A method for reducing the risk of coronary disease

Abstract

Provided herein is a method for reducing the risk of coronary disease in a subject in need thereof, the method comprising administering to the subject a lipid nanoparticle encapsulating a payload comp

Description

A METHOD FOR REDUCING THE RISK OF CORONARY DISEASE CROSS-REFERENCE TO RELATED APPLICATION

[0001] This application claims the benefit of U.S. Provisional Application No. 63 / 078,982 filed on September 16, 2020 and U.S. Provisional Application No. 62 / 984,866 filed on March 4, 2020, which are hereby incorporated by reference in their entirety. SEQUENCE LISTING

[0002] The instant application contains a Sequence Listing which has been submitted electronically in ASCII format and is hereby incorporated by reference in its entirety. Said ASCII copy, created on March 3, 2021, is named 53989706601_SL.txt and is 67,230 bytes in size. FIELD OF THE DISCLOSURE

[0003] The instant disclosure relates to compositions for use in methods for targeted delivery of therapeutic agents such as CRISPR-guide RNA and other nucleic acid agents. BACKGROUND

[0004] All publications herein are incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference. The following description includes information that may be useful in understanding the present disclosure. It is not an admission that any of the information provided herein is prior art or relevant to the presently claimed invention, or that any publication specifically or implicitly referenced is prior art. SUMMARY [0004b] In one aspect, the present invention relates to a lipid nanoparticle encapsulating a payload comprising one or more pharmaceutically active agents, for use in a method for reducing the risk of coronary disease; wherein the lipid nanoparticle further comprises a receptor targeting conjugate of Formula (V): Formula (V) wherein, each of L!, L2 1% L* L5 LS L7, L8 L?, L!° and L'?is independently substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-C12 alkynylene, - (CH2CH; 0), (OCH:CHy)n-, -O-, -S-, -S(=0)-, -S(=0)z-, -S(=0)(=NR})-, -C(=0)-, -C(=N- OR)-, -C(=0)0-, -OC(=0)-, -C(=0)C(=0)-, -C(=0)NR!-, -NR!C(=0)-, -OC(=O)NR!-, - NR!C(=0)0-, -NR'C(=0)NR'-, -§(=0);NR'-, -NR!§(=0)2-, -NR-, or -N(OR})-; L!! is a bond, substituted or unsubstituted -(CH2CH20),- or substituted or unsubstituted - (OCH2CH2)u-; each R! is independently H or substituted or unsubstituted C;-Cs alkyl; R comprises a lipid; m is an integer selected from 1 to 10; and n is an integer selected from 1 to 200; wherein each of the A groups is a N-acetylgalactosamine moiety.

[0005] In some embodiments, each L', L* and L7 is independently substituted or unsubstituted Ci-C2 alkylene. In some embodiments, each L!, L* and L” is independently substituted or unsubstituted C2-Cs alkylene. In some embodiments, each L!, L*, and L” is C4 alkylene. In some embodiments, each L?, L°, and L® is independently -C(=O)NR'-, - NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)O- or -NR'C(=0)NR!-. In some embodiments, each 12, L and L? is independently -C(=O)NR!- or -NR'C(=0)-. In some embodiments, each L?, L% and Lis -C(=0)NH-. In some embodiments, each L?, L®, and L’ is independently substituted or unsubstituted C1-Ci2 alkylene. In some embodiments, each L? is substituted or unsubstituted C2-Cs alkylene. In some embodiments, L* is C4 alkylene. In some embodiments, each L¢ and L? is independently substituted or unsubstituted C2-Cio alkylene. In some embodiments, each LS and L° is independently substituted or unsubstituted C2-Cs alkylene. In some embodiments, each L® and L? is C3 alkylene. Described herein is a receptor targeting conjugate, comprising a compound of Formula (VI): o WLLL AEA A—L4-L5-L8 i? AU Formula (VI) wherein, a plurality of the A groups collectively comprise a receptor targeting ligand; each L!, L213, L* L% L6 L7 L8 L° LY and L'2is independently substituted or unsubstituted C;-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-Ci2 alkenylene, substituted or unsubstituted C2-C12 alkynylene, -(CH2CH20)m-, -(OCH2CH2)m-, -O-, -S-, -S(=0)-, -S(=0)2-, - S(=0)(=NR!})-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, -C(=0)C(=0)-, - C(=0)NR!-, -NR!C(=0)-, -OC(=0O)NR!-, -NR!C(=0)O-, -NR!C(=O)NR!-, C(=0)NR!C(=0)-, -S(=0):NR!-, -NR!S(=0),-, -NR!-, or -N(OR})-; L!! is substituted or unsubstituted -(CH2CH20)n-, or substituted or unsubstituted - (OCH:CH2)n-; each R! is independently H or substituted or unsubstituted Ci-Csalkyl; Ris a lipid, nucleic acid, amino acid, protein, or lipid nanoparticle; m 1s an integer selected from 1 to 10; and n is an integer selected from 1 to 200.

[0006] In some embodiments, each L', L* and L7 is independently substituted or unsubstituted Ci-Ci2 alkylene or substituted or unsubstituted C1-C12 heteroalkylene. In some embodiments, each L!, L* and L is independently substituted or unsubstituted C1-Ci2 heteroalkylene. In some embodiments, each L!, L* and L is independently substituted or unsubstituted C1-Ci2 heteroalkylene comprising 1-10 O atoms. In some embodiments, each L!,L* and Lis independently -(CH;CH20),1<(CHz)q1-; wherein pl is 1-8; and q1 is 1-6. In some embodiments, each L!, L*, and L” is -(CH2CH20)3-(CHz)2-. In some embodiments, each L', L* and L7 is independently substituted or unsubstituted Ci-Ci2 alkylene. In some embodiments, each L!, L*, and L is independently substituted or unsubstituted C2-Cs alkylene. In some embodiments, each L!, L*, and L7 is Cs alkylene. In some embodiments, each L? L*, and L?® is independently -C(=O)NR!-, -NR!C(=0)-, -OC(=O)NR!-, - NR!C(=0)0-, -NR'C(=0)NR!-, or -C(=0)NR'C(=0)-. In some embodiments, each L?, L°, and L8 is independently -C(=0)NR!- or -NR'C(=0)-. In some embodiments, each L2, L®, and L? is -NHC(=0)-. In some embodiments, each L? L°, and L® is -C(=O)NH-. In some embodiments, each L?, LS, and L° is independently substituted or unsubstituted C1-Ci2 heteroalkylene. In some embodiments, each L? LS, and L is independently substituted or unsubstituted C1-Ci2 heteroalkylene comprising 1-10 O atoms. In some embodiments, each L3, L¢ and L? is independently -(CH;CH20)p2-(CH2CH2CH20)q2-; wherein p2 is 1-8; and q2 is 1-6. In some embodiments, each L3, LS, and L? is (CH,CH,0)-(CH2CH2CH;0)-. In some embodiments, each L*, L®, and L? is independently -(CH2CH,CH.0)g3-; wherein q3 is 1-8. In some embodiments, each L?, L%, and L is -(CH,CH;CH;0),-. In some embodiments, L'° is substituted or unsubstituted C1-Ci2 alkylene. In some embodiments, L'° is substituted or unsubstituted C1-Cs alkylene. In some embodiments, L'” is C; alkylene. In some embodiments, L'! is (OCH2CHz)n-. In some embodiments, n is 1-100. In some embodiments, nis 2-50. In some embodiments, nis 2, 12, 37, or 45. In some embodiments, L'2 is -O-, - C(=0)0-, -C(=0)NR!-, -NR!C(=0)-, or -NR'C(=0)0-. In some embodiments, L'? is - C(=0)0- or -NR'C(=0)0-. In some embodiments, L'? is -C(=0)O-. In some embodiments, L'? is -NHC(=0)O-. In some embodiments, L'? is -NHC(=0)-. In some embodiments, A binds to a lectin. In some embodiments, the lectin is an asialoglycoprotein receptor (ASGPR). In some embodiments, A is N-acetylgalactosamine (GalNAc) or a derivative ye O HO. i ~ “iy o 4 he NH © or a derivative thereof. A is N-acetylgalactosamine (GalNAc) HO OH oO vo JX Fo. HO or a derivative thereof In some embodiments each R! is indepe HO" © ora derivative thereof. In some embodiments, each R! is independently H or -CHs. In some embodiments, each R' is H. In some embodiments, the R comprises one or more of fatty alcohols, fatty acids, glycerolipids, glycerophospholipids, sphingolipids, saccharolipids, polyketides, sterol lipids, and prenol lipids. In some embodiments, the R comprises one or more fatty alcohols. In some embodiments, each fatty alcohol is independently a saturated, monounsaturated, or polyunsaturated fatty alcohol. In some embodiments, the fatty alcohol comprises one or more a C2-Cas fatty alcohol. In some embodiments, the fatty alcohol comprises two or more a C2-Cas fatty alcohol. In some embodiments, each fatty alcohol is a C12, C14, C16, C18, C20, or C22 fatty alcohol. In some embodiments, each fatty alcohol is independently docosahexaenol, eicosapentaenol, oleyl alcohol, stearyl alcohol, (9Z,12Z)-octadeca-9,12-dien-1-yl alcohol, (Z)-docos-13-en-1-yl alcohol, docosanyl alcohol, (E)-octadec-9-en-1-yl alcohol, icosanyl alcohol, (9Z,12Z,15Z)- octadeca-9,12,15-trien-1-yl alcohol, or palmityl alcohol. In some embodiments, each fatty alcohol is a stearyl alcohol. In some embodiments, the R comprises one or more sterol lipids. In some embodiments, the R comprises one or more of vitamins. In some embodiments, each vitamin is independently a vitamin A, vitamin D, vitamin E, or vitamin K. In some embodiments, the R comprises a nucleic acid. In some embodiments, the nucleic acid is a mRNA, guide RNA, siRNA, antisense oligonucleotide, aptamer, microRNA, immunostimulatory oligonucleotide, splice switching oligonucleotide, self-amplifying RNA, circular RNA or DNA, but not limited to the aforementioned. In some embodiments, the R comprises a protein. In some embodiments, the protein is a gene editor protein, an antibody, an antigen-binding antibody fragment or a peptide, but not limited to the aforementioned.

[0007] Described herein is a receptor targeting conjugate, comprising a compound from Table 4.

[0008] Described herein is a nanoparticle composition comprising: (a) one or more nucleic acid molecular entities; and (b) a receptor targeting conjugate as described herein. In some embodiments, the receptor targeting conjugate comprises from about 0.001 mol % to about 20 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, the receptor targeting conjugate comprises from about 0.01 mol % to about 1 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, comprising a sterol or a derivative thereof, comprising from 10 mol % to 70 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, the sterol or the derivative thereof is cholesterol or a cholesterol derivative. In some embodiments, the cholesterol or the cholesterol derivative comprises from 20 mol % to 50 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, the nanoparticle composition comprises a phospholipid, comprising from 1 mol % to 20 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, the phospholipid comprises from about 5 mol % to about 15 mol % of the total lipid content present in said nanoparticle composition. In some embodiments, the phospholipid is selected from 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC), 1,2- dipalmitoyl-sn-glycero-3-phosphocholine (DPPC), 1,2-dimyristoyl-sn-glycero- phosphocholine (DMPC), 2-oleoyl-1-palmitoyl-sn-glycero-3-phosphocholine (POPC), 1,2- dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE), and sphingomyelin. In some embodiments, the phospholipid is DSPC. In some embodiments, the nanoparticle composition comprises a stealth lipid, comprising from 0.1 mol % to 6 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, the stealth lipid comprises about 2.0 mol % to about 2.5 mol % of the total lipid content present in said nanoparticle composition. In some embodiments, the stealth lipid is a PEG-lipid that has a number average molecular weight of from about 200 Da to about 5000 Da. In some embodiments, the nanoparticle composition comprises an amino lipid, comprising from about 10 mol % to about 60 mol % of the total lipid content present in the nanoparticle composition. In some embodiments, the nanoparticle composition comprises an antioxidant. In some embodiments, the antioxidant comprises ethylenediaminetetraacetic acid (EDTA). In some embodiments, the one or more nucleic acid molecular entities comprise a single guide RNA (sgRNA) or guide RNA (gRNA) targeting a disease causing gene of interest produced in the hepatocytes. In some embodiments, the one or more nucleic acid molecular entities comprise an mRNA that encodes a Cas nuclease. In some embodiments, at least one of the one or more nucleic acid molecular entities comprises a chemical modification. In some embodiments, the chemical modification is a 2’-F modification, a phosphorothioate internucleotide linkage modification, acyclic nucleotides, LNA, HNA, CeNA, 2'- methoxyethyl, 2'- O-methyl, 2'-O-allyl, 2'-C-allyl, 2'-deoxy, 2'-fluoro, 2'-O-N- methylacetamido (2'-O-NMA), a 2'-O-dimethylaminoethoxyethyl (2'-0-DMAEOE), 2'-0- aminopropyl (2'-O-AP), 4’-O-methyl, or a 2'-ara-F modification. In some embodiments, the chemical modification is a 2'- O-methyl modification.

[0009] Described herein is a pharmaceutical composition comprising a herein described receptor targeting conjugate or a herein described nanoparticle composition, and an excipient or carrier. In some embodiments, the pharmaceutical composition comprises an mRNA encoding a gene editor nuclease. In some embodiments, the pharmaceutical composition comprises one or more guide RNA molecules. In some embodiments, the pharmaceutical composition comprises two or more guide RNA molecules. In some embodiments, the two or more guide RNA molecules target two or more genes of interest. In some embodiments, the mRNA encodes Cas9 nuclease. In some embodiments, the mRNA encodes a base editor nuclease. In some embodiments, the mRNA and the one or more guide RNA molecules are present in the same nanoparticle composition. In some embodiments, the mRNA and the one or more guide RNA molecules are present in different nanoparticle compositions. In some embodiments, a ratio of the gRNA molecules to the mRNA in the pharmaceutical composition is from about 0.01 to about 100 by weight or by mole. In some embodiments, a ratio of said gRNA molecules to said mRNA in said pharmaceutical composition is about 50:1, about 40:1, about 30:1, about 20:1, about 18:1, about 16:1, about 14:1, about 12:1, about 10:1, about 9:1, about 8:1, about 7:1, about 6:1, about 5:1, about 4:1, about 3:1, about 2:1, about 1:1, about 1:2, about 1:3, about 1:4, about 1:5, about 1:6, about 1:7, about 1:8, about 1:9, or about 1:10 by weight or by mole.

[0010] Described herein is a pharmaceutical composition comprising: (a) a first receptor targeting conjugate or a first nanoparticle composition as described herein, and (b) a second receptor targeting conjugate or a second nanoparticle composition as described herein. In some embodiments, the first nanoparticle composition comprises a gene editor mRNA. In some embodiments, the second nanoparticle composition comprises one or more guide RNA molecules. In some embodiments, a ratio of guide RNA molecules to mRNA in said pharmaceutical composition is about 50:1, about 40:1, about 30:1, about 20:1, about 18:1, about 16:1, about 14:1, about 12:1, about 10:1, about 9:1, about 8:1, about 7:1, about 6:1, about 5:1, about 4:1, about 3:1, about 2:1, about 1:1, about 1:2, about 1:3, about 1:4, about 1:5, about 1:6, about 1:7, about 1:8, about 1:9, or about 1:10 by weight or by mole.

[0011] Described herein is a method of delivering a nucleic acid to a cell, the method comprising contacting the cell with a nanoparticle composition or a pharmaceutical composition as described herein, whereby the nucleic acid is delivered to said cell. In some embodiments, the cell is contacted in vivo, ex vivo, or in intro.

[0012] Described herein is a method of producing a polypeptide of interest in a cell, the method comprising contacting said cell with a nanoparticle composition or a pharmaceutical composition as described herein, whereby the nucleic acid is capable of being translated in said cell to produce the polypeptide.

[0013] Described herein is a method of treating a disease or condition in a subject, the method comprising administering to the subject a therapeutically effective amount of a pharmaceutical composition as described herein. In some embodiments, the disease or condition is a coronary disease. In some embodiments, the subject is low-density lipoprotein receptor (LDLR)-deficient. In some embodiments, the subject has heterozygous familial hypercholesterolemia (HeFH), homozygous familial hypercholesterolemia(HoFH) or clinical atherosclerotic cardiovascular disease (ASCVD). In some embodiments, the subject is at high risk of cardiovascular events. In some embodiments, the subject requires additional lowering of low-density lipoprotein cholesterol (LDL-C) despite maximally tolerated lipid-lowering therapy.

[0014] Described herein is a method of delivering a nucleic acid molecular entity to the liver of a subject, comprising administering to the subject a pharmaceutical composition as described herein, thereby delivering the nucleic acid molecular entity.

[0015] Described herein is a nucleotide conjugate comprising: (a) a nucleic acid, and (b) a targeting moiety connected to the nucleic acid in (a), wherein the targeting moiety comprises a structure of Table 1. In some embodiments, the targeting moiety further comprises a coupling sequence that hybridizes with the nucleic acid in (a). Described herein is a nucleotide conjugate comprising: (a) a nucleic acid, and (b) a targeting moiety connected to the nucleic acid in (a), wherein the targeting moiety comprises a coupling sequence that hybridizes with the nucleic acid in (a). In some embodiments, the nucleic acid comprises a single stranded, double stranded, a partially double stranded, or a hairpin stem-loop nucleic acid, and wherein the targeting moiety is a receptor targeting moiety. In some embodiments, the targeting moiety binds to a lectin. In some embodiments, the lectin is an asialoglycoprotein receptor (ASGPR). In some embodiments, the targeting moiety comprises one or more N-acetylgalactosamine (GalNAc) or GalNAc derivatives. In some embodiments, the targeting moiety comprises one or more N-acetylgalactosamine (GalNAc) or GalNAc derivatives and a spacer. In some embodiments, the targeting moiety comprises one or more galactose or galactose derivatives. In some embodiments, the targeting moiety comprises one or more galactose or galactose derivatives and a spacer. In some embodiments, the spacer comprises polyethylene glycol, substituted or unsubstituted C1-C12 alkylene, or both, wherein the polyethylene glycol has from 1 to 5 repeating units. In some embodiments, the targeting moiety is linked to one or more strands of the nucleic acid through one or more linkers. In some embodiments, the targeting moiety comprises a structure of Table 1. In some embodiments, the coupling sequence hybridizes with the nucleic acid in (a). In some embodiments, the coupling sequence hybridizes with an extension in the nucleic acid in (a). In some embodiments, the targeting moiety is attached to the 5° end of the nucleic acid sequence, the 3’ end of the nucleic acid sequence, or the middle of the nucleic acid sequence. In some embodiments, the targeting moiety comprises at least two GalNAcs or GalNAc derivatives. In some embodiments, the targeting moiety comprises at least three GalNAcs or GalNAc derivatives. In some embodiments, the GaNAcs or GalNAc derivatives are connected to the nucleic acid in (a) via a linker in the targeting moiety, via hybridization of the coupling sequence in the targeting moiety that hybridizes with the nucleic acid in (a), or via a combination thereof. In some embodiments, the targeting moiety comprises at least two galactose or galactose derivatives. In some embodiments, the targeting moiety comprises at least three galactoses or galactose derivatives. In some embodiments, the galactoses or galactose derivatives are connected to the nucleic acid in (a) via a linker in the targeting moiety, via hybridization of the coupling sequence in the targeting moiety that hybridizes with the nucleic acid in (a), or via a combination thereof. In some embodiments, the targeting moiety comprises at least two coupling sequences that hybridize with the nucleic acid in (a). In some embodiments, the at least two coupling sequences are identical. In some embodiments, the at least two coupling sequences are different. In some embodiments, the nucleotide conjugate further comprises a second targeting moiety. In some embodiments, the second targeting moiety binds to an asialoglycoprotein receptor (ASGPR). In some embodiments, the second targeting moiety is linked to one or more strands the nucleic acid through a spacer and / or through one or more linkers. In some embodiments, the second targeting moiety comprises a GalNAc or GalNAc derivative. In some embodiments, the second targeting moiety comprises at least three GalNAc moieties or GalNAc derivatives. In some embodiments, the GalNAc or GalNAc derivatives are connected to the nucleic acid in (a) via a linker in the targeting moiety, via hybridization of the coupling sequence in the targeting moiety that hybridizes with the nucleic acid in (a), or via a combination thereof. In some embodiments, the second targeting moiety comprises a galactose or galactose derivative. In some embodiments, the second targeting moiety comprises at least three galactose moieties or galactose derivatives. In some embodiments, the galactose or galactose derivatives are connected to the nucleic acid in (a) via a linker in the targeting moiety, via hybridization of the coupling sequence in the targeting moiety that hybridizes with the nucleic acid in (a), or via a combination thereof. In some embodiments, the second targeting moiety comprises a structure of Table 1. In some embodiments, the second targeting moiety comprises a coupling sequence that hybridizes with the nucleic acid. In some embodiments, the second targeting moiety is attached to the 5° end of the nucleic acid, the 3’ end of the nucleic acid, or the middle of the nucleic acid. In some embodiments, the nucleic acid in (a) comprises RNA or DNA. In some embodiments, the coupling sequence comprises RNA, DNA, chemically modified RNA, chemically modified DNA, or a hybrid of DNA and RNA. In some embodiments, the coupling sequence comprises one or more of (a), (¢), (g), (u), (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein ais 2’-O- methyladenosine (2°-OMe A), wherein c is 2’-O-methylacytidine (2’-OMe-C), wherein g is 2’-O-methylacytidine guanine (2’-OMe-G), and wherein u is 2’-O-methyluridine (2’-OMe- U). In some embodiments, the coupling sequence comprises one or more of (a), (c), (g), (u), (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O- methyladenosine (2°-OMe A), wherein c is 2’-O-methylacytidine (2’-OMe-C), wherein g is 2’-O-methylacytidine guanine (2’-OMe-G), and wherein u is 2’-O-methyluridine (2’-OMe- VU). In some embodiments, the (a), (c), (g), or (u) is scattered along the nucleic acid or the coupling sequence. In some embodiments, the nucleic acid and the coupling sequence comprise one or more G-C base pairing within a hybridization duplex wherein the coupling sequence hybridizes with the nucleic acid and wherein said one or more G-C base pairing increases stability of the hybridization duplex. In some embodiments, the linker comprises a covalent linker. In some embodiments, the linker comprises a non-covalent linker. In some embodiments, the linker comprises a monovalent linker, a bivalent linker, a trivalent linker, or a combination thereof. In some embodiments, the linker comprises a biocleavable linker. In some embodiments, the linker comprises a non-biocleavable linker. In some embodiments, the linker comprises a phosphate, phosphorothioate, amide, ether, oxime, hydrazine or carbamate. In some embodiments, the linker is a phosphate or phosphorothioate. In some embodiments, the nucleic acid in (a) comprises a chemical modification. In some embodiments, the nucleic acid in (a) comprises a 2’-F modification, a phosphorothioate internucleotide linkage modification, acyclic nucleotides, LNA, HNA, CeNA, 2'- methoxyethyl, 2'- O-methyl, 2'-O-allyl, 2'-C-allyl, 2'-deoxy, 2'-fluoro, 2'-O-N- methylacetamido (2'-O-NMA), a 2'-O-dimethylaminoethoxyethyl (2'-0-DMAEOE), 2'-0- aminopropyl (2'-O-AP), 4’-O-methyl, or a 2'-ara-F modification. In some embodiments, the nucleic acid comprises a 2'- O-methyl modification. In some embodiments, the nucleic acid comprises a phosphorothioate internucleotide linkage modification. In some embodiments, the nucleic acid is capable of hybridizing with a target sequence within a target gene of a genome. In some embodiments, the nucleic acid comprises a mRNA, siRNA, shRNA, antisense oligonucleotide, microRNA, anti-microRNA or antimir, supermir, antagomir, ribozyme, triplex-forming oligonucleotide, decoy oligonucleotide, splice-switching oligonucleotide, immunostimulatory oligonucleotide, RNA activator, Ul adaptor, guide RNA, or any combinations thereof. In some embodiments, the nucleic acid encodes a protein. In some embodiments, the nucleic acid is a CRISPR enzyme. In some embodiments, the nucleic acid is a guide RNA capable of forming a complex with a CRISPR enzyme. In some embodiments, the guide RNA is a single guide RNA or a dual guide RNA. In some embodiments, the CRISPR enzyme is selected from the group consisting of Cas9, Cpf1, CasX, CasY, C2cl, C2c3, and base editor fusion protein. In some embodiments, the nucleic acid further comprises a mRNA encoding the CRISPR enzyme. In some embodiments, the CRISPR enzyme results in an alteration in the target sequence. In some embodiments, the target gene is involved in a lipid metabolism pathway. In some embodiments, the target gene is selected from the group consisting of PCSK9, ANGPTL3, APOC3, LPA, APOB, MTP, ANGPTL4, ANGPTLS, APOAS, APOE, LDLR, IDOL, NPCI1L1, ASGR1, TM6SF2, GALNT?2, GCKR, LPL, MLXIPL, SORT1, TRIB1, MARCI, ABCGS, and ABCG8. In some embodiments, the guide RNA comprises a sequence selected from sequences of Table 3. In some embodiments, the guide RNA comprises a sequence selected from sequences of Table 5

[0016] Described herein is a particle comprising the described nucleotide conjugate and the described CRISPR enzyme. In some embodiments, the particle is a lipid nanoparticle, a liposome, an inorganic nanoparticle, or an RNP.

[0017] Described herein is a cell comprising the nucleotide conjugate of any one of the preceding claims. In some embodiments, the cell is a prokaryotic cell, a eukaryotic cell, a vertebrate cell, a mouse cell, a non-human primate cell, or a human cell.

[0018] Described herein is a pharmaceutical composition comprising the described nucleotide conjugate, the particle, or the cell. In some embodiments, the pharmaceutical composition comprises a pharmaceutically acceptable adjuvant, diluent, carrier, preservative, excipient, buffer, stabilizer, or a combination thereof. In some embodiments, the carrier comprises solvents, dispersion media, dispersion or suspension aids, surface active agents, isotonic agents, thickening or emulsifying agents, preservatives, lipids, lipidoids, polymers, lipoplexes, core-shell nanoparticles, hyaluronidase, nanoparticle mimics, or combinations thereof.

[0019] Described herein is a kit comprising the described nucleotide conjugate.

[0020] Described herein is a method for reducing the risk of coronary disease in a subject in need thereof, comprising administering to the subject an effective amount of the described nucleotide conjugate. Described herein is a method for reducing the risk of coronary disease in a subject in need thereof, comprising administering to the subject an effective amount of a pharmaceutical composition, said pharmaceutical composition comprising (a) a nucleic acid, and (b) a targeting moiety connected to the nucleic acid in (a), wherein the targeting moiety comprises a structure of Table 1. Described herein is a method of delivering a nucleic acid to the liver of a subject, comprising administering to the subject said nucleic acid connected to a targeting moiety, wherein the targeting moiety comprises a structure of Table 1. In some embodiments, the targeting moiety further comprises a coupling sequence that hybridizes with the nucleic acid in (a). Described herein is a method for reducing the risk of coronary disease in a subject in need thereof, comprising administering to the subject an effective amount of a pharmaceutical composition, said pharmaceutical composition comprising (a) a nucleic acid, and (b) a targeting moiety connected to the nucleic acid in (a), wherein the targeting moiety comprises a coupling sequence that hybridizes with the nucleic acid in (a). Described herein is a method of delivering a nucleic acid to the liver of a subject, comprising administering to the subject said nucleic acid connected to a targeting moiety, wherein the targeting moiety comprises a coupling sequence that hybridizes with the nucleic acid. In some embodiments, the nucleic acid comprises a single stranded, double stranded, a partially double stranded, or a hairpin stem-loop nucleic acid, and wherein the targeting moiety is a receptor targeting moiety. In some embodiments, the targeting moiety binds to a lectin. In some embodiments, the lectin is an asialoglycoprotein receptor (ASGPR). In some embodiments, the targeting moiety comprises one or more N-acetylgalactosamine (GalNAc) or GalNAc derivatives. In some embodiments, the targeting moiety comprises at least three GalNAc or GalNAc derivatives. In some embodiments, the targeting moiety comprises one or more galactose or galactose derivatives. In some embodiments, the targeting moiety comprises at least three galactose or galactose derivatives. In some embodiments, the nucleic acid comprises (i) a guide RNA and a nuclease mRNA or (ii) a guide RNA complexed in a nuclease RNP, and wherein the guide RNA is capable of directing the nuclease to a target sequence in a target gene. In some embodiments, the guide RNA comprises a single guide RNA or a dual guide RNA. In some embodiments, the nuclease is a CRISPR enzyme. In some embodiments, the CRISPR enzyme selected from the group consisting of Cas9, Cpf1, CasX, CasY, C2cl, C2¢3, and base editor fusion protein. In some embodiments, the CRISPR enzyme results in an alteration in the target sequence. In some embodiments, the administration results in reduced expression of the target gene in the liver of the subject. In some embodiments, expression of the target gene in the liver of the subject is reduced by at least 1%, at least 5%, at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or greater than 99.99% as compared to a control tissue of the subject. In some embodiments, the target gene is associated with a coronary disease. In some embodiments, the target gene is selected from the group consisting of PCSK9, ANGPTL3, APOC3, LPA, APOB, MTP, ANGPTL4, ANGPTLS8, APOAS, APOE, LDLR, IDOL, NPC1L1, ASGR1, TM6SF2, GALNT2, GCKR, LPL, MLXIPL, SORTI, TRIBI, MARCI, ABCGS3, and ABCG8. In some embodiments, the coupling sequence comprises RNA, DNA, chemically modified RNA, chemically modified DNA, or a hybrid of DNA and RNA. In some embodiments, the coupling sequence comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O-methyladenosine (2°-OMe A), and wherein u is 2°-O-methyluridine (2’-OMe-U). In some embodiments, the nucleic acid in (a) comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O-methyladenosine, and wherein u is 2°-O-methyluridine. In some embodiments, the targeting moiety is linked to the nucleic acid in (a) via a linker in the targeting moiety, via hybridization of the coupling sequence in the targeting moiety that hybridizes with the nucleic acid in (a), or via a combination thereof. In some embodiments, the linker comprises a covalent linker. In some embodiments, the linker comprises a phosphate, phosphorothioate, amide, ether, oxime, hydrazine or carbamate. In some embodiments, the linker is a phosphate or phosphorothioate. In some embodiments, the nucleic acid in (a) comprises a chemical modification. In some embodiments, the nucleic acid in (a) comprises a 2’-F modification, a phosphorothioate internucleotide linkage modification, acyclic nucleotides, LNA, HNA, CeNA, 2'-methoxyethyl, 2'- O-methyl, 2'-O-allyl, 2'-C-allyl, 2'-deoxy, 2'-fluoro, 2'-O-N- methylacetamido (2'-O-NMA), a 2'-O-dimethylaminoethoxyethyl (2'-0-DMAEOE), 2'-0- aminopropyl (2'-O-AP), or a 2'-ara-F modification. In some embodiments, the nucleic acid comprises a 2'- O-methyl modification. In some embodiments, the nucleic acid comprises a phosphorothioate internucleotide linkage modification. In some embodiments, the level of the nucleic acid in the liver of the subject is at least 1.5, at least 2, at least 2.5, at least 3, at least 5, at least 10, at least 15, at least 20, at least 30, at least 40, at least 50 folds higher as compared to other tissues of the subject at least 1 hours, 2 hours, 6 hours, 12 hours, 24 hours, 2 days, 1 week, 2 weeks, 3 weeks, 6 weeks, or 8 weeks post delivery. In some embodiments, the effective amount is about 1 mg / kg to about 10 mg / kg. In some embodiments, the administration results in reduced blood triglycerides and / or reduced low-density lipo-protein cholesterol in the subject in need thereof. In some embodiments, the administration is performed intravenously, intrathecally, intramuscularly, intraventricularly, intracerebrally, intracerebellarly, intracerebroventricularly, intraperenchymally, subcutaneously, or a combination thereof.

[0021] Described herein is a method for reducing the risk of coronary disease in a subject in need thereof, the method comprising administering to the subject a pharmaceutical composition comprising (a) (i) a single guide RNA and a nuclease mRNA |, (ii)a dual guide RNA and a nuclease mRNA, (iii) a single guide RNA and an RNP, or (iv) a dual guide RNAs and an RNP; and (b) a asialoglycoprotein receptor (ASGPR) targeting moiety connected to the nucleic acid in (a), wherein the single guide RNA or the dual guide RNA comprises 4 or more 2’-O-methyl modifications and 2 or more phosphorothioate internucleotide linkages, wherein the targeting moiety comprises a structure of Table 1, and wherein the guide RNA hybridizes with a PCSK9 gene. Described herein is a method for reducing the risk of coronary disease in a subject in need thereof, the method comprising administering to the subject a pharmaceutical composition comprising (a) (1) a single guide RNA and a nuclease mRNA , (ii)a dual guide RNA and a nuclease mRNA, (iii) a single guide RNA and an RNP, or (iv) a dual guide RNAs and an RNP; and (b) a targeting moiety connected to the nucleic acid in (a), wherein the single guide RNA or the dual guide RNA comprises 4 or more 2°-O- methyl modifications and two or more phosphorothioate internucleotide linkages, wherein the targeting moiety comprises a coupling sequence that hybridizes with the single guide RNA in (a), and wherein the guide RNA hybridizes with a PCSK9 gene. In some embodiments, the nuclease mRNA and / or the single guide RNA comprises at least one chemical modification. In some embodiments, the chemical modification is selected from the group consisting of a 2’-F modification, phosphorothioate internucleotide linkage modification, acyclic nucleotides, LNA, HNA, CeNA, 2'-methoxyethyl, 2'- O-methyl, 2'-O-allyl, 2'-C-allyl, 2'- deoxy, 2'-fluoro, 2'-O-N-methylacetamido (2'-O-NMA), a 2'-O-dimethylaminoethoxyethyl (2'-0-DMAEOE), 2'-0-aminopropyl (2'-O-AP), 4’-O-methyl, and a 2'-ara-F modification. In some embodiments, administrating of the nucleic acid conjugate results in a reduced level of immune response as compared to a control nucleic acid conjugate without said chemical modification.

[0022] Described herein is a nucleotide conjugate comprising a structure of Formula (IV) x0 ox “0 JN Noman fio ACY ~ x0 OX 2 LN0 x0, Loft ACN Q A sen rene i ey x0 [ XO ’ ~- i ~ ‘ jr . y "df Formula (IV) wherein each X is independently H or a protecting group, R* is -OX or -NHAc, Yis O or S, and W represents (a) (1) a single guide RNA and a nuclease mRNA , (ii) a dual guide RNA and a nuclease mRNA, (iii) a single guide RNA and an RNP, or (iv) a dual guide RNAs and an RNP; or (b) a coupling sequence.

[0023] In some embodiments, the one or more linkers comprise a structure selected from the group consisting of: SNM NETS | pe—— linker linker Jan A linker Jnr linker HE—o~n shin © SN—, linker p—nN7 and mm CT In some embodiments, each of the linkers independently has a structure of —(L")i~(L?)a~(L*)k3~(L*)k4—, wherein each of k1, k2, k3, and k4 is independently 0, 1 or 2, and each of the L!, L?, L* and L*is independently selected from -O-, -S-, S(=0)1.2-, -C(=0)-, -C(=S)-, -NR'-, -OC(=0)-, -C(=0)0-, - 0C(=0)0-, -C(=0)NR!-, -OC(=0)NR"-, -NR*C(=0)-, -NR*C(=0) NR!-, -P(=0O)R"-, NR'S(=0)(=NR")-, -NR"S(=0)z-, -S(=0):NR"-, -N=N-, -(CH2-CHz-O)1.5-, linear or branched Ci. alkylene, linear or branched Cz. alkenylene, linear or branched C26 alkynylene, C3—Cs cycloalkylene, C2—C heterocycloalkylene, Cs—Cio arylene, and Cs—Co heteroarylene, wherein the alkylene, alkenylene, alkynylene, cycloalkylene, cycloalkylene, arylene, or heteroarylene is substituted or unsubstituted, and wherein each R'is independently H, D, cyano, halogen, substituted or unsubstituted Ci-Cs alkyl, -CD3, -OCHs, - OCD, substituted or unsubstituted C1-Cs haloalkyl, substituted or unsubstituted Ci-Cs heteroalkyl, substituted or unsubstituted C3-Cs cycloalkyl, substituted or unsubstituted C>-C7 heterocycloalkyl, substituted or unsubstituted aryl, or substituted or unsubstituted heteroaryl. In some embodiments, each R" is independently H, substituted or unsubstituted C1-Cs alkyl, - OCH, substituted or unsubstituted C1-Cs haloalkyl, substituted or unsubstituted Ci-Cs heteroalkyl, substituted or unsubstituted C3-Cs cycloalkyl, or substituted or unsubstituted Ca- C7heterocycloalkyl. In some embodiments, the sum of k1, k2, k3, and k4 is 1, 2, or 3.

