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Small Delivery Vehicles of siRNA for Enhanced Cancer Targeting Hyun Jin Kim, Yu Yi, Ahram Kim, and Kanjiro Miyata Biomacromolecules, Just Accepted Manuscript • DOI: 10.1021/acs.biomac.8b00546 • Publication Date (Web): 04 Jun 2018 Downloaded from http://pubs.acs.org on June 5, 2018
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Biomacromolecules
Small Delivery Vehicles of siRNA for Enhanced Cancer Targeting
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Hyun Jin Kim1, Yu Yi2,3, Ahram Kim4, Kanjiro Miyata2,*
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University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
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Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The
Department of Materials Engineering, Graduate School of Engineering, The University of
CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biological Effects of
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Nanomaterials and Nanosafety, National Center for Nanosciecne and Technology, No. 11
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Beiyitiao, Zhongguancun, Beijing 100190, China
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Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8573, Japan
Department of Materials Science, Graduate School of Pure and Applied Sciences, University of
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*
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K. Miyata:
[email protected] Corresponding Authors:
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Abstract
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Small interfering RNA (siRNA) drugs have been considered to treat various diseases in major
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organs. However, siRNA drugs developed for cancer therapy are hindered from proceeding to
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clinics. To date, various delivery formulations have been developed from cationic lipids,
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polymers, and/or inorganic nanoparticles for systemic siRNA delivery to solid tumors. Most of
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these delivery vehicles do not generate small particle sizes and pharmacokinetics required for
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accumulation in target cancer cells, compared with clinically tested anticancer drug-loaded
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polymeric micelles. This review describes the significance of small, long-circulating vehicles for 1 ACS Paragon Plus Environment
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efficient delivery of siRNA to cancer tissues via the enhanced permeability and retention (EPR)
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effect. We summarize recent biological evidence that supports the size effect of delivery vehicles
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in tumor microenvironments and introduce the promising strategies for construction of small
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vehicles with a size of 10 to 50 nm. We then discuss the feasibility of these delivery vehicles
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with respect to translation to clinical trials.
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Keywords: RNAi, siRNA delivery, cationic block copolymer, cancer targeting, EPR effect.
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1. Introduction
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Small interfering RNA (siRNA) drugs have been gradually developed to treat various
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intractable diseases and have been tested in clinical trials. A post-transcriptional gene silencing
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mechanism, termed RNA interference (RNAi), is triggered by siRNA in mammalian cells.1 As a
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double-stranded RNA molecule, siRNA typically has 21–23 nucleotides in each strand. In
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cytoplasm, siRNA binds with a protein complex, called the RNA-induced silencing complex
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(RISC). The sense strand of the siRNA is cleaved and ejected.2,3 The antisense strand
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thermodynamically selects complementary messenger RNA (mRNA). Antisense strands with
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partial target hybridization promote translational repression, and those with perfect
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complementary hybridization induce mRNA degradation by cleavage of the phosphodiester bond
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at the mRNA position paired with antisense strand nucleotides 10 and 11.3 Drugs based on
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siRNA have potential advantages over traditional drugs in cancer therapy. RNAi can inhibit the
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targets, which are inaccessible to traditional drugs, by using mRNA genetic information.4 KRAS
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protein was dismissed as “undruggable” for many years until recent research showed that
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covalent inhibitors bind and selectively inhibit one of the KRAS mutant isoforms (KRAS
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G12C).5,6 This was because the KRAS protein did not appear to present suitable pockets, except
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for the GDP/GTP-binding site. The KRAS protein binds very tightly to these nucleotides, which
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makes identifying competitive nucleotide analogs virtually impossible.7 Drugs based on siRNA
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provide an alternative approach to controlling KRAS expression and have proven efficacious in
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animal models of various tumors.8,9 Furthermore, RNAi is suitable for gene silencing in multiple
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target mRNAs, which induces therapeutic synergy. Certain malignant tumors depend on a 2 ACS Paragon Plus Environment
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developmental hierarchy, in which many transcription factors (TFs) can function as oncogenes.10
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Glioblastoma (GBM) stem-like cells drive tumor propagation and therapeutic resistance. Thus,
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TFs in GBM stem-like cells may function as novel therapeutic targets. One study demonstrated
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that simultaneous RNAi on four TFs (SOX2, OLIG2, SALL2, and POU3F2) successfully
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suppressed the growth of brain tumor-initiating cells in a murine brain tumor model.11
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For RNAi in the body, siRNA must be transported into target cells after administration.
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Native (or unmodified) siRNA molecules are degraded by nucleases in blood and hydrolyzed in
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lysosomes. Thus, siRNA molecules have been chemically modified or formulated into delivery
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vehicles to enhance their availability. Chemical modification of internucleotide linkages and
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oligonucleotide sugars enhances nuclease resistance and decreases the immunostimulatory
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properties of native siRNA.12 Various synthetic materials, such as cationic polymers, lipids (or
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lipidoids), and inorganic materials, have been employed to formulate multimolecular assemblies
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(i.e., delivery vehicles) with siRNA.13‒15 These have been improved to increase the transport
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efficacy of therapeutic siRNA to achieve more efficient RNAi in target cells. The vehicles
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protect vulnerable siRNA from enzymatic degradation and prevent rapid renal filtration and non-
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specific interaction with serum proteins after systemic administration. Once the delivery vehicles
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reach target cells, they (i) facilitate internalization in the target cells through adsorptive (or
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receptor-mediated) endocytosis, (ii) escape from the endosome to the cytoplasm, and (iii) finally
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release the siRNA to be loaded into the RISC [Fig. 1]. For cancer therapy, the vehicles need to
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reach into cancer cell nests while avoiding accumulation in major organs. Tumor vessels lack
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tight endothelial monolayers and thus the vehicles can pass through (penetrate) these vasculature
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defects (e.g., pores).16 This phenomenon is known as the enhanced permeability and retention
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(EPR) effect.17 The penetration behavior of vehicles is mainly governed by diffusion with the
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assumption that their sizes are smaller than those of the vascular defects. Thus, the vehicle size
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(or diffusion coefficient) and concentration gradient between bloodstream and tumor tissue are
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the main factors affecting tumor accumulation profiles (see the section 2.2 in this review).
