Compositions and methods for treating PCSK9-associated disorders
Patent Information
- Application Number
- PCT/CN2026/091189
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2025-06-13
- Filing Date
- 2026-04-17
- Publication Date
- 2026-10-22
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Figure PCTCN2026091189-FTAPPB-I100001 
Figure PCTCN2026091189-FTAPPB-I100002 
Figure PCTCN2026091189-FTAPPB-I100003
Abstract
Description
COMPOSITIONS AND METHODS FOR TREATING PCSK9-ASSOCIATED DISORDERS
[0001] CLAIM OF PRIORITY
[0002] This application claims priority to International Application No. PCT / CN2025 / 089529, filed on April 17, 2025 and International Application No. PCT / CN2025 / 100886, filed on June 13, 2025. The entire contents of the foregoing applications are incorporated herein by reference by their entireties.TECHNICAL FIELD
[0003] The present disclosure relates to the field of RNA interference.BACKGROUND
[0004] Proprotein convertase subtilisin / kexin type 9 serine protease (PCSK9) gene is the ninth member of the mammalian family of serine proteinases. PCSK9 plays an important role in the metabolism of low-density lipoproteins (LDL) , development and progression of the neurological diseases including neuroinflammation, Alzheimer's Disease, alcohol use disorder (AUD) , stroke, etc.
[0005] In recent years, inhibitors with the protease PCSK9 as a target have become novel therapeutic drugs for these diseases. As a new treatment method, an siRNA has great development potential. The siRNA acts on an mRNA in a cell and can directly silence a target gene compared with traditional small molecule drugs, and thus can fundamentally prevent occurrence and development of diseases more efficiently. However, due to poor stability, easy degradation by a nuclease in vivo, difficult absorption by tissues, difficult uptake by cells, easy generation of an off-target effect and other defects, the siRNA is limited in clinical application. At present, an siRNA capable of effectively inhibiting expression of a PCSK9 gene in a cell is required urgently.SUMMARY
[0006] The present disclosure relates to PCSK9-targeting dsRNAs conjugated with LDL-lowering enhancers, such as a compound of formula V or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof. Also disclosed herein are cells, pharmaceutical compositions, and kits thereof. The present disclosure further relates to methods of treating and / or preventing a disease or disorder (e.g., a cardiovascular disease) in a subject, including administering an effective amount of a composition comprising the compound or a combination of a PCSK9-targeting dsRNA and an LDL-lowering enhancer, to the subject.
[0007] Experiments of the present disclosure show that the compounds exhibited significantly reduced off-target effects and satisfactory PD / PK characteristics. For example, some of the dual-targeting siRNAs described herein exhibited significantly higher explosure in plasma with a favorable plasma stability and exhibited greater reduction of serum PCSK9, Lp (a) , and / or LDL-C as compared to the corresponding single-targeting siRNAs.
[0008] In one aspect, the disclosure is related to a compound of formula (V) or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof: G1-L-G2 (V) , in some embodiments, G1 is a first oligonucleotide targeting PCSK9; L is a bond or a linker; and G2 is an LDL-lowering enhancer. In some embodiments, G2 is a second oligonucleotide targeting LPA. In some embodiments, G1 is a first dsRNA for inhibiting PCSK9 gene expression, comprising a first sense strand and a first antisense strand forming a first duplex region, in some embodiments, the first sense strand and the first antisense strand are independently 15-30 nucleotides in length; G2 is a second dsRNA for inhibiting LPA gene expression, comprising a second sense strand and a second antisense strand forming a second duplex region, in some embodiments, the second sense strand and the second antisense strand are independently 15-30 nucleotides in length. In some embodiments, the first antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence as set forth in SEQ ID NO: 1, and the second antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence as set forth in SEQ ID NO: 2. In some embodiments, the first antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence complementary to nucleotides 3529-3618 of SEQ ID NO: 1, preferably nucleotides 3529-3576 of SEQ ID NO: 1, more preferably nucleotides 3535-3566 of SEQ ID NO: 1. In some embodiments, the first antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78, preferably the first antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78. In some embodiments, the second antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164, preferably the second antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164. In some embodiments, the first sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40, preferably the first sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40. In some embodiments, the second sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121, preferably the second sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121.
[0009] In some embodiments, one of the following is true:
[0010] 1) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;
[0011] 2) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;
[0012] 3) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;
[0013] 4) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;
[0014] 5) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;
[0015] 6) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;
[0016] 7) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;
[0017] 8) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;
[0018] 9) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;
[0019] 10) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;
[0020] 11) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;
[0021] 12) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;
[0022] 13) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;
[0023] 14) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;
[0024] 15) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;
[0025] 16) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;
[0026] 17) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;
[0027] 18) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;
[0028] 19) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;
[0029] 20) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;
[0030] 21) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;
[0031] 22) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;
[0032] 23) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;
[0033] 24) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;
[0034] 25) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;
[0035] 26) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;
[0036] 27) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;
[0037] 28) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;
[0038] 29) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;
[0039] 30) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138
[0040] 31) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;
[0041] 32) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;
[0042] 33) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;
[0043] 34) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;
[0044] 35) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143
[0045] 36) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;
[0046] 37) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;
[0047] 38) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;
[0048] 39) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;
[0049] 40) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;
[0050] 41) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;
[0051] 42) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;
[0052] 43) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;
[0053] 44) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;
[0054] 45) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;
[0055] 46) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;
[0056] 47) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;
[0057] 48) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;
[0058] 49) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;
[0059] 50) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;
[0060] 51) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;
[0061] 52) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;
[0062] 53) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;
[0063] 54) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;
[0064] 55) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;
[0065] 56) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;
[0066] 57) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;
[0067] 58) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;
[0068] 59) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;
[0069] 60) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;
[0070] 61) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:104 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 147;
[0071] 62) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:105 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 148;
[0072] 63) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:106 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 149;
[0073] 64) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:107 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 150; or
[0074] 65) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:108 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 151.
[0075] In some embodiments, G1 and G2 each independently is a siRNA. In some embodiments, the first sense strand connects to L at its 3’ end and the second sense strand connects to the L at its 5’ end.
[0076] In some embodiments, substantially all nucleotides of the first sense strand, substantially all nucleotides of the first antisense strand, substantially all nucleotides of the second sense strand and / or substantially all nucleotides of the second antisense strand are modified nucleotides, or all nucleotides of the first sense strand, all nucleotides of the second sense strand, all nucleotides of the first antisense strand and / or all nucleotides of the second antisense strand are modified nucleotides. In some embodiments, the first sense strand, the first antisense strand, the second sense strand, and the second antisense strand each independently comprises one or more modified nucleotides selecting from the group consisting of 2'-O-alkyl modified nucleotide (e.g., a 2'-O-methyl modified nucleotide) , a 2’ -methoxyethyl modified nucleotide, a 2'-fluoro modified nucleotide, a 2'-deoxy modified nucleotide, an inosine ribonucleotide, an abasic nucleotide, an inverted abasic deoxyribonucleotide, a phosphorothioate internucleotide linkage modification, a vinylphosphonate modified nucleotide, a locked nucleotide, a unlocked nucleotide, a 2'-amino modified nucleotide, a 2'-C-alkyl modified nucleotide, a 2'‐O‐allyl modified nucleotide, a morpholino nucleotide, a phosphoramidate, a non-natural base containing nucleotide, a terminal nucleotide linked to a cholesteryl derivative or a dodecanoic acid bisdecylamide group, deoxyribonucleotide, a 3'‐terminal deoxythymine (dT) nucleotide, a conformation-restricted nucleotide, a restricted ethyl nucleotide, a 2'-hydroxyl-modified nucleotide, a nucleotide containing methylphosphonic acid groups, a nucleotide containing 5'-phosphate, a nucleotide containing 5'-phosphate mimics, a glycol-modified nucleotide (GNA) , a 2’ -O- (N-methylacetamide) -modified nucleotide, a 2’ -methoxyethoxyethoxyl modified nucleotide, a 2’ -methoxyethoxyl modified nucleotide, and a SCP modified nucleotide. In some embodiments, the first sense strand, the first antisense strand, the second sense strand, and the second antisense strand each independently comprises one or more modified nucleotides selecting from the group consisting of 2’ -O-methyl modified nucleotides, 2’ -fluoro modified nucleotides, 2’ -deoxy modified nucleotides, nucleotides containing phosphorothioate internucleotide linkages, and SCP modified nucleotides. In some embodiments, the first antisense strand and / or the second antisense strand have two to eight 2’-fluoro modified nucleotides, preferably four to six 2’ -fluoro modified nucleotides, more preferably five 2’ -fluoro modified nucleotides. In some embodiments, the first antisense strand and / or the second antisense strand have 4-12 phosphorothioate internucleotide linkages, preferably 6-10 phosphorothioate internucleotide linkages, more preferably 7 or 8 phosphorothioate internucleotide linkages. In some embodiments, the first sense strand and / or the second sense strand have 4-12 phosphorothioate internucleotide linkages, preferably 5-10 phosphorothioate internucleotide linkages, more preferably 5-8 phosphorothioate internucleotide linkages. In some embodiments, the internucleotide linkage between nucleotide positions 1 and 2 (counting from the 5’ end) of the first antisense strand and / or the second antisense strand is a natural phosphodiester linkage.
[0077] In some embodiments, each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise: (i) (counting from the 5'end) an SCP modification at position 1; (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14; (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0078] In some embodiments, each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise: (i) (counting from the 5'end) an SCP modification at position 1; (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14; (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0079] In some embodiments, each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise: (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 18 and 19.
[0080] In some embodiments, each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise: (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, and between nucleotide positions 18 and 19.
[0081] In some embodiments, each or both of the first sense strand and the second sense strand optionally contain at their 5'end and / or 3'end one or more terminal modifications. In some embodiments, the 3'end of the first sense strand and the 5'end of the second sense strand each contains a terminal modification, preferably the 3'end of the first sense strand contains a terminal modification. In some embodiments, the terminal modification is selected from an abasic nucleotide (e.g., IB) , an inverted nucleotide, and an optionally substituted preferably the optionally substituted is substituted with a GalNAc-containing side chain substituent. In some embodiments, the terminal modification is IB.
[0082] In some embodiments, the 3'ends of the first antisense strand and the second antisense strand are a blunt end or overhang, preferably an overhang, more preferably an overhang of two nucleotides.
[0083] In some embodiments, the compound is further conjugated with a ligand moiety; preferably, the compound is conjugated with a GalNAc-containing ligand moiety, more preferably with a GalNAc-containing ligand moiety through a phosphate group or a phosphorothioate group; preferably the second sense strand is conjugated with the ligand moiety; more preferably the 3’ end of the second sense strand is conjugated with the ligand moiety; preferably, the ligand moiety has the following structure:
[0084] in some embodiments, represents a position linked to siRNA through a phosphate group or a phosphorothioate group.
[0085] In some embodiments, the compound is formula (I) or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof:
[0086] G1-S1-X-S2-G2 (I)
[0087] S1 and S2 are each independently a bond, - (OCH2CH2) k-, - (CH2CH2O) k-, -O (CH2CH2O) k-, or - (CH2) k-; k is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10; X is a bond or a linker; preferably, S1 and S2 are each independently a bond or -O (CH2CH2O) k-, in some embodiments, k is 1, 2, 3, 4, 5, 6, 7, or 8; preferably, S1 and S2 are each independently a bond, -O (CH2CH2O) 3-, or -O (CH2CH2O) 6-.
[0088] In some embodiments, X comprises one or more compounds selected from formula (I-1) or formula (I-2) , or a tautomer or stereoisomer thereof:
[0089] in some embodiments, ring A is selected from C5-10 cycloalkyl, 5-membered to 10-membered heterocyclyl, C6-10 aryl, or 5-membered to 10-membered heteroaryl, preferably C6-10 aryl or 5-membered to 10-membered heteroaryl; Tg is selected from -S-Rt, -S-S-Rt, -OCH2-S-S-Rt, a sugar moiety, or a polypeptide; Rt is selected from H, C1-6 alkyl, or C1-6 haloalkyl; the sugar moiety is a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar; the polypeptide is a group comprising 1, 2, 3, 4, or 5 amino acid residues; L0 is selected from -NRc-, C (O) , -OC (O) NRc-, -C (O) NRc-, -NRcC (O) -, -NRc-C (O) O-, or -C (O) NRc-C (O) -; L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (CH2) q- (OCH2CH2) p-, - (CH2CH2O) p-, -O (CH2CH2O) p-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -; L1 and L2 are optionally substituted with 1, 2, or 3 substituents selected from halogen, OH, NH2, -C1-6 alkylene OH, -C1-6 alkylene NH2, C1-6 alkyl, or C1-6 haloalkyl; w is selected from 0, 1, 2, 3, or 4; p and q are each independently 1, 2, 3, 4, 5, or 6; in some embodiments, and in formula (I-1) or formula (I-2) are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage (S1) , and in formula (I-1) or formula (I-2) represents connection to G2 via a bridged linkage (S2) ; Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated.
[0090] In some embodiments, X comprises one or more compounds of formula (II) , or a tautomer or stereoisomer thereof:
[0091] in some embodiments, Tg is -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide; the sugar moiety is preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose; the polypeptide is selected from - (AA) a-R, -NH (AA) a-R, - (AA) a-C (O) R, -NH (AA) a-C (O) R, or -C (O) -NH (AA) a-C (O) NR; in some embodiments, each AA is independently selected from amino acid residues, preferably each AA is independently selected from natural amino acid residues; a is selected from 1, 2, 3, or 4; R is selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, in some embodiments, R may be optionally deuterated or fully deuterated; Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated; each Rd is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated; in some embodiments, L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, -O (CH2CH2O) p-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -; in some embodiments, p and q are each independently 1, 2, 3, 4, 5, or 6; in some embodiments, and in formula (II) are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) ; preferably, Tg is selected from -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide; the sugar moiety is selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose; the polypeptide is -NH (AA) a-C (O) R; each AA is independently selected from a valine residue, an alanine residue, a glycine residue, a leucine residue, or an isoleucine residue, more preferably from a valine residue or an alanine residue; a is selected from 1, 2, or 3, preferably 2 or 3; R is selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as CH3; Ra, Rb, and Rc are each independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably H or C1-6 alkyl, such as H or CH3; each Rd is independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as CH3; L1 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-; L2 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably - (CH2) p-O-; each p is independently selected from 2, 3, 4, 5, or 6, preferably 4, 5, or 6; each p is independently selected from 1, 2, 3, 4, or 5, preferably 1, 2, or 3; represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) ; more preferably, Tg is selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose; Ra, Rb, and Rc are each independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably H or C1-6 alkyl, such as H or CH3; each Rd is independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as C (CH3) 3; L1 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-; L2 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably - (CH2) p-O-; each p is independently selected from 2, 3, 4, 5, or 6, preferably 4, 5, or 6; each p is independently selected from 1, 2, 3, 4, or 5, preferably 1, 2, or 3; represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) .
[0092] In some embodiments, the compound described herein is further provided that: i) Tg is -S-S-C (CH3) 3; ii) Tg is galactose, glucose, N-acetylgalactosamine, or N-acetylglucosamine, preferably galactose or N-acetylgalactosamine or 3) Tg is -NH (AA) a-C (O) R, such as in some embodiments, each AA is independently selected from valine or alanine; a is selected from 1, 2, or 3, preferably 2 or 3; R is selected from H or C1-6 alkyl, such as CH3.
[0093] In some embodiments, Ra, Rb, and Rc are each independently selected from H, D, halogen, or C1-6 alkyl, L1 and L2 are each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-, and p and q are each independently 1, 2, 3, 4, 5, or 6.
[0094] In some embodiments, X comprises one or more compounds of formula (III) , or a tautomer or stereoisomer thereof:
[0095] in some embodiments, Sg is a sugar moiety, preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose; L3 and L4 are linkers, preferably each independently selected from a bond, - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, - (CH2) j- (OCH2CH2) i-, -NHC (O) -, -C (O) NH-, -C (O) -, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -; in some embodiments, i and j are each independently 1, 2, 3, 4, 5, or 6; L5 is a linker, preferably selected from a bond, C3-7 cycloalkyl, C6-10 aryl, 3-membered to 7-membered heterocyclyl, or 5-membered to 10-membered heteroaryl, more preferably, L5 is selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, in some embodiments, the heteroatom is N or O; in some embodiments, in formula (III) are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage (S1) , and in formula (III) represents connection to G2 via a bridged linkage (S2) ; preferably, Sg is selected from N-acetylgalactosamine, galactose, galactosamine, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose, e.g. N-acetylgalactosamine or L3 is selected from a bond, - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, or - (CH2) j- (OCH2CH2) i-; L4 is selected from a bond , - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, -NHC (O) -, -C (O) NH-, -C (O) -, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, or -OC (O) NH-; each i is independently selected from 1, 2, 3, 4, 5, or 6; each j is independently selected from 1, 2, 3, 4, 5, or 6; L5 is selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, in some embodiments, the heteroatom is N or O; represents connection to G1 via a bridged linkage (S1) , and in formula (III) represents connection to G2 via a bridged linkage (S2) .
[0096] In some embodiments, X comprises one or more compounds of formula (IIIa) , or a tautomer or stereoisomer thereof:
[0097] L3 is selected from a bond, - (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, or - (CH2) j- (OCH2CH2) i-; L4 is selected from a bond, -NHC (O) -, -C (O) NH-, -C (O) -, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, or -OC (O) NH-; L5 is selected from a bond, C5-6 cycloalkyl, or 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, in some embodiments, the heteroatom is N or O; in some embodiments, i and j are each independently 1, 2, 3, 4, 5, or 6; represents connection to G1 via a bridged linkage (S1) , and in formula (IIIa) represents connection to G2 via a bridged linkage (S2) ; optionally in some embodiments, one of the following is true:
[0098] i) L3 is - (CH2) 4-, L4 is a bond, and L5 is a bond;
[0099] ii) L3 is - (CH2) 5-, L4 is -OC (O) -, and L5 is (such as ) ;
[0100] iii) L3 is - (CH2) 4-, L4 is -C (O) -, and L5 is (such as ) ;
[0101] iv) L3 is -CH2CH2- (OCH2CH2) 2-, L4 is -NHC (O) -, and L5 is (such as ) ; or
[0102] v) L3 is -CH2CH2- (OCH2CH2) 2-, L4 is -OC (O) -, and L5 is (such as ) .
[0103] In some embodiments, X comprises one or more of the following compounds:
[0104] in some embodiments, represents connection to G1 via a bridged linkage (S1) , and represents connection to G2 via a bridged linkage (S2) .
[0105] In some embodiments, X is a nucleotide linker, the nucleotide is selected from one or more of a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, a 2'-5'ribonucleotide, and a 2'-5'deoxyribonucleotide. In some embodiments, X is Nt (dN) m, in some embodiments, Nt is selected from a bond, a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, or a 2'-5'ribonucleotide, each dN is independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, 5, 6, 7, or 8, preferably m is 1, 2, 3, 4, or 5. In some embodiments, X is selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, -GfAfUf-, dTdTdTdT, and dTdTdTdTdT, preferably selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, dTdTdTdT, and dTdTdTdTdT.
[0106] In some embodiments, X is - (BL) p (dN) m-; in some embodiments, each BL is independently selected from a compound of formula (I-1) or (I-2) as defined in claim 2, a compound of formula (II) as defined in any one of claims 3 to 5, a compound of formula (III) as defined in any one of claims 6 to 8 or a tautomer or stereoisomer thereof, or BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12 as defined in claim 9 or a tautomer or stereoisomer thereof; each dN is independently selected from dA, dT, dG, or dC; p is selected from 0, 1, 2, 3, 4, 5, or 6, preferably 0, 1, 2, or 3; m is selected from 0, 1, 2, 3, 4, 5, 6, 7, or 8, preferably 0, 1, 2, 3, 4, or 5; p and m are not both 0; preferably, X is - (BL) p-; each BL is independently selected from a compound of formula (I-1) or (I-2) as defined in claim 2, a compound of formula (II) as defined in any one of claims 3 to 5, a compound of formula (III) as defined in any one of claims 6 to 8 or a tautomer or stereoisomer thereof, or BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12 as defined in claim 9 or a tautomer or stereoisomer thereof; p is selected from 0, 1, 2, 3, 4, 5, or 6, preferably 0, 1, 2, or 3.