[0024] Described herein is a method of preparing a formulation comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, the method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities;(b) providing a second solution comprising at least one of the one or more lipids; (c) mixing the first solution and the second solution, thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities and the one or more lipids; (d) mixing the receptor targeting conjugate with the nanoparticles produced in step (c); (e) incubating the nanoparticles; and (f) optionally carrying out a buffer exchange process. In some embodiments, the receptor targeting conjugate is combined with the one or more lipids after the mixing step in (c). In some embodiments, the receptor targeting conjugate is added in a dilution buffer, and wherein the dilution buffer is mixed with preformed nucleic acid-lipid nanoparticles coming out of an inline mixing chamber thereby forming the nanoparticles. In some embodiments, the receptor targeting conjugate is introduced after an addition of a dilution buffer to the mixture and holding the diluted mixture for a period of time. In some embodiments, the holding time is between 1 and 120 minutes. In some embodiments, the holding time is between 1 and 90 minutes, between 1 and 60 minutes, or between 10 and 40 minutes. In some embodiments, the holding time is about 30 minutes. In some embodiments, the receptor targeting conjugate is introduced to the nanoparticles after buffer exchange. In some embodiments, the receptor targeting conjugate is introduced to the nanoparticles after buffer exchange and concentration, but prior to storage. In some embodiments, the receptor targeting conjugate is introduced to the nanoparticles after storage and thawing, and prior to dosing or evaluation. Described herein is a method of preparing a formulation comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, the method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising at least one of the one or more lipids; (c) inline mixing of the first solution and the second solution, thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities and the one or more lipids; (d) inline mixing of the receptor targeting conjugate to the mixture of step (c), thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities, the one or more lipids, and the receptor targeting conjugate; (e) diluting the mixture of step (d) by adding a dilution buffer; and (f) optionally carrying out a buffer exchange process. In some embodiments, the inline mixing of step (c) and the inline mixing of step (d) are performed successively. Described herein is a method of preparing a formulation comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, the method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising (i) at least one of the one or more lipids and (ii) at least a portion of the receptor targeting conjugate; (c) mixing the first solution and the second solution, thereby producing a mixture comprising nanoparticles; (d) optionally incubating the nanoparticles; and (e) optionally carrying out a buffer exchange process. In some embodiments, the second solution comprises all the receptor targeting conjugate. Described herein is a method of preparing a formulation comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, the method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising at least one of the one or more lipids; (c) mixing the first solution and the second solution, thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities and the one or more lipids; (d) combining the receptor targeting conjugate with the one or more lipids, wherein at least a portion of the receptor targeting conjugate is combined with the one or more lipids prior to or concurrently with the mixing step; (e) optionally incubating the nanoparticles; and (f) optionally carrying out a buffer exchange process. In some embodiments, at least a portion of the receptor targeting conjugate is combined with the one or more lipids concurrently with the mixing step. In some embodiments, at least a portion of the receptor targeting conjugate is combined with the one or more lipids prior to the mixing step. In some embodiments, the receptor targeting conjugate is combined with the one or more lipids in the second solution. In some embodiments, a portion of the receptor targeting conjugate is combined with the one or more lipids in the second solution and a portion of the receptor targeting conjugate is combined with the one or more lipids after the mixing. In some embodiments, a portion of the receptor targeting conjugate is combined with the one or more lipids in the second solution and a portion of the receptor targeting conjugate is combined with the one or more lipids after the incubating step. In some embodiments, a portion of the receptor targeting conjugate is combined with the one or more lipids in the second solution and a portion of the receptor targeting conjugate is combined with the one or more lipids after the buffer exchange step. In some embodiments, the method further comprises diluting the mixture produced by mixing the first and the second solutions by adding a dilution buffer. In some embodiments, the mixture is diluted inline. In some embodiments, the dilution buffer comprises at least a portion of the receptor targeting conjugate. In some embodiments, the dilution buffer comprises at least a portion of the stealth lipid. In some embodiments, the first solution comprises an aqueous buffer. In some embodiments, the second solution comprises ethanol. In some embodiments, the mixing comprises laminar mixing, vortex mixing, turbulent mixing, or a combination thereof. In some embodiments, the mixing comprises cross-mixing. In some embodiments, the mixing comprises inline mixing. In some embodiments, the mixing comprises introducing at least a portion of the first solution through a first inlet channel and at least a portion of the second solution through a second inlet channel, and wherein an angle between the first inlet channel and the second inlet channel is from about 15 to 180 degrees. In some embodiments, the mixing comprises introducing a portion of the first solution through a third inlet channel. In some embodiments, the buffer exchange comprises dialysis, chromatography, or tangential flow filtration (TFF). In some embodiments, the method further comprises a filtration step. In some embodiments, the receptor targeting conjugate comprises one or more N- acetylgalactosamine (GalNAc) or GalNAc derivatives. In some embodiments, the receptor targeting conjugate comprises one or more galactose or galactose derivatives. In some embodiments, the receptor targeting conjugate is selected from Table 4. In some embodiments, the receptor targeting conjugate is a targeting conjugate described herein. In some embodiments, the nanoparticles comprise a first nanoparticle composition described herein. In some embodiments, the formulation is a pharmaceutical composition described herein.

[0025] Described herein is a pharmaceutical composition comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, wherein the formulation is prepared by a method described herein. Described herein is a pharmaceutical composition comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, wherein the formulation is prepared by a method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising at least one of the one or more lipids; (c) mixing the first solution and the second solution, thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities and the one or more lipids; (d) mixing the receptor targeting conjugate with the nanoparticles produced in step (c); (e) incubating the nanoparticles; and (f) optionally carrying out a buffer exchange process. Described herein is a pharmaceutical composition comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, wherein the formulation is prepared by a method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising at least one of the one or more lipids; (c) mixing the first solution and the second solution, thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities and the one or more lipids; (d) combining the receptor targeting conjugate with the one or more lipids, wherein at least a portion of the receptor targeting conjugate is combined with the one or more lipids prior to or concurrently with the mixing step; (e) optionally incubating the nanoparticles; and (f) optionally carrying out a buffer exchange process. Described herein is a pharmaceutical composition comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, wherein the formulation is prepared by a method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising at least one of the one or more lipids; (c) inline mixing of the first solution and the second solution, thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities and the one or more lipids; (d) inline mixing of the receptor targeting conjugate to the mixture of step (c), thereby producing a mixture comprising nanoparticles that comprise the one or more nucleic acid molecular entities, the one or more lipids, and the receptor targeting conjugate; (e) diluting the mixture of step (d) by adding a dilution buffer; and (f) optionally carrying out a buffer exchange process. Described herein is a pharmaceutical composition comprising nanoparticles, wherein the nanoparticles comprise (i) one or more nucleic acid molecular entities, (ii) one or more lipids selected from a sterol or a derivative thereof, a phospholipid, a stealth lipid, and an amino lipid, and (iii) a receptor targeting conjugate, wherein the formulation is prepared by a method comprising: (a) providing a first solution comprising the one or more nucleic acid molecular entities; (b) providing a second solution comprising (i) at least one of the one or more lipids and (ii) at least a portion of the receptor targeting conjugate; (¢) mixing the first solution and the second solution, thereby producing a mixture comprising nanoparticles; (d) optionally incubating the nanoparticles; and optionally carrying out a buffer exchange process. INCORPORATION BY REFERENCE

[0026] All publications, references, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. In the event of inconsistent usages between this document and those documents so incorporated by reference, the usage in the incorporated reference(s) should be considered supplementary to that of this document; for irreconcilable inconsistencies, the usage in this document controls BRIEF DESCRIPTION OF THE DRAWINGS

[0027] Novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments in which the principles of the inventions are utilized, and the accompany drawings of which:

[0028] FIG. 1A-FIG. 1B illustrate the HPLC chromatogram of GalNAc-lipid incorporation of compositions herein. FIG. 1A shows reference LNP with no GalNAc-lipid present and FIG. 1B shows LNP constituted with GalNAc-lipid.

[0029] FIG. 2 illustrates in vitro PCSK9 gene editing efficiency in primary human hepatocytes of LNP formulations in compositions herein.

[0030] FIG. 3 illustrates PCSK9 gene editing in wild type, LDLr - / -, and ApoE - / - mice liver, after retro-orbital administration of LNPs compositions here within, carrying SpCas9 mRNA and PCSK9 gRNA at 1:1 ratio.

[0031] FIG. 4 illustrates ANGPTL3 gene editing in LDLr - / - mice liver after retro-orbital administration of LNPs compositions herein carrying ABE mRNA and ANGPTL3 gRNA at 1:1 ratio.

[0032] FIG. 5 illustrates PCSK9 gene editing in wild type and LDLr - / - mice liver after retro-orbital administration of LNPs carrying ABE mRNA and PCSK9 gRNA at 1:1 ratio.

[0033] FIG. 6 illustrates PCSK9 gene editing in wild type female mice hepatocytes after retro-orbital administration of LNPs compositions herein.

[0034] FIG. 7 illustrates PCSK9 gene editing in wild type female mice hepatocytes after retro-orbital administration of LNPs compositions herein.

[0035] FIG. 8 illustrates PCSKO editing in LDLR- / - female mice hepatocytes after retro- orbital administration of LNPs compositions herein carrying Cas9 mRNA and gRNA.

[0036] FIG. 9 illustrates four general processes of introducing GalNAc-lipids into lipid nanoparticles.

[0037] FIG. 10 illustrates three protocols for preparing lipid nanoparticles comprising post-addition of GalNAc-lipids.

[0038] FIG. 11 illustrates three protocols for preparing lipid nanoparticles comprising post-addition of GalNAc-lipids.

[0039] FIG. 12 illustrates three protocols for preparing lipid nanoparticles comprising addition of GalNAc-lipid into LNP excipients and split addition of GalNAc-Lipid.

[0040] FIG. 13 illustrates two protocols for preparing lipid nanoparticles comprising addition of GalNAc-lipid into LNP excipients and split addition of GalNAc-Lipid.

[0041] FIG. 14 illustrates two protocols for preparing lipid nanoparticles comprising cross-mixing of GalNAc-lipid.

[0042] FIG. 15 illustrates PCSK9 editing in LDLR- / - female mice hepatocytes after retro- orbital administration of LNP compositions herein carrying PCSK9 ABE mRNA and guide RNA ina 1:1 ratio. DETAILED DESCRIPTION

[0043] Certain specific details of this description are set forth in order to provide a thorough understanding of various embodiments. However, one skilled in the art will understand that the present disclosure may be practiced without these details. In other instances, well-known structures and / or methods have not been shown or described in detail to avoid unnecessarily obscuring descriptions of the embodiments. Unless the context requires otherwise, throughout the specification and claims which follow, the word “comprise” and variations thereof, such as, “comprises” and “comprising” are to be construed in an open, inclusive sense, that is, as “including, but not limited to.” Further, headings provided herein are for convenience only and do not interpret the scope or meaning of the claimed disclosure. The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter described.

[0044] Efficient delivery to cells requires specific targeting and substantial protection from the extracellular environment, particularly serum proteins. One method of achieving specific targeting is to conjugate a targeting moiety to active agents or pharmaceutical effector such as a nucleic acid agent, thereby directing the active agent or pharmaceutical effector to particular cells or tissues depending on the specificity of the targeting moiety. One way a targeting moiety can improve delivery is by receptor mediated endocytotic activity. In some cases, this mechanism of uptake can involve the movement of nucleic acid agent bound to membrane receptors into the interior of an area that is enveloped by the membrane via invagination of the membrane structure or by fusion of the delivery system with the cell membrane. This process is initiated via activation of a cell-surface or membrane receptor following binding of a specific ligand to the receptor. Many receptor-mediated endocytotic systems are known and have been studied, including those that recognize sugars such as galactose, mannose, mannose-6-phosphate, peptides and proteins such as transferrin, asialoglycoprotein, vitamin B12, insulin and epidermal growth factor (EGF). Lipophilic moieties, such as cholesterol or fatty acids, when attached to highly hydrophilic molecules such as nucleic acids can substantially enhance plasma protein binding and consequently circulation half life. Lipophilic conjugates can also be used in combination with the targeting ligands in order to improve the intracellular trafficking of atargeted delivery approach.

[0045] The Asialoglycoprotein receptor (ASGP-R) is a high capacity receptor, which is highly abundant on hepatocytes. The ASGP-R shows a 50-fold higher affinity for N-Acetyl- D-Galactosylamine (GalNAc) than D-Gal. Previous work has shown that multivalency is required to achieve high affinity, while spacing among sugars is also crucial. The inventors here recognized that there is a clear need for new receptor specific ligand conjugated RNA or DNA agents and methods for their preparation, that address the shortcomings of in vivo delivery of therapeutics with nucleic acids or nucleic acid involved complexes as described above. The present disclosure is directed to this very important objective.

[0046] As used in this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural referents unless the content clearly dictates otherwise. It should also be noted that the term “or” is generally employed in its sense including “and / or” unless the content clearly dictates otherwise.

[0047] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present disclosure, suitable methods and materials are described below. All references cited herein are incorporated by reference in their entirety as though fully set forth. Singleton et al., Dictionary of Microbiology and Molecular Biology 3rd ed., J. Wiley & Sons (New York, NY 2001); March, Advanced Organic Chemistry Reactions, Mechanisms and Structure 5th ed., J. Wiley & Sons (New York, NY 2001); and Sambrook and Russel, Molecular Cloning: A Laboratory Manual 3rd ed., Cold Spring Harbor Laboratory Press (Cold Spring Harbor, NY 2001), provide one skilled in the art with a general guide to many of the terms used in the present application. Specific Definitions

[0048] When indicating the number of substituents, the term “one or more” refers to the range from one substituent to the highest possible number of substitution, e.g. replacement of one hydrogen up to replacement of all hydrogens by substituents.

[0049] The term “optional” or “optionally” denotes that a subsequently described event or circumstance can but need not occur, and that the description includes instances where the event or circumstance occurs and instances in which it does not.

[0050] The term “nucleic acid molecular entity” is used interchangeably with “nucleic acid.”

[0051] The term “nucleic acid” as used herein generally refers to one or more nucleobases, nucleosides, or nucleotides, and the term includes polynucleobases, polynucleosides, and polynucleotides. A nucleic acid can include polynucleotides, mononucleotides, and oligonucleoitdes. A nucleic acid can include DNA, RNA, or a mixture thereof, and can be single stranded, double stranded, or partially single or double stranded, and can form secondary structures. In some embodiments, a nucleic acid has multiple double- stranded segments and single stranded segments. For example, a nucleic acid may comprise a polynucleotide, e.g. a mRNA, with multiple double stranded segments within it. DNA may be in the form of, e.g., antisense molecules, plasmid DNA, pre-condensed DNA, a PCR product, vectors, expression cassettes, chimeric sequences, chromosomalDNA, or derivatives and combinations of these groups. RNA may be in the form of siRNA, asymmetrical interfering RNA (aiRNA), microRNA (miRNA), mRNA, tRNA, rRNA, tRNA, viral RNA (VRNA), CRISPR RNA, base editor RNA and combinations thereof. Nucleic acids include nucleic acids containing known nucleotide analogs or modified backbone residues or linkages, which are synthetic, naturally occurring, and non-naturally occurring, and which have similar binding properties as the reference nucleic acid. Examples of such analogs include, without limitation, phosphorothioates, phosphoramidates, methyl phosphonates, chiral-methyl phosphonates, 2'-O-methyl ribonucleotides, and peptide-nucleic acids (PNAs). Unless specifically limited, the term encompasses nucleic acids containing known analogues of natural nucleotides that have similar binding properties as the reference nucleic acid. Unless otherwise indicated, a particular nucleic acid sequence also implicitly encompasses conservatively modified variants thereof (e.g., degenerate codon substitutions), alleles, orthologs, SNPs, and complementary sequences as well as the sequence explicitly indicated. Specifically, degenerate codon substitutions may be achieved by generating sequences in which the third position of one or more selected ( or all) codons is substituted with mixed- base and / or deoxyinosine residues (Batzer et al., Nucleic Acid Res., 19:5081 (1991); Ohtsuka etal ,J Biol. Chem., 260:2605-2608 (1985);Rossolini et al., Mal. Cell. Probes, 8:91-98 (1994)). "Nucleotides" contain a substituted and / or unsubtsitued sugar deoxyribose (DNA), or a substituted and / or unsustituted sugar ribose (RNA), or a substituted and / or unsubstituted carbocylic, or a substituted and / or unsubstituted acyclic moiety (glycol nucleic, for e,g.), a base, and a phosphate group. Nucleotides are linked together through the phosphate groups. "Bases" include purines and pyrimidines, which further include natural compounds adenine, thymine, guanine, cytosine, uracil, inosine, and natural analogs, and synthetic derivatives of purines and pyrimidines, which include. but are not limited to, modifications which place new reactive groups such as, but not limited to, amines, alcohols, thiols, carboxylates, and alkylhalides.

[0052] The term "gene" refers to a nucleic acid (e.g., DNA or RNA) sequence that comprises partial length or entire length coding sequences necessary for the production of a polypeptide or precursor polypeptide.

[0053] "Gene product," as used herein, refers to a product of a gene such as an RNA transcript or a polypeptide.

[0054] The term “polynucleotide”, as used herein generally refers to a molecule comprising two or more linked nucleic acid subunits, e.g., nucleotides, and can be used interchangeably with “oligonucleotide”. For example, a polynucleotide may include one or more nucleotides selected from adenosine (A), cytosine (C), guanine (G), thymine (T) and uracil (U), or variants thereof. A nucleotide generally includes a nucleoside and at least 1, 2, 3,4,5,6,7,38,9, 10, or more phosphate (POs) groups. A nucleotide can include a nucleobase, a five—carbon sugar (either ribose or deoxyribose), and one or more phosphate groups. Ribonucleotides include nucleotides in which the sugar is ribose. Deoxyribonucleotides include nucleotides in which the sugar is deoxyribose. A nucleotide can be a nucleoside monophosphate, nucleoside diphosphate, nucleoside triphosphate or a nucleoside polyphosphate. For example, a nucleotide can be a deoxyribonucleoside polyphosphate, such as a deoxyribonucleoside triphosphate (INTP), Exemplary dNTPs include deoxyadenosine triphosphate (dATP), deoxycytidine triphosphate (dCTP), deoxyguanosine triphosphate (dGTP), uridine triphosphate (dUTP) and deoxythymidine triphosphate (dTTP). dNTPs can also include detectable tags, such as luminescent tags or markers (e.g., fluorophores). For example, a nucleotide can be a purine (e.g., A or G, or variant thereof) or a pyrimidine (e.g., C, T or U, or variant thereof). In some examples, a polynucleotide is deoxyribonucleic acid (DNA), ribonucleic acid (RNA), or derivatives or variants thereof. Exemplary polynucleotides include, but are not limited to, short interfering RNA (siRNA), a microRNA (miRNA), a plasmid DNA (pDNA), a short hairpin RNA (shRNA), small nuclear RNA (snRNA), messenger RNA (mRNA), precursor mRNA (pre-mRNA), antisense RNA (asRNA), and heteronuclear RNA (hnRNA), and encompasses both the nucleotide sequence and any structural embodiments thereof, such as single-stranded, double-stranded, triple— stranded, helical, hairpin, stem loop, bulge, etc. In some cases, a polynucleotide is circular. A polynucleotide can have various lengths. For example, a polynucleotide can have a length of at least about 7 bases, 8 bases, 9 bases, 10 bases, 20 bases, 30 bases, 40 bases, 50 bases, 100 bases, 200 bases, 300 bases, 400 bases, 500 bases, 1 kilobase (kb), 2 kb, 3, kb, 4 kb, 5 kb, 10 kb, 50 kb, or more. A polynucleotide can be isolated from a cell or a tissue. For example, polynucleotide sequences may comprise isolated and purified DNA / RNA molecules, synthetic DNA / RNA molecules, and / or synthetic DNA / RNA analogs. [00S5] Polynucleotides can include one or more nucleotide variants, including nonstandard nucleotide(s), non-natural nucleotide(s), nucleotide analog(s) and / or modified nucleotides. Examples of modified nucleotides include, but are not limited to diaminopurine, 5—fluorouracil, 5-bromouracil, 5—chlorouracil, 5-iodouracil, hypoxanthine, xantine, 4— acetylcytosine, 5—(carboxyhydroxylmethyl)uracil, 5—carboxymethylaminomethyl-2— thiouridine, 5-carboxymethylaminomethyluracil, dihydrouracil, beta—D—-galactosylqueosine, inosine, N6—isopentenyladenine, 1-methylguanine, 1-methylinosine, 2,2-dimethylguanine, 2-methyladenine, 2-methylguanine, 3-methylcytosine, 5S-methylcytosine, N6—adenine, 7— methylguanine, 5-methylaminomethyluracil, 5-methoxyaminomethyl-2—thiouracil, beta-D— mannosylqueosine, 5’—methoxycarboxymethyluracil, 5-methoxyuracil, 2-methylthio-N6— isopentenyladenine, uracil-5—-oxyacetic acid (v), wybutoxosine, pseudouracil, queosine, 2— thiocytosine, 5S-methyl—2-thiouracil, 2—thiouracil, 4-thiouracil, 5S-methyluracil, uracil-5— oxyacetic acid methylester, 5—methyl-2—thiouracil, 3—(3-amino— 3— N-2—carboxypropyl) uracil, (acp3)w, 2,6—diaminopurine and the like. In some cases, nucleotides may include modifications in their phosphate moieties, including modifications to a triphosphate moiety. Non-limiting examples of such modifications include phosphate chains of greater length (e.g., a phosphate chain having, 4, 5, 6, 7, 8, 9, 10 or more phosphate moieties) and modifications with thiol moieties (e.g., alpha—thiotriphosphate and beta—thiotriphosphates). Nucleic acid molecules may also be modified at the base moiety (e.g., at one or more atoms that typically are available to form a hydrogen bond with a complementary nucleotide and / or at one or more atoms that are not typically capable of forming a hydrogen bond with a complementary nucleotide), sugar moiety or phosphate backbone. Nucleic acid molecules may also contain amine —modified groups, such as amino ally 1-dUTP (aa—dUTP) and aminohexhylacrylamide—-dCTP (aha—dCTP) to allow covalent attachment of amine reactive moieties, such as N-hydroxysuccinimide esters (NHS). Alternatives to standard DNA base pairs or RNA base pairs in the oligonucleotides of the present disclosure can provide higher density in bits per cubic mm, higher safety (resistant to accidental or purposeful synthesis of natural toxins), easier discrimination in photo—programmed polymerases, or lower secondary structure. Such alternative base pairs compatible with natural and mutant polymerases for de novo and / or amplification synthesis are described in Betz K, Malyshev DA, Lavergne T, Welte W, Diederichs K, Dwyer TJ, Ordoukhanian P, Romesberg FE, Marx A. Nat. Chem. Biol. 2012 Jul;8(7):612—4, which is herein incorporated by reference for all purposes.

[0056] As used herein, the terms “polypeptide”, “protein” and “peptide” are used interchangeably and refer to a polymer of amino acid residues linked via peptide bonds and which may be composed of two or more polypeptide chains. The terms “polypeptide”, “protein” and “peptide” refer to a polymer of at least two amino acid monomers joined together through amide bonds. An amino acid may be the L-optical isomer or the D-optical isomer. More specifically, the terms “polypeptide”, “protein” and “peptide” refer to a molecule composed of two or more amino acids in a specific order; for example, the order as determined by the base sequence of nucleotides in the gene or RNA coding for the protein. Proteins are essential for the structure, function, and regulation of the body’s cells, tissues, and organs, and each protein has unique functions. Examples are hormones, enzymes, antibodies, and any fragments thereof. In some cases, a protein can be a portion of the protein, for example, a domain, a subdomain, or a motif of the protein. In some cases, a protein can be a variant (or mutation) of the protein, wherein one or more amino acid residues are inserted into, deleted from, and / or substituted into the naturally occurring (or at least a known) amino acid sequence of the protein. A protein or a variant thereof can be naturally occurring or recombinant.

[0057] As used herein, the term “intercalating” or “intercalation” refers to the actions of agents (e.g., small molecules) that insert themselves between succesive bases in DNA. In some cases, the intercalation prevents the proper functioning of the DNA.

[0058] As used herein, “complement” means the complementary sequence to a nucleic acid according to standard Watson / Crick pairing rules. A complement sequence can also be a sequence of RNA complementary to the DNA sequence or its complement sequence, and can also be a cDNA. Complements may be fully complementary or partially complementary such that the two sequences will hybridize under stringent hybridization conditions. The skilled artisan will understand that complementary or substantially complementary sequences need not hybridize along their entire length. In particular embodiments, complementary or substantially complementary sequences may comprise a contiguous sequence of bases that do not hybridize to a target sequence, positioned 3' or 5' to a contiguous sequence of bases that hybridize to a target sequence.

[0059] As used herein, “hybridize” refers to a process where two nucleic acid strands anneal to each in accordance with Watson-Crick base pairing rules. Nucleic acid hybridization techniques are well known in the art. See, e.g., Sambrook, et al., 1989, Molecular Cloning: A Laboratory Manual, Second Edition, Cold Spring Harbor Press, Plainview, N.Y. Those skilled in the art understand how to determine the appropriate stringency of hybridization / washing conditions such that sequences having at least a desired level of complementarity will stably hybridize, while those having lower complementarity will not. For examples of hybridization conditions and parameters, see, e.g., Sambrook, et al., 1989, Molecular Cloning: A Laboratory Manual, Second Edition, Cold Spring Harbor Press, Plainview, N.Y; Ausubel, F. M. et al. 1994, Current Protocols in Molecular Biology. John Wiley & Sons, Secaucus, N.J, all of which are incorporated herein by reference in their entireties. In certain embodiments, hybridizations may occur between nucleic acid molecules of 20-100 nucleotides in length. In some embodiments, hybridization may occur between at least 1,2,3,4,5,6,7,8,9,10, 11, 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, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77,78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, or 100 consecutive nucleotides. In some embodiments, the hybridizing nucleic acid molecules may containup to 1,2,3,4,5,6,7,8,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20 mismatches that are tolerated.

[0060] As used herein, the term “biological sample” means any biological material from which polynucleotides, polypeptides, biomarkers, and / or metabolites can be prepared and examined. Non-limiting examples encompasses whole blood, plasma, saliva, cheek swab, fecal specimen, urine specimen, cell mass, or any other bodily fluid or tissue.

[0061] The terms “administer,” “administering”, “administration,” and the like, as used herein, refer to the methods that may be used to enable delivery of compounds or compositions to the desired site of biological action. These methods include, but are not limited to oral routes (p.o.), intraduodenal routes (i.d.), parenteral injection (including intravenous (i.v.), subcutaneous (s.c.), intraperitoneal (i.p.), intramuscular (i.m.), intravascular or infusion (inf.)), topical (top.) and rectal (p.r.) administration. Those of skill in the art are familiar with administration techniques that can be employed with the compounds and methods described herein. In some embodiments, the compounds and compositions described herein are administered orally.

[0062] The terms “co—administration” or the like, as used herein, are meant to encompass administration of the selected therapeutic agents to a single patient, and are intended to include treatment regimens in which the agents are administered by the same or different route of administration or at the same or different time.

[0063] The terms “effective amount” or “therapeutically effective amount,” as used herein, refer to a sufficient amount of an agent or a compound being administered which will relieve to some extent one or more of the symptoms of the disease or condition being treated; for example a reduction and / or alleviation of one or more signs, symptoms, or causes of a disease, or any other desired alteration of a biological system. For example, an “effective amount” for therapeutic uses can be an amount of an agent that provides a clinically significant decrease in one or more disease symptoms. An appropriate “effective” amount may be determined using techniques, such as a dose escalation study, in individual cases.

[0064] The terms “enhance” or “enhancing,” as used herein, means to increase or prolong either in amount, potency or duration a desired effect.

[0065] As used herein, “carbohydrate” refers to a compound which is either a carbohydrate per se made up of one or more monosaccharide units having at least 6 carbon atoms (which may be linear, branched or cyclic) with an oxygen, nitrogen or sulfur atom bonded to each carbon atom; or a compound having as a part thereof a carbohydrate moiety made up of one or more monosaccharide units each having at least six carbon atoms (which may be linear, branched or cyclic), with an oxygen, nitrogen or sulfur atom bonded to each carbon atom. Representative carbohydrates include the sugars (mono-, di-, tri- and oligosaccharides containing from about 4-9 monosaccharide units), and polysaccharides such as starches, glycogen, cellulose and polysaccharide gums. Specific monosaccharides include C5 and above (preferably C5-C8) sugars; di- and trisaccharides include sugars having two or three monosaccharide units (preferably C5-C8).

[0066] The term “monosaccharide” embraces radicals of allose, altrose, arabinose, cladinose, erythrose, erythrulose, fructose, D-fucitol, L-fucitol, fucosamine, fucose, fuculose, galactosamine, D-galactosaminitol, N-acetyl-galctosamine, galactose, glucosamine, N-acetyl- glucosamine, glucosaminitol, glucose, glucose-6-phosphate gulose glyceraldehyde, L- glycero-D-mannos-heprose, glycerol, glycerone, gulose idose, lyxose, mannosamine, mannose, mannose-6-phosphate, psicose, quinovose, quinovosamine, rhamnitol, rhamnosamine, rhamnose, ribose, ribulose, sedoheptulose, sorbose, tagatose, talose, tartaric acid, throse, xylose and xylulose. The monosaccharide can be in D- or L-configuration. The monosaccharide may further be a deoxy sugar (alcoholic hydroxy group replaced by hydrogen), amino sugar (alcoholic hydroxy group replaced by amino group), a thio sugar (alcoholic hydroxy group replaced by thiol, or C=0 replaced by C=S, or a ring oxygen of cyclic form replaced by sulfur), a seleno sugar, a telluro sugar, an aza sugar (ring carbon replaced by nitrogen), a imino sugar (ring oxygen replaced by nitrogen), a phosphano sugar (ring oxygen replaced with phosphorus), a phospha sugar (ring carbon replaced with phosphorus), a C-substituted monosaccharide (hydrogen at a non-terminal carbon atom replaced with carbon), an unsaturated monosaccharide, an alditol (carbonyl group replaced with CHOH group), aldonic acid (aldehydic group replaced by carboxy group), a ketoaldonic acid, a uronic acid, an aldaric acid, and so forth. Amino sugars include amino monosaccharides, preferably galactosamine, glusamine, mannosamine, fucosmine, quinavosamine, neuraminic acid, muramic acid, lactosediamine, acosamine, bacillosamine, daunosamine, desosamine, forosamine, garosamine, kanosamine, kanosamine, mycaminose, myosamine, persosamine, pneumosamine, purpurosamine, rhodosmine. It is understood that the monosaccharide and the like can be further substituted

[0067] As used herein, the “N / P ratio” is the molar ratio of ionizable (e.g., in the physiological pH range) nitrogen atoms in a lipid (or lipids) to phosphate groups in a nucleic acid molecular entity (or nucleic acid molecular entities), e.g., in a nanoparticle composition comprising a lipid component and an RNA. Ionizable nitrogen atoms can include, for example, nitrogen atoms that can be protonated at about pH 1, about pH 2, about pH 3, about pH 4, about pHS5, about pH 6, about pH 7, about pH 7.5, or about pH 8 or higher. The physiological pH range can include, for example, the pH range of different cellular compartments (such as organs, tissues, and cells) and bodily fluids (such as blood, CSF, gastric juice, milk, bile, saliva, tears, and urine). In certain specific embodiments, the physiological pH range refers to the pH range of blood in a mammal, for example, from about 7.35 to about 7.45. In some embodiments, ionizable nitrogen atoms refer to those nitrogen atoms that are ionizable within a pH range between 5 and 14

[0068] The terms “disaccharide”, “trisaccharide” and “polysaecharide” embrace radicals of abequose, acrabose, amicetose, amylopectin, amylose, apiose, arcanose, ascarylose, ascorbic acid, boivinose, cellobiose, cellotriose, cellulose, chacotriose, chalcose, chitin, colitose, cyclodextrin, cymarose, dextrin, 2-deoxyribose, 2-deoxyglucose diginose, digitalose, digitoxose, evalose, evemitrose, fructooligosachharide, galto-oligosaccharide, gentianose, genitiobiose, glucan, gluicogen, glylcogen, hamamelose, heparin, inulin, isolevoglucosenone, isomaltose, isomaltotriose, isopanose, kojibiose, lactose, lactosamine, lactosediamine, laminarabiose, levoglucosan, levoglucosenone, B-maltose, maltriose, mannan- oligosacchardie, amnninotriose, melezitose, melibiose, muramic acid, mycarose, mycinose, neuaminic acid, migerose, nojirimycon, noviose, oleandrose, panose, paratose, planteose, primeverose, raffinose, rhodone, rutinose, oleandrose, panose, paratose, planteose, primeverose, raffinose, rhodinose, rutinose, sarmentose, sedoheptulose, sedoheptulosan, solatriose, sophorose, stachyose, streptose, sucrose, a,0-trehalose, trahalosamine, turanose, tyvelose, xylobiose, umbelliferose and the like. Further, it is understood that the “disaccharide”, “trisaccharide” and “polysaccharide” and the like can further substituted. Disaccharide also includes amino sugars and their derivatives, particularly, a mycaminose derivatized a the C-4' position or a 4 deoxy-3-amino-glucose derivatized at the C-6' position.

[0069] The term “subject” or “patient” encompasses mammals. Examples of mammals include, but are not limited to, any member of the mammalian class: humans, non-human primates such as chimpanzees, and other apes and monkey species; farm animals such as cattle, horses, sheep, goats, swine; domestic animals such as rabbits, dogs, and cats; laboratory animals including rodents, such as rats, mice and guinea pigs, and the like. In one aspect, the mammal is a human. The term “animal” as used herein comprises human beings and non-human animals. In one embodiment, a “non-human animal” is a mammal, for example a rodent such as rat or a mouse. In one embodiment, a non-human animal is a mouse or a monkey.

[0070] The terms “treat,” “treating” or “treatment,” as used herein, include alleviating, abating or ameliorating at least one symptom of a disease or condition, preventing additional symptoms, inhibiting the disease or condition, e.g., arresting the development of the disease or condition, relieving the disease or condition, causing regression of the disease or condition, relieving a condition caused by the disease or condition, or stopping the symptoms of the disease or condition either prophylactically and / or therapeutically. The term “treating” further encompasses the concept of “prevent,” “preventing,” and “prevention,” as stated below. It is appreciated that, although not precluded, treating a disorder or condition does not require that the disorder, condition, or symptoms associated therewith be completely eliminated.

[0071] The term “preventing” or “prevention” of a disease state denotes causing the clinical symptoms of the disease state not to develop in a subject that can be exposed to or predisposed to the disease state, but does not yet experience or display symptoms of the disease state.

[0072] The terms “pharmaceutical composition” and “pharmaceutical formulation” (or “formulation”) are used interchangeably and denote a mixture or solution comprising a therapeutically effective amount of an active pharmaceutical ingredient together with one or more pharmaceutically acceptable excipients to be administered to a subject, e.g., a human in need thereof.

[0073] The term “pharmaceutical combination” as used herein, means a product that results from mixing or combining more than one active ingredient and includes both fixed and non-fixed combinations of the active ingredients. The term “fixed combination” means that the active ingredients, e.g., a compound described herein and a co—agent, are both administered to a patient simultaneously in the form of a single entity or dosage. The term “non—fixed combination” means that the active ingredients, e.g. a compound described herein and a co—agent, are administered to a patient as separate entities either simultaneously, concurrently or sequentially with no specific intervening time limits, wherein such administration provides effective levels of the two compounds in the body of the patient. The latter also applies to cocktail therapy, e.g., administration of three or more active ingredients.

[0074] The term “pharmaceutically acceptable” denotes an attribute of a material which is useful in preparing a pharmaceutical composition that is generally safe, non-toxic, and neither biologically nor otherwise undesirable and is acceptable for veterinary as well as human pharmaceutical use. “Pharmaceutically acceptable” can refer to a material, such as a carrier or diluent, which does not abrogate the biological activity or properties of the compound, and is relatively nontoxic, e.g., the material may be administered to an individual without causing undesirable biological effects or interacting in a deleterious manner with any of the components of the composition in which it is contained.

[0075] The terms “pharmaceutically acceptable excipient”, “pharmaceutically acceptable carrier”, “pharmaceutically acceptable vehicle” and “therapeutically inert excipient” can be used interchangeably and denote any pharmaceutically acceptable ingredient in a pharmaceutical composition having no therapeutic activity and being non-toxic to the subject administered, such as disintegrators, binders, fillers, solvents, buffers, tonicity agents, stabilizers, antioxidants, surfactants, carriers, diluents, excipients, preservatives or lubricants used in formulating pharmaceutical products.

[0076] The term "base editing" and “base correction” are used interchangeably to indicate a base change or mutation at a target sequence within the target gene leading to base modification. In certain embodiments, base editing occurs at a single base of the target sequence. In preferred embodiments, base editing does not involve double strand breaks of the target sequence.

[0077] As used herein, the term "siRNA" refers to an agent that mediates the targeted cleavage of an RNA transcript. These agents associate with a cytoplasmic multi-protein complex known as RNAi-induced silencing complex (RISC). Agents that are effective in inducing RNA interference are also referred to as siRNA, RNAI agent, or iRNA agent, herein. As used herein, the term siRNA includes microRNAs and pre-microRNAs. As used herein, the terms "siRNA activity" and "RNAI activity" refer to gene silencing by an siRNA.

[0078] The term “2'-O-methoxyethyl” (also 2'-MOE, 2'-O(CH2)2—OCH3 and 2'-0-(2- methoxyethyl)) refers to an O-methoxy-ethyl modification of the 2 position of a furosyl ring. A 2'-O-methoxyethyl modified sugar is a modified sugar.

[0079] The term “2'-O-methoxyethyl nucleotide” means a nucleotide comprising a 2'-O- methoxyethyl modified sugar moiety.

[0080] The term “S-methylcytosine” means a cytosine modified with a methyl group attached to the 5' position. A 5-methylcytosine is a modified nucleobase.

[0081] The term “oxo” refers to the =O substituent.

[0082] The term “alkyl” refers to a straight or branched hydrocarbon chain radical, having from one to twenty carbon atoms, and which is attached to the rest of the molecule by a single bond. An alkyl comprising up to 10 carbon atoms is referred to as a Ci-Cio alkyl, likewise, for example, an alkyl comprising up to 6 carbon atoms is a C1-Cs alkyl. Alkyls (and other moieties defined herein) comprising other numbers of carbon atoms are represented similarly. Alkyl groups include, but are not limited to, C1-C1o alkyl, Ci-Cy alkyl, C1-Cs alkyl, C1-C7 alkyl, C1-Cs alkyl, C1-Cs alkyl, C1-C4 alkyl, C1-Cs alkyl, C1-Cz alkyl, C2-Cs alkyl, Cs- Cs alkyl and Cs-Cs alkyl. Representative alkyl groups include, but are not limited to, methyl, ethyl, n-propyl, 1-methylethyl (i-propyl), n-butyl, i-butyl, s-butyl, n-pentyl, 1,1-dimethylethyl (t-butyl), 3-methylhexyl, 2-methylhexyl, 1-ethyl-propyl, and the like. In some embodiments, the alkyl is methyl or ethyl. In some embodiments, the alkyl is -CH(CH3). or -C(CHs)s. Unless stated otherwise specifically in the specification, an alkyl group may be optionally substituted as described below. “Alkylene” or “alkylene chain” refers to a straight or branched divalent hydrocarbon chain linking the rest of the molecule to a radical group. In some embodiments, the alkylene is -CHz-, -CH2CHa-, or -CH2CH2CH,-. In some embodiments, the alkylene is -CHz-. In some embodiments, the alkylene is -CH2CHz-. In some embodiments, the alkylene is -CH,CH,CHa-.

[0083] The term “alkoxy” refers to a radical of the formula -OR where R is an alkyl radical as defined. Unless stated otherwise specifically in the specification, an alkoxy group may be optionally substituted as described below. Representative alkoxy groups include, but are not limited to, methoxy, ethoxy, propoxy, butoxy, pentoxy. In some embodiments, the alkoxy is methoxy. In some embodiments, the alkoxy is ethoxy.

[0084] The term “alkylamino” refers to a radical of the formula -NHR or -NRR where each R is, independently, an alkyl radical as defined above. Unless stated otherwise specifically in the specification, an alkylamino group may be optionally substituted as described below.

[0085] The term “alkenyl” refers to a type of alkyl group in which at least one carbon-carbon double bond is present. In one embodiment, an alkenyl group has the formula -C(R)=CRq, wherein R refers to the remaining portions of the alkenyl group, which may be the same or different. In some embodiments, R is H or an alkyl. In some embodiments, an alkenyl is selected from ethenyl (i.e., vinyl), propenyl (i.e., allyl), butenyl, pentenyl, pentadienyl, and the like. Non-limiting examples of an alkenyl group include -CH=CHa,, -C(CH3)=CHa, - CH=CHCH3, -C(CH3)=CHCHj3, and -CH,CH=CH.. Depending on the structure, an alkenyl group can be monovalent or divalent (i.e., an alkenylene group).