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Higher concentration gradients are obtained by longer circulation of vehicles in the bloodstream
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as well as higher dosing. These facts emphasize the significance of delivery vehicles with
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smaller size and longer circulation property in achieving more efficient cancer targeting based on
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the EPR effect. This review (i) describes the recent biological evidence supporting the 3 ACS Paragon Plus Environment
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significance of small vehicles; (ii) summarizes promising fabrication techniques of the small
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vehicles for siRNA delivery; and (iii) discusses the feasibility of these delivery vehicles for
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translation to clinical trials.
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Figure 1. Schematic illustration of siRNA delivery in stroma-rich tumor microenvironments. (1)
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Long-circulating delivery vehicles maintain a concentration gradient between bloodstream and
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tumor tissue, facilitating their diffusion into the tumor tissue. (2) Small vehicles easily penetrate
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vascular pores with heterogeneous sizes in tumor lesions. (3) Small vehicles easily diffuse into
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stroma region and reach cancer cell nests. (4) Vehicles are endocytosed into cancer cells, escape
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from late endosomes/lysosomes to the cytoplasm, and release siRNA payloads. Finally, the
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siRNA molecules are loaded into RISC and induce RNAi.
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Biomacromolecules
2. Behavior of delivery vehicles in tumor microenvironments
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Molecules in the bloodstream are transported into tissue area by different routes. Gases
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(O2 and CO2), lipophilic solutes, and small hydrophilic solutes freely pass (or diffuse) through
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capillary endothelia.18,19 In continuous capillary blood vessels, macromolecules pass through
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endothelia by transcellular and/or paracellular routes. The transcellular route requires active
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transport mechanisms using caveolae and vesiculo-vacuolar organelles. The paracellular route is
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mediated by the coordinated opening and closing of the intercellular junctions of endothelial
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cells (e.g., vascular pores).18,19 Macromolecules larger than ~40 kDa in molecular weight (MW)
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cannot spontaneously extravasate through these continuous capillary vascular pores.20 In tumor
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vessels, vascular endothelial growth factor (VEGF), which is secreted by cancer cells, weakens
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intercellular junction and induces the increase of paracellular permeability.21 Consequently,
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macromolecules larger than ~40 kDa can extravasate from this leaky vasculature to the tumor
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mass when their sizes are smaller than those of tumor vascular pores, which vary even in the
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same tumor tissue (see the section 2.1 in this review). Smaller macromolecules more rapidly
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extravasate than larger ones, following two reasons. One is that smaller macromolecules have
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more opportunities for extravasation by penetrating even smaller vessel pores. The other is that
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the penetration behavior of macromolecules is mainly governed by diffusion.22 Dextran with a
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MW of 3.3 kDa (~3 nm in hydrodynamic diameter (DH)) penetrated two orders of magnitude
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faster than dextran with a MW of 2 MDa (~50 nm in DH) in a tumor tissue in human squamous
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tumor-bearing mice, as estimated by the Kedem–Katchalsky equation.23 Intravenously
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administered delivery vehicles extravasate from the bloodstream and reach cancer cell nests via
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three transport steps [Fig. 1]. Firstly, the vehicles penetrate undeveloped and leaky vasculature
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and reach a tumor tissue. When cancer cells surround the blood vessels, the vehicles immediately
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reach the cancer cells. In stroma-rich tumors, the blood vessels are frequently surrounded with
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extracellular matrices. In this case, the vehicles need to go through the matrices while avoiding
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non-specific absorption to collagens and sulfated glycosaminoglycans. Then, the vehicles reach
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the cancer cell nests and are internalized by target cells.
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2.1. Significance of size of delivery vehicles. Tumor accumulation of macromolecules by the
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EPR effect remains controversial because of disagreement regarding the vascular pore cutoff size
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in solid tumors (e.g., human cancer patients vs. experimental animal models). Early studies on 5 ACS Paragon Plus Environment
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the vascular pore cutoff size reported extremely leaky tumor blood vessels in murine ectopic
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models, with pore sizes between 380 nm and 780 nm [Fig. 2A-C].24,25 However, recent studies
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suggested that a realistic pore size in patients should be less than a few hundred nanometers.26
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Heterogeneous tumor accumulation by the EPR effect is observed in the same tumor tissue or
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individual patient. Cancer patients develop metastases in different organs. Tumors at the
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metastatic sites are exposed to different cellular compositions and extracellular matrices, leading
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to heterogeneous EPR effects. In 19 human patients with HER2-positive metastatic breast cancer,
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a HER2-targeted poly(ethylene glycol)-conjugated (PEGylated) liposome (~100 nm in DH)
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exhibited a 35 fold higher accumulation from 24 to 48 h (0.52–18.5% ID/kg) in bone and brain
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tumor lesions.26 The accumulation amounts in an individual patient (patient 02) exhibited a 20-
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fold difference between the highest (10% ID/kg) and the lowest (0.5% ID/kg) values in two
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different tumor lesions [Fig. 3]. Metastatic tumor lesions in various organs exhibited different
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tumor accumulation profiles. Among all the metastatic tumors in 19 patients, tumor lesions in the
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liver generally exhibited higher tumor accumulation than those in other organs (e.g., breast, bone,
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lymph node, lung, skin, mediastinum, and chest wall). Another study observed the heterogeneity
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of the EPR effect in canine tumors. In 11 canines with spontaneous solid tumors, 110 nm-sized
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PEGylated liposomes exhibited widely varying tumor accumulation profiles.27 In detail, the
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liposomes displayed high accumulations in six of seven carcinomas, whereas the same liposomes
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accumulated in only one of four sarcomas. Biological differences between tumors were not
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clearly explained in the above two studies. It is probable that such tumor lesions in patients have
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different vascular pore sizes. In achieving accumulation in various tumor lesions in all organs,
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downsizing of delivery vehicles will be one of the most plausible approaches to maximizing the
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EPR effect in heterogeneous tumors. Size-dependent tumor accumulation of vehicles was clearly
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observed in lymph node metastases in a murine model.28 A 30 nm polymeric micelle
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significantly accumulated in lymph node metastases, whereas an 80 nm PEGylated liposome
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could barely penetrate the metastatic masses [Fig. 4]. Similarly, 18 nm lipid-coated calcium
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phosphate nanoparticles (LCP-NPs) also exhibited more efficient accumulation in murine models
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of various subcutaneous or orthotopic tumors, compared to 65 nm LCP-NPs.29 Note that these
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two LCP-NPs had similar blood circulation properties (half-lives = ~4 h).
