was no interest in microRNAs at all,” he says.

The first microRNA was discovered in 1993 in roundworms. It took another seven years before the next microRNA was found in the same organism. Though both of those microRNAs help control worm development, most scientists regarded them as biological curiosities.

But then researchers found microRNAs at work in fruit flies, people and other organisms. Those discoveries suggested that microRNAs might be important regulatory molecules for all animals, not just flukes of worm biology.

MicroRNAs work in middle management in most plant and animal cells, scientists now know. The molecules help regulate the protein-manufacturing process by essentially issuing permits decreeing when and where proteins may be built. By riding piggyback on messenger RNAs, which are copies of the protein-building blueprints contained within DNA, microRNAs prevent the instructions from reaching protein-building machinery inside cells.

While it may sound nefarious, microRNAs’ interference with protein production helps a cell maintain balance. MicroRNAs ensure that cells save energy by not making unnecessary proteins and help prevent levels of potentially harmful proteins, such as those that initiate the self-destruct program known as apoptosis, from reaching critical mass.

Each type of microRNA in a cell may potentially pair with hundreds of different types of messenger RNA, says Isidore Rigoutsos, a computational and molecular biologist at Thomas Jefferson University in Philadelphia. And each messenger RNA may have many different microRNAs piling on its back.

“It’s safe to say that microRNAs are important,” Rigoutsos says. “The difficulty is saying what are the limits of importance, and they keep being expanded more and more and more.”

Cancer connection

Croce’s lab was among the first to illustrate just how big a role the little molecules could play in people. His group showed that genes encoding microRNAs frequently go missing in tumor cells. In particular, two microRNAs, miR-15 and miR-16, are missing or found at lower than normal levels in 68 percent of chronic lymphocytic leukemia cases.

Cancer biologists usually lump microRNAs into two groups: those that protect against cancer and those that promote it (though the distinction isn’t perfect). Cancer cells tend to have lower levels of most microRNAs but have an oversupply of a few others.

In the protective corner are microRNAs such as miR-15 and miR-16. One of the many proteins regulated by those two microRNAs is BCL2, which keeps cells from pushing the self-destruct button. Cells commit suicide when they become too damaged to operate properly — an important self-defense mechanism for an organism that doesn’t want to walk around with malfunctioning cells. So cells need just the right amount of BCL2 to keep from killing themselves unnecessarily, but not so much of it that they can never die.

The microRNAs pair with messenger RNA to strike the right balance of BCL2. But when miR-15 and miR-16 levels are knocked down — which can happen if a copy of a gene is lost or if something goes wrong during microRNA manufacturing — cells make far too much BCL2, essentially disabling the self-destruct mechanism and making cells immortal. Immortality is one hallmark of cancer.

At the opposite end of the spectrum is one of the baddest microRNA bad boys, miR-21. Elevated levels cause cancer in mice, researchers from Yale University reported online August 8 in Nature. And higher than normal levels have been linked to at least 13 major types of cancer in people and to poor prognoses for people with colon, lung, breast, pancreatic or head and neck cancers, Harris says (SN: 2/2/08, p. 70).

High levels of miR-21 can slow an important cellular security system involving a protein named p53, researchers from the University of California, Santa Barbara have found. This protein performs multiple protective services, including spurring repair of damaged DNA, halting growth until damage is repaired or ending it all if repair isn’t possible (SN: 12/6/08, p. 22). Last year researchers reported in Nature that p53 helps slice microRNAs into their mature form. Too much miR-21 can strip cells of their p53 defenses, leading to cancer.

Though miR-21 has stood out among the troublemakers, Croce’s team has shown that this microRNA and others don’t work alone. The molecular managers are master networkers. In 50 different normal human tissues, microRNAs collaborate to direct cellular activities, Croce and colleagues reported online May 3 in Genome Research. The networks consist of microRNAs that help direct production of proteins, some of which, in turn, control production of other microRNAs, and so on.

