Compositions and methods for regulating APOC3 expression

Abstract

Oligonucleotides and compositions comprising the same for inhibiting or reducing Apolipoprotein C-III (APOC3) gene expression are disclosed. Methods of making and using the oligonucleotides are also disclosed, particularly for use in the treatment of diseases, disorders, and / or conditions associated with APOC3 expression.

Description

Technical Field

[0001] Cross - reference to Related Applications This application claims the priority of U.S. Provisional Application No. 63 / 264,730, filed on December 1, 2021, which is incorporated herein by reference in its entirety.

[0002] Sequence Listing The sequence listing conforming to the rules of WIPO Standard ST.26 is incorporated herein by reference in its entirety. The sequence listing is submitted as an electronic document via EFS - Web in ASCII format encoded as XML. The title of the electronic document created on November 29, 2022 is "400930 - 032WO - 194344_ST26.xml" and its size is 2,599,277 bytes.

[0003] The present disclosure generally relates to biology and medicine, and more specifically to oligonucleotide compositions, and their use for inhibiting or reducing apolipoprotein C - III (APOC3) gene expression, and their use for treating diseases, disorders, and / or conditions related to APOC3.

Background Art

[0004] APOC3 is a protein encoded by the APOC3 gene, which is present on high - triglyceride lipoproteins (TRL) and high - density lipoproteins (HDL), has inhibitory activity against lipoprotein lipase (LPL) and hepatic lipase (HL), and is a protein that delays the hepatic clearance of TRL. Human APOC3 is highly expressed in hepatocytes and the small intestine. [[ID=​Several naturally occurring gain-of-function polymorphisms (GMOs) have been identified in the APOC3 gene, and these are thought to be contributing factors to the development of hypertriglyceridemia. These polymorphisms are strongly associated with a wide range of diseases resulting from hypertriglyceridemia, including non-alcoholic fatty liver disease (NAFLD), metabolic syndrome (MetS), insulin resistance, acute coronary artery disease (ACD), and coronary heart disease (CHD). Several loss-of-function polymorphisms have been shown to be associated with decreased plasma triglycerides and hepatic fat, increased plasma HDL cholesterol and APOA1 concentrations, and a reduced risk of ischemic artery disease, heart disease, and coronary artery disease.

[0006] Several RNA-based therapies are known that can inhibit or reduce APOC3 expression. For example, International Patent Application Publications WO2010 / 083615, WO2012 / 177947, WO2016 / 011123, WO2016 / 081444, and WO2019 / 051402, as well as CN Patent Application Publication 108239644, describe double-stranded (ds) RNAi constructs for inhibiting or reducing APOC3 expression, and methods of using them to treat or prevent lipid metabolic conditions, diseases and / or disorders such as obesity and cardiac metabolic disorders. International Patent Application Publication WO2014 / 205451 also describes antisense oligonucleotides for inhibiting or reducing APOC3 expression.

[0007] Despite the existence of several therapeutic drugs targeting APOC3, the treatment of liver disease still requires additional therapies that inhibit or reduce APOC3 expression. [Overview of the project]

[0008] To address this need, this disclosure describes compositions and methods for treating diseases, disorders, and / or conditions associated with APOC3 expression. This disclosure is partly based on the discovery and development of ds oligonucleotides (e.g., RNAi oligonucleotides) for selectively inhibiting and / or reducing APOC3 expression, for example, in the liver. Thus, target sequences within APOC3 were identified, and RNAi oligonucleotides were generated that bind to these target sequences to inhibit the expression of APOC3 mRNA. As shown herein, RNAi oligonucleotides inhibit APOC3 expression in the liver of humans and non-human primates (NHPs). Without being bound by theory, the RNAi oligonucleotides herein are useful for treating diseases, disorders, or conditions associated with APOC3 expression (e.g., hypertriglyceridemia or other dyslipidemias). In general, the RNAi oligonucleotides herein are useful for treating diseases, disorders, or conditions associated with abnormal APOC3 expression (e.g., APOC3 gain-of-function polymorphisms). In particular, the RNAi oligonucleotides of the present invention are useful for treating diseases, disorders, or conditions associated with mutant APOC3 expression.

[0009] Accordingly, this disclosure describes RNAi oligonucleotides for reducing or inhibiting APOC3 expression, comprising a sense strand and / or an antisense strand, wherein the sense strand has a sequence listed in Table 2 and the antisense strand has a sequence listed in Table 2.

[0010] In some embodiments, the sense strand has one of the sequences listed in Table 2 (e.g., any one of the odd numbers from sequence numbers 9 to 170), in particular sequence numbers 37, 43, 45, 87, 89, 99, 101, and 105.

[0011] In some embodiments, the antisense chain has one of the sequences listed in Table 2 (e.g., any even number from sequence numbers 9 to 170), in particular sequence numbers 38, 44, 46, 88, 90, 100, 102, and 106.

[0012] Alternatively, the present disclosure describes RNAi oligonucleotides for reducing or inhibiting APOC3 expression, comprising a sense strand and / or an antisense strand, wherein the sense strand has a sequence listed in Table 3 and the antisense strand has a sequence listed in Table 3.

[0013] In some embodiments, the sense strand has one of the sequences listed in Table 3 (for example, any one of the odd numbers from sequence numbers 171 to 332), in particular sequence numbers 199, 205, 207, 249, 251, 261, 263, and 267.

[0014] In some embodiments, the antisense strand has one of the sequences listed in Table 3 (e.g., any even number from sequence numbers 171 to 332), in particular sequence numbers 200, 206, 208, 250, 252, 262, 264, and 268.

[0015] Alternatively, RNAi oligonucleotides for reducing or inhibiting APOC3 expression are described, comprising a sense strand and an antisense strand, wherein the sense strand and antisense strand form a double-stranded region, and the antisense strand has a region complementary to one of the APOC3 mRNA target sequences of SEQ ID NOs. 334-341.

[0016] In any of the embodiments described above, the sense strand is approximately 15 to 50 nucleotides long. In some embodiments, the sense strand is approximately 20 to 40 nucleotides long. In some embodiments, the sense strand is 36 nucleotides long.

[0017] In any of the embodiments described above, the antisense chain is approximately 15 to 30 nucleotides long. In some embodiments, the antisense chain is approximately 20 to 25 nucleotides long. In some embodiments, the antisense chain is 22 nucleotides long.

[0018] In any of the embodiments described above, the double-stranded region is approximately 19 to 21 nucleotides long. In some embodiments, the double-stranded region is 20 nucleotides long.

[0019] In any of the embodiments described above, the complementary region is the length of at least 15 consecutive nucleotides. In some embodiments, the complementary region is the length of at least 19 consecutive nucleotides to at least 21 consecutive nucleotides. In other embodiments, the complementary region is the length of 19 consecutive nucleotides, 20 consecutive nucleotides, or 21 consecutive nucleotides.

[0020] In any of the embodiments described above, the RNAi oligonucleotide includes a 3' terminal stem loop on the sense strand, represented as S1-L-S2, where S1 is complementary to S2, and L forms a loop between S1 and S2 that is approximately 3 to 5 nucleotides long.

[0021] In any of the embodiments described above, the antisense strand, the sense strand, or both have a protruding sequence. In some embodiments, the antisense strand includes a 3' protrusion the length of one or more nucleotides. In other embodiments, the 3' protrusion is the length of two nucleotides, for example, GG.

[0022] Oligonucleotides are also described as comprising an antisense strand and a sense strand, the antisense strand may be about 21 to 27 nucleotides long and have a region complementary to APOC3, the sense strand has a stem-loop at its 3' end, denoted as S1-L-S2, where S1 is complementary to S2 and L forms a loop between S1 and S2 about 3 to 5 nucleotides long, and the antisense and sense strands form a double-stranded structure of at least about 19 nucleotides long but are not linked by covalent bonds.

[0023] In some embodiments, loop L is a triloop (triL) or a tetraloop (L). In some embodiments, L is a tetraloop that is 4 nucleotides in length. In other embodiments, L comprises the sequence 5'-GAAA-3'.

[0024] In some embodiments, S1 and S2 are 1 to 10 nucleotides in length and have the same length. In other embodiments, S1 and S2 are 1 nucleotide, 2 nucleotides, 3 nucleotides, 4 nucleotides, 5 nucleotides, 6 nucleotides, 7 nucleotides, 8 nucleotides, 9 nucleotides, or 10 nucleotides in length. In other embodiments, S1 and S2 are 6 nucleotides in length. In certain embodiments, the stem-loop comprises the sequence 5'-GCAGCCGAAAGGCUGC-3' (SEQ ID NO: 333).

[0025] In some embodiments, the sense strand is 25 nucleotides in length and the antisense strand is 27 nucleotides in length. In other embodiments, the sense strand is 36 nucleotides in length and the antisense strand is 22 nucleotides in length.

[0026] In the above embodiments, the double-stranded region comprises a 3' overhang sequence on the antisense strand. In some embodiments, the 3' overhang sequence on the antisense strand is 2 nucleotides in length.

[0027] In any of the above embodiments, at least one nucleotide in the oligonucleotide is a modified nucleotide. In some embodiments, all nucleotides in the oligonucleotide are modified except for the nucleotides within the stem-loop (i.e., S1-L-S2). In other embodiments, all nucleotides in the oligonucleotide are modified except for the nucleotides within the loop (i.e., L).

[0028] In some embodiments, modified nucleotides include 2'-modifications such as 2'-aminoethyl (EA), 2'-fluoro (2'-F), 2'-O-methyl (2'-OMe), 2'-O-methoxyethyl (2'-MOE), and 2'-deoxy-2'-fluoro-β-arabinonucleotide (2'-FANA). In certain embodiments, all nucleotides in the oligonucleotide contain 2'-modifications such as 2'-F or 2'-OMe.

[0029] In any of the embodiments described above, at least one nucleotide in the oligonucleotide contains a modified nucleoside bond. In some embodiments, the modified nucleotide bond is a phosphorothioate bond.

[0030] In any of the embodiments described above, the 4'-carbon of the sugar of the 5'-nucleotide of the antisense chain contains a phosphate analog, such as oxymethylphosphonate, vinylphosphonate, or malonylphosphonate. Alternatively, or optionally, the phosphate analog is a 4'-phosphate analog containing 5'-methoxyphosphonate-4'-oxy.

[0031] In any of the embodiments described above, at least one nucleotide of the oligonucleotide can be conjugated to one or more target ligands, such as amino sugars, carbohydrates, cholesterol, lipids, or polypeptides. In some embodiments, the targeted ligand is an N-acetylgalactosamine (GalNAc) moiety. In other embodiments, the GalNAc moiety is a monovalent GalNAc moiety, a divalent GalNAc moiety, a trivalent GalNAc moiety, or a tetravalent GalNAc moiety.

[0032] In some embodiments, the targeting ligand is conjugated to one or more nucleotides of the stem-loop L. In certain embodiments, up to four nucleotides of the stem-loop nucleotide are each conjugated to a monovalent GalNac portion.

[0033] In certain embodiments, one or more nucleotides at positions 8, 9, 10, or 11 of the sense strand are modified with 2'-F. In other embodiments, the sugar moieties of each nucleotide at positions 1-7, 12-27, and 31-36 of the sense strand are modified with 2'-OMe. In certain embodiments, the nucleotides at positions 8-11 of the sense strand are modified with 2'-F, and those at positions 1-7, 12-27, and 31-36 are modified with 2'-OMe.

[0034] In other specific embodiments, the sense strand includes 2'-F modified nucleotides at positions 8–11, 2'-OMe modified nucleotides at positions 1–7, 12–27, and 31–36, GalNAc conjugate nucleotides at positions 28, 29, and 30, and a phosphorothioate linkage between positions 1 and 2.

[0035] In other specific embodiments, one or more nucleotides at positions 2-5, 7, 10, and 14 of the antisense strand are modified with 2'-F, and one or more nucleotides at positions 1, 6, 8-9, 11-13, and 15-22 are modified with 2'-OMe. In other embodiments, the antisense strand contains 2'-F modified nucleotides at positions 2-5, 7, 10, and 14, and 2'-OMe modified nucleotides at positions 1, 6, 8-9, 11-13, and 15-22.

[0036] In certain embodiments, the antisense chain includes 2'-F modified nucleotides at positions 2-5, 7, 10, and 14, 2'-OMe at positions 1, 6, 8-9, 11-13, and 15-22, and phosphorothioate bonds between positions 1 and 2, positions 2 and 3, positions 3 and 4, positions 20 and 21, and positions 21 and 22.

[0037] In certain embodiments, the oligonucleotide has a modification pattern as shown in Figure 1A, 1B, or 1C.

[0038] Figure 1A shows modification pattern 1, and the modification patterns of each chain are shown below: Sense strand: 5' mX-S-mX-fX-mX-mX-mX-mX-fX-fX-fX-mX-fX-fX-mX-mX-mX-fX-mX-mX-mX-mX-mX-mX -mX-mX-mX-[X-GalNAc]-[X-GalNAc]-[X-GalNAc]-[X-GalNAc]-mX-mX-mX-mX-mX-mX 3' Hybridize as follows: Antisense chain: 5' [MePhosphonate-4O-mX]-S-fX-S-fX-S-mX-fX-mX-fX-fX-mX-fX-mX-fX-mX-fX-mX-fX-mX-fX-mX-S-mX-S-mX 3'; Alternatively, it can be expressed as follows: Sense strand: 5' [mXs][mX][fX][mX][mX][mX][mX][fX][fX][fX][mX][fX][fX][mX] 3' Hybridize as follows: Antisense chain: 5' [MePhosphorate-4O-mXs][fXs][fXs][mX][fX][mX][fX][fX][mX][fX] [mX][fX][mX][fX][mX][fX][mX][fX][mX][fX][mXs][mXs][mX] 3'.

[0039] Figure 1B shows modification pattern 2, and the modification patterns of each chain are shown below: Sense strand: 5' mX-S-mX-mX-mX-mX-mX-mX-fX-fX-fX-fX-mX-mX-mX-mX-mX-mX-mX-mX-mX-mX-m X-mX-mX-mX-mX-mX-[X-GalNAc]-[X-GalNAc]-[X-GalNAc]-mX-mX-mX-mX-mX-mX 3' Hybridize as follows: Antisense chain: 5' [MePhosphonate-4O-mX]-S-fX-S-fX-S-fX-fX-mX-fX-mX-fX-mX-mX-mX-fX-mX-mX-mX-mX-mX-mX-S-mX-S-mX 3'; Alternatively, it can be expressed as follows: Sense strand: 5' [mXs][mX][mX][mX][mX][mX][mX][fX][fX][fX][fX][mX][mX][mX] [mX][mX][mX][mX][mX][mX][mX][mX][mX][mX][mX][mX][mX][X-GalNAc][X-GalNAc][X-GalNAc][mX][mX][mX][mX][mX][mX] 3' Hybridize as follows: Antisense strand: 5' [MePhosphonate-4O-mXs][fXs][fXs][fX][fX][mX][fX][mX][mX][fX] [mX][mX][mX][fX][mX][mX][mX][mX][mX][mXs][mXs][mX] 3'.

[0040] Figure 1C shows modification pattern 3, and the modification patterns of each chain are shown below: Sense strand: 5' mX-S-mX-fX-mX-fX-mX-mX-fX-fX-fX-fX-mX-fX-mX-fX-mX-fX-mX-mX-mX-mX-mX-mX -mX-mX-mX-[X-GalNAc]-[X-GalNAc]-[X-GalNAc]-[X-GalNAc]-mX-mX-mX-mX-mX-mX 3' Hybridize as follows: Antisense chain: 5' [MePhosphonate-4O-mX]-S-fX-S-fX-S-mX-fX-mX-fX-mX-fX-mX-fX-mX-fX-fX-mX-fX-fX-mX-fX-mX-S-mX-S-mX 3'; Alternatively, it can be expressed as follows: Sense strand: 5' [mXs][mX][fX][mX][fX][mX][mX][fX][fX][fX][fX][mX][fX][mX] 3' Hybridize as follows: Antisense chain: 5' [MePhosphorate-4O-mXs][fXs][fXs][mX][fX][mX][fX][mX][mX][fX] [mX][fX][mX][fX][mX][fX][fX][mX][fX][mXs][mXs][mX] 3'. Legend for the above modification patterns 1-3: [Table 1]

[0041] In any of the embodiments described above, the RNAi oligonucleotide is an RNAi oligonucleotide. In some embodiments, the RNAi oligonucleotide includes a sense strand having one of the nucleotide sequences shown in Table 2, in particular SEQ ID NOs: 37, 43, 45, 87, 89, 99, 101, and 105. In certain embodiments, the RNAi oligonucleotide includes a sense strand having one of the nucleotide sequences shown in Table 3, in particular SEQ ID NOs: 199, 205, 207, 249, 251, 261, 263, and 267. In some embodiments, the RNAi oligonucleotide includes an antisense strand having one of the nucleotide sequences shown in Table 2, in particular SEQ ID NOs: 38, 44, 46, 88, 90, 100, 102, and 106. In certain embodiments, the RNAi oligonucleotide includes an antisense strand having one of the nucleotide sequences shown in Table 3, in particular SEQ ID NOs: 200, 206, 208, 250, 252, 262, 264, and 268.

[0042] In certain embodiments, the RNAi oligonucleotide comprises a sense strand having one nucleotide sequence of sequence numbers 37, 43, 45, 87, 89, 99, 101, and 105, and an antisense strand having one nucleotide sequence of sequence numbers 38, 44, 46, 88, 90, 100, 102, and 106.

[0043] In certain embodiments, the RNAi oligonucleotide comprises a sense strand having one of the nucleotide sequences of SEQ ID NOs: 37, 89, and 101, and an antisense strand having one of the nucleotide sequences of SEQ ID NOs: 38, 90, and 102.

[0044] In other specific embodiments, the sense strand and antisense strand of the RNAi oligonucleotide are selected from the following, respectively: (a) Sequence IDs 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106.

[0045] In certain embodiments, the RNAi oligonucleotide comprises a sense strand having one nucleotide sequence of sequence numbers 199, 205, 207, 249, 251, 261, 263, and 267, and an antisense strand having one nucleotide sequence of sequence numbers 200, 206, 208, 250, 252, 262, 264, and 268.

[0046] In certain embodiments, the RNAi oligonucleotide comprises a sense strand having one of the nucleotide sequences of SEQ ID NOs: 199, 251, and 263, and an antisense strand having one of the nucleotide sequences of SEQ ID NOs: 200, 252, and 264.

[0047] In other specific embodiments, the sense strand and antisense strand of the RNAi oligonucleotide are selected from the following, respectively: (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 206, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

[0048] Oligonucleotides for inhibiting or reducing APOC3 expression are also described, which comprise a sense strand and an antisense strand, the sense strand and antisense strand forming a double-stranded region, all nucleotides in the sense strand and antisense strand include base, sugar, and / or internucleotide bond modifications, and the antisense strand includes a region complementary to any of the APOC3 mRNA target sequences of SEQ ID NOs. 334-341, the complementary region being at least approximately 15 consecutive nucleotides in length.

[0049] In other embodiments, pharmaceutical compositions comprising at least one oligonucleotide of this specification, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier, delivery agent, or excipient are described. In some embodiments, the pharmaceutical composition includes additional therapeutic agents, such as lipid-lowering agents, antidiabetic agents, or anti-obesity agents.

[0050] In other embodiments, methods for reducing APOC3 expression in cells, cell populations, tissues, organs, or individuals are described, the methods comprising at least the step of administering / contacting the cells, cell populations, tissues, organs, or individuals with the oligonucleotides or pharmaceutical compositions of this specification. In some embodiments, reducing APOC3 expression includes reducing the amount or level of APOC3 mRNA, the amount or level of APOC3 protein, or both, in cells, cell populations, tissues, organs, or individuals. In some embodiments, the cells, cell populations, tissues, organs, or individuals have a disease, disorder, or condition associated with APOC3 expression. In certain embodiments, the disease, disorder, or condition associated with APOC3 expression is hypertriglyceridemia, high non-HDL cholesterol, hepatic steatosis, insulin resistance, or atherosclerotic cardiovascular disease (ASCVD).

[0051] In other embodiments, methods are described for treating individuals who have or are suspected of having a disease, disorder, or condition associated with APOC3 expression. These methods include at least the step of administering an effective amount of the oligonucleotide or pharmaceutical composition of this specification to an individual in need. In some embodiments, the diseases, disorders, or conditions associated with APOC3 expression include hypertriglyceridemia, hypernon-HDL cholesterol, hepatic steatosis, insulin resistance, and even ASCVD. In some embodiments, the oligonucleotide or pharmaceutical composition is administered subcutaneously (SQ) daily, weekly, monthly, quarterly, annually, or in particular monthly or quarterly.

[0052] In some embodiments, the individual has NAFLD, fatty liver, non-alcoholic steatohepatitis (NASH), alcoholic hepatitis (AH), alcoholic liver disease (ALD), cholangiocarcinoma (CCA), cirrhosis, hepatic fibrosis, hepatitis, hepatocellular carcinoma (HCC), primary sclerosing cholangitis (PSC), hyperlipidemia, diabetes mellitus, and / or obesity.