[0107] In some embodiments, the compound described herein is provided that: i) X is BL (dN) m, in some embodiments, BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12, preferably BL1, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5; ii) X is selected from BL1-dTdTdT or BL1-dCdA; iii) X is (BL) p, in some embodiments, each BL is independently selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, or BL9, preferably BL7 or BL8, and p is 1, 2, or 3; or iv) X is BL1, -BL1-BL1-BL1-, BL5, BL7, BL8, BL9, BL10, BL11, BL12, BL7-BL7-BL7, BL8-BL8-BL8, or BL9-BL9-BL9, preferably X is BL7, BL7-BL7-BL7, BL8, BL8-BL8-BL8, BL9, or BL9-BL9-BL9.
[0108] In some embodiments, the compound is DR014023, DR014027, DR014028, DR014192, DR014193, DR014194, DR014195, DR013525, DR013526, DR013527, DR014017, DR014220, DR014222, DR014270, DR014271, or DR014278.
[0109] In one aspect, the disclosure is related to a cell comprising the compound described herein or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof.
[0110] In one aspect, the disclosure is related to a pharmaceutical composition comprising the compound described herein or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof, or the cell described herein, and optionally a pharmaceutically acceptable carrier or excipient.
[0111] In one aspect, the disclosure is related to a kit comprising the compound described herein or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof, or the cell described herein.
[0112] In one aspect, the disclosure is related to a method of decreasing the LPA, PCSK9, and / or LDL level in a subject, or decreasing the LPA, PCSK9, and / or LDL-C (low-density lipoprotein-cholesterol) levels in a cell, comprising introducing the compound described herein, or the pharmaceutically acceptable salt, tautomer, or stereoisomer thereof, to the subject or cell.
[0113] In one aspect, the disclosure is related to the use of a compound described herein or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof for the manufacture of a medicament for treating and / or preventing a disease or disorder. In some embodiments, the disease or disorder is a cardiovascular disease, a liver disease, an infection, an autoimmune disorder, a neurocognitive disorder, or a cancer.
[0114] In one aspect, the disclosure is related to a method of treating and / or preventing a disease or disorder in a subject, comprising administering an effective amount of a composition comprising a first oligonucleotide targeting PCSK9 (G1) and an LDL-lowering enhancer to the subject. In some embodiments, the LDL-lowering enhancer is a second oligonucleotide targeting LPA (G2) . In some embodiments, G1 is a first dsRNA for inhibiting PCSK9 gene expression, comprising a first sense strand and a first antisense strand forming a first duplex region, in some embodiments, the first sense strand and the first antisense strand are independently 15-30 nucleotides in length; G2 is a second dsRNA for inhibiting LPA gene expression, comprsing a second sense strand and a second antisense strand forming a second duplex region, in some embodiments, the second sense strand and the second antisense strand are independently 15-30 nucleotides in length.
[0115] In some embodiments, one of the following is true: (a) the first antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78, preferably the first antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78; (b) the second antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164, preferably the second antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164; (c) the first sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40, preferably the first sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40; and / or (d) the second sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121, preferably the second sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121.
[0116] In some embodiments, one of the following is true:
[0117] 1) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;
[0118] 2) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;
[0119] 3) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;
[0120] 4) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;
[0121] 5) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;
[0122] 6) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;
[0123] 7) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;
[0124] 8) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;
[0125] 9) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;
[0126] 10) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;
[0127] 11) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;
[0128] 12) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;
[0129] 13) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;
[0130] 14) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;
[0131] 15) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;
[0132] 16) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;
[0133] 17) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;
[0134] 18) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;
[0135] 19) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;
[0136] 20) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;
[0137] 21) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;
[0138] 22) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;
[0139] 23) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;
[0140] 24) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;
[0141] 25) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;
[0142] 26) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;
[0143] 27) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;
[0144] 28) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;
[0145] 29) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;
[0146] 30) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138
[0147] 31) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;
[0148] 32) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;
[0149] 33) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;
[0150] 34) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;
[0151] 35) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO:100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143
[0152] 36) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;
[0153] 37) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;
[0154] 38) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;
[0155] 39) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;
[0156] 40) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;
[0157] 41) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;
[0158] 42) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;
[0159] 43) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;
[0160] 44) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;
[0161] 45) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;
[0162] 46) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;
[0163] 47) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;
[0164] 48) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;
[0165] 49) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;
[0166] 50) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;
[0167] 51) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;
[0168] 52) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;
[0169] 53) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;
[0170] 54) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;
[0171] 55) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;
[0172] 56) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;
[0173] 57) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;
[0174] 58) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;
[0175] 59) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;
[0176] 60) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;
[0177] 61) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 104 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 147;
[0178] 62) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 105 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 148;
[0179] 63) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 106 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 149;
[0180] 64) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 107 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 150; or
[0181] 65) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 108 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 151.
[0182] In some embodiments, G1 and G2 each independently is a siRNA. In some embodiments, substantially all nucleotides of the first sense strand, substantially all nucleotides of the first antisense strand, substantially all nucleotides of the second sense strand and / or substantially all nucleotides of the second antisense strand are modified nucleotides, or all nucleotides of the first sense strand, all nucleotides of the second sense strand, all nucleotides of the first antisense strand and / or all nucleotides of the second antisense strand are modified nucleotides.
[0183] In some embodiments, each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise: (i) (counting from the 5'end) an SCP modification at position 1; (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14; (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0184] In some embodiments, each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise: (i) (counting from the 5'end) an SCP modification at position 1; (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14; (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0185] In some embodiments, each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise: (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 18 and 19.
[0186] In some embodiments, each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise: (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, and between nucleotide positions 18 and 19.
[0187] In some embodiments, each or both of the first sense strand and the second sense strand optionally contain at their 5'end and / or 3'end one or more terminal modifications. In some embodiments, the 3'ends of the first antisense strand and / or the second antisense strand are a blunt end or overhang. In some embodiments, G1 and / or G2 are further conjugated with a ligand moiety.
[0188] In some embodiments, G1 is DR011740 or DR005672, and G2 is DR011826, DR014067, or DR011666.
[0189] In one aspect, the disclosure is related to a multivalent (e.g., bivalent or trivalent) siRNA compound comprising a first oligonucleotide and a second oligonucleotide, in some embodiments, the first oligonucleotide is G1 described herein, and the second nucleotide is G2 described herein.
[0190] 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 invention belongs. Methods and materials are described herein for use in the present invention; other, suitable methods and materials known in the art can also be used. The materials, methods, and examples are illustrative only and not intended to be limiting. All publications, patent applications, patents, sequences, database entries, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control.
[0191] Other features and advantages of the invention will be apparent from the following detailed description and figures, and from the claims.DESCRIPTION OF DRAWINGS
[0192] FIGS. 1A-1C show the results of pharmacodynamics (PD) study of the compounds of the present disclosure in non-human primates.DETAILED DESCRIPTION
[0193] RNA interference is a phenomenon of specific and highly efficient degradation of the target mRNA induced by a double-stranded RNA (dsRNA) , e.g., siRNA. The use of a linker to connect two or more dsRNAs (including siRNA) for delivery enables multiple genes to be targeted at once, producing a synergistic effect. Proprotein convertase subtilisin / kexin type 9 (PCSK9) is a serine proteas mainly expressed in liver, small intestine and kidney. It is a regulatory targeting substance for low density lipoproteins (LDL) , and mainly plays a role by regulating expression and secretion activity of LDL receptors on the liver. The first PCSK9-targeting siRNA has been approved recently. There is still a need in the art to develop an LDL-lowering enhancer conjugated with a PCSK9-targeting siRNA to further enhance the efficacy of the siRNA drug.
[0194] I. Definitions
[0195] 1. Chemical Definitions
[0196] Definitions of specific functional groups and chemical terms are described in more detail as follows.
[0197] When a numerical range is provided, it is intended that a particular numerical point and sub-range within said range be included. For example, "C1-6 alkyl" includes alkyls C1, C2, C3, C4, C5, C6, C1-6, C1-5, C1-4, C1-3, C1-2, C2-6, C2-5, C2-4, C2-3, C3-6, C3-5, C3-4, C4-6, C4-5, and C5-6.
[0198] "C1-6 alkyl" refers to any straight-chain or branched hydrocarbon group being saturated and with 1 to 6 carbon atoms. In some embodiments, C1-4 alkyl is preferred. Examples of C1-6 alkyl described herein include: methyl (C1) , ethyl (C2) , n-propyl (C3) , isopropyl (C3) , n-butyl (C4) , tert-butyl (C4) , sec-butyl (C4) , isobutyl (C4) , n-pentyl (C5) , 3-pentyl (C5) , pentyl (C5) , neopentyl (C5) , 3-methyl-2-butyl (C5) , tert-pentyl (C5) and n-hexyl (C6) . The term "C1-6 alkyl" also includes any heteroalkyl in which one or more (e.g., 1, 2, 3, or 4) carbon atoms are replaced with heteroatoms (e.g., oxygen, sulfur, nitrogen, boron, silicon, phosphorus) . The alkyls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent. The conventional abbreviations for alkyl include: Me (-CH3) , Et (-CH2CH3) , iPr (-CH (CH3) 2) , nPr (-CH2CH2CH3) , n-Bu (-CH2CH2CH2CH3) , or i-Bu (-CH2CH (CH3) 2) .
[0199] "C2-6 alkenyl" refers to a straight-chain or branched hydrocarbon group with 2 to 6 carbon atoms and at least one carbon-carbon double bond. In some embodiments, C2-4 alkenyl is preferred. Examples of C2-6 alkenyl include, but are not limited to: vinyl (C2) , 1-propenyl (C3) , 2-propenyl (C3) , 1-butenyl (C4) , 2-butenyl (C4) , butadienyl (C4) , pentenyl (C5) , pentadienyl (C5) , and hexenyl (C6) . The term "C2-6 alkenyl" also includes any heteroalkenyl in which one or more (e.g., 1, 2, 3, or 4) carbon atoms are replaced with heteroatoms (e.g., oxygen, sulfur, nitrogen, boron, silicon, phosphorus) . The alkenyls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0200] "C2-6 alkynyl" refers to a straight-chain or branched hydrocarbon group with 2 to 6 carbon atoms and at least one carbon-carbon triple bond and optionally one or more carbon-carbon double bonds. In some embodiments, C2-4 alkynyl is preferred. Examples of C2-6 alkynyl include, but are not limited to: ethynyl (C2) , 1-propynyl (C3) , 2-propynyl (C3) , 1-butynyl (C4) , 2-butynyl (C4) , pentynyl (C5) , and hexynyl (C6) . The term "C2-6 alkynyl" also includes any heteroalkynyl in which one or more (e.g., 1, 2, 3, or 4) carbon atoms are replaced with heteroatoms (e.g., oxygen, sulfur, nitrogen, boron, silicon, phosphorus) . The alkynyls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0201] "Halogenated" or "halogen" refers to (substitution by) fluorine (F) , chlorine (Cl) , bromine (Br) , and iodine (I) .
[0202] Accordingly, "C1-6 haloalkyl" refers to the aforementioned "C1-6 alkyl" , with one or more halogen groups. In some embodiments, a C1-4 haloalkyl is particularly preferred, and a C1-2 haloalkyl is even more preferred. Exemplary haloalkyls include, but are not limited to: -CF3, -CH2F, -CHF2, -CHFCH2F, -CH2CHF2, -CF2CF3, -CCl3, -CH2Cl, -CHCl2, and 2, 2, 2-trifluoro-1, 1-dimethyl-ethyl. The haloalkyls may be substituted at any substitutable connection site, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0203] "C3-10 cycloalkyl" refers to a non-aromatic cyclic hydrocarbon group with 3 to 10 ring carbon atoms and no heteroatoms. In some embodiments, C4-7 cycloalkyl and C3-6 cycloalkyl are particularly preferred, and C5-6 cycloalkyl is even more preferred. A cycloalkyl herein also includes a ring system in which an aforementioned cycloalkyl ring is fused with one or more aryls or heteroaryls through any connection site (s) on the cycloalkyl ring; in this context, the number of carbons still represents the number of carbons in the cycloalkyl system. Examples of said cycloalkyls include, but are not limited to: cyclopropyl (C3) , cyclopropenyl (C3) , cyclobutyl (C4) , cyclobutenyl (C4) , cyclopentyl (C5) , cyclopentenyl (C5) , cyclohexyl (C6) , cyclohexenyl (C6) , cyclohexadienyl (C6) , cycloheptyl (C7) , cycloheptenyl (C7) , cycloheptadienyl (C7) , and cycloheptatrienyl (C7) . The cycloalkyls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0204] The term herein "3-membered to 10-membered heterocyclyl" refers to a group of a 3-membered to 10-membered non-aromatic ring system with ring carbon atom (s) and 1 to 5 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, sulfur, boron, phosphorus and silicon. In said heterocyclyl containing one or more nitrogen atoms, the connection site may be a carbon or nitrogen atom as long as the valence permits. In some embodiments, a 4-membered to 10-membered heterocyclyl is preferred, which is a 4-membered to 10-membered non-aromatic ring system with ring carbon atom (s) and 1 to 5 ring heteroatoms; in some embodiments, a 3-membered to 8-membered heterocyclyl is preferred, which is a 3-membered to 8-membered non-aromatic ring system with ring carbon atom (s) and 1 to 4 ring heteroatoms; preferably a 3-membered to 6-membered heterocyclyl as a 3-membered to 6-membered non-aromatic ring system with ring carbon atom (s) and 1 to 3 ring heteroatoms; preferably a 4-membered to 7-membered heterocyclyl as a 4-membered to 7-membered non-aromatic ring system with ring carbon atom (s) and 1 to 3 ring heteroatoms; more preferably a 5-membered to 6-membered heterocyclyl as a 5-membered to 6-membered non-aromatic ring system with ring carbon atom (s) and 1 to 3 ring heteroatoms. A heterocyclyl herein also includes a ring system in which an aforementioned heterocyclyl ring is fused with one or more cycloalkyls through any connection site (s) on the cycloalkyl ring, or said heterocyclyl includes a ring system in which an aforementioned heterocyclyl ring is fused with one or more aryls or heteroaryls through any connection site (s) on the heterocyclyl ring; in these contexts, the number of ring members still represents the number of ring members in the heterocyclyl ring system. Exemplary 3-membered heterocyclyls containing one heteroatom include, but are not limited to: aziridinyl, oxiranyl, and thiorenyl. Exemplary 4-membered heterocyclyls containing one heteroatom include, but are not limited to: azetidinyl, oxetidinyl, and thietanyl. Exemplary 5-membered heterocyclyls containing one heteroatom include, but are not limited to: tetrahydrofuryl, dihydrofuryl, tetrahydrothienyl, dihydrothienyl, pyrrolidinyl, dihydropyrrolyl, and pyrroli-2, 5-dione. Exemplary 5-membered heterocyclyls containing two heteroatoms include, but are not limited to: dioxolanyl, oxasulfuranyl, disulfuranyl, and oxazolidin-2-one. Exemplary 5-membered heterocyclyls containing three heteroatoms include, but are not limited to: triazolinyl, oxadiazolinyl and thiadiazolinyl. Exemplary 6-membered heterocyclyls containing one heteroatom include, but are not limited to: piperidinyl, tetrahydropyranyl, dihydropyridyl and thianyl. Exemplary 6-membered heterocyclyls containing two heteroatoms include, but are not limited to: piperazinyl, morpholinyl, dithianyl, and dioxanyl. Exemplary 6-membered heterocyclyls containing three heteroatoms include, but are not limited to: triazinanyl. Exemplary 7-membered heterocyclyls containing one heteroatom include, but are not limited to: azepanyl, oxepanyl, and thiepanyl. Exemplary 5-membered heterocyclyls each of which is fused with a C6 aryl ring (also referred to herein as a 5, 6-bicycloheterocyclyl) include, but are not limited to: dihydroindolyl, isodihydroindolyl, dihydrobenzofuryl, dihydrobenzothienyl, and benzoxazolinonyl. Exemplary 6-membered heterocyclyls each of which is fused with a C6 aryl ring (also referred to herein as a 6, 6-bicycloheterocyclyl) include, but are not limited to: tetrahydroquinolinyl, and tetrahydroisoquinolinyl. The heterocyclyls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0205] "C6-10 aryl” refers to a monocyclic or polycyclic (e.g., bicyclic) group that is a 4n+2 aromatic ring system having 6 to 10 ring carbon atoms and no heteroatom (e.g., with 6 or 10 π electrons shared in a cyclic arrangement) . In some embodiments, an aryl has six ring carbon atoms ( “C6 aryl” ; e.g., phenyl) . In some embodiments, an aryl has ten ring carbon atoms ( “C10 aryl” ; e.g., a naphthyl, such as 1-naphthyl and 2-naphthyl) . An aryl herein also includes a ring system in which an aforementioned aryl ring is fused with one or more cycloalkyls or heterocyclyls through the connection sites on said aryl ring; in this context, the number of carbon atoms still represents the number of carbon atoms in said aryl ring system. The aryls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0206] "5-membered to14-membered heteroaryl" refers to a 5-membered to 14-membered monocyclic or bicyclic group of a 4n+2 aromatic ring system (e.g., with 6, 10 or 14 πelectrons shared in a cyclic arrangement) that has ring carbon atom (s) and 1 to 4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen and sulfur. In said heteroaryl containing one or more nitrogen atoms, the connection site may be a carbon or nitrogen atom as long as the valence permits. A bicyclic heteroaryl system herein may comprise one or more heteroatoms in one or both rings thereof. A heteroaryl herein also includes a ring system in which an aforementioned heteroaryl ring is fused with one or more cycloalkyls or heterocyclyls through the connection sites on said heteroaryl ring; in this context, the number of carbon atoms still represents the number of carbon atoms in said heteroaryl ring system. In some embodiments, a 5-membered to 10-membered heteroaryl is preferred, which is a 4n+2 aromatic ring system of a 5-membered to 10-membered monocyclic or bicyclic ring with ring carbon atom (s) and 1 to 4 ring heteroatoms. In some other embodiments, a 5-membered to 6-membered heteroaryl is particularly preferred, which is a 4n+2 aromatic ring system of a 5-membered to 6-membered monocyclic or bicyclic ring with ring carbon atom (s) and 1 to 4 ring heteroatoms. Exemplary 5-membered heteroaryls containing one heteroatom include, but are not limited to: pyrrolyl, furyl, and thienyl. Exemplary 5-membered heteroaryls containing two heteroatoms include, but are not limited to:imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, and isothiazolyl. Exemplary 5-membered heteroaryls containing three heteroatoms include, but are not limited to: triazolyl, oxadiazolyl (e.g., 1, 2, 4-oxadiazolyl) , and thiadiazolyl. Exemplary 5-membered heteroaryls containing four heteroatoms include, but are not limited to: tetrazolyl. Exemplary 6-membered heteroaryls containing one heteroatom include, but are not limited to: pyridinyl. Exemplary 6-membered heteroaryls containing two heteroatoms include, but are not limited to:pyridazinyl, pyrimidinyl, and pyrazinyl. Exemplary 6-membered heteroaryls containing three or four heteroatoms include, but are not limited to: triazinyl, and tetrazinyl. Exemplary 7-membered heteroaryls containing one heteroatom include, but are not limited to: azepinyl, oxepinyl, and thiepinyl. Exemplary 5, 6-bicycloheteroaryls include, but are not limited to: indolyl, isoindolyl, indazolyl, benzotriazolyl, benzothienyl, isobenzothienyl, benzofuryl, benzoisofuryl, benzimidazolyl, benzoxazolyl, benzisoxazolyl, benzooxadiazolyl, benzothiazolyl, benzoisothiazolyl, benzothiadiazolyl, indolizinyl, and purinyl. Exemplary 6, 6-bicycloheteroaryls include, but are not limited to: naphthalidinyl, pteridinyl, quinolyl, isoquinolyl, cinnolinyl, quinoxalinyl, phthalazinyl, and quinazolinyl. The heteroaryls may be optionally substituted by one or more substituents, for example, 1 to 5 substituents, 1 to 3 substituents, or 1 substituent.
[0207] Alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl as defined herein are optionally substituted groups.
