Key result
Administration of REVERSIR efficiently counteracted RNAi-mediated silencing of AAV-delivered transgenes, enabling dynamic, dose-dependent, and reversible control of therapeutic protein expression in vivo.
Why the study?
AAV-based gene therapy could be facilitated by molecular switches that dynamically control the magnitude and timing of therapeutic transgene expression.
An RNAi-based rheostat using siRNA or shRNA combined with REVERSIR technology enables dynamic, dose-dependent, and reversible control of AAV-delivered transgenes in preclinical models.
Supports reversible AAV transgene control in preclinical models; leaves open clinical translation of RNAi rheostats.
Adeno-associated virus (AAV)-based gene therapy could be facilitated by the development of molecular switches to control the magnitude and timing of expression of therapeutic transgenes. RNA interference (RNAi)-based approaches hold unique potential as a clinically proven modality to pharmacologically regulate AAV gene dosage in a sequence-specific manner. We present a generalizable RNAi-based rheostat wherein hepatocyte-directed AAV transgene expression is silenced using the clinically validated modality of chemically modified small interfering RNA (siRNA) conjugates or vectorized co-expression of short hairpin RNA (shRNA). For transgene induction, we employ REVERSIR technology, a synthetic high-affinity oligonucleotide complementary to the siRNA or shRNA guide strand to reverse RNAi activity and rapidly recover transgene expression. For potential clinical development, we report potent and specific siRNA sequences that may allow selective regulation of transgenes while minimizing unintended off-target effects. Our results establish a conceptual framework for RNAi-based regulatory switches with potential for infrequent dosing in clinical settings to dynamically modulate expression of virally-delivered gene therapies.
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Subramanian et al. (2023) studied AAV gene therapy regulation. RNAi (siRNA/shRNA) and REVERSIR vs. Non-targeting REVERSIR or vehicle was evaluated on Transgene expression levels (e.g., GLuc, mEPO). Administration of REVERSIR efficiently counteracted RNAi-mediated silencing of AAV-delivered transgenes, enabling dynamic, dose-dependent, and reversible control of therapeutic protein expression in vivo.