[0053] In any of the embodiments described above, the method may include additional steps such as measuring or obtaining genotype information, APOC3 expression, APOC3 protein levels, body weight and / or blood glucose and / or cholesterol and / or LPL and / or TG of an individual, and then comparing the obtained values ​​with one or more baseline values ​​or previously obtained values ​​to evaluate the effectiveness of contact or administration. In some embodiments, the additional step includes confirming that the individual has APOC3 gain-of-function polymorphisms. In some embodiments, the additional step includes confirming that the individual has the single nucleotide polymorphism (SNP) rs5128, rs2854116, rs2854117, rs2070666, or the mutation 1100C>T, 2845T>G, or Gln38Lys.

[0054] In any of the embodiments described above, the method may include administering the RNAi oligonucleotide or pharmaceutical composition simultaneously with, separately from, or sequentially with the second composition or second therapeutic agent. In some embodiments, the second composition or second therapeutic agent is an APOC3 antibody or a fragment thereof, a lipid-lowering agent, an antidiabetic agent, or an anti-obesity agent. In some embodiments, the second composition or second therapeutic agent is administered at the same frequency as the RNAi oligonucleotide (i.e., every other day, twice a week, or weekly). In other embodiments, the second composition or second therapeutic agent is administered at a different frequency than the RNAi oligonucleotide. Similarly, in other embodiments, the second composition or second therapeutic agent is administered via the same route as the RNAi oligonucleotide (e.g., SQ). In yet another embodiment, the second composition or second therapeutic agent is administered via a different route than the RNAi oligonucleotide.

[0055] In other embodiments, the use of the RNAi oligonucleotides of this specification for treating diseases, disorders, or conditions related to APOC3 expression is described, administered separately, or sequentially (i.e., in combination) with, optionally, a second composition or a second therapeutic agent.

[0056] In other embodiments, the use of the RNAi oligonucleotides of this specification in the manufacture of a medicament for the treatment of a disease, disorder or condition related to APOC3 expression, the medicament further optionally comprising a second composition or a second therapeutic agent.

[0057] In other embodiments, a kit is described comprising at least one oligonucleotide of this specification, an optional pharmaceutically acceptable carrier, and a package insert including instructions for use to administer it to an individual having a disease, disorder, or condition related to APOC3 expression.

[0058] The advantage of the oligonucleotides and compositions described herein is that suppressed APOC3 expression exerts beneficial effects across the entire range of dyslipidemia.

[0059] Other advantages, effects, features, and purposes will become clearer upon consideration of the following detailed explanation. Such detailed explanation refers to the following diagram(s). [Brief explanation of the drawing]

[0060] [Figure 1A] A schematic diagram showing the structure and chemical modification pattern of a typical GalNAc-conjugated APOC3 oligonucleotide (M1) is shown. [Figure 1B] A schematic diagram showing the structure and chemical modification pattern of a typical GalNAc-conjugated APOC3 oligonucleotide (M2) is shown. [Figure 1C] A schematic diagram showing the structure and chemical modification pattern of a typical GalNAc-conjugated APOC3 oligonucleotide (M3) is shown. [Modes for carrying out the invention]

[0061] overview Dyslipidemia refers to an unhealthy condition in which the levels of one or more types of lipids (fats) in the blood are abnormal. There are mainly three types of lipids: high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG). Dyslipidemia is divided into primary and secondary types. Primary dyslipidemia is hereditary, while secondary dyslipidemia is an acquired condition (i.e., it develops due to other causes such as obesity or diabetes).

[0062] RNA interference (RNAi) is a process that involves introducing exogenous RNA into a cell to specifically degrade mRNA encoding a targeted protein, thereby reducing the expression of the target gene.

[0063] In humans, APOC3 is 99 amino acids long (however, residues 1-20 are a signal peptide that is subsequently cleaved) and has a predicted molecular weight of 8.8 kDa. Exemplary nucleic acid sequences of APOC3 are described in GenBank reference sequence number NM_000040 (human), GenBank reference sequence number NM_001289755 (mouse), GenBank reference sequence number NM_001271053 (rat), GenBank reference sequence number XM_005579730 (NHP), GenBank reference sequence number XM_001090312 (NHP), GenBank reference sequence number XM_008020977 (NHP), and GenBank reference sequence number XM_035264642 (NHP). However, those skilled in the art will understand that additional examples of APOC3 nucleic acid sequences are readily available using public databases such as GenBank and UniProt.

[0064] definition As used herein, “approximately” means a statistically meaningful range of a given value or set of values, such as concentration, length, molecular weight, pH, sequence similarity, time frame, temperature, or volume. Such values ​​or ranges are typically within 20%, more typically within 10%, and more generally within 5% of a given value or range. The permissible variation included in “approximately” depends on the system under study and is readily apparent to those skilled in the art.

[0065] As used herein, “administer,” “give administration,” and “give administration” refer to providing an individual with a substance (e.g., an oligonucleotide or composition herein) in a pharmacologically useful manner (e.g., to treat a disease, disorder, or condition of the individual).

[0066] As used herein, “antisense strand” means the oligonucleotide herein that is complementary to the region of the target sequence. Similarly, as used herein, “sense strand” means the oligonucleotide herein that is complementary to the region of the antisense strand.

[0067] As used herein, "APOC3" refers to the apolipoprotein C-III gene that encodes the very low-density lipoprotein (VLDL) protein (APOC3), which inhibits lipoprotein lipase and hepatic lipase.

[0068] As used herein, “asialoglycoprotein receptor” or “ASGPR” refers to a bipartite C-type lectin formed by a 48 kDa major subunit (ASGPR-1) and a 40 kDa minor subunit (ASGPR-2). ASGPR is primarily expressed on the sinusoidal surface of hepatocytes and plays a major role in the binding, internalization, and subsequent efflux of circulating glycoproteins (asialoglycoproteins) containing terminal galactose or GalNAc residues.

[0069] As used herein, “weakening,” “attenuation,” and “reduction” refer to reducing or effectively stopping. As a non-limiting example, one or more of the treatments herein can reduce or effectively stop the onset or progression of AH, ACD, ALD, CCA, CHD, MetS, PSC, cirrhosis, hepatic fibrosis, hepatitis, HCC, NAFLD, and NASH, as well as related diseases, disorders, and conditions in individuals such as hyperlipidemia, diabetes, and / or obesity. This attenuation means, for example, a reduction in one or more aspects of one or more aspects of the associated diseases, disorders, and conditions in an individual, such as AH, ACD, ALD, CCA, CHD, MetS, PSC, cirrhosis, hepatic fibrosis, hepatitis, HCC, NAFLD, and NASH, as well as hyperlipidemia, diabetes, and / or obesity (e.g., symptoms, tissue characteristics, and cellular, inflammatory, or immunological activity); or the absence of detectable progression (worsening) of one or more aspects of the associated diseases, disorders, and conditions in an individual, such as AH, ACD, ALD, CCA, CHD, MetS, PSC, cirrhosis, hepatic fibrosis, hepatitis, HCC, NAFLD, and NASH, as well as hyperlipidemia, diabetes, and / or obesity; or AH, ACD, ALD This may be exemplified by the failure to detect conditions that would normally be expected, such as CCA, CHD, MetS, PSC, cirrhosis, hepatic fibrosis, hepatitis, HCC, NAFLD, NASH, and related diseases, disorders, and conditions in individuals, such as hyperlipidemia, diabetes, and / or obesity.

[0070] As used herein, “attenuate,” “reduce,” and “attenuate” mean to reduce or effectively halt. In non-limiting examples, one or more of the treatments herein can reduce or effectively halt the onset or progression of dyslipidemia / hypertriglyceridemia / hyperlipidemia in an individual. This attenuation may be exemplified by a reduction where, for example, AH, ACD, ALD, CCA, CHD, MetS, PSC, cirrhosis, hepatic fibrosis, hepatitis, HCC, NAFLD, and NASH, as well as one or more aspects of related diseases, disorders, and conditions in an individual, such as hyperlipidemia, diabetes, and / or obesity (e.g., symptoms, tissue characteristics, and cellular, inflammatory, or immunological activity, etc.), would otherwise be expected.

[0071] As used herein, “complementary” means a structural relationship between two nucleotides that enables them to form base pairs with one another (for example, on two opposing nucleic acids or on opposing regions of a single nucleic acid chain). For example, a purine nucleotide of one nucleic acid that is complementary to a pyrimidine nucleotide of an opposing nucleic acid may form base pairs with one another by forming hydrogen bonds with one another. Complementary polynucleotide chains can form base pairs in the Watson-Crick configuration or in any other form that enables the formation of a stable double helix. Similarly, two nucleic acids may have regions of multiple nucleotides that form complementary regions by being complementary to one another, as described herein.

[0072] In this specification, "contact," "bringing into contact," etc., means introducing or delivering RNAi directly or indirectly into cells by promoting or carrying out uptake or absorption into cells.

[0073] As used herein, “deoxyribonucleotide” means a nucleotide that, in comparison to a ribonucleotide, has a hydrogen atom instead of a hydroxyl group at the 2' position of its pentose sugar. Modified deoxyribonucleotides have one or more modification substitutions of atoms other than the 2' position, including modifications or substitutions of nucleic acid bases, sugars, or phosphate groups.

[0074] As used herein, “double-stranded oligonucleotide” or “ds oligonucleotide” means an oligonucleotide that is substantially double-stranded. Complementary base pairing of the double-stranded region(s) of a ds oligonucleotide may occur between antiparallel sequences of nucleotides from covalently separated nucleic acid strands. Similarly, complementary base pairing of the double-stranded region(s) of a ds oligonucleotide may occur between antiparallel sequences of nucleotides from covalently bonded nucleic acid strands. Furthermore, complementary base pairing of the double-stranded region(s) of a ds oligonucleotide may occur from a single nucleic acid strand that folds (e.g., via a hairpin) and provides a complementary antiparallel sequence of nucleotides that form base pairs together. A ds oligonucleotide may comprise two covalently separated nucleic acid strands that are completely double-stranded. However, a ds oligonucleotide may comprise two covalently separated nucleic acid strands that are partially double-stranded (e.g., having protrusions at one or both ends). ds oligonucleotides may contain antiparallel sequences of partially complementary nucleotides and therefore may have one or more mismatches, including internal or terminal mismatches.

[0075] As used herein, “double helix” in relation to nucleic acids (e.g., oligonucleotides) means a structure formed by complementary base pairing of two antiparallel sequences of nucleotides.

[0076] As used herein, “excipient” means, for example, a non-therapeutic agent that can be included in the compositions herein to provide or contribute to a desired consistency or stabilizing effect.

[0077] As used herein, “hepatocytes” or “multiple hepatocytes” means cells of the parenchymal tissue of the liver. These cells constitute approximately 70%–85% of the liver’s mass and produce serum albumin, fibronectin (FBN), and the prothrombin group of coagulation factors (excluding factors 3 and 4). Markers of hepatocyte lineage cells include, but are not limited to, transthyretin (Ttr), glutamine synthase (GluI), hepatocyte nuclear factor 1a (Hnf1a), and hepatocyte nuclear factor 4a (Hnf4a). Markers of mature hepatocytes include, but are not limited to, cytochrome P450 (Cyp3a11), fumarylacetoacetate hydrolase (Fah), glucose 6-phosphate (G6p), albumin (Alb), and OC2-2F8. See, for example, Huch et al. (2013) Nature 494:247–50.

[0078] As used herein, “hepatotoxic agent” means a compound, virus, or other substance that is toxic to the liver in itself or can be processed to form metabolites that are toxic to the liver. Examples of hepatotoxic agents include, but are not limited to, carbon tetrachloride (CCl4), acetaminophen (paracetamol), vinyl chloride, arsenic, chloroform, and nonsteroidal anti-inflammatory drugs (such as aspirin and phenylbutazone).

[0079] As used herein, “unstable linker” means a linker that can be cleaved (for example, by an acidic pH). Similarly, “fairly stable linker” means a linker that cannot be cleaved.

[0080] As used herein, “inflammation of the liver” or “hepatitis” means a physical condition resulting in swelling, dysfunction, and / or pain of the liver, particularly due to injury or infection, such as that which may be caused by exposure to hepatotoxic substances. Symptoms may include jaundice, fatigue, weakness, nausea, vomiting, loss of appetite, and weight loss. If left untreated, inflammation of the liver may progress to fibrosis, cirrhosis, liver failure, or liver cancer.

[0081] As used herein, “hepatic fibrosis,” “hepatic fibrosis,” or “fibrosis of the liver” refers to the excessive accumulation in the liver of extracellular matrix proteins, which may include collagen (I, III, and IV), FBN, undulin, elastin, laminin, hyaluronan, nephrite, and proteoglycans, resulting from inflammation and hepatocyte death. If left untreated, hepatic fibrosis can progress to cirrhosis, liver failure, or liver cancer.

[0082] As used herein, “loop” means an unpaired region of a nucleic acid (e.g., oligonucleotide) flanked by two sufficiently complementary antiparallel regions of nucleic acids, where, under appropriate hybridization conditions (e.g., in a phosphate buffer solution, intracellularly), the two antiparallel regions flanking the unpaired region hybridize to form a double helix (called a “stem”).

[0083] As used herein, “modified nucleotide bond” means a nucleotide bond having one or more chemical modifications compared to a reference nucleotide bond having a phosphodiester bond. The modified nucleotide may be a bond that does not exist in nature. Typically, a modified nucleotide bond confers one or more desirable properties to the nucleic acid in which it is present. For example, a modified nucleotide can improve thermal stability, resistance to degradation, nuclease resistance, solubility, bioavailability, biological activity, or immunogenicity.

[0084] As used herein, “modified nucleotide” means a nucleotide having one or more chemical modifications when compared to a corresponding reference nucleotide selected from adenine ribonucleotide, guanine ribonucleotide, cytosine ribonucleotide, uracil ribonucleotide, adenine deoxyribonucleotide, guanine deoxyribonucleotide, cytosine deoxyribonucleotide, and thymidine deoxyribonucleotide. Modified nucleotides may be nucleotides that do not exist in nature. For example, a modified nucleotide may have one or more chemical modifications to its sugar, nucleic acid base, and / or phosphate group. Additionally or alternatively, a modified nucleotide may have one or more chemical moieties conjugated to the corresponding reference nucleotide. Typically, a modified nucleotide confers one or more desirable properties to the nucleic acid in which it exists. For example, a modified nucleotide can improve thermal stability, resistance to degradation, nuclease resistance, solubility, bioavailability, biological activity, and reduced immunogenicity.

[0085] As used herein, “nic tetraloop structure” means an RNAi oligonucleotide structure characterized by separate sense and antisense strands, wherein the sense (passenger) strand has a region complementary to the antisense (guide) strand, and generally, at least one of the strands that is the sense strand has a tetraloop configured to stabilize an adjacent stem region formed within at least one of the strands.

[0086] As used herein, “nucleotide” means an organic molecule having a nucleoside (for example, a nucleic acid base such as adenine, cytosine, guanine, thymine, or uracil, and a pentose sugar such as ribose or 2'-deoxyribose, and a phosphate group, which can function as a monomer unit of nucleic acid polymers such as deoxyribonucleic acid (DNA) and ribonucleic acid (RNA)).

[0087] As used herein, “oligonucleotide” means a short nucleic acid molecule (for example, one less than 100 oligonucleotides in length). Oligonucleotides may be single-stranded (ss) or ds. Oligonucleotides may or may not have a double-stranded region. A range of non-limiting examples of oligonucleotides include, but are not limited to, small interfering RNA (siRNA), microRNA (miRNA), short hairpin RNA (shRNA), dicer substrate interfering RNA (dsiRNA), antisense oligonucleotide (ASO), short siRNA, or ss siRNA. Typically, ds oligonucleotides are RNAi oligonucleotides.

[0088] As used herein, “extension” means a terminal unpaired nucleotide(s) resulting from the extension of one strand or region beyond the end of the complementary strand with which that strand or region forms a double helix. An extension may include one or more unpaired nucleotides extending from the double helix region at the 5' or 3' end of a ds oligonucleotide. An extension may be a 3' or 5' extension on the antisense or sense strand of a ds oligonucleotide.

[0089] As used herein, “phosphate analog” means a chemical moiety that mimics the electrostatic and / or steric properties of a phosphate group. In some embodiments, the phosphate analog is located at the 5' terminal nucleotide of an oligonucleotide in place of the 5'-phosphate, which is often susceptible to enzymatic removal. The 5'-phosphate analog may include a phosphatase-resistant binding. Preferred phosphate analogs include, but are not limited to, 5'-phosphonates such as 5'-methylenephosphonate (5'-MP) and 5'-(E)-vinylphosphonate (5'-VP). Oligonucleotides may have a phosphate analog (referred to as a 4'-phosphate analog) at the 4' position of the sugar at the 5' terminal nucleotide. An example of a 4'-phosphate analog is oxymethylphosphonate or its analog, in which the oxygen atom of the oxymethyl group is bonded to the sugar moiety (e.g., its 4'-carbon). See, for example, International Patent Application Publication WO2018 / 045317. Other modifications to the 5' end of oligonucleotides have been developed (see, for example, International Patent Application WO2011 / 133871; U.S. Patent No. 8,927,513; and Prakash et al. (2015) Nucleic Acids Res. 43:2993-3011).

[0090] As used herein, “APOC3-related disease,” “APOC3-related disorder,” or “APOC3-related condition” means a condition characterized by increased APOC3 expression and / or the presence of, for example, APOC3 polymorphisms. Exemplary APOC3-related conditions, diseases, or disorders include, but are not limited to, AH, ACD, ALD, CCA, CHD, MetS, PSC, cirrhosis, hepatic fibrosis, hepatitis, HCC, NAFLD, and NASH, as well as related diseases, disorders, and conditions in individuals such as hyperlipidemia, diabetes, and / or obesity.

[0091] As used herein, “reduced expression” and, with respect to a gene (e.g., APOC3), “reduced expression” means a reduction in the amount or level of the RNA transcript (e.g., APOC3 mRNA) or protein encoded by that gene, and / or a reduction in the amount or level of the gene’s activity, in a cell, cell population, sample, or subject compared to a suitable reference (e.g., a reference cell, cell population, sample, or subject). For example, contacting cells with an oligonucleotide as defined herein (e.g., an oligonucleotide having an antisense strand with a nucleotide sequence complementary to the nucleotide sequence containing APOC3 mRNA) may result in a reduction in the amount or level of mRNA, protein, and / or activity (e.g., due to degradation of APOC3 mRNA via the RNAi pathway) compared to cells not treated with the ds oligonucleotide. Similarly, as used herein, “reducing expression” means an action that results in a decrease in the expression of a gene (e.g., APOC3). Specifically, as used herein, “reduction in APOC3 expression” means a decrease in the amount or level of APOC3 mRNA, APOC3 protein, and / or APOC3 activity in a cell, cell population, sample, or individual compared to a suitable reference (e.g., a reference cell, cell population, tissue, or individual).

[0092] As used herein, “complementary region” means a sequence of nucleic acid nucleotides (e.g., ds oligonucleotides) that is sufficiently complementary to the antiparallel sequence of nucleotides, thereby enabling hybridization between the sequences of two nucleotides under appropriate hybridization conditions (e.g., in phosphate buffer, intracellularly, etc.). The oligonucleotides herein include a targeting sequence having a region complementary to the mRNA target sequence.

[0093] As used herein, "ribonucleotide" means a nucleotide having ribose, which has a hydroxyl group at the 2' position, as its pentose sugar. A modified ribonucleotide is a ribonucleotide having one or more modification substitutions of atoms other than the 2' position, including modifications or substitutions of nucleic acid bases, sugars, or phosphate groups.

[0094] As used herein, “RNAi oligonucleotide” means either (a) a ds oligonucleotide having a sense strand (passenger) and an antisense strand (guide), wherein the antisense strand or a portion of the antisense strand is used to cleave target mRNA by Argonaut 2 (Ago2) endonuclease, or (b) an ss oligonucleotide having a single-stranded antisense strand, wherein the antisense strand (or a portion of the antisense strand) is used to cleave target mRNA by Ago2 endonuclease.

[0095] As used herein, “chain” refers to a single, continuous sequence of nucleotides linked together by internucleotide bonds (e.g., phosphodiester bonds, phosphorothioate bonds). A chain has two free ends (e.g., a 5' end and a 3' end).

[0096] As used herein, “individual” means any mammal, including cats, dogs, mice, rats, and primates, especially humans. “Subject” or “patient” may be used interchangeably with “individual.”

[0097] As used herein, “synthetic” means a nucleic acid or other molecule that is artificially synthesized (for example, using a machine, such as a solid-phase nucleic acid synthesizer) or does not originate from a natural source that normally produces nucleic acids or other molecules (for example, a cell or organism).

[0098] As used herein, “targeting ligand” means a molecule (e.g., amino sugars, carbohydrates, cholesterol, lipids, or polypeptides) that selectively binds to a homologous molecule (e.g., a receptor) of a tissue or cell of interest and is conjugable to another substance for targeting that substance to the tissue or cell of interest. For example, a targeting ligand can be conjugated to an oligonucleotide as herein for the purpose of targeting the oligonucleotide to a specific tissue or cell of interest. The targeting ligand can selectively bind to a cell surface receptor. Therefore, when conjugated to an oligonucleotide, the targeting ligand facilitates the delivery of the oligonucleotide to a specific cell via selective binding to a receptor expressed on the cell surface and endosomal internalization by the cell of the complex containing the oligonucleotide, targeting ligand, and receptor. Furthermore, the targeting ligand can be conjugated to the oligonucleotide via a linker that is cleaved after intracellular migration or during intracellular internalization so that the oligonucleotide is released from the targeting ligand within the cell.