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Figure 2. (A) Scanning electron microscopic (SEM) image of luminal surface of normal blood
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vessel in mouse mammary gland. The surface is smooth and has tight endothelial junctions. (B)
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SEM image of tumor blood vessel in MCa-IV mouse mammary carcinoma. The vessel has
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widened intercellular spaces, overlapping endothelial cells. (C) SEM image of high
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magnification of a hole (arrows) in the endothelium in MCa-IV mouse mammary carcinoma.
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Arrowheads indicate basement membrane filaments. Scale bar in (C) applies to all panels in 5
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µm in (A); 2 µm in (B); 0.5 µm in (C). Reprinted by permission from Springer Nature, ref [24],
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Copyright 2003. https://www.nature.com/articles/nm0603-713
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Figure 3. Tumor deposition of doxorubicin-loaded
Cu-labeled HER2-targeted PEGylated
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liposome (64Cu-MM-302) in individual patients with metastatic breast cancer was shown to be
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highly variable. Each patient with multiple lesions was measured by positron emission
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tomographic scans. Reprinted from [26]. Copyright 2017, with permission from American
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Association for Cancer Research.
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Figure 4. Intravital microscopic analyses of metastatic lymph nodes after co-injection of 30 nm
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(1,2-diaminocyclohexane)platinum(II) (DACHPt)-loaded polymeric micelles (green) and 80 nm
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PEGylated liposomes, Doxil (red). Quantification of the changes in the fluorescence signals
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within the metastatic region (enclosed area by dotted line). Reprinted with permission from [28].
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Copyright 2015, American Chemical Society.
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In cancer cell nests (or tumor mass), delivery vehicles need to reach more cancer cells. It was
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suggested that poorly developed intratumoral lymphatic vessels are functionally compromised,30
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resulting in interstitial hypertension. This elevated interstitial fluid pressure compromises
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convective transport of vehicles.22 Thus, the dominant mechanism of vehicle transport within
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tumors should be diffusion. The diffusion coefficient of biologically inert (or stealth) vehicles
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depends on the particle sizes and the constituents of tumor matrices. Smaller nanoparticles
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exhibited longer penetration distances in tumor mass. A 25 nm polymeric micelle diffused from
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the blood vessels to an average distance of 42 ± 7 µm in a murine model of a subcutaneous
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breast MDA-MB-468 tumor, whereas a 60 nm polymeric micelle showed an average distance of
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23 ± 4 µm.31 The similar results were also observed for PEGylated 12 nm quantum dots,32 20 nm
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gold nanoparticles,33 and 30 nm polymeric micelles.34 These nanoparticles diffused more deeply
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from tumoral blood vessels, compared with control nanoparticles with sizes of larger than 50 nm. 8 ACS Paragon Plus Environment
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In fibrotic tumors, delivery vehicles also need to penetrate the stroma (or fibroblast- and
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collagen-rich) tissue to reach the cancer cell nests. In clinical tumors, e.g., breast, pancreatic,
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colorectal, and non-small-cell lung cancers, stromal tissues surrounding the blood vessels are
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observed [Fig. 5A].35 These stromal tissues obstruct the diffusion of delivery vehicles and act as
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a physical barrier to vehicle penetration. Indeed, subcutaneous BxPC3 tumor tissues are
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equipped with fibrotic tissues that surround the blood vessels.36,37 Two different sized polymeric
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micelles were separately prepared with DH of 30 nm and 70 nm and were systemically
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administered into the same BxPC3 tumor-bearing mice.38 The 30 nm micelles were uniformly
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distributed in the cancer cell nest. In contrast, the 70 nm micelles could not enter it. Although
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some portions of 70 nm micelles penetrated the tumor vessel, they were entrapped close to a
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blood vessel [Fig. 5B]. Consequently, the 30 nm micelles efficiently reduced the growth rate of
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the pancreatic tumor model, whereas the 70 nm micelles were ineffective. This research clearly
13
demonstrates that a smaller vehicle is essential for increasing the delivery efficacy in stroma-rich
14
tumors. Meanwhile, it is reported that diffusion of vehicles in tumor tissues depends on the
15
collagen content.22 When virus-derived nanoparticles with a size of 150 nm were intratumorally
16
administrated into human melanoma tumor grown in a dorsal skinfold chamber, collagen regions
17
with higher density displayed a lower concentration of the nanoparticles compared with those
18
with lower density.39 These results suggest that collagen contents might be the major determinant
19
for vehicle diffusion in stroma tissues. Similarly, the penetration of 35 nm LCP-NPs into cancer
20
cell nests was greatly enhanced in the stroma-rich bladder cancer xenograft model after the
21
treatment of Quercetin, which is a small molecule used to decrease both fibroblast population
22
and collagen content.40
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Figure 5. (A) Patient tumor stromal architecture. A tumor structure dominated by a pattern of
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cancer cell nests surrounded by well-developed stromal structures, which contain the majority of
4
the vessels. Tumor cells were stained with DAPI (blue). Myofibroblast-like cells and blood
5
vessels were stained by α-smooth muscle actin (red) and CD31 (green), respectively. Reprinted
6
from [35]. Copyright 2013, with permission from American Association for Cancer Research.
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(B) Z-stack volume reconstruction of BxPC3 tumors 1 h after co-injection of fluorescently
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labeled 30 nm (green) and 70 nm (red) DACHPt-loaded polymeric micelles. Reprinted by
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permission from Springer Nature, ref [38]. Copyright 2011.