[0208] Exemplary substituents on carbon atoms include, but are not limited to: halogen, -CN, -NO2, -N3, -SO2H, -SO3H, -OH, -ORaa, -ON (Rbb) 2, -N (Rbb) 2, -N (Rbb) 3+X-, -N (ORcc) Rbb, -SH, -SRaa, -SSRcc, -C (=O) Raa, -CO2H, -CHO, -C (ORcc) 2, -CO2Raa, -OC (=O) Raa, -OCO2Raa, -C (=O) N (Rbb) 2, -OC (=O) N (Rbb) 2, -NRbbC (=O) Raa, -NRbbCO2Raa, -NRbbC (=O) N (Rbb) 2, -C (=NRbb) Raa, -C (=NRbb) ORaa, -OC (=NRbb) Raa, -OC (=NRbb) ORaa, -C (=NRbb) N (Rbb) 2, -OC (=NRbb) N (Rbb) 2, -NRbbC (=NRbb) N (Rbb) 2, -C (=O) NRbbSO2Raa, -NRbbSO2Raa, -SO2N (Rbb) 2, -SO2Raa, -SO2ORaa, -OSO2Raa, -S (=O) Raa, -OS (=O) Raa, -Si (Raa) 3, -OSi (Raa) 3, -C (=S) N (Rbb) 2, -C (=O) SRaa, -C (=S) SRaa, -SC (=S) SRaa, -SC (=O) SRaa, -OC (=O) SRaa, -SC (=O) ORaa, -SC (=O) Raa, -P (=O) 2Raa, -OP (=O) 2Raa, -P (=O) (Raa) 2, -OP (=O) (Raa) 2, -OP (=O) (ORcc) 2, -P (=O) 2N (Rbb) 2, -OP (=O) 2N (Rbb) 2, -P (=O) (NRbb) 2, -OP (=O) (NRbb) 2, -NRbbP (=O) (ORcc) 2, -NRbbP (=O) (NRbb) 2, -P (Rcc) 2, -P (Rcc) 3, -OP (Rcc) 2, -OP (Rcc) 3, -B (Raa) 2, -B (ORcc) 2, -BRaa (ORcc) , alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl, wherein each of alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rdd groups;
[0209] or wherein two geminal hydrogens at a carbon atom are substituted by a group, such as =O, =S, =NN (Rbb) 2, =NNRbbC (=O) Raa, =NNRbbC (=O) ORaa, =NNRbbS (=O) 2Raa, =NRbb, or =NORcc;
[0210] wherein each of Raa is independently selected from alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl, or two Raa groups are connected each other to form a heterocyclyl ring or heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rdd groups;
[0211] each of Rbb is independently selected from: hydrogen, -OH, -ORaa, -N (Rcc) 2, -CN, -C (=O) Raa, -C (=O) N (Rcc) 2, -CO2Raa, -SO2Raa, -C (=NRcc) ORaa, -C (=NRcc) N (Rcc) 2, -SO2N (Rcc) 2, -SO2Rcc, -SO2ORcc, -SORaa, -C (=S) N (Rcc) 2, -C (=O) SRcc, -C (=S) SRcc, -P (=O) 2Raa, -P (=O) (Raa) 2, -P (=O) 2N (Rcc) 2, -P (=O) (NRcc) 2, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl, or two Rbb groups are connected each other to form a heterocyclyl ring or heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl group is independently substituted with 0, 1, 2, 3, 4 or 5 Rdd groups;
[0212] wherein each of Rcc is independently selected from hydrogen, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl, or two Rcc groups are connected to form a heterocyclyl ring or heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rdd groups;
[0213] each of Rdd is independently selected from: halogen, -CN, -NO2, -N3, -SO2H, -SO3H, -OH, -ORee, -ON (Rff) 2, -N (Rff) 2, -N (Rff) 3+X-, -N (ORee) Rff, -SH, -SRee, -SSRee, -C (=O) Ree, -CO2H, -CO2Ree, -OC (=O) Ree, -OCO2Ree, -C (=O) N (Rff) 2, -OC (=O) N (Rff) 2, -NRffC (=O) Ree, -NRffCO2Ree, -NRffC (=O) N (Rff) 2, -C (=NRff) ORee, -OC (=NRff) Ree, -OC (=NRff) ORee, -C (=NRff) N (Rff) 2, -OC (=NRff) N (Rff) 2, -NRffC (=NRff) N (Rff) 2, -NRffSO2Ree, -SO2N (Rff) 2, -SO2Ree, -SO2ORee, -OSO2Ree, -S (=O) Ree, -Si (Ree) 3, -OSi (Ree) 3, -C (=S) N (Rff) 2, -C (=O) SRee, -C (=S) SRee, -SC (=S) SRee, -P (=O) 2Ree, -P (=O) (Ree) 2, -OP (=O) (Ree) 2, -OP (=O) (ORee) 2, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl, heteroaryl, wherein each of alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rgg groups, or two geminal Rdd substituents may be combined to form =O or =S;
[0214] each of Ree is independently selected from: alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, aryl, heterocyclyl and heteroaryl, wherein each alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rgg groups;
[0215] wherein each of Rff is independently selected from hydrogen, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl, or two Rff groups are connected each other to form a heterocyclyl ring or heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rgg groups;
[0216] each of Rgg is independently selected from: halogen, -CN, -NO2, -N3, -SO2H, -SO3H, -OH, -OC1-6Alkyl, -ON (C1-6Alkyl) 2, -N (C1-6Alkyl) 2, -N (C1-6Alkyl) 3+X-, -NH (C1-6Alkyl) 2+X-, -NH2 (C1-6Alkyl) +X-, -NH3+X-, -N (OC1-6Alkyl) (C1-6Alkyl) , -N (OH) (C1-6Alkyl) , -NH (OH) , -SH, -SC1-6Alkyl, -SS (C1-6Alkyl) , -C (=O) (C1-6Alkyl) , -CO2H, -CO2 (C1-6Alkyl) , -OC (=O) (C1-6Alkyl) , -OCO2 (C1-6Alkyl) , -C (=O) NH2, -C (=O) N (C1-6Alkyl) 2, -OC (=O) NH (C1-6Alkyl) , -NHC (=O) (C1-6Alkyl) , -N (C1-6Alkyl) C (=O) (C1-6Alkyl) , -NHCO2 (C1-6Alkyl) , -NHC (=O) N (C1-6Alkyl) 2, -NHC (=O) NH (C1-6Alkyl) , -NHC (=O) NH2, -C (=NH) O (C1-6Alkyl) , -OC (=NH) (C1-6Alkyl) , -OC (=NH) OC1-6Alkyl, -C (=NH) N (C1-6Alkyl) 2, -C (=NH) NH (C1-6Alkyl) , -C (=NH) NH2, -OC (=NH) N (C1-6Alkyl) 2, -OC (NH) NH (C1-6Alkyl) , -OC (NH) NH2, -NHC (NH) N (C1-6Alkyl) 2, -NHC (=NH) NH2, -NHSO2 (C1-6Alkyl) , -SO2N (C1-6Alkyl) 2, -SO2NH (C1-6Alkyl) , -SO2NH2, -SO2C1-6Alkyl, -SO2OC1-6Alkyl, -OSO2C1-6Alkyl, -SOC1-6Alkyl, -Si (C1-6Alkyl) 3, -OSi (C1-6Alkyl) 3, -C (=S) N (C1-6Alkyl) 2, C (=S) NH (C1-6Alkyl) , C (=S) NH2, -C (=O) S (C1-6Alkyl) , -C (=S) SC1-6Alkyl, -SC (=S) SC1-6Alkyl, -P (=O) 2 (C1-6Alkyl) , -P (=O) (C1-6Alkyl) 2, -OP (=O) (C1-6Alkyl) 2, -OP (=O) (OC1-6Alkyl) 2, C1-6Alkyl, C1-6Haloalkyl, C2-C6Alkenyl, C2-C6Alkynyl, C3-C7Cycloalkyl, C6-C10Aryl, C3-C7Heterocyclyl, C5-C10Heteroaryl; or two geminal Rgg substituents may be connected to form =O or =S; wherein, X-is a counterion.
[0217] Exemplary substituents on a nitrogen atom include, but are not limited to: hydrogen, -OH, -ORaa, -N (Rcc) 2, -CN, -C (=O) Raa, -C (=O) N (Rcc) 2, -CO2Raa, -SO2Raa, -C (=NRbb) Raa, -C (=NRcc) ORaa, -C (=NRcc) N (Rcc) 2, -SO2N (Rcc) 2, -SO2Rcc, -SO2ORcc, -SORaa, -C (=S) N (Rcc) 2, -C (=O) SRcc, -C (=S) SRcc, -P (=O) 2Raa, -P (=O) (Raa) 2, -P (=O) 2N (Rcc) 2, -P (=O) (NRcc) 2, alkyl, haloalkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl, or two Rcc groups connecting to said nitrogen atom are connected to form a heterocyclyl ring or heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, cycloalkyl, heterocyclyl, aryl and heteroaryl is independently substituted with 0, 1, 2, 3, 4 or 5 Rdd groups, and wherein Raa, Rbb, Rcc and Rdd are as described above.
[0218] When any variable (e.g., R) occurs more than once in the composition or structure of a compound, the definition of the variable is independent for each occurrence. Thus, for example, if a group is substituted with 0 to 2 R, the group may optionally be substituted with up to two R, wherein the definition of R is independent for each occurrence. Furthermore, combinations of substituents and / or variants thereof are permissible only if such combinations result in stable compounds.
[0219] When one of the variables is a single bond, it means that the two groups linked by the single bond are connected directly. For example, when L in A-L-B represents a single bond, the structure of A-L-B is actually A-B.
[0220] When an enumerated linking group (i.e., divalent group) does not indicate its linking direction, the linking direction is arbitrary. For example, when the linking group L in A-L-B is -M-W-, -M-W-can be linked to variables A and B in the same direction in the reading order from left to right to form A-MW-B, or it can be linked to rings A and B in the reverse direction in the reading order from left to right to form A-WM-B.
[0221] 2. Some additional definitions
[0222] The term "nucleic acid molecule" as used herein refers to its meaning as is generally accepted in the art. A nucleic acid molecule generally refers to a molecule consisting of nucleotides, including but not limited to siRNA, ASO, and shRNA.
[0223] The term "nucleotide" as used herein refers to its meaning as is generally accepted in the art. A nucleotide generally comprises a heterocyclic base moiety (i.e., a base) , a sugar moiety, and an internucleoside linkage (e.g., a phosphate group or a phosphorothioate group) . The base can be a natural base (A, U, T, C, G, collectively referred to herein as N) , a modified base, or a base analog. Additionally, the nucleotides can be unmodified or modified at the sugar, internucleoside linkage, or base moiety (also referred to interchangeably as nucleotide analogs, non-natural nucleotides, non-standard nucleotides, and the like) . A naturally occurring internucleoside linkage refers to a 3'to 5'phosphodiester linkage (also referred to herein as a 3'-5'phosphodiester linkage) . Modified nucleotides include inverted nucleotides connected to the front and back nucleotides via a 5'to 5'phosphodiester linkage and a 3'to 3'phosphodiester linkage.
[0224] The term "2'-5'ribonucleotide" as used herein refers to its meaning as is generally accepted in the art. In contrast to a native ribonucleotide (i.e., 3'-5'ribonucleotide) , the phosphate is attached at the 2'position rather than at the 3'position of the sugar moiety, including but not limited to A2p, C2p, G2p, and U2p, wherein A2p is adenosine 2'-phosphate, C2p is cytidine 2'-phosphate, G2p is guanosine 2'-phosphate, and U2p is uridine 2'-phosphate.
[0225] The term "2'-5'deoxyribonucleotide" as used herein refers to its meaning as is generally accepted in the art. In contrast to a native deoxyribonucleotide (i.e., 3'-5'deoxyribonucleotide) , the phosphate is attached at the 2'position rather than at the 3'position of the sugar moiety.
[0226] The term "abasic" as used herein refers to its meaning as is generally accepted in the art. For nucleotides, the term generally refers to a sugar moiety (1) lacking a base, or (2) having a hydrogen atom or other non-base chemical groups in place of a base at the 1'position of the sugar moiety. In some embodiments, a compound of the present disclosure may contain one or more abasic moieties that are ribose, deoxyribose, or dideoxyribose.
[0227] The term "sugar moiety" as used herein refers to a natural or modified sugar ring or sugar surrogate. As used herein, galactose is galactosamine is which is optionally substituted with -Ac, -C (O) -C1-6 alkylene-OH, e.g. N-acetylgalactosamine is N-acetylglucosamine is glucose is mannose is glucuronic acid is neuraminic acid (sialic acid) is xylose is or fucose is
[0228] The term "blunt end" as used herein refers to that there are no unpaired nucleotides at that end of a nucleic acid (e.g., dsRNA) , i.e., there are no nucleotide that overhangs at that end. A "blunt-ended RNA" is an RNA that is double-stranded throughout its length, i.e., there are no nucleotide overhangs at either end of the molecule.
[0229] The term "overhang" as used herein refers to at least one unpaired nucleotide that protrudes from the double-stranded region of a nucleic acid (e.g., dsRNA) . Nucleotide overhangs exist, for example, when the 3'-end of one strand of the nculeci acid extends beyond the 5'-end of the other strand, or vice versa. A dsRNA can comprise an overhang of at least one nucleotide, at least two nucleotides, at least three nucleotides, at least four nucleotides, at least five nucleotides, or more. A nucleotide overhang may comprise or consist of a nucleotide / modified nucleotide (including a deoxynucleotide / nucleoside) . One or more overhangs can be on the sense strand, the antisense strand, or any combination thereof. The overhang having one or more nucleotides may be present at the 5'-end, 3'-end, or both ends of the antisense or sense strand of the dsRNA.
[0230] The term "terminal modification" as used herein refers to a modification at an end (i.e., the 5'end and / or the 3'end) of a nucleic acid strand, including but not limited to optionally substituted abasic nucleotides, inverted nucleotides, and compounds in PCT Publication No. WO2024002006A1 below.
[0231] Table 1.
[0232] In the above table, "*" represents a chiral center selected from the (S) or (R) absolute configuration, or the racemic form thereof.
[0233] The substituted terminal modifications may include terminal modifications conjugated to the GalNAc molecule in a manner known in the art. Representative structures are, for example,
[0234] The term "IB" as used herein refers to an inverted abasic deoxyribonucleotide, which is an abasic nucleotide and can be of the following three structures depending on its position / connection method in dsRNA. IB is well known in the art. See, for example, F. Czauderna, Nucleic Acids Res., 2003, 31 (11) , 2705-16 and PCT Publication Nos. WO2016011123 and WO2019051402.
[0235] The term "STM1" as used herein refers to a molecule of the following structure as described in PCT Publication No. WO2024002006A1.
[0236] The term "siRNA" herein is a class of dsRNA molecules each of which can mediate the silencing of target RNA (e.g., mRNA, e.g., transcript of a gene encoding a protein) complementary thereto. A siRNA is generally double-stranded, including an antisense strand complementary to the target RNA thereof and a sense strand complementary to this antisense strand. For the sake of convenience, such an mRNA is also referred to herein as mRNA to be silenced. And such a gene is also called target gene. Usually, an RNA to be silenced herein is an endogenous gene or a pathogen gene. In addition, RNAs other than mRNA (e.g., tRNA) as well as viral RNA may also be targeted.
[0237] The term "antisense strand" herein refers to a strand of a siRNA, wherein said strand contains a region that is completely, sufficiently or substantially complementary to the target sequence thereof. The term "sense strand" herein refers to a strand of a siRNA, wherein said strand contains a region that is completely, sufficiently or substantially complementary to a region of an antisense strand as defined herein.
[0238] The term "complementary region" herein refers to a region on an antisense strand that is completely, sufficiently or substantially complementary to the target mRNA sequence thereof. In cases where a complementary region is incompletely complementary to the target sequence thereof, a mismatch may be located in an internal or terminal region of the molecule. Typically, a mismatch most tolerant is located in a terminal region, e.g., within 5, 4, 3, 2 or 1 nucleotide at the 5'a nd / or 3'end. A region in an antisense strand, which is most sensitive to mismatch, is called "seed region" . For example, in a siRNA containing a strand of 19 nt, the 19th site (counting from the 5'end to the 3'end) can tolerate some mismatches.
[0239] The term "complementary" refers to the ability of a first polynucleotide to hybridize with a second polynucleotide under certain conditions, such as stringent conditions. For example, stringent conditions may include 400 mM NaCl, 40 mM PIPES pH 6.4, 1 mM EDTA, and 50℃ or 70℃ for 12-16 hours. With respect to fulfilling the above required capabilities related to the hybridization ability thereof, said "complementary" sequences may also include or be entirely composed of non-Watson-Crick base pairs and / or base pairs formed from non-natural as well as modified nucleotides. Such non-Watson-Crick base pairs include, but are not limited to, G: U wobble base pairing or Hoogsteen base pairing.
[0240] A polynucleotide that is "at least partially complementary" , "sufficiently complementary" or "substantially complementary" to a messenger RNA (mRNA) refers to a polynucleotide that is substantially complementary to a continuous portion of the mRNA of interest. For example, a polynucleotide is at least partially complementary to an mRNA encoding PCSK9, when the sequence thereof is substantially complementary to an uninterrupted portion of said PCSK9 mRNA. The terms "complementary, " "completely complementary, " "sufficiently complementary" and "substantially complementary" as used herein may be applied to base pairing between the sense strand and antisense strand of a siRNA, or between the antisense strand of a siRNA reagent and the target sequence thereof.
[0241] "Sufficiently complementary" refers to the extent to which the sense strand only needs to be complementary to the antisense strand to maintain the overall double-stranded character of the molecule. In other words, although perfect complementarity is generally desired, in some cases, particularly in the antisense strand, one or more, e.g., 6, 5, 4, 3, 2, or 1 mismatch (relative to the target mRNA) may be included, but the sense and antisense strands can still maintain the overall double-stranded character of the molecule.
[0242] The term "shRNA" herein refers to short hairpin RNA. An shRNA comprises two short inverted repeat sequences. An shRNA cloned into an shRNA expression vector comprises two short inverted repeat sequences, separated by a loop sequence, forming a hairpin structure and controlled by the RNA polymerase III (pol III) promoter. Subsequently, 5 to 6 Ts are ligated as transcription terminators of pol III.
[0243] "Nucleoside" is a compound comprising two substances: one is a purine base or a pyrimidine base, and the other is a ribose or a deoxyribose; "nucleotide" is a compound comprising three substances: one is a purine base or a pyrimidine base, another is a ribose or deoxyribose, and the third is a phosphoric acid; and "oligonucleotide" refers to, for example, a nucleic acid molecule (RNA or DNA) with a length of less than 100, 200, 300 or 400 nucleotides.
[0244] The term "base" is a fundamental building block of nucleosides, nucleotides and nucleic acids; as always containing nitrogen, said base is also referred to as "nitrogenous base. " Unless otherwise specified, the capital letters herein, i.e., A, U, T, G and C, denote the bases of nucleotides, which is adenine, uracil, thymine, guanine and cytosine, respectively.
[0245] As used herein, the "modification" of nucleotides includes, but is not limited to: methoxyl substitution (methoxy-modified) , fluorine substitution (fluoro-modified) , connection with a phosphorothioate group, or protection with a conventional protecting group. For example, a fluoro-modified nucleotide refers to a nucleotide formed by substituting the hydroxyl at the 2'position of the ribosyl of the nucleotide with a fluorine atom, while a methoxy-modified nucleotide refers to a nucleotide formed by substituting the 2'-hydroxyl of the ribosyl with a methoxyl.
[0246] "Modified nucleotides" herein include, but are not limited to: a 2'-O-methyl modified nucleotide, a 2'-fluoro modified nucleotide, a 2'-deoxy-modified nucleotide, an inosine ribonucleotide, an abasic nucleotide, an inverted abasic deoxyribonucleotide, a nucleotide comprising a phosphorothioate group, a nucleotide modified by vinylphosphonate, a locked nucleotide, 2'-amino-modified nucleotide, 2'-alkyl-modified nucleotide, a morpholino nucleotide, a phosphoramidate, a non-natural base comprising nucleotide, and a terminal nucleotide linked to a cholesteryl derivative or a dodecanoic acid bisdecylamide group, deoxyribonucleotide, or a nucleotide with protection of a conventional protecting group. For example, a 2'-fluoro modified nucleotide refers to a nucleotide formed by substituting the hydroxyl at the 2'position of the ribosyl in a nucleotide with a fluorine atom. Said 2'-deoxy-modified nucleotide refers to a nucleotide formed by substituting the 2'-hydroxyl of the ribosyl with a methoxyl.
[0247] The term "SCP modification" as used herein refers to a modified nucleotide of the following structure: wherein Base is independently selected from H, a modified or unmodified base, or a leaving group. Preferably, Base is an unmodified base, including an adenine base, a guanine base, a uracil base, and a cytosine base. In other embodiments, Base is a modified base. The SCP modifications can be found, for example, in PCT Publication No. WO2023241587A1.
[0248] The term "phosphorothioate internucleotide linkage" as used herein refers to a modification in which two adjacent left and right nucleotides are linked by a phosphorothioate group.