[0099] As used herein, “tetraloop” means a loop that increases the stability of adjacent stem double helices formed by the hybridization of adjacent nucleotide sequences. The increase in stability is the T of adjacent stem double helices expected from a set of equally lengthed loops consisting of randomly selected nucleotide sequences. m The melting temperature of adjacent stem double chains is higher than (T m This can be detected as an increase in ) for example, a tetraloop is a hairpin containing a double helix of at least two base pairs in 10 mM NaHPO4 at at least 50°C, at least 55°C, at least 56°C, at least 58°C, at least 60°C, at least 65°C, or at least 75°C. mThis can result in the following. Tetraloops can also stabilize the bp of adjacent stem double helixes through stacking interactions. Furthermore, interactions between nucleotides within a tetraloop include, but are not limited to, non-Watson-Crick base pairing, stacking interactions, hydrogen bonding, and contact interactions (Cheong et al. (1990) Nature 346:680-82; Heus & Pardi (1991) Science 253:191-94). Here, a tetraloop contains or can have approximately 3 to 6 nucleotides, typically about 4 to 5. Thus, a tetraloop can have 3, 4, 5, or 6 nucleotides, particularly 4 nucleotides, which may or may not be modified (e.g., conjugated to the targeting moiety). Any nucleotide can be used in a tetraloop, and the standard IUPAC-IUB symbols for such nucleotides can be used, as described in Cornish-Bowden (1985) Nucleic Acids Res. 13:3021-30. For example, the letter "N" can be used to indicate that any base can be in that position, the letter "R" can be used to indicate that A (adenine) or G (guanine) can be in that position, and "B" can be used to indicate that C (cytosine), G (guanine), or T (thymine) can be in that position. Examples of tetraloops include the tetraloops of the UNCG family (e.g., UUCG), the tetraloops of the GNRA family (e.g., GAAA), and the CUUG tetraloop (Woese et al. (1990) Proc. Natl. Acad. Sci. USA 87:8467-71; Antao et al. (1991) Nucleic Acids Res. 19:5901-05). Examples of DNA tetraloops include tetraloops of the d(GNNA) family (e.g., d(GTTA)), tetraloops of the d(GNRA) family, tetraloops of the d(GNAB) family, tetraloops of the d(CNNG) family, and tetraloops of the d(TNCG) family (e.g., d(TTCG)).See, for example, Nakano et al. (2002) Biochem. 41:4281-92; and Shinji et al. (2000) Nippon Kagakkai Koen Yokoshu 78:731. Here, the tetraloop is contained within a tetraloop structure having a nick.

[0100] As used herein, “to treat” or “to treat” means the act of providing care to an individual in need of care by administering a therapeutic agent (e.g., oligonucleotides as herein) to the individual for the purpose of improving the individual’s health condition, for example, for the purpose of improving health and / or with respect to an existing condition (e.g., disease, disorder), or to prevent or reduce the likelihood of the condition occurring. Treating may also include reducing the frequency or severity of at least one sign, symptom, or contributing factor of a condition (e.g., disease, disorder) experienced by the individual.

[0101] As used herein, "iRNA," "iRNA agent," "RNAi," "RNAi agent," and "RNA interferant" mean agents containing RNA that mediate targeted cleavage of RNA-containing transcripts via the RNA-induced silencing complex (RISC) pathway. RNAi induces sequence-specific degradation of mRNA through RNA interference. RNAi modulates, inhibits, or reduces intracellular APOC3 expression.

[0102] composition In some embodiments, the disclosure provides oligonucleotides (e.g., ds RNAi oligonucleotides) that reduce, regulate, or inhibit APOC3 expression in the liver. In some embodiments, the oligonucleotides provided herein are used to treat diseases associated with APOC3 expression. In some embodiments, the disclosure provides a method for treating diseases associated with APOC3 expression by reducing, regulating, or inhibiting APOC3 expression in the liver (e.g., cells constituting the liver).

[0103] Oligonucleotide inhibitors of APOC3 expression

[0104] I. APOC3 Target Sequence: The oligonucleotides described herein (e.g., RNAi oligonucleotides) target a target sequence containing APOC3 mRNA (i.e., an APOC3 target sequence). In some embodiments, the oligonucleotide or a portion, fragment, or chain thereof (e.g., the antisense or guide strand of a ds RNAi oligonucleotide) binds to or anneals to the APOC3 target sequence, thereby inhibiting APOC3 expression. In some embodiments, the oligonucleotide targets the APOC3 target sequence to inhibit APOC3 expression in vivo. In some embodiments, the amount or degree of APOC3 expression inhibition by an oligonucleotide targeting the APOC3 target sequence correlates with the potency of the oligonucleotide. In some embodiments, the amount or degree of APOC3 expression inhibition by an oligonucleotide targeting the APOC3 target sequence correlates with the amount or degree of therapeutic effect in an individual having or suspected of having a disease, disorder, or condition associated with APOC3 expression treated with the oligonucleotide.

[0105] By investigating and analyzing the nucleotide sequences of APOC3 mRNA, including mRNA from multiple different species (e.g., humans and cynomolgus monkeys; see, e.g., Example 1), and by the results of in vitro and in vivo tests (e.g., see, Examples 2-3), it is shown herein that certain nucleotide sequences of APOC3 mRNA are more readily adapted to oligonucleotide-based inhibition of APOC3 expression than other nucleotide sequences, and are therefore useful as target sequences for the oligonucleotides herein. In some embodiments, the sense strand of the oligonucleotide described herein (e.g., Table 2 or 3) (e.g., ds RNAi oligonucleotide) contains the APOC3 target sequence. In some embodiments, a portion or region of the sense strand of the oligonucleotide described herein (e.g., Table 2 or 3) contains the APOC3 target sequence. In some embodiments, the APOC3 target sequence contains or consists of one of the sequences of SEQ ID NOs: 334-341.

[0106] II. APOC3 mRNA Targeting Sequences: In some embodiments, the oligonucleotides herein have a complementary region to APOC3 mRNA (e.g., within the APOC3 mRNA targeting sequence) in order to target APOC3 mRNA in a cell and inhibit APOC3 expression. In some embodiments, the oligonucleotides herein include an APOC3 targeting sequence (e.g., the antisense or guide strand of the ds oligonucleotide) having a complementary region that binds to or anneals to the APOC3 mRNA targeting sequence by complementary (Watson-Crick) base pairing. The complementary region is of an appropriate length and base content that allows the oligonucleotide (or its chain) to bind to or anneal to APOC3 mRNA in order to inhibit APOC3 mRNA expression. In some embodiments, the targeting sequence or complementary region is at least about 12, at least about 13, at least about 14, at least about 15, at least about 16, at least about 17, at least about 18, at least about 19, at least about 20, at least about 21, at least about 22, at least about 23, at least about 24, at least about 25, at least about 26, at least about 27, at least about 28, at least about 29, or at least about 30 nucleotides in length. Alternatively, the targeting sequence or complementary region is at least about 12–30 nucleotides in length (e.g., 12–30, 12–22, 15–25, 17–21, 18–27, 19–27, or 15–30). Alternatively, the targeting sequence or complementary region is approximately 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides long. In certain embodiments, the targeting sequence or complementary region is 18 nucleotides long. In certain embodiments, the targeting sequence or complementary region is 19 nucleotides long. In certain embodiments, the targeting sequence or complementary region is 20 nucleotides long. In certain embodiments, the targeting sequence or complementary region is 21 nucleotides long.In certain embodiments, the targeting sequence or complementary region is 22 nucleotides long. In certain embodiments, the targeting sequence or complementary region is 23 nucleotides long. In certain embodiments, the targeting sequence or complementary region is 24 nucleotides long.

[0107] In some embodiments, the oligonucleotides herein include a targeting sequence or complementary region (e.g., an antisense or guide chain of the ds oligonucleotide) that is fully complementary to the AOC3 target sequence. In some embodiments, the targeting sequence or complementary region is partially complementary to the APOC3 target sequence. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region that is fully complementary to any one of the sequences of SEQ ID NOs. 334-341. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region that is partially complementary to any one of the sequences of SEQ ID NOs. 334-341.

[0108] Alternatively, in some embodiments, the oligonucleotides herein comprise a targeting sequence or complementary region complementary to a sequence of nucleotides containing the mRNA of APOC3, the sequence of nucleotides being approximately 12 to approximately 30 nucleotides in length (e.g., 12 to 30, 12 to 28, 12 to 26, 12 to 24, 12 to 20, 12 to 18, 12 to 16, 14 to 22, 16 to 20, 18 to 20, or 18 to 19 nucleotides in length). In some embodiments, the oligonucleotides comprise a targeting sequence or complementary region complementary to a sequence of nucleotides containing the mRNA of APOC3, the sequence of nucleotides being approximately 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 nucleotides in length. In some embodiments, the oligonucleotide comprises a targeting sequence or complementary region complementary to a sequence of nucleotides containing the mRNA of APOC3, with the sequence of nucleotides being 19 nucleotides long. In some embodiments, the oligonucleotide comprises a targeting sequence or complementary region complementary to a sequence of nucleotides containing the mRNA of APOC3, with the sequence of nucleotides being 20 nucleotides long. In other embodiments, the oligonucleotide comprises a targeting sequence or complementary region complementary to a sequence of nucleotides of any one of sequence numbers 334-341, with the sequence of nucleotides being 19 nucleotides long (optional).

[0109] With respect to the targeting sequence or complementary region of the oligonucleotides herein, it is complementary to a sequence of nucleotides of the sequence shown in any one of SEQ ID NOs. 334-341 and extends over the entire length of the antisense strand. In some embodiments, the complementary region of the oligonucleotide is complementary to a sequence of nucleotides of the sequence shown in any one of SEQ ID NOs. 334-341 and extends over a portion of the entire length of the antisense strand. In some further embodiments, the oligonucleotide includes a complementary region (e.g., on the antisense strand of the ds oligonucleotide) that is at least partially (e.g., fully) complementary to a sequence of nucleotides of the sequence shown in any one of SEQ ID NOs. 334-341, such as nucleotides 1-20, 1-19, 1-18, etc.

[0110] Alternatively, the oligonucleotides herein include a targeting sequence or complementary region having one or more base pair (bp) mismatches with the corresponding APOC3 target sequence. In some embodiments, the targeting sequence or complementary region has a mismatch of up to approximately 1, up to approximately 2, up to approximately 3, up to approximately 4, up to approximately 5, etc., with respect to the ability of the targeting sequence or complementary region to bind to or anneal to APOC3 mRNA under appropriate hybridization conditions, and / or the ability of the oligonucleotide to reduce or inhibit APOC3 expression. In other words, the targeting sequence or complementary region has a mismatch of one or fewer, two or fewer, three or fewer, four or five or fewer, with respect to the corresponding APOC3 target sequence, provided that the ability of the targeting sequence or complementary region to bind to or anneal to APOC3 mRNA under appropriate hybridization conditions, and / or the ability of the oligonucleotide to reduce or inhibit APOC3 expression. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region having one mismatch with the corresponding target sequence. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region having two mismatches with the corresponding target sequence. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region having three mismatches with the corresponding target sequence. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region having four mismatches with the corresponding target sequence. In some embodiments, the oligonucleotide includes a targeting sequence or complementary region having five mismatches with the corresponding target sequence. In other embodiments, the oligonucleotide includes a targeting sequence or complementary region with one or more mismatches (e.g., two, three, four, five or more mismatches) with the corresponding target sequence, where at least two (e.g., all) mismatches are contiguous (e.g., two, three, four, five or more consecutive mismatches), or the mismatches are scattered at any position throughout the targeting sequence or complementary region.In other embodiments, the oligonucleotide comprises a target sequence or complementary region with one or more mismatches (e.g., two, three, four, five or more mismatches) with the corresponding target sequence, where at least two (e.g., all) mismatches are located consecutively (e.g., two, three, four, five or more consecutive mismatches), or at least one non-mismatched bp is located between the mismatches, or a combination thereof.

[0111] III. Types of Oligonucleotides: A variety of oligonucleotide types and / or structures, including but not limited to RNAi oligonucleotides, antisense oligonucleotides, and miRNAs, are useful for targeting APOC3 mRNA. Any oligonucleotide types described herein or elsewhere are intended to be used as a framework for incorporating targeting sequences herein for the purpose of inhibiting APOC3 expression. In some embodiments, the oligonucleotides herein inhibit APOC3 expression by engaging in the RNAi pathway upstream or downstream of dicer involvement. For example, RNAi oligonucleotides have been developed with each strand having a size of 19 to 25 nucleotides and at least one 1 to 5 nucleotide 3' overhang (see, e.g., U.S. Patent No. 8,372,968). Longer oligonucleotides have also been developed that are processed by dicers to produce active RNAi products (see, e.g., U.S. Patent No. 8,883,996). Further research has led to the creation of extended ds oligonucleotides in which at least one end of at least one chain extends beyond the targeting region of the double helix, including structures in which one chain has a thermodynamically stable tetraloop structure (see, for example, U.S. Patents 8,513,207 and 8,927,705, and International Patent Application Publication WO2010 / 033225). Such structures include ss extensions (on one or both sides of the molecule) and ds extensions.

[0112] The oligonucleotides described herein are involved in the RNAi pathway downstream of dicer involvement (e.g., dicer cleavage). In some embodiments, the oligonucleotides have a protrusion (e.g., 1, 2, or 3 nucleotides long) at the 3' end of the sense strand. In some embodiments, the oligonucleotide (e.g., siRNA) comprises a 21-nucleotide antisense strand that is antisense to a target mRNA (e.g., the mRNA of APOC3) and a complementary sense strand, both strands annealing to form a 19 bp double helix with 2 nucleotide protrusions at one or both 3' ends. The design of longer oligonucleotides has also been contemplated, including oligonucleotides having a 23-nucleotide antisense strand and a 21-nucleotide sense strand, with a blunt end on the right side of the molecule (3' end of the sense strand / 5' end of the antisense strand) and a 2-nucleotide 3' antisense strand protrusion on the left side of the molecule (5' end of the sense strand / 3' end of the antisense strand). Such molecules have a 21 bp double helix region. See, for example, U.S. Patent Nos. 9,012,138; 9,012,621; and 9,193,753.

[0113] The oligonucleotides described herein comprise a sense strand and an antisense strand, both having lengths in the range of approximately 17 to approximately 26 nucleotides (e.g., 17 to 26, 20 to 25, or 21 to 23). In some embodiments, the oligonucleotide comprises a sense strand and an antisense strand, both having lengths in the range of approximately 19 to approximately 22 nucleotides. In some embodiments, the sense strand and the antisense strand are of equal length. In some embodiments, the oligonucleotide comprises a sense strand and an antisense strand, with a 3' overhang present on either the sense strand or the antisense strand, or on both the sense strand and the antisense strand. In some embodiments, for oligonucleotides having a sense strand and an antisense strand, both having lengths in the range of approximately 21 to approximately 23 nucleotides, the 3' overhang on the sense strand, the antisense strand, or on both the sense strand and the antisense strand is the length of one or two nucleotides. In some embodiments, the oligonucleotide has an antisense strand of 22 nucleotides and a sense strand of 20 nucleotides, with a blunt end on the right side of the molecule (3' end of the sense strand / 5' end of the antisense strand) and a 3' antisense strand overhang of 2 nucleotides on the left side of the molecule (5' end of the sense strand / 3' end of the antisense strand). Such a molecule has a 20 bp double-stranded region.

[0114] Other oligonucleotide designs for use herein include 16-mer siRNA (see, e.g., “Nucleic Acids in Chemistry & Biology,”, Blackburn (ed.), Royal Society of Chemistry, 2006), shRNA (e.g., those with stems of 19 bp or shorter; see, e.g., Moore et al. (2010) Methods Mol. Biol. 629:141-58), blunt siRNA (e.g., those 19 bp in length; see, e.g., Kraynack & Baker (2006) RNA 12:163-76), asymmetric siRNA (aiRNA; see, e.g., Sun et al. (2008) Nat. Biotechnol. 26:1379-82), and asymmetric short double-stranded siRNA (e.g., Chang et al. Examples include al. (2009) Mol.Ther. 17:725-32), fork siRNA (see, for example, Hohjoh (2004) FEBS Lett. 557:193-98), ss siRNA (see, for example, Elsner (2012) Nat. Biotechnol. 30:1063), dumbbell-shaped circular siRNA (see, for example, Abe et al. (2007) J.Am. Chem. Soc. 129:15108-09), and small internal segmentation interfering RNA (sisiRNA; see, for example, Bramsen et al. (2007) Nucleic Acids Res. 35:5886-97). Further non-limiting examples of oligonucleotide structures that can be used herein to reduce or inhibit APOC3 expression include miRNAs, shRNAs, and short siRNAs (see, for example, Hamilton et al. (2002) EMBO J.21:4671-79; also see U.S. Patent No. 7,659,389).

[0115] Alternatively, the oligonucleotides used herein are ss. Such structures include, but are not limited to, ss RNAi molecules. Recent efforts have demonstrated the activity of ss RNAi molecules (see, e.g., Matsui et al. (2016) Mol.Ther. 24:946-55). In some embodiments, the oligonucleotide is an ASO. An ASO is an ss oligonucleotide having a nucleic acid base sequence that has been appropriately modified (e.g., as a gapmer) to induce RNaseH-mediated cleavage of its target RNA in a cell, or (e.g., as a mixmer) to inhibit translation of the target mRNA in a cell. ASOs for use herein are modified in any suitable manner well known in the art, including, for example, those shown in U.S. Patent No. 9,567,587 (e.g., including modifications of nucleic acid base length, sugar moieties (pyrimidines, purines), and heterocyclic moieties of nucleic acid bases). Furthermore, ASOs have been used for decades to reduce the expression of specific target genes (see, for example, Bennett et al. (2017) Annu. Rev. Pharmacol. 57:81-105).

[0116] IV. ds RNAi oligonucleotides: ds oligonucleotides for targeting APOC3 mRNA and inhibiting APOC3 expression (e.g., via the RNAi pathway) comprise a sense strand (i.e., a passenger strand) and an antisense strand (i.e., a guide strand). In some embodiments, the antisense strand and the sense strand are separate strands and are not covalently bonded. In some embodiments, the antisense strand and the sense strand are covalently bonded.

[0117] In some embodiments, the sense strand comprises a first region (R1) and a second region (R2), where R2 comprises a first subregion (S1), triL or L, and a second subregion (S2), where triL or L is located between S1 and S2, and S1 and S2 form a second double helix (D2). D2 can have various lengths. In some embodiments, D2 is about 1 to about 6 bp long. In other embodiments, D2 is 2 to 6, 3 to 6, 4 to 6, 5 to 6, 1 to 5, 2 to 5, 3 to 5, or 4 to 5 bp long. In other embodiments, D2 is 1, 2, 3, 4, 5, or 6 bp long. In certain embodiments, D2 is 6 bp long.

[0118] In some embodiments, the sense strand R1 and the antisense strand form a first double helix (D1). In some embodiments, D1 has a length of at least 15 nucleotides (e.g., at least 15, at least 16, at least 17, at least 18, at least 19, at least 20, or at least 21). In other embodiments, D1 has a length of about 12 to about 30 nucleotides (e.g., 12 to 30, 12 to 27, 15 to 22, 18 to 22, 18 to 25, 18 to 27, 18 to 30, or 21 to 30 nucleotides). In other embodiments, D1 has a length of at least 12 nucleotides (e.g., at least 12, at least 15, at least 20, at least 25, or at least 30 nucleotides). In other embodiments, D1 is the length of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides. In some embodiments, D1 is the length of 20 nucleotides. In some embodiments, D1 does not extend the entire length of the sense strand and / or antisense strand. In other embodiments, D1 extends the entire length of either the sense strand or the antisense strand, or both. In some embodiments, D1 extends the entire length of both the sense strand and the antisense strand.

[0119] In certain embodiments, the disclosure describes RNAi oligonucleotides for reducing or inhibiting APOC3 expression, comprising a sense strand having (including or consisting of) the sequences shown in Table 2 (e.g., any one of the odd numbers from SEQ ID NOs. 9 to 170), particularly SEQ ID NOs. 37, 43, 45, 87, 89, 99, 101, and 105.

[0120] In certain embodiments, the disclosure describes RNAi oligonucleotides for reducing or inhibiting APOC3 expression, comprising an antisense strand having (including or consisting of) the sequences shown in Table 2 (e.g., any even number from SEQ ID NOs. 9 to 170), particularly SEQ ID NOs. 38, 44, 46, 88, 90, 100, 102, and 106.

[0121] In certain other embodiments, the RNAi oligonucleotide comprises a sense strand having (including or consisting of) one nucleotide sequence of SEQ ID NOs: 37, 43, 45, 87, 89, 99, 101, and 105, and an antisense strand having (including or consisting of) one nucleotide sequence of SEQ ID NOs: 38, 44, 46, 88, 90, 100, 102, and 106.

[0122] In certain embodiments, the RNAi oligonucleotide comprises a sense strand having (including or consisting of) one nucleotide sequence of sequence numbers 37, 89, and 101, and an antisense strand having (including or consisting of) one nucleotide sequence of sequence numbers 38, 90, and 102.