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https://www.nature.com/articles/nnano.2011.166
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2.2. Significance of blood circulation properties of delivery vehicles. In the bloodstream,
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vehicle transport in the flow direction is dominated by convection. Transfer of vehicles from the
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bloodstream to tumor tissues is dominated by concentration-dependent diffusion because the
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flow velocity in the radial direction is much slower than that in the flow direction.41 Additionally,
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the interstitial fluid pressure elevated in tumor tissues reduces the pressure gradient across the
17
vessel wall, which further compromises the convection from the blood to the tumor tissues.22 The
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concentration gradient of vehicles between the bloodstream and tumor tissues is maintained in a
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certain extent if they can steadily circulate in the bloodstream. Based on the concentration
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gradient, vehicles with sizes of several tens nanometer slowly diffuse into tumor tissue during
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circulation. Thus, long-circulating vehicles are advantageous for enhanced tumor accumulation.
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Herein, the blood circulation property of delivery vehicles is discussed based on the
4
pharmacokinetics. Classic pharmacokinetics describes that drug elimination rate follows the
5
first-order reaction, where the drug concentration exponentially decreases with time.42 Also,
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pharmacokinetic studies on drug delivery have utilized a two-compartment model, where the
7
drug elimination is represented by two different phases: first distribution (or α) phase and second
8
elimination (or β) phase. The distribution phase is generated by the drug distribution into
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peripheral compartment, which is significantly slower than the instantaneous drug distribution
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into central compartment after administration [Fig. 6A]. Accordingly, a slope in the distribution
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phase is affected by the drug elimination and the drug distribution/redistribution. Once the
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distribution and redistribution reach equilibrium, the distribution phase shifts to the elimination
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phase featuring a less negative slope. Small drugs are instantaneously distributed into highly
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perfused organs, e.g., heart, lungs, kidneys, liver, and brain, as well as blood, whereas not into
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less well-perfused tissues, e.g., muscle, fat, and skin. Thus, the highly perfused organs and the
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less well-perfused tissues are considered as central compartments and peripheral compartments,
17
respectively. In contrast, macromolecular drugs generally display substantially slow distribution
18
even in the highly perfused organs. This indicates that blood and organs/tissues should
19
correspond to central compartments and peripheral compartments, respectively, in the
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macromolecular drug delivery. In this regard, stable delivery vehicles follow a two-compartment
21
model with a fairly long α-phase or apparently single-compartment model without distribution
22
phase [Fig. 6B].42 The gentle slope in the profile of polymeric micelles indicates that they stably
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circulated in the bloodstream without rapid organ/tissue distribution. This profile is in sharp
24
contrast with that of small drugs (oxaliplatin), which disappeared from the blood much faster in a
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clear two phase-manner.
26
A confocal laser scanning microscopic (CLSM) technique enables direct and real-time
27
observation of fluorescent nanoparticles (or macromolecules) circulating in the bloodstream.43
28
The obtained time profile of fluorescence intensity represents the circulation property, including
29
stability, of nanoparticles in the blood [Fig. 6C]. A rapid decline in the initial fluorescence
30
intensity indicates that the nanoparticles were rapidly eliminated from the bloodstream, possibly 11 ACS Paragon Plus Environment
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due to distribution into organs/tissues following nanoparticle dissociation. It should be noted that
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the PEGylated liposome on the market and the polymeric micelles tested in clinical trials show
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half-lives from ten to hundred hours in the blood circulation, as summarized in Table 1. A
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HER2-targeted PEGylated liposome (half-life = 33 h in patients) continuously accumulated in a
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tumor for 72 h and achieved high tumor accumulation (2.3–10.6% ID/kg) in some tumor lesions,
6
as described above.26 A cisplatin-loaded polymeric micelle, which completed phase II clinical
7
trials44 and is being evaluated in phase III clinical trials, exhibited half-lives of 129 ± 40 h in a
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human patient45 and approximately 8 h in a mouse.46 This micelle (DH = 25 ± 1 nm) continuously
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accumulated in a murine model of a subcutaneous pancreatic BxPC3 tumor for 24 h and
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achieved approximately 5% ID/g.47 These data suggest that siRNA delivery vehicles also need
11
longer blood circulation property for efficient tumor accumulation. An siRNA-loaded lipid
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nanoparticle (LNP) tested in clinical trials is reported to have half-lives of 1–2 h in patients
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[Table 2], which are considerably shorter than those of PEGylated liposomes and cisplatin-
14
loaded polymeric micelles. The fabrication of long-circulating vehicles for siRNA delivery is
15
technically more difficult compared with low MW anticancer drugs, because of the rigid
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cylindrical architecture (2 × 6 nm in size) of siRNA with high hydrophilicity.
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Several previous studies reported the relationship between nanoparticle size and blood
18
circulation property. The 30 and 50 nm polymeric micelles prepared from PEG-b-poly(amino
19
acid)s showed no significant differences in blood circulation profiles (half-lives = 14 h for both
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polymeric micelles).38 Also, 18 and 65 nm lipid-coated calcium phosphate nanoparticles showed
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the similar blood circulation profiles with half-lives of 4 h.29 However, the effect of nanoparticle
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size of less than 50 nm on the blood circulation property remains to be investigated.
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2 3
Figure 6. (A) A two-compartment model for drug elimination. (B) Time profiles of platinum
4
concentration in the plasma after intravenous administration of DACHPt-loaded polymeric
5
micelles (■) and free oxaliplatin (◊), determined by ion coupled plasma-mass spectrometry.
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Reprinted from [48]. Copyright 2004, with permission from Elsevier. The polymeric micelle
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exhibits a long α-phase with a half-life of > 9 h. In contrast, a small molecule, oxaliplatin, is
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cleared rapidly from circulation. (C) A representative blood circulation profile of fluorescent-
9
labeled antisense oligonucleotide-loaded polymeric micelles, determined by intravital real-time
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CLSM observation. The polymeric micelles were intentionally prepared to show a short blood
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circulation profile with a half-life of ~8 min in α phase. Unpublished data.
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Table 1. Representative long-circulating delivery vehicles for cancer therapy.13,49
13 Delivery
Name
Drug
Size
vehicle Polymeric
NK012
SN-38
20
NC-6004
137 ± 19 h in
II
Triple negative
cisplatin
25
129 ± 40 h in
breast cancer III
Pancreatic cancer
I
Various solid
patient NC-4016
micelle PEGylated
Disease
patient
micelle Polymeric
Phase
(nm)
micelle Polymeric
Half-life
(1,2-diaminocyclohexane)
30
10–50 h in mice
platinum(II) (DACHPt) Doxil
doxorubicin
tumors 90
liposome
21–90 h in
On the
patient
market
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Various tumors
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1
3. siRNA-based drugs tested in clinical trials for cancer therapy
2
This section introduces current siRNA delivery vehicles tested in clinical trials [Table 2].