[0249] The term “ligand moiety” as used herein refers to a chemical component conjugated with a siRNA, wherein the moiety is capable of changing the distribution, targeting, or lifespan of the siRNA. In a preferred embodiment, such a ligand offers enhanced affinity for selected targets, such as molecules, cells or cell types, and compartments (e.g., cellular or organ compartments, tissues, organs, or regions of the body) , compared to for example a siRNA without such a ligand. Exemplary ligand moieties are, for example, ligands comprising GalNAc, ligands comprising an aliphatic chain, and ligands designed based on a small molecule compound.
[0250] The term "amino acid residue" refers to any natural or synthetic amino acid residue, which is not limited to those in the group consisting of 20 naturally occurring amino acids, wherein the residue refers to the remaining portion of an amino acid connected by a peptide bond after dehydration. The 20 naturally occurring amino acid residues are selected from the group consisting of: alanine (Ala or A) , cysteine (Cys or C) , aspartic acid (Asp or D) , glutamic acid (Glu or E) , phenylalanine (Phe or F) , glycine (Gly or G) , histidine (His or H) , isoleucine (Ile or I) , lysine (Lys or K) , leucine (Leu or L) , methionine (Met or M) , asparagine (Asn or N) , proline (Pro or P) , glutamine (Gln or Q) , arginine (Arg or R) , serine (Ser or S) , threonine (Thr or T) , valine (Val or V) , tryptophan (Trp or W) , and tyrosine (Tyr or Y) residues.
[0251] "Protecting group" refers to any atom or group of atoms added to a molecule to prevent undesired chemical reactions of existing groups within the molecule. A "protecting group" may be an unstable chemical moiety known in the art, which is used to protect reactive groups such as hydroxyl, amino and thiol groups to prevent undesired or premature reactions during chemical synthesis. Protecting groups are typically used selectively and / or orthogonally to protect sites during the reactions of other reactive sites, which can then be removed to leave the unprotected groups intact or available for further reactions.
[0252] A non-limiting list of protecting groups include benzyl; substituted benzyl; alkylcarbonyls and alkoxycarbonyls (e.g., t-butoxycarbonyl (BOC) , acetyl, or isobutyryl) ; arylalkylcarbonyls and arylalkoxycarbonyls (e.g., benzyloxycarbonyl) ; substituted methyl ether (e.g. methoxymethyl ether) ; substituted ethyl ether; a substituted benzyl ether; tetrahydropyranyl ether; silyls (e.g., trimethylsilyl, triethylsilyl, triisopropylsilyl, t-butyldimethylsilyl, tri-iso-propylsilyloxymethyl, [2- (trimethylsilyl) ethoxy] methyl or t-butyldiphenylsilyl) ; esters (e.g. benzoate ester) ; carbonates (e.g. methoxymethylcarbonate) ; sulfonates (e.g. tosylate or mesylate) ; acyclic ketal (e.g. dimethyl acetal) ; cyclic ketals (e.g., 1, 3-dioxane, 1, 3-dioxolanes, and those described herein) ; acyclic acetal; cyclic acetal (e.g., those described herein) ; acyclic hemiacetal; cyclic hemiacetal; cyclic dithioketals (e.g., 1, 3-dithiane or 1, 3-dithiolane) ; orthoesters (e.g., those described herein) and triarylmethyl groups (e.g., trityl; monomethoxytrityl (MMTr) ; 4, 4′-dimethoxytrityl (DMTr) ; 4, 4′, 4″-trimethoxytrityl (TMTr) ; and those described herein) . Preferred protecting groups are selected from acetyl (Ac) , benzoyl (Bzl) , benzyl (Bn) , isobutyryl (iBu) , phenylacetyl, benzyloxymethyl acetal (BOM) , beta-methoxyethoxymethyl ether (MEM) , methoxymethylether (MOM) , p-methoxybenzyl ether (PMB) , methylthiomethyl ether, pivaloyl (Piv) , tetrahydropyranyl (THP) , triphenylmethyl (Trt) , methoxytrityl [ (4-methoxyohenyl) diphenylmethyl-] (MMT) , dimethoxytrityl, [bis- (4-methoxyphenyl) phenylmethyl (DMT) , trimethylsilyl ether (TMS) , tert-butyldimethylsilyl ether (TBDMS) , tri-iso-propylsilyloxymethyl ether (TOM) , tri-isopropylsilyl ether (TIPS) , methyl ethers, ethoxyethyl ethers (EE) N, N-dimethylformamidine and 2-cynaonethyl (CE) .
[0253] "Hydroxy-protecting group" refers to a group that can prevent a hydroxyl from undergoing chemical reactions and can be removed under specific conditions to restore the hydroxyl. The main hydroxy-protecting groups include silane-type, acyl-type, or ether-type protecting groups, preferably the following: trimethylsilyl (TMS) , triethylsilyl (TES) , dimethylisopropylsilyl (DMIPS) , diethylisopropylsilyl (DEIPS) , tert-butyldimethylsilyl (TBDMS) , tert-butyldiphenylsilyl (TBDPS) , triisopropylsilyl (TIPS) , acetyl (Ac) , chloroacetyl, dichloroacetyl, trichloroacetyl, trifluoroacetyl (TFA) , benzoyl, p-methoxybenzoyl, 9-fluorenylmethoxycarbonyl (Fmoc) , allyloxycarbonyl (Alloc) , 2, 2, 2-trichloroethoxycarbonyl (Troc) , benzyloxycarbonyl (Cbz) , tert-butoxycarbonyl (Boc) , benzyl (Bn) , p-methoxybenzyl (PMB) , allyl, triphenylmethyl (Tr) , di-p-methoxytrityl (DMTr) , methoxymethyl (MOM) , benzyloxymethyl (BOM) , 2, 2, 2-trichloroethoxymethyl, 2-methoxyethoxymethyl (MEM) , methylthiomethyl (MTM) , p-methoxybenzyloxymethyl (PMBM) , -C (O) CH2CH2C (O) OH or 4, 4'-dimethoxytrityl, preferably -C (O) CH2CH2C (O) OH or 4, 4'-dimethoxytrityl, more preferably -C (O) CH2CH2C (O) OH.
[0254] As used herein, the term "pharmaceutically acceptable salt" represents carboxylates or amino acid salts of a compound of the present disclosure, which are suitable for contact with patient tissues within the scope of sound medical judgment without causing excessive toxicity, irritation, allergic reactions, etc., and are effective in terms of the intended use with a reasonable benefit / risk ratio; said salt includes, where applicable, the zwitterionic form of a compound of the present disclosure.
[0255] The present disclosure includes tautomers, which are functional-group isomers resulting from the rapid migration of an atom in a molecule between two positions. A compound with different tautomeric forms, said herein, refers to all the tautomers and does not be restricted to any specific tautomeric form.
[0256] A compound of the present disclosure may include one or more asymmetric centers, and thus may exist in various stereoisomeric forms, such as enantiomers and / or diastereomers. For example, a compound of the present disclosure may be one of the forms of enantiomer, diastereoisomer or geometric isomer (e.g. a cis isomer or a trans isomer) , or may be a mixture of any type of stereoisomerism, including a racemic mixture and a mixture enriched with one or more forms of stereoisomer. The present disclosure contemplates all such compounds, including cis and trans isomers, (-) -and (+) -enantiomers, (R) -and (S) -enantiomers, diastereomers, (D) -isomers, (L) -isomers, and racemic and other mixtures thereof, such as enantiomeric or diastereomerically enriched mixtures, all of which are within the scope of the present disclosure. Herein, for a compound or linking structure containing a chiral center, it may be in the (S) absolute configuration, or in the (R) absolute configuration, or a mixture of both, i.e., a racemic form. An isomer herein may be achieved by separating from a mixture via any method known to those skilled in the art, wherein the method includes chiral high-pressure liquid chromatography (HPLC) and the formation and crystallization of chiral salts; alternatively, a preferred isomer may be prepared through asymmetric synthesis.
[0257] The present disclosure also includes isotopically labeled compounds (isotopic variants) which are equivalent to those described by formula (I) , except that one or more atoms are replaced with atoms with an atomic mass or mass number different from that common in nature. Examples of isotopes which may be incorporated into a compound of the present disclosure include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorus, sulfur, fluorine, and chlorine, such as 2H, 3H, 13C, 11C, 14C, 15N, 18O, 17O, 31P, 32P, 35S, 18F, and 36Cl. Any compounds based on a compound of the present disclosure and containing any aforementioned isotope and / or any isotope of other atoms, the prodrugs thereof and the pharmaceutically acceptable salts of said compounds or said prodrugs all fall in the scope of the present disclosure. Certain isotopically labeled compounds of the present disclosure, such as a compound into which any radioisotope (e.g., 3H and 14C) is introduced, may be used for distribution determinations of a drug and / or the substrate tissue thereof. Tritium, i.e. 3H and carbon-14, i.e. 14C isotopes are particularly preferred, because they can be easily prepared and detected. Furthermore, substitution with an isotope heavier, such as deuterium, i.e. 2H, may in some cases be preferred because resultant increased metabolic stability may provide therapeutic benefits such as prolonged in vivo half-life or reduced dosage. An isotopically labeled compound of formula (I) of the present disclosure and the prodrug thereof may generally be prepared with any readily available isotopically labeled reagent instead of any non-isotopically labeled reagent, in a procedure described below and / or in a process disclosed in any of the Examples and Preparations.
[0258] As used here, the term “multivalent siRNA compound” refers to an siRNA compound that suppresses one gene at multiple sites (e.g., 2, 3, 4, 5, 6, 7, 8, 9, or 10 sites) or an siRNA compound that suppresses multiple genes (e.g., 2, 3, 4, 5, 6, 7, 8, 9, or 10 genes) all at once. In some embodiments, the multivalent siRNA compound is a bivalent siRNA compound, e.g., an siRNA compound that suppresses two identical or different genes all at once. In some embodiments, the multivalent siRNA compound is a trivalent siRNA compound, e.g., an siRNA compound that suppresses three identical or different genes all at once.
[0259] II. Compounds
[0260] The present disclosure relates to a compound of formula I or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof:
[0261] G1-L-G2 (V)
[0262] wherein G1, G2, and L are as defined below.
[0263] The present disclosure relates to a compound of formula I or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof:
[0264] G1-S1-X-S2-G2 (I)
[0265] wherein G1, G2, S1, S2, and X are as defined below.
[0266] The present disclosure further relates to a cell comprising a compound as described above.
[0267] The present disclosure further relates to a pharmaceutical composition comprising a compound as described above, or a cell as described above, and optionally a pharmaceutically acceptable carrier or excipient.
[0268] The present disclosure further relates to a kit comprising a compound as described above, or a cell as described above.
[0269] “S1” , “S2” , “X” , and “L” can be any relevant moieties described in PCT Application No. PCT / CN2025 / 074781 which is incorporated herein by reference in its entirety.
[0270] 1. G1 and G2
[0271] In some embodiments, one of G1 and G2 is a first oligonucleotide targeting PCSK9 and the other one of G1 and G2 is an LDL-lowering enhancer.
[0272] In some embodiments, the LDL-lowering enhancer described herein targets a gene encoding CETP (Cholesteryl Ester Transfer Protein) , SCAP (SREBP cleavage activating protein) , ASGR1 (Asialoglycoprotein Receptor 1) , USP20 (Ubiquitin Specific Peptidase 20) , ACLY (ATP Citrate Lyase) , MYLIP (Myosin Regulatory Light Chain Interacting Protein) , KLKB1 (Kallikrein B1) , ANGPTL8 (Angiopoietin Like 8) , or DGAT2 (Diacylglycerol O-Acyltransferase 2) . In some embodiments, the LDL-lowering enhancer described herein is a oligonucleotide targeting any one of the genes described herein. In some embodiments, the oligonucleotide is a siRNA, e.g., a siRNA targeting CETP (see WO2005045041A2) , SCAP (see WO2008036638A2, WO2017100542A1, WO2023201043A1, WO2020243702A2, WO2023230495A2, and WO2024104416A1) , ASGR1 (see WO2019079294A1, WO2018039647A1, and WO2024046297A1) , USP20 (see CN119020355A) , ACLY, MYLIP (see WO2011091396A1 or WO2023108020A2) , KLKB1 (see WO2016179342A2, WO2012170945A2, WO2013003808A1, WO2015168532A2, WO2018148449A1, WO2021183857A1, WO2023056440A1, WO2020238758A1, WO2022143531A1, and WO2023143483A1) , ANGPTL8 (see WO2020104649A2, WO2022271808A1, WO2024138111A1, WO2024160147A1, and WO2024227059A2) , and DGAT2 (see WO2017011276A1, WO2023173061A2, WO2024238752A1, WO2024005158A1, WO2024245151A1, WO2025031444A1, and WO2025040139A1) . Each of the above publications is incorporated herein by reference in its entirety.
[0273] In some embodiments, G1 is a first oligonucleotide targeting PCSK9 and G2 is a second oligonucleotide targeting LPA. In some embodimentsIn some embodiments, G1 is a first oligonucleotide targeting LPA and G2 is a second oligonucleotide targeting PCSK9.
[0274] In some embodimentsIn some embodiments, G1 and G2 are each independently a dsRNA. In another embodiment, G1 and G2 are each independently a siRNA. In another embodiment, G1 is a single-stranded RNA and G2 is a dsRNA. In another embodiment, G1 is a dsRNA and G2 is a single-stranded RNA.
[0275] In some embodiments, G1 and G2 are each independently a siRNA, and each sense strand is connected to a linker of the present disclosure. In more specific embodiments, the sense strand of G1 connects to a linker at its 3’ end and the sense strand of G2 connects to the linker at its 5’ end. In more specific embodiments, the sense strand of G1 connects to a linker at its 5’ end and the sense strand of G2 connects to the linker at its 3’ end.
[0276] In some embodiments, G1 and G2 may each optionally be conjugated to a ligand moiety. In a specific embodiment, the 5'end of G1 is conjugated to a ligand moiety. In a specific embodiment, the 3'end of G2 is conjugated to a ligand moiety.
[0277] In some embodiments, G1 and / or G2 are independently 10-100, 10-50, 15-30, 17-25, 20-25, or 21-32 nucleotides in length.
[0278] 2. dsRNA, siRNA, and modifications of nucleotides
[0279] Both dsRNA and siRNA comprise a sense strand and an antisense strand.
[0280] In some embodiments, substantially all nucleotides of the sense strand and substantially all nucleotides of the antisense strand are modified nucleotides. In some embodiments, at least 80%of the nucleotides of the sense strand are modified nucleotides, and / or at least 80%, at least 85%, at least 90%, at least 92%, and at least 95%of the nucleotides of the antisense strand are modified nucleotides. In some embodiments, at least 80%of the nucleotides of the antisense strand are modified nucleotides, and / or at least 80%, at least 85%, at least 90%, at least 92%, and at least 95%of the nucleotides of the sense strand are modified nucleotides.
[0281] In some embodiments, all nucleotides of the sense strand and / or all nucleotides of the antisense strand are modified nucleotides.
[0282] The modification of a nucleotide described in the present disclosure may be a modification at the phosphate group, ribose group, and / or base group of the nucleotide.
[0283] In some specific embodiments, the sense strand and antisense strand each independently comprise one or more nucleotide modifications selected from the group consisting of: 2'-O-alkyl modified nucleotides (e.g., 2'-O-methyl modified nucleotide) , 2'-methoxyethyl modified nucleotides, 2'-fluoro modified nucleotides, 2'-deoxy-modified nucleotides, inosine ribonucleotides, abasic nucleotides, inverted abasic deoxyribonucleotides, nucleotides containing a phosphorothioate group, vinylphosphonate modified nucleotides, locked nucleotides, unlocked nucleotides, 2'-amino modified nucleotides, 2'-C-alkyl modified nucleotides, 2'-O-allyl modified nucleotides, morpholino nucleotides, phosphoramidates, nucleotides containing a non-natural base, terminal nucleotides linked to a cholesteryl derivative or a dodecanoic acid bisdecylamide group, deoxyribonucleotides, 3'‐terminal deoxythymine (dT) nucleotides, conformationally restricted nucleotides, constrained ethyl nucleotides, 2'‐hydroxy modified nucleotides, nucleotides containing a methylphosphonic acid group, nucleotides containing 5'‐phosphoric acid, nucleotides containing a 5'-phosphate mimetic, glycol nucleic acids (GNAs) , and 2‐O‐(N‐methylacetamide) modified nucleotides.
[0284] In some preferred embodiments, the sense strand and antisense strand each independently comprise one or more nucleotide modifications selected from the group consisting of: 2'-O-methyl modified nucleotides, 2'-fluoro modified nucleotides, and nucleotides containing a phosphorothioate group. In some preferred embodiments, the sense strand and / or the antisense strand comprises at least two 2'-fluoro modified nucleotides. In some preferred embodiments, the sense strand and / or the antisense strand comprises at least eight 2'-O-methyl modified nucleotides. In some preferred embodiments, the 3'region and / or 5'region of the sense strand and / or the antisense strand comprises 1 to 5 phosphorothioate internucleotide linkages, preferably 1, 2, or 3 phosphorothioate internucleotide linkages.
[0285] In some preferred embodiments, the 3'region of the sense strand comprises only one phosphorothioate internucleotide linkage. In some preferred embodiments, the 5'region of the antisense strand comprises only one phosphorothioate internucleotide linkage.
[0286] The term “3’ region” or “5’ region” as used herein means first 5 nucleotides counting from 3’ end or 5’ end, respectively, of a strand of a dsRNA.
[0287] In some preferred embodiments, the first antisense strand and / or the second antisense strand has 2-8 2’ -fluoro modified nucleotides, preferably 4-6 2’ -fluoro modified nucleotides, more preferably 5 2’ -fluoro modified nucleotides.
[0288] In some preferred embodiments, the first antisense strand and / or the second antisense strand has 4-12 phosphorothioate internucleotide linkages, preferably 6-10 phosphorothioate internucleotide linkages, more preferably 7 or 8 phosphorothioate internucleotide linkages.
[0289] In some preferred embodiments, the first sense strand and / or the second sense strand has 4-12 phosphorothioate internucleotide linkages, preferably 5-10 phosphorothioate internucleotide linkages, more preferably 5-8 phosphorothioate internucleotide linkages.
[0290] In some preferred embodiments, the internucleotide linkage between nucleotide positions 1 and 2 (counting from the 5’ end) of the first antisense strand and / or the second antisense strand is a natural phosphodiester linkage.
[0291] In some embodiments, the antisense strand has a length of 21 nucleotides and has (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, and 21, and 2'-fluoro modified nucleotides at positions 2, 4, 6, 8, 10, 12, 14, 16, 18, and 20; and / or
[0292] (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0293] In some embodiments, the antisense strand has a length of 21 nucleotides and has
[0294] (i) (counting from the 5'end) an SCP modification at position 1;
[0295] (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 4, 6, 8, 10, 12, 14, 16, and 18;
[0296] (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 5, 7, 9, 11, 13, 15, 17, 19, 20, and 21; and / or
[0297] (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0298] In some embodiments, the antisense strand has a length of 21 nucleotides and has
[0299] (i) (counting from the 5'end) an SCP modification at position 1;
[0300] (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;
[0301] (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or
[0302] (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0303] In some embodiments, the antisense strand has a length of 19 nucleotides and has (i) (counting from the 5'end) an SCP modification at position 1;
[0304] (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;
[0305] (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, and 19; and / or
[0306] (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 17 and 18, and between nucleotide positions 18 and 19.
[0307] In some embodiments, the antisense strand has a length of 21 nucleotides and has (i) (counting from the 5'end) an SCP modification at position 1;
[0308] (ii) (counting from the 5'end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;
[0309] (iii) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or
[0310] (iv) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0311] In some embodiments, the antisense strand has a length of 21 nucleotides and has
[0312] (i) (counting from the 5'end) 2'-deoxy modifications at positions 2, 5, 7, and 12;
[0313] (ii) (counting from the 5'end) an SCP modification at position 1;
[0314] (iii) (counting from the 5'end) a 2'-fluoro modification at position 14;
[0315] (iv) (counting from the 5'end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or
[0316] (v) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.
[0317] In some embodiments, the sense strand has a length of 19 nucleotides and has (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or
[0318] (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, and between nucleotide positions 18 and 19.
[0319] In some embodiments, the sense strand has a length of 19 nucleotides and has
[0320] (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or
[0321] (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 17 and 18, and between nucleotide positions 18 and 19.
[0322] In some embodiments, the sense strand has a length of 19 nucleotides and has
[0323] (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or
[0324] (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 18 and 19.
[0325] In some embodiments, the sense strand has a length of 19 nucleotides and has
[0326] (i) (counting from the 5'end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or
[0327] (ii) (counting from the 5'end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, and between nucleotide positions 18 and 19.