[0123] In certain embodiments, the sense strand and antisense strand of the RNAi oligonucleotide are selected from the following, respectively: (a) Sequence IDs 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106.

[0124] In some embodiments, the RNAi oligonucleotide includes a sense strand having (including or consisting of) the nucleotide sequences shown in Table 3 (e.g., any of the odd numbers of SEQ ID NOs. 171-332), particularly SEQ ID NOs. 199, 205, 207, 249, 251, 261, 263, and 267.

[0125] In certain embodiments, the RNAi oligonucleotide comprises an antisense strand having (including or consisting of) the nucleotide sequences shown in Table 3 (e.g., any even number from SEQ ID NOs. 171 to 332), particularly SEQ ID NOs. 200, 206, 208, 250, 252, 262, 264, and 268.

[0126] In certain other embodiments, the RNAi oligonucleotide comprises a sense strand having (including or consisting of) one nucleotide sequence of SEQ ID NOs: 199, 205, 207, 249, 251, 261, 263, and 267, and an antisense strand having (including or consisting of) one nucleotide sequence of SEQ ID NOs: 200, 206, 208, 250, 252, 262, 264, and 268.

[0127] In certain embodiments, the RNAi oligonucleotide comprises a sense strand having (including or consisting of) one nucleotide sequence of SEQ ID NOs: 199, 251, and 263, and an antisense strand having (including or consisting of) one nucleotide sequence of SEQ ID NOs: 200, 252, and 264.

[0128] In certain embodiments, the sense strand and antisense strand of the RNAi oligonucleotide are selected from the following, respectively: (a) Sequence IDs 199 and 200, (b) Sequence IDs 205 and 206, (c) Sequence IDs 207 and 208, (d) Sequence IDs 249 and 250, (e) Sequence numbers 251 and 252, (f) Sequence numbers 261 and 262, (g) Sequence IDs 263 and 264, and (h) Sequences 267 and 268.

[0129] Those skilled in the art will understand that in some embodiments, when describing the structure of an oligonucleotide (e.g., a ds oligonucleotide) or other nucleic acid, a sequence listed in a sequence listing is referenced. In such embodiments, the actual oligonucleotide or other nucleic acid has one or more alternative nucleotides (e.g., an RNA counterpart to a DNA nucleotide or a DNA counterpart to an RNA nucleotide) and / or one or more modified nucleotides and / or one or more modified nucleotide interbonds and / or one or more other modifications compared to the identified sequence, while retaining essentially the same or similar complementary properties as the identified sequence.

[0130] In some embodiments, the ds oligonucleotides herein include a sense strand of 25 nucleotides and an antisense strand of 27 nucleotides that, upon action by the Dicer enzyme, is incorporated into the mature RISC. In other embodiments, the sense strand of the ds oligonucleotide is longer than 25 nucleotides (e.g., 26, 27, 28, 29, or 30 nucleotides). In other embodiments, the sense strand of the ds oligonucleotide is longer than 27 nucleotides (e.g., 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, or 40 nucleotides).

[0131] In some embodiments, the ds oligonucleotides herein have one 5' end that is thermodynamically unstable compared to the other 5' end. In some embodiments, the ds oligonucleotides are asymmetric, with a blunt end at the 3' end of the sense strand and a 3' overhang at the 3' end of the antisense strand. In some embodiments, the 3' overhang on the antisense strand is about 1 to about 8 nucleotides long (e.g., 1, 2, 3, 4, 5, 6, 7, or 8 nucleotides long). Typically, ds oligonucleotides for RNAi have a 2-nucleotide overhang at the 3' end of the antisense (guide) strand. However, other overhangs are also possible. In some embodiments, the protrusion is a 3' protrusion having a length of approximately 1 to approximately 6 nucleotides, optionally 1 to 5, 1 to 4, 1 to 3, 1 to 2, 2 to 6, 2 to 5, 2 to 4, 2 to 3, 3 to 6, 3 to 5, 3 to 4, 4 to 6, 4 to 5, or 5 to 6 nucleotides, or 1, 2, 3, 4, 5, or 6 nucleotides. However, in other embodiments, the protrusion is a 5' protrusion having a length of approximately 1 to approximately 6 nucleotides, optionally 1 to 5, 1 to 4, 1 to 3, 1 to 2, 2 to 6, 2 to 5, 2 to 4, 2 to 3, 3 to 6, 3 to 5, 3 to 4, 4 to 6, 4 to 5, or 5 to 6 nucleotides.

[0132] In some embodiments, the two terminal nucleotides at the 3' end of the antisense strand are modified. In some embodiments, the two terminal nucleotides at the 3' end of the antisense strand are complementary to the target mRNA (e.g., the mRNA of APOC3). In other embodiments, the two terminal nucleotides at the 3' end of the antisense strand are not complementary to the target mRNA. In some embodiments, the two terminal nucleotides at the 3' end of each oligonucleotide in a nicked tetraloop structure are GG. Typically, one or both of the two terminal GG nucleotides at the 3' end of each ds oligonucleotide are not complementary to the target mRNA.

[0133] In some embodiments, there are one or more (e.g., one, two, three, four, or five) mismatches between the sense strand and the antisense strand. If there are more than one mismatch between the sense strand and the antisense strand, they may be arranged consecutively (e.g., two, three, or more consecutively) or scattered throughout the complementary region. In some embodiments, the 3' end of the sense strand contains one or more mismatches. In certain embodiments, two mismatches are incorporated into the 3' end of the sense strand. In some embodiments, base mismatches or destabilization of the segment at the 3' end of the sense strand of the oligonucleotide improves or increases the potency of the ds oligonucleotide.

[0134] A. Sense strand: The oligonucleotides of this specification (e.g., ds oligonucleotides) for targeting APOC3 mRNA and inhibiting APOC3 expression include sense strand sequences containing the sequences shown in Table 2 or Table 3. In some embodiments, the oligonucleotides include a sense strand having at least about 12 consecutive nucleotides (e.g., at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, at least 20, at least 21, at least 22, or at least 23) of the sequence shown in any one of SEQ ID NOs: 37, 43, 45, 87, 89, 99, 101, and 105, or a sense strand having any one nucleotide sequence of SEQ ID NOs: 199, 205, 207, 249, 251, 261, 263, and 267.

[0135] Furthermore, the oligonucleotides of this specification (e.g., ds oligonucleotides) include a sense strand (or passenger strand) with a length of up to about 40 nucleotides (e.g., a length of up to 40, 36, 30, 27, 25, 21, 19, 17, or 12 nucleotides). In some embodiments, the oligonucleotide may have a sense strand with a length of at least 12 nucleotides (e.g., a length of at least 12, at least 15, at least 19, at least 21, at least 25, at least 27, at least 30, at least 36, or at least 38 nucleotides). Alternatively, oligonucleotides can have a sense strand with a length range of approximately 12 to approximately 40 nucleotides (e.g., 12-40, 12-36, 12-32, 12-28, 15-40, 15-36, 15-32, 15-28, 17-21, 17-25, 19-27, 19-30, 20-40, 22-40, 25-40, or 32-40). In certain embodiments, the oligonucleotide may have a sense strand with a length of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, or 40 nucleotides.

[0136] In some embodiments, the sense strand includes a stem-loop structure at its 3' end. In some embodiments, the sense strand includes a stem-loop structure at its 5' end. In further embodiments, the stem is a double helix with a length of approximately 2 bp, 3 bp, 4 bp, 5 bp, 6 bp, 7 bp, 8 bp, 9 bp, 10 bp, 11 bp, 12 bp, 13 bp, or 14 bp. In some embodiments, the stem-loop more effectively protects the oligonucleotide from degradation (e.g., enzymatic degradation) and facilitates or improves targeting and / or delivery to target cells, tissues, or organs (e.g., the liver), or both. For example, the loop of the stem-loop provides a nucleotide having one or more modifications that facilitate, improve, or increase targeting to target mRNA (e.g., mRNA of APOC3), inhibition of target gene expression (e.g., APOC3 expression), and / or delivery to target cells, tissues, or organs (e.g., the liver), or any of the above. In some embodiments, the stem-loop itself or modifications to the stem-loop do not substantially affect the intrinsic gene expression inhibitory activity of the oligonucleotide, but they enhance, improve, or increase stability (e.g., provide protection against degradation) and / or delivery of the oligonucleotide to target cells, tissues, or organs (e.g., the liver). In certain embodiments, the oligonucleotide includes a sense strand comprising a stem-loop represented as S1-L-S2 (e.g., at its 3' end), where S1 is complementary to S2, and L forms an ss loop between S1 and S2 with a length of up to approximately 10 nucleotides (e.g., 3, 4, 5, 6, 7, 8, 9, or 10 nucleotides). In certain embodiments, the loop (L) is 4 nucleotides long. Figures 1A–1C show non-limiting examples of such oligonucleotides. In some embodiments, the loop (L) of the stem-loop having the above-described structure S1-L-S2 is a tetraloop (e.g., within a tetraloop structure with a nick). In some embodiments, the tetraloop includes ribonucleotides, deoxyribonucleotides, modified nucleotides, delivery ligands, and combinations thereof.

[0137] B. Antisense strands: The oligonucleotides of this specification (e.g., ds oligonucleotides) for targeting APOC3 mRNA and inhibiting APOC3 expression include antisense strands containing the sequences shown in Table 2 or Table 3. In some embodiments, the oligonucleotides include antisense strands having at least 12 consecutive nucleotides (e.g., at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, at least 20, at least 21, at least 22, or at least 23) of the sequence shown in any one of SEQ ID NOs: 38, 44, 46, 88, 90, 100, 102, and 106, or antisense strands having any one nucleotide sequence of SEQ ID NOs: 200, 206, 208, 250, 252, 262, 264, and 268.

[0138] Furthermore, the oligonucleotides of this specification (e.g., ds oligonucleotides) may include an antisense chain with a length of up to about 40 nucleotides (e.g., a length of up to 40, 35, 30, 27, 25, 21, 19, 17, or 12 nucleotides). In some embodiments, the oligonucleotide may have an antisense chain with a length of at least 12 nucleotides (e.g., a length of at least 12, at least 15, at least 19, at least 21, at least 22, at least 25, at least 27, at least 30, at least 35, or at least 38 nucleotides). Alternatively, oligonucleotides can have antisense strands with a length range of approximately 12 to 40 nucleotides (e.g., 12-40, 12-36, 12-32, 12-28, 15-40, 15-36, 15-32, 15-28, 17-22, 17-25, 19-27, 19-30, 20-40, 22-40, 25-40, or 32-40). In certain embodiments, the oligonucleotide may have an antisense chain of length of 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, or 40 nucleotides.

[0139] As described above, the antisense strands of oligonucleotides in this specification are sometimes referred to as “guide strands.” For example, an antisense strand that engages with RISC and binds to an Argonaut protein such as Ago2, or an antisense strand that engages with or binds to one or more similar factors to direct the silencing of a target gene, is called a guide strand (or “passenger strand”).

[0140] V. Modification of oligonucleotides

[0141] A. Sugar Modification: Modified sugars (also called sugar analogs herein) include modified deoxyribose or ribose moieties, for example, in which one or more modifications occur at the 2', 3', 4', and / or 5' carbons of the sugar. Other examples of modified sugars include locked nucleic acids ("LNA", see, e.g., Koshkin et al. (1998) Tetrahedron 54:3607-30), unlocked nucleic acids ("UNA", see, e.g., Snead et al. (2013) Mol.Ther-Nuc. Acids 2:e103), and cross-linked nucleic acids ("BNA"; see, e.g., Imanishi & Obika (2002) Chem.Commun. 16:1653-59).

[0142] In some embodiments, nucleotide modifications in sugars are 2'-modifications such as 2'-O-propargyl, 2'-O-propylamine, 2'-amino, 2'-ethyl, 2'-F, 2'-aminoethyl (EA), 2'-OMe, 2'-MOE, 2'-O-[2-(methylamino)-2-oxoethyl](2'-O-NMA), or 2'-FANA. In certain embodiments, the modification is 2'-F, 2'-OMe, or 2'-MOE. In some embodiments, the modification in sugars may include modifications of a sugar ring, and may include modifications of one or more carbons of the sugar ring. For example, the modification in a sugar may be a 2'-oxygen of the sugar bonded to the 1'-carbon or 4'-carbon of the sugar, or a 2'-oxygen bonded to the 1'-carbon or 4'-carbon via an ethylene or methylene bridge. In some embodiments, the modification is an acyclic sugar lacking a bond between the 2'-carbon and 3'-carbon. In other embodiments, the modification is, for example, a thiol group at the 4' position of a sugar.

[0143] The oligonucleotides herein contain at least one modified nucleotide (e.g., at least one, at least five, at least ten, at least fifteen, at least twenty, at least twenty-five, at least thirty, at least thirty-five, at least forty, at least forty-five, at least fifty, at least fifty, at least sixty, or more). In some embodiments, the sense chain contains at least one modified nucleotide (e.g., at least one, at least five, at least ten, at least fifteen, at least twenty, at least twenty-five, at least thirty, at least thirty-five, or more). In some embodiments, the antisense chain contains at least one modified nucleotide (e.g., at least one, at least five, at least ten, at least fifteen, at least twenty, or more).

[0144] In certain embodiments, all nucleotides in the sense strand except for the tetraloop are modified. Similarly, all nucleotides in the antisense strand are modified. In some embodiments, all ds nucleotides (i.e., the paired nucleotides of the sense and antisense strands) of the oligonucleotides herein are modified. As described above, and in some embodiments, the modified nucleotides are 2'-modified (e.g., 2'-F, 2'-OMe, 2'-MOE, and / or 2'-FANA). In certain embodiments, the modified nucleotides are 2'-modified, such as 2'-F or 2'-OMe.

[0145] Furthermore, the oligonucleotides described herein have different modification patterns. In some embodiments, the modified oligonucleotides include an antisense chain having the modification pattern shown in Table 3 and a sense chain sequence having the modification pattern shown in Table 3 (and Figures 1A-1C). In some embodiments, one or more of the sense chain positions 8, 9, 10, or 11 are modified with 2'-F. In other embodiments, the sugar moieties of each nucleotide at positions 1-7, 12-27, and 31-36 of the sense chain are modified with 2'-OMe. In a particular embodiment, positions 8-11 of the sense chain are modified with 2'-F, and positions 1-7, 12-27, and 31-36 are modified with 2'-OMe.

[0146] In a further specific embodiment, the sense strand includes 2'-F modified nucleotides at positions 8-11, 2'-OMe modified nucleotides at positions 1-7, 12-27, and 31-36, GalNAc conjugate nucleotides at positions 28, 29, and 30, and a phosphorothioate bond between positions 1 and 2.

[0147] In some embodiments, the antisense chain comprises one or more nucleotides modified with 2'-F at positions 2-5, 7, 10, and 14, and one or more nucleotides modified with 2'-OMe at positions 1, 6, 8-9, 11-13, and 15-22. A particular embodiment discloses an oligonucleotide having an antisense chain containing 2'-F modified nucleotides at positions 2-5, 7, 10, and 14, and 2'-OMe modified nucleotides at positions 1, 6, 8-9, 11-13, and 15-22.

[0148] In certain embodiments, the antisense chain includes 2'-F modified nucleotides at positions 2-5, 7, 10, and 14, 2'-OMe at positions 1, 6, 8-9, 11-13, and 15-22, and phosphorothioate bonds between positions 1 and 2, positions 2 and 3, positions 3 and 4, positions 20 and 21, and positions 21 and 22.

[0149] B. 5'-terminated phosphate: A 5'-terminated phosphate group can be used to enhance the interaction between the oligonucleotides herein and Ago2. However, oligonucleotides having a 5'-terminated phosphate group may be susceptible to degradation by phosphatases or other enzymes, which may limit their in vivo bioavailability. In some embodiments, the oligonucleotides herein (e.g., ds oligonucleotides) include analogues of 5' phosphate that are resistant to such degradation. Examples of such phosphate analogues include, but are not limited to, oxymethylphosphonates, vinylphosphonates, malonylphosphonates, or combinations thereof. In certain embodiments, the 3' end of the oligonucleotide chain is bonded to a chemical moiety ("phosphate mimetic") that mimics the electrostatic and steric properties of a natural 5' phosphate group.

[0150] Alternatively or additionally, oligonucleotides may have a phosphate analog (referred to as a 4'-phosphate analog) at the 4' carbon of the sugar. See, for example, International Patent Application Publication WO2018 / 045317. In some embodiments, the oligonucleotides herein include a 4'-phosphate analog at the 5' terminal nucleotide. In some embodiments, the phosphate analog is an oxymethylphosphonate or analog thereof, in which the oxygen atom of the oxymethyl group is bonded to the sugar moiety (e.g., its 4' carbon). In other embodiments, the 4'-phosphate analog is a thiomethylphosphonate or aminomethylphosphonate or analog thereof, in which the sulfur atom of the thiomethyl group or the nitrogen atom of the aminomethyl group is bonded to the 4' carbon of the sugar moiety. In certain embodiments, the 4'-phosphate analog is a 4'-oxymethylphosphonate represented by the formula -O-CH2-PO(OH)2 or O-CH2-PO(OR)2 (wherein R is independently selected from H, CH3, an alkyl group, CH2CH2CN, CH2OCOC(CH3)3, CH2OCH2CH2Si(CH3)3, or a protecting group). In certain embodiments, the alkyl group is CH2CH3. In other specific embodiments, R is independently selected from H, CH3, or CH2CH3.

[0151] C. Modified nucleotide bonds: In addition to the modifications described above, the oligonucleotides of this specification (e.g., ds oligonucleotides) include modified nucleotide bonds. In some embodiments, modification or substitution of phosphate may result in an oligonucleotide containing at least one (e.g., at least one, at least two, at least three, or at least five) modified nucleotide bonds. In some embodiments, the oligonucleotides of this specification (e.g., ds oligonucleotides) contain about 1 to about 10 (e.g., 1 to 10, 2 to 8, 4 to 6, 3 to 10, 5 to 10, 1 to 5, 1 to 3, or 1 to 2) modified nucleotide bonds. In other embodiments, the oligonucleotide contains one, two, three, four, five, six, seven, eight, nine, or ten modified nucleotide bonds.

[0152] Examples of modified nucleotide interlinking bonds include, but are not limited to, phosphorodithioate bonds, phosphorothioate bonds, phosphotriester bonds, thionoalkylphosphonate bonds, thioalkylphosphotriester bonds, phosphoramidite bonds, phosphonate bonds, and / or boranophosphate bonds. In some embodiments, at least one modified nucleotide interlinking bond of any one of the oligonucleotides disclosed herein is a phosphorothioate bond.

[0153] In some embodiments, the oligonucleotides herein include a phosphorothioate bond between one or more of the following: positions 1 and 2 of the sense chain, positions 1 and 2 of the antisense chain, positions 2 and 3 of the antisense chain, positions 3 and 4 of the antisense chain, positions 20 and 21 of the antisense chain, and / or positions 21 and 22 of the antisense chain. In other embodiments, the oligonucleotides include a phosphorothioate bond between each of the following: positions 1 and 2 of the sense chain, positions 1 and 2 of the antisense chain, positions 2 and 3 of the antisense chain, positions 3 and 4 of the antisense chain, positions 20 and 21 of the antisense chain, and / or positions 21 and 22 of the antisense chain.

[0154] In certain embodiments, the oligonucleotides of this specification include: A sense strand having 2'-F modified nucleotides at positions 8-11, 2'-OMe modified nucleotides at positions 1-7, 12-27, and 31-36, GalNAc conjugate nucleotides at positions 28, 29, and 30, and a phosphorothioate bond between positions 1 and 2; An antisense chain having 2'-F modified nucleotides at positions 2-5, 7, 10, and 14, 2'-OMe at positions 1, 6, 8-9, 11-13, and 15-22, phosphorothioate bonds between positions 1 and 2, positions 2 and 3, positions 3 and 4, positions 20 and 21, and positions 21 and 22, and a 5'-terminal nucleotide containing a 4'-phosphate analog at position 1 (optionally, the 5'-terminal nucleotide may be 4-O-monomethylphosphonate-2'-O-methyluridine [MePhosph An antisense strand having [onate-4O-mU]; where positions 1-20 of the antisense strand form a double-stranded region with positions 1-20 of the sense strand, positions 21-36 of the sense strand form a stem-loop, positions 27-30 form a loop of the stem-loop, optionally positions 27-30 include a tetraloop, positions 21 and 22 of the antisense strand include protrusions, and the sense and antisense strands contain nucleotide sequences selected from the group consisting of: (a) Sequence IDs 199 and 200, (b) Sequence IDs 205 and 206, (c) Sequence IDs 207 and 208, (d) Sequence IDs 249 and 250, (e) Sequence numbers 251 and 252, (f) Sequence numbers 261 and 262, (g) Sequence IDs 263 and 264, and (h) Sequences 267 and 268.

[0155] D. Modification of Bases: In addition to the modifications described above, the oligonucleotides herein (e.g., ds oligonucleotides) also include one or more modified nucleic acid bases. In some embodiments, the modified nucleic acid base (also referred to herein as a base analog) is ligated to the 1' position of the nucleotide sugar moiety. In some embodiments, the modified nucleic acid base is a nitrogen base. In other embodiments, the modified nucleic acid base does not contain a nitrogen atom. See, for example, U.S. Patent Application Publication 2008 / 0274462. In other specific embodiments, the modified nucleic acid base is a universal base. However, in certain embodiments, the modified nucleotide does not contain a nucleic acid base (debased).