But time and again, in 51 different types of cancer, Croce’s team found that the microRNAs’ teamwork had broken down. The cohesive networks disintegrated into rogue hubs of activity. These anarchist factions throw a wrench into the well-oiled machinery that usually keeps a cell healthy.

It’s a rather small wrench, though. MicroRNAs wield their power subtly, tweaking and massaging protein levels up or down a wee bit here and there instead of stopping production altogether.

“A microRNA doesn’t function like an ‘off’ switch,” says cancer biologist Dihua Yu of the University of Texas MD Anderson Cancer Center in Houston.

Even a little bump or dip in protein levels, maybe by just 5 to 10 percent, is enough to send a cell careening down the path to cancer, Croce says.

One of the most delicately balanced cancer-associated proteins is PTEN. It reins in cell growth to prevent wild replication, as seen in cancer. In the parlance of cancer research, PTEN is known as a tumor suppressor, and it works best when there is just the right amount of it.

Losing one copy of the gene for PTEN — essentially cutting protein levels in half — is enough to turn a cell cancerous, previous studies have shown. Other research has demonstrated that microRNAs, including miR-21, help govern production of PTEN. And a study reported June 24 in Nature found that a messenger RNA doppelgänger of PTEN found in healthy cells distracts PTEN-stifling microRNAs, allowing more of the protein to be made. If the twin is missing, the weight of microRNAs on messenger RNA’s back can crush protein production.

New research from Yu’s lab also suggests that reducing the amount of PTEN protein in a tumor cell even slightly is not a good idea. Higher levels of miR-21 slow down PTEN production and make breast cancer cells resistant to an anticancer agent called Herceptin, Yu and colleague Sumaiyah Rehman reported in April in Washington, D.C., at the annual meeting of the American Association for Cancer Research.

Dicer danger

PTEN isn’t the only protein that can make cancer worse. A new study shows that small changes in the amount of a protein involved in producing microRNAs can determine whether tumors stay put or spread to the rest of the body.

That discovery grew from efforts to figure out why most microRNAs are at lower levels in cancer cells but some microRNAs are overproduced. “We were intrigued by this paradox,” says Stefano Piccolo, a cellular and molecular biologist at the University of Padua in Italy.

The resolution came from an unexpected source, a protein that helps slice larger RNAs into microRNAs. This protein, Dicer, is a key component of the microRNA manufacturing machinery. Cutting levels of Dicer in half spurs on cancer because less of it leads to less microRNA, which can mean increased production of proteins that drive rapid growth. Still, cancer cells need some Dicer to survive and reproduce, since Dicer helps make microRNAs that regulate production of proteins.

So cancer cells need to control Dicer levels the way a student sets the volume on an iPod to provide background study music. The volume shouldn’t be too quiet or too loud. “You need to find that perfect middle,” Piccolo says.

Cells dial in just the right amount of Dicer by using a family of microRNAs, miR-103.1, miR-103.2 and miR-107, Piccolo and his colleagues reported in the June 25 Cell. Those three micro­RNAs, which occur at high levels in some cancer cells, latch on to messenger RNAs encoding Dicer and ratchet down its production, meaning less of other micro­RNAs get made. But Dicer levels never drop to nothing, because the same microRNAs rely on the protein to snip them free from larger pieces of RNA.

Piccolo’s finding neatly solves the paradox of why most microRNA levels can be low in cancer cells while some are high, but his study didn’t stop there. The research also provides further evidence that low Dicer levels make cancer more dangerous.

In the study, Piccolo’s team discovered that some aggressive tumors had higher than normal levels of the micro­RNAs that regulate Dicer, and thus less of the protein. More of these micro­RNAs were also associated with breast cancer’s spread and poor prognosis in patients.