[0328] a. PCSK9-targeting dsRNA
[0329] The PCSK9-targeting dsRNA of the present disclosure is a first dsRNA (especially siRNA) for inhibiting expression of proprotein convertase subtilisin / kexin type 9 (PCSK9) , wherein the first dsRNA comprises a first sense strand and a first antisense strand forming a first duplex region, wherein the first antisense strand comprises at least 15 contiguous nucleotides from a target PCSK9 mRNA sequence.
[0330] The target PCSK9 mRNA sequence is, for example, the gene shown under Genbank Accession No. NM_174936.4 (SEQ ID NO: 1) .
[0331] In some embodiments, the first antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence complementary to nucleotides 3529-3618 of SEQ ID NO: 1, preferably nucleotides 3529-3576 of SEQ ID NO: 1, more preferably nucleotides 3535-3566 of SEQ ID NO: 1.
[0332] In some embodiments, the first antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of Table 2, preferably the first antisense strand comprises a nucleotide sequence as set forth in any one of Table 2.
[0333] In some embodiments, the first sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of Table 2, preferably the first sense strand comprises a nucleotide sequence as set forth in any one of Table 2.
[0334] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 3, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 41.
[0335] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 4, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 42.
[0336] In some embodiments, the dsRNA comprises a paired sense strand sequence and antisense strand sequence as set forth in any one of Table 2.
[0337] Table 2. Sense strand and antisense strand nucleotide sequences targeting PCSK9 mRNA
[0338] Specifically, PCSK9#1 targets nucleotides 3529-3551 of SEQ ID NO: 1; PCSK9#2 targets nucleotides 3537-3556 of SEQ ID NO: 1; PCSK9#3 targets nucleotides 3536-3556 of SEQ ID NO: 1; PCSK9#4 targets nucleotides 3537-3559 of SEQ ID NO: 1; PCSK9#5 targets nucleotides 3543-3563 of SEQ ID NO: 1; PCSK9#6 targets nucleotides 3543-3563 of SEQ ID NO: 1; PCSK9#7 targets nucleotides 3535-3557 of SEQ ID NO: 1; PCSK9#8 targets nucleotides 3536-3556 of SEQ ID NO: 1; PCSK9#9 targets nucleotides 3545-3564 of SEQ ID NO: 1; PCSK9#10 targets nucleotides 3570-3588 of SEQ ID NO: 1; PCSK9#11 targets nucleotides 3467-3487 of SEQ ID NO: 1; PCSK9#12 targets nucleotides 3574-3594 of SEQ ID NO: 1; PCSK9#13 targets nucleotides 1088-1108 of SEQ ID NO: 1; PCSK9#14 targets nucleotides 3535-3555 of SEQ ID NO: 1; PCSK9#15 targets nucleotides 3571-3591 of SEQ ID NO: 1; PCSK9#16 targets nucleotides 3597-3617 of SEQ ID NO: 1; PCSK9#17 targets nucleotides 3535-3551 of SEQ ID NO: 1; PCSK9#18 targets nucleotides 3593-3613 of SEQ ID NO: 1; PCSK9#19 targets nucleotides 3581-3600 of SEQ ID NO: 1; PCSK9#20 targets nucleotides 3588-3606 of SEQ ID NO: 1; PCSK9#21 targets nucleotides 3536-3555 of SEQ ID NO: 1; PCSK9#22 targets nucleotides 3536-3556 of SEQ ID NO: 1; PCSK9#23 targets nucleotides 3535-3555 of SEQ ID NO: 1; PCSK9#24 targets nucleotides 1547-1567 of SEQ ID NO: 1; PCSK9#25 targets nucleotides 3550-3570 of SEQ ID NO: 1; PCSK9#26 targets nucleotides 3531-3553 of SEQ ID NO: 1; PCSK9#27 targets nucleotides 3538-3559 of SEQ ID NO: 1; PCSK9#28 targets nucleotides 3543-3565 of SEQ ID NO: 1; PCSK9#29 targets nucleotides 3573-3595 of SEQ ID NO: 1; PCSK9#30 targets nucleotides 3575-3597 of SEQ ID NO: 1; PCSK9#31 targets nucleotides 3316-3338 of SEQ ID NO: 1; PCSK9#32 targets nucleotides 893-913 of SEQ ID NO: 1; PCSK9#33 targets nucleotides 3465-3484 of SEQ ID NO: 1; PCSK9#34 targets nucleotides 3191-3210 of SEQ ID NO: 1; PCSK9#35 targets nucleotides 3231-3253 of SEQ ID NO: 1; PCSK9#36 targets nucleotides 3555-3577 of SEQ ID NO: 1; PCSK9#37 targets nucleotides 2888-2910 of SEQ ID NO: 1; and PCSK9#38 targets nucleotides 3543-3569 of SEQ ID NO: 1.
[0339] b. LPA-targeting dsRNA
[0340] The LPA-targeting dsRNA of the present disclosure is a second dsRNA (especially siRNA) for inhibiting expression of Lipoprotein (a) (LPA) , wherein the second dsRNA comprises a second sense strand and a second antisense strand forming a second duplex region, wherein the second antisense strand comprises at least 15 contiguous nucleotides from a target LPA mRNA sequence.
[0341] The target LPA mRNA sequence is, for example, the gene shown under Genbank Accession No. NM_005577.4 (SEQ ID NO: 2) .
[0342] In some embodiments, the second antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of Table 3, preferably the second antisense strand comprises a nucleotide sequence as set forth in any one of Table 3.
[0343] In some embodiments, the second sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of Table 3, preferably the second sense strand comprises a nucleotide sequence as set forth in any one of Table 3.
[0344] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 79, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 122.
[0345] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 80, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 123.
[0346] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 81, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 124.
[0347] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 87, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 130.
[0348] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 95, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 138.
[0349] In a preferred embodiment, the first sense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 118, and / or the first antisense strand comprises a nucleotide sequence as set forth in SEQ ID NO: 161.
[0350] In some embodiments, the dsRNA comprises a paired sense strand sequence and antisense strand sequence as set forth in any one of Table 3.
[0351] Table 3. Sense strand and antisense strand nucleotide sequences targeting LPA mRNA
[0352] Specifically, LPA#1 targets nucleotides 1176-1195 of SEQ ID NO: 2; LPA#2 targets nucleotides 494-511 of SEQ ID NO: 2; LPA#3 targets nucleotides 491-510 of SEQ ID NO: 2; LPA#4 targets nucleotides 504-522 of SEQ ID NO: 2; LPA#5 targets nucleotides 155-174 of SEQ ID NO: 2; LPA#6 targets nucleotides 3283-3302 of SEQ ID NO: 2; LPA#7 targets nucleotides 2888-2907 of SEQ ID NO: 2; LPA#8 targets nucleotides 3463-3482 of SEQ ID NO: 2; LPA#9 targets nucleotides 2704-2726 of SEQ ID NO: 2; LPA#10 targets nucleotides 2707-2726 of SEQ ID NO: 2; LPA#11 targets nucleotides 2706-2726 of SEQ ID NO: 2; LPA#12 targets nucleotides 2707-2726 of SEQ ID NO: 2; LPA#13 targets nucleotides 2707-2726 of SEQ ID NO: 2; LPA#14 targets nucleotides 4602-4622 of SEQ ID NO: 2; LPA#15 targets nucleotides 3092-3110 of SEQ ID NO: 2; LPA#16 targets nucleotides 3280-3298 of SEQ ID NO: 2; LPA#17 targets nucleotides 3282-3302 of SEQ ID NO: 2; LPA#18 targets nucleotides 157-176 of SEQ ID NO: 2; LPA#19 targets nucleotides 4637-4656 of SEQ ID NO: 2; LPA#20 targets nucleotides 4708-4727 of SEQ ID NO: 2; LPA#21 targets nucleotides 5502-5520 of SEQ ID NO: 2; LPA#22 targets nucleotides 2892-2910 of SEQ ID NO: 2; LPA#23 targets nucleotides 3667-3686 of SEQ ID NO: 2; LPA#24 targets nucleotides 489-511 of SEQ ID NO: 2; LPA#25 targets nucleotides 4957-4979 of SEQ ID NO: 2; LPA#26 targets nucleotides 492-511 of SEQ ID NO: 2; LPA#27 targets nucleotides 3580-3598 of SEQ ID NO: 2; LPA#28 targets nucleotides 493-513 of SEQ ID NO: 2; LPA#29 targets nucleotides 3048-3068 of SEQ ID NO: 2; LPA#30 targets nucleotides 312-332 of SEQ ID NO: 2; LPA#31 targets nucleotides 2899-2917 of SEQ ID NO: 2; LPA#32 targets nucleotides 4580-4598 of SEQ ID NO: 2; LPA#33 targets nucleotides 4923-4941 of SEQ ID NO: 2; LPA#34 targets nucleotides 1177-1194 of SEQ ID NO: 2; LPA#35 targets nucleotides 494-510 of SEQ ID NO: 2; LPA#36 targets nucleotides 4231-4248 of SEQ ID NO: 2; LPA#37 targets nucleotides 494-511 of SEQ ID NO: 2; LPA#38 targets nucleotides 4231-4249 of SEQ ID NO: 2; LPA#39 targets nucleotides 493-510 of SEQ ID NO: 2; LPA#40 targets nucleotides 1177-1195 of SEQ ID NO: 2; LPA#41 targets nucleotides 312-332 of SEQ ID NO: 2; LPA#42 targets nucleotides 311-331 of SEQ ID NO: 2; LPA#43 targets nucleotides 310-330 of SEQ ID NO: 2.
[0353] c.Combination of PCSK9-targeting dsRNA and LPA-targeting dsRNA
[0354] The compound of the present disclosure comprises a PCSK9-targeting dsRNA as set forth in any one of Table 2 and an LPA-targeting dsRNA as set forth in any one of Table 3.
[0355] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 4 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 42; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 79 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 122.
[0356] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 4 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 42; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 80 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 123.
[0357] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 4 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 42; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 81 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 124.
[0358] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 5 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 43; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 79 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 122.
[0359] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 5 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 43; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 80 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 123.
[0360] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 5 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 43; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 81 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 124.
[0361] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 92 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 135.
[0362] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 93 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 136.
[0363] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 94 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 137.
[0364] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 95 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 138.
[0365] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 96 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 139.
[0366] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 97 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 140.
[0367] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 98 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 141.
[0368] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 99 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 142.
[0369] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 100 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 143.
[0370] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 10 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 48; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 101 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 144.
[0371] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 92 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 135.
[0372] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 93 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 136.
[0373] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 94 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 137.
[0374] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 95 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 138.
[0375] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 96 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 139.
[0376] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 97 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 140.
[0377] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 98 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 141.
[0378] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 99 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 142.
[0379] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 100 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 143.
[0380] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 11 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 49; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 101 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 144.
[0381] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 92 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 135.
[0382] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 93 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 136.
[0383] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 94 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 137.
[0384] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 95 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 138.
[0385] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 96 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 139.
[0386] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 97 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 140.
[0387] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 98 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 141.
[0388] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 99 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 142.
[0389] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 100 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 143.
[0390] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 12 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 50; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 101 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 144.
[0391] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 20 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 58; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 109 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 152.
[0392] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 20 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 58; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 110 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 153.
[0393] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 20 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 58; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 111 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 154.
[0394] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 21 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 59; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 109 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 152.
[0395] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 21 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 59; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 110 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 153.
[0396] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 21 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 59; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 111 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 154.
[0397] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 22 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 60; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 109 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 152.
[0398] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 22 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 60; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 110 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 153.
[0399] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 22 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 60; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 111 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 154.
[0400] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 23 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 61; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 87 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 130.
[0401] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 23 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 61; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 88 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 131.
[0402] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 23 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 61; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 89 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 132.
[0403] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 23 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 61; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 90 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 133.
[0404] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 23 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 61; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 91 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 134.
[0405] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 24 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 62; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 87 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 130.
[0406] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 24 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 62; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 88 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 131.
[0407] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 24 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 62; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 89 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 132.
[0408] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 24 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 62; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 90 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 133.
[0409] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 24 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 62; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 91 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 134.
[0410] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 25 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 63; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 87 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 130.
[0411] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 25 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 63; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 88 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 131.
[0412] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 25 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 63; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 89 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 132.
[0413] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 25 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 63; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 90 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 133.
[0414] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 25 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 63; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 91 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 134.
[0415] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 26 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 64; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 104 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 147.
[0416] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 26 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 64; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 105 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 148.
[0417] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 26 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 64; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 106 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 149.
[0418] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 26 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 64; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 107 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 150.
[0419] In some embodiments, the PCSK9-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 26 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 64; the LPA-targeting dsRNA comprises a sense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 108 and an antisense strand having at least 16, 17, 18, 19, or 20 nucleotides of a nucleotide sequence as set forth in SEQ ID NO: 151.
[0420] In preferred embodiments, the PCSK9-targeting dsRNA and the LPA-targeting dsRNA comprise sequences as set forth in any one compound of Table 4.
[0421] Table 4. Sense strand and antisense strand nucleotide sequences targeting PCSK9 and LPA mRNA
[0422] In some embodiments, the sense strand of the PCSK9-targeting dsRNA described herein and the sense strand of the LPA-targeting dsRNA described herein are linked via one or more bonds and / or one or more linkers (e.g., any of bonds and / or linkers described herein) . In some embodiments, the sense strand of the PCSK9-targeting dsRNA includes any of the modifications described in Section II. 2 of the detailed description. In some embodiments, the antisense strand of the PCSK9-targeting dsRNA includes any of the modifications described in Section II. 2 of the detailed description. In some embodiments, the sense strand of the LPA-targeting dsRNA includes any of the modifications described in Section II. 2 of the detailed description. In some embodiments, the antisense strand of the LPA-targeting dsRNA includes any of the modifications described in Section II. 2 of the detailed description. In some embodiments, the modifications in the corresponding strands are identical to those shown in Table 11.
[0423] In one aspect, the disclosure is related to a compound including a sense strand, a first antisense strand, and a second antisense strand. The sense strand can include a sense strand of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and a sense strand of a LPA-targeting dsRNA described herein (e.g., any of the PCSK9-targeting dsRNAs described herein) that are linked via one or more bonds and / or one or more linkers (e.g., any of bonds and / or linkers described herein) . In some embodiments, the sense strand of the PCSK9-targeting dsRNA is linked via the one or more bonds and / or one or more linkers at its 3’ end, and the sense strand of the LPA-targeting dsRNA is linked via the one or more bonds and / or one or more linkers at its 5’ end. In some embodiments, the sense strand of the PCSK9-targeting dsRNA is linked via the one or more bonds and / or one or more linkers at its 5’ end, and the sense strand of the LPA-targeting dsRNA is linked via the one or more bonds and / or one or more linkers at its 3’ end. The first antisense strand can include an antisense strand of the PCSK9-targeting dsRNA. The second antisense strand can include an antisense strand of the LPA-targeting dsRNA. In some embodiments, the compound includes the same modifications in the corresponding strands shown in Table 11.
[0424] In some embodiments, the one or more bonds and / or one or more linkers described herein are selected from: IBs-SP1, BL-13, IB-SP1, IB-SP1-BL1, IBs-SP1-BL1, and IBs-SP1-BL10.
[0425] In some embodiments, the LDL-lowering enhancer described herein is a LPA-targeting dsRNA (e.g., any of the LPA-targeting dsRNAs described herein) .
[0426] 3. Terminal modification
[0427] In some embodiments, an end of the sense strand of each of G1 and G2 optionally contains one or more terminal modifications.
[0428] In a specific embodiment, an end of the sense strand of each of G1 and G2 optionally contains a terminal modification; in another specific embodiment, the 5'end and / or 3'end of the sense strand of each of G1 and G2 optionally contains a terminal modification.
[0429] In a specific embodiment, the 3'end of the sense strand of G1 and the 5'end of the sense strand of G2 contain a terminal modification.
[0430] In a specific embodiment, the 5'end of the sense strand of G1 has no terminal modification; in another specific embodiment, the modification at the 5'end of the sense strand of G1 is GL34.
[0431] In a specific embodiment, the 3'end of the sense strand of G1 has no terminal modification; in another specific embodiment, the modification at the 3'end of the sense strand of G1 is GL34; in another specific embodiment, the modification at the 3'end of the sense strand of G1 is IB.
[0432] In a specific embodiment, the 5'end of the sense strand of G2 has no terminal modification; in another specific embodiment, the modification at the 5'end of the sense strand of G2 is GL34; in another specific embodiment, the modification at the 5'end of the sense strand of G2 is IB.
[0433] In a specific embodiment, the 3'end of the sense strand of G2 has no terminal modification; in another specific embodiment, the modification at the 3'end of the sense strand of G2 is GL34; in another specific embodiment, the modification at the 3'end of the sense strand of G2 is GL6.
[0434] In some embodiments, the terminal modification is an abasic nucleotide; in another embodiment, the terminal modification is an inverted nucleotide; in another embodiment, the terminal modification is optionally substituted preferably substituted with a GalNAc-containing side chain substituent.
[0435] In a preferred embodiment, the terminal modification is IB; in a preferred embodiment, the terminal modification is STM1; in a preferred embodiment, the terminal modification is GL34; in a preferred embodiment, the terminal modification is GL35; in a preferred embodiment, the terminal modification is GL36.
[0436] 4. S1 and S2
[0437] In some embodiments, S1 is a bond. In some embodiments, S1 is - (OCH2CH2) k-, wherein k is an integer from 1 to 10, preferably 3 or 6. In some embodiments, S1 is - (CH2CH2O) k-, wherein k is an integer from 1 to 10, preferably 3 or 6. In some embodiments, S1 is -O (CH2CH2O) k-, wherein k is an integer from 1 to 10, preferably 3 or 6. In some embodiments, S1 is - (CH2) k-, wherein k is an integer from 1 to 10.
[0438] In some embodiments, S2 is a bond. In some embodiments, S2 is - (OCH2CH2) k-, wherein k is an integer from 1 to 10, preferably 3 or 6. In some embodiments, S2 is - (CH2CH2O) k-, wherein k is an integer from 1 to 10, preferably 3 or 6. In some embodiments, S2 is -O (CH2CH2O) k-, wherein k is an integer from 1 to 10, preferably 3 or 6. In some embodiments, S2 is - (CH2) k-, wherein k is an integer from 1 to 10.
[0439] 5. X
[0440] In some embodiments, X is a bond.
[0441] In some embodiments, X is Nt (dN) m, wherein Nt is selected from a deoxyribonucleotide, a ribonucleotide, a 2'-5'ribonucleotide, or a 2'-5'deoxyribonucleotide, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5.
[0442] In some embodiments, X is (G2p) dAdT; in another embodiment, X is rGdAdT; in another embodiment, X is dCdA; in another embodiment, X is dAdT; in another embodiment, X is dAdCdA; in another embodiment, X is dTdCdA; in another embodiment, X is dAdAdA; in another embodiment, X is dTdTdT; in another embodiment, X is dTdTdTdT; in another embodiment, X is dTdTdTdTdT.
[0443] In some embodiments, X comprises one or more compounds selected from formula (I-1) or formula (I-2) , or a tautomer or stereoisomer thereof, wherein ring A, Tg, Ra, Rb, Rc, w, L0, L1, and L2 are as defined below; further, X may also comprise one or more Nt.
[0444] In some embodiments, X comprises one or more compounds of formula II, or a tautomer or stereoisomer thereof, wherein Tg, Ra, Rb, Rc, L1, and L2 are as defined below; further, X may also comprise one or more Nt.
[0445] In some embodiments, X comprises one or more compounds of formula III, or a tautomer or stereoisomer thereof, wherein Sg, L3, L4, and L5 are as defined below; further, X may also comprise one or more Nt.
[0446] In some embodiments, X comprises one or more compounds of formula IIIa, or a tautomer or stereoisomer thereof, wherein L3, L4, and L5 are as defined below; further, X may also comprise one or more Nt.
[0447] In some embodiments, X comprises one or more compounds selected from the group consisting of:
[0448] further, X may also comprise one or more Nt.
[0449] In some embodiments, X is - (BL) p (dN) m, wherein BL is selected from a compound of formula (I-1) , (I-2) , (II) , (III) , or (IIIa) as defined herein, or a tautomer or stereoisomer thereof, or from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12, or a tautomer or stereoisomer thereof.
[0450] In some embodiments, X is BL (dN) m, wherein BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11 or BL12, or a tautomer or stereoisomer thereof, preferably BL1, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5. In a preferred embodiment, X is BL1-dTdTdT or BL1-dCdA.