3
Major advances have been achieved for liver diseases, including transthyretin (TTR)-mediated
4
amyloidosis, hypercholesterolemia, and hepatitis B virus infection, because of the histological
5
characteristics. Sinusoidal capillaries in liver have larger intercellular pores (~150 nm),
6
compared with continuous capillary blood vessels, and a discontinuous basement membrane,
7
allowing the easy access of nanoparticles to hepatocytes.50,51 The presence of various receptors
8
(e.g., asialoglycoprotein, retinol binding protein, and low-density lipoprotein receptor) on
9
hepatocytes can further facilitate the cellular uptake of delivery vehicles equipped with targeting
10
ligands.52–54 Importantly, the duration of RNAi-induced silencing effects is correlated to the
11
doubling time of target cells. Under cultured conditions, the RNAi activity continued for 3–7
12
days in rapidly dividing cells (e.g., doubling time ≈ 1 day) and for several weeks in non-dividing
13
cells.55 Dilution of intracellular siRNA associated with the cell division mainly affects the
14
duration of gene silencing. Thus, the siRNA-mediated gene silencing in the liver, where
15
hepatocytes are quiescent and rarely replicated in the normal status,56 can be sustained for long
16
periods.
17
Delivery vehicles targeting the liver have been extensively optimized with respect to the
18
endosome-escapability of cationic components57,58 or the targetability using ligands.52,53 Among
19
them, Patisiran (ALN-TTR02) has completed Phase III trials for the treatment of TTR-mediated
20
amyloidosis. Patisiran is an LNP formulation comprising a synthetic amino lipid (DLin-MC3-
21
DMA), distearoylphosphatidylcholine (DSPC), cholesterol, and PEG-lipid. The amino lipid,
22
DLin-MC3-DMA, was selected to have an appropriate ionizable property (or pKa = 6.44) from a
23
large pool of lipid candidates for enhanced endosomal escape.57 The LNP had a size distribution
24
from 70 nm to 90 nm and a polydispersity index of 0.11 ± 0.04.57 Two doses of Patisiran every 3
25
weeks in a Phase II study reduced the mean serum TTR level by approximately 80%, and the
26
RNAi effect continued for approximately 110 days.59
27
For siRNA delivery to cancer, two LNP formulations, Atu027 and ALN-VSP02, have
28
completed their Phase I/II and I trials, respectively. Atu027 is composed of four components, a
29
cationic lipid (AtuFECT01), a neutral helper lipid, a PEGylated lipid, and a 23-mer blunt-ended
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1
siRNA for targeting protein kinase N3 (PKN3).60,61 Atu027 has an average DH of 120 nm with a
2
size distribution in the range of 30–480 nm.62 A pharmacokinetic analysis of siRNA and two
3
lipid components (AtuFECT01 and a neutral helper lipid) was carried out for 4 h of infusion.60
4
The antisense strand of siRNA has a half-life of only 1 h in plasma. Interestingly, the two lipid
5
components exhibited much longer half-lives in plasma of ~40 h. This result indicates that
6
siRNA was immediately detached from the surface of Atu027 in the bloodstream. ALN-VSP02
7
is
a
LNP
composed
of
five
components,
a
cationic 58
lipid
(DLinDMA),
8
distearylphosphatidylserine, cholesterol, PEG-lipid, and siRNA.
Two different siRNAs
9
targeting VEGF-A and kinesin spindle protein (KSP) are mixed at a 1:1 molar ratio.63 ALN-
10
VSP02 has a DH of 80 nm to 100 nm with a ζ-potential of +6 mV at pH 7.4. A pharmacokinetic
11
analysis of two different siRNAs after 15 min of infusion showed a rapid decline in the plasma
12
concentration (half-life = 1‒2 h).63 Biopsies from 12 patients were subjected to quantitative RT-
13
PCR to measure VEGF and KSP mRNA levels; most of the patients showed no difference in the
14
amounts of VEGF (8 patients) and KSP mRNA (10 patients) relative to the pretreatment biopsy.
15
In Atu027 and ALN-VSP02, the cationic lipid components (AtuFECT01 and DLinDMA) were
16
developed to provide LNPs with higher surface charges permitting the effective siRNA loading
17
and more efficient endosome-escapability, respectively. Nevertheless, the clinical results suggest
18
that these design parameters should be insufficient to elicit successful RNAi for cancer therapies.
19
The sizes and blood circulation properties of these vehicles should not be suitable for efficient
20
tumor accumulation.
21 22
Table 2. RNAi-based drug examples tested in clinical trials for liver diseases and cancer therapy. Delivery
Name
Target
Size (nm)
Half-life
Phase
Disease (organ)
ALN-PCSsc
PCSK9
6
5.8–11 h in
II
Hypercholesterolemia
vehicle GalNAcsiRNA
a,b52
LNP
57,59
LNP
53
c
(Inclisiran) ALN-TTR02
patient TTR
70–90
NP
d
(Liver) III
(Patisiran) ND-L02-s0201
Hereditary
ATTR
amyloidosis (Liver) Hsp47
153 ± 29
ND
e
I
Hepatic (Liver)
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LNP60
Atu027
PKN3
120
~1
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h
in
I/II
patients LNP
63
LNP
64
ALN-VSP02
VEGF,
80–100
KSP siRNA-EphA2-
EphA2
1–2
h
Advanced
solid
tumor in
I
Liver cancer
I
Advanced tumor
patients ND
ND
DOPC
1
a: subcutaneous administration, b: the same delivery system is applied for other diseases. ALN-AS1 (Givosiran) for
2
acute hepatic porphyrias, ALN-AT3 (Fitusiran) for hemophilia and rare bleeding disorders, ALN-CC5 (Cemdisiran)
3
for complement-mediated diseases, ALN-GO1 (Lumasiran) for primary hyperoxaluria type 1, and ALN-TTRsc02
4
for hereditary ATTR amyloidosis. c: half-life in β phase, the data from the same delivery system, Revusiran,65 d: not
5
provided. Area-under-curve and Cmax values are provided. e: no data.