Additional experiments with tumor cells growing in lab dishes showed that the cells usually tend to cluster. But when Dicer levels are lowered to about 50 to 60 percent of normal, or levels of miR-107 are increased, cells begin migrating across the dish. Dips in Dicer levels make cells mobile, the team suggests. Less Dicer may mean less of other microRNAs that hold back production of proteins that are responsible for getting cells in gear. With fewer inhibitory microRNAs around, go-proteins can be made and cells get a move on.

Tumor cells may be taking advantage of one of Dicer’s jobs in normal cells — helping cells move around. “Cancer doesn’t invent anything,” Piccolo says.

Tiny treatment options

Getting a clue that a microRNA is involved in a problem also gives researchers a potential solution. In experiments with mice, inhibiting miR-21 made resistant tumor cells more susceptible to Herceptin, Rehman reported at the cancer research meeting.

Increasing susceptibility to anti­cancer drugs is just one way that micro­RNAs could be useful in the clinic, says oncologist Muller Fabbri of Ohio State.

Specific microRNA levels rise or fall in different tumor types, creating a signature for that type of cancer, studies have shown. Such signatures could help correctly diagnose cancer in people whose tumors have migrated. Often pathologists can examine a brain tumor and determine that it arose from breast cancer cells, but sometimes cancer cells conceal their real birthplace. Characteristic patterns of microRNA could help identify where tumor cells originated in the 8 to 10 percent of cases when “even the pathologist doesn’t have a clue,” Fabbri says. Examining the pattern of microRNA levels in a patient’s tumor may also help doctors identify aggressive forms (SN: 2/2/08, p. 70).

In diseases such as liver cancer, researchers may be able to replace missing microRNAs or boost levels to stop the cancer, a team reported last year in Cell. And in cancers in which levels of certain micro­RNAs are too high, researchers can deploy decoy molecules to pull micro­RNAs from their targets. A team reported in January in Science that the strategy appears to work for treating hepatitis C infection in monkeys (SN: 1/2/10, p. 14).

Croce thinks that targeting several microRNAs in anarchist networks may help treat cancer with little chance of resistance developing. But such therapies are still years away. “We have to show that it is really true,” he says, “not just in experiments with mice, but in clinical trials.”

For now, no microRNA therapies are available for cancer, but researchers are watching trials of the anti-microRNA therapy against hepatitis C in people.

“The rapidity of what’s going on is what gives some of us optimism that this could have value,” Harris says. “Relatively shortly, we’re going to know the degree of importance of microRNAs.”

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July 15, 2010

Mayo Clinic Health Letter Highlights MicroRNA -- A Switch that Determines Cell Behavior and Holds Answers on Disease, Prevention, Treatment

Posted : Thu, 15 Jul 2010 21:19:45 GMT
Author : Mayo Clinic
Category : Press Release
News Alerts by Email ( click here )
Press Release News Home

ROCHESTER, Minn. - (Business Wire) Thousands of research studies are under way to better understand microRNA -- short for micro ribonucleic acid. These tiny genetic strands may play a role in identifying, treating and possibly preventing many diseases, according to the July issue of Mayo Clinic Health Letter.

MicroRNA acts like a switch that changes cell behavior. Different microRNAs are in each tissue of the body. For instance, what makes liver cells unique is, in part, their expression of a particular microRNA that influences which protein is produced.

About 1,000 distinct human microRNAs have been identified. Each can influence and regulate expression of hundreds of genes that determine a major change for the cell, such as whether it lives or dies, multiplies rapidly or develops into bone, muscle or another type of cell.

MicroRNA is a relatively new discovery. Scientists have been aware of its role for about 20 years, and there is still much to be learned. Scientists hope that microRNA research might eventually lead to improved diagnosis, more accurate predictions of disease outcomes and new treatment and medication options with fewer side effects.

Diseases being studied include:

•Heart failure -- MicroRNAs associated with this disease process may eventually tie into innovative therapeutic approaches.

•Alzheimer’s disease -- Studies have linked survival of brain cells (neurons) to their ability to produce microRNAs. Neurons incapable of doing so slowly die.