[0156] Regarding universal bases, they include heterocyclic moies located at the 1' position of the nucleotide sugar moiety of a modified nucleotide, or at an equivalent position of a nucleotide sugar moiety substitution, where they are positioned opposite one or more types of bases without substantially altering the structure of the double helix when present in a double helix. Furthermore, compared to ss nucleic acids (e.g., oligonucleotides) that are perfectly complementary to the target nucleic acid, ss nucleic acids with universal bases have a lower T than the double helix formed with the complementary nucleic acid. m It forms a double helix with the target nucleic acid which has the universal base. However, compared to the reference ss nucleic acid in which the universal base is replaced by a base, resulting in one mismatch, the ss nucleic acid with the universal base has a higher T than the double helix formed with the nucleic acid with the mismatch base. m It forms a double helix with the target nucleic acid which has the following properties.

[0157] Examples of universally bound nucleotides include, but are not limited to, inosine, 1-β-D-ribofuranosyl-5-nitroindole, and / or 1-β-D-ribofuranosyl-3-nitropyrrole (see, for example, U.S. Patent Application Publication 2007 / 0254362; Van Aerschot et al. (1995) Nucleic Acids Res. 23:4363-70; Loakes et al. (1995) Nucleic Acids Res. 23:2361-66; and Loakes & Brown (1994) Nucleic Acids Res. 22:4039-403).

[0158] E. Reversible Modification: Certain modifications can be made to protect the oligonucleotides described herein (e.g., ds oligonucleotides) from the in vivo environment before they reach target cells, but modifications can also be made to reduce the potency or activity of the oligonucleotides after they reach the cytoplasm of target cells. Thus, reversible modifications can be made so that the oligonucleotides retain desirable properties extracellularly and are removed once they enter the cytoplasmic environment of the cell. Reversible modifications can be removed, for example, by the action of intracellular enzymes or by intracellular chemical conditions (e.g., by reduction by intracellular glutathione).

[0159] In some embodiments, reversibly modified nucleotides include a glutathione-sensitive moiety. Typically, oligonucleotides are chemically modified with a cyclic disulfide moiety to mask the negative charge generated by the internucleotide diphosphate bond and to improve cellular uptake and nuclease resistance. See U.S. Patent Application Publication 2011 / 0294869, International Patent Application Publications WO2014 / 088920 and WO2015 / 188197, and Meade et al. (2014) Nat. Biotechnol. 32:1256-63. This reversibly modified internucleotide diphosphate bond is designed to be cleaved intracellularly by the reductive environment of the cytosol (e.g., glutathione). Early examples include neutralizing phosphotriester modifications, which have been reported to be cleavable within cells (see, for example, Dellinger et al. (2003) J.Am.Chem.Soc.125:940-50).

[0160] Some reversible modifications protect oligonucleotides during in vivo administration (e.g., transport through the blood and / or cellular lysosome / endosomal compartments) where they are exposed to nucleases and other harsh environmental conditions (e.g., pH). When released into the cellular cytosol, where glutathione levels are higher than in the extracellular space, the modifications are reversed, resulting in cleaved oligonucleotides. Using reversible glutathione-sensitive moieties makes it possible to introduce sterically larger chemical groups into oligonucleotides compared to options available using irreversible chemical modifications. This is because these larger chemical groups are removed in the cytosol and therefore should not interfere with the bioactivity of the oligonucleotide in the cellular cytosol. As a result, these larger chemical groups can be manipulated to impart various advantages to oligonucleotides, such as nuclease resistance, lipophilicity, charge, thermal stability, specificity, and reduced immunogenicity. In some embodiments, the structure of the glutathione-sensitive moiety can be manipulated to alter the dynamics of its release.

[0161] In some embodiments, the glutathione-sensitive moiety is bonded to the sugar of the nucleotide. In certain embodiments, the glutathione-sensitive moiety is bonded to the 2'-carbon of the sugar of the modified nucleotide. Additionally or alternatively, the glutathione-sensitive moiety is bonded to the 5'-carbon of the sugar, particularly when the modified nucleotide is the 5'-terminal nucleotide of an oligonucleotide. Additionally or alternatively, the glutathione-sensitive moiety is bonded to the 3'-carbon of the sugar, particularly when the modified nucleotide is the 3'-terminal nucleotide of an oligonucleotide. In some embodiments, the glutathione-sensitive moiety includes a sulfonyl group (see, for example, International Patent Application Publication WO2018 / 039364).

[0162] VI. Targeting Ligands: It is desirable to target the oligonucleotides of this specification (e.g., ds oligonucleotides) to one or more cells or one or more organs. Such strategies may help to avoid undesirable effects in other organs or to avoid excessive loss of oligonucleotides to cells, tissues, or organs that do not benefit from them. Therefore, oligonucleotides are modified to facilitate targeting and / or delivery to tissues, cells, or organs (e.g., to facilitate delivery of oligonucleotides to the liver). In some embodiments, oligonucleotides are modified to facilitate delivery of oligonucleotides to hepatocytes in the liver. In some embodiments, oligonucleotides comprise at least one nucleotide (e.g., one, two, three, four, five, six, or more nucleotides) conjugated to one or more targeting ligands.

[0163] Targeting ligands include, but are not limited to, carbohydrates, amino sugars, cholesterol, peptides, polypeptides, proteins or parts of proteins (e.g., antibodies or antibody fragments), or lipids. In some embodiments, the targeting ligand is an aptamer. For example, the targeting ligand may be an Arg-Gly-Asp (RGD) peptide used to target tumor vascular systems or glioma cells, a Cys-Arg-Glu-Lys-Ala (CREKA) peptide for targeting tumor vascular systems or tumor stroma, a transferrin, lactoferrin, or aptamer for targeting transferrin receptors expressed on central nervous system (CNS) vascular systems, or an anti-EGFR antibody for targeting epidermal growth factor receptor (EGFR) on glioma cells. In certain embodiments, the targeting ligand is one or more GalNAc moieties.

[0164] In some embodiments, one or more nucleotides (e.g., one, two, three, four, five, or six) of an oligonucleotide can be conjugated to distinct targeting ligands. In some embodiments, two to four nucleotides of an oligonucleotide are conjugated to distinct targeting ligands. In other embodiments, the targeting ligand can be conjugated to two to four nucleotides at the end of either the sense strand or the antisense strand (e.g., the targeting ligand is conjugated to the protruding or elongated portion of two to four nucleotides at the 5' or 3' end of the sense strand or antisense strand), so that the targeting ligand resembles the bristles of a toothbrush and the oligonucleotide resembles a toothbrush. For example, an oligonucleotide may include a stem loop at either the 5' or 3' end of the sense strand, and one, two, three, or four nucleotides of the stem loop can be individually conjugated to targeting ligands. In some embodiments, the oligonucleotide includes a stem loop at the 3' end of the sense strand, the loop of the stem loop contains triL or L, and the three or four nucleotides of triL or L are each individually conjugated to a targeting ligand.

[0165] GalNAc is a high-affinity ligand for ASGPR, which is primarily expressed on the sinusoidal surface of hepatocytes, and plays a major role in the binding, internalization, and subsequent efflux of circulating glycoproteins (asialoglycoproteins) containing terminal galactose or GalNAc residues. In some embodiments, the GalNAc moiety can be conjugated (indirectly or directly) to the oligonucleotides herein to target the oligonucleotides to ASGPR expressed in cells. In some embodiments, the oligonucleotide is conjugated to at least one or more GalNAc moieties, and the GalNAc moieties target the oligonucleotide to ASGPR expressed on human liver cells (e.g., human hepatocytes).

[0166] Oligonucleotides are conjugated directly or indirectly to monovalent GalNAc. In some embodiments, oligonucleotides are conjugated directly or indirectly to more than one monovalent GalNAc (i.e., conjugated to two, three, or four monovalent GalNAc moieties, typically three or four monovalent GalNAc moieties). In some embodiments, oligonucleotides are conjugated to one or more divalent, trivalent, or tetravalent GalNAc moieties.

[0167] In some embodiments, one or more nucleotides (e.g., 1, 2, 3, 4, 5, or 6) of the oligonucleotide can be conjugated to the GalNAc moiety. In some embodiments, 2 to 4 nucleotides of L are each conjugated to a separate GalNAc. In other embodiments, 1 to 3 nucleotides of triL are each conjugated to a separate GalNAc. In some embodiments, the targeting ligand is conjugated to 2 to 4 nucleotides at the end of either the sense or antisense strand (e.g., the ligand is conjugated to the protruding or elongated portion of 2 to 4 nucleotides at the 5' or 3' end of the sense or antisense strand), so that the GalNAc moiety resembles the bristles of a toothbrush and the oligonucleotide resembles a toothbrush. In some embodiments, the GalNAc moiety is conjugated to nucleotides in the sense strand. For example, four GalNAc moieties are conjugated to nucleotides in L of the sense strand, and each GalNAc moiety is conjugated to one nucleotide. In a particular embodiment, three GalNAc moieties are conjugated to nucleotides within the sense strand L, and each GalNAc moiety is conjugated to a single nucleotide.

[0168] In certain embodiments, the oligonucleotide comprises a monovalent GalNAc bonded to a guanidine nucleotide, referred to as [ademG-GalNAc] or 2'-aminodiethoxymethanol-guanidine-GalNAc, as shown below: [ka]

[0169] In certain embodiments, the oligonucleotides of this specification include monovalent GalNAc bound to an adenine nucleotide, referred to as [ademA-GalNAc] or 2'-aminodiethoxymethanol-adenine-GalNAc, as shown below: [ka]

[0170] In certain embodiments, the oligonucleotide comprises a monovalent 2'-GalNAc conjugated to a guanine nucleotide called [prgG-peg-GalNAc], as shown below, where N-acetylgalactosamine (GalNAc) is conjugated to guanine via polyethylene glycol and a propargyl (alkyne) linker: [ka]

[0171] In certain embodiments, the oligonucleotides herein include a monovalent 2'-GalNAc conjugated to an adenine nucleotide called [prgA-peg-GalNAc], as shown below, where N-acetylgalactosamine (GalNAc) is conjugated to adenine via polyethylene glycol and a propargyl (alkyne) linker: [ka]

[0172] An example of such a conjugation is shown below for a loop having the nucleotide sequence GAAA in the 5'-3' direction (L = linker, X = heteroatom). The stem junction is indicated. Such loops are listed in Table 4, for example, and are located at positions 27-30 on the sense strand shown in Figure 1. In chemical formula, [ka] This is used to represent the binding site to the oligonucleotide chain: [ka]

[0173] The targeted ligand is conjugated to a nucleotide using an appropriate method or chemical technique (e.g., click chemistry). One method for conjugating the targeted ligand to a nucleotide is to use a click linker. In some embodiments, an acetal-based linker is used to conjugate the targeted ligand to one nucleotide of any of the oligonucleotides herein. An acetal-based linker is disclosed, for example, in International Patent Application Publication WO2016 / 100401. In some embodiments, the linker is an unstable linker. However, in other embodiments, the linker is stable. An example of a loop having nucleotide GAAA in the 5'-3' direction, where the GalNAc portion is conjugated to the nucleotide of the loop using an acetal linker, is shown below. Such a loop is located, for example, at positions 27-30 of any one of the sense strands listed in Table 2 or 3. In the chemical formula, [ka] This is a binding site to the oligonucleotide chain: [ka]

[0174] In some embodiments, a double-chain extension portion (e.g., up to 3, 4, 5, or 6 bp in length) is positioned between the targeting ligand (e.g., the GalNAc portion) and the oligonucleotide of this specification (e.g., the ds oligonucleotide). In other embodiments, the oligonucleotide does not have GalNAc conjugated to it.

[0175] Pharmaceutical preparations and pharmaceutical compositions

[0176] Oligonucleotides as defined herein (e.g., ds oligonucleotides), or their pharmaceutically acceptable salts (e.g., trifluoroacetate, acetate, or hydrochloride), are incorporated into formulations or pharmaceutical compositions. Various formulations have been developed to facilitate the use of oligonucleotides. For example, oligonucleotides can be delivered to an organism or cellular environment using formulations that minimize degradation, promote delivery and / or uptake, or impart other beneficial properties to the oligonucleotide in the formulation. In some embodiments, oligonucleotides are formulated in buffers such as phosphate-buffered saline, liposomes, micelle structures, and capsids.

[0177] To improve in vivo compatibility and efficacy, oligonucleotides can react with a number of inorganic and organic acid / bases to form pharmaceutically acceptable acid / base addition salts. Pharmaceutically acceptable salts and common methods for preparing them are well known in the art (e.g., Stahl et al., “Handbook of Pharmaceutical Salts: Properties, Selection and Use,” 2) nd See Revised Edition (Wiley-VCH, 2011). Pharmaceutically acceptable salts used herein include sodium, trifluoroacetate, hydrochloride, and acetate.

[0178] Formulations of oligonucleotides containing cationic lipids are used to promote the transfection of oligonucleotides into cells. Cationic lipids such as lipofectin, cationic glycerol derivatives, and polycationic molecules (e.g., polylysine) can be used. Suitable lipids include oligofectamine (ThermoFisher Technologies), lipofectamine (Life Technologies), NC388 (Ribozyme Pharmaceuticals, Inc., Boulder, Colo.), or FuGene6 (Roche), all of which can be used according to the manufacturer's instructions for use.

[0179] Therefore, in some embodiments, the formulations herein may comprise liposomes, lipids, complex lipids, microspheres, microparticles, nanospheres, or nanoparticles (such as lipid nanoparticles), or may be formulated in other forms for administration to cells, tissues, organs, or bodies of an individual requiring administration (e.g., Remington, “The Science and Practice of Pharmacy” (LV Allen Jr., ed., 22 nd (See Edition, Pharmaceutical Press, 2013).

[0180] In some embodiments, the formulations herein further comprise excipients, which can impart to the composition improved stability, improved absorption, improved solubility, and / or therapeutic enhancement effects of the active ingredient. In some embodiments, the excipient is a buffer (e.g., sodium citrate, sodium phosphate, Tris base, or sodium hydroxide) or a vehicle (e.g., buffer solution, petrolatum, dimethyl sulfoxide, or mineral oil). In some embodiments, the oligonucleotides herein are lyophilized to extend their shelf life and then dissolved before use (e.g., administration to an individual). Therefore, the excipients in a pharmaceutical composition comprising one or more oligonucleotides are lyophilization protectants (e.g., mannitol, lactose, polyethylene glycol, or polyvinylpyrrolidone) or decay temperature regulators (e.g., dextran, Ficol®, or gelatin).

[0181] Pharmaceutical compositions are formulated to suit their intended route of administration. Routes of administration include, but are not limited to, parenteral (e.g., intravenous, intramuscular, intraperitoneal, intradermal, and subcutaneous), oral (e.g., inhalation), transdermal (e.g., topical), transmucosal, and rectal administration.

[0182] Pharmaceutical compositions suitable for injection include sterile aqueous solutions (if water-soluble) or dispersions, and sterile powders for the immediate preparation of sterile injection solutions or dispersions. For intravenous administration, suitable carriers include, but are not limited to, physiological saline, bacteriostatic water, Cremophor EL® (BASF), or phosphate-buffered saline (PBS). The carrier may be a solvent or dispersion medium containing, for example, water, ethanol, polyols (e.g., glycerol, propylene glycol, and liquid polyethylene glycol), and suitable mixtures thereof. In many embodiments, it is preferable to include in the composition, for example, sugars, polyhydric alcohols such as mannitol and sorbitol, and / or isotonic agents such as sodium chloride. Sterile injection solutions are prepared by mixing the required amount of oligonucleotides specified herein with a selected solvent, along with one or a combination of the components listed above as needed, and then sterilizing by filtration.

[0183] Furthermore, the pharmaceutical composition contains at least about 0.1% or more of the therapeutic agent (e.g., one or more oligonucleotides as specified herein), although the percentage of the therapeutic agent may be about 1% to about 80% or more of the total weight or volume of the composition. Factors such as solubility, bioavailability, biological half-life, route of administration, shelf life of the product, and other pharmacological considerations are conceivable by those skilled in the art in the field of preparing such pharmaceutical formulations, and therefore, various dosages and treatment regimens may be desirable.

[0184] Some examples involve the targeted delivery of at least one of the oligonucleotides described herein to the liver, but targeting other tissues is also intended.

[0185] kit

[0186] The oligonucleotides herein (e.g., ds oligonucleotides) can be incorporated into a kit comprising one or more oligonucleotides herein and instructions for use. In some embodiments, the kit comprises one or more oligonucleotides and accompanying documentation including instructions for use of the kit and / or any of its components. In other embodiments, the kit comprises a suitable container, one or more oligonucleotides, one or more controls, and various buffers, reagents, enzymes, and other standard components known in the art.

[0187] In some embodiments, the container is at least one vial, well, test tube, flask, bottle, syringe, or other container means in which one or more oligonucleotides are placed and, in some embodiments, appropriately dispensed. In other embodiments in which additional components are provided, the kit includes additional containers in which these components are placed. The kit also includes means for housing one or more oligonucleotides and other reagents in a sealed state for commercial sale. Such containers include injection-molded or blow-molded plastic containers in which the desired vials are held. The container and / or kit includes a label with instructions for use and / or warnings.

[0188] In some embodiments, the kit includes one or more oligonucleotides as herein and a pharmaceutically acceptable carrier, or a pharmaceutical composition comprising one or more oligonucleotides, and instructions for use to treat or slow the progression of a disease, disorder, or condition related to APOC3 expression in an individual requiring it.

[0189] method Manufacturing method

[0190] The oligonucleotides described herein (e.g., ds oligonucleotides) are prepared using methods and / or techniques known to those skilled in the art, such as conventional solid-phase nucleic acid synthesis. The polynucleotides of the oligonucleotides are assembled using standard nucleotides or nucleoside precursors (e.g., phosphoramidites) in a suitable nucleic acid synthesizer. Automated nucleic acid synthesizers, including DNA / RNA synthesizers, are commercially available from companies such as Applied Biosystems (Foster City, CA), BioAutomation (Irving, TX), and GE Healthcare Life Sciences (Pittsburgh, PA).

[0191] As those skilled in the art will understand, other methods and / or techniques for synthesizing the oligonucleotides described herein are also used. Furthermore, various synthetic steps are carried out in alternating or sequential order to obtain the desired compounds. Other synthetic chemical transformations, protecting groups (e.g., hydroxyl, amino, etc., present in bases), and protecting group methodologies (protection and deprotection) useful for the synthesis of oligonucleotides are known in the art, e.g., Larock, “Comprehensive Organic Transformations,” VCH Publishers (1989); Greene & Wuts, Protective Groups in Organic Synthesis, 2 nd It is described in Ed., John Wiley & Sons (1991); Fieser & Fieser, Fieser and Fieser's Reagents for Organic Synthesis, John Wiley & Sons (1994); and Paquette, ed., Encyclopedia of Reagents for Organic Synthesis, John Wiley & Sons (1995).

[0192] How to use

[0193] I. Methods for reducing APOC3 expression in cells, tissues, organs, and organisms: The oligonucleotides described herein (e.g., ds oligonucleotides) are used to reduce the mRNA of APOC3 in cells, tissues, organs, or organisms. The method comprises the steps described herein, which may, but do not necessarily, be performed in the order described. However, other orders are also possible. Furthermore, individual or multiple steps may be performed in parallel and / or overlapping time and / or individually or in repeated steps. Furthermore, the method comprises additional unspecified steps.

[0194] This method involves contacting or delivering an effective amount of any of the specified oligonucleotides to a cell, a population of cells, a tissue, an organ, or an individual in order to reduce APOC3 expression. In some embodiments, the reduction in APOC3 expression is determined by measuring the decrease in the amount or level of APOC3 mRNA, APOC3 protein, or APOC3 activity in the cell.

[0195] Regarding appropriate cell types, the cell type is any cell that expresses mRNA (e.g., hepatocytes, macrophages, monocyte-derived cells, prostate cancer cells, brain, endocrine tissue, bone marrow, lymph nodes, lung, gallbladder, liver, duodenum, small intestine, pancreas, kidney, gastrointestinal tract, bladder, adipose and soft tissue, and skin cells). In some embodiments, the cells are primary cells obtained from an organism. In some embodiments, the primary cells have undergone a limited number of passages so that the cells substantially retain their native phenotypic characteristics. In some embodiments, the cells are ex vivo, in vivo, or in vitro (i.e., one or more oligonucleotides herein can be delivered to cells in culture or to an organism in which the cells reside).

[0196] In some embodiments, the oligonucleotides herein are delivered to cells or populations of cells using nucleic acid delivery methods known in the art, including, but not limited to, injecting a solution containing the oligonucleotide, impacting cells or populations of cells with oligonucleotide-coated particles, exposing cells or populations of cells to a solution containing the oligonucleotide, or electroporating cell membranes in the presence of the oligonucleotide. Other methods known in the art for delivering oligonucleotides to cells are used, such as lipid-mediated transport, chemical-mediated transport, and cationic liposome transfection, such as calcium phosphate.