6 7
4. Construction of small delivery vehicles
8
This section introduces construction techniques of small delivery vehicle of siRNA with a
9
size of 10 to 50 nm. Although some examples described in this section were developed for
10
delivery of single-strand RNA or short DNA with the length of less than 30 bases, they should be
11
readily applied for the delivery of siRNA due to their structural similarity. Section 2 highlighted
12
the important roles of particle size for efficient blood extravasation and tumor penetration. Other
13
physicochemical factors (e.g., surface chemistry, charge, and shape) also affect the performances
14
of delivery vehicles, yet not explained in detail here because (i) most of small delivery vehicles
15
are equipped with PEG to reduce non-specific absorption of blood components, such as serum
16
proteins; (ii) the PEG layer provides nearly neutral surface charges to the vehicles; and (iii) most
17
of multimolecular assemblies in the rage of 10–50 nm are spherical. Other reviews summarize
18
the impact of surface chemistry,13 charge,66 and shape67,68 of delivery vehicles.
19 20
4.1. Polymer-conjugated siRNA delivery vehicles
21
One of the simplest siRNA delivery vehicles is a covalent conjugate of siRNA and
22
polymer, such as linear or branched PEGs. Polymer-siRNA conjugates can avoid kidney
23
filtration because of their larger size compared to the pore size (approximately 6‒10 nm) of the
24
glomerular basement membrane.69 Linear PEG chains with MWs of 5,600 and 13,400 are 16 ACS Paragon Plus Environment
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1
calculated to have DH values of 6 and 10 nm, respectively, according to the random coil
2
conformation model.70 Thus, PEG molecules with a MW above ~10,000 should be essential for
3
enhancing the blood circulation properties of polymer-siRNA conjugates. Indeed, an
4
intravenously administered PEG-aptamer conjugate, containing a PEG molecule with a MW of
5
40,000, stably circulated in the bloodstream with a half-life of ~1 day in a mouse, while an
6
unconjugated aptamer control showed a half-life of 5‒10 min.71 Note that simple conjugation
7
with PEG (or PEGylation) does not sufficiently protect siRNA from nuclease attack, and thus
8
chemically
9
phosphorothioate linkages, have been widely applied for conjugate preparation.
modified
(thus
stabilized)
siRNAs,
employing
2′-O-methylation
and
10
As an alternative to PEG, functional polymers comprising endosome-disrupting moieties
11
or targeting ligands have been developed. Amphipathic poly(vinyl ether) derivatives,72
12
poly(amido amine)s,73,74 and melittin-like polypeptides75 were reported as endosome-disrupting
13
backbone polymers. These polymers originally have positively charged groups, which
14
electrostatically interact with negatively charged endosomal membranes, eventually disrupting
15
them. However, these positively charged groups also disrupt cytoplasmic membranes and induce
16
cytotoxicity. Additionally, positively charged polymers are electrostatically associated with
17
siRNA and thus prohibit efficient covalent conjugation between them. To avoid these unwanted
18
behaviors, the positively charged groups, i.e., primary amines, can be masked with acidic pH- or
19
redox potential-responsive cleavable moieties, such as maleic acid amide and disulfide bonds,
20
respectively. Targeting ligands, PEG, and siRNA are conjugated to the backbone polymers via
21
such responsive moieties. In this way, acidic pH-responsive polymers can expose their positively
22
charged groups preferably in late endosomes/lysosomes, while simultaneously releasing other
23
components (e.g., targeting ligands and PEG).72 Similarly, redox potential-responsive polymers
24
can release siRNA in glutathione-rich cytoplasm. In the conjugate design, chemical bonds
25
between the polymer and siRNA need to be carefully selected to tolerate circulation in the
26
bloodstream. For instance, thiosuccinimide bonds, which are formed by the reaction of thiol and
27
alkyl maleimide, have been widely used for developing antibody-drug conjugates (ADCs). This
28
chemistry proceeds rapidly under physiological conditions and attains quantitative conjugation
29
without a large excess of reactant. However, thiosuccinimide bonds are reported to reversibly
30
cleave to form thiol and maleimide groups in plasma, which results in loss of drug from the ADC 17 ACS Paragon Plus Environment
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1
during circulation,76 presumably diminishing the therapeutic efficacy. Shape (or topology) of
2
polymers (e.g., linear or cyclic polymers) influences their blood circulation property. In a
3
previous study, a cyclic polymer with MW of 115 kDa exhibited a blood half-life of 43.9 ± 2.2 h
4
in the beta phase while a linear polymer with MW of 114 kDa exhibited a blood half-life of 38.9
5
± 1.8 h in the beta phase.77,78 The shorter blood circulation property of the linear polymer might
6
be due to faster filtration from the glomerular basement membrane, compared with the cyclic
7
polymer. On the other hand, accumulation profiles of these two polymers in subcutaneous colon
8
tumors were not significantly different presumably because the difference in blood circulation
9
properties was marginal for passive tumor targeting.
10
One of the most well-known polymer-siRNA conjugates is Dynamic PolyConjugate, in
11
which PEGs, hepatocyte-targeting ligands, and siRNAs were conjugated to a poly(vinyl ether)
12
derivative backbone.72 Notably, siRNA was conjugated via a disulfide bond, which can be
13
cleaved in the reductive cytoplasm. PEGs and targeting ligands were attached via an acidic pH-
14
cleavable linkage, to be released in late endosomes/lysosomes. Dynamic PolyConjugate showed
15
a hydrodynamic diameter of 10 ± 2 nm with a negative ζ-potential, while the exact conjugation
16
rates of each moiety were not reported. Dynamic PolyConjugate with apolipoprotein B (apoB)-
17
targeted siRNA exhibited nearly 80% gene silencing for apoB mRNA at an siRNA concentration
18
of 50 nM in cultured primary hepatocytes. A single injection of Dynamic PolyConjugate (50 µg
19
of siRNA) into mice obtained ~90% gene silencing for apoB mRNA in the liver, and the RNAi
20
effects continued for 15 days. In a different study, brush type copolymers were synthesized from
21
5 and 10 kDa PEG with total MWs of 134 and 204 kDa, respectively. These brush type
22
copolymers were then conjugated to an internal position of a nucleic acid strand via click
23
conjugation (or strain-promoted azide-alkyne cycloaddition reaction) to reduce nuclease
24
accessibility.79 The high MW of the brush type PEG enabled tumor accumulation of the
25
conjugates through the EPR effect and protection of nucleic acid strands. This research used
26
short double-stranded DNA, instead of siRNA, as model sequences. The polymer-assisted
27
compaction of DNAs (pacDNAs) had hydrodynamic diameters of 17‒32 nm (depending on the
28
MW of the PEG chains) with slightly negative ζ-potentials close to neutral (−12 to −0.6 mV).