[0086] The term “alkynyl” refers to a type of alkyl group in which at least one carbon- carbon triple bond is present. Accordingly, “alkynylene” can refer to a divalent alkynyl group. In one embodiment, an alkenyl group has the formula -C=C-R, wherein R refers to the remaining portions of the alkynyl group. In some embodiments, R is H or an alkyl. In some embodiments, an alkynyl is selected from ethynyl, propynyl, butynyl, pentynyl, hexynyl, and the like. Non-limiting examples of an alkynyl group include -C=CH, -C=CCH - C=CCH;CH3s, -CH,C=CH.

[0087] The term “aryl” refers to an aromatic ring wherein each of the atoms forming the ring is a carbon atom. Aryl groups can be optionally substituted. Examples of aryl groups include, but are not limited to phenyl, and naphthyl. In some embodiments, the aryl is phenyl. Depending on the structure, an aryl group can be monovalent or divalent (i.e., an “arylene” group). Unless stated otherwise specifically in the specification, the term “aryl” or the prefix “ar-"(such as in “aralkyl”) is meant to include aryl radicals that are optionally substituted. In some embodiments, an aryl group is partially reduced to form a cycloalkyl group defined herein. In some embodiments, an aryl group is fully reduced to form a cycloalkyl group defined herein. In some embodiments, an aryl group is a Cé-C14 aryl. In some embodiments, an aryl group is a C¢-Co aryl.

[0088] The term “cycloalkyl” refers to a monocyclic or polycyclic non-aromatic radical, wherein each of the atoms forming the ring (i.e. skeletal atoms) is a carbon atom. In some embodiments, cycloalkyls are saturated or partially unsaturated. In some embodiments, cycloalkyls are spirocyclic or bridged compounds. In some embodiments, cycloalkyls are fused with an aromatic ring (in which case the cycloalkyl is bonded through a non-aromatic ring carbon atom). Cycloalkyl groups include groups having from 3 to 10 ring atoms. Representative cycloalkyls include, but are not limited to, cycloalkyls having from three to ten carbon atoms, from three to eight carbon atoms, from three to six carbon atoms, or from three to five carbon atoms. Monocyclic cycloalkyl radicals include, for example, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl. In some embodiments, the monocyclic cycloalkyl is cyclopropyl, cyclobutyl, cyclopentyl or cyclohexyl. In some embodiments, the monocyclic cycloalkyl is cyclopentenyl or cyclohexenyl. In some embodiments, the monocyclic cycloalkyl is cyclopentenyl. Polycyclic radicals include, for example, adamantyl, 1,2-dihydronaphthalenyl, 1,4-dihydronaphthalenyl, tetrainyl, decalinyl, 3,4-dihydronaphthalenyl-1(2H)-one, spiro[2.2]pentyl, norbornyl and bicycle[1.1.1]pentyl. Unless otherwise stated specifically in the specification, a cycloalkyl group may be optionally substituted. Depending on the structure, a cycloalkyl group can be monovalent or divalent (i.e., a cycloalkylene group).

[0089] The term “haloalkyl” denotes an alkyl group wherein at least one of the hydrogen atoms of the alkyl group has been replaced by same or different halogen atoms, particularly fluoro atoms. Examples of haloalkyl include monofluoro-, difluoro-or trifluoro-methyl, -ethyl or -propyl, for example 3,3,3-trifluoropropyl, 2-fluoroethyl, 2,2,2-trifluoroethyl, fluoromethyl, or trifluoromethyl. The term “perhaloalkyl” denotes an alkyl group where all hydrogen atoms of the alkyl group have been replaced by the same or different halogen atoms.

[0090] The term “heteroalkylene” refers to an alkyl radical as described above where one or more carbon atoms of the alkyl is replaced with a O, N or S atom. “Heteroalkylene” or “heteroalkylene chain” refers to a straight or branched divalent heteroalkyl chain linking the rest of the molecule to a radical group. Unless stated otherwise specifically in the specification, the heteroalkyl or heteroalkylene group may be optionally substituted as described below. Representative heteroalkylene groups include, but are not limited to -OCH.CH20-, - OCH2CH,0CH,CH-0-, or -OCH,CH,0CH,CH,0CH,CH,0-.

[0091] The term “heterocycloalkyl” refers to a cycloalkyl group that includes at least one heteroatom selected from nitrogen, oxygen, and sulfur. Unless stated otherwise specifically in the specification, the heterocycloalkyl radical may be a monocyclic, or bicyclic ring system, which may include fused (when fused with an aryl or a heteroaryl ring, the heterocycloalkyl is bonded through a non-aromatic ring atom) or bridged ring systems. The nitrogen, carbon or sulfur atoms in the heterocyclyl radical may be optionally oxidized. The nitrogen atom may be optionally quaternized. The heterocycloalkyl radical is partially or fully saturated. Examples of heterocycloalkyl radicals include, but are not limited to, dioxolanyl, thienyl[1,3]dithianyl, tetrahydroquinolyl, tetrahydroisoquinolyl, decahydroquinolyl, decahydroisoquinolyl, imidazolinyl, imidazolidinyl, isothiazolidinyl, isoxazolidinyl, morpholinyl, octahydroindolyl, octahydroisoindolyl, 2-oxopiperazinyl, 2-oxopiperidinyl, 2- oxopyrrolidinyl, oxazolidinyl, piperidinyl, piperazinyl, 4-piperidonyl, pyrrolidinyl, pyrazolidinyl, quinuclidinyl, thiazolidinyl, tetrahydrofuryl, trithianyl, tetrahydropyranyl, thiomorpholinyl, thiamorpholinyl, 1-oxo-thiomorpholinyl, 1,1-dioxo-thiomorpholinyl. The term heterocycloalkyl also includes all ring forms of carbohydrates, including but not limited to monosaccharides, disaccharides and oligosaccharides. Unless otherwise noted, heterocycloalkyls have from 2 to 12 carbons in the ring. In some embodiments, heterocycloalkyls have from 2 to 10 carbons in the ring. In some embodiments, heterocycloalkyls have from 2 to 10 carbons in the ring and 1 or 2 N atoms. In some embodiments, heterocycloalkyls have from 2 to 10 carbons in the ring and 3 or 4 N atoms. In some embodiments, heterocycloalkyls have from 2 to 12 carbons, 0-2 N atoms, 0-2 O atoms, 0-2 P atoms, and 0-1 S atoms in the ring. In some embodiments, heterocycloalkyls have from 2 to 12 carbons, 1-3 N atoms, 0-1 O atoms, and 0-1 S atoms in the ring. It is understood that when referring to the number of carbon atoms in a heterocycloalkyl, the number of carbon atoms in the heterocycloalkyl is not the same as the total number of atoms (including the heteroatoms) that make up the heterocycloalkyl (i.e. skeletal atoms of the heterocycloalkyl ring). Unless stated otherwise specifically in the specification, a heterocycloalkyl group may be optionally substituted. As used herein, the term “heterocycloalkylene” can refer to a divalent heterocycloalkyl group.

[0092] The term “heteroaryl” refers to an aryl group that includes one or more ring heteroatoms selected from nitrogen, oxygen and sulfur. The heteroaryl is monocyclic or bicyclic. Illustrative examples of monocyclic heteroaryls include pyridinyl, imidazolyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, fury, thienyl, isoxazolyl, thiazolyl, oxazolyl, isothiazolyl, pyrrolyl, pyridazinyl, triazinyl, oxadiazolyl, thiadiazolyl, furazanyl, indolizine, indole, benzofuran, benzothiophene, indazole, benzimidazole, purine, quinolizine, quinoline, isoquinoline, cinnoline, phthalazine, quinazoline, quinoxaline, 1,8-naphthyridine, and pteridine. Illustrative examples of monocyclic heteroaryls include pyridinyl, imidazolyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, fury, thienyl, isoxazolyl, thiazolyl, oxazolyl, isothiazolyl, pyrrolyl, pyridazinyl, triazinyl, oxadiazolyl, thiadiazolyl, and furazanyl. Illustrative examples of bicyclic heteroaryls include indolizine, indole, benzofuran, benzothiophene, indazole, benzimidazole, purine, quinolizine, quinoline, isoquinoline, cinnoline, phthalazine, quinazoline, quinoxaline, 1,8-naphthyridine, and pteridine. In some embodiments, heteroaryl is pyridinyl, pyrazinyl, pyrimidinyl, thiazolyl, thienyl, thiadiazolyl or furyl. In some embodiments, a heteroaryl contains 0-6 N atoms in the ring. In some embodiments, a heteroaryl contains 1-4 N atoms in the ring. In some embodiments, a heteroaryl contains 4-6 N atoms in the ring. In some embodiments, a heteroaryl contains 0-4 N atoms, 0-1 O atoms, 0-1 P atoms, and 0-1 S atoms in the ring. In some embodiments, a heteroaryl contains 1-4 N atoms, 0-1 O atoms, and 0-1 S atoms in the ring. In some embodiments, heteroaryl is a C1-Co heteroaryl. In some embodiments, monocyclic heteroaryl is a C1-Cs heteroaryl. In some embodiments, monocyclic heteroaryl is a 5-membered or 6- membered heteroaryl. In some embodiments, a bicyclic heteroaryl is a Cs-Co heteroaryl. In some embodiments, a heteroaryl group is partially reduced to form a heterocycloalkyl group defined herein. In some embodiments, a heteroaryl group is fully reduced to form a heterocycloalkyl group defined herein. Depending on the structure, a heteroaryl group can be monovalent or divalent (i.e., a “heteroarylene” group).

[0093] The term “substituted,” “substituent” or the like, unless otherwise indicated, can refer to the replacement of one or more hydrogen radicals in a given structure individually and independently with the radical of a specified substituent including, but not limited to: D, halogen, -CN, -NH,, -NH(alkyl), -N(alkyl);, -OH, -CO:H, -COzalkyl, -C(=O)NHz, - C(=0)NH(alkyl), -C(=O)N(alkyl),, -S(=0)2NHz, -S(=0):NH(alkyl), -S(=0):N(alkyl), alkyl, cycloalkyl, fluoroalkyl, heteroalkyl, alkoxy, fluoroalkoxy, heterocycloalkyl, aryl, heteroaryl, aryloxy, alkylthio, arylthio, alkylsulfoxide, arylsulfoxide, alkylsulfone, and arylsulfone. In some other embodiments, optional substituents are independently selected from D, halogen, - CN, -NH_, -NH(CH3), -N(CHj3),, -OH, -CO.H, -CO,(C;-Cs alkyl), -C(=0)NH_, -C(=0)NH(C;- C4 alkyl), -C(=0)N(Ci-Cs4 alkyl)z, -S(=0)2NHz, -S(=0)2NH(Ci-C4 alkyl), -S(=0)2N(C1-C4 alkyl), C1-Ca alkyl, C3-Cs cycloalkyl, C1-Cafluoroalkyl, Ci-Ca heteroalkyl, C1-Cs alkoxy, Ci- Cs fluoroalkoxy, -SCi-Cs alkyl, -S(=0)Ci-Cs alkyl, and -S(=0)2(Ci-Cs alkyl). In some embodiments, optional substituents are independently selected from D, halogen, -CN, -NHa, - OH, -NH(CHs), -N(CHs3)2, - NH(cyclopropyl), -CHs, -CH2CH3, -CF3, -OCH3, and -OCF3. In some embodiments, substituted groups are substituted with one or two of the preceding groups. In some embodiments, an optional substituent on an aliphatic carbon atom (acyclic or cyclic) includes oxo (=0).

[0094] The term “unsubstituted” means that the specified group bears no substituents. The term “optionally substituted” means that the specified group is unsubstituted or substituted by one or more substituents, independently chosen from the group of possible substituents. When indicating the number of substituents, the term “one or more” means from one substituent to the highest possible number of substitution, i.e. replacement of one hydrogen up to replacement of all hydrogens by substituents.

[0095] “About” means within 10% of a value. For example, if it is stated, “a marker may be increased by about 50%”, it is implied that the marker may be increased between 45%-55%

[0096] “Active pharmaceutical agent” means the substance or substances in a pharmaceutical composition that provide a therapeutic benefit when administered to an individual

[0097] “Dosage unit” means a form in which a pharmaceutical agent is provided, e.g. pill, tablet, or other dosage unit known in the art. In certain embodiments, a dosage unit is a vial containing lyophilized antisense oligonucleotide. In certain embodiments, a dosage unit is a vial containing reconstituted antisense oligonucleotide.

[0098] “Dose” means a specified quantity of a pharmaceutical agent provided in a single administration, or in a specified time period. In certain embodiments, a dose can be administered in one, two, or more boluses, tablets, or injections. For example, in certain embodiments where subcutaneous administration is desired, the desired dose requires a volume not easily accommodated by a single injection, therefore, two or more injections can be used to achieve the desired dose. In certain embodiments, the pharmaceutical agent is administered by infusion over an extended period of time or continuously. Doses can be stated as the amount of pharmaceutical agent per hour, day, week, or month. Doses can also be stated as mg / kg or g / kg.

[0099] “Modified internucleoside linkage” refers to a substitution or any change from a naturally occurring internucleoside bond. For example, a phosphorothioate linkage is a modified internucleoside linkage.

[0100] “Modified nucleobase” refers to any nucleobase other than adenine, cytosine, guanine, thymidine, or uracil. For example, 5-methylcytosine is a modified nucleobase. An “unmodified nucleobase” means the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C), and uracil (U).

[0101] “Modified nucleoside” means a nucleoside having at least one modified sugar moiety, and / or modified nucleobase.

[0102] “Modified nucleotide” means a nucleotide having at least one modified sugar moiety, modified internucleoside linkage and / or modified nucleobase.

[0103] “Modified oligonucleotide” means an oligonucleotide comprising at least one modified nucleotide.

[0104] “Modified sugar” refers to a substitution or change from a natural sugar. For example, a 2'-O-methoxyethyl modified sugar is a modified sugar.

[0105] “Motif” means the pattern of chemically distinct regions in an antisense compound.

[0106] “Statin” means an agent that inhibits the activity of HMG-CoA reductase.

[0107] “Symptom of cardiovascular disease or disorder” means a phenomenon that arises from and accompanies the cardiovascular disease or disorder and serves as an indication of it. For example, angina; chest pain; shortness of breath; palpitations; weakness; dizziness; nausea; sweating; tachycardia; bradycardia; arrhythmia; atrial fibrillation; swelling in the lower extremities; cyanosis; fatigue; fainting; numbness of the face; numbness of the limbs; claudication or cramping of muscles; bloating of the abdomen; or fever are symptoms of cardiovascular disease or disorder.

[0108] “Target nucleic acid,” and “target sequence” refer to a nucleic acid capable of being targeted by a genome editing composition. For example, a target DNA sequence within or adjacent to the ANGPTL3 gene may be targeted by a guide nucleotide associated with a Cas9 nuclease.

[0109] Methods for detection and / or measurement of polypeptides in biological material are well known in the art and include, but are not limited to, Western-blotting, flow cytometry, ELISAs, RIAs, and various proteomics techniques. An exemplary method to measure or detect a polypeptide is an immunoassay, such as an ELISA. This type of protein quantitation can be based on an antibody capable of capturing a specific antigen, and a second antibody capable of detecting the captured antigen. Exemplary assays for detection and / or measurement of polypeptides are described in Harlow, E. and Lane, D. Antibodies: A Laboratory Manual, (1988), Cold Spring Harbor Laboratory Press.

[0110] Methods for detection and / or measurement of RNA in biological material are well known in the art and include, but are not limited to, Northern-blotting, RNA protection assay, RT PCR. Suitable methods are described in Molecular Cloning: A Laboratory Manual (Fourth Edition) By Michael R. Green, Joseph Sambrook, Peter MacCallum 2012, 2,028 pp, ISBN 978-1-936113—-42—2_

[0111] A ribonucleoprotein (RNP) refers to a nucleoprotein that contains RNA. A RNP can be a complex of a ribonucleic acid and an RNA-binding protein. Such a combination can also be referred to as a protein—RNA complex. These complexes can function in a number of biological functions that include, but are not limited to, DNA replication, DNA modification, gene expression, metabolism and modification of RNA, and pre-mRNA splicing.

[0112] The term "nucleobase editors (BEs)" or "base editors (BEs)," as used herein, refers to a composition, e.g. a fusion protein comprising a polypeptide capable of making a nucleobase modification and a Cas protein. In some embodiments, the fusion protein comprises a nuclease-inactive Cas9 (dCas9) fused to a deaminase. In some embodiments, the fusion protein comprises a Cas9 nickase fused to a deaminase. In some embodiments, the fusion protein comprises a D10X mutation or a H840X mutation of a Cas9 as numbered in a wild type Cas9 sequence, e.g. SEQ ID NO: 1, which renders Cas9 capable of cleaving only one strand of a nucleic acid duplex. In some embodiments, the base editor comprises a programmable DNA nuclease domain fused or linked to a deaminase domain (e.g., adenosine deaminase domain or cytidine deaminase domain). Details of base editors are described in International PCT Application Nos. PCT / 2017 / 045381 (W02018 / 027078) and PCT / US2016 / 058344 (W02017 / 070632), each of which is incorporated herein by reference in its entirety. Also see Komor, A.C, et al., “Programmable editing of a target base in genomic DNA without double-stranded DNA cleavage” Nature 533, 420-424 (2016); Gaudelli, N.M,, et al., “Programmable base editing of A*T to G=C in genomic DNA without DNA cleavage” Nature 551, 464-471 (2017), Komor, A.C, et al., “Improved base excision repair inhibition and bacteriophage Mu Gam protein yields C:G-to-T:A base editors with higher efficiency and product purity” Science Advances 3:eaa04774 (2017); Nishida, K. et al. “Targeted nucleotide editing using hybrid prokaryotic and vertebrate adaptive immune systems”, Science 353, aaf8729 (2016); Gehrke JM, Cervantes O, Clement MK, Wu Y, Zeng J, Bauer DE, Pinello L, Joung JK. An APOBEC3A-Cas9 base editor with minimized bystander and off-target activities. Nat Biotechnol. 2018 Nov;36(10):977-982, the entire contents of which are hereby incorporated by reference.:

[0113] As used herein, the term “biomarker” or "marker" are used interchangeably to refer to any biochemical marker, serological marker, genetic marker, or other clinical or echographic characteristic that can be used to classify a sample from a patient as being associated with an pathological condition, such as a cardiovascular disease or disorder.

[0114] As used herein, the term "antibody" includes but is not limited to a population of immunoglobulin molecules, which can be polyclonal or monoclonal and of any class and isotype, or a fragment of an immunoglobulin molecule. There are five major classes of immunoglobulins: IgA, IgD, IgE, IgG, and IgM, and several of these may be further divided into subclasses (isotypes), e.g., IgG1, IgG2, IgG3, I1gG4, IgA1 (human), IgA2 (human), IgAa (canine), IgAb (canine), IgAc (canine), and IgAd (canine). Such fragment generally comprises the portion of the antibody molecule that specifically binds an antigen. For example, a fragment of an immunoglobulin molecule known in the art as Fab, Fab' or F(ab')2 is included within the meaning of the term antibody.

[0115] The term "label," as used herein, refers to a detectable compound, composition, or solid support, which can be conjugated directly or indirectly (e.g., via covalent or non- covalent means, alone or encapsulated) to a monoclonal antibody or a protein. The label may be detectable by itself (e.g., radioisotope labels, chemiluminescent dye, electrochemical labels, metal chelates, latex particles, or fluorescent labels) or, in the case of an enzymatic label, may catalyze chemical alteration of a substrate compound or composition which is detectable (e.g., enzymes such as horseradish peroxidase, alkaline phosphatase, and the like). The label employed in the current disclosure could be, but is not limited to alkaline phosphatase; glucose-6-phosphate dehydrogenase ("G6PDH"); horseradish peroxidase (HRP), chemiluminescers such as isoluminol, fluorescers such as fluorescein and rhodamine compounds; ribozymes; and dyes. The label may also be a specific binding molecule which itself may be detectable (e.g., biotin, avidin, streptavidin, digioxigenin, maltose, oligohistidine, e.g., hexa-histidine (SEQ ID NO: 114), 2, 4-dinitrobenzene, phenylarsenate, ssDNA, dsDNA, and the like). The utilization of a label produces a signal that may be detected by means such as detection of electromagnetic radiation or direct visualization, and that can optionally be measured.

[0116] "Substantial binding" or "substantially binding" refer to an amount of specific binding or affinity between molecules in an assay mixture under particular assay conditions. In its broadest aspect, substantial binding relates to the difference between a first molecule's incapability of binding or recognizing a second molecule, and the first molecules capability of binding or recognizing a third molecule, such that the difference is sufficient to allow a meaningful assay to be conducted to distinguish specific binding under a particular set of assay conditions, which includes the relative concentrations of the molecules, and the time and temperature of an incubation. In another aspect, one molecule is substantially incapable of binding or recognizing another molecule in a cross-reactivity sense where the first molecule exhibits a reactivity for a second molecule that is less than 25%, e.g. less than 10%, e.g, less than 5% of the reactivity exhibited toward a third molecule under a particular set of assay conditions, which includes the relative concentration and incubation of the molecules. Specific binding can be tested using a number of widely known methods, e.g, an immunohistochemical assay, an enzyme-linked immunosorbent assay (ELISA), a radioimmunoassay (RIA), or a western blot assay.

[0117] As used herein, the term "substantially the same amino acid sequence” includes an amino acid sequence that is similar, but not identical to, the naturally-occurring amino acid sequence. For example, an amino acid sequence, e.g., polypeptide, that has substantially the same amino acid sequence as a flagellin protein can have one or more modifications such as amino acid additions, deletions, or substitutions relative to the amino acid sequence of the naturally-occurring flagellin protein, provided that the modified polypeptide retains substantially at least one biological activity of flagellin such as immunoreactivity. The "percentage similarity" between two sequences is a function of the number of positions that contain matching residues or conservative residues shared by the two sequences divided by the number of compared positions times 100. In this regard, conservative residues in a sequence is a residue that is physically or functionally similar to the corresponding reference residue, e.g., that has a similar size, shape, electric charge, chemical properties, including the ability to form covalent or hydrogen bonds, or the like.

[0118] The term “targeting moiety” refers to any molecule that provides an enhanced affinity for a selected target, e.g., a cell, cell type, tissue, organ, region of the body, or a compartment, e.g., a cellular, tissue or organ compartment. Some exemplary targeting moieties include, but are not limited to, antibodies, antigens, carbohydrate base moieties, folates, receptor ligands, carbohydrates, aptamers, integrin receptor ligands, chemokine receptor ligands, transferrin, biotin, serotonin receptor ligands, PSMA, endothelin, GCPII, somatostatin, LDL and HDL ligands. Carbohydrate based targeting moieties include, but are not limited to, D-galactose, multivalent galactose, N-acetyl-D-galactosamine (GalNAc), multivalent GalNAc, e.g. GalNAc2 and GalNAc3; D-mannose, multivalent mannose, multivalent lactose, N-acetyl-gulucosamine, multivalent fucose, glycosylated polyaminoacids and lectins. The term multivalent indicates that more than one monosaccharide unit is present. Such monosaccharide subunits can be linked to each other through glycosidic linkages or linked to a scaffold molecule.

[0119] The term "heterologous" refers to any two or more nucleic acid or polypeptide sequences that are not normally found in the same relationship to each other in nature. For instance, a heterologous nucleic acid is typically recombinantly produced, having two or more sequences, e.g., from unrelated genes arranged to make a new functional nucleic acid, e.g., a promoter from one source and a coding region from another source. Similarly, a heterologous polypeptide will often refer to two or more subsequences that are not found in the same relationship to each other in nature (e.g., a fusion protein).

[0120] As used herein, the term "fragment" includes a peptide, polypeptide or protein segment of amino acids of the full-length protein, provided that the fragment retains reactivity with at least one antibody in sera of disease patients.

[0121] An "epitope" is the antigenic determinant on a polypeptide that is recognized for binding by a paratope on antibodies specific to the polypeptide, for example, an IBD- associated antibody.

[0122] The term "clinical factor" includes a symptom in a patient that is associated with a cardiovascular disease. Examples of clinical factors include, without limitation, angina; chest pain; shortness of breath; palpitations; weakness; dizziness; nausea; sweating; tachycardia; bradycardia; arrhythmia; atrial fibrillation; swelling in the lower extremities; cyanosis; fatigue; fainting; numbness of the face; numbness of the limbs; claudication or cramping of muscles; bloating of the abdomen; or fever. In some embodiments, a diagnosis of a cardiovascular disease is based upon a combination of analyzing the presence or level of one or more markers in a patient using statistical algorithms and determining whether the patient has one or more clinical factors.

[0123] The term "prognosis" includes a prediction of the probable course and outcome of a pathological condition, for example a cardiovascular disease, or the likelihood of recovery from the disease. In some embodiments, the use of statistical algorithms provides a prognosis of cardiovascular disease in a patient. For example, the prognosis can be surgery, development of one or more clinical factors, or recovery from the disease.

[0124] Provided herein are methods and compositions for targeted delivery of therapeutic agents such as nucleic acid agents. The therapeutic agents as used herein may be connected to or associated with a targeting moiety to assist targeted delivery. For example, the therapeutic agent and the targeting moiety may form a conjugate. The therapeutic agent may comprise a nucleic acid guided programmable nuclease system complexed with nucleic acids, such as guide RNAs. In some embodiments, the guide RNAs may be chemically modified. In some embodiments, the modified guide RNAs can be used for the preparation of a medicament for the treatment of any disease, disorder or condition relating to a gene where the gene may be altered, manipulated, edited, and modified by insertion or deletion of DNA. According to a further aspect of the disclosure, the modified guide RNA may be used for altering genes by deleting, substituting, repairing or inserting DNA. This can be done in microorganisms, or animals, in particular mammals and more particularly in humans. Human cells or tissue may be genetically altered or amended using the guide RNAs of the present disclosure and the CRISPR / Cas system known in the art in vitro and then inserted back into the patient in need thereof. Also described herein is a pharmaceutical composition comprising a modified guide RNA according to the disclosure and a CRISPR-Cas system and a pharmaceutically acceptable carrier or excipient. The pharmaceutical composition may include a vector or a cell with the modified guide RNA of the disclosure. Also described herein is a composition comprising a modified guide RNA and at least one delivery means selected from GalNAc, polymers, liposomes, peptides, aptamers, antibodies, viral vectors, folate or transferrin. Nuclease Systems

[0125] Provided herein are compositions and methods for targeted delivery of active agents, or therapeutic agents, including nucleic acids, polynucleotides or oligonucleotides. The active agent can be a pharmaceutic composition, a drug, a polynucleotide, an oligonucleotide, an RNP, a lipid nanoparticle, or a protein-RNA complex. Targeted delivery as described herein may direct the active agent to a particular desired location, for example, to specific in vivo positions, cells, tissues, or organs, recognition locations in an intracellular matrix, specific locations within a cell. In some embodiments, the active agent comprises a guide RNA associated with a nuclease, for example, a CRISPR nuclease. In some embodiments, the active agent comprises a nuclease system capable of modifying the activity and / or function of one or more target genes, e.g. a PCSK9 or ANGPTL3gene.

[0126] In some embodiments, the active agent comprises a genome editing composition comprising a nuclease system. In some embodiments, the genome editing composition is a target specific genome editing composition. In some embodiments, the genome editing composition comprises a nucleic acid guided programmable nuclease or a portion thereof. In some embodiments of the present disclosure, a nuclease system includes at least one nuclease. In some embodiments, the nuclease system comprises at least one programmable nuclease. In some embodiments, the nuclease may comprise at least one DNA binding domain and at least one nuclease domain. In some embodiments, the nuclease domain may be heterologous to the DNA binding domain. In certain embodiments, the nuclease is a DNA endonuclease, and may cleave single or double-stranded DNA. In certain embodiments, the nuclease may cleave RNA.

[0127] In some embodiments, a nuclease system may include a Cas protein domain (also called a “Cas nuclease”) from a CRISPR / Cas system. The Cas protein may comprise at least one domain that interacts with a guide nucleic acid, for example, a guide RNA (gRNA). Additionally, the Cas protein may be directed to a target sequence by a guide RNA. The guide RNA interacts with the Cas protein as well as the target sequence such that, the Cas protein is directed to the target sequence and may be capable of cleaving the target sequence. In certain embodiments, e.g., Cas9, the Cas protein is a single-protein effector, an RNA- guided nuclease. In some embodiments, the guide RNA provides the specificity for the targeted cleavage, and the Cas protein may be universal and paired with different guide RNAs to cleave different target sequences. The terms Cas protein and Cas nuclease are used interchangeably herein.

[0128] In some embodiments, the CRISPR / Cas system may comprise Type-I, Type-II, or Type-III system components, or any orthologues thereof. Updated classification schemes for CRISPR / Cas loci define Class 1 and Class 2 CRISPR / Cas systems, having Types Ito V or VI. See, e.g., Makarova et al., Nat Rev Microbiol, 13(11): 722-36 (2015); Shmakov et al., Molecular Cell, 60:385-397 (2015). Class 2 CRISPR / Cas systems have single protein effectors. Cas proteins of Types II, V, and VI may be single-protein, RNA-guided endonucleases, herein called “Class 2 Cas nucleases.” Class 2 Cas nucleases include, for example, Cas9, Cpf1, C2c1, C2c2, and C2c3 proteins. Cpf1 protein, Zetsche et al., Cell, 163: 1-13 (2015), is homologous to Cas9, and contains a RuvC-like nuclease domain. S3.

[0129] In some embodiments, the Cas protein may be from a Type-II CRISPR / Cas system, i.e., a Cas9 protein from a CRISPR / Cas9 system. In some embodiments, the Cas protein may be from a Class 2 CRISPR / Cas system, i.e., a single-protein Cas nuclease such as a Cas9 protein or a Cpf1 protein. The Cas9 and Cpf1 family of proteins are enzymes with DNA endonuclease activity, and they can be directed to cleave a desired nucleic acid target by designing an appropriate guide RNA, as described further herein.

[0130] A Type-II CRISPR / Cas system component may be from a Type-IIA, Type-1IB, or Type-IIC system. Cas9 nuclease structure and sequences are known to those skilled in the art (Jinek et al. Science 2012, 337: 816-821; Delcheva et al. Nature 2011, 471: 602-607, incorporated herein by reference). In some embodiments, wild type Cas9 corresponds to Streptococcus pyogenes Cas9 (NCBI Ref No. NC_002737.2, SEQ ID NO: 2) and Uniprot Reference Q99ZW2 (SEQ ID NO: 1).

[0131] Streptococcus pyogenes Cas9 (wild type) protein sequence (SEQ ID NO: 1)

[0132] MDKKYSIGLDIGTNSVGWAVITDEYK VPSKKFKVLGNTDRHSIKKNLIGA LLFDSGEAEATRLKRTARRRYTRRKNRICYLQEIFSNEMAK VDDSFFHRLEESFLVEE DKKHERHPIFGNIVDEVAYHEK YPTIYHLRKKLVDSTDKADLRLIYLALAHMIKFRG HFLIEGDLNPDNSDVDKLFIQLVQTYNQLFEENPINASGVDAKAILSARLSKSRRLEN LIAQLPGEKKNGLFGNLIALSLGLTPNFKSNFDLAEDAKLQLSKDTYDDDLDNLLAQI GDQYADLFLAAKNLSDAILLSDILRVNTEITKAPLSASMIKRYDEHHQDLTLLKALVR QQLPEKYKEIFFDQSKNGYAGYIDGGASQEEFYKFIKPILEKMDGTEELLVKLNREDL LRKQRTFDNGSIPHQIHLGELHAILRRQEDFYPFLKDNREKIEKILTFRIPYYVGPLAR GNSRFAWMTRK SEETITPWNFEEVVDKGASAQSFIERMTNFDKNLPNEK VLPKHSLL YEYFTVYNELTKVKYVTEGMRKPAFLSGEQKKAIVDLLFKTNRKVTVKQLKEDYFK KIECFDSVEISGVEDRFNASLGTYHDLLKIIKDKDFLDNEENEDILEDIVLTLTLFEDRE MIEERLKTYAHLFDDK VMK QLKRRRY TGWGRLSRKLINGIRDKQSGKTILDFLKSD GFANRNFMQLIHDDSLTFKEDIQKAQVSGQGDSLHEHIANLAGSPAIKKGILQTVKV VDELVKVMGRHKPENIVIEMARENTTK GQKNSRERMKRIEEGIKELGSQILKEHPVE NTQLQNEKLYLYYLQNGRDMYVDQELDINRLSD YD VDHIVPQSFLKDDSIDNKVLT RSDKNRGKSDNVPSEEVVKKMKNYWRQLLNAKLITQRKFDNLTKAERGGLSELDK AGFIKRQLVETRQITKHVAQILDSRMNTKYDENDKLIREVK VITLKSKLVSDFRKDFQ FYKVREINNYHHAHDAYLNAVVGTALIKKYPKLESEFVYGDYKVYDVRKMIAK SEE IGKATAKYFFYSNIMNFFKTEITLANGEIRKRPLIETNGETGEIVWDKGRDFATVRKV LSMPVNIVKKTEVTGGFSKESILPKRNSDKLIARKKDWDPKKYGGFDSPTVAYSVLV VAKVEKGKSKKLKSVKELLGITIMERSSFEKNPIDFLEAKGYKEVKKDLIKLPKYSLF ELENGRKRMLASAGELQKGNELALPSKYVNFLYLASHYEKLKGSPEDNEQKQLFVE QHKHYLDEIIEQISEFSKRVILADANLDK VLSAYNKHRDKPIREQAENIIHLFTLTNLG APAAFKYFDTTIDRKRYTSTKEVLDATLIHQSITGLYETRIDLSQLGGD

[0133] Streptococcus pyogenes Cas9 (wild type) nucleotide sequence (SEQ ID NO:2) ATGGATAAGAAATACTCAATAGGCTTAGATATCGGCACAAATAGCGTCGGATGG GCGGTGATCACTGATGAATATAAGGTTCCGTCTAAAAAGTTCAAGGTTCTGGGAA ATACAGACCGCCACAGTATCAAAAAAAATCTTATAGGGGCTCTTTTATTITGACAG TGGAGAGACAGCGGAAGCGACTCGTCTCAAACGGACAGCTCGTAGAAGGTATAC ACGTCGGAAGAATCGTATTITIGTTATCTACAGGAGATTTITTICAAATGAGATGGCG AAAGTAGATGATAGTTTCTTTCATCGACTTGAAGAGTCTTTTTTGGTGGAAGAAG ACAAGAAGCATGAACGTCATCCTATTTTTGGAAATATAGTAGATGAAGTTGCTTA TCATGAGAAATATCCAACTATCTATCATCTGCGAAAAAAATTGGTAGATTCTACT GATAAAGCGGATTTGCGCTTAATCTATITGGCCTTAGCGCATATGATTAAGTTTC GTGGTCATTTTTTGATTGAGGGAGATTTAAATCCTGATAATAGTGATGTGGACAA ACTATTTATCCAGTTGGTACAAACCTACAATCAATTATTTGAAGAAAACCCTATT AACGCAAGTGGAGTAGATGCTAAAGCGATTCTTTCTGCACGATTGAGTAAATCA AGACGATTAGAAAATCTCATTGCTCAGCTCCCCGGTGAGAAGAAAAATGGCTTA TTTGGGAATCTCATTGCTTTGTCATTGGGTTTGACCCCTAATTTTAAATCAAATTT TGATTTGGCAGAAGATGCTAAATTACAGCTTTCAAAAGATACTTACGATGATGAT TTAGATAATTTATTGGCGCAAATTGGAGATCAATATGCTGATTTGTTTTTGGCAG CTAAGAATTTATCAGATGCTATTTTACTTTCAGATATCCTAAGAGTAAATACTGA AATAACTAAGGCTCCCCTATCAGCTTCAATGATTAAACGCTACGATGAACATCAT CAAGACTTGACTCTTTTAAAAGCTTTAGTTCGACAACAACTTCCAGAAAAGTATA AAGAAATCTTTTTTGATCAATCAAAAAACGGATATGCAGGTTATATTGATGGGGG AGCTAGCCAAGAAGAATTTTATAAATTTATCAAACCAATTTTAGAAAAAATGGAT GGTACTGAGGAATTATTGGTGAAACTAAATCGTGAAGATTTGCTGCGCAAGCAA CGGACCTTTGACAACGGCTCTATTCCCCATCAAATTCACTTGGGTGAGCTGCATG CTATTTTGAGAAGACAAGAAGACTTTTATCCATTTTTAAAAGACAATCGTGAGAA GATTGAAAAAATCTTGACTTTTCGAATTCCTTATTATGTTGGTCCATTGGCGCGTG GCAATAGTCGTTTTGCATGGATGACTCGGAAGTCTGAAGAAACAATTACCCCATG GAATTTTGAAGAAGTTGTCGATAAAGGTGCTTCAGCTCAATCATTTATTGAACGC ATGACAAACTTTGATAAAAATCTTCCAAATGAAAAAGTACTACCAAAACATAGT TTGCTTTATGAGTATTTTACGGTTTATAACGAATTGACAAAGGTCAAATATGTTA CTGAAGGAATGCGAAAACCAGCATTTCTTTCAGGTGAACAGAAGAAAGCCATTG TTGATTTACTCTTCAAAACAAATCGAAAAGTAACCGTTAAGCAATTAAAAGAAG ATTATTTCAAAAAAATAGAATGTTTTGATAGTGTTGAAATTTCAGGAGTTGAAGA TAGATTTAATGCTTCATTAGGTACCTACCATGATTTGCTAAAAATTATTAAAGAT AAAGATTTTTTGGATAATGAAGAAAATGAAGATATCTTAGAGGATATTGTTTTAA CATTGACCTTATTTGAAGATAGGGAGATGATTGAGGAAAGACTTAAAACATATG CTCACCTCTTTGATGATAAGGTGATGAAACAGCTTAAACGTCGCCGTTATACTGG TTGGGGACGTTTGTCTCGAAAATTGATTAATGGTATTAGGGATAAGCAATCTGGC AAAACAATATTAGATTTTTTGAAATCAGATGGTTTTGCCAATCGCAATTTTATGC AGCTGATCCATGATGATAGTTTGACATTTAAAGAAGACATTCAAAAAGCACAAG TGTCTGGACAAGGCGATAGTTTACATGAACATATTGCAAATTTAGCTGGTAGCCC TGCTATTAAAAAAGGTATTTTACAGACTGTAAAAGTTGTTGATGAATTGGTCAAA GTAATGGGGCGGCATAAGCCAGAAAATATCGTTATTGAAATGGCACGTGAAAAT CAGACAACTCAAAAGGGCCAGAAAAATTCGCGAGAGCGTATGAAACGAATCGA AGAAGGTATCAAAGAATTAGGAAGTCAGATTCTTAAAGAGCATCCTGTTGAAAA TACTCAATTGCAAAATGAAAAGCTCTATCTCTATTATCTCCAAAATGGAAGAGAC ATGTATGTGGACCAAGAATTAGATATTAATCGTTTAAGTGATTATGATGTCGATC ACATTGTTCCACAAAGTTTCCTTAAAGACGATTCAATAGACAATAAGGTCTTAAC GCGTTCTGATAAAAATCGTGGTAAATCGGATAACGTTCCAAGTGAAGAAGTAGT CAAAAAGATGAAAAACTATTGGAGACAACTTCTAAACGCCAAGTTAATCACTCA ACGTAAGTTTGATAATTTAACGAAAGCTGAACGTGGAGGTTTGAGTGAACTTGAT AAAGCTGGTTTTATCAAACGCCAATTGGTTGAAACTCGCCAAATCACTAAGCATG TGGCACAAATTTTGGATAGTCGCATGAATACTAAATACGATGAAAATGATAAAC TTATTCGAGAGGTTAAAGTGATTACCTTAAAATCTAAATTAGTTTCTGACTTCCG AAAAGATTTCCAATTCTATAAAGTACGTGAGATTAACAATTACCATCATGCCCAT GATGCGTATCTAAATGCCGTCGTTGGAACTGCTTTGATTAAGAAATATCCAAAAC TTGAATCGGAGTTTGTCTATGGTGATTATAAAGTTTATGATGTTCGTAAAATGATT GCTAAGTCTGAGCAAGAAATAGGCAAAGCAACCGCAAAATATTTCTTTTACTCTA ATATCATGAACTTCTTCAAAACAGAAATTACACTTGCAAATGGAGAGATTCGCA AACGCCCTCTAATCGAAACTAATGGGGAAACTGGAGAAATTGTCTGGGATAAAG GGCGAGATTTTGCCACAGTGCGCAAAGTATTGTCCATGCCCCAAGTCAATATTGT CAAGAAAACAGAAGTACAGACAGGCGGATTCTCCAAGGAGTCAATTTTACCAAA AAGAAATTCGGACAAGCTTATTGCTCGTAAAAAAGACTGGGATCCAAAAAAATA TGGTGGTTTTGATAGTCCAACGGTAGCTTATTCAGTCCTAGTGGTTGCTAAGGTG GAAAAAGGGAAATCGAAGAAGTTAAAATCCGTTAAAGAGTTACTAGGGATCACA ATTATGGAAAGAAGTTCCTTTGAAAAAAATCCGATTGACTTTTTAGAAGCTAAAG GATATAAGGAAGTTAAAAAAGACTTAATCATTAAACTACCTAAATATAGTCTTTT TGAGTTAGAAAACGGTCGTAAACGGATGCTGGCTAGTGCCGGAGAATTACAAAA AGGAAATGAGCTGGCTCTGCCAAGCAAATATGTGAATTTTTTATATTITAGCTAGT CATTATGAAAAGTTGAAGGGTAGTCCAGAAGATAACGAACAAAAACAATTGTTT GTGGAGCAGCATAAGCATTATTTAGATGAGATTATTGAGCAAATCAGTGAATTTT CTAAGCGTGTTATTTTAGCAGATGCCAATTTAGATAAAGTTCTTAGTGCATATAA CAAACATAGAGACAAACCAATACGTGAACAAGCAGAAAATATTATTCATTTATT TACGTTGACGAATCTTGGAGCTCCCGCTGCTTTTAAATATTTTGATACAACAATTG ATCGTAAACGATATACGTCTACAAAAGAAGTTTTAGATGCCACTCTTATCCATCA ATCCATCACTGGTCTTTATGAAACACGCATTGATTTGAGTCAGCTAGGAGGTGAC TGA

[0134] Non-limiting exemplary species that the Cas9 protein or other components may be derived from include Streptococcus pyogenes, Streptococcus thermophilus, Streptococcus sp., Staphylococcus aureus, Listeria innocua, Lactobacillus gasseri, Francisella novicida, Wolinella succinogenes, Sutterella wadsworthensis, Gamma proteobacterium, Neisseria meningitidis, Campylobacter jejuni, Pasteurella multocida, Fibrobacter succinogene, Rhodospirillum rubrum, Nocardiopsis dassonvillei, Streptomyces pristinaespiralis, Streptomyces viridochromogenes, Streptomyces viridochromogenes, Streptosporangium roseum, Streptosporangium roseum, Alicyclobacillus acidocaldarius, Bacillus pseudomycoides, Bacillus selenitireducens, Exiguobacterium sibiricum, Lactobacillus delbrueckii, Lactobacillus salivarius, Lactobacillus buchneri, Treponema denticola, Microscilla marina, Burkholderiales bacterium, Polaromonas naphthalenivorans, Polaromonas sp., Crocosphaera watsonii, Cyanothece sp., Microcystis aeruginosa, Synechococcus sp., Acetohalobium arabaticum, Ammonifex degensii, Caldicelulosiruptor becscii, Candidatus Desulforudis, Clostridium botulinum, Clostridium difficile, Finegoldia magna, Natranaerobius thermophilus, Pelotomaculum thermopropionicum, Acidithiobacillus caldus, Acidithiobacillus ferrooxidans, Allochromatium vinosum, Marinobacter sp., Nitrosococcus halophilus, Nitrosococcus watsoni, Pseudoalteromonas haloplanktis, Ktedonobacter racemifer, Methanohalobium evestigatum, Anabaena variabilis, Nodularia spumigena, Nostoc sp., Arthrospira maxima, Arthrospira platensis, Arthrospira sp., Lyngbya sp., Microcoleus chthonoplastes, Oscillatoria sp., Petrotoga mobilis, Thermosipho africanus, Streptococcus pasteurianus, Neisseria cinerea, Campylobacter lari, Parvibaculum lavamentivorans, Corynebacterium diphtheria, or Acaryochloris marina. In some embodiments, the Cas9 protein may be from Streptococcus pyogenes. In some embodiments, the Cas9 protein may be derived from Streptococcus thermophilus. In some embodiments, the Cas9 protein may be derived from Neisseria meningitidis. In some embodiments, the Cas9 protein may be derived from Staphylococcus aureus.