[0197] The decrease in APOC3 expression is determined by an assay or technique that evaluates one or more molecules, properties, or characteristics of cells or cell populations associated with APOC3 expression (e.g., using APOC3 expression biomarkers), or by an assay or technique that evaluates a molecule that directly indicates APOC3 expression in cells or cell populations (e.g., APOC3 mRNA or APOC3 protein). In some embodiments, the extent to which an oligonucleotide reduces APOC3 expression is evaluated by comparing APOC3 expression in cells or cell populations contacted with the oligonucleotide to that of a control cell population (e.g., cells or cell populations not contacted with the oligonucleotide or contacted with a control oligonucleotide). In some embodiments, the control amount or level of APOC3 expression in the control cell population is predetermined so that it is not necessary to measure the control amount or level in all cases in which the assay or technique is performed. The predetermined level or value can take various forms, including but not limited to a single cutoff value such as a median or mean.

[0198] Contact or delivery of the oligonucleotides of this specification to cells or populations of cells reduces APOC3 expression. In some embodiments, the reduction in APOC3 expression is compared to a control amount or level of APOC3 expression in cells or populations of cells that have not been contacted with the oligonucleotide or that have been contacted with a control oligonucleotide. In some embodiments, the reduction in APOC3 expression is about 1% or less, about 5% or less, about 10% or less, about 15% or less, about 20% or less, about 25% or less, about 30% or less, about 35% or less, about 40% or less, about 45% or less, about 50% or less, about 55% or less, about 60% or less, about 70% or less, about 80% or less, or about 90% or less, compared to a control amount or level of APOC3 expression. In some embodiments, the control amount or level of APOC3 expression is the amount or level of APOC3 mRNA and / or APOC3 protein in cells or populations of cells that have not been contacted with the oligonucleotides of this specification. In some embodiments, the effect of delivering oligonucleotides to cells or populations of cells by the methods herein is evaluated after any finite period or a fixed time (e.g., minutes, hours, days, weeks, and / or months). For example, APOC3 expression is determined in cells or populations of cells over at least about 4 hours, about 8 hours, about 12 hours, about 18 hours, or about 24 hours. Alternatively, APOC3 expression is determined in cells or populations of cells over at least about 1 day, about 2 days, about 3 days, about 4 days, about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, about 10 days, about 11 days, about 12 days, about 13 days, about 14 days, about 21 days, about 28 days, about 35 days, about 42 days, about 49 days, about 56 days, about 63 days, about 70 days, about 77 days, or about 84 days or longer after contacting or delivering the oligonucleotide to the cells or populations of cells. In some embodiments, APOC3 expression is determined in cells or a population of cells at least about 1 month, about 2 months, about 3 months, about 4 months, about 5 months, or about 6 months or longer after contacting or delivering the oligonucleotide to the cells or population of cells.

[0199] In some embodiments, the oligonucleotides of this specification are delivered in the form of a transgene engineered to express one or more oligonucleotides or chains (e.g., a sense strand and an antisense strand) within a cell. For example, the oligonucleotides are delivered using a transgene engineered to express any of the oligonucleotides of this specification. The transgene engineer may be delivered using a viral vector (e.g., adenovirus, retrovirus, vaccinia virus, poxvirus, adeno-associated virus, or herpes simplex virus) or a non-viral vector (e.g., plasmid or synthetic mRNA). In some embodiments, the transgene engineer is injected directly into the organism.

[0200] II. Treatment Methods: A method for treating an individual who has, is suspected of having, or is at risk of developing, a disease, disorder, or condition related to APOC3 expression comprises administering at least one of the oligonucleotides specified herein (e.g., ds oligonucleotides) to the individual. Furthermore, a method for treating or mitigating the onset or progression of a disease, disorder, or condition related to APOC3 expression in an individual comprises using one or more of the oligonucleotides specified herein. Furthermore, a method for achieving one or more therapeutic effects in an individual having a disease, disorder, or condition related to APOC3 expression comprises providing one or more of the oligonucleotides specified herein. In some embodiments, an individual can be treated by administering one or more of the oligonucleotides specified in a therapeutically effective amount. In some embodiments, the treatment comprises reducing APOC3 expression. In some embodiments, the individual is treated therapeutically. In some embodiments, the individual is treated prophylactically. In all these embodiments, the oligonucleotides are selected from Table 3.

[0201] In some embodiments, one or more oligonucleotides, or a pharmaceutical composition containing them, are administered to an individual having a disease, disorder, or condition related to APOC3 expression to reduce APOC3 expression in the individual and thereby treat the individual. In some embodiments, the amount or level of APOC3 mRNA in the individual is reduced. In other embodiments, the amount or level of APOC3 protein in the individual is reduced. In yet another embodiment, the amount or level of APOC3 activity in the individual is reduced. In yet another embodiment, the amount or level of hepatic TG (e.g., one or more TG or total TG in the liver) in the individual is reduced. In yet another embodiment, the amount or level of hepatic inflammation can be reduced. In yet another embodiment, the level of hepatic fibrosis is reduced. In yet another embodiment, the amount or level of plasma aspartate aminotransferase (AST), plasma alanine aminotransferase (ALT), cytokeratin 18 (CK-18), or N-terminal type III collagen propeptide (Pro-C3) is reduced. In any of the embodiments disclosed above, the oligonucleotide comprises a sense strand having one nucleotide sequence of SEQ ID NOs: 143, 149, 151, 193, 195, 205, 207, and 211, and an antisense strand having one nucleotide sequence of SEQ ID NOs: 144, 150, 152, 194, 196, 206, 208, and 212.

[0202] In some embodiments, APOC3 expression in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to APOC3 expression before administration of one or more oligonucleotides or a pharmaceutical composition thereof. In other embodiments, APOC3 expression in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to APOC3 expression in an individual that has not received one or more oligonucleotides or a pharmaceutical composition, or in an individual that has received a control oligonucleotide, pharmaceutical composition, or treatment (e.g., a reference or control individual).

[0203] In certain embodiments, the amount or level of APOC3 mRNA in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of APOC3 mRNA before administration of one or more oligonucleotides or the pharmaceutical composition thereof. In some embodiments, the amount or level of APOC3 mRNA in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of APOC3 mRNA in an individual that has not received one or more oligonucleotides or pharmaceutical compositions, or in an individual that has received a control oligonucleotide, pharmaceutical composition, or treatment (e.g., a reference or control individual).

[0204] In certain embodiments, the amount or level of APOC3 protein in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of APOC3 protein before administration of one or more oligonucleotides or their pharmaceutical composition. In other embodiments, the amount or level of APOC3 protein in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of APOC3 protein in an individual that has not received one or more oligonucleotides or pharmaceutical compositions, or in an individual that has received a control oligonucleotide, pharmaceutical composition, or treatment (e.g., a reference or control individual).

[0205] In certain embodiments, the amount or level of APOC3 activity in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of APOC3 activity before administration of one or more oligonucleotides or their pharmaceutical composition. In some embodiments, the amount or level of APOC3 activity in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of APOC3 activity in an individual that has not received one or more oligonucleotides or pharmaceutical compositions, or in an individual that has received a control oligonucleotide, pharmaceutical composition, or treatment (e.g., a reference or control individual).

[0206] In certain embodiments, the amount or level of TG in an individual, particularly TG in the liver, can be reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of TG before administration of one or more oligonucleotides or their pharmaceutical compositions. In some embodiments, the amount or level of TG in an individual is reduced by at least about 30%, about 35%, about 40%, about 45%, about 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or more than 99% compared to the amount or level of TG in an individual that has not received one or more oligonucleotides or pharmaceutical compositions, or in an individual that has received a control oligonucleotide, pharmaceutical composition, or treatment (e.g., a reference or control individual).

[0207] Here, the amount or level of APOC3 expression, APOC3 mRNA, APOC3 protein, APOC3 activity, hepatic TG, or any combination thereof is reduced in cells (e.g., hepatocytes), populations or groups of cells (e.g., organoids), tissues (e.g., liver tissue), specimens (e.g., liver biopsy specimens), organs (e.g., liver), blood or fraction thereof (e.g., plasma), or any other biological material obtained or isolated from an individual. In some embodiments, the amount or level of APOC3 expression, APOC3 mRNA, APOC3 protein, APOC3 activity, TG, or any combination thereof is reduced in one or more types of cells (e.g., hepatocytes and one or more other types of cells), one or more groups of cells, one or more types of tissues (e.g., liver tissue and one or more other types of tissues), one or more samples (e.g., liver biopsy samples and one or more other types of biopsy samples), one or more organs (e.g., liver and one or more other organs), or one or more blood fractions (e.g., plasma and one or more other blood fractions) collected or isolated from an individual.

[0208] Examples of diseases, disorders, or conditions associated with APOC3 expression include, but are not limited to, ACD, AH, ALD, ASCVD, HCC, CHD, CCA, PSC, MetS, NAFLD, NASH, high non-HDL cholesterol, hyperlipidemia, hypertriglyceridemia, diabetes mellitus, obesity, fatty liver (steatosis), liver inflammation, insulin resistance, hepatic fibrosis, cirrhosis, or combinations thereof.

[0209] Due to the high specificity of the oligonucleotides herein, they specifically target the mRNA of target genes in cells, tissues, or organs (e.g., the liver). In disease prevention, target genes are those identified as necessary for the onset or maintenance of the disease, or associated with a high risk of developing the disease. In the treatment of a disease, one or more oligonucleotides herein are brought into contact with cells, tissues, or organs exhibiting the disease or involved in the mediation of the disease. For example, oligonucleotides substantially identical in whole or in part to all or part of a wild-type (i.e., native) or mutant gene associated with a disorder or condition related to APOC3 expression are brought into contact with or introduced into target cell or tissue types such as hepatocytes or other liver cells.

[0210] In some embodiments, the target gene is derived from any mammal, such as a human. Any gene can be silenced according to the methods herein. The methods herein typically involve administering to an individual a therapeutically effective dose, i.e., an amount of one or more oligonucleotides herein that can produce a desired therapeutic outcome. A therapeutically acceptable dose is an amount that therapeutically treats a disease or disorder or symptom. An appropriate dose for any individual depends on specific factors, including the individual's size, body surface area, age, the composition administered, the active ingredient(s) in the composition, the time and route of administration, overall health status, and other therapeutic agents being administered concurrently.

[0211] In this method, an individual is administered one of the oligonucleotides or compositions specified herein by enteral (e.g., orally, by gastric feeding tube, by duodenal feeding tube, via gastrostomy, or rectally), parenterally (e.g., subcutaneous injection, intravenous injection or infusion, intra-arterial injection or infusion, intraosseous injection, intramuscular injection, intracerebral injection, intraventricular injection, or intrathecal injection), topically (e.g., percutaneously, by inhalation, by eye drops, or via mucous membrane), or by direct injection into a target organ (e.g., the individual's liver). Typically, the oligonucleotide or composition is administered intravenously or subcutaneously.

[0212] As a non-limiting set of examples, the oligonucleotides or compositions herein are typically administered quarterly (once every three months), every two months (once every two months), monthly, or weekly. For example, the oligonucleotides or compositions are administered weekly, or at intervals of two or three weeks. In certain embodiments, the oligonucleotides or compositions are administered daily. In some embodiments, an individual is administered one or more loading doses of the oligonucleotide or composition, followed by one or more maintenance doses of the oligonucleotide or composition.

[0213] In some embodiments, the individual is a human, NHP, or other mammalian individual. In other embodiments, the individual is a domestic animal such as a dog or cat, a livestock such as a horse, cattle, pig, sheep, goat, or chicken, and an animal such as a mouse, rat, guinea pig, or hamster.

[0214] III. Medical Uses: The oligonucleotides herein (e.g., ds oligonucleotides) can be used and adapted to treat individuals (e.g., humans having diseases, disorders, or conditions related to APOC3 expression) who can benefit from reduced APOC3 expression. In some embodiments, oligonucleotides are provided for use in treating individuals having diseases, disorders, or conditions related to APOC3 expression, or adapted to such use. Oligonucleotides are also provided for use in the manufacture of pharmaceuticals or pharmaceutical compositions for treating diseases, disorders, or conditions related to APOC3 expression, or adapted to such use. In other embodiments, oligonucleotides are provided for targeting APOC3 mRNA to reduce APOC3 expression (e.g., via the RNAi pathway), or adapted to such use. In other embodiments, oligonucleotides are used to target APOC3 mRNA to reduce the amount or level of APOC3 mRNA, APOC3 protein, and / or APOC3 activity, or adapted to be used.

[0215] In some embodiments, the method includes selecting individuals for treatment based on individuals having or being predisposed to markers (e.g., biomarkers) of diseases, disorders, or conditions related to APOC3 expression, such as but not limited to APOC3 mRNA, APOC3 protein, or combinations thereof. Similarly, as detailed below, the method also includes additional steps such as measuring or obtaining baseline values ​​of APOC3 expression markers (e.g., APOC3 protein) and then comparing the obtained values ​​to one or more other baseline values ​​or values ​​obtained after administering one or more oligonucleotides to the individuals to evaluate the effectiveness of the treatment. [Examples]

[0216] The following non-limiting examples are included for illustrative purposes only and are not limiting.

[0217] Synthesis of oligonucleotides

[0218] Example 1: Preparation of ds RNAi oligonucleotides

[0219] Synthesis and Purification of Oligonucleotides: The ds RNAi oligonucleotides of the examples are chemically synthesized using the methods described herein. Generally, dsRNAi oligonucleotides are synthesized using solid-phase oligonucleotide synthesis methods described for 19-23mer siRNAs (see, for example, Scaringe et al. (1990) Nucleic Acids Res. 18:5433-41 and Usman et al. (1987) J.Am. Chem. Soc. 109:7845-45; also see U.S. Patent Nos. 5,804,683; 5,831,071; 5,998,203; 6,008,400; 6,111,086; 6,117,657; 6,353,098; 6,362,323; 6,437,117; and 6,469,158).

[0220] Individual RNA strands were synthesized and purified by HPLC according to the standard method (Integrated DNA Technologies). For example, RNA oligonucleotides were synthesized using solid-phase phosphoramidite chemical reactions, deprotected, and desalted on an NAP-5 column (Amersham Pharmacia Biotech; Piscataway, NJ) using the standard technique (Damha & Olgivie (1993) Methods Mol. Biol. 20:81-114; Wincott et al. (1995) Nucleic Acids Res. 23:2677-84). The oligomers were purified by ion-exchange high-performance liquid chromatography (IE-HPLC) on an Amersham Source 15Q column (1.0 cm × 25 cm, Amersham Pharmacia Biotech) using a 15-minute stepwise linear gradient. The gradient varied from 90:10 buffer A:B to 52:48 buffer A:B, where buffer A is 100 mM Tris at pH 8.5, and buffer B is 100 mM Tris and 1 M NaCl at pH 8.5. The samples were monitored at 260 nm, peaks corresponding to full-length oligonucleotide species were collected, pooled, desalted on an NAP-5 column, and lyophilized.

[0221] The purity of each oligomer was determined by capillary electrophoresis (CE) on a Beckman PACE 5000 (Beckman Coulter, Inc.). The CE capillary had an inner diameter of 100 μm and contained ssDNA 100R Gel (Beckman-Coulter). Typically, oligonucleotides of approximately 0.6 nmole were injected into the capillary, flowed through an electric field of 444 V / cm, and detected by UV absorbance at 260 nm. Denatured Tris-borate-7M-urea running buffer was purchased from Beckman-Coulter. Oligoribonucleotides that were at least 90% pure when evaluated by CE for use in the experiments described below were obtained. The identity of the compounds was verified by matrix-assisted laser desorption / ionization time-of-flight (MALDI-TOF) mass spectrometry on a Voyager DE® Biospectometry Workstation (Applied Biosystems) according to the manufacturer's recommended protocol. The relative molecular weights of all oligomers were obtained within 0.2% of the often assumed molecular weight.

[0222] Preparation of double helical molecules: ssRNA oligomers were resuspended in a double helical buffer containing 100 mM potassium acetate and 30 mM HEPES (pH 7.5) (e.g., at a concentration of 100 μM). Complementary sense and antisense strands were mixed in equimolar amounts to obtain a final double helical solution, e.g., 50 μM. The sample was heated to 100°C in RNA buffer (IDT) for 5 minutes and cooled to room temperature before use. dsRNA oligonucleotides are stored at -20°C. ssRNA oligomers are stored lyophilized or in nuclease-free water at -80°C.

[0223] In vitro function

[0224] Example 2: In vitro inhibition of APCO3 expression by RNAi oligonucleotides - DsiRNA-based compounds

[0225] APOC3 Target Sequence Identification: To identify RNAi oligonucleotide inhibitors of APOC3 expression, a computer-based algorithm is used to computationally generate APOC3 target sequences suitable for assaying APOC3 expression inhibition by the RNAi pathway. This algorithm provides RNAi oligonucleotide antisense (guide) strand sequences complementary to the appropriate APOC3 target sequence of human APOC3 mRNA (e.g., SEQ ID NO: 1). Some of the antisense strand sequences identified by the algorithm are also complementary to the corresponding APOC3 target sequence of NHP APOC3 mRNA (e.g., monkey, SEQ ID NO: 5). This generates 384 ds RNAi oligonucleotides (formatted as DsiRNA oligonucleotides), each with a unique antisense strand containing a region complementary to the APOC3 target sequence identified by the algorithm.

[0226] In vitro cell-based assay: The ability of each of the 384 DsiRNAs to inhibit APOC3 expression is determined by an in vitro cell-based assay. Furthermore, as shown herein, the nucleotide sequences of the passenger and guide strands of the DsiRNAs have a distinct pattern of modified nucleotides and phosphorothioate bonds. Briefly, HepG2 cells that stably express APOC3 are transfected with each DsiRNA (0.5 nM) in separate wells of a multi-well cell culture plate. The cells are maintained for 24 hours post-transfection, and then the level of residual APOC3 mRNA from the transfected cells is determined using a TAQMAN®-based qPCR assay. Two qPCR assays, a 3' assay and a 5' assay, are used to determine the mRNA level measured by a HEX probe.

[0227] Table 1 shows the results of a HepG2 cell-based assay using 384 DsiRNAs. Here, the 384 DsiRNAs have guide strands complementary to human and NHP APOC3 mRNA ("double common"). Transfection with double common DsiRNAs that results in less than 30% of APOC3 mRNA remaining in cells compared to a negative control is considered a candidate APOC3 expression inhibitor (referred to herein as a "hit").

[0228] [Table 2-1] [Table 2-2] [Table 2-3] [Table 2-4] [Table 2-5] [Table 2-6] [Table 2-7] [Table 2-8] [Table 2-9] [Table 2-10]

[0229] These results demonstrate that DsiRNA designed to target human APOC3 mRNA inhibits intracellular APOC3 expression (determined by a reduction in the amount of APOC3 mRNA in cells transfected with DsiRNA), and that nucleotide sequences containing DsiRNA hits are useful for generating RNAi oligonucleotides that inhibit APOC3 expression. Furthermore, these results indicate that multiple APOC3 target sequences are suitable for inhibiting APOC3 expression via RNAi.

[0230] Example 3: In vitro inhibition of APOC3 expression by RNAi oligonucleotides - GalXC-based compound

[0231] Of the 384 DsiRNAs screened using the HepG2 cell-based assay described in Example 2, nucleotide sequences of 81 DsiRNA hits were selected for in vitro evaluation as GalXC-based compounds. Briefly, the nucleotide sequences of the selected DsiRNAs were used to generate 53 corresponding ds RNAi oligonucleotides containing a nicked tetraloop GalNAc conjugate structure (referred herein to as "GalXC APOC3 oligonucleotide") with a 36-mer sense (passenger) strand and a 22-mer antisense (guide) strand. Furthermore, the nucleotide sequences of the sense and antisense strands of the GalXC APOC3 oligonucleotide exhibit a distinct pattern of modified nucleotides and phosphorothioate bonds (see, for example, Figures 1A-1C for a schematic diagram of the general structure and chemical modification pattern of the GalXC APOC3 oligonucleotide). Each of the three adenosine nucleotides of the tetraloop is conjugated to the GalNAc moiety (CAS number: 14131-60-3). Furthermore, the nucleotide sequences of the sense and antisense strands of the GalXC APOC3 oligonucleotide have one of three different patterns of modified nucleotides and phosphorothioate bonds (see, for example, Figures 1A-1C), with exemplary modification patterns shown in Table 3.

[0232] Table 3-1 Table 3-2 Table 3-3 Table 3-4 Table 3-5 Table 3-6 Table 3-7 Table 3-8 Table 3-9 Table 3-10

[0233] Table 4-1 Table 4-2 Table 4-3 Table 4-4 Table 4-5 Table 4-6 Table 4-7 Table 4-8 Table 4-9 Table 4-10 Table 4-11 Table 4-12 Table 4-13 Table 4-14 Table 4-15 Table 4-16 Table 4-17 Table 4-18 Table 4-19 Table 4-20 Table 4-21 Table 4-22 Table 4-23 [Table 4-24] [Table 4-25] [Table 4-26] [Table 4-27]

[0234] In Vivo Function Example 4: In vitro inhibition of APOC3 expression by RNAi oligonucleotides

[0235] Mouse Studies: Various GalXC APOC3 oligonucleotides listed in Table 2 (unmodified) and Table 3 (modified) were evaluated in a hydrodynamic injection (HDI) mouse model. Additional HDI studies are listed in Tables 5–13. In these HDI studies, mice were designed to transiently express human APOC3 mRNA in hepatocytes. GalXC APOC3 oligonucleotide controls were used as benchmark controls. Briefly, 6–8 week old female CD-1 mice were treated with SQ containing GalXC APOC3 oligonucleotide at a dose of 1 mg / kg. Three days (72 hours) later, a DNA plasmid encoding a complete human gene was hydrodynamically injected into the mice under the control of a ubiquitous cytomegalovirus (CMV) promoter sequence. Liver samples were collected one day after plasmid introduction. Total RNA from these mice was compared to mice treated with the same amount of PBS alone, and APOC3 mRNA was individually analyzed by qRT-PCR. The values ​​are normalized for transfection efficiency using the NeoR gene contained in the plasmid.