29
Although the blood circulation properties were not reported, the pacDNAs induced enhanced
30
accumulation in a mouse orthotopic breast tumor model.80 The large pacDNA with a diameter of 18 ACS Paragon Plus Environment
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Biomacromolecules
1
32 ± 8 nm more efficiently accumulated in the tumor, compared with the naked DNA control.
2
Interestingly, two different fluorophores were used to label brush PEG and DNA separately.
3
Fluorescence signals obtained from the two dyes were observed similarly in the tumor, indicating
4
that pacDNA was not degraded in the bloodstream and accumulated intact in the tumor. Whereas
5
the research did not investigate RNAi efficacy in the animal model, the pacDNA represented a
6
potential to formulate long-circulating PEG-siRNA conjugates (17‒32 nm in size) by using brush
7
PEGs with an extremely high MW. The effects of brush PEGs (or the shape of PEG) on cellular
8
internalization should be clarified in future studies to estimate the RNAi efficacy in this system.
9
The conjugation chemistry between the brush PEG and siRNA should also be optimized for PEG
10
detachment in the cytoplasm.
11 12
4.2. Electrostatically-associated siRNA delivery vehicles
13
Electrostatic associations between PEG-based block catiomers and siRNAs (or aniomers)
14
generate spontaneous assemblies, i.e., polyion complexes (PICs), through simple mixing of their
15
aqueous solutions. Thus, this formulation can avoid tedious conjugation and purification steps
16
associated with polymer-siRNA conjugate systems. As illustrated in Fig. 7A, the PIC formation
17
is subjected to two assembling processes; one is the formation of primary assemblies, termed
18
unit PICs (uPICs), with the minimal association number for charge neutralization and the other is
19
the secondary associations of uPICs to form multimolecular assemblies, e.g., micelles and
20
vesicles, above a critical association concentration (CAC).81–83 This section highlights the uPIC
21
formulation rather than conventional micellar vehicles, because of its appreciably smaller size
22
for enhanced tumor penetrability.
23
24 19 ACS Paragon Plus Environment
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1
2 3
Figure 7. (A) Electrostatic association processes between PEG-b-catiomers and aniomers.86 (B)
4
Construction of uPICs by stoichiometric charge neutralization between PEG-PLL and siRNA.
5
(C) Chemical structures of FolA-PEG24-K(Stp4-C)2. (D) Schematic illustration for construction
6
of single siRNA nanocapules. Reprinted with permission from [87] and [88], respectively.
7
Copyright 2012, American Chemical Society.
8 9
The construction of siRNA-loaded uPICs was firstly accomplished by charge-
10
stoichiometric association between siRNA and PEG-b-poly(L-lysine) (PEG-PLL) with a well-
11
defined degree of polymerization (DP). The primary amines in PLL have a pKa of 10.5 and are
12
99% protonated at pH 7.4. Thus, the number of positively charged groups coupling with siRNA
13
phosphates is readily calculated from the DPPLL. A single siRNA molecule has a charge of −40,
14
which can be neutralized by a single PEG-PLL with DPPLL = 40 (+40 charges) or three PEG-
15
PLLs with DPPLL = 14 (+14 charges) below CAC [Fig. 7B].84,85 Interestingly, excess PEG-PLL
16
molecules with DPPLL = 40 did not participate in the electrostatic association with siRNA and
17
remained as free polymer; when 10 times charge-equivalent PEG-PLLs with DPPLL = 40 were 20 ACS Paragon Plus Environment
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Biomacromolecules
1
mixed with siRNAs, only 10% PEG-PLLs were bound to siRNAs, leaving 90% unbound PEG-
2
PLLs.84 Accordingly, the structures (or size and association number) of siRNA-loaded uPICs can
3
be precisely controlled by the MWPEG and DPPLL in block catiomer, which is a strong advantage
4
for construction of small siRNA delivery vehicles. A uPIC prepared from PEG-PLL (MWPEG =
5
42k and DPPLL = ~40) and siRNA exhibited a DH of 12.7 ± 0.6 nm,83 which may avoid the rapid
6
renal filtration. Another important criterion is the stability under physiological conditions. In this
7
regard, the ion pairs between PLL segment and siRNA were tolerable in 150 mM NaCl and 10%
8
fetal bovine serum-containing media,84 allowing for stable uPIC formation in the physiological
9
milieu. Note that a relatively high CAC for secondary association is required for selective
10
preparation of uPICs at a wide range of concentrations. Otherwise, the associates form
11
multimolecular structures (micelles or vesicles) with several tens nanometer in size [Fig. 7A]. A
12
previous study revealed that the rigid cylindrical structure of siRNA significantly elevated the
13
CAC values (>10 mg/mL) for the multimolecular assembly, compared with flexible single-
14
stranded RNA (ssRNA) ( 8.5, was selected for ion-pairing with
14
siRNA.89 The cross-linker B was degradable at pH < 6, allowing the release of siRNA in the
15
acidic compartments. The monomer C was a hydrophilic component facilitating colloidal
16
dispersion of the nanocapsule assembly in aqueous media. The resulting assembly showed an
17
average diameter of 20 nm in the TEM image. Interestingly, a dark core with a diameter around
18
5 nm was clearly observed within each assembly, which was probably tungsten-stained siRNA.
19
The assemblies were efficiently internalized by cultured cancer cells, probably due to their
20
positively charged surface (~12 mV in ζ-potential). As a result, the assemblies induced
21
significant luciferase gene silencing in cultured cancer cells, compared with a scramble siRNA-
22
loaded control. However, this study did not investigate RNAi efficacy in animal models.