[0135] In some embodiments, a Cas protein may comprise more than one nuclease domain. For example, a Cas9 protein may comprise at least one RuvC-like nuclease domain (e.g. Cpf1 / Cas12a) and at least one HNH-like nuclease domain (e.g. Cas9). In some embodiments, the Cas9 protein may be capable of introducing a DSB in the target sequence. In some embodiments, the Cas9 protein may be modified to contain only one functional nuclease domain. For example, the Cas9 protein may be modified such that one of the nuclease domains is mutated or fully or partially deleted to reduce its nucleic acid cleavage activity. In some embodiments, the Cas9 protein may be modified to contain no functional RuvC-like nuclease domain. In other embodiments, the Cas9 protein may be modified to contain no functional HNH-like nuclease domain. In some embodiments in which only one of the nuclease domains is functional, the Cas9 protein may be a nickase that is capable of introducing a single-stranded break (a “nick™) into the target sequence. In some embodiments, a conserved amino acid within a Cas9 protein nuclease domain is substituted to reduce or alter a nuclease activity. In some embodiments, the Cas protein nickase may comprise an amino acid substitution in the RuvC-like nuclease domain. Exemplary amino acid substitutions in the RuvC-like nuclease domain include D10A (based on the S. pyogenes Cas9 protein). In some embodiments, the nickase may comprise an amino acid substitution in the HNH-like nuclease domain. Exemplary amino acid substitutions in the HNH-like nuclease domain include E762A, H840A, N863A, H983A, and D986A (based on the S. pyogenes Cas9 protein). In some embodiments, the nuclease system described herein may comprise a nickase and a pair of guide RNAs that are complementary to the sense and antisense strands of the target sequence, respectively. The guide RNAs may direct the nickase to target and introduce a DSB by generating a nick on opposite strands of the target sequence (i.e., double nicking). Chimeric Cas9 proteins may also be used, where one domain or region of the protein is replaced by a portion of a different protein. For example, a Cas9 nuclease domain may be replaced with a domain from a different nuclease such as Fok1. A Cas9 protein may be a modified nuclease.

[0136] Wild type Cas9 and Cas9 sequences from various species may be aligned to determine corresponding homologous amino acid residues and determine and / or modify amino acid residues at, for example, D10 and H840 of SEQ ID NO: 1, allowing the generation of Cas9 variants with corresponding mutations of the homologous amino acid residues. The alignment method is known to those skilled in the art. For example, an alignment may be carried out using the NCBI Constraint-based Multiple Alignment Tool (COBALT, accessible at st-va.ncbi. nlm.nih.gov / tools / cobalt).

[0137] In alternative embodiments, the Cas protein may be from a Type-I CRISPR / Cas system. In some embodiments, the Cas protein may be a component of the Cascade complex of a Type-I CRISPR / Cas system. For example, the Cas protein may be a Cas3 protein. In some embodiments, the Cas protein may be from a Type-III CRISPR / Cas system. In some embodiments, the Cas protein may be from a Type-IV CRISPR / Cas system. In some embodiments, the Cas protein may be from a Type-V CRISPR / Cas system. In some embodiments, the Cas protein may be from a Type-VI CRISPR / Cas system. In some embodiments, the Cas protein may have an RNA cleavage activity. Fusion Proteins

[0138] Provided herein are compositions and methods of targeted modification of genes, e.g. PCSK9, ANGPTL3, APOC3, LPA, APOB, MTP, ANGPTL4, ANGPTLS8, APOAS, APOE, LDLR, IDOL, NPCIL1, ASGR1, TM6SF2, GALNT2, GCKR, LPL, MLXIPL, SORT1, TRIB1, MARC1, ABCGS, or ABCG8. In certain instances, the modification may be ex vivo or in vivo. In preferred embodiments, the targeted modification may be directed to a particular type of organ, tissue, or cells, for example, liver hepatocytes. In some embodiments, the target gene is modified genetically with a genome editing composition comprising a fusion protein. Accordingly, in some embodiments, provided herein are fusion proteins for targeted modification of genes. In some embodiments, the fusion protein comprises a target specific nuclease domain. In some embodiments, the fusion protein comprises a nucleic acid guided programmable nuclease domain. In some embodiments, the nucleic acid guided programmable nuclease may comprise at least one DNA binding domain and at least one nuclease domain. In some embodiments, the nuclease domain may be heterologous to the DNA binding domain. In some embodiments, the nuclease domain may be modified such that the nuclease domain is mutated to reduce its nuclease cleavage activity. In some embodiments, the nuclease activity is completely abolished. In some embodiments, the nuclease activity is partially reduced. In some embodiments, the modified nuclease domain may comprise a modified Cas protein domain. In certain embodiments, the modified Cas protein domain is a modified Cas9. In some embodiments, the modified Cas9 domain is a nuclease inactive Cas9 (dCas9) domain. In some embodiments, the modified dCas9 domain is a nickase domain. In some embodiments, the modified Cas9 domain contains at least one substitutions selected from D10A, N497A, R661A, Q695A, E762A, H840A, N863A, , Q926A, H983A and D986A based on the S. pyogenes Cas9 protein. In some embodiments, the modified nuclease domain is a catalytically inactive Cpfl domain, a catalytically inactive Cas13a domain, a catalytically inactive Cas13b domain, or a catalytically in active Cas 13¢ domain. In some embodiments, the modified nuclease domain is a catalytically inactive CasX, CasY, Cpfl, C2cl, C2c2, C2c3, and Argonaute protein domain.

[0139] In some embodiments, a fusion protein as described herein comprises one or more functional domains besides the nuclease domain. At least one protein domain may be located at the N-terminus, the C-terminus, or in an internal location of the fusion protein. In some embodiments, two or more heterologous protein domains are at one or more locations on the fusion protein. Non-limiting examples of functional domains include a repressor domain, an activator domain, a methyltransferase domain, a de-methylase domain. In some embodiments, the functional domain comprises a base-editing enzyme domain. In some embodiments, the functional domain is a cytidine deaminase domain. For example, the cytidine deaminase may deaminate a specific cytidine to uracil, resulting in a U-G mismatch which is subsequently resolved via cellular repair mechanisms to form a U-A base pair, and subsequently a T-A base pair, thereby creating a C-to-T substitution. Cytidine deaminase domain and cytidine-deaminase fusion protein sequences are known to those skilled in the art, as described in Komor et al., Science Advances 2017, 3(8): eaao4774; Komor et al., Nature 2016, 533: 420-424. In some embodiments, the functional domain is an adenine deaminase domain. For example, the adenine deaminase domain may deaminate an adenosine to generate inosine, which can base pair with cytidine and subsequently be corrected by the cellular repair meachanisms to guanine, thereby converting A into G. Exemplary adenosine deaminase fusion proteins as described in Gaudelli et al., Nature 2017 551(7681): 464-471, the entirety of which is incorporated herein by reference.

[0140] In some embodiments, a fusion protein as described herein comprises a nuclear localization signal (NLS). In some embodiments, the fusion protein may comprise 2, 3, 4, or 5 NLSs. In some embodiments, the fusion protein may comprise 1-10 NLS(s). The NLS sequence may be fused at the N terminus and / or the C terminus of the fusion protein. In some embodiments, the NLS may be a monopartite sequence, such as, e.g., the SV40 NLS, PKKKRKYV (SEQ ID NO: 3) or PKKKRRYV (SEQ ID NO:4). In some embodiments, the NLS may be a bipartite sequence, such as, e.g., the NLS of nucleoplasmin, KRPAATKKAGQAKKKK (SEQ ID NO:5). In some embodiments, the NLS may be genetically modified from its wild-type counterpart. In a preferred embodiment, the fusion protein comprises the sequence of ABE7.10 (SEQ ID NO: 6).

[0141] In some embodiments, the fusion protein can further comprise a tag domain. In some embodiments, the tag domain may comprise a fluorescent tag, a purification tag, an epitope tags, or a reporter gene tag. In some embodiments, the tag domain may comprise a fluorescent protein domain. Non-limiting examples of suitable fluorescent proteins include green fluorescent proteins (e.g., GFP, GFP-2, tagGFP, turboGFP, sfGFP, EGFP, Emerald, Azami Green, Monomeric Azami Green, CopGFP, AceGFP, ZsGreenl), yellow fluorescent proteins (e.g., YFP, EYFP, Citrine, Venus, YPet, PhiYFP, ZsYellowl), blue fluorescent proteins (e.g., EBFP, EBFP2, Azurite, mKalamal, GFPuv, Sapphire, T-sapphire,), cyan fluorescent proteins (e.g., ECFP, Cerulean, CyPet, AmCyanl, Midoriishi-Cyan), red fluorescent proteins (e.g., mKate, mKate2, mPlum, DsRed monomer, mCherry, mRFP1, DsRed-Express, DsRed2, DsRed-Monomer, HcRed-Tandem, HcRedl, AsRed2, eqFP611, mRasberry, mStrawberry, Jred), and orange fluorescent proteins (mOrange, mKO, Kusabira- Orange, Monomeric Kusabira-Orange, mTangerine, tdTomato) or any other suitable fluorescent protein. In some embodiments, the tag domain may comprise a purification tag and / or an epitope tag. Non-limiting exemplary tags include glutathione-S-transferase (GST), chitin binding protein (CBP), maltose binding protein (MBP), thioredoxin (TRX), poly(NANP), tandem affinity purification (TAP) tag, myc, AcVS5, AU1, AUS, E, ECS, E2, FLAG, HA, nus, Softag 1, Softag 3, Strep, SBP, Glu-Glu, HSV, KT3, S, S1, T7, V5, VSV-G, 6xHis (SEQ ID NO: 114), biotin carboxyl carrier protein (BCCP), and calmodulin. In some embodiments, the tag domain may comprise a reporter gene domain. Non-limiting exemplary reporter genes include glutathione-S-transferase (GST), horseradish peroxidase (HRP), chloramphenicol acetyltransferase (CAT), beta-galactosidase, beta-glucuronidase, luciferase, or fluorescent proteins.

[0142] In additional embodiments, the nuclease in the nuclease systems may comprise one or more programmable nucleases other than a Cas protein. For example, the nuclease may be chosen from a meganuclease (e.g., homing endonucleases), ZFN, TALEN, and megaTAL.

[0143] Naturally-occurring meganucleases may recognize and cleave double-stranded DNA sequences of about 12 to 40 base pairs, and are commonly grouped into five families. In some embodiments, the meganuclease may be chosen from the LAGLIDADG family, the GIY-YIG family, the HNH family, the His-Cys box family, and the PD-(D / E)XK family. In some embodiments, the DNA binding domain of the meganuclease may be engineered to recognize and bind to a sequence other than its cognate target sequence. In some embodiments, the DNA binding domain of the meganuclease may be fused to a heterologous nuclease domain. In some embodiments, the meganuclease, such as a homing endonuclease, may be fused to TAL modules to create a hybrid protein, such as a “megaTAL” protein. The megaTAL protein may have improved DNA targeting specificity by recognizing the target sequences of both the DNA binding domain of the meganuclease and the TAL modules.

[0144] ZFNs are fusion proteins comprising a zinc-finger DNA binding domain (“zinc fingers” or “ZFs”) and a nuclease domain. Each naturally-occurring ZF may bind to three consecutive base pairs (a DNA triplet), and ZF repeats are combined to recognize a DNA target sequence and provide sufficient affinity. Thus, engineered ZF repeats may be combined to recognize longer DNA sequences, such as, e.g., 9-, 12-, 15-, or 18-bp, etc. In some embodiments, the ZFN may comprise ZFs fused to a nuclease domain from a restriction endonuclease. For example, the restriction endonuclease may be FokI. In some embodiments, the nuclease domain may comprise a dimerization domain, such as when the nuclease dimerizes to be active, and a pair of ZFNs comprising the ZF repeats and the nuclease domain may be designed for targeting a target sequence, which comprises two half target sequences recognized by each ZF repeats on opposite strands of the DNA molecule, with an interconnecting sequence in between (which is sometimes called a spacer in the literature). For example, the interconnecting sequence may be 5 to 7 bp in length. When both ZFNs of the pair bind, the nuclease domain may dimerize and introduce a DSB within the interconnecting sequence. In some embodiments, the dimerization domain of the nuclease domain may comprise a knob-into-hole motif to promote dimerization. For example, the ZFN may comprise a knob-into-hole motif in the dimerization domain of FokI.

[0145] The DNA binding domain of TALENS usually comprises a variable number of 34 or 35 amino acid repeats (“modules” or “TAL modules”), with each module binding to a single DNA base pair, A, T, G, or C. Adjacent residues at positions 12 and 13 (the “repeat- variable di-residue” or RVD) of each module specify the single DNA base pair that the module binds to. Though modules used to recognize G may also have affinity for A, TALENS benefit from a simple code of recognition—one module for each of the 4 bases— which greatly simplifies the customization of a DNA-binding domain recognizing a specific target sequence. In some embodiments, the TALEN may comprise a nuclease domain from a restriction endonuclease. For example, the restriction endonuclease may be FokI. In some embodiments, the nuclease domain may dimerize to be active, and a pair of TALENS may be designed for targeting a target sequence, which comprises two half target sequences recognized by each DNA binding domain on opposite strands of the DNA molecule, with an interconnecting sequence in between. For example, each half target sequence may be in the range of 10 to 20 bp, and the interconnecting sequence may be 12 to 19 bp in length. When both TALENS of the pair bind, the nuclease domain may dimerize and introduce a DSB within the interconnecting sequence. In some embodiments, the dimerization domain of the nuclease domain may comprise a knob-into-hole motif to promote dimerization. For example, the TALEN may comprise a knob-into-hole motif in the dimerization domain of FokI.

[0146] Certain embodiments of the disclosure also provide nucleic acids encoding the nuclease system described herein provided on a vector. In some embodiments, the nucleic acid may be a DNA molecule. In other embodiments, the nucleic acid may be an RNA molecule. In some embodiments, the nucleic acid encoding the nuclease may be an mRNA molecule.

[0147] In some embodiments, the nucleic acid encoding the nuclease may be codon optimized for efficient expression in one or more eukaryotic cell types. In some embodiments, the nucleic acid encoding the nuclease may be codon optimized for efficient expression in one or more mammalian cells. In some embodiments, the nucleic acid encoding the nuclease may be codon optimized for efficient expression in human cells. Methods of codon optimization including codon usage tables and codon optimization algorithms are available in the art. Guide polynucleotides

[0148] In some embodiments of the present disclosure, a CRISPR / Cas nuclease system includes at least one guide polynucleotide, for example, a guide RNA. In some embodiments, the guide RNA and the Cas protein may form a ribonucleoprotein (RNP), e.g., a CRISPR / Cas complex. The guide RNA may guide the Cas protein to a target sequence on a target nucleic acid molecule, where the guide RNA hybridizes with and the Cas protein cleaves the target sequence. In some embodiments, the CRISPR / Cas complex may be a Cpf1 / guide RNA complex. In some embodiments, the CRISPR complex may be a Type-II CRISPR / Cas9 complex. In some embodiments, the Cas protein may be a Cas9 protein. In some embodiments, the CRISPR / Cas9 complex may be a Cas9 / guide RNA complex.

[0149] A guide nucleic acid (e.g., guide RNA) can bind to a Cas protein and target the Cas protein to a specific location within a target polynucleotide. A guide nucleic acid can comprise a nucleic acid-targeting segment and a Cas protein binding segment.

[0150] A guide nucleic acid can refer to a nucleic acid that can hybridize to another nucleic acid, for example, the target polynucleotide in the genome of a cell. A guide nucleic acid can be RNA, for example, a guide RNA. A guide nucleic acid can be DNA. A guide nucleic acid can comprise DNA and RNA. A guide nucleic acid can be single stranded. A guide nucleic acid can be double-stranded. A guide nucleic acid can comprise a nucleotide analog. A guide nucleic acid can comprise a modified nucleotide. The guide nucleic acid can be programmed or designed to bind to a sequence of nucleic acid site-specifically.

[0151] A guide nucleic acid can comprise one or more modifications to provide the nucleic acid with a new or enhanced feature. A guide nucleic acid can comprise a nucleic acid affinity tag. A guide nucleic acid can comprise synthetic nucleotide, synthetic nucleotide analog, nucleotide derivatives, and / or modified nucleotides.

[0152] The guide nucleic acid can comprise a nucleic acid-targeting region (e.g., a spacer region), for example, at or near the 5° end or 3” end, that is complementary to a protospacer sequence in a target polynucleotide. The spacer of a guide nucleic acid can interact with a protospacer in a sequence-specific manner via hybridization (base pairing). The protospacer sequence can be located 5” or 3’ of protospacer adjacent motif (PAM) in the target polynucleotide. The nucleotide sequence of a spacer region can vary and determines the location within the target nucleic acid with which the guide nucleic acid can interact. The spacer region of a guide nucleic acid can be designed or modified to hybridize to any desired sequence within a target nucleic acid.

[0153] A guide nucleic acid can comprise two separate nucleic acid molecules, which can be referred to as a double guide nucleic acid. A guide nucleic acid can comprise a single nucleic acid molecule, which can be referred to as a single guide nucleic acid (e.g., sSgRNA). In some embodiments, the guide nucleic acid is a single guide nucleic acid comprising a fused CRISPR RNA (crRNA) and a transactivating crRNA (tracrRNA). In some embodiments, the guide nucleic acid is a single guide nucleic acid comprising a crRNA. In some embodiments, the guide nucleic acid is a single guide nucleic acid comprising a crRNA but lacking a tracRNA. In some embodiments, the guide nucleic acid is a double guide nucleic acid comprising non-fused crRNA and tracrRNA. An exemplary double guide nucleic acid can comprise a crRNA-like molecule and a tracrRNA- like molecule. An exemplary single guide nucleic acid can comprise a crRNA-like molecule. An exemplary single guide nucleic acid can comprise a fused crRNA-like and tracrRNA-like molecules.

[0154] A crRNA can comprise the nucleic acid-targeting segment (e.g., spacer region) of the guide nucleic acid and a stretch of nucleotides that can form one half of a double-stranded duplex of the Cas protein- binding segment of the guide nucleic acid.

[0155] A tracrRNA can comprise a stretch of nucleotides that forms the other half of the double-stranded duplex of the Cas protein-binding segment of the gRNA. A stretch of nucleotides of a crRNA can be complementary to and hybridize with a stretch of nucleotides of a tracrRNA to form the double-stranded duplex of the Cas protein-binding domain of the guide nucleic acid.

[0156] The crRNA and tracrRNA can hybridize to form a guide nucleic acid. The crRNA can also provide a single- stranded nucleic acid targeting segment (e.g., a spacer region) that hybridizes to a target nucleic acid recognition sequence (e.g., protospacer). The sequence of a crRNA, including spacer region, or tractrRNA molecule can be designed to be specific to the species in which the guide nucleic acid is to be used.

[0157] A guide RNA for a CRISPR / Cas9 system typically comprises a CRISPR RNA (crRNA) and a tracr RNA (tracr). A guide RNA for a CRISPR / Cpf1 system typically comprises a crRNA. In some embodiments, the cRNA may comprise a targeting sequence that is complementary to and hybridizes with the target sequence on the target nucleic acid molecule. The crRNA may also comprise a sequence that is complementary to and hybridizes with a portion of the tracrRNA. In some embodiments, the crRNA may parallel the structure of a naturally occurring crRNA transcribed from a CRISPR locus of a bacteria, where the targeting sequence acts as the spacer of the CRISPR / Cas9 system.

[0158] The guide RNA may target any sequence of interest via the targeting sequence of the crRNA. In some embodiments, the degree of complementarity between the targeting sequence of the guide RNA and the target sequence on the target nucleic acid molecule may be about 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 97%, 98%, 99%, or 100%. In some embodiments, the targeting sequence of the guide RNA and the target sequence on the target nucleic acid molecule may be 100% complementary. In other embodiments, the targeting sequence of the guide RNA and the target sequence on the target nucleic acid molecule may contain at least one mismatch. For example, the targeting sequence of the guide RNA and the target sequence on the target nucleic acid molecule may contain 1, 2, 3,4, 5,6, 7, 8,9, or 10 mismatches. In some embodiments, the targeting sequence of the guide RNA and the target sequence on the target nucleic acid molecule may contain 1-6 mismatches. In some embodiments, the targeting sequence of the guide RNA and the target sequence on the target nucleic acid molecule may contain 5 or 6 mismatches.

[0159] The length of the targeting sequence may depend on the CRISPR / Cas9 system and components used. For example, different Cas proteins from different bacterial species have varying optimal targeting sequence lengths. Accordingly, the targeting sequence may comprise 5, 6,7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 35, 40, 45, 50, or more than 50 nucleotides in length. In some embodiments, the targeting sequence may comprise 18-30 nucleotides in length. In some embodiments, the targeting sequence may comprise 19-24 nucleotides in length. In some embodiments, the targeting sequence may comprise 20 nucleotides in length.

[0160] The crRNA and the tracr may comprise any sequence with sufficient complementarity to promote the formation of a functional CRISPR / Cas9 complex. In some embodiments, the complementary sequence between the crRNA and the tracr may comprise all or a portion of the sequence (also called a “tag” or “handle”) of a naturally-occurring crRNA that is complementary to the tracr RNA in the same CRISPR / Cas9 system. In some embodiments, the complementary sequence may comprise all or a portion of a repeat sequence from a naturally-occurring CRISPR / Cas9 system. In some embodiments, the complementary sequence may comprise a truncated or modified tag or handle sequence. In some embodiments, the degree of complementarity between the tracr RNA and the portion of the complementary portion that hybridizes with the tracr RNA along the length of the shorter of the two sequences may be about 40%, 50%, 60%, 70%, 80%, or higher, but lower than 100%. In some embodiments, the tracr RNA and the portion that hybridizes with the tracr RNA are not 100% complementary along the length of the shorter of the two sequences because of the presence of one or more bulge structures on the tracr and / or wobble base pairing. The length of the tracr RNA complementary portion to tracr may depend on the CRISPR / Cas9 system or the tracr RNA used. For example, the complementary portion may comprise 10-50 nucleotides, or more than 50 nucleotides in length. In some embodiments, the complementary portion may comprise 15-40 nucleotides in length. In other embodiments, the complementary portion may comprise 20-30 nucleotides in length. In yet other embodiments, the complementary portion may comprise 22 nucleotides in length. When a dual guide RNA is used, for example, the length of the complementary portion may have no upper limit.

[0161] In some embodiments, the tracr RNA may comprise all or a portion of a wild-type tracr RNA sequence from a naturally-occurring CRISPR / Cas9 system. In some embodiments, the tracr RNA may comprise a truncated or modified variant of the wild-type tracr RNA. The length of the tracr RNA may depend on the CRISPR / Cas9 system used. In some embodiments, the tracr RNA may comprise 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30, 40, 50, 60, 70, 80, 90, 100, or more than 100 nucleotides in length. In certain embodiments, the tracr is at least 26 nucleotides in length. In additional embodiments, the tracr is at least 40 nucleotides in length. In some embodiments, the tracr RNA may comprise certain secondary structures, such as, e.g., one or more hairpins or stem-loop structures, or one or more bulge structures.

[0162] In some embodiments, the guide RNA may comprise two RNA molecules and is referred to herein as a “dual guide RNA” or “dgRNA”. In some embodiments, the dgRNA may comprise a first RNA molecule comprising a crRNA, and a second RNA molecule comprising a tracr RNA. The first and second RNA molecules may form a RNA duplex via the base pairing between the flagpole on the crRNA and the tracr RNA.

[0163] In some embodiments, the guide RNA may comprise a single RNA molecule and is referred to herein as a “single guide RNA” or “sgRNA”. In some embodiments, the sgRNA may comprise a crRNA covalently linked to a tracr RNA. In some embodiments, the crRNA and the tracr RNA may be covalently linked via a linker. In some embodiments, the single- molecule guide RNA may comprise a stem-loop structure via the base pairing between the flagpole on the crRNA and the tracr RNA.

[0164] Certain embodiments of the disclosure also provide nucleic acids, e.g., vectors, encoding the guide RNA described herein. In some embodiments, the nucleic acid may be a DNA molecule. In other embodiments, the nucleic acid may be an RNA molecule. In some embodiments, the nucleic acid may comprise a nucleotide sequence encoding a crRNA. In some embodiments, the nucleotide sequence encoding the crRNA comprises a targeting sequence flanked by all or a portion of a repeat sequence from a naturally-occurring CRISPR / Cas system. In some embodiments, the nucleic acid may comprise a nucleotide sequence encoding a tracr RNA. In some embodiments, the crRNA and the tracr RNA may be encoded by two separate nucleic acids. In some embodiments, the crRNA and the tracr RNA may be encoded by a single nucleic acid. In some embodiments, the crRNA and the tracr RNA may be encoded by opposite strands of a single nucleic acid. In other embodiments, the crRNA and the tracr RNA may be encoded by the same strand of a single nucleic acid.

[0165] In certain embodiments, more than one guide RNA can be used with a CRISPR / Cas nuclease system. Each guide RNA may contain a different targeting sequence, such that the CRISPR / Cas system cleaves more than one target sequence. In some embodiments, one or more guide RNAs may have the same or differing properties such as activity or stability within the Cas9 RNP complex. Where more than one guide RNA is used, each guide RNA can be encoded on the same or on different vectors. The promoters used to drive expression of the more than one guide RNA may be the same or different.

[0166] The methods of selecting guide RNAs for efficient targeting with high specificity and low off-target effect are known to those skilled in the art. For programmable base- editing, [ selection of a genomic sequence containing a target sequence may be as described in Komor et al, Nature, 533, 420-424 (2016)is incorporated herein by reference. The guide RNA sequence and PAM preference define the genomic target sequence(s) of programable nuclease domains (e.g. Cas9, dCas9, Cas9n, Cpfl, NgAgo domains). Methods of reducing off-target binding as described in Hsu et al (Nature biotechnology, 2013, 31(9):827-832), Fusi et al (bioRxiv 021568; doi: http: / / dx.doi.org / 10.1101 / 021568), Chari et al (Nature Methods, 2015, 12(9):823-6), Doench et al (Nature Biotechnology, 2014, 32(12): 1262-7), Wang et al (Science, 2014, 343(6166): 80-4), Moreno-Mateos et al (Nature Methods, 2015, 12(10):982-8), Housden et al (Science Signaling, 2015, 8(393):rs9), Haeussler et al, (Genome Biol. 2016; 17: 148)are incorporated herein by reference., The potential for the formation of bulges between the guide RNA and the target DNA and other parameters that may influence target sequence binding may also be considered as described in Bae et al (Bioinformatics, 2014, 30, 1473-5) Housden et al (Science Signaling, 2015, 8(393):rs9), and Farboud et al (Genetics, 2015, 199(4):959-71) are also incorporated herein by reference. RNA Modification

[0167] Provided herein are modified RNA molecules suitable for targeted ex vivo and in vivo delivery systems. A modified RNA molecule may comprise two or more linked ribonucleic acid subunits. Non-limiting exemplary modified RNAs include CRISPR guide RNA, short interfereing RNA (siRNA), microRNA (miRNA), short hairpin RNA (shRNA), small nuclear RNA (snRNA), messenger RNA (mRNA), precursor mRNA (pre-mRNA), antisense RNA (asRNA), and heteronuclear RNA (hnRNA). Modified RNAs as described herein encompass both the RNA sequence and any structural embodiment thereof, e.g. single stranded, double stranded, triple stranded, circular, helical, hairpin, stem loop, buldge, etc. A modified RNA may comprise a length of at least about 3, 4, 5, 6, 7, 8, 9, 10, 20, 30, 40, 50, 100, 200, 300, 400, or 500 bases. A modified RNA may comprise a length of at least about 1 kilobase (kb), 2kb, 3kb, 4 kb, 5 kb, 10 kb, 20kb, 50 kb, or more. In some embodiments, the modified RNA is a CRISPR guide RNA (gRNA). A gRNA may be a single guide RNA or a dual guide RNA. In some embodiments, the modified RNA is a mRNA. In some embodiments, a mRNA can be isolated from a cell or a tissue. In some embodiments, a mRNA can be transcribed from a DNA. In some embodiments, a mRNA can be chemically synthesized.

[0168] In certain embodiments, modified RNA molecules provided herein are resistant to degradation by RNases or other exonucleases. In certain embodiments, modified RNA molecules provided herein are stabilized to prevent degradation by endonucleases. In some embodiments, modified RNA molecules provided herein are suitable for in vivo delivery and induces less cellular immune receptor activation (e.g. TLR, RIG-I) as compared to unmodified RNA. RNA modifications as described in Diebold (2008) Adv Drug Deliv Rev. Apr 29;60(7):813-23) and Sorrentino (1998) Cell Mol Life Sci.Aug;54(8):785-94, the entirety of both are incorporated herein by reference.

[0169] In addition to "unmodified" or "natural" nucleobases such as the purine nucleobases adenine (A) and guanine (G), and the pyrimidine nucleobases thymine (T), cytosine (C) and uracil (U), many modified nucleobases or nucleobase mimetics known to those skilled in the art are amenable with the compounds described herein. The unmodified or natural nucleobases can be modified or replaced to provide oligonucleotides having improved properties. For example, nuclease resistant oligonucleotides can be prepared with these bases or with synthetic and natural nucleobases (e.g., inosine, xanthine, hypoxanthine, nubularine, isoguanisine, or tubercidine) and any one of the oligomer modifications described herein. Alternatively, substituted or modified analogs of any of the above bases and "universal bases" can be employed. When a natural base is replaced by a non-natural and / or universal base, the nucleotide is said to comprise a modified nucleobase and / or a nucleobase modification herein. Modified nucleobase and / or nucleobase modifications also include natural, non- natural and universal bases, which comprise conjugated moieties, e.g. a ligand described herein. Preferred conjugate moieties for conjugation with nucleobases include cationic amino groups which can be conjugated to the nucleobase via an appropriate alkyl, alkenyl or a linker with an amide linkage.