•Hepatitis C virus -- This virus “hijacks” certain microRNA to make copies of the virus within liver cells. Work is under way to develop a treatment that might keep the microRNA away from the virus.

•Schizophrenia -- Researchers are looking at possible associations between microRNA and this severe psychiatric disorder.

•Cancer -- Scientists have used microRNA to destroy liver cancer cells without harming healthy liver cells. Researchers have discovered a correlation between certain microRNAs and aggressive prostate cancer.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 1-800-333-9037 (toll-free), extension 9771, or visit www.HealthLetter.MayoClinic.com.

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July 6, 2010

Small Molecule Modifiers of MicroRNA miR-122 Function for the Treatment of Hepatitis C Virus Infection and Hepatocellular Carcinoma

Douglas D. Young‡, Colleen M. Connelly‡, Christoph Grohmann and Alexander Deiters*

Department of Chemistry, North Carolina State University, Raleigh, North Carolina 27695

J. Am. Chem. Soc., 2010, 132 (23), pp 7976–7981
DOI: 10.1021/ja910275u
Publication Date (Web): May 19, 2010
Copyright © 2010 American Chemical Society
alex_deiters@ncsu.edu, ‡ These authors contributed equally to this work


Abstract

MicroRNAs are a recently discovered new class of important endogenous regulators of gene function. Aberrant regulation of microRNAs has been linked to various human diseases, most importantly cancer. Small molecule intervention of microRNA misregulation has the potential to provide new therapeutic approaches to such diseases. Here, we report the first small molecule inhibitors and activators of the liver-specific microRNA miR-122. This microRNA is the most abundant microRNA in the liver and is involved in hepatocellular carcinoma development and hepatitis C virus (HCV) infection. Our small molecule inhibitors reduce viral replication in liver cells and represent a new approach to the treatment of HCV infections. Moreover, small molecule activation of miR-122 in liver cancer cells selectively induced apoptosis through caspase activation, thus having implications in cancer chemotherapy. In addition to providing a new approach for the development of therapeutics, small molecule modifiers of miR-122 function are unique tools for exploring miR-122 biogenesis.

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Targeting a Master Regulator of Disease

Drugmakers place big bets on the emerging science of microRNA.

By Arlene Weintraub
Tuesday, July 06, 2010

San Diego startup Regulus, founded in 2007, has quietly been working on a new way to target RNA for drug development. The company has been studying a subset of RNA molecules called microRNAs, or miRNAs. First discovered in the 1990s, misbehaving miRNAs have been linked to several diseases, including cancer and heart failure. Drug developers hope these molecules will prove to be particularly effective drug targets because manipulating just one seems to suppress several disease-linked proteins--whereas most biotech drugs only target individual proteins.

Regulus is co-owned by Alnylam and Isis, leaders in RNA-based drug development. While it is just one of a handful of startups developing miRNA therapeutics, it has attracted significant attention from big pharmaceutical companies. Last month, French pharmaceutical giant Sanofi-Aventis announced a research alliance with the company. Sanofi has pledged up to $750 million in payments, including $35 million up front to Regulus--an unusually large investment in such early-stage science. Sanofi and Regulus will work together to target fibrosis, an excessive buildup of hard collagen that can wreak havoc on the heart, kidneys, and other organs. Regulus already has a multimillion-dollar alliance with GlaxoSmithKline to codevelop drugs to treat immune diseases and a hepatitis C treatment.

While many RNAs encode proteins, miRNAs instead regulate the expression of multiple genes by preventing protein-coding RNAs from fulfilling their function. That, in turn, controls everything from metabolism to immune response to muscle development. About 700 miRNAs have been identified so far.

"The analogy we like to use is that miRNA is the maestro conducting the orchestra--the entire biological network," says Zak Zimmerman, Regulus's director of business development. "If something goes wrong with the maestro, the orchestra starts to play off-key."