[0236] As shown in Tables 4-12, many of the tested GalXC APOC3 oligonucleotides inhibited APOC3 expression, as determined by the reduced amount of APOC3 mRNA in liver samples from oligonucleotide-treated mice compared to mice treated with PBS. The mean percentage of residual APOC3 mRNA in liver samples from mice treated with a benchmark GalXC APOC3 oligonucleotide control was compared to that from mice treated with PBS. Table 4 shows that some of the 12 tested GalXC APOC3 oligonucleotides significantly inhibited APOC3 expression more than the reference GalXC APOC3 oligonucleotide used as a control. The sequences of these oligonucleotides, along with their modification patterns and sequence numbers, are disclosed in Tables 2 and 3 in relation to Figure 1.

[0237] [Table 5]

[0238] Tables 5-12 show an additional set of HDI mouse studies using GalXC-APOC3 oligonucleotides with the same reference oligonucleotide.

[0239] [Table 6]

[0240] [Table 7]

[0241] [Table 8] [Table 9]

[0242] [Table 10]

[0243] [Table 11]

[0244] [Table 12]

[0245] [Table 13]

[0246] [Table 14]

[0247] Based on these results, eight GalXC-APOC3 oligonucleotides were selected to evaluate their ability to inhibit APOC3 expression in NHP. Six of these were selected as dual common, and two are unique to humans. The GalXC-APOC3 oligonucleotides have chemically modified nucleotides in the patterns shown in Figure 1, particularly Figure 1C.

[0248] NHP Study: Eight GalXC-APOC3 oligonucleotides selected from the mouse studies described above were evaluated in cynomolgus monkeys (Macaca fascicularis) with a single dose (6 mg / kg) over an 84-day study. Here, NHP grouping was performed so that mean body weight (approximately 5.4 kg) was equivalent between the control and experimental groups. Each cohort contained 5 individuals (2 males, 3 females). GalXC-APOC3 oligonucleotides were administered via single-dose injection on day 0 of the study. Blood samples were collected at two time points before administration (i.e., -21 and day 0), and then weekly after administration, for liver enzyme panel and lipid profile analysis. Ultrasound-guided core needle liver biopsies were collected on study days -21, 28, 56, and 83. At each time point, total RNA from the liver biopsy samples was individually analyzed by qRT-PCR, and the mRNA of APOC3 in oligonucleotide-treated monkeys was measured compared to monkeys treated with an equivalent amount of PBS. To normalize the data, measurements were performed against the geometric mean of two reference genes, PPIB and 18S rRNA. As shown in Table 13, treatment of NHP with GalXC-APOC3 oligonucleotide inhibits APOC3 expression in the liver. This is determined by a decrease in the amount of APOC3 mRNA in liver samples of NHP treated with oligonucleotide compared to NHP treated with PBS. At all time points evaluated, GalXC-APOC3 oligonucleotide significantly inhibited APOC3 expression compared to benchmark PBS and time-matched controls. From the same NHP study, inhibition of APOC3 expression was also determined by measuring APOC3 protein in serum prepared from pre-administration and weekly blood samples using ELISA. In summary, treatment of NHP with GalXC-APOC3 oligonucleotide demonstrates a decrease in the amount of APOC3 mRNA in the liver and simultaneously a decrease in the amount of APOC3 protein in serum.

[0249] [Table 15-1] [Table 15-2]

[0250] In addition to the above, RNA-seq of liver biopsies on day 28 showed that GalXC-APOC3-47 was the most potent test for knockdown of APOC3 mRNA (23.4% residual), followed by GalXC-APOC3-46 (27.3% residual), GalXC-15 (B, 34.4% residual), GalXC-41 (38.4% residual), and GalXC-18 (43.0% residual). As shown in Table 14, GalXC-APOC3-15, GalXC-APOC3-18, GalXC-APOC3-46, and GalXC-APOC3-47 showed only slight overall changes in the liver transcriptome, while GalXC-APOC3-41 showed changes in the expression of more genes. In this RNA-seq study, no off-target effects based on GalXC-guided mRNA hybridization were observed, except for APOC3-41.

[0251] [Table 16]

[0252] In summary, these results indicate that GalXC-APOC3 oligonucleotides, designed to target human APOC3 mRNA, inhibit APOC3 expression in vivo (as determined by a decrease in the amounts of APOC3 mRNA and APOC3 protein in treated animals).

[0253] array The following nucleic acid sequences and / or amino acid sequences are referenced in this disclosure and are provided below for reference.

[0254] Sequence ID 1 - Wild-type human APOC3 (535bp; NCBI reference sequence ID: NM_000040.3) ctgctcagttcatccctagaggcagctgctccaggaacagaggtgccatgcagccccgggtactccttgttgttgccctcctggcgctcctggcctctgcccgagcttcagaggccgaggatgcctcccttctcagcttcatgcagggttacatgaagcacgccaccaagaccgccaaggatgcactgagcagcgtgcaggagtcccaggtggcccagcaggccaggggctgggtgaccgatggcttcagttccctgaaagactactggagcaccgttaaggacaagttctctgagttctgggatttggaccctgaggtcagaccaacttcagccgtggctgcctgagacctcaataccccaagtccacctgcctatccatcctgcgagctccttgggtcctgcaatctccagggctgcccctgtaggttgcttaaaagggacagtattctcagtgctctcctaccccacctcatgcctggcccccctccaggcatgctggcctcccaataaagctggacaagaagctgctatga

[0255] SEQ ID NO: 2 - Wild-type human APOC3 (99 aa; NCBI reference sequence number NP_079501.2) MQPRVLLVVALLALLASARASEAEDASLLSFMQGYMKHATKTAKDALSSVQESQVAQQARGWVTDGFSSLKDYWSTVKDKFSEFWDLDPEVRPTSAVAA

[0256] SEQ ID NO: 3 - Mouse APOC3 (631 bp; NCBI reference sequence number: NM_001289755.1) gcctgctcagttttatccctagaagcagctagctactccaggtaatgcccctggggaggagaggaaggaagggaagaaacaaagagctggagggagaagctctcaccacccagccatctagcccacagaaggcttgggactcatggtacgtaggtgccatgcagccccggacgctcctcactgtggccctcttggctctcctggcatctgcccgagctgaagaggtagagggatccttgctgctgggctctgtacagggctacatggaacaagcctccaagacggtccaggatgcgctaagtagcgtgcaggagtccgatatagctgtggtggccaggggctggatggacaatcacttcagatccctgaaaggctactggagcaagtttactgacaagttcaccggcttctgggattctaaccctgaggaccaaccaactccagctattgagtcgtgagacttctgtgttgcagatgtgcctgttcctccatcctgctgcccccctccaggcctgccaggtggcccctgaaggttgctttaaggggaaagtatgttctcatgtcttcacccctccctagatctcacctaaacatgctgtccctaataaagctggataagaagctgctgtta

[0257] SEQ ID NO: 4 - Mouse APOC3 (99 aa; NCBI Ref Seq ID: NP_001276684.1) MQPRTLLTVALLALLASARAEEVEGSLLLGSVQGYMEQASKTVQDALSSVQESDIAVVARGWMDNHFRSLKGYWSKFTDKFTGFWDSNPEDQPTPAIES

[0258] SEQ ID NO: 5 - Rat APOC3 (579 bp; NCBI Ref Seq ID NM_001271053) atgcccctggggaggagaggaagggagggaggagacagagagaagacgctctggccactcagccagctagcctacagaatgcttggaattcatggcctccacccttgggttcctggtgcacaggtgccatgcagccccgaatgctcctcatcgtggccctcgtggctctcctggcctctgcccgagctgatgagggagagggatccttgctgctgggctctatgcagggctacatggaacaagcctccaagacggtccaggatgcactaagcagcatgcaggagtctgatatagctgtggtggccaggggctggatggacaatcgcttcaaatccctgaaaggctactggagcaagttcactgataagttcactggcctctgggagtctggccctgaggaccaactaacaacaccaactcttgagccgtgagacctccatgttccagatgtgtctggccatctatcctgctgcctccgaaggttgctctaaggggaaagtatattctcatgcctttatccctccccagacctcacctaaacatgctgtccctaataaagctggacacgaagctgccatg

[0259] SEQ ID No. 6 - Rat APOC3 (100 aa; NCBI Ref. Seq. No.: NP_001257982.1) MQPRMLLIVALVALLASARADEGEGSLLLGSMQGYMEQASKTVQDALSSMQESDIAVVARGWMDNRFKSLKGYWSKFTDKFTGLWESGPEDQLTTPTLEP

[0260] SEQ ID No. 7 - Primate APOC3 (567 bp; NCBI Ref. Seq. No. XM_005579730.1) aatataaaacaggtcagaaccctcctgcctgcctgctctgttcatccctagaggcagctgctccaggaacagaggcgccatgcagccccgggtactccttgttgctgccctgctgtcactcctggcctctgccagagcttcagaggccgaggacacctcccttcttggcttcatgcagggctacatgcagcatgccaccaagaccgccaaggatgcactgaccagcgtccaggagtcccaggtggcccagcaggccagaggctgggtgaccgatggcttcagttccctgaaagactactggagcaccgttaaggacaagttatctgggttctgggatttgaaccctgaggccaaacccactctggctgaggctgcctgagacctcaataccccaagtccacctgcctgtccatcctgccagctccttgggtcctgcagcctccagggctgcccctgtaggttgcttaaaagggacagtattctcagtgccctcctaccgcacctcatgcctggcccccctccaggcagggtgtcctcccaataaagctggacaagaagctgctatga

[0261] SEQ ID NO:8 - Primate APOC3 (99 aa; NCBI reference sequence number XP_005579787.1) MQPRVLLVAALLSLLASARASEAEDTSLLGFMQGYMQHATKTAKDALTSVQESQVAQQARGWVTDGFSSLKDYWSTVKDKLSGFWDLNPEAKPTLAEAA

[0262]

Table 17 - 1

[0263] Table 18-1 Table 18-2 Table 18-3 Table 18-4 Table 18-5 Table 18-6 Table 18-7 Table 18-8 Table 18-9 Table 18-10 Table 18-11 Table 18-12 Table 18-13 [Table 18-14] [Table 18-15] [Table 18-16] [Table 18-17] [Table 18-18] [Table 18-19] [Table 18-20] [Table 18-21] [Table 18-22] [Table 18-23]

[0264] Sequence ID 333 - Artificial Sequence GCAGCCGAAAGGCUGC

[0265] Sequence ID 334 - Target Sequence 1 TTCAGTTCCCTGAAAGACTA

[0266] Sequence ID 335 - Target Sequence 2 TGGAGCACCGTTAAGGACAA

[0267] Sequence ID 336 - Target Sequence 3 ACCGTTAAGGACAAGTTCT

[0268] Sequence ID 337 - Target Sequence 4 GCTGCCCCTGTAGGTTGCT

[0269] Sequence ID 338 - Target Sequence 5 GTAGGTTGCTTAAAAGGGA

[0270] Sequence ID 339 - Target Sequence 6 CTTAAAAGGGACAGTATTC

[0271] Sequence ID 340 - Target Sequence 7 AAAAGGGACAGTATTCTCA

[0272] Sequence ID 341 - Target Sequence 8 GACAGTATTCTCAGTGCTC Another aspect of the present invention may be as follows: [1] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand, the sense strand and the antisense strand form a double-stranded region, the antisense strand includes a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, and the complementary region is at least 15 consecutive nucleotides long. [2] The RNAi oligonucleotide described in [1], wherein the sense strand has a length of 15 to 50 nucleotides. [3] The RNAi oligonucleotide according to [1] or [2], wherein the sense strand has a length of 18 to 36 nucleotides. [4] The RNAi oligonucleotide described in any one of the above [1] to [3], wherein the antisense strand has a length of 15 to 30 nucleotides. [5] The RNAi oligonucleotide according to any one of [1] to [4], wherein the antisense strand is 22 nucleotides long, and the antisense strand and the sense strand form a double-stranded region having a length of at least 19 nucleotides, and optionally at least 20 nucleotides. [6] The RNAi oligonucleotide according to any one of [1] to [5] above, wherein the complementary region has a length of at least 19 consecutive nucleotides, and optionally a length of at least 20 nucleotides. [7] The RNAi oligonucleotide according to any one of [1] to [6], wherein the 3' end of the sense strand includes a stem loop represented as S1-L-S2, where S1 is complementary to S2, and L forms a loop between S1 and S2 of a length of 3 to 5 nucleotides. [8] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand having a length of 15 to 50 nucleotides, the sense strand and the antisense strand form a double-stranded region, the antisense strand includes a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, and the complementary region has a length of at least 15 consecutive nucleotides. [9] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand of 15 to 50 nucleotides in length and an antisense strand of 15 to 30 nucleotides in length, the sense strand and the antisense strand form a double-stranded region, the antisense strand comprises a region complementary to one of the APOC3 mRNA target sequences from sequence numbers 334 to 341, and the complementary region is at least 15 consecutive nucleotides in length.

[10] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand having a length of 15 to 50 nucleotides, the sense strand and the antisense strand form a double-stranded region, the antisense strand includes a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, and the complementary region has a length of 19 consecutive nucleotides, or optionally 20 nucleotides.

[11] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand having a length of 18 to 36 nucleotides, the sense strand and the antisense strand form a double-stranded region, the antisense strand includes a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, and the complementary region has a length of 19 consecutive nucleotides, or optionally 20 nucleotides.

[12] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand of 18 to 36 nucleotides in length and an antisense strand of 22 nucleotides in length, the sense strand and the antisense strand form a double-stranded region, the antisense strand comprises a region complementary to one of the APOC3 mRNA target sequences from sequence numbers 334 to 341, and the complementary region is 19 consecutive nucleotides long, or optionally 20 nucleotides long.

[13] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand of 18 to 36 nucleotides in length and an antisense strand of 22 nucleotides in length, wherein the sense strand and the antisense strand form a double-stranded region, the 3' end of the sense strand comprises a stem-loop represented as S1-L-S2, where S1 is complementary to S2, and L forms a loop of 3 to 5 nucleotides in length between S1 and S2, the antisense strand comprises a region complementary to any one of the APOC3 mRNA target sequences from sequence numbers 334 to 341, and the complementary region is 19 consecutive nucleotides in length, and optionally 20 nucleotides in length.

[14] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand of 36 nucleotides in length and an antisense strand of 22 nucleotides in length, wherein the sense strand and the antisense strand form a double-stranded region, the 3' end of the sense strand comprises a stem-loop represented as S1-L-S2, where S1 is complementary to S2, and L forms a loop of 3 to 5 nucleotides in length between S1 and S2, the antisense strand comprises a region complementary to any one of the APOC3 mRNA target sequences from sequence numbers 334 to 341, and the complementary region is 19 consecutive nucleotides in length, and optionally 20 nucleotides in length.

[15] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand of 36 nucleotides in length and an antisense strand of 22 nucleotides in length, wherein the sense strand and the antisense strand form a double-stranded region of at least 19 nucleotides in length, optionally 20 nucleotides in length, the 3' end of the sense strand comprises a stem-loop represented as S1-L-S2, where S1 is complementary to S2, and L forms a loop of 3 to 5 nucleotides in length between S1 and S2, the antisense strand comprises a region complementary to any one of the APOC3 mRNA target sequences of sequence numbers 334 to 341, wherein the complementary region is 19 consecutive nucleotides in length, optionally 20 nucleotides in length.

[16] RNAi oligonucleotides according to any one of the above items [7] and

[13] to

[15] , wherein L is a triloop or a tetraloop.

[17] The RNAi oligonucleotide described in

[16] above, wherein L is a tetraloop.

[18] The RNAi oligonucleotide according to

[17] , wherein the tetraloop contains the sequence 5'-GAAA-3'.

[19] RNAi oligonucleotides according to any one of the above

[13] to

[18] , wherein S1 and S2 are the same length as 1 to 10 nucleotides.

[20] The RNAi oligonucleotide according to

[19] , wherein S1 and S2 have lengths of 1 nucleotide, 2 nucleotides, 3 nucleotides, 4 nucleotides, 5 nucleotides, 6 nucleotides, 7 nucleotides, 8 nucleotides, 9 nucleotides, or 10 nucleotides.

[21] The RNAi oligonucleotide described in

[20] , wherein S1 and S2 have a length of 6 nucleotides.

[22] The RNAi oligonucleotide according to any one of the above

[13] to

[21] , wherein the stem-loop comprises the sequence 5'-GCAGCCGAAAGGCUGC-3' (SEQ ID NO: 333).

[23] The RNAi oligonucleotide according to any one of the above [1] to

[22] , wherein the antisense strand includes a 3' overhang sequence having the length of one or more nucleotides.

[24] The RNAi oligonucleotide according to

[23] , wherein the 3' overhang is the length of two nucleotides, and the 3' overhang is optionally GG.

[25] RNAi oligonucleotide according to any one of the prior embodiments, comprising at least one modified nucleic acid base.

[26] The RNAi oligonucleotide according to any one of

[13] to

[25] , wherein all nucleotides in the stem loop of the oligonucleotide, except for the nucleotide in the loop, are modified.

[27] The RNAi oligonucleotide according to

[25] or

[26] , wherein the modified nucleotide includes a 2' modification.

[28] The RNAi oligonucleotide according to

[27] , wherein the 2' modification is a modification selected from the group consisting of 2'-aminoethyl, 2'-fluoro, 2'-O-methyl, 2'-O-methoxyethyl, and 2'-deoxy-2'-fluoro-β-d-arabinonucleotide.

[29] The RNAi oligonucleotide according to any one of the above

[25] to

[28] , wherein all nucleotides including the RNAi oligonucleotide are modified, and optionally the modification is a 2'-modification selected from the group consisting of 2'-fluoro and 2'-O-methyl.

[30] The RNAi oligonucleotide according to

[29] , wherein one or more nucleotides at position 8, 9, 10, or 11 of the sense strand are modified with a 2'-fluoronucleotide.

[31] The RNAi oligonucleotide according to

[29] or

[30] , wherein one or more nucleotides at positions 2, 3, 4, 5, 7, 10, or 14 of the antisense strand are modified with a 2'-fluoro compound.

[32] The RNAi oligonucleotide according to either

[29] or

[31] , wherein one or more nucleotides at positions 1, 2, 3, 4, 5, 6, 7, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 31, 32, 33, 34, 35, or 36 of the sense strand are modified with 2'-O-methyl.

[33] The RNAi oligonucleotide according to any one of the above

[29] to

[32] , wherein one or more nucleotides at position 1, 6, 8, 9, 11, 12, 13, 15, 16, 17, 18, 19, 20, 21, or 22 of the antisense strand are modified with 2'-O-methyl.

[34] The RNAi oligonucleotide according to any one of the preceding embodiments, comprising at least one modified nucleoside bond.

[35] The RNAi oligonucleotide according to

[34] , wherein the bond between at least one modified nucleotide is a phosphorothioate bond.

[36] The RNAi oligonucleotide according to

[35] , wherein the internucleotide bonds of the nucleotides at positions 1 and 2 of the sense strand are modified with phosphorothioate bonds.

[37] The RNAi oligonucleotide according to

[35] or

[36] , wherein the internucleotide bond of one or more nucleotides at positions 1 and 2, 2 and 3, 3 and 4, 20 and 21, or 21 and 22 of the antisense strand is modified by a phosphorothioate bond.

[38] The RNAi oligonucleotide according to any one of the above items [1] to

[24] , wherein the RNAi oligonucleotide has a modification pattern as shown in Figure 1A, Figure 1B, or Figure 1C.

[39] The RNAi oligonucleotide according to

[38] , wherein the RNAi oligonucleotide has a modification pattern as shown in Figure 1B.

[40] The RNAi oligonucleotide according to any one of the prior embodiments, wherein the 4' carbon of the sugar of the 5' nucleotide of the antisense chain contains a phosphate analog.

[41] The RNAi oligonucleotide according to

[40] , wherein the phosphate analog is oxymethylphosphonate, vinylphosphonate, or malonylphosphonate, and optionally the phosphate analog is a 4'-phosphate analog containing 5'-methoxyphosphonate-4'-oxy.

[42] The RNAi oligonucleotide according to any one of the prior embodiments, wherein at least one nucleotide of the oligonucleotide is conjugated to one or more targeting ligands.

[43] The RNAi oligonucleotide described in

[42] , wherein each targeted ligand comprises a carbohydrate, amino sugar, cholesterol, polypeptide, or lipid.

[44] The RNAi oligonucleotide described in

[43] , wherein each targeted ligand contains an N-acetylgalactosamine (GalNAc) moiety.