[0170] As used herein, "unmodified" or "natural" nucleobases include the purine bases adenine (A) and guanine (G), and the pyrimidine bases thymine (T), cytosine (C) and uracil (U). Exemplary modified nucleobases include, but are not limited to, other synthetic and natural nucleobases such as inosine, xanthine, hypoxanthine, nubularine, isoguanisine, tubercidine, 2-(halo)adenine, 2-(alkyl)adenine, 2-(propyl)adenine, 2-(amino)adenine, 2- (aminoalkyll)adenine, 2- (aminopropyl)adenine, 2-(methylthio)-N6-(isopentenyl)adenine, 6- (alkyl)adenine, 6- (methyl)adenine, 7-(deaza)adenine, 8-(alkenyl)adenine, 8-(alkyl)adenine, 8-(alkynyl)adenine, 8-(amino)adenine, 8-(halo)adenine, 8-(hydroxyl)adenine, 8- (thioalkyl)adenine, 8-(thiol)adenine, N6-(isopentyl)adenine, N6-(methyl)adenine, N6, N6- (dimethyl)adenine, 2-(alkyl)guanine,2-(propyl)guanine, 6-(alkyl)guanine, 6-(methyl)guanine, 7-(alkyl)guanine, 7- (methyl)guanine, 7-(deaza)guanine, 8-(alkyl)guanine, 8- (alkenyl)guanine, 8-(alkynyl)guanine, 8- (amino)guanine, 8-(halo)guanine, 8- (hydroxyl)guanine, 8-(thioalkyl)guanine, 8-(thiol)guanine, N-(methyl)guanine, 2- (thio)cytosine, 3-(deaza)-5-(aza)cytosine, 3-(alkyl)cytosine, 3- (methyl)cytosine, 5- (alkyl)cytosine, 5-(alkynyl)cytosine, 5-(halo)cytosine, 5-(methyl)cytosine, 5- (propynyl)cytosine, 5-(propynyl)cytosine, 5-(trifluoromethyl)cytosine, 6-(azo)cytosine, N4- (acetyl)cytosine, 3-(3-amino-3-carboxypropyl)uracil, 2-(thio)uracil, 5-(methyl)-2-(thio)uracil, 5-(methylaminomethyl)-2-(thio)uracil, 4-(thio)uracil, 5-(methyl)-4-(thio)uracil, 5- (methylaminomethyl)-4-(thio)uracil, 5-(methyl)-2.4-(dithio)uracil, 5-(methylaminomethyl)- 2,4-(dithio)uracil, 5-(2-aminopropyl)uracil, 5-(alkyl)uracil, 5-(alkynyl)uracil, 5- (allylamino)uracil, 5-(aminoallyl)uracil, 5-(aminoalkyl)uracil, 5-(guanidiniumalkyl)uracil, 5- (1,3-diazole-l-alkyl)uracil, 5-(cyanoalkyl)uracil, 5-(dialkylaminoalkyl)uracil, 5- (dimethylaminoalkyl)uracil, 5-(halo)uracil, 5-(methoxy)uracil, uracil-5-oxyacetic acid, 5- (methoxycarbonylmethyl)-2-(thio)uracil, 5-(methoxycarbonyl-methyl)uracil, 5- (propynyl)uracil, 5-(propynyl)uracil, 5-(trifluoromethyl)uracil, 6-(azo)uracil, dihydrouracil, N -(methyl)uracil, 5-uracil (i.e., pseudouracil), 2-(thio)pseudouracil,4-(thio)pseudouracil2,4- (dithio)psuedouracil,5-(alkyl)pseudouracil, 5-(methyl)pseudouracil, 5-(alkyl)-2- (thio)pseudouracil, 5-(methyl)-2-(thio)pseudouracil, 5-(alkyl)-4-(thio)pseudouracil, 5- (methyl)- 4- (thio)pseudouracil, 5-(alkyl)-2,4-(dithio)pseudouracil, 5-(methyl)-2,4- (dithio)pseudouracil, 1-methylpseudouracil (N1-methylpseudouracil), 1 -substituted pseudouracil, 1 -substituted 2(thio)-pseudouracil, 1 -substituted 4-(thio)pseudouracil, 1 - substituted 2,4-(dithio)pseudouracil, 1 -(aminocarbonylethylenyl)-pseudouracil, 1 - (aminocarbonylethylenyl)-2(thio)-pseudouracil, 1 -(aminocarbonylethylenyl)-4- (thio)pseudouracil, 1-(aminocarbonylethylenyl)-2,4-(dithio)pseudouracil, 1 - (aminoalkylaminocarbonylethylenyl)-pseudouracil, 1 -(aminoalkylamino-carbonylethylenyl)- 2(thio)-pseudouracil, 1-(aminoalkylaminocarbonylethylenyl)-4-(thio)pseudouracil, 1- (aminoalkylaminocarbonylethylenyl)-2,4-(dithio)pseudouracil, 1,3-(diaza)-2-(0x0)- phenoxazin-1-yl, 1-(aza)-2-(thio)-3-(aza)-phenoxazin-l-yl, 1,3-(diaza)-2-(oxo)-phenthiazin-I- yl, 1-(aza)-2-(thio)-3-(aza)-phenthiazin-l-yl, 7-substituted 1,3-(diaza)-2-(oxo0)-phenoxazin-1-yl, 7-substituted-1- (aza)-2-(thio)-3-(aza)-phenoxazin-l-yl, 7-substituted 1,3-(diaza)-2-(ox0)- phenthiazin-l-yl, 7-substituted 1-(aza)-2-(thio)-3-(aza)-phenthiazin-1-yl, 7- (aminoalkylhydroxy)-l,3-(diaza)-2-(ox0)-phenoxazin- 1 -yl, 7-(aminoalkylhy droxy)- 1 - (aza)-2-(thio)-3 -(aza)-phenoxazin- 1-yl, 7-(aminoalkylhy droxy)- 1,3 -(diaza)-2-(ox0)- phenthiazin- 1 -yl, 7-(aminoalkylhy droxy)- 1 -(aza)-2-(thio)-3 -(aza)-phenthiazin- 1 -yl, 7- (guanidiniumalkylhy droxy)- 1,3 -(diaza)-2-(oxo)-phenoxazin- 1 -yl, 7- (guanidiniumalkylhydroxy)-1-(aza)-2-(thio)-3-(aza)-phenoxazin-l-yl, 7-(guanidiniumalkyl-hy droxy)- 1,3 -(diaza)-2-(oxo)-phenthiazin- 1-yl, 7-(guanidiniumalkylhy droxy)- 1 -(aza)-2- (thio)-3 -(aza)-phenthiazin-l-yl, 1,3,5-(triaza)-2,6-(dioxa)-naphthalene, inosine, xanthine, hypoxanthine, nubularine, tubercidine, isoguanisine, inosinyl, 2-aza-inosinyl, 7-deaza- inosinyl, nitroimidazolyl, nitropyrazolyl, nitrobenzimidazolyl, nitroindazolyl, aminoindolyl, pyrrolopyrimidinyl, 3-(methyl)isocarbostyrilyl, 5-(methyl)isocarbostyrilyl, 3-(methyl)-7- (propynyl)isocarbostyrilyl, 7-(aza)indolyl, 6-(methyl)-7-(aza)indolyl, imidizopyridinyl, 9- (methyl)-imidizopyridinyl, pyrrolopyrizinyl, isocarbostyrilyl, 7-(propynyl)isocarbostyrilyl, propynyl-7-(aza)indolyl, 2,4,5-(trimethyl)phenyl, 4-(methyl)indolyl, 4,6-(dimethyl)indolyl, phenyl, napthalenyl, anthracenyl, phenanthracenyl, pyrenyl, stilbenyl, tetracenyl, pentacenyl, difluorotolyl, 4-(fluoro)-6-(methyl)benzimidazole, 4-(methyl)benzimidazole, 6-(azo)thymine, 2-pyridinone, 5-nitroindole, 3-nitropyrrole, 6-(aza)pyrimidine, 2-(amino)purine, 2,6- (diamino)purine, 5-substituted pyrimidines, N2-substituted purines, N6-substituted purines, 06-substituted purines, substituted 1,2,4-triazoles, pyrrolo-pyrimidin-2-on-3-yl, 6-phenyl- pyrrolo-pyrimidin-2-on-3-yl, para-substituted-6-phenyl-pyrrolo-pyrimidin-2-on-3-yl, ori / zo- substituted-6-phenyl-pyrrolo-pyrimidin- 2- on-3-yl, bis-ori / zo-substituted-6-phenyl-pyrrolo- pyrimidin-2-on-3-yl, para-(aminoalkylhy droxy)- 6-phenyl-pyrrolo-pyrimidin-2-on-3-yl, ori / zo-(aminoalkylhy droxy)- 6-phenyl-pyrrolo-pyrimidin-2-on-3-yl, bis- ori / zo~(aminoalkylhy droxy)- 6-phenyl-pyrrolo-pyrimidin-2-on-3-yl, pyridopyrimidin-3-yl, 2-0x0-7-amino-pyridopyrimidin-3-yl, 2-oxo-pyridopyrimidine-3-yl, or any O-alkylated or N- alkylated derivatives thereof. Alternatively, substituted or modified analogs of any of the above bases and "universal bases" can be employed. A universal nucleobase is any nucleobase that can base pair with all of the four naturally occurring nucleobases without substantially affecting the melting behavior, recognition by intracellular enzymes or activity of the oligonucleotide duplex. Some exemplary universal nucleobases include, but are not limited to, 2,4-difluorotoluene, nitropyrrolyl, nitroindolyl, 8-aza-7-deazaadenine, 4-fluoro-6- methylbenzimidazle, 4-methylbenzimidazle, 3-methyl isocarbostyrilyl, 5- methyl isocarbostyrilyl, 3-methyl-7-propynyl isocarbostyrilyl, 7-azaindolyl, 6-methyl-7-azaindolyl, imidizopyridinyl, 9-methyl-imidizopyridinyl, pyrrolopyrizinyl, isocarbostyrilyl, 7-propynyl isocarbostyrilyl, propynyl-7-azaindolyl, 2,4,5-trimethylphenyl, 4-methylinolyl, 4,6- dimethylindolyl, phenyl, napthalenyl, anthracenyl, phenanthracenyl, pyrenyl, stilbenyl, tetracenyl, pentacenyl, and structural derivatives thereof (see for example, Loakes, 2001, Nucleic Acids Research, 29, 2437-2447, incorporated herein by reference in its entirety). Further nucleobases include those disclosed in U.S. Pat. No. 3,687,808; those disclosed in International Application No. PCT US09 / 038425, filed March 26, 2009; those disclosed in the Concise Encyclopedia Of Polymer Science And Engineering, pages 858-859, Kroschwitz, J. 1, ed. John Wiley & Sons, 1990; those disclosed by English et al, Angewandte Chemie, International Edition, 1991, 30, 613; those disclosed in Modified Nucleosides in Biochemistry, Biotechnology and Medicine, Herdewijin, P.Ed. Wiley-VCH, 2008; and those disclosed by Sanghvi, Y.S., Chapter 15, dsRNA Research and Applications, pages 289-302, Crooke, S.T. and Lebleu, B., Eds., CRC Press, 1993. Contents of all of the above are herein incorporated by reference.

[0171] In some embodiments, modified RNAs as described herein are modified to attach a delivery and / or targeting moiety such as GalNAc. Suitably, GalNAc can be attached to the 3'-end, 5 '-end of the RNA, or both. In some embodiments, GalNAc is attached to the 3 '-end. In some embodiments, the modified RNAs show improvements relative to their unmodified equivalents. Such improvements can relate to improved specificity (such that, for example, off-target effects are reduced or a lower concentration of gRNA is required), improved stability (e.g. resistance to enzymes such as nucleases), improved functionality or decreased immunogenicity or immunostimulatory properties. In some embodiments, the modified RNAs show efficient transfection into cells and / or improved properties allowing it to be delivered and maintained in an organism, tissue, body fluid or cell such that the RNA, e.g. a guide RNA, functionality can take place. Methods for measuring these improved properties compared to their unmodified equivalents are known to those skilled in the art and include those methods described herein. Accordingly in some embodiments, provided herein is a modified RNA that has increased stability compared to the unmodified equivalent. By un- modified equivalent is meant a RNA, e.g. a guide RNA which targets the same specific gene sequence and interacts with the same Cas9 or CRISPR nuclease and comprises natural nucleotides. Increased stability includes increased stability or resistance to enzymes such as nucleases which may be present in cells, tissues or body fluids and which may otherwise contribute to degradation of the RNA such that is has decreased functionality. In certain embodiments, increased stability includes increased serum stability. In some embodiments, provided herein is a modified guide RNA that has increased CRISPR activity compared to the un-modified equivalent. Methods for measuring CRISPR activity are described herein. In some embodiments, provided herein is a modified guide RNA that has decreased immunostimulatory activity compared to the un-modified equivalent. Methods for measuring immunostimulation are described herein.

[0172] Provided herein are modified mRNA molecules for targeted delivery. For example, a mRNA that encodes a CRISPR enzyme, e.g. a Cas9, Cas12b, or a base editor (BE) may be modified for specific tissue targeting. The mRNA may be modified at least one nucleotide at the 2’ position and / or backbone modification. In some embodiments, the nucleotides in a mRNA can include modification of the thioates. In some embodiments, a mRNA can include modification of one or more of 2’-OMe, 2’-F, N-1-methyl-psuedouridine, 5-methyluridine 5-methoxyuridine, and 5-ethoxyuridine.

[0173] In certain embodiments, mRNA sequences provided herein comprise a fully modified or partially modified mRNA. In some embodiments, a mRNA comprises chemical modifications in a fragment, or multiple fragments of the entire length. Non-limiting exemplary modifications and modification patterns of the nucleotides of a mRNA, or segments thereof, are shown in Table 2 and Table 3.

[0174] Provided herein are modified guide RNAs for use with CRISPR / Cas system where the guide RNA may be modified by a chemical modification of at least one nucleotide at the 2' position and / or backbone modification. The backbone modification can include modification of the thioates. In certain embodiments, the nucleotides that are modified are selected from a group of nucleotides which interact with the Cas amino acids in the Cas protein to effect binding of the guide RNA to Cas. In certain embodiments, the modification can comprise that the 2'-OH on the nucleotide is replaced with at least one of H, -OR, -R, -O- Ci1-Cs-alkylene-OR, -O-C;-Ce-alkylene-OH, halo, -SH, -SR, -NHz, -NHR, -N(R)z, -C1-Cs- alkylene-NHa, -C1-Cs-alkylene-NHR, -C1-Cg-alkylene-N(R)z, or CN, wherein each R is independently Ci-Cs alkyl, C2-Cs alkenyl, or C2-Cs alkynyl and halo is F, CI, Br or I. In some instances, the modifications are 2'-O-methyl and / or 2'-F. In some embodiments, the modification comprises one or more of 2’-F, phosphorothioate internucleotide linkage modification, acyclic nucleotides, LNA, HNA, CeNA, 2'-methoxyethyl, 2'-O-methyl, 2'-O- allyl, 2'-C-allyl, 2'-deoxy, 2'-O-N-methylacetamido (2'-O-NMA), a 2'-O- dimethylaminoethoxyethyl (2'-0-DMAEOE), 2'-0-aminopropyl (2'-O-AP), and 2'-ara-F modification. In some embodiments, the modification comprises 2'-MOE. In some embodiments, the modification comprises phosphorothioate internucleotide linkage modification. In some embodiments, the modification comprises 4-O-alkyl ribosugars such as 4’-methoxy and 4’-ethoxy modifications.

[0175] Suitably, the modified guide RNA can be applied with the S.pyogenes CRISPR / Cas9 system, or any other CRISPR / Cas systems such as those in Staphylococcus aureus or Staphylococcus haemolyticus. The modification, or similar modification patterns, can also be made to guide RNAs for Cpf1 from Lachnospiraceae bacterium ND2006 or Cpfl from Acidominococcus species BV3L6.

[0176] In certain embodiments, guide RNA sequences comprise a fully modified single guide RNA. In some embodiments, a guide RNA comprises chemical modifications in the tracr RNA portion. Non-limiting exemplary modifications and modification patterns of the nucleotides of a guide RNA according to the disclosure are shown in Table 2 and Table 3.

[0177] Modified guide RNAs as described herein may be used in complex with CRISPR / Cas system or CRISPR / Cas enzymes to effect alteration in a target gene or DNA sequence. The CRISPR / Cas enzymes may comprise CRISPR nucleases, such as Cas9, Cpfl, C2cl, C2¢2, or C2¢3. In some embodiments, the CRISPR / Cas enzyme may comprise CRISPR nucleases with modified or reduced nuclease activity, such as a nuclease inactive Cas9 or Cpfl. For example, mutations may be introduced into one or both nuclease subdomains of a Cas9 enzyme to generate a Cas9 nickase or a nuclease inactive Cas9. Exemplary inactivating mutations in Cas9 include alterations at positions D10, E762, H840, N854, N863, or D986 of SEQ ID NO: 1. For example, a D10Amutation in the RuvC subdomain and an H840A mutation in the HNH subdomain of Cas9 renders the Cas9 nuclease inactive. A D10A mutation in the RuvC subdomain or a H840A in the HNH subdomain of Cas9 generates a Cas9 nickase. Additional amino acid substitutions in Cas9 are discussed in WO15 / 89354, which is incorporated herein in its entirety.

[0178] The modified guide RNAs share sequence identity with, or is capable of hybridize to, a target nucleotide such as a target gene or a target DNA sequence. In some embodiments, modified guide RNA has at least 100%, 99%, 98%, 96%, 95%, 90%, 85%, 80%, 75%, or 70% correspondence or identity to a target nucleotide of a gene or target DNA.

[0179] The nucleotides as described herein can be synthetic or chemically modified. For example, guide RNAs provided herein can be synthetic or chemically modified guide RNAs. The nucleotides in the guide RNA that are modified may be those corresponding to one or more nucleotides in the binding region of the guide RNA with Cas9 and / or the nucleotides in the binding region of the guide RNA with the target DNA. Remaining unmodified nucleotides of the guide RNA may be those required to be identified for minimal binding of Cas9 to the 2' -OH location on the bases. In some embodiments, the nucleotides may be modified at the 2' position of the sugar moiety of the nucleotide. In some embodiments, the 2'-OH group of the sugar moiety is replaced by a group selected from H, OR, R, halo, SH, SR, H2, NHR, N(R)2 or CN, wherein R is C1-C6 alkyl, alkenyl or alkynyl and halo is F, CI, Br or I. Other modifications may include, inverted (deoxy) abasics, amino, fluoro, chloro, bromo, CN, CF, methoxy, imidazole, carboxylate, thicate, CI to CIO lower alkyl, substituted lower alkyl, alkaryl or aralkyl, heterozycloalkyl; heterozycloalkaryl; aminoalkylamino; polyalkylamino or substituted silyl. Methods for making RNAs with specific sequences and modifications are known by those skilled in the art, for example, in Dellinger et al. (201 1), J. Am. Chem. Soc, 133, 11540; US 8,202,983; Kumar et al., (2007), J. Am. Chem. Soc, 129, 6859-64, W02013176844, the entirety of which are incorporated herein by reference.

[0180] In some embodiments, polynucleotides or oligonucleotides as provided herein may be synthetic. For example, guide RNAs maybe chemically synthesized guide RNAs. Synthetic RNA production yield is based on sequences and modifications. 2° -O- methyl modifications have been shown to increase coupling efficacy or efficiency during RNA synthesis and therefore increase yield of chemically synthesized RNA. Furthermore, nucleotides may be modified by phosphorothioates. Phosphothioate (phosphorothioate)(PS) bonds substitute a sulphur atom for a non-bridging oxygen in the phosphate backbone of an oligonucleotide. Accordingly, exemplary nucleotides of the disclosure include, but are not limited to, ribonucleic acids (RNAs), deoxyribonucleic acids (DNAs), threose nucleic acids (TNAs), glycol nucleic acids (GNAs), peptide nucleic acids (PNAs), locked nucleic acids (LNAs, including LNA having a B- D-ribo configuration, a-LNA having an a-L-ribo configuration (a diastereomer of LNA), 2'-amino-LNA having a 2'-amino functionalization, and 2'-amino- a-LNA having a 2'- amino functionalization) or hybrids thereof. Conjugates for Targeted Delivery

[0181] Provided herein are conjugates suitable for targeted delivery of agents, such as mRNA, guide RNA, miRNA, siRNA, DNA, peptides, or other micro or macro molecules. A conjugate can contain one or more aptamers, ligands, or moieties for targeted delivery ex vivo or in vivo. In some embodiments, a conjugate comprises a targeting moiety (or ligand), a linker, and an active agent (or payload) that is connected to the targeting moiety. An active agent can be a therapeutic agent, a prophylactic agent, or a diagnostic / prognostic agent. An active agent may have a capability of manipulating a physiological function (e.g., gene expression) in a subject. An active agent maybe a guide RNA, a mRNA, a miRNA, a siRNA, a DNA, or a peptide. The active agent may be connected with the targeting moiety via a linker, via a non-covalent linkage, via nucleobase paring, or any combination thereof. In some embodiments, the conjugate may be a conjugate between a single active agent and a single targeting moiety with the formula (I): X-Y-Z, wherein X is the targeting moiety; Y isa linker; and Z is the guide RNA. In certain embodiments, one targeting ligand can be conjugated to two or more active agents, wherein the conjugate has the formula: X-(Y-Z)n. For example, the conjugate may comprise a guide RNA and a mRNA. In certain embodiments, one active agent can be linked to two or more targeting ligands wherein the conjugate has the formula: (X-Y)n-Z. In other embodiments, one or more targeting moieties may be connected to one or more active pay loads wherein the conjugate formula may be (X- Y-Z)n. In various combinations, the formula of the conjugates maybe, for example, X-Y-Z- Y-X, (X-Y-Z)n-Y-Z, or X-Y-(X-Y-Z)n, wherein X is a targeting moiety; Y is a linker; Z is an active agent, e.g. a guide RNA. The number of each moiety in the conjugate may vary dependent on types of agents, sizes of the conjugate, delivery targets, particles used to packaging the conjugate, other active agents (e.g., immunologic adjuvants) and routes of administration. Each occurrence of X, Y, and Z can be the same or different, e.g. the conjugate can contain more than one type of targeting moiety, more than one type of linker, and / or more than one type of active agent, n is an integer equal to or greater than 1. In some embodiments, n is an integer between 1 and 50, or between 2 and 20, or between 5 and 40. In some embodiments, n may be an integer of 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 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, 40, 41, 41 , 43, 44, 45, 46, 47, 48, 49 or 50.

[0182] In some embodiments, an active agent, e.g., a guide RNA may be delivered to cells and tissues using viral, polymeric and liposomal formulations, cell-penetrating peptides, aptamers, ligands, or conjugates and antibody approaches. A moiety or ligand may direct guide RNAs to particular organ, tissue, or cell, for example , a liver hepatocyte, and may be referred to as a targeting moiety. In some embodiments, targeting moieties modify one or more properties of the attached molecule (e.g., a mRNA or a guide RNA), including but not limited to pharmacodynamic, pharmacokinetic, binding, absorption, cellular distribution, cellular uptake, charge and clearance.

[0183] Exemplary moieties that can be attached to a herein described active agent include, but are not limited to, intercalators, reporter molecules, polyamines, polyamides, polyethylene glycols, thioethers, polyethers, cholesterols, thiocholesterols, cholic acid moieties, folate, lipids, phospholipids, biotin, phenazine, phenanthridine, anthraquinone, adamantane, acridine, fluoresceins, rhodamines, coumarins, dyes, lipid moieties such as a cholesterol moiety (Letsinger et al., Proc. Natl. Acad. Sci. USA, 1989, 86, 6553); cholic acid (Manoharan et al, Bioorg. Med. Chem. Lett., 1994, 4, 1053); a thioether, e.g., hexyl-S- tritylthiol (Manoharan et al, Ann. NY. Acad. Sci., 1992, 660, 306; Manoharan et al, Bioorg. Med. Chem. Let., 1993, 3, 2765); a thiocholesterol (Oberhauser et al., Nucl. Acids Res., 1992, 20, 533); an aliphatic chain, e.g., dodecandiol or undecyl residues (Saison-Behmoaras etal, EMBO, 1991, 10, 111; Kabanov et al, FEBS Lett., 1990, 259, 327, Svinarchuk et al, Biochimie, 1993, 75, 49); a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethylammonium-1,2-di-0-hexadecyl-rac-glycero-3-H-phosphonate (Manoharan et al, Tetrahedron Lett., 1995, 36, 3651; Shea et al, Nucl. Acids Res., 1990, 18, 3777); a polyamine or a polyethylene glycol chain (Manoharan et al., Nucleosides & Nucleotides, 1995, 14, 969); adamantane acetic acid (Manoharan et al., Tetrahedron Lett., 1995, 36, 3651); a palmityl moiety (Mishra et al, Biochim. Biophys. Acta, 1995, 1264, 229); or an octadecylamine or hexylamino-carbonyl-oxycholesterol moiety (Crooke et al, J. Pharmacol. Exp. Ther., 1996, 2717, 923), all references incorporated herein in their entirety. Targeting moieties may include naturally occurring molecules, or recombinant or synthetic molecules, including, but not limited to, GalNAc or derivative thereof (e.g., a dimer, trimer, or tetramer of GalNAc or derivative thereof), polylysine (PLL), poly L-aspartic acid, poly L-glutamic acid, styrene- maleic acid anhydride copolymer, poly(L-lactide-co-glycolied) copolymer, divinyl ether- maleic anhydride copolymer, N-(2-hydroxypropyl)methacrylamide copolymer (HMPA), polyethylene glycol (PEG, e.g., PEG-2K, PEG-5K, PEG-10K, PEG-12K, PEG-15K, PEG- 20K, PEG-40K), MPEG, [MPEG]2, polyvinyl alcohol (PVA), polyurethane, poly(2- ethylacryllic acid), N-isopropylacrylamide polymers, polyphosphazine, polyethylenimine, cationic groups, spermine, spermidine, polyamine, pseudopeptide-polyamine, peptidomimetic polyamine, dendrimer polyamine, arginine, amidine, protamine, cationic lipid, cationic porphyrin, quaternary salt of a polyamine, thyrotropin, melanotropin, lectin, glycoprotein, surfactant protein A, mucin, glycosylated polyaminoacids, transferrin, bisphosphonate, polyglutamate, polyaspartate, aptamer, asialofetuin, hyaluronan, procollagen, immunoglobulins (e.g., antibodies), insulin, transferrin, albumin, sugar-albumin conjugates, intercalating agents (e.g., acri dines), cross-linkers (e.g. psoralen, mitomycin C), porphyrins (e.g., TPPC4, texaphyrin, Sapphyrin), polycyclic aromatic hydrocarbons (e.g., phenazine, dihydrophenazine), artificial endonucleases (e.g., EDTA), lipophilic molecules (e.g, steroids, bile acids, cholesterol, cholic acid, adamantane acetic acid, 1-pyrene butyric acid, dihydrotestosterone, 1,3-Bis-O(hexadecyl)glycerol, geranyloxyhexyl group, hexadecylglycerol, borneol, menthol, 1,3 -propanediol, heptadecyl group, palmitic acid, myristic acid,03-(oleoyl)lithocholic acid, 03-(oleoyl)cholenic acid, dimethoxytrityl, or phenoxazine), peptides (e.g., an alpha helical peptide, amphipathic peptide, RGD peptide, cell permeation peptide, endosomolytic / fusogenic peptide), alkylating agents, phosphate, amino, mercapto, polyamino, alkyl, substituted alkyl, radiolabeled markers, enzymes, haptens (e.g. biotin), transport / absorption facilitators (e.g., naproxen, aspirin, vitamin E, folic acid), synthetic ribonucleases (e.g., imidazole, bisimidazole, histamine, imidazole clusters, acridine- imidazole conjugates, Eu3+ complexes of tetraazamacrocycles), dinitrophenyl, HRP, AP, antibodies, hormones and hormone receptors, lectins, carbohydrates, multivalent carbohydrates, vitamins (e.g, vitamin A, vitamin E, vitamin K, vitamin B, e.g, folic acid, B12, riboflavin, biotin and pyridoxal), vitamin cofactors, lipopolysaccharide, an activator of p38 MAP kinase, an activator of NF-kB, taxon, vincristine, vinblastine, cytochalasin, nocodazole, japlakinolide, latrunculin A, phalloidin, swinholide A, indanocine, myoservin, tumor necrosis factor alpha (TNFalpha), interleukin-1 beta, gamma interferon, natural or recombinant low density lipoprotein (LDL), natural or recombinant high-density lipoprotein (HDL), and a cell-permeation agent (e.g., a.helical cell-permeation agent), peptide and peptidomimetic ligands, including those having naturally occurring or modified peptides, e.g., D or L peptides; a, B, or y peptides; N-methyl peptides; azapeptides; peptides having one or more amide, i.e., peptide, linkages replaced with one or more urea, thiourea, carbamate, or sulfonyl urea linkages; or cyclic peptides; amphipathic peptides including, but not limited to, cecropins, lycotoxins, paradaxins, buforin, CPF, bombinin-like peptide (BLP), cathelicidins, ceratotoxins, S. clava peptides, hagfish intestinal antimicrobial peptides (HFIAPs), magainines, brevinins-2, dermaseptins, melittins, pleurocidin, H2A peptides, Xenopus peptides, esculentinis-1, and caerins. A peptidomimetic (also referred to herein as an oligopeptidomimetic) is a molecule capable of folding into a defined three-dimensional structure similar to a natural peptide. The peptide or peptidomimetic ligand or moiety can be about 5-50 amino acids long, e.g., about 5, 10, 15, 20, 25, 30, 35, 40, 45, or 50 amino acids long. In some embodiments, the targeting moiety may be other peptides such as somatostatin, octeotide, LHRH (luteinizing hormone releasing hormone), epidermal growth factor receptor (EGFR) binding peptide, aptide or bipodal peptide, RGD-containing peptides, a protein scaffold such as a fibronectin domain, a single domain antibody, a stable scFv, or other homing peptides. As non-limiting examples, a protein or peptide based targeting moiety may be a protein such as thrombospondin, tumor necrosis factors (TNF), annexin V, an interferon, angiostatin, endostatin, cytokine, transferrin, GM-CSF (granulocyte-macrophage colony- stimulating factor), or growth factors such as vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), (platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF), and epidermal growth factor (EGF). In some embodiments, the targeting moiety maybe an antibody, an antibody fragment, RGD peptide, folic acid or prostate specific membrane antigen (PSMA). In some embodiments, the protein scaffold may be an antibody-derived protein scaffold. Non-limiting examples include single domain antibody (dAbs), nanobody, single-chain variable fragment (scFv), antigen-binding fragment (Fab), Avibody, minibody, CH2D domain, Fcab, and bispecific T-cell engager (BiTE) molecules. In some embodiments, scFv is a stable scFv, wherein the scFv has hyperstable properties. In some embodiments, the nanobody may be derived from the single variable domain (VHH) of camelidae antibody.

[0184] In some embodiments, a targeting moiety recognizes or binds a target cell, a marker, or a molecule that is present exclusively or predominantly on the surface of particular cells. For example, a targeting moiety may bind a tumor antigen and direct the activating agent, e.g. a guide RNA-Cas complex to a malignant cell. In some embodiments, the targeting moiety recognizes an intra-cellular protein. In some embodiments, a targeting moiety directs a conjugate to specific tissues, cells, or locations in a cell. The targeting moiety can direct the conjugate in culture or in a whole organism, or both. In each case, the targeting moiety may bind to a receptor that is present on the surface of or within the targeted cell(s), wherein the targeting moiety binds to the receptor with an effective specificity, affinity and avidity. In other embodiments the targeting moiety targets the conjugate to a specific tissue such as the liver, kidney, lung or pancreas. In other cases, targeting moieties can direct the conjugate to cells of the reticular endothelial or lymphatic system, or to professional phagocytic cells such as macrophages or eosinophils. In some embodiments, the targeting moiety may recognize a RTK receptor, an EGF receptor, a serine or threonine kinase, G-protein coupled receptor, methyl CpG binding protein, cell surface glycoprotein, cancer stem cell antigen or marker, carbonic anhydrase, cytolytic T lymphocyte antigen, DNA methyltransferase, an ectoenzyme, a glycosylphosphatidylinositol-anchored co- receptor, a glypican-related integral membrane proteoglycan, a heat shock protein, a hypoxia induced protein, a multi drug resistant transporter, a Tumor-associated macrophage marker, a tumor associated carbohydrate antigen, a TNF receptor family member, a transmembrane protein, a tumor necrosis factor receptor superfamily member, a tumour differentiation antigen, a zinc dependent metallo-exopeptidase, a zinc transporter, a sodium-dependent transmembrane transport protein, a member of the SIGLEC family of lectins, or a matrix metalloproteinase.

[0185] In some embodiments, a herein described conjugate, e.g., a guide RNA conjugate, comprise at least one N-Acetyl-Galactosamine (GalNAc), N-Ac-Glucosamine (GluNAc), or mannose (e.g., mannose-6-phosphate). In some embodiments, a targeting moiety comprise at least one N-Acetyl-Galactosamine (GalNAc), N-Ac-Glucosamine (GluNAc), or mannose (e.g., mannose-6-phosphate).

[0186] In some embodiments, a herein described conjugate comprises one or more targeting moieties that comprise N-acetylgalactosamine (GalNAc) or GalNAc derivatives. Such a conjugate is also referred to herein as a GalNAc conjugate. In some embodiments, the conjugate targets a RNA to a particular cell, e.g., a liver cell, e.g., a hepatocyte. In some embodiments, the GalNAc derivatives can be attached via a linker, e.g., a bivalent or trivalent branched linker.

[0187] In some embodiments, a herein described conjugate is a carbohydrate conjugate. In some embodiments, a carbohydrate conjugate comprises a monosaccharide. In some embodiments, the monosaccharide is an N-acetylgalactosamine (GalNAc). GaNAc and GalNAc derivatives are capable of binding Asialoglycoprotein receptor (ASGPR), also known as Ashwell-Morell receptor, a lectin predominantly expressed on liver hepatocytes.

[0188] GalNAc conjugates are described, for example, in U.S. Pat. No. 8,106,022, the entire content of which is hereby incorporated herein by reference. In some embodiments, the GalNAc conjugate serves as a ligand that targets the guide RNA to particular cells. In some embodiments, the GaNAc conjugate targets the guide RNA to liver cells, e.g, by serving as a ligand for the asialoglycoprotein receptor of liver cells (e.g., hepatocytes). In some embodiments, the carbohydrate conjugate comprises one or more GalNAc derivatives. The GalNAc derivatives may be attached via a linker, e.g, a bivalent or trivalent branched linker. In some embodiments the GaNAc conjugate is conjugated to the 3' end of the sense strand. In some embodiments, the GalNAc ligand is conjugated to the active agent (e.g., to the 3’ end of guide RNA) via a linker, e.g., a linker as described herein. In some other embodiments, the GalNAc ligand is conjugated to the active agent (e.g., to the 5' end of guide RNA) via a linker, e.g., a linker as described herein.

[0189] In some embodiments, the GaNAc ligand may be conjugated to a shortmer oligonucleotide via a linker and spacer, wherein the shorter oligonucleotide conjugate is complementary to a segment of an RNA. The RNA encompasses all length, structure, and forms of RNA moledules, including, for example, a mRNA of interest and guide RNA of interest. In some embodiments, a shortmer — GalNAc conjugate and a RNA constitute a pharmaceutical composition. For example, a shortmer GalNAc-conjugated oligonucleotide and a RNA, e.g. a coupling sequence, together may constitute a pharmaceutical composition via W-C H-bonding of complementary nuceotides. The shortmer oligonucleotide conjugate may comprise 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27,28, 29, 30, 35, 40, 45, 50, or more than 50 nucleotides in length. In some embodiments, the coupling sequence may comprise 15-40 nucleotides in length. In some embodiments, the coupling sequence may comprise 19-30 nucleotides in length. In some embodiments, the coupling sequence may comprise 20-24 nucleotides in length.

[0190] In some embodiments, provided herein are pharmaceutical compositions comprising one or more GalNAc conjugated shortmer oligonucleoitdes and one or more RNAs. In some embodiments, a single GalNAc conjugated shortmer oligonucleotide, e.g., a GalNAc conjugated RNA, may be complementary to multiple oligonucleotide segments within a RNA. For example, the single GaNAc conjugated shortmer may comprise a coupling sequence complementary to multiple segments within a RNA. In some embodiments, multiple GaINAc ligand conjugated shortmer oliognucleotides that are complementary to multiple oligonucleotide segments within an RNA may constitute a pharmaceutical composition.

[0191] In certain embodiments, the targeting moiety of a herein described conjugate comprises a ligand having a structure shown in Table 1 below. Table 1. Non-limiting examples of targeting moiety structures. (1-3a) and (1-3b) (1-4a) and (1-4b) (1-5a) and (1-5b) (1-6a) and (1-6b) (1-7a) and (1-7b) (1-8a) and (1-8b) JG png Na TG nmr hy | oF mn Sn did oF gangs diedy IG gm al = SON . i (1-92) and (1-9b) (1-10) and (1-10b) FG mgmt Ne 0 IG nm Sw | 0G ran de 0 EPH tpi 0G npg of 0G moro 1s (1-11a) and (1-11b) 7 (1-12a) and (1-12b) - T mJ somone oo TG ron % FIT en Tron diedy Thomond IG mpm } (1-13a) and (1-13b) (1-14a) and (1-14b) oi 2h . or K TY o TG Fo SE 3 nt ai 0G rpm JG igi . (1-15a) and (1-15b) a, — (1—16a) and (1-16b) = 2% “A 10 JG mth % LN 1-17) (1-18 2 Foo vor : NA Ta 1G mong " oJ amotio JETT BTA, 1-19) (1-20) n Fo 9s 0 0 ody le ad Lo HO OH A. He LOH i HN, J aaah ET HO. Ho OH © © q o J AHN on iq wf Pn (1-21a) and (1-21b) (1-22a) and (1-22) St of (1-21a) and (1-21b) (1-22a) and (1-22b) %L0 0 ym eo on 0. oI if 3 YS a i LON oe , ON i oI iid 3 wok i foot 0dGo ine] A A (1-23a) and (1-23b) (1-24a) and (1-24b) +09 +09 (1-25 and (1-25b 1-264) and 1-26b) 52. Tho nih Mg vo on “hl GE 3G ST (1-27a) and (1-27b) (1-28a) and (1-28b)

[0192] As shown in Table 1, each of t, n, p, q and m is independently 0, or an integer from 1 to 30. In some embodiments, each of t, n, p, q and m of Table 1 is independently 0, 1, 2.3.4,5.6,7.8.9. 10,11, 12, 14, 13, 15, 16, 17, 18, 19, or 20. In some embodiments, each of't,n, p, q and m of Table 1 is independently 0, 1, 2, 3, 4, or 5. In some embodiments, each of t, n, p, q and m of Table 1 is independently 0, 1, 2, or 3. In some embodiments, each of t, n, p, q and m of Table 1 is independently 1 or 2. Accordingly, it should be understood that it is contemplated herein that in some embodiments of compounds of Table 1, tis 0 to 10. In some embodiments, tis 1 to 5. In some embodiments, t is 10 to 20. In some embodiments, t is 1 or 2. In some embodiments, tis 1. In some embodiments, t is 2. In some embodiments of compounds of Table 1, m is 0 to 10. In some embodiments, m is 1 to 5. In some embodiments, m is 10 to 20. In some embodiments, m is 1 or 2. In some embodiments, m is 1. In some embodiments, m is 2. In some embodiments of compounds of Table 1, nis 0 to 10. In some embodiments, n is 1 to 5. In some embodiments, nis 10 to 20. In some embodiments, nis 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2. In some embodiments of compounds of Table 1, p is 0 to 10. In some embodiments, pis 1 to 5. In some embodiments, p is 10 to 20. In some embodiments, p is 1 or 2. In some embodiments, p is 1. In some embodiments, p is 2. In some embodiments of compounds of Table 1, q is 0 to 10. In some embodiments, q is 1 to 5. In some embodiments, q is 10 to 20. In some embodiments, q is 1 or 2. In some embodiments, q is 1. In some embodiments, q is 2. In some embodiments, each R is OH or NHC(O)CH3 or combination thereof. In some embodiments, x is 0 or an integer from 1-5 in compound (1-1a), (1-2a), (1-3a), (1-4a), (1-5a), (1-6a), (1-7a), (1-8a), (1-9a), (1-10a), (1-11a)), (1-12a), (1-16a), (1-21a), (1-22a), (1-23a), (1-24a), (1-25a) and (1-26a) of Table 1. In some embodiments, x is 0 or an integer from 1-5 in compound (1- 1b), (1-2b), (1-3b), (1-4b), (1-5b), (1-6b), (1-7b), (1-8b), (1-9b), (1-10b), (1-11b)), (1-12b), (1-16b), (1-21b), (1-22b), (1-23b), (1-24b), (1-25b) and (1-26b) of Table 1. In some embodiments, x is 1. In some embodiments, x is 2. In some embodiments, x is 0. In some embodiments, x is 3. In some embodiments, x is 4. In some embodiments, x is 5.

[0193] Targeting moieties can be conjugated to nucleobases, sugar moieties, or internucleosidic linkages of a nucleic acid, e.g. a guide RNA or mRNA. Conjugation to purine nucleobases or derivatives thereof can occur at any position including, endocyclic and exocyclic atoms. In some embodiments, the 2-, 6-, 7-, or 8-positions of a purine nucleobase are attached to a moiety. Conjugation to pyrimidine nucleobases or derivatives thereof can also occur at any position. In some embodiments, the 2-, 5-, and 6-positions of a pyrimidine nucleobase can be substituted with a moiety. When a moiety is conjugated to a nucleobase, the preferred position is one that does not interfere with hybridization, i.e., does not interfere with the hydrogen bonding interactions needed for base pairing.

[0194] Conjugation to sugar moieties of nucleosides can occur at any carbon atom. Example carbon atoms of a sugar moiety that can be attached to a conjugate moiety include the 2', 3', and 5' carbon atoms. The gamma-position can also be attached to a conjugate moiety, such as in an abasic residue. Internucleosidic linkages can also bear conjugate moieties. For phosphorus-containing linkages (e.g., phosphodiester, phosphorothioate, phosphorodithiotate, phosphoroamidate, and the like), the conjugate moiety can be attached directly to the phosphorus atom or to an O, N, or S atom bound to the phosphorus atom. For amine- or amide-containing internucleosidic linkages (e.g., PNA), the conjugate moiety can be attached to the nitrogen atom of the amine or amide or to an adjacent carbon atom.