[0451] In some embodiments, X is (BL) p, wherein BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, or BL9, and p is 1, 2, or 3. In a preferred embodiment, X is BL1; in a preferred embodiment, X is BL1-BL1-BL1; in a preferred embodiment, X is BL7; in a preferred embodiment, X is BL7-BL7-BL7; in a preferred embodiment, X is BL8; in a preferred embodiment, X is BL8-BL8-BL8; in a preferred embodiment, X is BL9; in a preferred embodiment, X is BL9-BL9-BL9; in a preferred embodiment, X is BL10; in a preferred embodiment, X is BL10-BL10-BL10; in a preferred embodiment, X is BL11; in a preferred embodiment, X is BL11-BL11-BL11.
[0452] a. Ring A
[0453] In some embodiments, ring A is C5-10 cycloalkyl; in another embodiment, ring A is 5-membered to 10-membered heterocyclyl; in another embodiment, ring A is C6-10 aryl, such as phenyl; in another embodiment, ring A is 5-membered to 10-membered heteroaryl, such as pyridine.
[0454] b. Tg or Sg
[0455] In some embodiments, Tg is selected from -S-Rt, -S-S-Rt, or -OCH2-S-S-Rt, wherein each Rt is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated.
[0456] In some embodiments, Tg is -S-S-C (Rd) 3 or -OCH2-S-S-C (Rd) 3, wherein each Rd is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated; in a specific embodiment, Tg is -S-S-C (CH3) 3.
[0457] In some embodiments, Tg is a sugar moiety; in a specific embodiment, Tg is a five-membered sugar; in another specific embodiment, Tg is a six-membered sugar; in a more specific embodiment, Tg is N-acetylgalactosamine in a more specific embodiment, Tg is galactose in a more specific embodiment, Tg is N-acetylglucosamine; in a more specific embodiment, Tg is glucose; in a more specific embodiment, Tg is mannose; in a more specific embodiment, Tg is glucuronic acid; in a more specific embodiment, Tg is neuraminic acid (sialic acid) ; in a more specific embodiment, Tg is xylose; in a more specific embodiment, Tg is fucose.
[0458] In some embodiments, Tg is a polypeptide; in one embodiment, Tg is a group comprising 1, 2, 3, 4, or 5 amino acid residues; in one embodiment, Tg is - (AA) a-R; in one embodiment, Tg is -NH (AA) a-R; in one embodiment, Tg is - (AA) a-C (O) R; in one embodiment, Tg is -NH (AA) a-C (O) R; in one embodiment, Tg is -C (O) -NH (AA) a-C (O) NR.
[0459] In some embodiments, Sg is a sugar moiety; in a specific embodiment, Sg is a five-membered sugar; in another specific embodiment, Sg is a six-membered sugar; in a more specific embodiment, Sg is N-acetylgalactosamine in a more specific embodiment, Sg is galactose in a more specific embodiment, Sg is galactosamine which is optionally substituted with -Ac, -C (O) -C1-6 alkylene-OH, e.g. in a more specific embodiment, Sg is N-acetylglucosamine; in a more specific embodiment, Sg is glucose; in a more specific embodiment, Sg is mannose; in a more specific embodiment, Sg is glucuronic acid; in a more specific embodiment, Sg is neuraminic acid (sialic acid) ; in a more specific embodiment, Sg is xylose; in a more specific embodiment, Sg is fucose.
[0460] c. AA
[0461] In some embodiments, AA is an amino acid residue; in another embodiment, AA is a natural amino acid residue; in another embodiment, AA is a valine residue; in another embodiment, AA is an alanine residue; in another embodiment, AA is a glycine residue; in another embodiment, AA is a leucine residue; in another embodiment, AA is an isoleucine residue.
[0462] d. R
[0463] In some embodiments, R is H; in another embodiment, R is C1-6 alkyl; in another embodiment, R is C1-6 haloalkyl.
[0464] e. L0
[0465] In some embodiments, L0 is -NRc-; in another embodiment, L0 is C (O) ; in another embodiment, L0 is -OC (O) NRc-; in another embodiment, L0 is -C (O) NRc-; in another embodiment, L0 is -NRcC (O) -; in another embodiment, L0 is -NRc-C (O) O-; in another embodiment, L0 is -C (O) NRc-C (O) -.
[0466] f. L1 and L2
[0467] In some embodiments, L1 is a bond; in another embodiment, L1 is - (CH2) p-; in another embodiment, L1 is -O- (CH2) p-; in another embodiment, L1 is - (CH2) p-O-; in another embodiment, L1 is -O- (CH2) p-O- (CH2) q-; in another embodiment, L1 is -O- (CH2) p-NHCO-; in another embodiment, L1 is - (OCH2CH2) p-; in another embodiment, L1 is - (CH2CH2O) p-; in another embodiment, L1 is -O (CH2CH2O) p-; in another embodiment, L1 is -NHC (O) -; in another embodiment, L1 is -C (O) NH-; in another embodiment, L1 is -OC (O) -; in another embodiment, L1 is -C (O) O-; in another embodiment, L1 is -S-S-; in another embodiment, L1 is -NHC (O) O-; in another embodiment, L1 is -NHC (O) NH-; in another embodiment, L1 is -OC (O) O-; in another embodiment, L1 is -OC (O) NH-; in another embodiment, L1 is -O-CH (CH (OH) CH2OH) -; in another embodiment, L1 is -O-CH (CH (NH2) CH2OH) -; in another embodiment, L1 is -O-CH (CH2OH) CH (OH) -; in another embodiment, L1 is -NH-CH (CH2OH) CH (OH) -; in another embodiment, L1 is -O-CH2CH (OH) CH (OH) -; in another embodiment, L1 is -O-CH2CH (NH2) CH (OH) -; in another embodiment, L1 is -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -; in another embodiment, L1 is -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -; in another embodiment, L1 is -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -; in another embodiment, L1 is -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -; in another embodiment, L1 is -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -; in another embodiment, L1 is -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -.
[0468] In some embodiments, L2 is a bond; in another embodiment, L2 is - (CH2) p-; in another embodiment, L2 is -O- (CH2) p-; in another embodiment, L2 is - (CH2) p-O-; in another embodiment, L2 is -O- (CH2) p-O- (CH2) q-; in another embodiment, L2 is -O- (CH2) p-NHCO-; in another embodiment, L2 is - (OCH2CH2) p-; in another embodiment, L2 is - (CH2CH2O) p-; in another embodiment, L2 is -O (CH2CH2O) p-; in another embodiment, L2 is -NHC (O) -; in another embodiment, L2 is -C (O) NH-; in another embodiment, L2 is -OC (O) -; in another embodiment, L2 is -C (O) O-; in another embodiment, L2 is -S-S-; in another embodiment, L2 is -NHC (O) O-; in another embodiment, L2 is -NHC (O) NH-; in another embodiment, L2 is -OC (O) O-; in another embodiment, L2 is -OC (O) NH-; in another embodiment, L2 is -O-CH (CH (OH) CH2OH) -; in another embodiment, L2 is -O-CH (CH (NH2) CH2OH) -; in another embodiment, L2 is -O-CH (CH2OH) CH (OH) -; in another embodiment, L2 is -NH-CH (CH2OH) CH (OH) -; in another embodiment, L2 is -O-CH2CH (OH) CH (OH) -; in another embodiment, L2 is -O-CH2CH (NH2) CH (OH) -; in another embodiment, L2 is -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -; in another embodiment, L2 is -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -; in another embodiment, L2 is -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -; in another embodiment, L2 is -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -; in another embodiment, L2 is -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -; in another embodiment, L2 is -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -.
[0469] In some embodiments, L1 and L2 are optionally substituted with 1, 2, or 3 substituents selected from halogen, OH, NH2, -C1-6 alkylene OH, -C1-6 alkylene NH2, C1-6 alkyl, or C1-6 haloalkyl.
[0470] In some embodiments, p = 1; in another embodiment, p = 2; in another embodiment, p = 3; in another embodiment, p = 4; in another embodiment, p = 5; in another embodiment, p = 6.
[0471] In some embodiments, q = 1; in another embodiment, q = 2; in another embodiment, q = 3; in another embodiment, q = 4; in another embodiment, q = 5; in another embodiment, q = 6.
[0472] In a more specific embodiment, L1 is -O- (CH2) 3-O-CH2-, and L2 is - (CH2) 2-O-.
[0473] g. L3 and L4
[0474] In some embodiments, L3 is a bond; in another embodiment, L3 is - (CH2) i-; in another embodiment, L3 is -O- (CH2) i-; in another embodiment, L3 is - (CH2) i-O-; in another embodiment, L3 is -O- (CH2) i-O- (CH2) j-; in another embodiment, L3 is -O- (CH2) i-NHCO-; in another embodiment, L3 is - (OCH2CH2) i-; in another embodiment, L3 is - (CH2CH2O) i-; in another embodiment, L3 is -O (CH2CH2O) i-; in another embodiment, L3 is - (CH2) j- (OCH2CH2) i-; in another embodiment, L3 is -NHC (O) -; in another embodiment, L3 is -C (O) NH-; in another embodiment, L3 is -C (O) -; in another embodiment, L3 is -OC (O) -; in another embodiment, L3 is -C (O) O-; in another embodiment, L3 is -S-S-; in another embodiment, L3 is -NHC (O) O-; in another embodiment, L3 is -NHC (O) NH-; in another embodiment, L3 is -OC (O) O-; in another embodiment, L3 is -OC (O) NH-; in another embodiment, In another embodiment, L3 is -O-CH (CH (OH) CH2OH) -; in another embodiment, L3 is -O-CH (CH (NH2) CH2OH) -; in another embodiment, L3 is -O-CH (CH2OH) CH (OH) -; in another embodiment, L3 is -NH-CH (CH2OH) CH (OH) -; in another embodiment, L3 is -O-CH2CH (OH) CH (OH) -; in another embodiment, L3 is -O-CH2CH (NH2) CH (OH) -; in another embodiment, L3 is -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -; in another embodiment, L3 is -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -; in another embodiment, L3 is -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -; in another embodiment, L3 is -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -; in another embodiment, L3 is -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -; in another embodiment, L3 is -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -.
[0475] In some embodiments, L4 is a bond; in another embodiment, L4 is - (CH2) i-; in another embodiment, L4 is -O- (CH2) i-; in another embodiment, L4 is - (CH2) i-O-; in another embodiment, L4 is -O- (CH2) i-O- (CH2) j-; in another embodiment, L4 is -O- (CH2) i-NHCO-; in another embodiment, L4 is - (OCH2CH2) i-; in another embodiment, L4 is - (CH2CH2O) i-; in another embodiment, L4 is -O (CH2CH2O) i-; in another embodiment, L4 is - (CH2) j- (OCH2CH2) i-; in another embodiment, L4 is -NHC (O) -; in another embodiment, L4 is -C (O) NH-; in another embodiment, L4 is -C (O) -; in another embodiment, L4 is -OC (O) -; in another embodiment, L4 is -C (O) O-; in another embodiment, L4 is -S-S-; in another embodiment, L4 is -NHC (O) O-; in another embodiment, L4 is -NHC (O) NH-; in another embodiment, L4 is -OC (O) O-; in another embodiment, L4 is -OC (O) NH-; in another embodiment, In another embodiment, L4 is -O-CH (CH (OH) CH2OH) -; in another embodiment, L4 is -O-CH (CH (NH2) CH2OH) -; in another embodiment, L4 is -O-CH (CH2OH) CH (OH) -; in another embodiment, L4 is -NH-CH (CH2OH) CH (OH) -; in another embodiment, L4 is -O-CH2CH (OH) CH (OH) -; in another embodiment, L4 is -O-CH2CH (NH2) CH (OH) -; in another embodiment, L4 is -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -; in another embodiment, L4 is -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -; in another embodiment, L4 is -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -; in another embodiment, L4 is -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -; in another embodiment, L4 is -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -; in another embodiment, L4 is -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -.
[0476] In some embodiments, i = 1; in another embodiment, i = 2; in another embodiment, i = 3; in another embodiment, i = 4; in another embodiment, i = 5; in another embodiment, i =6.
[0477] In some embodiments, j = 1; in another embodiment, j = 2; in another embodiment, j = 3; in another embodiment, j = 4; in another embodiment, j = 5; in another embodiment, j =6.
[0478] In a more specific embodiment, L3 is -O- (CH2) 4-, and L4 is a bond.
[0479] In a more specific embodiment, L3 is -O- (CH2) 5-, and L4 is -OC (O) -.
[0480] In a more specific embodiment, L3 is -O- (CH2) 4, and L4 is -C (O) -.
[0481] In a more specific embodiment, L3 is - (OCH2CH2) 3-, and L4 is -NHC (O) -.
[0482] In a more specific embodiment, L3 is - (OCH2CH2) 3-, and L4 is -OC (O) -.
[0483] h. L5
[0484] In some embodiments, L5 is a bond; in one embodiment, L5 is C3-7 cycloalkyl, such as C5-6 cycloalkyl; in one embodiment, L5 is C6-10 aryl; in one embodiment, L5 is 3-membered to 7-membered heterocyclyl, preferably 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms; in one embodiment, L5 is 5-membered to 10-membered heteroaryl, such as 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms.
[0485] In some embodiments, the heteroatom is N; in one embodiment, the heteroatom is O;
[0486] In a more specific embodiment, L5 is a bond.
[0487] In a more specific embodiment, L5 is (such as ) .
[0488] In a more specific embodiment, L5 is (such as ) .
[0489] i. Ra, Rb and Rc
[0490] In some embodiments, Ra is H; in another embodiment, Ra is D; in another embodiment, Ra is halogen; in another embodiment, Ra is C1-6 alkyl; in another embodiment, Ra is C1-6 haloalkyl.
[0491] In some embodiments, Rb is H; in another embodiment, Rb is D; in another embodiment, Rb is halogen; in another embodiment, Rb is C1-6 alkyl; in another embodiment, Rb is C1-6 haloalkyl.
[0492] In some embodiments, Rc is H; in another embodiment, Rc is D; in another embodiment, Rc is halogen; in another embodiment, Rc is C1-6 alkyl; in another embodiment, Rc is C1-6 haloalkyl.
[0493] In a more specific embodiment, Ra is H, Ra is H, and Rc is methyl.
[0494] j. w
[0495] In some embodiments, w is 0, 1, 2, 3, or 4.
[0496] Any technical solution or any combination thereof in any of the above specific embodiments can be combined with any technical solution or any combination thereof in other specific embodiments. The present disclosure is intended to include all combinations of these technical solutions, which are not listed one by one due to space limitations.
[0497] The present disclosure relates specifically to a compound of formula (I) or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof:
[0498] G1-S1-X-S2-G2 (I)
[0499] wherein G1 and G2 are each independently a nucleic acid molecule;
[0500] S1 and S2 are each independently a bond, - (OCH2CH2) k-, - (CH2CH2O) k-, -O (CH2CH2O) k-, or - (CH2) k-;
[0501] k is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10;
[0502] X is a linker;
[0503] preferably, S1 and S2 are each independently a bond or -O (CH2CH2O) k-, wherein k is 1, 2, 3, 4, 5, 6, 7, or 8; preferably, S1 and S2 are each independently a bond, -O (CH2CH2O) 3-, or -O (CH2CH2O) 6-.
[0504] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more compounds selected from formula (I-1) or formula (I-2) , or a tautomer or stereoisomer thereof:
[0505] wherein,
[0506] ring A is selected from C5-10 cycloalkyl, 5-membered to 10-membered heterocyclyl, C6-10 aryl, or 5-membered to 10-membered heteroaryl, preferably C6-10 aryl or 5-membered to 10-membered heteroaryl;
[0507] Tg is selected from -S-Rt, -S-S-Rt, -OCH2-S-S-Rt, a sugar moiety, or a polypeptide;
[0508] Rt is selected from H, C1-6 alkyl, or C1-6 haloalkyl;
[0509] the sugar moiety is a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar;
[0510] the polypeptide is a group comprising 1, 2, 3, 4, or 5 amino acid residues;
[0511] L0 is selected from -NRc-, C (O) , -OC (O) NRc-, -C (O) NRc-, -NRcC (O) -, -NRc-C (O) O-, or -C (O) NRc-C (O) -;
[0512] L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (CH2) q- (OCH2CH2) p-, - (CH2CH2O) p-, -O (CH2CH2O) p-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;
[0513] L1 and L2 are optionally substituted with 1, 2, or 3 substituents selected from halogen, OH, NH2, -C1-6 alkylene OH, -C1-6 alkylene NH2, C1-6 alkyl, or C1-6 haloalkyl;
[0514] p and q are each independently 1, 2, 3, 4, 5, or 6;
[0515] wherein in formula (I-1) and formula (I-2) are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage (S1) , and in formula (I-1) and formula (I-2) represents connection to G2 via a bridged linkage (S2) ;
[0516] w is selected from 0, 1, 2, 3, or 4;
[0517] Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated.
[0518] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more compounds of formula (II) , or a tautomer or stereoisomer thereof:
[0519] wherein Tg is -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide;
[0520] the sugar moiety is preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0521] the polypeptide is selected from - (AA) a-R, -NH (AA) a-R, - (AA) a-C (O) R, -NH (AA) a-C (O) R, or -C (O) -NH (AA) a-C (O) NR;
[0522] wherein each AA is independently selected from amino acid residues, preferably each AA is independently selected from natural amino acid residues;
[0523] a is selected from 1, 2, 3, or 4;
[0524] R is selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, wherein R may be optionally deuterated or fully deuterated;
[0525] Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated;
[0526] each Rd is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated;
[0527] wherein L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, -O (CH2CH2O) p-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;
[0528] wherein p and q are each independently 1, 2, 3, 4, 5, or 6;
[0529] wherein in formula (II) are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) ;
[0530] preferably,
[0531] Tg is selected from -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide;
[0532] the sugar moiety is selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0533] the polypeptide is -NH (AA) a-C (O) R;
[0534] each AA is independently selected from a valine residue, an alanine residue, a glycine residue, a leucine residue, or an isoleucine residue, more preferably from a valine residue or an alanine residue;
[0535] a is selected from 1, 2, or 3, preferably 2 or 3;
[0536] R is selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as CH3;
[0537] Ra, Rb, and Rc are each independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably H or C1-6 alkyl, such as H or CH3;
[0538] each Rd is independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as CH3;
[0539] L1 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-;
[0540] L2 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably - (CH2) p-O-;
[0541] each p is independently selected from 2, 3, 4, 5, or 6, preferably 4, 5, or 6;
[0542] each p is independently selected from 1, 2, 3, 4, or 5, preferably 1, 2, or 3;
[0543] represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) ;
[0544] more preferably, Tg is selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0545] Ra, Rb, and Rc are each independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably H or C1-6 alkyl, such as H or CH3;
[0546] each Rd is independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as C (CH3) 3;
[0547] L1 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-;
[0548] L2 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O-(CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably - (CH2) p-O-;
[0549] each p is independently selected from 2, 3, 4, 5, or 6, preferably 4, 5, or 6;
[0550] each p is independently selected from 1, 2, 3, 4, or 5, preferably 1, 2, or 3;
[0551] represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) .
[0552] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more compounds of formula (I-1) , formula (I-2) , or formula (II) , or a tautomer or stereoisomer thereof, provided that:
[0553] i) Tg is -S-S-C (CH3) 3;
[0554] ii) Tg is galactose, glucose, N-acetylgalactosamine, or N-acetylglucosamine, preferably galactose or N-acetylgalactosamine or
[0555] 3) Tg is -NH (AA) a-C (O) R, such as
[0556] wherein each AA is independently selected from valine or alanine;
[0557] a is selected from 1, 2, or 3, preferably 2 or 3;
[0558] R is selected from H or C1-6 alkyl, such as CH3;
[0559] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more compounds of formula (I-1) , formula (I-2) , or formula (II) , or a tautomer or stereoisomer thereof, wherein Ra, Rb, and Rc are each independently selected from H, D, halogen, or C1-6 alkyl, L1 and L2 are each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-, and p and q are each independently 1, 2, 3, 4, 5, or 6.
[0560] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more compounds of formula (III) , or a tautomer or stereoisomer thereof:
[0561] wherein Sg is a sugar moiety, preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0562] L3 and L4 are linkers, preferably each independently selected from a bond, - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, - (CH2) j- (OCH2CH2) i-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;
[0563] wherein i and j are each independently 1, 2, 3, 4, 5, or 6;
[0564] L5 is a linker, preferably selected from a bond, C3-7 cycloalkyl, C6-10 aryl, 3-membered to 7-membered heterocyclyl, or 5-membered to 10-membered heteroaryl, more preferably, L5 is selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;
[0565] wherein in formula (III) are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage (S1) , and in formula (III) represents connection to G2 via a bridged linkage (S2) ;
[0566] preferably,
[0567] Sg is selected from N-acetylgalactosamine, galactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0568] L3 is selected from a bond, - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, or - (CH2) j- (OCH2CH2) i-;
[0569] L4 is selected from a bond , - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, or -OC (O) NH-;
[0570] each i is independently selected from 1, 2, 3, 4, 5, or 6;
[0571] each j is independently selected from 1, 2, 3, 4, 5, or 6;
[0572] L5 is selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;
[0573] represents connection to G1 via a bridged linkage (S1) , and in formula (III) represents connection to G2 via a bridged linkage (S2) .