Regulus has synthesized several compounds that block or modify "oligonucleotides"--the chains of nucleotides that comprise miRNAs. In 2008, the company demonstrated that it could inhibit a particular miRNA in mouse hearts, reversing a fibrotic condition that causes heart failure. Regulus is also researching potential remedies for renal fibrosis, a major cause of kidney failure and common complication among transplant patients. Sanofi had a team of scientists researching miRNA for quite some time, but they lacked the chemistry know-how to transform their discoveries into drugs.

Despite their promise, translating miRNA targeting compounds into safe drugs is likely to prove challenging. MiRNAs control many bodily processes, so altering them can cause unwanted side effects. "They're promiscuous--they affect multiple downstream components," says Sumit Chanda, associate professor at the Sandford Burnham Medical Research Institute in La Jolla, CA. "The more targets you take out, the more toxicities there can be."

Regulus's scientists acknowledge that they'll have to perform extensive toxicity testing before they identify molecules that are safe for testing in people. Funding from Sanofi and GSK will help move that testing forward. The company expects to choose its first drug candidate for clinical trials by the end of this year.

Also See:
Micromanaging RNA Researchers target a tiny strand of RNA to try to treat hepatitis C.
Hepatitis C Drug Targets RNA A new drug suppresses the virus in chimps without generating resistance.

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June 20, 2010

New kids on the block

By Penni Crabtree, SPECIAL TO THE UNION-TRIBUNE
Sunday, June 20, 2010 at 12:01 a.m

A decade after the Human Genome Project, which provided new insights into genes and novel tools to explore them, biotechnology companies are using that knowledge to develop cutting-edge therapies and technologies.

Here are some of the newest and most innovative leaders on San Diego’s biotech block:

REGULUS THERAPEUTICS
Founded: 2007
Employees: 45

Product: Potential treatments for inflammatory disease, hepatitis C

What happens when two venerable biotech players in the field of RNA research come together to create something new?

You get Regulus Therapeutics, the decidedly precocious offspring of Carlsbad’s Isis Pharmaceuticals and joint-venture partner Alnylam Pharmaceuticals of Cambridge, Mass.

RNA, the genetic material crucial in the production of proteins, has spawned several biotech companies over the years.

But Regulus is cutting its baby teeth on a relatively new discovery — microRNA — and has already signed major deals to develop drugs to treat hepatitis C and inflammatory diseases.

MicroRNA, tiny strands of RNA that regulate gene expression, weren’t discovered in humans until 2001. Nearly 700 microRNAs have been identified in the human genome, and more than one-third of all human genes are believed to be regulated by them, said Regulus Chief Executive Kleanthis Xanthopoulos.

MicroRNAs can affect one gene or protein, or entire networks of genes. That makes them the “master maestros” of the human genome, holding sway like a conductor over an orchestra, Xanthopoulos said.

But in a disease, the maestro microRNA — like any sensitive conductor — can get into a huff, erratically blocking some musicians or occasionally disemboweling them with the genetic baton.

“When the maestro gets out of whack and overdoes the job, there are severe consequences,” Xanthopoulos said with a laugh. “We want to develop drugs to get the maestro to return to normal so the musicians can get back on key.”

At least one major pharmaceutical company is already tapping its feet to the beat. In 2008, Regulus signed a deal with GlaxoSmithKline for $20 million, and as much as $600 million in future milestone and development fees, to create microRNA drugs for inflammatory diseases.

And GlaxoSmithKline came to the table again in February, this time paying as much as $150 million for a collaboration to develop drugs for hepatitis C.

Xanthopoulos says drug companies are jumping at microRNA because it has the same potential for blockbuster therapies that monoclonal antibodies showed 20 years ago.

“MicroRNA is one of the most innovative discoveries of the decade,” Xanthopoulos said. “The science is exploding right now.”

http://www.signonsandiego.com/news/2010/jun/20/new-kids-on-the-block/