[0195] There are numerous methods for preparing conjugates of oligonucleotides. Generally, an oligonucleotide is attached to a conjugate moiety by contacting a reactive group (e.g., OH, SH, amine, carboxyl, aldehyde, and the like) on the oligonucleotide with a reactive group on the conjugate moiety. In some embodiments, one reactive group is electrophilic and the other is nucleophilic. For example, an electrophilic group can be a carbonyl-containing functionality and a nucleophilic group can be an amine or thiol. Methods for conjugation of nucleic acids and related oligomeric compounds with and without linking groups are well described in the literature such as, for example, in Manoharan in Antisense Research and Applications, Crooke and LeBleu, eds., CRC Press, Boca Raton, Fla., 1993, Chapter 17, which is incorporated herein by reference in its entirety.

[0196] A targeting moiety can be attached to an active agent or therapeutic nucleic acid described herein, such as a guide RNA, via RNA-RNA or RNA-DNA base pairing and hybridization. Not intended to be bound by any theories, a targeting moiety can comprise a coupling sequence that is capable of recognizing or binding an active agent, e.g., a guide RNA or a mRNA. In some embodiments, a targeting moiety comprises a coupling sequence capable of hybridizing to a 5° portion, a 3’ portion, or a middle portion of a guide RNA. A guide RNA that hybridizes with a coupling sequence may comprise an extension. For example, the coupling sequence may be able to hybridize with the extension sequence of the guide RNA, thereby directing the guide RNA to desired in vivo, ex vivo, intercellular or intracellular locations, while the guide RNA functionality such as interaction with CRISPR enzyme or binding with target sequence(s) is not affected. In some embodiments, the guide RNA comprises an extension that includes a polynucleotide tail. In some embodiments, the guide nucleic acid comprises a poly(A) tail, a poly(U) tail, or a poly(T) tail capable of hybridizing with a poly(U) tail, a poly(A) tail, or a poly(A) tail of the coupling sequence respectively. In some embodiments, the guide nucleic acid may be a guide RNA that comprises the sequence of (A)n or (U)n. In some embodiments, the guide nucleic acid may comprise DNA and may comprise the sequence of (A)n or (T)n. In some embodiments, the coupling sequence may comprise the sequence of (A)n (SEQ ID NO: 115), (U)n (SEQ ID NO: 116) or (T)n (SEQ ID NO: 117). As instantly used, n may be any integer between 1 and 200.

[0197] A coupling sequence may share sequence identity or complementarity with a nucleic acid active agent, or a portion thereof. In some embodiments, a coupling sequence may share at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 98%, at least 99%, or 100% of identity with a guide RNA described herein, or a portion of such guide RNA. In some embodiments, a coupling sequence may share at least 10%, at least 15%, at least 20%, at least 25%, at least 30%, at least 35%, at least 40%, at least 45%, at least 50%, at least 55%, at least 60%, at least 65%, at least 70%, at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 98%, at least 99%, or 100% of identity with the complementary sequence of a guide RNA described herein, or the complementary of a portion of such guide RNA. In some embodiments, the coupling sequence may comprise identity or complementarity with at least 2, at least 3, at least 4, at least 5, at least 6, at least 7, at least 8, at least 9, at least 10, at least 11, 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, at least 23, at least 24, at least 25, at least 26, at least 27, at least 28, at least 29, at least 30, at least 31, at least 32, at least 33, at least 34, at least 35, at least 36, at least 37, at least 38, at least 39, at least 40, at least 41, at least 42, at least 43, at least 44, at least 45, at least 46, at least 47, at least 48, at least 49, at least 50, at least 51, at least 52, at least 53, at least 54, at least 55, at least 56, at least 57, at least 58, at least 59, at least 60, at least 61, at least 62, at least 63, at least 64, at least 65, at least 66, at least 67, at least 68, at least 69, at least 70, at least 71, at least 72, at least 73, at least 74, at least 75, at least 76, at least 77, at least 78, at least 79, at least 80, at least 81, at least 82, at least 83, at least 84, at least 85, at least 86, at least 87, at least 88, at least 89, at least 90, at least 91, at least 92, at least 93, at least 94, at least 95, at least 96, at least 97, at least 98, at least 99, or at least 100 contiguous nucleobases of the guide RNA or a complementary thereof.

[0198] In some embodiments, a targeting moiety may comprise or be associated with a coupling sequence that is chemically modified. In some embodiments, the coupling sequence comprises an extension that hybridizes with a therapeutic nucleic acid, e.g. a guide RNA, or a portion thereof. In some embodiments, the extension of the coupling sequence may be chemically modified. In some embodiments, the therapeutic nucleic acid, e.g. a guide RNA, may comprise an extension. In some embodiments, the extension of the guide RNA may be chemically modified. Non-limiting examples of guide RNA extensions and complementary or substantially complementary coupling sequence extensions are shown below in Table 2. RNA-GalNAc conjugate single chemical entity coupling No sequences 1 Table 2. Exemplary RNA GalNAc conjugate single chemical entity coupling sequences. RNA- SEQ ID GalNAc RNA-GalNAc conjugate single chemical entity coupling No Conjugate | sequences No. ms 2-1 5-RNA-AAAAAAAAAAAAA 7 3'- ususuuuuuuuuuuus(GalNAc)-5° _8 2-2 5-RNA-AAAAAAAAAAAAA 2 3'- (GalNA c)uuuuuuuuuuususy -2 2-3 5-RNA-AAAAAAAAAAAAA iy 3'- (GalNA cjususuuuuuuuuuuu(GalNAc 12 2-4 5"RNA-AAAAAAAAAAAAAAAAAAAAAAAA 13 3'- ususuuuuuuuuuuuuuuuuuuuuuus(GalNAc)-5° 14 2-5 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 15 3'- (GalNAc)uuuuuuuuuuUULUULUULULUSUSU 16 2-6 5'RNA-AAAAAAAAAAAAAAAAAAAAAAAA 17 3'- (GalNAc)uuuuuuuuuuuuuuuuuuuuuuuus(GalNAc)-5° 18 27 5'RNA-AAAAAAAAAAAAA 19 3'- usUsuUuUuUuUuUus(GalNAc)-5° 20 2-8 5-RNA-AAAAAAAAAAAAA 21 3'- (GalNAc)uUuUuUuUuUusUsu 22 29 5'RNA-AAAAAAAAAAAAA 23 3'- (GalNAc)usUsuUuUuUuUuUu(GalNAc 24 2-10 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 25 3'- usUsuUuUuUuUuUuUuUuUuUuUuus(GalNAc)-5° 26 2-11 5'RNA-AAAAAAAAAAAAAAAAAAAAAAAA 27 3'- (GaINAc)uUuUuUuUuUuUuUuUuUuUuUsusu 28 2-12 5'-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 29 3'- (GaINAc)uUuUuUuUuUuUuUuUuUuUuUuus(GalNAc)-5° 30 2-13 5'-RNA-AAAAAAAAAAAAA 31 3'- UsUsUUUUUUUUUUUs(GalNAc)-5* 32 2-14 5-RNA-AAAAAAAAAAAAA 33 3'- (GalNAc)UUUUUUUUUUUsUsU 34 2-15 5-RNA-AAAAAAAAAAAAA 35 36 2-16 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 37 5'-RNA-AAAAAAAAAAAAA 3'- ususuuuuuuuuuuus(GalNAc)-5 5-RNA-AAAAAAAAAAAAA 3'- (GalNAc)uuuuuuuuyuususy 5-RNA-AAAAAAAAAAAAA 3'- (GalNAc)ususuuuuuuuuuuu(GalNAc 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- ususuuuuuuuuuuuuuuuuuuuuuus(GalNAc)-5' 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GalNAC)uuuuuuUUUUUUUUUULULUUUSUSY 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GalNAc)uuuuuuuuyuuuuuuuuuuuuuuus(GalNAc)-5' 5-RNA-AAAAAAAAAAAAA 3'- usUsuUuUuUuUuUus(GalNAc)-5" 5RNA-AAAAAAAAAAAAA 3'- (GalNAc)uUuUuUuUuUusUsu 5-RNA-AAAAAAAAAAAAA 3'- (GalNAc)usUsuUuUuUuUuUu(GalNAc 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- usUsuUuUuUuUuUuUuUuUuUuUuus(GalNAc)-5 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GaINAc)uUuUuUuUuUuUuUuUuUuUuUsusu 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GaINAc)uUuUuUuUuUuUuUuUuUuUuUuus(GalNAc)-5' 5RNA-AAAAAAAAAAAAA 3'- UsUsUUUUUUUUUUUs(GalNAc)-5" 5-RNA-AAAAAAAAAAAAA 3'- (GaINAc)UUUUUUUUUUUsUsU 5'-RNA-AAAAAAAAAAAAA 3'- (GalNA¢)UsUsUUUUUUUUUUU(GalNAc 5'-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- UsUsUUUUUUUUUUUUUUUUUUUUUUs(GalNAc)-5 38 2-17 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 39 3'- (GalNAc)UUUUUUUUUUUUUUUUUUUUUUsUsU 40 2-18 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 41 GaNAUUUUUUUUUUUUUUUUUUULIUS(GRINAGY- | 42 5 2-19 5-RNA-AAAAAAAAAAAA A 43 3'- usTsuTuTuTuTuTus(GalNAc)-5 44 2-20 5-RNA-AAAAAAAAAAAA A 45 3'- (GaINAc)uTuTuTuTuTusTsu 46 2-21 5-RNA-AAAAAAAAAAAAA 47 3'- (GalNAc)usTsuTuTuTuTuTu(GalNAc 48 2-22 5 .RNA-AAAAAAAAAAAAAAAAAAAAAAAA 49 3'- usTsuTuTuTuTuTuTuTuTuTuTuus(GalNAc)-5" 50 2-23 5"RNA-AAAAAAAAAAAAAAAAAAAAAAAA 51 3'- (GaINAc)uTuTuTuTuTuTuTuTuTuTuTsusu 32 2-24 5'-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 53 3'- (GaINAc)uTuTuTuTuTuTuTuTuTuTuTuus(GalNAc)-5 34 2-25 5'-RNA-AAAAAAAAAAAAA 55 3- TsTSTTTTTTTTTTTs(GalNAc)-5 356 2-26 5-RNA-AAAAAAAAAAAAA 57 3'- (GaINAC)TTTTTTTTTTusTsT 38 2-27 5'-RNA-AAAAAAAAAAAAA 32 3'- (GaINAC)TSTSTTTTTTTTTTT(GalNAc, 60 2-28 5'-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 61 62 2-29 5"RNA-AAAAAAAAAAAAAAAAAAAAAAAA 63 3'- (GaINAC) TTTTTTTTTTTTTTTTTTTTTTsTsT 64 2-30 S-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 65 66 3'- UsUsUUUUUUUUUUUUUUUUUUUUUUs(GalNAc)-5' 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GalNA¢)UUUUUUUUUUUUUUUUUUUUUUsUsU 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3 (GalNAc)UUUUUUUUUUUUUUUUUUUUUUUUs(GalNAc)- | 5 5RNA-AAAAAAAAAAAA A 3'- usTsuTuTuTuTuTus(GalNAc)-5 5-RNA-AAAAAAAAAAAA A 3'- (GaINAc)uTuTuTuTuTusTsu 5RNA-AAAAAAAAAAAAA 3'- (GaINAc)usTsuTuTuTuTuTu(GalNAc, 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- usTsuTuTuTuTuTuTuTuTuTuTuus(GalNAc)-5' 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GaINAc)uTuTuTuTuTuTuTuTuTuTuTsusu 5-RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GaINAc)uTuTuTuTuTuTuTuTuTuTuTuus(GalNAc)-5' 5'-RNA-AAAAAAAAAAAAA 3- TsTSTTTTTTTTTTTs(GalNAc)-5' 5'-RNA-AAAAAAAAAAAAA 3'- (GaINAC)TTTTTTTTTTusTsT 5RNA-AAAAAAAAAAAAA 3'- (GaINAC)TSTSTTTTTTTTTTT(GalNAc 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3- TsTSTTTTTTTTTTTTTITTTTTTTTTs(GalNAc)-5" 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GaINAC)TTTTTTTTTTTTTTTTTTTTTTsTsT 5RNA-AAAAAAAAAAAAAAAAAAAAAAAA 3'- (GaINAQ)TTTTTTTTTTTITTTITTTTTTTTTTs(GalNAc)-5"

[0199] As used in Table 2, uppercase A, C, G and U refer to ribonucleotides bearing nucleobases adenine, cytosine, guanidine and uracil, respectively; lowercase a, ¢, g and u refer to modified (e.g., 2’-OMe or 2°-MOE) ribonucleotides bearing nucleobases adenine, cytosine, guanidine and uracil, respectively; letter “T” refers to thymdine or deoxythymidine; and letter “s” refers to a phosphorus-containing linkage (such as a phosphorothioate (PS) linkage, a phosphodiester linkage, or a phosphorodithioate linkage). As used in Table 2, “(GalNAc)” refers to a targeting moiety such as one comprising a GalNAc or a derivative thereof. As used in Table 2, “(GalNAc)” also encompasses a targeting moiety that comprises multiple GalNAc structures or derivatives thereof such as a dimer, trimer, a tetramer of GalNAc or derivatives thereof, including the GalNAc structures described in Table 1. In some embodiments, “s” represents a phosphorothioate (PS) linkages. As disclosed herein, the nucleotide sequences and modification patterns encompass all length, structure, and type of RNAs or fragments thereof, CRISPR guide RNAs, e.g. sgRNAs, dual guide RNAs, or mRNAs. For example, nucleotide sequences and modification patterns as described in Table 2 above may indicate RNA sequences and modification patterns in a single guide RNA, a dual guide RNA, anuclease mRNA, or any fragment or segment thereof.

[0200] Non-limiting examples of guide RNAs conjugated to receptor targeting moeity and coupling sequences comprising a targeting moiety are provided in Table 3 below. The (GalNAc) conjugate moiety is covalently conjugated to the 3’ and / or 5’ end of the guide RNA and / or covalently conjugated to the 3° and / or 5° end of the guide RNA with additional nucleotide spacer(s) between the ligand and guide RNA. The guide RNA conjuagtes 3-1 and 3-2 (Table 3) are represeantive examples of direct conjugation of the GalNAc ligand to the guide RNA. The guide RNA conjugates 3-10 to 3-21 where the GalNAc ligand is conjugated to the 3° / 5’-terminal of the additional 3’ and / or 5° nucleotide spacers. Guide RNA strand is extended to 3’-end or to the 5’-end or both ends with desired number of nucleotides. (GalNAc) is conjugated to the 3’-end, 5’-end or both ends of oligonucleotide that is (are) complementary to the extended nucleotides on the guide RNA strand to form complementary duplex leading to a single chemical entity. The conjugate designs 3-3 to 3-8 are constructued from extended nucleotide spacers and the spacer complementary strand carrying a GalNAc ligand. As used in Table 3, uppercase A, C, G and U refer to ribonucleotides bearing nucleobases adenine, cytosine, guanidine and uracil, respectively; lowercase a, ¢, g and u refer to modified (e.g., 2’-OMe or 2’-MOE) ribonucleotides bearing nucleobases adenine, cytosine, guanidine and uracil, respectively; letter “T” refers to thymdine or deoxythymidine; and letter “s” refers to a phosphate linkage (such as a phosphorothioate (PS) linkage, a phosphodiester linkage, or a phosphorodithioate linkage). In some embodiments, “s” represents a PS linkages. As used in Table 3, “(GalNAc)” refers to a targeting moiety such as one comprising a GalNAc or a derivative thereof. As used in Table 3, “(GalNAc)” also encompasses a targeting moiety that comprises multiple GalNAc structures or derivatives thereof such as a dimer, trimer, a tetramer of GalNAc or derivatives thereof. Table 3. Guide RNA GalNAc conjugate designs RNA GalNAc conjugate designs 5'-gsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauagc Conjugate ) No. 3-1 AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu _ ggeaccgagu cggugcuususus-(GalNAc3)-3” } _ 3-2 5'-gsgscsUsGAUSGAG GCCGCsACsAUG GUUUUsAGAge usagaaausagc AAGUUsAAAAUs AAGGCUsAGUC CGUUsAUCsAac | _ uusgaaaaagus ggeaccgagu cggugcuuusus-(GalNAc3)-3” 3-3 5'-gsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauagc AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu ggcaccgagu cggugcusususuuuccuuuguuuuugsc3’ — i — 3'gsgsaaacaaaaacgs( GalNAc) 3-4 5'-cscuuuguuuuugeuugsgscsUGAUGAG GCCGCACAUG 5'-cscuuuguuuuugeuugsgscsUGAUGAG GCCGCACAUG | GUUUUAGAGgc uagaaauagc AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu ggcaccgagu cggugcusususu 3'gsgsaaacaaaaacgs(GalNAc) 3'gsgsaaacaaaaacgs(Gal _ SEQ ID NO 71 SEQ ID N 3-5 5'-cscuuuguuuuugeuugsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauagc AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu ggcaccgagu cggugeusususuuuccuuuguuuuugse-3' 3'gsgsaaacaaaaacgs(GalNAc) 3'gsgsaaacaaaaacgs(GalNAc) SEQ ID NO 74 SEQ ID NO 75 TS — Sn Shee 57-gsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauagc [36 AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu ggcaccgagu cggugcusususuT TTccuuuguuuuugsed' — - 3gsgsamacasanmac s(GalNAc 3-7 5'-cscuuuguuuuugcTTTgsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauagc AAGUUAAAAU AAGGCUAGUC UUUUUAUAEL Uagddalagl AAUUUAAAAU AAUULUAUUL CGUUAUCAac uugaaaaagu ggcaccgagu Cggugcusususu 3'gsgsaaacaaaaacgs(GalNAc) 38 5'-cscuuuguuuuugcTTTgsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauagc AAGUUAAAAU AAGGCUAGUC CGUUAUCAac ‘uugaaaaagu ggeaccgagu cggugcusususuTTTecuuuguuuuugse-3' 3'gsgsaaacaaaaacgs(GalNAc) 3'gsgsaaacaaaaacgs(GalNAc) SEQ ID NO 81 SEQ ID NO 82 EV LARIAT A ~cdittstsmvmemem mec J ICO ATTICA CCC ACAI, CITTIITIITAL A vm 5'-(GalNAc)uuugsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc [35 uagaaauagc AAGUUAAAAU AAGGCUAGUC CGUUAUCAac 5'-(GalNAc)uuugsgscsUsGAUsGAG GCCGCsACsAUG _ uugaaaaagu ggcaccgagu cggugcuususus-(GalNAc3)-3° 3-10 5'-(GalNAc)uuugsgscsUsGAUsGAG GCCGCsACsAUG GUUUUsAGAgc usagaaausagc AAGUUSAAAAUs AAGGCUsSAGUC CA. Dad dastun aed gui a ndalibiotb asad athe So io wba Sata ludui tate dean 8 GUUUUsAGAgc usagaaausagc AAGUUSAAAAUs AAGGCUsAGUC CGUUsAUCsAac uusgaaaaagus ggeaccgagu cggugeuuusus-(GalNAc3)- 3 cr bse - 3'- ususuuuuuuuuuuuuuuus(GalNAc)-5 5'-gsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauage AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu caccgagu cggugcususuSUAAAAAAAAAAAAAAAAAAAA-S 1 3'- ususuuuuuuuuuuuuuuus(GalNAc)-5° 3-25 102 | 5'-gsgscsUGAUGAG GCCGCACAUG GUUUUAGAgc uagaaauage AAGUUAAAAU AAGGCUAGUC CGUUAUCAac uugaaaaagu caccgagu cf cusususSUAAAAAAAAAAAAAAAAAAAA-S — — ———— 103° 3'- ususuuuyuuuuuuuuuuuuuus(GalNAc)-5

[0201] As disclosed herein, the nucleotide sequences and modification patterns encompass all length, structure, and type of RNAs or fragments thereof, CRISPR guide RNAs, e.g. sgRNAs, dual guide RNAs, or mRNAs. For example, nucleotide sequences and modification patterns as described in Table 3 above may indicate RNA sequences and modification patterns in a single guide RNA, a dual guide RNA, a nuclease mRNA, or any fragment or segment thereof.

[0202] A targeting moiety can be attached to a nucleic acid described herein via a carrier. The carriers may include (i) at least one "backbone attachment point," preferably two "backbone attachment points" and (ii) at least one "tethering attachment point." A "backbone attachment point" as used herein refers to a functional group, e.g. a hydroxyl group, or generally, a bond available for, and that is suitable for incorporation of the carrier monomer into the backbone, e.g., the phosphate, or modified phosphate, e.g., sulfur containing, backbone, of an oligonucleotide. A "tethering attachment point" (TAP) in refers to an atom of the carrier monomer, e.g., a carbon atom or a heteroatom (distinct from an atom which provides a backbone attachment point), that connects a selected moiety. The selected moiety can be, e.g., a carbohydrate, e.g. monosaccharide, disaccharide, trisaccharide, tetrasaccharide, oligosaccharide and polysaccharide. Optionally, the selected moiety is connected by an intervening tether to the carrier monomer. Thus, the carrier will often include a functional group, e.g., an amino group, or generally, provide a bond, that is suitable for incorporation or tethering of another chemical entity, e.g., a ligand to the constituent atom. Representative U.S. patents that teach the preparation of conjugates of nucleic acids include, but are not limited to, U.S. Pat. Nos. 4,828,979; 4,948,882; 5,218, 105; 5,525,465; 5,541,313; 5,545,730; 5,552,538; 5,578, 717, 5,580,731; 5,580,731; 5,591,584; 5,109,124; 5,118, 802; 5,138,045; 5,414,077; 5,486,603; 5,512,439; 5,578, 718; 5,608,046; 4,587,044; 4,605,735; 4,667,025; 4,762, 779; 4,789,737; 4,824,941; 4,835,263; 4,876,335; 4,904, 582; 4,958,013; 5,082,830; 5,112,963; 5,214,136; 5,082, 830; 5,112,963; 5,149,782; 5,214,136; 5,245,022; 5,254, 469; 5,258,506; 5,262,536; 5,272,250; 5,292,873; 5,317, 098; 5,371,241, 5,391,723; 5,416,203, 5,451,463; 5,510, 475; 5,512,667; 5,514,785; 5,565,552; 5,567,810; 5,574, 142; 5,585,481; 5,587,371; 5,595,726; 5,597,696; 5,599, 923; 5,599,928; 5,672,662; 5,688,941; 5,714,166; 6,153, 737; 6,172,208: 6,300,319: 6.335.434: 6.335.437: 6.395, 437: 6,444,806: 6.486.308: 6,525,031; 6,528,631, 6,559, 279; contents of which are herein incorporated in their entireties by reference.

[0203] A targeting moiety can be attached to an active agent, e. g. a guide RNA, via a linker. A linker may be bound to one or more active agents and a targeting moiety ligand to form a conjugate, wherein the conjugate releases at least one active agent, e.g. a guide RNA or guide RNA-Cas complex, upon delivery to a target cell. The linker may be attached to the targeting moiety and the active agent by functional groups independently selected from an ester bond, disulfide, amide, acylhydrazone, ether, carbamate, carbonate, and urea. Alternatively the linker can be attached to either the targeting moiety or the active agent by a non-cleavable group such as provided by the conjugation between a thiol and a maleimide, an azide and an alkyne. In some embodiments, a targeting moiety comprises one or more linkers. In some embodiments, one or more linkers as described herein connect a portion of the targeting moiety to a different portion of the targeting moiety. For example, a targeting moiety can comprise 2, 3, 4, 5 or more GalNAc structures or derivatives thereof that are connected by one or more linkers. In some embodiments, two or more GalNAc structures or derivatives thereof in a targeting moiety are connected by one or more non-cleavable linkers. In some embodiments, a herein described conjugate comprises an active agent that is directly connected to a sugar moiety of the targeting moiety.

[0204] The linkers can each independently comprises one or more functional groups selected from the group consisting of ethylene glycol, propylene glycol, amide, ester, ether, alkyl, cycloalkyl, heterocyclyl, aryl, and heteroaryl, wherein each of the alkyl, alkenyl, cycloalkyl, heterocyclyl, aryl, and heteroaryl groups optionally is substituted with one or more groups, each independently selected from halogen, cyano, nitro, hydroxyl, carboxyl, carbamoyl, ether, alkoxy, aryloxy, amino, amide, carbamate, alkyl, alkenyl, alkynyl, aryl, arylalkyl, cycloalkyl, heteroaryl, heterocyclyl, wherein each of the carboxyl, carbamoyl, ether, alkoxy, aryloxy, amino, amide, carbamate, alkyl, alkenyl, alkynyl, aryl, arylalkyl, cycloalkyl, heteroaryl, or heterocyclyl is optionally substituted with one or more groups, each independently selected from halogen, cyano, nitro, hydroxyl, carboxyl, carbamoyl, ether, alkoxy, aryloxy, amino, amide, carbamate, alkyl, alkenyl, alkynyl, aryl, arylalkyl, cycloalkyl, heteroaryl, heterocyclyl. In some embodiments, a linker independently comprises phosphate, phosphorothioate, amide, ether, oxime, hydrazine or carbamate. As contemplated herein it should be understood that, in some embodiments, a targeting conjugate of Formula (V), (VI), (VIa) or (VIb) comprises a linker described herein. For example, any of the groups R and L!- L'2 can comprise one or more linkers.

[0205] In some embodiments, the linker can independently comprise a C1-Cio straight chain alkyl, Ci-Cio straight chain O-alkyl, C1-Cio straight chain substituted alkyl, C1-C1o straight chain substituted O-alkyl, C4-Ci13 branched chain alkyl, C4-Ci3 branched chain O- alkyl, C2-Ci2 straight chain alkenyl, C2-Ci2 straight chain O-alkenyl, aralkyl, C3-Ci2 straight chain substituted alkenyl, C3-Ci2 straight chain substituted O-alkenyl, polyethylene glycol, polylactic acid, polygly colic acid, poly(lactide-co-glycolide), polycarprolactone, polycyanoacrylate, ketone, aryl, heterocyclic, succinic ester, amino acid, aromatic group, ether, crown ether, urea, thiourea, amide, purine, pyrimidine, bypiridine, indole derivative acting as a cross linker, chelator, aldehyde, ketone, bisamine, bis alcohol, heterocyclic ring structure, azirine, disulfide, thioether, hydrazone and combinations thereof. For example, the linker can be a C3 straight chain alkyl or a ketone. The alkyl chain of the linker can be substituted with one or more substituents or heteroatoms. In some embodiments, the alkyl chain of the linker may optionally be interrupted by one or more atoms or groups selected from -O-, -C(=0)-, -NR, -0-C(=0)-NR-, -S-, -S-S-.

[0206] In some embodiments, the linker may be cleavable and is cleaved to release the active agent. The cleavable functionality may be hydrolyzed in vivo or may be designed to be hydrolyzed enzymatically, for example by Cathepsin B. A "cleavable" linker, as used herein, refers to any linker which can be cleaved physically or chemically. Examples for physical cleavage may be cleavage by light, radioactive emission or heat, while examples for chemical cleavage include cleavage by re- dox-reactions, hydrolysis, pH-dependent cleavage.

[0207] Linkers may comprise a direct bond or an atom such as oxygen or sulfur, a unit such as NR!, C(0), C(O)NH, SO, S02, SO2NH or a chain of atoms, such as, but not limited to, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl, heteroarylalkynyl, heterocyclylalkyl, heterocyclylalkenyl, heterocyclylalkynyl, aryl, heteroaryl, heterocyclyl, cycloalkyl, cycloalkenyl, alkylarylalkyl, alkylarylalkenyl, alkylarylalkynyl, alkenylarylalkyl, alkenylarylalkenyl, alkenylarylalkynyl, alkynylarylalkyl, alkynylarylalkenyl, alkynylarylalkynyl, alkylheteroarylalkyl, alkylheteroarylalkenyl, alkylheteroarylalkynyl, alkenylheteroarylalkyl, alkenylheteroarylalkenyl, alkenylheteroarylalkynyl, alkynylheteroarylalkyl, alkynylheteroarylalkenyl, alkynylheteroarylalkynyl, alkylheterocyclylalkyl, alkylheterocyclylalkenyl, alkylhererocyclylalkynyl, alkenylheterocyclylalkyl, alkenylheterocyclylalkenyl, alkenylheterocyclylalkynyl, alkynylheterocyclylalkyl, alkynylheterocyclylalkenyl, alkynylheterocyclylalkynyl, alkylaryl, alkenylaryl, alkynylaryl, alkylheteroaryl, alkenylheteroaryl, alkynylhereroaryl, which one or more methylenes can be interrupted or terminated by O, S, S(O), SO2, N(R), C(O), substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted heterocyclic; where R' is hydrogen, acyl, aliphatic or substituted aliphatic. In one embodiment, the linker is between 1-24 atoms, preferably 4-24 atoms, preferably 6-18 atoms, more preferably 8-18 atoms, and most preferably 8-16 atoms.

[0208] In one embodiment, the linker is —[(P-Q"-R)q—X—(P'Q""-R")q']q"-T-, wherein P,R, T, P',R' and T are each independently for each occurrence absent, CO, NH, O, S, 0OC(0), NHC(0), CH2, CH2NH, CH20; NHCH(Ra)C(0), —C(0)—CH(Ra)—NH— CH=N—O, G3 i % AL 2 3% a ETE . sol 3 FN ANS > §—3. or heterocyclyl; Q" and Q™ are each independently for each occurrence absent, —(CH2)n— —C(R1)(R2)(CH2)n— —(CH2)nC(R1)(R2)— (CH2CH20)mCH2CH2—, or —(CH2CH20)mCH2CH2NH—; X is absent or a cleavable linking group; Ra is H or an amino acid side chain; R1 and R2 are each independently for each occurrence H, CH3, OH, SH or N(RN)2; RN is independently for each occurrence H, methyl, ethyl, propyl, isopropyl, butyl or benzyl; q, q' and q" are each independently for each occurrence 0-20 and wherein the repeating unit can be the same or different; n is independently for each occurrence 1-20; and m is independently for each occurrence 0-50.

[0209] In one embodiment, the linker comprises at least one cleavable linking group. In certain embodiments, the linker is a branched linker. The branchpoint of the branched linker may be at least trivalent, but may be a tetravalent, pentavalent or hexavalent atom, or a group presenting such multiple valencies. In certain embodiments, the branchpoint is, —N, — N(0)—C, —0—C, —S—C, —SS—C, —C(0)N(0)—C, —OC(O)N(0)—C, — N(0)C(0)—C, or —N(0)C(0)O—C; wherein Q is independently for each occurrence H or optionally substituted alkyl. In other embodiment, the branchpoint is glycerol or glycerol derivative.

[0210] In one embodiment, a linker may be cleaved by an enzyme. As a non-limiting example, the linker may be a polypeptide moiety, e.g. AA in W02010093395 to Govindan, the content of which is incorporated herein by reference in its entirety; that is cleavable by intracellular peptidase. Govindan teaches AA in the linker may be a di, tri, or tetrapeptide such as Ala-Leu, Leu- Ala-Leu, and Ala-Leu- Ala-Leu. In another example, the cleavable linker may be a branched peptide. The branched peptide linker may comprise two or more amino acid moieties that provide an enzyme cleavage site. Any branched peptide linker disclosed in WO 1998019705 to Dubowchik, the content of which is incorporated herein by reference in its entirety, may be used as a linker in the conjugate of the present disclosure. As another example, the linker may comprise a lysosomally cleavable polypeptide disclosed in US 8877901 to Govindan et al., the content of which is incorporated herein by reference in its entirety. As another example, the linker may comprise a protein peptide sequence which is selectively enzymatically cleavable by tumor associated proteases, such as any Y and Z structures disclosed in US 6214345 to Firestone et al, the content of which is incorporated herein by reference in its entirety.

[0211] In some embodiments, a linker may comprise a cleavable linking group. A cleavable linking group is one which is sufficiently stable outside the cell, but which upon entry into a target cell is cleaved to release the two parts the linker is holding together. In a preferred embodiment, the cleavable linking group is cleaved at least 10 times or more, preferably at least 100 times faster in the target cell or under a first reference condition (which can, e.g, be selected to mimic or represent intracellular conditions) than in the blood of a subject, or under a second reference condition (which can, e.g., be selected to mimic or represent conditions found in the blood or serum). Cleavable linking groups may be susceptible to cleavage agents, e.g., pH, redox potential or the presence of degradative molecules. Generally, cleavage agents are more prevalent or found at higher levels or activities inside cells than in serum or blood. Examples of such degradative agents include: redox agents which are selected for particular substrates or which have no substrate specificity, including, e.g., oxidative or reductive enzymes or reductive agents such as mercaptans, present in cells, that can degrade a redox cleavable linking group by reduction; esterases; endosomes or agents that can create an acidic environment, e.g., those that result in a pH of five or lower; enzymes that can hydrolyze or degrade an acid cleavable linking group by acting as a general acid, peptidases (which can be substrate specific), and phosphatases.

[0212] A cleavable linkage group, such as a disulfide bond can be susceptible to pH. The pH of human serum is 7.4, while the average intracellular pH is slightly lower, ranging from about 7.1-7.3. Endosomes have a more acidic pH, in the range of 5.5-6.0, and lysosomes have an even more acidic pH at around 5.0. Some linkers will have a cleavable linking group that is cleaved at a preferred pH, thereby releasing the cationic lipid from the ligand inside the cell, or into the desired compartment of the cell.

[0213] A linker can include a cleavable linking group that is cleavable by a particular enzyme. The type of cleavable linking group incorporated into a linker can depend on the cell to be targeted. For example, liver targeting ligands can be linked to the cationic lipids through a linker that includes an ester group. Liver cells are rich in esterases, and therefore the linker will be cleaved more efficiently in liver cells than in cell types that are not esterase-rich. Other cell-types rich in esterases include cells of the lung, renal cortex, and testis.

[0214] One class of cleavable linking groups are redox cleavable linking groups that are cleaved upon reduction or oxidation. An example of reductively cleavable linking group is a disulphide linking group (—S—S—). To determine if a candidate cleavable linking group is a suitable “reductively cleavable linking group,” or for example is suitable for use with a particular RNA moiety and particular targeting agent one can look to methods described herein. For example, a candidate can be evaluated by incubation with dithiothreitol (DTT), or other reducing agent using reagents know in the art, which mimic the rate of cleavage which would be observed in a cell, e.g., a target cell. The candidates can also be evaluated under conditions which are selected to mimic blood or serum conditions. In a preferred embodiment, candidate compounds are cleaved by at most 10% in the blood. In preferred embodiments, useful candidate compounds are degraded at least 2, 4, 10 or 100 times faster in the cell (or under in vitro conditions selected to mimic intracellular conditions) as compared to blood (or under in vitro conditions selected to mimic extracellular conditions). The rate of cleavage of candidate compounds can be determined using standard enzyme kinetics assays under conditions chosen to mimic intracellular media and compared to conditions chosen to mimic extracellular media.

[0215] In some embodiments, a linker may comprise a phosphate based cleavable linking group. Phosphate-based cleavable linking groups are cleaved by agents that degrade or hydrolyze the phosphate group. An example of an agent that cleaves phosphate groups in cells are enzymes such as phosphatases in cells. Examples of phosphate-based linking groups (i.e., phosphorus-containing linkages or phosphorus-containing linkers) are —P(O)(ORk)- O— —O—P(S)(ORk)—O— —O—P(S)(SRk)—O0— —S—P(O)(ORk)—O0— —O— P(0)(ORk)-S— —S—P(O)(ORk)-S— —O—P(S)(ORk)-S— —S—P(S)(ORk)—O— 0—P(0)(Rk)—O— —O—P(S)(Rk)—O0— —S—P(O)(Rk)—O— —S—P(S)(Rk)—O0— —S—P(0)(Rk)-S— —O—P(S)(Rk)-S—. In some embodiments, phosphate-based linking groups are —O—P(0)(OH)—O— —O—P(S)(OH)—O0— —O—P(S)(SH—0— —S— P(0)(OH)—O— —O—P(0)(OH)—S— —S—P(0)(OH)—S— —O—P(S)(OH)—S— $—P(S)(OH)—0— —O0—P(O)(H)—O0— —O—P(S)(H)—O0— —S—P(O)(H)—O0— S—P(S)(H—0— —S—P(0)(H)—S— —O—P(S)(H)—S—S—. In some embodiments, a phosphate-based linker is —O—P(0)(OH)—O—

[0216] In some embodiments, a linker may comprise an acid cleavable linking group. Acid cleavable linking groups are linking groups that are cleaved under acidic conditions. In preferred embodiments acid cleavable linking groups are cleaved in an acidic environment with a pH of about 6.5 or lower (e.g., about 6.0, 5.5, 5.0, or lower), or by agents such as enzymes that can act as a general acid. In a cell, specific low pH organelles, such as endosomes and lysosomes can provide a cleaving environment for acid cleavable linking groups. Examples of acid cleavable linking groups include but are not limited to hydrazones, esters, and esters of amino acids. Acid cleavable groups can have the general formula — C=NN—, C(0)0, or —OC(O). A preferred embodiment is when the carbon attached to the oxygen of the ester (the alkoxy group) is an aryl group, substituted alkyl group, or tertiary alkyl group such as dimethyl pentyl or t-butyl. These candidates can be evaluated using methods analogous to those described above.

[0217] In some embodiments, a linker may comprise a ester based linking group. Ester- based cleavable linking groups are cleaved by enzymes such as esterases and amidases in cells. Examples of ester-based cleavable linking groups include but are not limited to esters of alkylene, alkenylene and alkynylene groups. Ester cleavable linking groups have the general formula —C(0)O—, or —OC(O)—. These candidates can be evaluated using methods analogous to those described above.

[0218] In some embodiments, a linker may comprise a peptide based linking group. Peptide-based cleavable linking groups are cleaved by enzymes such as peptidases and proteases in cells. Peptide-based cleavable linking groups are peptide bonds formed between amino acids to yield oligopeptides (e.g., dipeptides, tripeptides etc.) and polypeptides. Peptide-based cleavable groups do not include the amide group (—C(O)NH—). The amide group can be formed between any alkylene, alkenylene or alkynelene. A peptide bond is a special type of amide bond formed between amino acids to yield peptides and proteins. The peptide based cleavage group is generally limited to the peptide bond (i.e., the amide bond) formed between amino acids yielding peptides and proteins and does not include the entire amide functional group. Peptide-based cleavable linking groups have the general formula — NHCHRAC(O)NHCHRBC(O)—, where RA and RB are the R groups of the two adjacent amino acids.

[0219] Linkers that contain peptide bonds can be used when targeting cell types rich in peptidases, such as liver cells and synoviocytes.