23 24
4.3. Inorganic nanoparticle-based siRNA delivery vehicle
25
Owing to the precise synthesis of inorganic nanoparticles with various sizes and shapes,
26
size-controllable delivery vehicles have been constructed from inorganic nanoparticles as
27
templates. Inorganic nanoparticles, including gold nanoparticles (AuNPs), quantum dots, iron
28
oxide nanoparticles, and silica nanoparticles, have been tailored for incorporating siRNA
29
molecules on their surface via covalent (or coordinate) bonding. AuNPs with gold-sulfur (Au-S) 22 ACS Paragon Plus Environment
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Biomacromolecules
1
bonds are one of the most widely used formulations for oligonucleotide delivery due to their low
2
toxicity, high traceability, and ease in functionalization under mild conditions. The Au-S bond is
3
probably cleaved in glutathione-rich cytoplasm (~10 mM concentration),90,91 allowing the
4
delivery vehicles to release their payload siRNA. Besides Au-S bonding, covalent bonding (e.g.,
5
ZnS-thiol) and metal-phosphate coordination (e.g., Zr-phosphate) are also used for conjugation
6
of oligonucleotides onto inorganic nanoparticles, such as quantum dots, iron oxide nanoparticles,
7
and metal-organic framework nanoparticles.92–95 Additional conjugation of functional
8
components, such as PEG and peptide ligand, can further functionalize siRNA-conjugated
9
inorganic nanoparticles for enhanced colloidal stability, endosome-escapability, and targetability.
10
These conjugation techniques are in sharp contrast with the nanoparticle constructions by
11
electrostatic interactions, e.g., layer-by-layer technique, which often induce secondary
12
aggregations of nanoparticles, losing the size integrity.96,97
13
Spherical nucleic acids (SNAs) are known as a representative AuNP functionalized with
14
DNA or RNA containing thiol moieties [Fig. 8A].98,99 In this formulation, thiol-functionalized
15
siRNAs were densely decorated on a 13 nm-sized AuNP via Au-S bonding, and then,
16
oligo(ethylene glycol) or short PEG molecules were backfilled on the AuNP surface to increase
17
colloidal stability in the physiological milieu.100–102 The SNAs contained 37.8 ± 5.3 antisense
18
strands of siRNA per particle and had a DH of 33.6 ± 0.2 nm. They efficiently entered cultured
19
cells, mediated by scavenger receptors and lipid rafts, eliciting the enhanced RNAi, compared
20
with naked siRNA.100,103 Several parameters, including the spacer moiety between RNA and the
21
AuNP surface, the density of capped RNA, and the backfill molecules, affected the RNAi
22
efficacy of the SNAs.104,105 A pharmacokinetic study showed that 90% of the SNAs were quickly
23
eliminated from the bloodstream in the first 5 min after intravenous injection. The blood
24
circulation profile analyzed by a two-compartment model exhibited half-lives of ~1 min in the α
25
phase and ~8.5 h in the β phase.101 Interestingly, the SNAs were reported to penetrate the blood-
26
brain barrier and the blood-brain tumor barrier [Fig. 8B] and successfully delivered siRNA to
27
reduce the expression of Bcl2L12 mRNA in a glioblastoma.101
28
The short half-life of SNAs in the α phase is disadvantageous for tumor accumulation, as
29
aforementioned. Our previous study developed a long-circulating siRNA-loaded AuNP by
30
utilizing the 1:1 uPICs between siRNA and a thiolated PEG-PLL (MWPEG = 2k and DPPLL = 23 ACS Paragon Plus Environment
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1
~40).84 The uPIC-conjugated AuNP (uPIC-AuNP) was prepared by a two-step bottom-up
2
approach [Fig. 8C]. siRNA-loaded uPICs were first prepared by the stoichiometric charge
3
neutralization between siRNA and thiolated PEG-PLL. Then, the thiolated uPICs were
4
conjugated on a 20 nm-sized AuNP template via Au-S bonding. The obtained uPIC-AuNPs had a
5
hydrodynamic diameter of 40 nm with a narrow size distribution and exhibited a prolonged
6
blood circulation property with a half-life of 30 min, probably due to the enhanced stealthiness
7
derived from the PEG shell. The sizes of uPIC-AuNPs were precisely controlled from 30 nm to
8
50 nm with a narrow size distribution (polydispersity index (PDI) in dynamic light scattering
200 nucleotide-long noncoding RNAs, which are coded by the
22
genome but are mostly not translated into proteins.114 LncRNAs are associated with various
23
types of cancer, and alternation in lncRNA expression promotes the tumorigenesis and
24
metastasis. LncRNA transcripts are degradable by using lncRNA-specific siRNAs and antisense
25
oligonucleotides (ASOs). The RISC-bound siRNAs can target the complementary mRNA only in
26
the cytoplasm, but RNase H-inducing ASOs can degrade mRNA in both the cytoplasm and the
27
nucleus.115 The cRGD-conjugated micelle with ASOs targeted for taurine-upregulated gene 1
28
(Tug1) lncRNA dramatically reduced the Tug1 lncRNA amounts and exerted the strong
29
antitumor effect for a patient-derived orthotopic brain tumor model.116 This preliminary result
30
demonstrates that lncRNAs are also promising targets in oligonucleotide therapeutics. 27 ACS Paragon Plus Environment
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1 2
Acknowledgements
3
This work was financially supported by Center of Innovation (COI) program from Japan
4
Science and Technology Agency (JST) and Grants-in-Aid for Scientific Research (KAKENHI
5
Grant Numbers 17H02098 for KM and 18K18378 for HJK) from Ministry of Education Culture,
6
Sports, Science and Technology (MEXT). This work was also partially supported by the Project
7
for Cancer Research and Therapeutics Evolution (P-CREATE) and Basic Science and Platform
8
Technology Program for Innovative Biological Medicine from Japan Agency for Medical
9
Research and Development (AMED).
10 11
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Arbel-Alon, S.; Abramovitch, R.; Shemi, A.; Galun, E. Mutant KRAS is a druggable target for
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