[45] The RNAi oligonucleotide according to

[43] , wherein the GalNAc portion is a monovalent GalNAc portion, a divalent GalNAc portion, a trivalent GalNAc portion, or a tetravalent GalNAc portion.

[46] The RNAi oligonucleotide according to any one of the above

[16] to

[41] , wherein up to four nucleotides of L in the stem-loop are each conjugated to a monovalent GalNAc portion.

[47] The sense chain is sequence numbers 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, 79, 81, 83, 85, 87, 89, 91, 93, 95, 97, 99, 101, 103, 105, 107, 10 RNAi oligonucleotides according to any one of the preceding embodiments, comprising any one nucleotide sequence of 9, 111, 113, 115, 117, 119, 121, 123, 125, 127, 129, 131, 133, 135, 137, 139, 141, 143, 145, 147, 149, 151, 153, 155, 157, 159, 161, 163, 165, 167, and 169.

[48] ​​The antisense chain is sequence numbers 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, 42, 44, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, 78, 80, 82, 84, 86, 88, 90, 92, 94, 96, 98, 100, 102, 104, 106, 108, RNAi oligonucleotides according to any one of the preceding embodiments, comprising one nucleotide sequence of any of the following: 110, 112, 114, 116, 118, 120, 122, 124, 126, 128, 130, 132, 134, 136, 138, 140, 142, 144, 146, 148, 150, 152, 154, 156, 158, 160, 162, 164, 166, 168, and 170.

[49] RNAi oligonucleotide according to any one of the preceding embodiments, wherein the sense strand and the antisense strand include nucleotide sequences selected from the group consisting of: (a) Sequence IDs 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106.

[50] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 37 and the antisense strand is sequence number 38.

[51] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 43 and the antisense strand is sequence number 44.

[52] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 45 and the antisense strand is sequence number 46.

[53] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 87 and the antisense strand is sequence number 88.

[54] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 89 and the antisense strand is sequence number 90.

[55] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 99 and the antisense strand is sequence number 100.

[56] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 101 and the antisense strand is sequence number 102.

[57] The RNAi oligonucleotide according to

[49] , wherein the sense strand is sequence number 105 and the antisense strand is sequence number 106.

[58] RNAi oligonucleotides according to any one of [1] and [8] to

[15] , wherein the sense strand and the antisense strand contain nucleotide sequences selected from the group consisting of the following: (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 206, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

[59] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 199 and the antisense strand is sequence number 200.

[60] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 205 and the antisense strand is sequence number 206.

[61] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 207 and the antisense strand is sequence number 208.

[62] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 249 and the antisense strand is sequence number 250.

[63] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 251 and the antisense strand is sequence number 252.

[64] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 261 and the antisense strand is sequence number 262.

[65] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 263 and the antisense strand is sequence number 264.

[66] The RNAi oligonucleotide according to

[58] , wherein the sense strand is sequence number 267 and the antisense strand is sequence number 268.

[67] The RNAi oligonucleotide according to any one of

[58] to

[66] , wherein at least one nucleotide of the oligonucleotide is conjugated to one or more targeting ligands.

[68] The RNAi oligonucleotide according to

[67] , wherein each targeting ligand is a carbohydrate, amino sugar, cholesterol, polypeptide, or lipid.

[69] The RNAi oligonucleotide described in

[68] , wherein each targeted ligand contains an N-acetylgalactosamine (GalNAc) moiety.

[70] The RNAi oligonucleotide according to

[69] , wherein the GalNAc portion is a monovalent GalNAc portion, a divalent GalNAc portion, a trivalent GalNAc portion, or a tetravalent GalNAc portion.

[71] The RNAi oligonucleotide according to

[69] , wherein the sequence 5'-GCAGCCGAAAGGCUGC-3' (SEQ ID NO: 333) in the sense strand forms a stem-loop structure, and the nucleotides in the 5'-GAAA-3' sequence in the loop are each conjugated to a monovalent GalNAc portion.

[72] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand, the sense strand and the antisense strand form a double-stranded region, all nucleotides including the sense strand and the antisense strand are modified, the antisense strand comprises a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, and the complementary region is the length of at least 15 consecutive nucleotides.

[73] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand, the sense strand and the antisense strand form a double-stranded region, all nucleotides comprising the sense strand and the antisense strand are modified, the antisense strand comprises a 4'-carbon phosphate analog of the sugar of the 5'-nucleotide, and the antisense strand comprises a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, wherein the complementary region is at least 15 consecutive nucleotides long.

[74] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand, the sense strand and the antisense strand form a double-stranded region, all nucleotides comprising the sense strand and the antisense strand are modified, the antisense strand comprises a 4'-carbon phosphate analog of the sugar of the 5'-nucleotide, and the antisense strand comprises a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, wherein the complementary region is at least 19 consecutive nucleotides long.

[75] RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand, the sense strand and the antisense strand form a double-stranded region, all nucleotides constituting the sense strand and the antisense strand are modified, the antisense strand and the sense strand comprise one or more nucleotides modified with 2'-fluoro and 2'-O-methyl and at least one phosphorothioate bond, the 4' carbon of the sugar of the 5' nucleotide of the antisense strand comprises a phosphate analog, and the antisense strand comprises a region complementary to any one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, wherein the complementary region is the length of at least 15 consecutive nucleotides.

[76] The RNAi oligonucleotide according to any one of the above

[72] to

[75] , wherein the sense strand comprises one of sequence numbers 37, 43, 45, 87, 89, 99, 101, and 105, and the sense strand comprises one of sequence numbers 199, 205, 207, 249, 251, 261, 263, and 267.

[77] The RNAi oligonucleotide according to any one of the above

[72] to

[76] , wherein the antisense strand comprises one of SEQ ID NOs: 38, 44, 46, 88, 90, 100, 102, and 106, and the antisense strand comprises one of the above

[700] , 206, 208, 250, 252, 262, 264, and 268.

[78] RNAi oligonucleotides according to any one of

[72] to

[77] , wherein the sense strand and the antisense strand are selected from the group consisting of the following: (a) Sequence IDs 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106; or (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 206, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

[79] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 199 and the antisense strand is sequence number 200.

[80] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 205 and the antisense strand is sequence number 206.

[81] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 207 and the antisense strand is sequence number 208.

[82] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 249 and the antisense strand is sequence number 250.

[83] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 251 and the antisense strand is sequence number 252.

[84] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 261 and the antisense strand is sequence number 262.

[85] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 263 and the antisense strand is sequence number 264.

[86] The RNAi oligonucleotide according to

[78] , wherein the sense strand is sequence number 267 and the antisense strand is sequence number 286.

[87] The RNAi oligonucleotide according to any one of

[72] to

[86] , wherein at least one nucleotide of the oligonucleotide is conjugated to one or more targeting ligands.

[88] The RNAi oligonucleotide described in

[87] , wherein each targeting ligand is a carbohydrate, amino sugar, cholesterol, polypeptide, or lipid.

[89] The RNAi oligonucleotide described in

[88] , wherein each targeted ligand contains an N-acetylgalactosamine (GalNAc) moiety.

[90] The RNAi oligonucleotide according to

[89] , wherein the GalNAc portion is a monovalent GalNAc portion, a divalent GalNAc portion, a trivalent GalNAc portion, or a tetravalent GalNAc portion.

[91] The RNAi oligonucleotide according to

[89] , wherein the sequence 5'-GCAGCCGAAAGGCUGC-3' (SEQ ID NO: 333) in the sense strand forms a stem-loop structure, and the nucleotides in the 5'-GAAA-3' sequence in the loop are each conjugated to a monovalent GalNAc portion.

[92] RNAi oligonucleotide for reducing the expression of apolipoprotein C-III (APOC3), wherein the oligonucleotide comprises a sense strand and an antisense strand, the sense strand and the antisense strand form a double-stranded region, and the sense strand and the antisense strand consist of sequences selected from the group consisting of the following: (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 206, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

[93] The RNAi oligonucleotide according to

[92] , wherein the sequence 5'-GCAGCCGAAAGGCUGC-3' (SEQ ID NO: 333) in the sense strand forms a stem-loop structure, and the nucleotides in the 5'-GAAA-3' sequence in the loop are each conjugated to a monovalent GalNAc portion.

[94] A pharmaceutical composition, An RNAi oligonucleotide described in any one of the above paragraphs [1] to

[93] , or a pharmaceutically acceptable salt thereof, The pharmaceutical composition comprising a pharmaceutically acceptable carrier, delivery agent, or excipient.

[95] A method for delivering oligonucleotides to an individual, wherein the method is: The method comprising the step of administering the pharmaceutical composition described in

[94] above to the individual.

[96] A method for treating an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) expression, wherein the method is: The method comprising the step of administering a therapeutically effective amount of the RNAi oligonucleotide described in any one of items [1] to

[93] above, or the pharmaceutical composition described in item

[94] above, to the individual, thereby treating the individual.

[97] A method for reducing the expression of apolipoprotein C-III (APOC3) in cells, a population of cells or an individual, wherein the method is: The step of contacting the cells or a group of cells with the RNAi oligonucleotide described in any one of items [1] to

[93] above or the pharmaceutical composition described in item

[94] above; or The method comprising the step of administering to the individual an RNAi oligonucleotide described in any one of items [1] to

[93] above or a pharmaceutical composition described in item

[94] above.

[98] The method according to

[97] , wherein reducing APOC3 expression includes reducing the amount or level of APOC3 mRNA, the amount or level of APOC3 protein, or both.

[99] The method according to

[97] or

[98] , wherein the individual has a disease, disorder, or condition related to APOC3 expression.

[100] The method according to

[99] , wherein the disease, disorder, or condition associated with APOC3 expression is acute coronary artery disease (ACD), atherosclerotic cardiovascular disease (ASCVD), alcoholic hepatitis (AH), alcoholic liver disease (ALD), cardiovascular metabolic disease, cholangiocarcinoma (CCA), cirrhosis, coronary heart disease (CHD), diabetes mellitus, hepatic fibrosis, hepatitis, hepatocellular carcinoma (HCC), hyperlipidemia, hypertriglyceridemia, high non-HDL cholesterol, insulin resistance, hepatic steatosis, metabolic syndrome (MetS), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), obesity, or primary sclerosing cholangitis (PSC).

[101] The method according to any one of the above

[96] to

[100] , wherein the RNAi oligonucleotide or pharmaceutical composition is administered in combination with a second composition or therapeutic agent.

[102] A method for treating an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) expression, wherein the method is: The method comprises the step of administering an RNAi oligonucleotide comprising a sense strand and an antisense strand to the individual, wherein the sense strand and the antisense strand form a double-stranded region, and the antisense strand comprises a region complementary to one of the APOC3 mRNA target sequences from SEQ ID NOs. 334 to 341, wherein the complementary region is the length of at least 15 consecutive nucleotides.

[103] A method for treating an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) expression, wherein the method is: The method comprising the step of administering to the individual a therapeutically effective amount of RNAi oligonucleotide or a pharmaceutical composition thereof, comprising a sense strand and an antisense strand selected from the rows shown in Table 2 or Table 3, thereby treating the individual.

[104] A method for treating an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) expression, wherein the method is: The method comprises the step of administering a therapeutically effective amount of an RNAi oligonucleotide comprising a sense strand and an antisense strand to the individual, wherein the sense strand and the antisense strand comprise nucleotide sequences selected from the group consisting of: (a) Sequence IDs 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106; or (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 260, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

[105] A method for treating an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) expression, wherein the method is: The method comprises the step of administering a therapeutically effective amount of an RNAi oligonucleotide comprising a sense strand and an antisense strand to the individual, wherein the sense strand and the antisense strand are selected from the group consisting of: (a) Sequence IDs 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106; or (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 260, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

[106] The method according to

[105] , wherein the sense chain is sequence number 199 and the antisense chain is sequence number 200.

[107] The method according to

[105] , wherein the sense chain is sequence number 205 and the antisense chain is sequence number 206.

[108] The method according to

[105] , wherein the sense chain is sequence number 207 and the antisense chain is sequence number 208.

[109] The method according to

[15] , wherein the sense chain is sequence number 249 and the antisense chain is sequence number 250.

[110] The method according to

[105] , wherein the sense chain is sequence number 251 and the antisense chain is sequence number 252.

[111] The method according to

[105] , wherein the sense chain is sequence number 261 and the antisense chain is sequence number 262.

[112] The method according to

[75] , wherein the sense chain is sequence number 263 and the antisense chain is sequence number 264.

[113] The method according to

[75] , wherein the sense chain is sequence number 267 and the antisense chain is sequence number 268.

[114] The method according to any one of the above

[105] to

[113] , wherein the disease, disorder, or condition associated with APOC3 expression is selected from the group consisting of acute coronary artery disease (ACD), atherosclerotic cardiovascular disease (ASCVD), alcoholic hepatitis (AH), alcoholic liver disease (ALD), cardiovascular metabolic disease, cholangiocarcinoma (CCA), cirrhosis, coronary heart disease (CHD), diabetes mellitus, hepatic fibrosis, hepatitis, hepatocellular carcinoma (HCC), hyperlipidemia, hypertriglyceridemia, high non-HDL cholesterol, insulin resistance, hepatic steatosis, metabolic syndrome (MetS), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), obesity, or primary sclerosing cholangitis (PSC).

[115] Use of an RNAi oligonucleotide described in any one of items [1] to

[93] above, or a pharmaceutical composition described in

[94] above, in the manufacture of a pharmaceutical for the treatment of a disease, disorder, or condition associated with apolipoprotein C-III (APOC3) expression, optionally, for the treatment of acute coronary artery disease (ACD), atherosclerotic cardiovascular disease (ASCVD), alcoholic hepatitis (AH), alcoholic liver disease (ALD), cardiovascular metabolic disease, cholangiocarcinoma (CCA), cirrhosis, coronary heart disease (CHD), diabetes mellitus, hepatic fibrosis, hepatitis, hepatocellular carcinoma (HCC), hyperlipidemia, hypertriglyceridemia, high non-HDL cholesterol, insulin resistance, hepatic steatosis, metabolic syndrome (MetS), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), obesity, or primary sclerosing cholangitis (PSC).

[116] RNAi oligonucleotides according to any one of the above paragraphs [1] to

[93] , or pharmaceutical compositions according to the above paragraph

[94] , for use in or applicable to use in the treatment of diseases, disorders, or conditions associated with apolipoprotein C-III (APOC3) expression, optionally, acute coronary artery disease (ACD), atherosclerotic cardiovascular disease (ASCVD), alcoholic hepatitis (AH), alcoholic liver disease (ALD), cardiovascular metabolic disease, cholangiocarcinoma (CCA), cirrhosis, coronary heart disease (CHD), diabetes mellitus, hepatic fibrosis, hepatitis, hepatocellular carcinoma (HCC), hyperlipidemia, hypertriglyceridemia, high non-HDL cholesterol, insulin resistance, hepatic steatosis, metabolic syndrome (MetS), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), obesity, or primary sclerosing cholangitis (PSC).

[117] A kit comprising an RNAi oligonucleotide as described in any one of items [1] to

[93] above, an optional pharmaceutically acceptable carrier, and a package insert including instructions for use in administering to an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) expression.

[118] RNAi oligonucleotides or pharmaceutical compositions or kits according to

[117] for use according to

[115] , use according to

[116] , or applicable to use thereof, for use according to

[115] , use according to

[116] , for use according to

[117] , for use according to

[117] , for use according to

[115] , for use according to

[116] , for use according to

[117] , for use according to

[117] , for use according to

[115] , for use according to

[116] , or applicable to use thereof, for use according to

[117] , for use according to

[115] , for use according to

[116] , or for use according to

[117] , for use according to

[117] , for use according to

[115] , for use according to

[116] , or for use according to

[117] , for use according to

[115] , for use according to

[116] , or applicable to use according to

[117] , for use according to

[115] , for use according to

[116] , or for use according to

[117] , for use according to [115

[119] RNAi oligonucleotides for reducing the expression of apolipoprotein C-III (APOC3), wherein the oligonucleotide has a sense strand and an antisense strand which are optionally modified, the sense strand and the antisense strand form a double-stranded region, and the sense strand and the antisense strand are a pair selected from the group consisting of: (a) Sequence numbers 37 and 38, (b) Sequence IDs 43 and 44, (c) Sequence IDs 45 and 46, (d) Sequence numbers 87 and 88, (e) Sequence numbers 89 and 90, (f) Sequence numbers 99 and 100, (g) Sequence IDs 101 and 102, and (h) Sequence IDs 105 and 106; The RNAi oligonucleotide wherein the sequence 5'-GCAGCCGAAAGGCUGC-3' (SEQ ID NO: 333) in the sense strand forms a stem-loop structure, and the nucleotides in the 5'-GAAA-3' sequence in the loop are each conjugated to a monovalent GalNAc portion.

[120] The RNAi oligonucleotide described in

[119] , wherein the sense strand and the antisense strand are optionally modified and the pair is selected from the group consisting of the following: each, (a') Sequence IDs 199 and 200, (b') Sequence numbers 205 and 260, (c') Sequences 207 and 208, (d') Sequence numbers 249 and 250, (e') Sequence numbers 251 and 252, (f') Sequence numbers 261 and 262, (g') Sequence IDs 263 and 264, and (h') Sequence numbers 267 and 268.

Claims

1. RNAi oligonucleotide for reducing apolipoprotein C-III (APOC3) expression, wherein the oligonucleotide comprises a sense strand and an antisense strand, and the sense strand and the antisense strand form a double-stranded region. The aforementioned sense chain, [mGs][mU][mA][mG][mG][mU][mU][fG][fC][fU][fU][mA][mA][mA][mA][mG][mG][mG][mA][mA][mG][mC][mA][mG][mC][mC][mG][ademA-GalN Ac][ademA-GalN Ac][ademA-GalNAc][mG][mG][mC][mU][mG][mC] (Sequence ID 251) and The aforementioned antisense chain, [MePhosphonate-4O-mUs][fUs][fCs][fC][fC][mU][fU][mU][mU][fA][mA][mG][mC][fA][mA][mC][mC][mU][mA][mCs][mGs][mG] (SEQ ID NO: 252) And, mGs represents 2'-O-methylguanosine having a 3'-phosphorothioate bond, mU represents 2'-O-methyluridine having a 3'-phosphodiester bond, mA represents 2'-O-methyladenosine having a 3'-phosphodiester bond, mG represents 2'-O-methylguanosine having a 3'-phosphodiester bond, fG represents 2'-fluoroguanosine having a 3'-phosphodiester bond, fC represents a 2'-fluorocytidine having a 3'-phosphodiester bond, fU represents a 2'-fluorouridine having a 3'-phosphodiester bond, mC represents 2'-O-methylcytidine having a 3'-phosphodiester bond, ademA-GalNAc represents 2'-aminodiethoxymethanol-adenosine-GalNAc having a 3'-phosphodiester bond, MePhosphonate-4O-mUs represents 5'-methoxyphosphonate-4'-oxy-2'-O-methyluridine having a 3'-phosphorothioate bond, fUs represents a 2'-fluorouridine having a 3'-phosphorothioate bond, fCs represents a 2'-fluorocytidine having a 3'-phosphorothioate bond, fA represents 2'-fluoroadenosine having a 3'-phosphodiester bond, mCs represents 2'-O-methylcytidine having a 3'-phosphorothioate bond. The aforementioned RNAi oligonucleotide.

2. The RNAi oligonucleotide according to claim 1, or a pharmaceutically acceptable salt thereof, A pharmaceutically acceptable carrier, delivery agent, or excipient A pharmaceutical composition containing the following:

3. The pharmaceutical composition according to claim 2, wherein the pharmaceutically acceptable carrier is a carrier suitable for intravenous administration.

4. The pharmaceutical composition according to claim 3, wherein the carrier comprises water.

5. The pharmaceutical composition according to claim 3, wherein the carrier comprises phosphate-buffered saline.

6. The pharmaceutical composition according to claim 2, for use in reducing the expression of the apolipoprotein C-III (APOC3) gene in cells, a population of cells, or an individual.

7. The pharmaceutical composition for use according to claim 6, wherein the reduction of APOC3 gene expression is a reduction in the amount of APOC3 mRNA, the amount of APOC3 protein, or both.

8. The pharmaceutical composition for use according to claim 6, wherein the individual has a disease, disorder, or condition related to APOC3 gene expression.

9. The pharmaceutical composition according to claim 2, for use in the treatment of an individual having a disease, disorder, or condition related to apolipoprotein C-III (APOC3) gene expression.

10. The pharmaceutical composition for use according to claim 8 or 9, wherein the disease, disorder, or condition associated with APOC3 gene expression is acute coronary artery disease (ACD), atherosclerotic cardiovascular disease (ASCVD), alcoholic hepatitis (AH), alcoholic liver disease (ALD), cardiovascular metabolic disease, cholangiocarcinoma (CCA), cirrhosis, coronary heart disease (CHD), diabetes mellitus, hepatic fibrosis, hepatitis, hepatocellular carcinoma (HCC), hyperlipidemia, hypertriglyceridemia, high non-HDL cholesterol, insulin resistance, hepatic steatosis, metabolic syndrome (MetS), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), obesity, or primary sclerosing cholangitis (PSC).

11. A pharmaceutical composition for use according to any one of claims 6 to 9, wherein the RNAi oligonucleotide or pharmaceutical composition is administered in combination with a second composition or therapeutic agent.

Images