[0220] In general, the suitability of a candidate cleavable linking group can be evaluated by testing the ability of a degradative agent (or condition) to cleave the candidate linking group. It will also be desirable to also test the candidate cleavable linking group for the ability to resist cleavage in the blood or when in contact with other non-target tissue. Thus one can determine the relative susceptibility to cleavage between a first and a second condition, where the first is selected to be indicative of cleavage in a target cell and the second is selected to be indicative of cleavage in other tissues or biological fluids, e.g., blood or serum. The evaluations can be carried out in cell free systems, in cells, in cell culture, in organ or tissue culture, or in whole animals. It may be useful to make initial evaluations in cell-free or culture conditions and to confirm by further evaluations in whole animals. In preferred embodiments, useful candidate compounds are cleaved at least 2, 4, 10 or 100 times faster in the cell (or under in vitro conditions selected to mimic intracellular conditions) as compared to blood or serum (or under in vitro conditions selected to mimic extracellular conditions).

[0221] In some embodiments, a herein described conjugate comprises a structure of Formula (I), x0 OX O X 0 AcHN xo OX O L352, One or more Ww AHN linkers OX xo / xo OX Oo S32 AHN Formula (I) wherein each X is independently H or a protecting group, and W represents an active agent or a coupling sequence. The one or more linkers of Formula (I) can each independently comprises a linker as described in this disclosure. In some embodiments, each of the protecting group of Formula (I) is independently selected from: 4-acetoxy-2,2- dimethylbutanoyl (ADMB), 3-(2-Hydroxyphenyl)-3,3-dimethylpropanoate (DMBPP), 3-(2- hydroxy-4,6-dimethylphenyl)-3,3-dimethylpropanoate groups (TMBPP), methylsulfonylethoxycarbonyl (Msc), 2,2-dimethyltrimethylene (DMTM) phosphate, 2- pyridylmethyl, ethyl mandelate, (phenylthiomethyl)benzyl, pentafluoropropionyl (PEP), benzoyl (Bz), acetyl (Ac), bacillosamine (Bac), benzyl (Bn), 1-benzenesulfinylpiperidine (BSP), tert-butoxycarbonyl (Boc), benzylidene acetal, propargyl, naphthylpropargyl, carbonate, dichloroacetyl, fert-butylsilylene, tetraisopropyldisiloxanylidene (TIPDS), methoxybenzyl (PMB), xylylene, and p-methoxyphenyl (MP). Exemplary protecting groups are further disclosed in Guo et al., Molecules 2010, 15, 7235-7265, which is hereby incorporated by reference in its entirety. In some embodiments, X is H. In some embodiments, each X is independently selected from H and Bz. In some embodiments of Formula (I), W is an active agent. In some embodiments, W is a nucleic acid. In some embodiments, W is a gRNA. In some embodiments, W is a single-stranded, double-stranded, partially double-stranded or hairpin stem-loop nucleic acid. In some embodiments of Formula (I), Wis a coupling sequence. In some embodiments, W comprises an RNA or DNA sequence. W can comprise one or more modified DNA or RNA bases. The nucleobases can comprise any chemical modifications as described herein. In some embodiments, the nucleobases include a 2°-OH or 2’-OMe modification. For example, W may comprise one or more 2’-OMe modified adenine, cytosine, guanidine and uracil, referred to as (a) (c), (g), or (u). In some embodiments, a modified RNA, e.g. a gRNA or mRNA, includes at least 1, 2, 3, 4,5,6,7,8,9,10, 11, 12, 13, 14, 15, 20, 25, 30, 35, 40, 50 or more modified nucleobases. In some embodiments, a modified RNA comprises one or more modified nucleobases near the 5’ end, near the 3’ end, or in the middle of the sequence. The modified nucleobases within a modified RNA may or may not be contiguous. In some embodiments, a modified RNA comprises one or more 2’-OMe modifications scattered along the length of the sequence. In some embodiments, a modified RNA comprises one or more 2’OH modifications scattered along the length of the sequence. In some embodiments, a modified RNA comprises alternating 2’-OH and 2’ OMe modifications. In some embodiments, W comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O-methyladenosine (2’-OMe A), and wherein u is 2’-O-methyluridine (2’-OMe-U). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 50 (SEQ ID NO: 118). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 20 (SEQ ID NO: 119) or 3 to 15 (SEQ ID NO: 120). In some embodiments, W comprises one or more nucleotide sequences that are complementary to a coupling sequence. In some embodiments, W comprises one or more guanines or cytidines. In some embodiments, W comprises at least 1, 2,3,4,5,6,7,8,9,10, 11, 12, 13, 14, 15, 20, 25, 30, 35, 40, 50 or more guanines or cytidines. In some embodiments, the one or more guanines or cytidines are complementary to one or more cytindines or guanines in a coupling sequence. In some embodiments, the guanines or cytidines are at the terminals of W or the coupling sequence. Not intended to be bound by any theory, it is contemplated that the guaninies-cytidine pairing forms “GC locks” or “CG locks” that would increase binding affinity. The guanines and / or cytidines in W or a coupling sequence may or may not be contiguous and may comprise any one of the chemical modifications as described herein, e.g. a 2’-OMe or 2’-OH modification.

[0222] In some embodiments, a conjugate of Formula (I) comprises a structure of Formula (Ia), Ho OH 0 Ho. o, AcHN HO OH 5 ) 2, One or more w AHN linkers HO OH rd HO OH O AcHN Formula (Ia).

[0223] In some embodiments, a conjugate of Formula (I) comprises a structure of Formula (Ib), Ho OH Si o. JC ) HO, 3 ON = } | Linker W ACHN Linker yo Lao abd Ho OH 0. Formula (Ib).

[0224] In some embodiments, a herein described conjugate comprises a structure of Formula (II), xo OX Oo XO, o AcH Z xo OX Oo wo JX AcHI ¥ £ Formula (II) wherein each X is independently H or a protecting group, Z is modified or unmodified Cs or Cs monosaccharide, and W represents an active agent or a coupling sequence. The one or more linkers of Formula (II) can each independently comprises a linker as described in this disclosure. In some embodiments, each of the protecting group of Formula (II) is independently selected from: 4-acetoxy-2,2-dimethylbutanoyl (ADMB), 3~(2- Hydroxyphenyl)-3,3-dimethylpropanoate (DMBPP), 3-(2-hydroxy-4,6-dimethylphenyl)-3,3- dimethylpropanoate groups (TMBPP), methylsulfonylethoxycarbonyl (Msc), 2,2- dimethyltrimethylene (DMTM) phosphate, 2-pyridylmethyl, ethyl mandelate, (phenylthiomethyl)benzyl, pentafluoropropionyl (PFP), benzoyl (Bz), acetyl (Ac), bacillosamine (Bac), benzyl (Bn), 1-benzenesulfinylpiperidine (BSP), tert-butoxycarbonyl (Boc), benzylidene acetal, propargyl, naphthylpropargyl, carbonate, dichloroacetyl, fert- butylsilylene, tetraisopropyldisiloxanylidene (TIPDS), methoxybenzyl (PMB), xylylene, and p-methoxyphenyl (MP). In some embodiments, X is H. In some embodiments, each X is independently selected from H and Bz. In some embodiments of Formula (II), Z is galactose or mannose. In some embodiments of Formula (II), Z is GalNAc. In some embodiments of Formula (II), W is an active agent. In some embodiments, W is a nucleic acid. In some embodiments, W is a gRNA. In some embodiments, W is a single-stranded, double-stranded, partially double-stranded or hairpin stem-loop nucleic acid. In some embodiments of Formula (I), W is a coupling sequence. In some embodiments, W comprises an RNA or DNA sequence. In some embodiments, W comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O-methyladenosine (2’-OMe A), and wherein u is 2’- O-methyluridine (2’-OMe-U). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 50 (SEQ ID NO: 118). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 20 (SEQ ID NO: 119) or 3 to 15 (SEQ ID NO: 120).

[0225] In some embodiments, a conjugate of Formula (II) comprises a structure of Formula (IIa), Ho OH 32 \ AcHN Ho OH O S32, One or more " AHN linkers Ho OH 7 Ho OH 0 / L532 AcHN ) Va Formula (I1a).

[0226] In some embodiments, a conjugate of Formula (II) comprises a structure of Formula (IIb), Ho JOH Ho. 2 Ader ~ Linker } Au ” Linker WN H H oN HO, 3 un OH LAU, A / Ho OH Ir, - % Linker oo Formula (IIb).

[0227] In some embodiments, a conjugate of Formula (II) comprises a structure of Formula (IIc), Formula (IIc).

[0228] In some embodiments, a herein described conjugate comprises a structure of Formula (III), x0 OX O XO, 0 AcHN’ Xo OX 0 3 S32. One or more linkers AcHN xo OX xo OX 0 oJ52. AcHN W— —Z7 Formula (III) wherein each X is independently H or a protecting group, Z is modified or unmodified Cs or Cs monosaccharide, and W represents an active agent or a coupling sequence. The one or more linkers of Formula (III) can each independently comprises a linker as described in this disclosure. In some embodiments, each of the protecting group of Formula (III) is independently selected from: 4-acetoxy-2,2-dimethylbutanoyl (ADMB), 3- (2-Hydroxyphenyl)-3,3-dimethylpropanoate (DMBPP), 3-(2-hydroxy-4,6-dimethylphenyl)- 3,3-dimethylpropanoate groups (TMBPP), methylsulfonylethoxycarbonyl (Msc), 2,2- dimethyltrimethylene (DMTM) phosphate, 2-pyridylmethyl, ethyl mandelate, (phenylthiomethyl)benzyl, pentafluoropropionyl (PFP), benzoyl (Bz), acetyl (Ac), bacillosamine (Bac), benzyl (Bn), 1-benzenesulfinylpiperidine (BSP), tert-butoxycarbonyl (Boc), benzylidene acetal, propargyl, naphthylpropargyl, carbonate, dichloroacetyl, ferz- butylsilylene, tetraisopropyldisiloxanylidene (TIPDS), methoxybenzyl (PMB), xylylene, and p-methoxyphenyl (MP). In some embodiments, X is H. In some embodiments, each X is independently selected from H and Bz. In some embodiments of Formula (III), Z is galactose or mannose. In some embodiments of Formula (III), Z is GalNAc. In some embodiments of Formula (III), W is an active agent. In some embodiments, W is a nucleic acid. In some embodiments, W is a gRNA. In some embodiments, W is a single-stranded, double-stranded, partially double-stranded or hairpin stem-loop nucleic acid. In some embodiments of Formula (III), W is a coupling sequence. In some embodiments, W comprises an RNA or DNA sequence. In some embodiments, W comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O-methyladenosine (2’-OMe A), and wherein u is 2’- O-methyluridine (2’-OMe-U). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 50 (SEQ ID NO: 118). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 20 (SEQ ID NO: 119) or 3 to 15 (SEQ ID NO: 120).

[0229] In some embodiments, a conjugate of Formula (III) comprises a structure of Formula (IIIa), Ho OH jo} HO, 0 AcHN Ho OH HO, o One or more linkers AcHN HO OH Ho OH 0 S32 AcHN wW— —7 Formula (IIIa).

[0230] In some embodiments, a conjugate of Formula (III) comprises a structure of Formula (IIIb), x0 OX w 52. AcHN xo OX S52, One or more | AHN linkers - OX xo xo OX Oo AcHN W— ATTN ” —0 x9 o / XO. A AcHN Formula (IIIb).

[0231] In some embodiments, a conjugate of Formula (IIT) comprises a structure of Formula (IIIc), xo OX O X o AcHN xo OX AcHN xo OX xo OX O S32 AHN AcHN” wo le XQ d XO. AcHN a Formula (IIIc), wherein YisOQor S.

[0232] In some embodiments, a conjugate of Formula (III) comprises a structure of Formula (111d), Ho OH ol HO. 0 AcHN’ Ho OH O AcHN’ oO AcHN™ o W—o—p— —0 Jo HO Pd HO. AcHN Formula (111d), wherein YisO or S.

[0233] In some embodiments, a conjugate of Formula (III) comprises a structure of Formula (Ile), Ho OH S52. AHN Ho OH AcHN 1 HO OH ) Ho JOH O S32 AGHN NL~L0 AcHN wf —f o vO HQ Jd HO. HO Formula (111e) Formula (Ile), wherein YisO or S.

[0234] In some embodiments, a herein described conjugate comprises a structure of Formula (IV), xo OX jel XO. AcHN’ X xo OX 0 XO, o. One or more linkers ] AcHN XO OX xo OX 052 AGHN TINE~L0 AcHN 9 W—p— —9 lo 2% XO: RA Farmnla (TV) Formula (IV) wherein each X is independently H or a protecting group, R* is -OX or -NHAc¢, Y is O or S, and W represents an active agent or a coupling sequence. The one or more linkers of Formula (IV) can each independently comprises a linker as described in this disclosure. In some embodiments, each of the protecting group of Formula (IV) is independently selected from: 4-acetoxy-2,2-dimethylbutanoyl (ADMB), 3-(2-Hydroxyphenyl)-3,3- dimethylpropanoate (DMBPP), 3-(2-hydroxy-4,6-dimethylphenyl)-3,3-dimethylpropanoate groups (TMBPP), methylsulfonylethoxycarbonyl (Msc), 2,2-dimethyltrimethylene (DMTM) phosphate, 2-pyridylmethyl, ethyl mandelate, (phenylthiomethyl)benzyl, pentafluoropropionyl (PFP), benzoyl (Bz), acetyl (Ac), bacillosamine (Bac), benzyl (Bn), 1- benzenesulfinylpiperidine (BSP), tert-butoxycarbonyl (Boc), benzylidene acetal, propargyl, naphthylpropargyl, carbonate, dichloroacetyl, zert-butylsilylene, tetraisopropyldisiloxanylidene (TIPDS), methoxybenzyl (PMB), xylylene, and p- methoxyphenyl (MP). In some embodiments, X is H. In some embodiments, each X is independently selected from H and Bz. In some embodiments, R* is -OX. In some embodiments, R* is -OH. In some embodiments, R* is -NHAc. In some embodiments of Formula (IV), W is an active agent. In some embodiments, W is a nucleic acid. In some embodiments, W is a gRNA. In some embodiments, W is a single-stranded, double-stranded, partially double-stranded or hairpin stem-loop nucleic acid. In some embodiments of Formula (IV), W is a coupling sequence. In some embodiments, W comprises an RNA or DNA sequence. In some embodiments, W comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2°-O-methyladenosine (2°-OMe A), and wherein u is 2°- O-methyluridine (2’-OMe-U). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 50 (SEQ ID NO: 118). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 20 (SEQ ID NO: 119) or 3 to 15 (SEQ ID NO: 120).

[0235] In some embodiments, a conjugate of Formula (IV) comprises a structure of 1-1, 1-2, 1-5, 1-6, 1-9, 1-10, 1-11, or 1-12 as shown in Table 1.

[0236] In some embodiments of Formula (I), Formula (Ia), Formula (II), Formula (IIa), Formula (IIc), Formula (III), Formula (Illa), Formula (IIIb), Formula (ITlc), Formula (IId), Formula (Ile), or Formula (IV), wherein the “one or more linkers” referenced in the box of the foregoing formulas comprises a structure selected from the group consisting of: Lo je—— —_— TTT ret linker linker fan [tinker J A linker fine T linker fn - - © SN—, linker f—N] and TT S——" , wherein each linker is independent. In some embodiments of Formula (I), Formula (Ia), Formula (Ib), Formula (II), Formula (Ila), Formula (IIb), Formula (IIc), Formula (IIT), Formula (IIIa), Formula (IIIb), Formula (IIIc), Formula (11d), Formula (Ile), or Formula (IV), wherein each of the linkers independently has a structure of —(LJi—(L2ka—~(L*)xa—(L*)4—, wherein each of k1, k2, k3, and k4 is independently 0, 1 or 2, and each of the L!, L?, L? and L*is independently selected from oxo, ester, amide, amino, Ci-Cs alkylene, and -(CH2-CH2-0)1.3-. In some embodiments, the sum of k1, k2, k3, and k4 is an integer larger than or equal to 1. In some embodiments, the sum of k1, k2, k3, and k4 is an integer larger than or equal to 2. As one of ordinary skill in the art would recognize “N” references nitrogen and “vv” implies an attachment point.

[0237] In some embodiments of Formula (I), Formula (Ia), Formula (Ib), Formula (II), Formula (IIa), Formula (IIb), Formula (IIc), Formula (III), Formula (Ila), Formula (IIIb), Formula (Illc), Formula (111d), Formula (Ile), or Formula (IV), wherein each of the linkers independently has a structure of —(L Ja—(L2ke~(L*)ka~(L*)4—, wherein each of k1, k2, k3, and k4 is independently 0, 1 or 2, and each of the L!, L?, L? and L*is independently selected from -O-, -S-, $(=0)1.2-, -C(=0)-, -C(=8)-, -NR"-, -OC(=0)-, -C(=0)0-, -OC(=0)0-, - C(=0)NRL-, -OC(=0)NR"-, -NRL'C(=0)-, -NRLC(=0) NRL-, -P(=O)R%-, NRIS(=0)(=NRL)-, -NRLS(=0);-, -S(=0),NRL-, -N=N-, -(CH2-CH-0);.¢-, linear or branched Ci. alkylene, linear or branched C2.¢ alkenylene, linear or branched Ca.¢ alkynylene, C3—Cs cycloalkylene, C2—C7 heterocycloalkylene, Cs—Cio arylene, and Cs—Co heteroarylene, wherein the alkylene, alkenylene, alkynylene, cycloalkylene, cycloalkylene, arylene, or heteroarylene is substituted or unsubstituted, and wherein each R'is independently H, D, cyano, halogen, substituted or unsubstituted Ci-Cs alkyl, -CD3, -OCHs, - OCD, substituted or unsubstituted C1-Cs haloalkyl, substituted or unsubstituted Ci-Cs heteroalkyl, substituted or unsubstituted C3-Cs cycloalkyl, substituted or unsubstituted C>-C7 heterocycloalkyl, substituted or unsubstituted aryl, or substituted or unsubstituted heteroaryl. In some embodiments, each R" is independently H, substituted or unsubstituted C1-Cs alkyl, - OCH, substituted or unsubstituted C1-Cs haloalkyl, substituted or unsubstituted Ci-Cs heteroalkyl, substituted or unsubstituted C3-Cs cycloalkyl, or substituted or unsubstituted Ca- C7 heterocycloalkyl.

[0238] In some embodiments of Formula (I), Formula (Ia), Formula (Ib), Formula (II), Formula (Ila), Formula (IIb), Formula (IIc), Formula (IIT), Formula (IIIa), Formula (IIIb), Formula (I1lc), Formula (111d), Formula (IIe), or Formula (IV), each of the linkers H Ag Omo NAO independently comprises a structure selected from: [o} oO 0 q -. aN Fp St © Ko Oo H A, A, id o__ / NSA Howrey LL f HH ° : my WTF FN Oo Xo AYN H ENA o L N Ao 2b and SH Vm Wn land OY wherein each of the p, q, m, and n is independently 0, 1,2,3,4,5,6,7,8,9, 10, 11, 12, 14, 13, 15, 16, 17, 18, 19, or 20. In some embodiments, each of the p, q, m, and n is independently 0, 1, 2, 3, 4, or 5.

[0239] In some embodiments of Formula (I), Formula (Ia), Formula (Ib), Formula (II), Formula (Ila), Formula (IIb), Formula (IIc), Formula (IIT), Formula (IIIa), Formula (IIIb), Formula (IIIc), Formula (111d), Formula (Ile), or Formula (IV), wherein the “one or more linkers” referenced in the box of the foregoing formulas comprises a structure that is Lid 2 J ONAN TN ted be Ayia ry pe orion ° oo Yd NN NON NS reer A . ~ Pn 4 res hel © x vo H ON 0. % Lie ~ ) . ’ ° IS enn IY, ” oN TT 3 H % Oo AO > wv r H Oo oo Ad bd wooo . “be Repsol re T o . ~ a ONAN OL Ia eon oS ET So WL OA ad rr rr TT 7 OE Ji H Smo A os I p rip oe oO Orono . OAH Oo O. H a H N. r a Ny ON r H ~ es — A _— ~ of + Ao ONS 0 0 Am OANA AP EF OS HN Ao le cel © OU - H Ie Og NN o_ / r Ag © hd LOS 0 & er 2 N No 71 MN N NY : L “No Q Hop N 0 "od C0 Se N H ld I bn A, Se " ¥ 0 Mp! 2 a Ann IR p 0 | 7 H Onl or op 5 0 3 ts bed oy # HN. hi HN ON, N EE MW Aa iy . Apt Hy speller RASS Oo 0 ~ N © ° : } 3 BU SSNUSE. OANA Noor J 0 ! r Oo ~~ Oo HON" 0 me WNT Q H H bk enn fa x H Pe " JU Tg Py ] Fmd nina ’ i 5 hon) errr oo 0 H H oy a Lo B o., sin a dort I; oh HN HN. fama i o Se ° i BR H . rr A ONG Ryo o Arsgrmgnlypmion, L Irmo Kf © Ammann OH La : , or ing = H Vm Vn H Angora A on % KX oe . ; o Lo ee NN OS xey © 0 fm An H 0 HN odin ro % ©, wherein each of the p, q, m, and n is independently 0, 1, 2, 3,4,5,6,7,8,9,10, 11, 12, 14, 13, 15, 16, 17, 18, 19, or 20. In some embodiments, each of the p, q, m, and n is independently 0, 1, 2, 3, 4, or 5.

[0240] In some embodiments of Formula (I), Formula (Ia), Formula (Ib), Formula (II), Formula (Ila), Formula (IIb), Formula (IIc), Formula (III), Formula (IIIa), Formula (IIIb), Formula (Illc), Formula (111d), Formula (Ile), or Formula (IV), W comprises one or more modified DNA or RNA bases. The nucleobases can comprise any chemical modifications as described herein. In some embodiments, the nucleobases include a 2’-OH or 2’-OMe modification. For example, W may comprise one or more 2’-OMe modified adenine, cytosine, guanidine and uracil, referred to as (a) (c), (g), or (u). In some embodiments, a modified RNA, e.g. a gRNA or mRNA, includes at least 1, 2, 3,4, 5,6, 7, 8,9, 10, 11, 12, 13, 14, 15, 20, 25, 30, 35, 40, 50 or more modified nucleobases. In some embodiments, a modified RNA comprises one or more modified nucleobases near the 5° end, near the 3° end, or in the middle of the sequence. The modified nucleobases within a modified RNA may or may not be contiguous. In some embodiments, a modified RNA comprises one or more 2°- OMe modifications scattered along the length of the sequence. In some embodiments, a modified RNA comprises one or more 2’OH modifications scattered along the length of the sequence. In some embodiments, a modified RNA comprises alternating 2’-OH and 2’0OMe modifications. In some embodiments, W comprises (A)n, (T)n, (U)n, (a)n, or (u)n, wherein n is an integer no less than 3, wherein a is 2’-O-methyladenosine (2’-OMe A), and wherein u is 2’-O-methyluridine (2’-OMe-U). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 50 (SEQ ID NO: 118). In some embodiments, W comprises (u)n, wherein n is an integer from 3 to 20 (SEQ ID NO: 119) or 3 to 15 (SEQ ID NO: 120). In some embodiments, W comprises one or more nucleotide sequences that are complementary to a coupling sequence. In some embodiments, W comprises one or more guanines or cytidines. In some embodiments, W comprises at least 1,2, 3,4, 5,6, 7, 8,9, 10, 11, 12, 13, 14, 15, 20, 25, 30, 35, 40, 50 or more guanines or cytidines. In some embodiments, the one or more guanines or cytidines are complementary to one or more cytindines or guanines in a coupling sequence. In some embodiments, the guanines or cytidines are at the terminals of W or the coupling sequence. Not intended to be bound by any theory, it is contemplated that the guaninies-cytidine pairing forms “GC locks” or “CG locks” that would increase binding affinity. The guanines and / or cytidines in W or a coupling sequence may or may not be contiguous and may comprise any one of the chemical modifications as described herein, e.g. a 2’-OMe or 2°-OH modification. Receptor Targeting Conjugates

[0241] The key to fulfilling of nucleic acid-based therapy is the safe and efficacious delivery of payload to specific cell types and tissues. Lipid nanoparticles (LNPs) represent the most advanced non-viral drug delivery technological platforms in the present time. LNPs are physically able to pass through blood vessels and reach hepatocytes [Am. J. Pathol. 2010, 176,14-21]. It has also been revealed that apolipoprotein E (ApoE) proteins bind to the LNPs post PEG-lipid diffusion from the LNP surface with a near neutral charge in the blood stream, and function as an endogenous ligand against hepatocytes, which express the low-density lipoprotein receptor (LDLr) [Mol. Ther., 2010, 18, 1357-1364.]. It is accordingly envisioned that two key factors that control the efficient hepatic delivery of LNP are: 1) effective PEG- lipid shedding from LNP surface in blood serum and 2) ApoE binding to the LNP. The above endogenous ApoE-mediated LDLr-dependent LNP delivery route is not an effective path to achieve LNP-based hepatic gene delivery for the LDLr deficient patient population.

[0242] Described herein are LNPs comprising receptor targeting conjugates. Described herein are receptor targeting conjugates. The LNPs with targeting conjugates are constituted to have the receptor targeting moiety on the surface or periphery of the particle. In one aspect low mol % of the receptor targeting conjugate is used while constituting the targeting LNP to achieve low surface density of the targeting moiety on the surface / peripherry of the particle. In another aspect, high mol % of the receptor targeting conjugate is used while constituting the targeting LNP to achieve high surface density of the targeting moiety on the surface / peripherry of the particle. In another aspect, desired mol % of the receptor targeting conjugate is used to achieve a range of surface density of the targeting moiety on the surface / peripherry of the particle. In some embodiments, the receptor targeting conjugate comprises a targeting moiety (or ligand), a linker, and a lipophilic moiety that is connected to the targeting moiety. In some embodiments, the receptor targeting moiety (or ligand) targets a lectin receptor. In some embodiments, the lectin receptor is asialoglycoprotein receptor (ASGPR). In some embodiments the receptor targeting moiety is GalNAc or a derivative GalNAc that targets ASGPR. In one aspect the receptor targeting conjugate comprises of one GalNAc moiety or derivative thereof. In another aspect, the receptor targeting conjugate comprises of two GalNAc moieties or derivative thereof. In another aspect, the receptor targeting conjugate comprises of three GalNAc moieties or derivate thereof. In another aspect, the receptor targeting conjugate is lipophilic. In some embodiments, the receptor targeting conjugate comprises one or more GalNAc moieties and one or more lipid moieties, i.e., GalNAc-Lipid. In some embodiments, the receptor targeting conjugate is a GalNAc- Lipid.

[0243] The current disclosure provides tissue specific efficient LNP delivery to hepatocytes in an LDLr independent manner. The developed by the present disclosure trivalent GaNAc-moieties are attached to hydrophobic glycerol-based dialkyl lipids chain, sterol (cholesterol, for e.g.) and hydrophobic a-tocopherol through different PEG-spacers. These GalNAc conjugated lipids are then formulated with various excipients to yield LNPs that carry low to high surface density of the custom-designed GalNAc ligands to target the asialoglycoprotein receptor (ASGPR), which is highly expressed on the surface of hepatocytes.

[0244] The ligand on the surface of the engineered LNPs facilitates ASGPR-mediated tissue-specific uptake into hepatocytes. Different GalNAc-LNPs are constituted to circumvent ApoE biding and to enable GaINAc-ASGPR interaction to facilitate clathrin- mediated uptake into hepatocytes. Modulating PEG-shedding kinetics and modulating net surface charge density of GaNAc-LNP particles by using PEG-lipids described herein in combination with GalNAc-lipids with varying PEG-tethers yield GaINAc-LNPs that lack endogenous ApoE-binding characteristics to deliver particles that carry RNA-payloads specifically to hepatocytes of LDLR-deficient preclinical animal models at safe and efficacious dose. Dose-optimization in pre-clinical animal models further advance lead GalNACc-LNP (or LNPs) to clinical development to treat LDLR-deficient patient population to elicit genome-editing at therapeutically viable safe and efficacious dose.

[0245] Disclosed herein is a receptor targeting conjugate, comprising a compound of Formula (V): Formula (V) wherein, each of LL, L2 L3 L% L° LS L7 L% L° L! and L"? is independently substituted or unsubstituted C1-Ci2 alkylene, substituted or unsubstituted C:-Ci2 heteroalkylene, substituted or unsubstituted C2-Ci2 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, -(OCH2CH2)m-, -O-, -S-, -S(=0)-, -S(=0)2-, - S(=0)(=NR!})-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, -C(=0)C(=0)-, - C(=0)NR!-, -NRIC(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=0)NR!-, . S(=0):NR!-, -NR!S(=0);-, -NR!-, -N(OR!})-, -O[(P=0)0O"]0- or -O[(P=0)S]0- or a bond; Lis a bond, substituted or unsubstituted -(CHCH20)a-, substituted or unsubstituted - (OCH:CH2)a-, substituted or unsubstituted —-(CHz)a-, or a bond; each R! is independently H or substituted or unsubstituted C1-Csalkyl, R comprises a lipid; m is an integer selected from 1 to 10; and n is an integer selected from 1 to 200; wherein each of the A groups is a N- acetylgalactosamine moiety.

[0246] In some embodiments, L'! is -(CH,CH20)q- or -(OCH2CHz)n-.

[0247] In some embodiments of a compound of Formula (V), A binds to a lectin. In some embodiment, the lectin is an asialoglycoprotein receptor (ASGPR). In some embodiments, A comprises one or more N-acetylgalactosamine (GalNAc) or GalNAc derivatives.

[0248] In some embodiments, A is GalNAc. In some embodiments, A is or comprises galactose.

[0249] In some embodiments of a compound of Formula (V), each L!, L* and L’ is independently substituted or unsubstituted C1-Ci2 alkylene. In some embodiments of a compound of Formula (V), each L!, L*, and L” is independently substituted or unsubstituted C2-Cs alkylene. In some embodiments of a compound of Formula (V), each L!, L* and L is Cs alkylene.

[0250] In some embodiments of a compound of Formula (V), each L?, L*, and L¥is independently -C(=O)NR'-, -NR'C(=0)-, -OC(=0)NR'-, -NR'C(=0)O- or -NR'C(=0)NR-. In some embodiments of a compound of Formula (V), each L?, L°, and L® is independently - C(=0)NR'- or -NR'C(=0)-. In some embodiments of a compound of Formula (V), each L?, L?, and L?is -C(=O)NH-.

[0251] In some embodiments of a compound of Formula (V), each L*, L%, and L’ is independently substituted or unsubstituted C1-Ci2 alkylene. In some embodiments of a compound of Formula (V), each L? is substituted or unsubstituted C2-Cs alkylene. In some embodiments of a compound of Formula (V), L* is C4 alkylene. In some embodiments of a compound of Formula (V), each LS and L? is independently substituted or unsubstituted Cz- Co alkylene. In some embodiments of a compound of Formula (V), each L® and L’ is independently substituted or unsubstituted C2-Cs alkylene. In some embodiments of a compound of Formula (V), each L® and L? is C3 alkylene.

[0252] In some embodiments of a compound of Formula (V), R! is H. In some embodiments, R'is substituted or unsubstituted Ci-Csalkyl. In some embodiments, R'is methyl.

[0253] Disclosed herein is a receptor targeting conjugate, comprising a compound of Formula (VI): o ASL AUR A—-L4-L5-L® [a a Formula (VI) wherein, a plurality of the A groups collectively comprise a receptor targeting ligand;; each of L1, L2 L3 L% L% LS L7 L% L° L!° and L'?is independently substituted or unsubstituted C1-Ci2 alkylene, substituted or unsubstituted C:-Ci2 heteroalkylene, substituted or unsubstituted C2-Ci2 alkenylene, substituted or unsubstituted C2-Ci12 alkynylene, -(CH2CH20)m-, -(OCH2CH2)m-, -O-, -S-, -S(=0)-, -S(=0)2-, - S(=0)(=NR!})-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, -C(=0)C(=0)-, - C(=0)NR!-, -NR!C(=0)-, -OC(=O)NR!-, -NR!C(=0)0-, -NR!C(=O)NR!-, . C(=0)NR!C(=0)-, -S(=0);NR!-, -NR!S(=0),-, -NR!-, -N(OR})-, -O[(P=0)0"]0-, - O[(P=0)S"]0-, or a bond; L!! is substituted or unsubstituted -(CHCH20),-, substituted or unsubstituted - (OCH:CHz2)s-, substituted or unsubstituted -(CHz)n-, or a bond; each R! is independently H or substituted or unsubstituted C1-Csalkyl; Ris a lipid, nucleic acid, amino acid, protein, or lipid nanoparticle; m is an integer selected from 1 to 10; and n is an integer selected from 1 to 200.

[0254] In some embodiments, disclosed herein is a receptor targeting conjugate, comprising a compound of Formula (VI): “ormula (VI): o HNL LR ar A—L4-15-18 2 a-L? Formula (VI) wherein, a plurality of the A groups collectively comprise a receptor targeting ligand; each of LL, L2 L3, L% L° LS L7 L% L° L!°and L!?is independently substituted or unsubstituted C;-Ci2 alkylene, substituted or unsubstituted C;-Ci2 heteroalkylene, substituted or unsubstituted C2-Ci2 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, -(OCH2CH2)m-, -O-, -S-, -S(=0)-, -S(=0)2-, - S(=0)(=NR!})-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, -C(=0)C(=0)-, - C(=0)NR!-, -NRIC(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=0)NR!-, . C(=0)NR!C(=0)-, -S(=0):NR!-, -NR!S(=0),-, -NR!-, or -N(OR})-; L! is substituted or unsubstituted -(CH2CH20),- or substituted or unsubstituted - (OCH:CH2)n- ; each R! is independently H or substituted or unsubstituted C;-Csalkyl; Ris a lipid, nucleic acid, amino acid, protein, or lipid nanoparticle; m is an integer selected from 1 to 10; and n is an integer selected from 1 to 200.

[0255] In some embodiments, L'! is -(CH,CH20)q- or -(OCH2CHz)n-.

[0256] In some embodiments of a compound of Formula (VI), A binds to a lectin. In some embodiment, the lectin is an asialoglycoprotein receptor (ASGPR). In some embodiments, A comprises one or more N-acetylgalactosamine (GalNAc) or GalNAc derivatives.

[0257] In some embodiments of a compound of Formula (VI), A is N- acetylgalactosamine (GalNAc) or a derivative thereof. In some embodiments, A is GalNAc.

[0258] In some embodiments of a compound of Formula (VI), each L!, L¥ and L” is independently substituted or unsubstituted C1-Ci2 alkylene or substituted or unsubstituted Ci- C12 heteroalkylene.

[0259] In some embodiments of a compound of Formula (VI), each L!, L* and L" is independently substituted or unsubstituted C1-Ci2 heteroalkylene.

[0260] In some embodiments of a compound of Formula (VI), each L!, L* and L” is independently substituted or unsubstituted C1-Ci2 heteroalkylene comprising 1-10 O atoms.

[0261] In some embodiments of a compound of Formula (VI), each L!, L¥ and L” is independently -(CH2CH20)p1-(CHz)q1-; wherein p1 is 1-8; and ql is 1-6.

[0262] In some embodiments of a compound of Formula (VI), each L!, L* and Lis - (CH2CH20)3-(CHz2)2-.

[0263] In some embodiments of a compound of Formula (VI), each L!, L* and L" is independently substituted or unsubstituted C1-Ci2 alkylene.

[0264] In some embodiments of a compound of Formula (VI), each L!, L* and Lis independently substituted or unsubstituted C2-Cs alkylene.

[0265] In some embodiments of a compound of Formula (VI), each L!, L* and L7 is C4 alkylene.

[0266] In some embodiments of a compound of Formula (VI), each L?, L* and L®is independently -C(=0)NR!-, -NR!C(=0)-, -OC(=0)NR'-, -NR!C(=0)0-, -NR'C(=O)NR!-, or -C(=0)NR!C(=0)-.

[0267] In some embodiments of a compound of Formula (VI), each L?, L*, and L¥is independently -C(=0)NR!- or -NR!C(=0)-.

[0268] In some embodiments of a compound of Formula (VI), each L?, L5, and L¥is - NHC(=0)-.

[0269] In some embodiments of a compound of Formula (VI), each L? L, and Lis - C(=0)NH-.

[0270] In some embodiments of a compound of Formula (VI), each L?, L, and L? is independently substituted or unsubstituted C1-C12 heteroalkylene.

[0271] In some embodiments of a compound of Formula (VI), each L?, L, and L? is independently substituted or unsubstituted C1-Ci2 heteroalkylene comprising 1-10 O atoms.

[0272] In some embodiments of a compound of Formula (VI), each L?, LS, and L is independently -(CH2CH20)p2-(CH2CH2CH20)q2-; wherein p2 is 1-8; and q2 is 1-6. In some embodiments, p2 is 1. In some embodiments, p2 is 2. In some embodiments, p2 is 3. In some embodiments, p2 is 4. In some embodiments, p2 is 5. In some embodiments, p2 is 6. In some embodiments, p2 is 7. In some embodiments, p2 is 8. In some embodiments, q2 is 1. In some embodiments, q2 is 2. In some embodiments, g2 is 3. In some embodiments, q2 is 4. In some embodiments, q2 is 5. In some embodiments, q2 is 6.

[0273] In some embodiments of a compound of Formula (VI), each L3, LS, and L’ is - (CH2CH20)-(CH2CH,CH20)-.

[0274] In some embodiments of a compound of Formula (VI), each L3, LS, and L’ is independently -(CH2CH2CH20)q3-; wherein q3 is 1-8. In some embodiments, g3 is 1. In some embodiments, q3 is 2. In some embodiments, q3 is 3. In some embodiments, q3 is 4. In some embodiments, q3 is 5. In some embodiments, q3 is 6. In some embodiments, q3 is 7. In some embodiments, q3 is 8.

[0275] In some embodiments of a compound of Formula (VI), each L3, LS, and L’ is - (CH2CH2CH:0);-.

[0276] In some embodiments, a compound of Formula (VI) has a structure of Formula (VIa): 0 HN” SL10- 11=| 12-R AL ~_O a ALT +0 at A-LT-LA A Formula (VIa) wherein each q4 1s 1-10.

[0277] In some embodiments of a compound of Formula (VIb), q4 is 1-8. In some embodiments, q4 is 1-4. In some embodiments, q4 is 1-3. In some embodiments, q4 is 1. In some embodiments, q4 is 2. In some embodiments, q4 is 3. In some embodiments, q4 is 4. In some embodiments, q4 is 5.

[0278] In some embodiments of a compound of Formula (V) or Formula (VI), L'? is substituted or unsubstituted C1-Ci2 alkylene. In some embodiments, L'° is substituted or unsubstituted C1-Cs alkylene. In some embodiments, L!° is C; alkylene.

[0279] In some embodiments, a compound of Formula (VI) has a structure of Formula (VIb): o L! 1—12-R HN si ' A—L4-L5-L6 [i 8 A-U7t Formula (VIb) wherein, ris 1-4.

[0280] In some embodiments of a compound of Formula (VIb), ris 1, 2, or 3. In some embodiments, ris 1 or 2. In some embodiments, r is 2 or 3. In some embodiments, ris 1. In some embodiments, ris 2. In some embodiments, r is 3. In some embodiments, r is 4.