[0574] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more compounds of formula (IIIa) , or a tautomer or stereoisomer thereof:
[0575] L3 is selected from a bond, - (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, or - (CH2) j- (OCH2CH2) i-;
[0576] L4 is selected from a bond, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, or -OC (O) NH-;
[0577] L5 is selected from a bond, C5-6 cycloalkyl, or 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;
[0578] wherein i and j are each independently 1, 2, 3, 4, 5, or 6;
[0579] represents connection to G1 via a bridged linkage (S1) , and in formula (IIIa) represents connection to G2 via a bridged linkage (S2) .
[0580] The present disclosure relates to a compound of formula (I) described above, provided that:
[0581] i) L3 is - (CH2) 4-, L4 is a bond, and L5 is a bond;
[0582] ii) L3 is - (CH2) 5-, L4 is -OC (O) -, and L5 is (such as ) ;
[0583] iii) L3 is - (CH2) 4-, L4 is -C (O) -, and L5 is (such as ) ;
[0584] iv) L3 is -CH2CH2- (OCH2CH2) 2-, L4 is -NHC (O) -, and L5 is (such as ); or
[0585] v) L3 is -CH2CH2- (OCH2CH2) 2-, L4 is -OC (O) -, and L5 is (such as ) .
[0586] The present disclosure relates to a compound of formula (I) described above, wherein X comprises one or more of the following compounds:
[0587] Table 5.
[0588] wherein represents connection to G1 via a bridged linkage (S1) , and represents connection to G2 via a bridged linkage (S2) .
[0589] The present disclosure relates to a compound of formula (I) described above, wherein X is a nucleotide linker, the nucleotide is selected from one or more of a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, a 2'-5'ribonucleotide, and a 2'-5'deoxyribonucleotide.
[0590] The present disclosure relates to a compound of formula (I) described above, wherein X is Nt (dN) m, wherein Nt is selected from a bond, a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, or a 2'-5'ribonucleotide, each dN is independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, 5, 6, 7, or 8, preferably m is 1, 2, 3, 4, or 5.
[0591] The present disclosure relates to a compound of formula (I) described above, wherein X is selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, -GfAfUf-, dTdTdTdT, or dTdTdTdTdT, preferably selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, dTdTdTdT, or dTdTdTdTdT.
[0592] The present disclosure relates to a compound of formula (I) described above, wherein X is - (BL) p (dN) m-;
[0593] wherein each BL is independently selected from a compound of formula (I-1) or (I-2) , a compound of formula (II) , or a compound of formula (III) as defined herein, or a tautomer or stereoisomer thereof, or BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12, or a tautomer or stereoisomer thereof;
[0594] each dN is independently selected from dA, dT, dG, or dC;
[0595] p is selected from 0, 1, 2, 3, 4, 5, or 6, preferably 0, 1, 2, or 3;
[0596] m is selected from 0, 1, 2, 3, 4, 5, 6, 7, or 8, preferably 0, 1, 2, 3, 4, or 5;
[0597] p and m are not both 0;
[0598] preferably, X is - (BL) p-;
[0599] wherein each BL is independently selected from a compound of formula (I-1) or (I-2) , a compound of formula (II) , or a compound of formula (III) as defined herein, or a tautomer or stereoisomer thereof, or BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12, or a tautomer or stereoisomer thereof;
[0600] p is selected from 0, 1, 2, 3, 4, 5, or 6, preferably 0, 1, 2, or 3.
[0601] The present disclosure relates to a compound of formula (I) described above, provided that:
[0602] i) X is BL (dN) m, wherein BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12, preferably BL1, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5;
[0603] ii) X is selected from BL1-dTdTdT or BL1-dCdA;
[0604] iii) X is (BL) p, wherein each BL is independently selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, or BL9, preferably BL7 or BL8, and p is 1, 2, or 3; or
[0605] iv) X is BL1, -BL1-BL1-BL1-, BL5, BL7, BL8, BL9, BL10, BL11, BL12, BL7-BL7-BL7, BL8-BL8-BL8, or BL9-BL9-BL9, preferably X is BL7, BL7-BL7-BL7, BL8, BL8-BL8-BL8, BL9, or BL9-BL9-BL9.
[0606] The present disclosure relates to a compound of formula (I) described above, wherein G1 and G2 are independently selected from a double-stranded nucleic acid molecule, preferably a dsRNA.
[0607] The present disclosure relates to a compound of formula (I) described above, wherein the dsRNA molecule has a sense strand and an antisense strand, each having 14 to 30 nucleotides, wherein the antisense strand comprises a sequence sufficiently complementary to the sense strand and the target mRNA.
[0608] The present disclosure relates to a compound of formula (I) described above, wherein G1 and G2 may target identical or different target mRNAs, preferably different target mRNAs.
[0609] The present disclosure relates to a compound of formula (I) described above, wherein G1 and G2 each have a sense strand connected to -S1-X-S2-.
[0610] The present disclosure relates to a compound of formula (I) described above, wherein the end of the sense strand of each of G1 and G2 optionally contains one or more terminal modifications, preferably the 5'end and / or 3'end of the sense strand of each of G1 and G2 optionally contains one or more terminal modifications.
[0611] The present disclosure relates to a compound of formula (I) described above, wherein the 5'end of the sense strand of G1 and the 5'end of the sense strand of G2 each contain an terminal modification.
[0612] The present disclosure relates to a compound of formula (I) described above, wherein the terminal modification is selected from an abasic nucleotide (such as IB) , an inverted nucleotide, and an optionally substituted preferably the optionally substituted is substituted with a GalNAc-containing side chain substituent.
[0613] The present disclosure relates to a compound of formula (I) described above, wherein the terminal modification is selected from IB, STM1, or GL34.
[0614] The present disclosure relates to a compound of formula (I) described above, wherein the 3'end of the antisense strand of each of G1 and G2 is a blunt end or overhang, preferably an overhang, more preferably an overhang of both nucleotides.
[0615] The present disclosure relates to a compound of formula (I) described above, wherein X, S1, and S2 are as defined in Table 6, preferably X, S1, S2, 5'terminal modification of G1, 3'terminal modification of G1, 5'terminal modification of G2, and 3'terminal modification of G2 are as defined in Table 6:
[0616] Table 6.
[0617] wherein,
[0618] the structures of BL1 to BL12 are as defined herein;
[0619] the 5'a nd 3'terminal modifications of G1 and G2 are connected to G1 and G2 via a phosphate group or a phosphorothioate group;
[0620] GL6 is
[0621] when located at the 5'end of G1, GL34 represents
[0622] when located at the 3'end of G2, GL34 represents
[0623] when located at the 3'end of G1 or at the 5'end of G2, GL34 represents
[0624] IB is
[0625] The present disclosure also provides a vector comprising a nucleotide sequence encoding the siRNA of the disclosure. The vector of the present disclosure can amplify or express a nucleotide encoding the siRNA of the disclosure linked thereto.
[0626] For example, a siRNA targeting the PCSK9 gene can be expressed from a transcription unit inserted into a DNA or RNA vector. Expression can be transient (within hours to weeks) or sustained (weeks to months or longer) , depending on the particular construct used and the target tissue or cell type. A nucleotide encoding the siRNA can be introduced into a linear construct, a circular plasmid, or a viral vector. A nucleotide encoding the siRNA can be stably expressed by integration into the cell genome, or can be stably inherited and expressed extrachromosomally. Generally speaking, a vector expressing the siRNA is usually a DNA plasmid or a viral vector.
[0627] Viral vector systems comprising a sequence encoding the siRNA include, but are not limited to: (a) adenoviral vectors; (b) retroviral vectors; (c) adeno-associated viral vectors; (d) herpes simplex virus vectors; (e) SV40 vectors; (f) polyomavirus vectors; (g) papillomavirus vectors; (h) picornavirus vectors; (i) poxvirus vectors; and (j) helper virus-dependent or gutless adenoviral vectors.
[0628] The present disclosure also provides a cell comprising the siRNA or vector of the disclosure, wherein the siRNA or vector of the disclosure can be transcribed in the cell.
[0629] The present disclosure further relates to the use of a compound of formula (I) for the manufacture of a medicament for treating and / or preventing diseases.
[0630] The present disclosure further provides a method for treating and / or preventing diseases comprising administering to a subject in need thereof a therapeutically effective amount of a compound of formula (I) .
[0631] The present disclosure further relates to a compound of formula (I) for use in the manufacture of a medicament for treating and / or preventing diseases.
[0632] In specific embodiments, the diseases include, but are not limited to, Berger's disease, peripheral arterial disease, coronary artery disease, metabolic syndrome, acute coronary syndrome, aortic valve stenosis, aortic regurgitation, aortic dissection, retinal artery occlusion, cerebrovascular disease, mesenteric ischemia, superior mesenteric artery occlusion, renal artery stenosis, stable / unstable angina pectoris, acute coronary syndrome, heterozygous or homozygous familial hypercholesterolemia, hyperlipoproteinemia, atherosclerosis (e.g., cerebrovascular atherosclerosis) , cerebrovascular disease, venous embolism, myocardial infarction, dyslipidemia, non-alcoholic fatty liver disease, and non-alcoholic steatohepatitis.
[0633] In another specific embodiment, the diseases include, but are not limited to, metabolic syndrome, cardiovascular disease, hypertension, type 2 diabetes mellitus, obesity, elevated triglyceride levels, lipodystrophy, liver inflammation, fatty liver disease, elevated liver enzyme-related diseases, non-alcoholic cirrhosis, cardiomyopathy, heart failure, and nephropathy.
[0634] In another specific embodiment, the diseases include, but are not limited to, senile systemic amyloidosis, generalized familial amyloidosis, familial amyloid polyneuropathy, familial amyloid cardiomyopathy, leptomeningeal / central nervous system amyloidosis, hyperthyroxinemia, Stargardt's disease, diabetic retinopathy, age-related macular degeneration, insulin resistance associated with type 2 diabetes mellitus, and cardiovascular diseases.
[0635] The present disclosure specifically relates to the following technical solutions:
[0636] Technical solution A1. A compound of formula I, or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof:
[0637] wherein G1 and G2 are each independently a nucleic acid molecule;
[0638] Ab1 and Ab2 are each independently an abasic nucleotide, an inverted nucleotide, - (OCH2CH2) k-, - (CH2CH2O) k-, -O (CH2CH2O) k-, or - (CH2) k-;
[0639] n1 and n2 are each independently 0, 1, 2, or 3, preferably 0 or 1;
[0640] k is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10;
[0641] X is a linker.
[0642] Technical solution A2. A compound according to technical solution A1, wherein X is a nucleotide linker, the nucleotide preferably selected from a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, a 2'-5'ribonucleotide, or a 2'-5'deoxyribonucleotide.
[0643] Technical solution A3. A compound according to technical solution A2, wherein X is Nt (dN) m, wherein Nt is selected from a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, or a 2'-5'ribonucleotide, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5.
[0644] Technical solution A4. A compound according to technical solution A3, wherein X is selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, dTdTdTdT, or dTdTdTdTdT.
[0645] Technical solution A5. A compound according to technical solution A1, wherein X comprises one or more compounds of formula (II) :
[0646] wherein Tg is -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide;
[0647] the sugar moiety is preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0648] Rd is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated;
[0649] wherein Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated;
[0650] wherein L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;
[0651] wherein p and q are each independently 1, 2, 3, 4, 5, or 6;
[0652] wherein are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage, and represents connection to G2 via a bridged linkage.
[0653] Technical solution A6. A compound according to technical solution A5, wherein Tg is -S-S-C (CH3) 3.
[0654] Technical solution A7. A compound according to technical solution A5, wherein Tg is galactose, glucose, N-acetylgalactosamine, or N-acetylglucosamine, preferably galactose.
[0655] Technical solution A8. A compound according to any one of technical solutions A5 to A7, wherein Ra, Rb, and Rc are each independently selected from H, D, halogen, or C1-6 alkyl, L1 and L2 are each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-, and p and q are each independently 1, 2, 3, 4, 5, or 6.
[0656] Technical solution A9. A compound according to technical solution A1, wherein X comprises one or more of the following compounds:
[0657] Table 7.
[0658] Technical solution A10. A compound according to any one of technical solutions A1 to A9, wherein G1 and G2 are independently selected from a double-stranded nucleic acid molecule, preferably a dsRNA.
[0659] Technical solution A11. A compound according to technical solution A10, wherein the dsRNA molecule has a sense strand and an antisense strand, each having 14 to 30 nucleotides, wherein the antisense strand comprises a sequence sufficiently complementary to the sense strand and the target mRNA.
[0660] Technical solution A12. A compound according to technical solution A10 or A11, wherein G1 and G2 may target identical or different target mRNAs, preferably different target mRNAs.
[0661] Technical solution A13. A compound according to any one of technical solutions A10 to A12, wherein G1 and G2 each have a sense strand connected to
[0662] Technical solution A14. A compound according to technical solution A13, wherein the 3'end of the antisense strand of each of G1 and G2 is a blunt end or overhang, preferably an overhang, more preferably an overhang of both nucleotides.
[0663] Technical solution A15. A cell comprising a compound of any one of technical solutions A1 to A14.
[0664] Technical solution A16. A pharmaceutical composition comprising a compound of any one of technical solutions A1 to A14, or a cell of technical solution A15, and optionally a pharmaceutically acceptable carrier or excipient.
[0665] Technical solution A17. A kit comprising a compound of any one of technical solutions A1 to A14, or a cell of technical solution A15.
[0666] Technical solution B1. A compound of formula I, or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof:
[0667] wherein G1 and G2 are each independently a nucleic acid molecule;
[0668] Ab1 and Ab2 are each independently an abasic nucleotide, an inverted nucleotide, - (OCH2CH2) k-, - (CH2CH2O) k-, -O (CH2CH2O) k-, or - (CH2) k-;
[0669] n1 and n2 are each independently 0, 1, 2, or 3, preferably 0 or 1;
[0670] k is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10;
[0671] X is a linker.
[0672] Technical solution B2. A compound according to technical solution B1, wherein X is a nucleotide linker, the nucleotide preferably selected from a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, a 2'-5'ribonucleotide, or a 2'-5'deoxyribonucleotide.
[0673] Technical solution B3. A compound according to technical solution B2, wherein X is Nt (dN) m, wherein Nt is selected from a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, or a 2'-5'ribonucleotide, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5.
[0674] Technical solution B4. A compound according to technical solution B3, wherein X is selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, dTdTdTdT, or dTdTdTdTdT.
[0675] Technical solution B5. A compound according to technical solution B1, wherein X comprises one or more compounds of formula (II) :
[0676] wherein Tg is -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide;
[0677] the sugar moiety is preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0678] Rd is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated;
[0679] wherein Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated;
[0680] wherein L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;
[0681] wherein p and q are each independently 1, 2, 3, 4, 5, or 6;
[0682] wherein are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage, and represents connection to G2 via a bridged linkage.
[0683] Technical solution B6. A compound according to technical solution B5, wherein Tg is -S-S-C (CH3) 3.
[0684] Technical solution B7. A compound according to technical solution B5, wherein Tg is galactose, glucose, N-acetylgalactosamine, or N-acetylglucosamine, preferably galactose.
[0685] Technical solution B8. A compound according to any one of technical solutions B5 to B7, wherein Ra, Rb, and Rc are each independently selected from H, D, halogen, or C1-6 alkyl, L1 and L2 are each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-, and p and q are each independently 1, 2, 3, 4, 5, or 6.
[0686] Technical solution B9. A compound according to technical solution B1, wherein X comprises one or more compounds of formula (III) :
[0687] wherein Sg is a sugar moiety, preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;
[0688] L3 and L4 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;
[0689] L5 is a linker, preferably independently selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;
[0690] wherein are connected to G1 or G2 via a bridged linkage; preferably represents connection to G1 via a bridged linkage, and represents connection to G2 via a bridged linkage.
[0691] Technical solution B10. A compound according to technical solution B9, wherein X comprises one or more compounds of formula (IIIa) :
[0692] wherein L3, L4, and L5 are as defined above.
[0693] Technical solution B11. A compound according to technical solution B9 or B10, wherein L3 is -O- (CH2) 4-, L4 is a bond, and L5 is a bond.
[0694] Technical solution B12. A compound according to technical solution B9 or B10, wherein L3 is -O- (CH2) 5-, L4 is -OC (O) -, and L5 is
[0695] Technical solution B13. A compound according to technical solution B9 or B10, wherein L3 is -O- (CH2) 4-, L4 is -C (O) -, and L5 is
[0696] Technical solution B14. A compound according to technical solution B1, wherein X comprises one or more of the following compounds:
[0697] Table 8.
[0698] Technical solution B15. A compound according to technical solution B14, wherein X is BL (dN) m, wherein BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, or BL9, preferably BL1, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5.
[0699] Technical solution B16. A compound according to technical solution B14, wherein X is selected from BL1-dTdTdT or BL1-dCdA.
[0700] Technical solution B17. A compound according to technical solution B14, wherein X is (BL) p, wherein BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, or BL9, preferably BL7 or BL8, and p is 1, 2, or 3.
[0701] Technical solution B18. A compound according to technical solution B17, wherein X is BL7, BL7-BL7-BL7, BL8, BL8-BL8-BL8, BL9, or BL9-BL9-BL9.
[0702] Technical solution B19. A compound according to any one of technical solutions B1 to B18, wherein G1 and G2 are independently selected from a double-stranded nucleic acid molecule, preferably a dsRNA.
[0703] Technical solution B20. A compound according to technical solution B19, wherein the dsRNA molecule has a sense strand and an antisense strand, each having 14 to 30 nucleotides, wherein the antisense strand comprises a sequence sufficiently complementary to the sense strand and the target mRNA.
[0704] Technical solution B21. A compound according to technical solution B19 or B20, wherein G1 and G2 may target identical or different target mRNAs, preferably different target mRNAs.
[0705] Technical solution B22. A compound according to any one of technical solutions B19 to B21, wherein G1 and G2 each have a sense strand connected to
[0706] Technical solution B23. A compound according to technical solution B22, wherein the 3'end of the antisense strand of each of G1 and G2 is a blunt end or overhang, preferably an overhang, more preferably an overhang of both nucleotides.
[0707] Technical solution B24. A cell comprising a compound of any one of technical solutions B1 to B23.
[0708] Technical solution B25. A pharmaceutical composition comprising a compound of any one of technical solutions B1 to B23, or a cell of technical solution B24, and optionally a pharmaceutically acceptable carrier or excipient.
[0709] Technical solution B26. A kit comprising a compound of any one of technical solutions B1 to B23, or a cell of technical solution B24.
[0710] 6. List of Specific Compounds
[0711] The compounds of the present disclosure are numbered and structured in oligonucleotides as follows, wherein represents connection to G1 via a bridged linkage (S1) , and represents connection to G2 via a bridged linkage (S2) ;
[0712] Table 9.
[0713] III. PCSK9 and LDL-lowering enhancer
[0714] 1. PCSK9
[0715] Proprotein convertase subtilisin / kexin type 9 (PCSK9) is a serine protease, which is mainly expressed in livers, small intestines and kidneys, is a regulatory targeting substance for a low density lipoprotein, and mainly plays a role by regulating expression and secretion activity of a low density lipoprotein receptor on the livers.
[0716] Cholesterol in the blood is mainly synthesized in the livers, and decomposition of excess cholesterol is also mainly carried out in the livers. The low density lipoprotein receptor (LDLR) that exists on surfaces of the livers can bind to the cholesterol circulating back to the livers and decompose the cholesterol into bile acid which is then excreted out of the body through intestines. As the protease synthesized in the livers, the PCSK9 can bind to the LDLR and promote the LDLR to enter a hepatocyte lysosome for decomposition, thereby decreasing the amount of the LDLR. On the contrary, inhibition of PSCK9 enzyme activity can increase the amount of the LDLR, thereby enhancing the abilities to uptake and decompose the cholesterol, and ultimately reducing the content of the cholesterol.