[0281] In some embodiments of a compound of Formula (V), Formula (VI), Formula (VIa), or Formula (VIb), L!! is -(OCH2CHa)s-. In some embodiments, n is 1-100. In some embodiments, n is 2-50. In some embodiments, n is 10-50. In some embodiments, n is 20-50. In some embodiments, n is 30-50. In some embodiments, n is 40-50. In some embodiments, n is 2, 12, 37, or 45. In some embodiments, n is 1. In some embodiments, n is 2. In some embodiments, n is 3. In some embodiments, n is 4. In some embodiments, n is 5. In some embodiments, n is 6. In some embodiments, n is 7. In some embodiments, n is 8. In some embodiments, nis 9. In some embodiments, n is 10. In some embodiments, n is 11. In some embodiments, n is 12. In some embodiments, n is 13. In some embodiments, n is 14. In some embodiments, n is 15. In some embodiments, n is 16. In some embodiments, n is 17. In some embodiments, n is 18. In some embodiments, n is 19. In some embodiments, n is 20. In some embodiments, nis 21. In some embodiments, n is 22. In some embodiments, n is 23. In some embodiments, n is 24. In some embodiments, n is 25. In some embodiments, n is 26. In some embodiments, n is 27. In some embodiments, n is 28. In some embodiments, n is 29. In some embodiments, n is 30. In some embodiments, n is 31. In some embodiments, n is 32. In some embodiments, n is 33. In some embodiments, n is 34. In some embodiments, n is 35. In some embodiments, n is 36. In some embodiments, n is 37. In some embodiments, n is 38. In some embodiments, n is 39. In some embodiments, n is 40. In some embodiments, n is 41. In some embodiments, n is 42. In some embodiments, n is 43. In some embodiments, n is 44. In some embodiments, n is 45. In some embodiments, n is 46. In some embodiments, n is 47. In some embodiments, n is 48. In some embodiments, n is 49. In some embodiments, n is 50. In some embodiments, n is at least 1. In some embodiments, n is at least 2. In some embodiments, n is at least 3. In some embodiments, n is at least 4. In some embodiments, n is at least 5. In some embodiments, n is at least 6. In some embodiments, n is at least 7. In some embodiments, n is at least 8. In some embodiments, n is at least 9. In some embodiments, n is at least 10. In some embodiments, n is at least 11. In some embodiments, n is at least 12. In some embodiments, n is at least 13. In some embodiments, n is at least 14. In some embodiments, n is at least 15. In some embodiments, n is at least 16. In some embodiments, n is at least 17. In some embodiments, n is at least 18. In some embodiments, n is at least 19. In some embodiments, n is at least 20. In some embodiments, n is at least 21. In some embodiments, n is at least 22. In some embodiments, n is at least 23. In some embodiments, n is at least 24. In some embodiments, n is at least 25. In some embodiments, n is at least 26. In some embodiments, n is at least 27. In some embodiments, n is at least 28. In some embodiments, n is at least 29. In some embodiments, n is at least 30. In some embodiments, n is at least 31. In some embodiments, n is at least 32. In some embodiments, n is at least 33. In some embodiments, n is at least 34. In some embodiments, n is at least 35. In some embodiments, n is at least 36. In some embodiments, n is at least 37. In some embodiments, n is at least 38. In some embodiments, n is at least 39. In some embodiments, n is at least 40. In some embodiments, n is at least 41. In some embodiments, n is at least 42. In some embodiments, n is at least 43. In some embodiments, n is at least 44. In some embodiments, n is at least 45. In some embodiments, n is at least 46. In some embodiments, n is at least 47. In some embodiments, n is at least 48. In some embodiments, n is at least 49. In some embodiments, n is at most 2. In some embodiments, n is at most 3. In some embodiments, n is at most 4. In some embodiments, n is at most 5. In some embodiments, n is at most 6. In some embodiments, n is at most 7. In some embodiments, n is at most 8. In some embodiments, n is at most 9. In some embodiments, n is at most 10. In some embodiments, n is at most 11. In some embodiments, n is at most 12. In some embodiments, n is at most 13. In some embodiments, n is at most 14. In some embodiments, n is at most 15. In some embodiments, nis at most 16. In some embodiments, n is at most 17. In some embodiments, n is at most 18. In some embodiments, n is at most 19. In some embodiments, n is at most 20. In some embodiments, n is at most 21. In some embodiments, n is at most 22. In some embodiments, nis at most 23. In some embodiments, n is at most 24. In some embodiments, n is at most 25. In some embodiments, n is at most 26. In some embodiments, n is at most 27. In some embodiments, n is at most 28. In some embodiments, n is at most 29. In some embodiments, nis at most 30. In some embodiments, n is at most 31. In some embodiments, n is at most 32. In some embodiments, n is at most 33. In some embodiments, n is at most 34. In some embodiments, n is at most 35. In some embodiments, n is at most 36. In some embodiments, nis at most 37. In some embodiments, n is at most 38. In some embodiments, n is at most 39. In some embodiments, n is at most 40. In some embodiments, n is at most 41. In some embodiments, n is at most 42. In some embodiments, n is at most 43. In some embodiments, nis at most 44. In some embodiments, n is at most 45. In some embodiments, n is at most 46. In some embodiments, n is at most 47. In some embodiments, n is at most 48. In some embodiments, n is at most 49. In some embodiments, n is at most 50.

[0282] In some embodiments of a compound of Formula (V), Formula (VI), Formula (VIa), or Formula (VIb), L'? is -O-, -C(=0)0-, -C(=0)NR'-, -NR!C(=0)-, or -NR'C(=0)O-. In some embodiments, L'? is -C(=0)O- or -NR!C(=0)O-. In some embodiments, L'?is - C(=0)0-. In some embodiments, L'? is -NHC(=0)O-. In some embodiments, L's - NHC(=0)-.

[0283] In some embodiments of a compound of Formula (VI), Formula (VIa), or Formula (VIb), R! is H. In some embodiments, R! is substituted or unsubstituted C;-Csalkyl. In some embodiments, R! is methyl.

[0284] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L!is substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-C12 alkynylene, -(CH2CH20)m-, (OCH2CH2)m-, - 0-, -S-, -8(=0)-, -S(=0)z-, -S(=0)(=NR!)-, -C(=0)-, -C(=N-OR')-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!~, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=O)NR!-, - C(=0)NR'C(=0)-, -8(=0):NR!-, -NR'S(=0);-, -NR!-, -N(OR")-, -O[(P=0)0"]O-, - O[(P=0)S"]0-, or a bond. In some embodiments, L' is substituted or unsubstituted C1-Ci2 alkylene. In some embodiments, L!is substituted or unsubstituted Ci-C 2 heteroalkylene. In some embodiments, L! is substituted or unsubstituted C2-C12 alkenylene. In some embodiments, L! is substituted or unsubstituted C2-C12 alkynylene. In some embodiments, L! is (CH2CH20)m- or -(OCH2CH2)m-. In some embodiments, L!is -O-. In some embodiments, L'is -S-. In some embodiments, L'is -S(=0)-. In some embodiments, L! is -S(=0).-. In some embodiments, Lis -S(=0)(=NR')-. In some embodiments, L' is -C(=0)-. In some embodiments, L'is -C(=N-OR!)-. In some embodiments, L!is -C(=0)O-. In some embodiments, L'is OC(=0)-. In some embodiments, Lis -C(=0)C(=0)-. In some embodiments, L'is -C(=O)NR!-. In some embodiments, L' is -NR!C(=0)-. In some embodiments, Lis -OC(=0)NR!-. In some embodiments, L!is -NR'C(=0)O-. In some embodiments, Lis -NR'C(=0)NR'-. In some embodiments, Lis -C(=0)NR'C(=0)-. In some embodiments, L! is -S(=0)NR!-. In some embodiments, L! is -NR'S(=0).-. In some embodiments, L'is -NR!-. In some embodiments, Lis -N(OR')-. In some embodiments, L' is -O[(P=0)0"]0-. In some embodiments, L' is -O[(P=0)S"]O-. In some embodiments, L'is a bond.

[0285] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L?is substituted or unsubstituted Ci-C12 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-C12 alkynylene, -(CH2CH20)m-, (OCH2CH2)m-, - 0-, -S-, -8(=0)-, -S(=0)2-, -S(=0)(=NR!)-, -C(=0)-, -C(=N-OR!)-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!-, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)O-, -NR!C(=O)NR!-, - C(=0)NR'C(=0)-, -S(=0)2NR!-, -NR'S(=0)z-, -NR!-, -N(OR")-, -O[(P=0)0"]0-, - O[(P=0)S"]0-, or a bond. In some embodiments, L?is substituted or unsubstituted C1-C12 alkylene. In some embodiments, L?is substituted or unsubstituted Ci-Ci2 heteroalkylene. In some embodiments, L?is substituted or unsubstituted C,-Ci2 alkenylene. In some embodiments, L2is substituted or unsubstituted C2-C12 alkynylene. In some embodiments, L? is -(CH2CH20)m- or -(OCH2CHa)m-. In some embodiments, L?is -O-. In some embodiments, L?is -S-. In some embodiments, L?is -S(=0)-. In some embodiments, L?is -S(=0),-. In some embodiments, L?is -S(=0)(=NR')-. In some embodiments, L2is -C(=0)-. In some embodiments, L?is -C(=N-OR!)-. In some embodiments, L?is -C(=0)O-. In some embodiments, L?is OC(=0)-. In some embodiments, L?is -C(=0)C(=0)-. In some embodiments, L?is -C(=O)NR!-. In some embodiments, L2is -NR!C(=0)-. In some embodiments, L? is -NRHC(=0)-. In some embodiments, Lis -OC(=0)NR'-. In some embodiments, L?is -NR!C(=0)O-. In some embodiments, L?is -NR'C(=0)NR'-. In some embodiments, L2is -C(=0)NR!C(=0)-. In some embodiments, L?is -S(=0);NR!-. In some embodiments, L?is -NR!S(=0),-. In some embodiments, L?is -NR'-. In some embodiments, L?is -N(OR!)-. In some embodiments, L?is -O[(P=0)0"]O-. In some embodiments, L?is - O[(P=0)S]0-. In some embodiments, L2is a bond.

[0286] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L*is substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, (OCH2CHz)m-, - 0-, -S-, -8(=0)-, -8(=0)z-, -S(=0)=NR!)-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!~, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=O)NR!-, - C(=0)NR!C(=0)-, -S(=0);NR!-, -NR!S(=0);-, -NR!-, -N(OR)-, -O[(P=0)0"]0-, - O[(P=0)S"]0-, or a bond. In some embodiments, L* is substituted or unsubstituted C1-C12 alkylene. In some embodiments, L*is an unsubstituted Cs.4 alkylene. In some embodiments, L*is an unsubstituted Ci.4 alkylene. In some embodiments, L? is substituted or unsubstituted C1-Ci2 heteroalkylene. In some embodiments, L* is substituted or unsubstituted C2-C12 alkenylene. In some embodiments, L*is substituted or unsubstituted C2-C2 alkynylene. In some embodiments, L? is -(CH2CH20)m- or (OCH2CH2)m-. In some embodiments, L*is -O-. In some embodiments, L*is -S-. In some embodiments, L*is -S(=0)-. In some embodiments, L3is -S(=0)2-. In some embodiments, Lis -S(=0)(=NR!)-. In some embodiments, L3is - C(=0)-. In some embodiments, Lis -C(=N-OR!)-. In some embodiments, L*is -C(=0)O-. In some embodiments, L* is OC(=0)-. In some embodiments, L*is -C(=0)C(=0)-. In some embodiments, L*is -C(=O)NR!-. In some embodiments, L* is -NR!C(=0)-. In some embodiments, Lis -OC(=0)NR'-. In some embodiments, Lis -NR'C(=0)O-. In some embodiments, Lis -NR'C(=0)NR'-. In some embodiments, L* is -C(=0)NR'C(=0)-. In some embodiments, L? is -S(=0):NR!-. In some embodiments, L*is -NR!S(=0)-. In some embodiments, Lis -NR!-. In some embodiments, L*is -N(OR!)-. In some embodiments, L* is -O[(P=0)0"]0-. In some embodiments, L*is -O[(P=0)S"]O-. In some embodiments, Lis a bond.

[0287] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L*is substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, (OCH2CH2)m-, - 0-, -S-, -8(=0)-, -S(=0)2-, -S(=0)(=NR')-, -C(=0)-, -C(=N-OR!)-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!~, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=O)NR!-, - C(=0)NR'C(=0)-, -S(=0):NR!-, -NR!S(=0);-, -NR-, -N(OR')-, -O[(P=0)0"]O-, - O[(P=0)S"]0-, or a bond. In some embodiments, L*is substituted or unsubstituted C1-C12 alkylene. In some embodiments, L*is an unsubstituted C4 alkylene. In some embodiments, L*is substituted or unsubstituted C;-Ci2 heteroalkylene. In some embodiments, L*is substituted or unsubstituted C2-Ci2 alkenylene. In some embodiments, L*is substituted or unsubstituted C-C12 alkynylene. In some embodiments, L*is -(CH2CH20)m- or - (OCH;CHz)m-. In some embodiments, L*is -O-. In some embodiments, L*is -S-. In some embodiments, L*is -S(=0)-. In some embodiments, L*is -S(=0)2-. In some embodiments, L* is -S(=0)(=NR!)-. In some embodiments, L*is -C(=0)-. In some embodiments, L*is -C(=N- OR!)-. In some embodiments, L*is -C(=0)O-. In some embodiments, L*is OC(=0)-. In some embodiments, L*is -C(=0)C(=0)-. In some embodiments, L*is -C(=0)NR'-. In some embodiments, L*is -NR'C(=0)-. In some embodiments, L*is -OC(=0)NR'-. In some embodiments, L*is -NR!C(=0)O-. In some embodiments, L*is -NR'C(=0)NR'-. In some embodiments, L*is -C(=0)NR!C(=0)-. In some embodiments, L*is -S(=0):NR!-. In some embodiments, L*is -NR'S(=0),-. In some embodiments, L*is -NR!-. In some embodiments, L*is -N(OR!)-. In some embodiments, L* is -O[(P=0)O0"]O-. In some embodiments, L* is - O[(P=0)S"]0-. In some embodiments, L*is a bond.

[0288] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L* is substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C>-Ci2 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, (OCH2CHz)m-, - 0-, -8-, -8(=0)-, -S(=0)z-, -S(=0)(=NR!)-, -C(=0)-, -C(=N-OR')-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!-, -NR!C(=0)-, -OC(=0)NR'-, -NR'C(=0)O-, -NR'C(=O)NR'-, - C(=0)NR'C(=0)-, -S(=0):NR!-, -NR'S(=0);-, -NR!-, -N(OR")-, -O[(P=0)0"]O-, - O[(P=0)S"]0-, or a bond. In some embodiments, L* is substituted or unsubstituted C;-Ci2 alkylene. In some embodiments, L*is substituted or unsubstituted Ci-Ci2 heteroalkylene. In some embodiments, L* is substituted or unsubstituted C2-Ci2 alkenylene. In some embodiments, L*is substituted or unsubstituted C2-C12 alkynylene. In some embodiments, L* is (CH2CH20)m- or -(OCH2CH2)m-. In some embodiments, L*is -O-. In some embodiments, L%is -S-. In some embodiments, L* is -S(=0)-. In some embodiments, L* is -S(=0),-. In some embodiments, L*is -S(=0)(=NR')-. In some embodiments, L*is -C(=0)-. In some embodiments, Lis -C(=N-OR!)-. In some embodiments, L*is -C(=0)O-. In some embodiments, L*is OC(=0)-. In some embodiments, Lis -C(=0)C(=0)-. In some embodiments, L*is -C(=O)NR!-. In some embodiments, L* is -NR!C(=0)-. In some embodiments, L2 is -NRHC(=0)-. In some embodiments, L® is -OC(=0)NR!'-. In some embodiments, L*is -NR!C(=0)O-. In some embodiments, L*is -NR'C(=O)NR!-. In some embodiments, L*is -C(=0)NR!C(=0)-. In some embodiments, L* is -S(=0):NR!-. In some embodiments, L*is -NR'S(=0),-. In some embodiments, L*is -NR!-. In some embodiments, L%is -N(OR')-. In some embodiments, L* is -O[(P=0)0"]O-. In some embodiments, L* is - O[(P=0)S"]0-. In some embodiments, L® is a bond.

[0289] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), Lis substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, (OCH2CHz)m-, - 0-, -S-, -8(=0)-, -8(=0)2-, -S(=0)(=NR!)-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!-, -NR!C(=0)-, -OC(=0)NR'-, -NR'C(=0)O-, -NR'C(=O)NR'-, - C(=0)NR!C(=0)-, -8(=0):NR!-, -NR!S(=0)z-, -NR!-, -N(OR})-, -O[(P=0)0"]0-, - O[(P=0)S"]0-, or a bond. In some embodiments, LSis substituted or unsubstituted C;-Ci2 alkylene. In some embodiments, L®is an unsubstituted Cs.4 alkylene. In some embodiments, Lis an unsubstituted Ci.4 alkylene. In some embodiments, Lis substituted or unsubstituted C1-Ci2 heteroalkylene. In some embodiments, L¢is substituted or unsubstituted C2-C12 alkenylene. In some embodiments, Léis substituted or unsubstituted C2-C2 alkynylene. In some embodiments, L® is -(CH2CH20)m- or (OCH2CH2)m-. In some embodiments, Léis -O-. In some embodiments, L%is -S-. In some embodiments, Lis -S(=0)-. In some embodiments, LSis -S(=0),-. In some embodiments, Lis -S(=0)(=NR')-. In some embodiments, L’is - C(=0)-. In some embodiments, Lis -C(=N-OR')-. In some embodiments, L¢is -C(=0)0-. In some embodiments, Léis OC(=0)-. In some embodiments, L¢is -C(=0)C(=0)-. In some embodiments, Lis -C(=0)NR'-. In some embodiments, Lis -NR!C(=0)-. In some embodiments, L%is -OC(=0)NR!-. In some embodiments, L®is -NR'C(=0)O-. In some embodiments, L®is -NR'C(=0)NR'-. In some embodiments, L®is -C(=0)NR'C(=0)-. In some embodiments, Léis -S(=0):NR!-. In some embodiments, L¢is -NR!S(=0).-. In some embodiments, L%is -NR!-. In some embodiments, L¢is -N(OR!)-. In some embodiments, LS is -O[(P=0)O"]O-. In some embodiments, LS is -O[(P=0)S"]O-. In some embodiments, L®is a bond.

[0290] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), Lis substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, (OCH2CH2)m-, - 0-, -S-, -8(=0)-, -8(=0)2-, -S(=0)(=NR)-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR'-, -NR'C(=0)-, -OC(=0)NR'-, -NR'C(=0)O-, -NR'C(=0)NR'-, - C(=0)NR'C(=0)-, -S(=0)2NR!-, -NR'S(=0)z-, -NR!-, -N(OR")-, -O[(P=0)0"]0-, - O[(P=0)S"]O-, or a bond. In some embodiments, L” is substituted or unsubstituted C1-Ci2 alkylene. In some embodiments, Lis an unsubstituted Cs alkylene. In some embodiments, Lis substituted or unsubstituted C;-Ci2 heteroalkylene. In some embodiments, Lis substituted or unsubstituted C2-Ci2 alkenylene. In some embodiments, Lis substituted or unsubstituted C»-C2 alkynylene. In some embodiments, L” is -(CH;CH20)m- or - (OCHzCHz)m-. In some embodiments, Lis -O-. In some embodiments, L’is -S-. In some embodiments, Lis -S(=0)-. In some embodiments, Lis -S(=0)z-. In some embodiments, L” is -S(=0)(=NR!)-. In some embodiments, L’is -C(=0)-. In some embodiments, L”is -C(=N- OR')-. In some embodiments, L’ is -C(=0)O-. In some embodiments, Lis OC(=0)-. In some embodiments, Lis -C(=0)C(=0)-. In some embodiments, L’is -C(=0)NR'-. In some embodiments, Lis -NR'C(=0)-. In some embodiments, L’is -OC(=0)NR'-. In some embodiments, L’is -NR!C(=0)O-. In some embodiments, Lis -NR'C(=0)NR'-. In some embodiments, Lis -C(=0)NR!C(=0)-. In some embodiments, Lis -S(=0):NR!-. In some embodiments, Lis -NR'S(=0),-. In some embodiments, L’is -NR'-. In some embodiments, L’is -N(OR!)-. In some embodiments, L” is -O[(P=0)0"]O-. In some embodiments, L” is - O[(P=0)S]0-. In some embodiments, L7 is a bond.

[0291] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), Lis substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, -(OCH2CH2)m-, - 0-, -S-, -8(=0)-, -S(=0)2-, -S(=0)(=NR')-, -C(=0)-, -C(=N-OR!)-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!~, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=O)NR'-, - C(=0)NR'C(=0)-, -S(=0)2NR!-, -NR'S(=0)z-, -NR!-, -N(OR")-, -O[(P=0)0"]0-, - O[(P=0)S"]0- or a bond. In some embodiments, L?is substituted or unsubstituted C1-C12 alkylene. In some embodiments, L¥is substituted or unsubstituted Ci-Ci2 heteroalkylene. In some embodiments, L¥is substituted or unsubstituted C,-Ci2 alkenylene. In some embodiments, L¥is substituted or unsubstituted C2-C12 alkynylene. In some embodiments, L® is (CH2CH20)m- or -(OCH2CH2)m-. In some embodiments, L¥is -O-. In some embodiments, L%is -S-. In some embodiments, L¥is -S(=0)-. In some embodiments, L¥is -S(=0),-. In some embodiments, L¥is -S(=0)(=NR')-. In some embodiments, L¥is -C(=0)-. In some embodiments, L¥is -C(=N-OR!)-. In some embodiments, L?is -C(=0)O-. In some embodiments, Lis OC(=0)-. In some embodiments, L8is -C(=0)C(=0)-. In some embodiments, Lis -C(=O)NR'-. In some embodiments, L®is -NR'C(=0)-. In some embodiments, Lis -OC(=0)NR!-. In some embodiments, L®is -NR'C(=0)O-. In some embodiments, L? is -NRHC(=0)-. In some embodiments, Lis -NR'C(=0)NR'-. In some embodiments, Lis -C(=0)NR'C(=0)-. In some embodiments, L*is -S(=0);NR!-. In some embodiments, L¥is -NR'S(=0),-. In some embodiments, L®is -NR!-. In some embodiments, L%is -N(OR!)-. In some embodiments, L? is -O[(P=0)0"]O-. In some embodiments, L® is - O[(P=0)S"]0-. In some embodiments, L? is a bond.

[0292] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L?is substituted or unsubstituted Ci-Ci2 alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-C12 alkynylene, -(CH2CH20)m-, (OCH2CH2)m-, - 0-, -S-, -8(=0)-, -8(=0)z-, -S(=0)=NR!)-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!~, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)0-, -NR!C(=O)NR!-, - C(=0)NR!C(=0)-, -8(=0):NR!-, -NR!S(=0)z-, -NR!-, -N(OR})-, -O[(P=0)0"]0-, - O[(P=0)S"]0-, or a bond. In some embodiments, L’ is substituted or unsubstituted C;-Ci2 alkylene. In some embodiments, Lis an unsubstituted C3.4 alkylene. In some embodiments, L®is an unsubstituted Ci.4 alkylene. In some embodiments, L’ is substituted or unsubstituted C1-Ci2 heteroalkylene. In some embodiments, L° is substituted or unsubstituted C2-C12 alkenylene. In some embodiments, L° is substituted or unsubstituted C-C12 alkynylene. In some embodiments, L? is -(CH2CH20)m- or (OCH;CHz)m-. In some embodiments, L° is -O-. In some embodiments, L’is -S-. In some embodiments, L’ is -S(=0)-. In some embodiments, L?is -S(=0)2-. In some embodiments, Lis -S(=0)(=NR!)-. In some embodiments, L’is - C(=0)-. In some embodiments, Lis -C(=N-OR!)-. In some embodiments, Lis -C(=0)O-. In some embodiments, L°is OC(=0)-. In some embodiments, L’is -C(=0)C(=0)-. In some embodiments, L?is -C(=O)NR!-. In some embodiments, L’ is -NR!C(=0)-. In some embodiments, L’is -OC(=0)NR'-. In some embodiments, Lis -NR'C(=0)O-. In some embodiments, L?is -NR!C(=0)NR'-. In some embodiments, Lis -C(=0)NR'C(=0)-. In some embodiments, Lis -S(=0):NR!-. In some embodiments, L’ is -NR'S(=0)-. In some embodiments, Lis -NR!-. In some embodiments, L°is -N(OR!)-. In some embodiments, L° is -O[(P=0)O"]O-. In some embodiments, L® is -O[(P=0)S]O-. In some embodiments, L’ is abond.

[0293] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L'is substituted or unsubstituted C1-Ci2 alkylene, substituted or unsubstituted C;-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-Ci2 alkynylene, -(CH2CH20)m-, -(OCH2CH2)m-, - 0-, -S-, -8(=0)-, -8(=0)2-, -S(=0)(=NR!)-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR!-, -NR!C(=0)-, -OC(=0)NR!-, -NR!C(=0)O-, -NR!C(=O)NR!-, - C(=0)NR'C(=0)-, -S(=0):NR!-, -NR'S(=0);-, -NR!-, -N(OR")-, -O[(P=0)0"]O-, - O[(P=0)S"]0-, or a bond. In some embodiments, L'°is substituted or unsubstituted C1-C12 alkylene. In some embodiments, L'%is substituted or unsubstituted C-Ci2 heteroalkylene. In some embodiments, L'%is substituted or unsubstituted C-Ci2 alkenylene. In some embodiments, L's substituted or unsubstituted C-C2 alkynylene. In some embodiments, L' is -(CH2CH20)m- or -(OCH2CHz)m-. In some embodiments, L'%is -O-. In some embodiments, L'%is -S-. In some embodiments, L'°is -S(=0)-. In some embodiments, L'%is -$(=0)2-. In some embodiments, L'%is -S(=0)(=NR!)-. In some embodiments, L'°is - C(=0)-. In some embodiments, L'%is -C(=N-OR!)-. In some embodiments, L'°is -C(=0)O-. In some embodiments, L'®is OC(=0)-. In some embodiments, L'°is -C(=0)C(=0)-. In some embodiments, L'%is -C(=0)NR!-. In some embodiments, L'°is -NR'C(=0)-. In some embodiments, L'%is -OC(=0)NR'-. In some embodiments, L'?is -NR'C(=0)O-. In some embodiments, L'%is -NR'C(=0)NR'-, In some embodiments, L'°is -C(=O)NR'C(=0)-. In some embodiments, L'%is -S(=0);NR!-. In some embodiments, L'°is -NR!S(=0),-. In some embodiments, L'%is -NR!-. In some embodiments, L'°is -N(OR!)-. In some embodiments, L' is -O[(P=0)0"]0-. In some embodiments, L! is -O[(P=0)S"]O-. In some embodiments, L'"is substituted or unsubstituted C;-Cs alkylene. In some embodiments, L's substituted or unsubstituted C1-C alkylene. In some embodiments, L's substituted or unsubstituted C,-C3 alkylene. In some embodiments, L'°is -CH2CHz-. In some embodiments, L'°is a bond.

[0294] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L'! is substituted or unsubstituted -(CH2CH20)n-, substituted or unsubstituted (OCH2CHa)n-, substituted or unsubstituted (CHz)a-, or bond. In some embodiments, L!! is substituted or unsubstituted -(CH2CH20)n-. In some embodiments, L! is substituted or unsubstituted -(OCH2CH)a-. In some embodiments, L!! is substituted or unsubstituted ~(CHz)s-. In some embodiments, L!! is a bond. In some embodiments, n is 30 to 50. In some embodiments, n is 30 to 40. In some embodiments, n is 40 to 50.

[0295] In accordance with the foregoing referenced formulas, in some embodiments of a compound of Formula (V) or (VI), L'?is substituted or unsubstituted C1-Ci, alkylene, substituted or unsubstituted C1-Ci2 heteroalkylene, substituted or unsubstituted C2-C12 alkenylene, substituted or unsubstituted C2-C12 alkynylene, -(CH2CH20)m-, (OCH2CH2)m-, - 0-, -S-, -8(=0)-, -8(=0)2-, -S(=0)(=NR)-, -C(=0)-, -C(=N-OR})-, -C(=0)0-, -OC(=0)-, - C(=0)C(=0)-, -C(=0)NR'-, -NR'C(=0)-, -OC(=0)NR'-, -NR'C(=0)O-, -NR'C(=0)NR'-, - C(=0)NR!C(=0)-, -S(=0);NR!-, -NR!S(=0);-, -NR!-, -N(OR})-, -O[(P=0)0"]O-, - O[(P=0)S"]O-, or a bond. In some embodiments, L'?is substituted or unsubstituted C1-C12 alkylene. In some embodiments, L'?is substituted or unsubstituted Ci-Ci2 heteroalkylene. In some embodiments, L'?is substituted or unsubstituted C2-C12 alkenylene. In some embodiments, L'?is substituted or unsubstituted C-C2 alkynylene. In some embodiments, L'? is -(CH2CH20)m- or -(OCH2CHz)m-. In some embodiments, L'?is -O-. In some embodiments, L'2is -S-. In some embodiments, L'2is -S(=0)-. In some embodiments, L'?is -S(=0...

Claims

CLAIMS 1. A lipid nanoparticle encapsulating a payload comprising one or more pharmaceutically active agents, for use in a method for reducing the risk of coronary disease; wherein the lipid nanoparticle further comprises a receptor targeting conjugate of Formula V): Formula (V) wherein, each of L!, L2 1% L* L5 LS L7, L8 L?, L!° and L'?is independently substituted or unsubstituted C1-Ci2 alkylene, substituted or unsubstituted Ci-Ci2 heteroalkylene, substituted or unsubstituted C,-Ci2 alkenylene, substituted or unsubstituted C2-C12 alkynylene, - (CH2CH20)m-, (OCH2CH2)m-, -O-, -S-, -8(=0)-, -S(=0)2-, -S(=0)(=NR})-, -C(=0)-, -C(=N- OR!)-, -C(=0)0-, -OC(=0)-, -C(=0)C(=0)-, -C(=0)NR!-, -NR!C(=0)-, -OC(=O)NR'-, - NR!C(=0)0-, -NR!C(=O)NR'-, -S(=0);NRL-, -NR!'S(=0)2-, -NR'-, or -N(OR')-; L!! is a bond, substituted or unsubstituted -(CH2CH20),- or substituted or unsubstituted - (OCH2CH2)n-; each R! is independently H or substituted or unsubstituted C;-Cs alkyl; R comprises a lipid; m is an integer selected from 1 to 10; and n is an integer selected from 1 to 200; wherein each of the A groups is a N-acetylgalactosamine moiety.

2. A lipid nanoparticle for use of claim 1, wherein a) each of L', L3 L* and L7 comprises unsubstituted Ci-Cs alkylene; b) each of L?, L*, and L® comprises -C(=0)NH- or -NHC(=0)-; c) each of L® and L° comprises unsubstituted Ci-Cs alkylene; d) Lis -(CH2)1.3-, -CH,CH,O- or -CH;0O-; e) Lis -(CH2CH20)s- or -(OCH2CH2)n-, where n is an integer selected from 1 to 50; f) Lis -NH(CO)O-; and g) Ris selected from the group consisting of dialkylglycerol, diacylglycerol, sterol, n- alkyl comprising C10-C3o carbon atoms, branched alkyl comprising C10-C3o carbon atoms or tocopherol.

3. A lipid nanoparticle for use of claim 1, wherein the receptor targeting conjugate is a conjugate is selected from the following: HO wd — & wi : EY whole hE PLL "<8 wo SSE Ay AGN TT 1001, wherein each of the p and q is independently an integer from 1 to 5, and n is an integer from 1 to 50; o Ho I Romo 0a I ini rmiiin HO _oH AN wth HO oH vo SS re aA HO OH wo Sf AoHN’ Aa = 1002; i — 2p I oocoeeee Nias ME ean Ao HO oH wo lp AHN AHN” 1003; Ho leo Tamanna, 0d I~ oR OANANAANANAANAS Jory ME wean Ao HO oH no JB AcHN’ 1004; STB Bp TO LL wih Cr Con Ag HO oH PY AcHN’ AN 100s; 4, drat monn Pt " BANAAANAAANAAS Cee ; wo io ACH! aN 1006, wherein n is an integer from 1 to 50; WT ee wo iFo AHN TT 1007; wh rey Mean A woo Jn, ho / AHN 1008; Ho, do of romm wd I I wh ? Seman wih Hires. won A HO oH 0. J; ar a 1009; lpg Bor 15 Cre Tee ys wv AHN 1010; wo Sn AcHN nit 2b A wth CLT TSG, o AHN TT 1011, wherein each of the p and q is independently an integer from 1 to 5, and n is an integer from 1 to 50; HO _oH NN AcH! 0 odo A srart SE ACH SON wih NET HO _oH Ao oe 101 HO _oH ho So ACHN’ AHN 1012; Q at TT Ho OH HN 1 peo wih ET HO _oH Ao modo 1013; OH vo SP AcHN’ 1014; AHN” 1013; . . Sole pA as wd IX SEG ES ACHN on Ro od 1014; HO oH HO. 0, 'AcHN’ o 0 » 0 o tS 2 TELE N 2 wo fo 2X ye ARN “So 10 AGHN 1013, wherein n is an integer from 1 to 50; OH HO. 0, AHN’ o pt ST a WIG ET AcHN’ 5 Ao ot 10 vo EF AHN AHN 1016, Ho oH AL WF 1 HO, o 0 RP - BBN wl TPT odSh_ AHN 1017; HO _oH wo SNe AcHN’ 1018; aa 1017; ET HO OH ° Se Fo “ why of 2 wi i HO OH 0 of To 1018; OH o— AcHI 1019; oon . a tT ogo Soo IG VE AN o A od ~ 10: IE a HO LOH I~ Sp A x 0 a rd AHN ow Hy Cea Ao HO _oH Ho AHN’ AHN 1060, wherein each of the p and q is independently an integer from 1 to 5, and n is an integer from 1 to 50; 9s 2 2 cn rT 39 ri work ro 1 HO oH wo JX Po_ AcHN’ AHN” TT 1065, wherein each of the p and q is independently an integer from 1 to 5, and nis an integer from 1 to 50; wg Ae ¥ 3 y . yi CE: eon A H HC 0 AcHN’ AHN 1066, wherein each of the p and q is independently an integer from 1 to 5, and n is an integer from 1 to 50; EN me Hoy 1075; Sv SO I Sa Fr 1076: Ep RT : w= il Nom Beng Omg Eng Bang Aman Ta fr AF STATE Hy 1078; ony rrr EB Saat Foy 1079; Be rn = rr X PT Se Sir Sty Foy 1080; 1081. IG, Among Amn 3G, EA 1082, or 3 ny eyes ‘wherein n is an integer from 1-50; Ho PM *1 1083; ; Jr FG To Ho Ho. 2 Q 5 ™ Ho PH a 1084; H 5b NAA AAA a APA and “a On Ho PH °™ nn pL EY rr he “ " ° 1085.

4. A lipid nanoparticle for use of claim 3, wherein the receptor targeting conjugate is o HO OH 0 aol Apsprgmamumonammamansrs 0 % N wry On ASASASAS HO oH EA AcHN’ HO 5 Ao HO 3 AHN’ ANT 1004. 3 A lipid nanoparticle for use of claim 3, wherein the receptor targeting conjugate is o woh 1. whoa don mon ol YT CAAA OH Nr! wih mT won Ag HO _OH wo fh AN TT , wherein pis 2, q is 2, and nis 35. H H AHN. ~ 6. A lipid nanoparticle for use of claim 3, wherein the receptor targeting conjugate is 0° JO dp Tire H ~o, wih LY WIHT . TINT wharain a H wo in _ ARN 1001, wherein each of p and q is 1-5, and wherein n is 30-40.

7. A lipid nanoparticle for use of claim 3, wherein each p and q are 2.

8. A lipid nanoparticle for use of claim 1, wherein n is 30 to 40.

9. A lipid nanoparticle for use of any one of claims 1-6, wherein the lipid further comprises two or more of the receptor targeting conjugates.

10. A lipid nanoparticle for use of claim 9, wherein the two or more of the receptor targeting conjugates have n of 30 to 50.

11. A lipid nanoparticle for use of claim 9, wherein the two or more of the receptor targeting conjugates comprise wh Jes whorl mymmm— K Le, On wih HO olf no Jf AcHN’ AGHNT 1004.

12. Alipid nanoparticle for use of claim 9, wherein the two or more of the receptor targeting conjugates comprise 230 dip re GL Two Ao HO _OH wo fh AN TT , wherein pis 2, q is 2, and nis 35.

13. A lipid nanoparticle for use of claim 1, wherein A is yo 0 HO. " ~ “hs © 4 hss NH 5 14. Alipid nanoparticle for use of claim 1, wherein the R comprises one or more of fatty alcohols, fatty acids, glycerolipids, glycerophospholipids, sphingolipids, saccharolipids, polyketides, or sterols or derivatives thereof.

15. Alipid nanoparticle for use of claim 1, wherein the R is a lipid nanoparticle that comprises one or more mRNA encoding one or more gene editor and one or more guide RNAs.

16. A lipid nanoparticle for use of any one of claims 1-5, wherein the lipid nanoparticle comprising the receptor targeting conjugate provides an improved delivery in a LDLr deficient mammal compared to a corresponding lipid nanoparticle without the receptor targeting conjugate.

17. A lipid nanoparticle for use of claim 16, wherein the improved delivery is at least 50% higher than the corresponding lipid nanoparticle without the receptor targeting conjugate as determined by percent editing.

18. A lipid nanoparticle for use of any one of claims 1-5, wherein the lipid nanoparticle comprising the receptor targeting conjugate provides an improved delivery in a mammal that lacks ApoE compared to a corresponding lipid nanoparticle without the receptor targeting conjugate.

19. A lipid nanoparticle for use of claim 18, wherein the improved delivery is at least 50% higher than the corresponding lipid nanoparticle without the receptor targeting conjugate as determined by percent editing.

20. Alipid nanoparticle for use of claim 1, wherein the one or more active agents comprise an mRNA encoding a gene editor and one or more guide RNAs.

21. A lipid nanoparticle for use of claim 20, wherein the gene editor is a Cas nuclease.

22. Alipid nanoparticle for use of claim 21, wherein the Cas nuclease is selected from the group consisting of Cas9, Cpfl, CasX, CasY, C2cl, and C2c3.

23. Alipid nanoparticle for use of claim 20, wherein the gene editor is a base editor.

24. Alipid nanoparticle for use of claim 1, wherein the receptor targeting conjugate comprises from about 0.001 mol % to about 0.5 mol % of the total excipients in the lipid nanoparticle.

25. Alipid nanoparticle for use of claim 1, wherein the lipid nanoparticle comprises a stereoisomer or salt of the receptor targeting conjugate of Formula (V).

26. A lipid nanoparticle for use of any one of claims 1 to 25, wherein the method comprises treating the coronary disease.