[0717] The PCSK9 can bind to the low density lipoprotein receptor through an extracellular pathway and an intracellular pathway and promote degradation of the LDLR. In the extracellular pathway, the PCSK9 secreted into an extracellular cell binds to the LDLR on a cell membrane, such that the LDLR is endocytosed to form an endosome and finally enters a lysosome for degradation. In the intracellular pathway, the PCSK9 secreted from a Golgi apparatus enters cytoplasm and directly binds to the LDLR, such that the LDLR directly enters a lysosomal degradation pathway in a cell.
[0718] Therefore, the PCSK9 is an effective target for treatment of hyperlipidemia and atherosclerosis. Although hypercholesterolemia itself is asymptomatic, long-term elevated serum cholesterol can lead to atherosclerosis. After decades, chronically elevated cholesterol leads to the formation of atherosclerotic plaques in arteries, and the atherosclerosis can lead to progressive stenosis or even complete occlusion of the arteries involved. In addition, smaller plaques may rupture and cause clot formation and vascular occlusion, leading to, for example, myocardial infarction and / or stroke. When the stenosis or the occlusion is gradually formed, blood supply to tissues and organs is slowly reduced until organ functions are impaired.
[0719] Details of PCSK9 and its functions can be found, e.g., in Bao, X., et al. "Targeting proprotein convertase subtilisin / kexin type 9 (PCSK9) : from bench to bedside. " Signal transduction and targeted therapy 9.1 (2024) : 13, which is incorporated herein by reference in its entirety.
[0720] 2. LDL-lowering enhancer
[0721] In some embodiments, the LDL-lowering enhancer described herein targets a gene encoding LPA. In some embodiments, the LDL-lowering enhancer described herein targets a gene encoding CETP (Cholesteryl Ester Transfer Protein) , SCAP (SREBP cleavage activating protein) , ASGR1 (Asialoglycoprotein Receptor 1) , USP20 (Ubiquitin Specific Peptidase 20) , ACLY (ATP Citrate Lyase) , MYLIP (Myosin Regulatory Light Chain Interacting Protein) , KLKB1 (Kallikrein B1) , ANGPTL8 (Angiopoietin Like 8) , or DGAT2 (Diacylglycerol O-Acyltransferase 2) .
[0722] Lipoprotein (a) , also known as LPA or Lp (a) , a low-density lipoprotein (LDL) -like particle containing apolipoprotein B (apoB) with an additional protein, apolipoprotein (a) (apo (a) ) , has been identified as a causal factor for coronary heart disease (CHD) based initially on epidemiological findings and most recently on genetic studies. Variants in the LPA gene coding for the apo (a) component of the lipoprotein have been associated with risk of myocardial infarction, stroke, and aortic valve stenosis. The plasma concentration of Lp (a) is regulated primarily by genetic factors and varies widely within populations and between ethnic groups. Recently, Lp (a) has received attention as a potential target for drug-based intervention. Statins do not lower Lp (a) and may even increase the level of this lipoprotein moderately. Specific agents to lower Lp (a) profoundly (>85%) are in clinical development. These RNA-based drugs act to suppress synthesis of the apo (a) polypeptide in the liver and thus inhibit Lp (a) formation. Details of LPA and its functions can be found, e.g., in E., et al. "Lipoprotein (a) is markedly more atherogenic than LDL: an apolipoprotein B-based genetic analysis. " Journal of the American College of Cardiology 83.3 (2024) : 385-395, which is incorporated herein by referece in its entirety.
[0723] Cholesteryl ester transfer protein (CETP) is a glycoprotein synthesized in the liver that is present in all primates (including humans) , rabbits and hamsters. The CETP molecule has a boomerang shape, with a tunnel that forms between spaces at each end for binding cholesteryl esters and triglycerides (TG) . It is responsible for the exchange of TG from very low-density lipoprotein (VLDL) particles with cholesteryl esters from high-density lipoprotein (HDL) particles and low-density lipoprotein (LDL) particles. The net effect of this exchange is to enrich VLDL and LDL particles with cholesteryl esters and deplete them of TG while simultaneously enriching HDL particles with TG and depleting them of cholesteryl esters. Epidemiological evidence that elevated HDL cholesterol (HDL-C) is inversely associated with atherosclerotic cardiovascular disease (ASCVD) , combined with the discovery of mutations in the CETP gene that are associated with increased HDL-C and reduced LDL cholesterol (LDL-C) concentrations, launched interest in the development of agents to pharmacologically inhibit CETP. CETP inhibitors reduce the rate of transfer of cholesteryl ester from HDL into TG-rich lipoproteins. This leads to the formation of larger, cholesteryl ester-enriched HDL particles that are slowly catabolized, and, as a consequence, depletion of cholesterol in the TG-rich and apolipoprotein (apo) B-containing lipoproteins, i.e., VLDL, LDL, intermediate density lipoproteins (IDL) , chylomicrons, and their remnants. Details of CETP and its functions can be found, e.g., in Nelson, Adam J., et al. "Cholesteryl ester transfer protein inhibition reduces major adverse cardiovascular events by lowering apolipoprotein B levels. " International Journal of Molecular Sciences 23.16 (2022) : 9417, which is incorporated herein by referece in its entirety.
[0724] SREBP cleavage activating protein (SCAP) is an ER sensing protein, which plays an inevitable role in the regulation of SREBP activity by transporting SREBP from the ER to the Golgi apparatus, facilitating the release of the N-terminus of SREBP by site-1 and site-2 proteases and permitting its entry into the nucleus. In this compartment, the N-terminal domain activates the transcription of several genes involved in lipid synthesis, such as HMG-CoA reductase, HMG-CoA synthase, fatty acid synthase, and glycerol-3-phosphateacyltransferase, when cellular cholesterol levels are low. On the other hand, when cholesterol is present in large quantities in the ER membrane and exceeds the sharp threshold of 4–5%of total lipids, it binds to SCAP, thereby triggering a conformational change promoting SCAP interaction and formation of a ternary complex with the ER membrane retention protein insulin-induced gene 1 (INSIG1) , which is composed of 277 amino acids, or insulin-induced gene 2 (INSIG2) , which is composed of 225 amino acids. This reduces the transport of the SCAP / SREBP complex to the Golgi, thereby inhibiting the synthesis of cholesterol and initiating a negative feedback mechanism that maintains cholesterol homeostasis. Details of CETP and its functions can be found, e.g., Chandrasekaran, Preethi, and Ralf Weiskirchen. "The role of SCAP / SREBP as central regulators of lipid metabolism in hepatic steatosis. " International Journal of Molecular Sciences 25.2 (2024) : 1109, which is incorporated herein by referece in its entirety.
[0725] Asialoglycoprotein Receptor 1 (ASGR1) is involved in not only the recognition and clearance of glycoproteins, but also regulating cholesterol and other metabolic processes in the liver, thereby influencing overall health. Although the internalization process mediated by ASGR1 is primarily focused on glycoprotein clearance, it may also involve the handling of cholesterol esters, triglycerides, and low-density lipoproteins (LDL) , which could have an impact on liver function and overall metabolic balance. Specifically, through these internalization processes, ASGR1 may help maintain cholesterol and lipid metabolism in the liver, preventing abnormal accumulation of cholesterol and fat, thereby reducing the risk of fatty liver and atherosclerosis. Therefore, the role of ASGR1 in these metabolic pathways requires further research to be fully understood. Research using ASGR1 knockout (KO) mouse models has further demonstrated the role of ASGR1 in liver metabolism. In these models, the absence of ASGR1 leads to a significant decrease in glycoprotein clearance function, resulting in abnormal accumulation of glycoproteins in the liver, accompanied by liver dysfunction and widespread metabolic disorders. These knockout models exhibit significantly elevated plasma cholesterol levels and show early signs of atherosclerosis. These findings suggest that the loss of ASGR1 function not only affects the normal metabolism of glycoproteins but may also increase the risk of cardiovascular diseases by altering cholesterol metabolism pathways. Details of ASGR1 and its functions can be found, e.g., in Song, J., et al. "Beyond conventional treatment: ASGR1 Leading the new era of hypercholesterolemia management. " Biomedicine &Pharmacotherapy 180 (2024) : 117488, which is incorporated herein by reference in its entirety.
[0726] In the cholesterol biosynthetic pathway, HMG-CoA reductase (HMGCR) is the rate-limiting enzyme that converts HMG-CoA to mevalonate. Mammalian cells regulate cholesterol biosynthesis at both mRNA and protein levels. High levels of cholesterol suppress transcription of the genes encoding cholesterol biosynthetic enzymes. Meanwhile, high levels of sterols, such as lanosterol and oxysterols, stimulate HMGCR degradation by promoting its binding to Insig and the associated ubiquitin ligases E3s, which ubiquitinate HMGCR and accelerate HMGCR turnover. Gp78 is the major E3 for HMGCR degradation in the liver that is the central organ for lipid metabolism. These feedback regulatory mechanisms prevent mammalian cells from making too much cholesterol. Ubiquitin Specific Peptidase 20 (USP20) can bind to gp78 and antagonize the degradation of HMGCR. By this mechanism, HMGCR protein level is increased by about 20-fold, and cholesterol biosynthetic rate is increased by about 10-fold in the feeding state compared with the fasting state. Genetic deletion or pharmacological inhibition of USP20 reduces body weight, increases energy expenditure, and improves glucose clearance. Hence, USP20 is a promising target for treatment of metabolic syndrome. Details of USP20 and its functions can be found, e.g., in Ding, Yi, et al. "siRNA nanoparticle targeting Usp20 lowers lipid levels and ameliorates metabolic syndrome in mice. " Journal of Lipid Research 65.9 (2024) : 100626, which is incorporated herein by reference in its entirety.
[0727] ATP Citrate Lyase (ACLY) is an important enzyme linking carbohydrate to lipid metabolism by generating acetyl-CoA from citrate for fatty acid and cholesterol biosynthesis. Mendelian randomization of large human cohorts has validated ACLY as a promising target for low-density-lipoprotein-cholesterol (LDL-C) lowering and cardiovascular protection. Among current ACLY inhibitors. ACLY deficiency in hepatocytes protects from hepatic steatosis and dyslipidemia. In addition, pharmacological inhibition of ACLY by bempedoic acid, prevents dyslipidemia and attenuates atherosclerosis in hypercholesterolemic ApoE- / -mice, LDLr- / -mice, and LDLr- / -miniature pigs. Details of ACLY and its functions can be found, e.g., in Feng, X., et al. "ATP-citrate lyase (ACLY) in lipid metabolism and atherosclerosis: an updated review. " Progress in Lipid Research 77 (2020) : 101006, which is incorporated herein by reference in its entirety.
[0728] Myosin Regulatory Light Chain Interacting Protein (MYLIP) is a regulator of the LDL receptor (LDLR) pathway for cellular cholesterol uptake. MYLIP is a direct target for regulation by the nuclear receptor liver X receptor (LXR) , and its expression is coordinately regulated with the ATP-binding cassette transporter in multiple cell types. In response to cellular cholesterol loading, activation of LXR leads to rapid induction of MYLIP expression. MYLIP stimulates ubiquitination of the LDLR on its cytoplasmic tail, thereby directing its degradation. Expression of Mylip in mouse liver by means of an adenoviral vector dramatically reduces LDLR protein levels and raises LDL-C levels. Thus, the LXR-MYLIP-LDLR pathway provides a complementary pathway to sterol regulatory element–binding proteins for the feedback inhibition of cholesterol uptake. Details of MYLIP and its functions can be found, e.g., in Weissglas-Volkov, D., et al. "The N342S MYLIP polymorphism is associated with high total cholesterol and increased LDL receptor degradation in humans. " The Journal of Clinical Investigation 121.8 (2011) : 3062-3071, which is incorporated herein by reference in its entirety.
[0729] Kallikrein B1 (KLKB1) , as a coagulation factor, was identified as a binding protein of LDLR. It was found that KLKB1 binds to LDLR and causes LDLR lysosomal degradation, while plasma KLKB1 concentrations in humans are positively correlated to LDL-C levels. Loss of KLKB1 increases hepatic LDLR and reduces FC, attenuating atherosclerosis progression in multiple rodent models. In addition, the use of anti-competitive neutralizing antibodies can also reduce plasma lipids by up-regulating liver LDLR. This study suggests that KLKB1 may represent a potential treatment target for ASCVD. Details of KLKB1 and its functions can be found, e.g., in Wang, J., et al. "Ablation of plasma prekallikrein decreases low-density lipoprotein cholesterol by stabilizing low-density lipoprotein receptor and protects against atherosclerosis. " Circulation 145.9 (2022) : 675-687, which is incorporated herein by reference in its entirety.
[0730] Angiopoietin Like 8 (ANGPTL8) has been ascribed various functions at the systemic and cellular levels. Angiopoietin-like protein (ANGPTL) family members, mainly ANGPTL3, ANGPTL4 and ANGPTL8, are physiological inhibitors of lipoprotein lipase (LPL) , and play a critical role in lipoprotein and triglyceride metabolism in response to nutritional cues. Circulating ANGPTL8 originates mainly from the liver and to a smaller extent from adipose tissues. In the blood, ANGPTL8 forms a complex with ANGPTL3 or ANGPTL4 to inhibit LPL in fed or fasted conditions, respectively. Evidence is emerging for additional intracellular and receptor-mediated functions of ANGPTL8, with implications in NFκB mediated inflammation, autophagy, adipogenesis, intra-cellular lipolysis and regulation of circadian clock. Elevated levels of plasma ANGPTL8 are associated with metabolic syndrome, type 2 diabetes, atherosclerosis, hypertension and NAFLD / NASH. Details of ANGPTL8 and its functions can be found, e.g., in Abu-Farha, M., et al. "The multi-faces of Angptl8 in health and disease: Novel functions beyond lipoprotein lipase modulation. " Progress in Lipid Research 80 (2020) : 101067, which is incorporated herein by reference in its entirety.
[0731] Diacylglycerol O-Acyltransferase 2 (DGAT2) expression has previously been shown to be important for the development of hepatic steatosis. Results from recent clinical trials reported that administration of a DGAT2 inhibitor alone or in combination with an ACC inhibitor to individuals with MASLD significantly improved hepatic steatosis and liver function tests. The mechanism by which DGAT2 inhibition improves liver steatosis has not been fully elucidated. In addition to blocking the last step in triglyceride (TG) synthesis, SREBP-1c-regulated genes responsible for fatty acid synthesis were also decreased when DGAT2 was deleted or inhibited in animals. It is not clear how or why DGAT2 blockade selectively suppresses SREBP-1c and de novo fatty acid synthesis. Details of DGAT2 and its functions can be found, e.g., in Rong, S., et al. "DGAT2 inhibition blocks SREBP-1 cleavage and improves hepatic steatosis by increasing phosphatidylethanolamine in the ER. " Cell Metabolism 36.3 (2024) : 617-629, which is incorporated herein by reference in its entirety.
[0732] IV. Pharmaceutical Compositions
[0733] In one aspect, the disclosure provides pharmaceutical compositions containing the compound disclosed herein or the combination of a PCSK9-targeting dsRNA and an LDL-lowering enhancer described herein, and a pharmaceutically acceptable carrier. The pharmaceutical composition containing the compound or the combination is useful for treating a disease or disorder related to the expression or activity of PCSK9, the LDL level, and / or the cholesteral level (e.g., a cardiovascular disease or a liver disease) .
[0734] Such pharmaceutical compositions are formulated based on the mode of delivery. In some embodiments, compositions can be formulated for localized delivery, e.g., by CNS delivery (e.g., intrathecal, intracranial, intracerebral, intraventricular, epidural, or intraganglionic routes of injection, optionally by infusion into the brain or spine, e.g., by continuous pump infusion) . In another example, compositions can be formulated for systemic administration via parenteral delivery, e.g., by intravenous (IV) delivery, intramuscular (IM) , or subcutaneous delivery (subQ) . In some embodiments, the pharmaceutical composition described herein is administered intravenously.
[0735] In some embodiments, a composition provided herein (e.g., a composition comprising an LNP formulation) is formulated for intravenous delivery. The pharmaceutical compositions featured herein are administered in a dosage sufficient to inhibit expression of PCSK9 and / or LPA. In general, a suitable dose of the compound, the combination, or the pharmaceutical composition thereof will be in the range of 0.01 to 200.0 milligrams per kilogram body weight of the recipient per day, generally in the range of 1 to 50 mg per kilogram body weight per day. For example, the compound, the combination, or the pharmaceutical composition thereof can be administered at 0.05 mg / kg, 0.5 mg / kg, 1 mg / kg, 1.5 mg / kg, 2 mg / kg, 3 mg / kg, 10 mg / kg, 20 mg / kg, 30 mg / kg, 40 mg / kg, or 50 mg / kg per single dose.
[0736] In some embodiments, a repeat-dose regimen may include administration of a therapeutic amount of the compound, the combination, or the pharmaceutical composition thereof on a regular basis, such as monthly to once every six months. In certain embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered about once per quarter (i.e., about once every three months) to about twice per year. After an initial treatment regimen (e.g., loading dose) , the treatments can be administered on a less frequent basis. In other embodiments, the compound, the combination, or the pharmaceutical composition thereof may be administered once daily, or the compound, the combination, or the pharmaceutical composition thereof may be administered as two, three, or more sub-doses at appropriate intervals throughout the day or even using continuous infusion or delivery through a controlled release formulation. In that case, the compound, the combination, or the pharmaceutical composition thereof contained in each sub-dose must be correspondingly smaller in order to achieve the total daily dosage. The dosage unit can also be compounded for delivery over several days, e.g., using a conventional sustained release formulation which provides sustained release of the compound, the combination, or the pharmaceutical composition thereof over a several-day period. Sustained release formulations are well known in the art and are particularly useful for delivery of therapeutic agents at a particular site, such as can be used with the agents of the present disclosure. In some embodiments, the dosage unit contains a corresponding multiple of the daily dose. The effect of a single dose on PCSK9 and / or LPA levels can be long lasting, such that subsequent doses are administered at not more than 3, 4, or 5-day intervals, or at not more than 1, 2, 3, 4, 12, 24, or 36-week intervals. The skilled artisan will appreciate that certain factors may influence the dosage and timing required to effectively treat a subject, including but not limited to the severity of the disease or disorder, previous treatments, the general health and / or age of the subject, and other diseases present. Moreover, treatment of a subject with a therapeutically effective amount of a composition can include a single treatment or a series of treatments.
[0737] Estimates of effective dosages and in vivo half-lives for the individual compound, the combination, or the pharmaceutical composition thereof encompassed by the disclosure can be made using conventional methodologies or on the basis of in vivo testing using a suitable animal model. A suitable animal model, e.g., a mouse or a cynomolgus monkey, e.g., an animal containing a transgene expressing human PCSK9 and / or LPA, can be used to determine the therapeutically effective dose and / or an effective dosage regimen administration of the compound, the combination, or the pharmaceutical composition thereof. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof described herein can be delivered in a manner to target a particular tissue, such as the liver. The present disclosure also includes pharmaceutical compositions and formulations that include the compound or the combination featured herein. The pharmaceutical compositions of the present disclosure may be administered in a number of ways depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be local (e.g., by intrathecal, intraventricular, intracerebroventricular, intracranial, epidural, or intraganglionic injection) , topical (e.g., buccal and sublingual administration) , oral, intravitreal, transdermal, airway (aerosol) , nasal, rectal, or parenteral. Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; subdermal, e.g., via an implanted device; or intracranial, e.g., by intraparenchymal, intrathecal, or intraventricular administration.
[0738] In some instances, the residual inhibition level (e.g., as determined using the methods described herein) is normalized, e.g., to pre-dose or to saline. Normalization to pre-dose is usually preferred while normalization to saline can be used when pre-dose level is not that stable. In some embodiments, the residual inhibition level of the compound (e.g., any of the dual-targeting siRNAs described herein) is less than 90%, less than less than 80%, less than 70%, less than 60%, less than 50%, less than 40%, less than 30%, less than 20%or less than 10%as compared to that of the saline control. In some embodiments, the residual inhibition level of the compound (e.g., any of the dual-targeting siRNAs described herein) is less than 90%, less than 80%, less than 70%, less than 60%, less than 50%, less than 40%, less than 30%, less than 20%, less than 10%, or less than 5%as compared to that of the combination of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) . In some embodiments, the residual inhibition level of the compound (e.g., any of the dual-targeting siRNAs described herein) is about 50%to about 150%, about 60%to about 140%, about 70%to about 130%, about 80%to about 120%, or about 90%to about 110%as compared to that of the combination of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) .
[0739] In some embodiments, the exposure level in plasma of the compound (e.g., any of the dual-targeting siRNAs described herein) , as detemined by its PK profile, is about 10%, about 20%, about 30%, about 40%, about 50%, about 60%, about 70%, about 80%, about 90%, about 100%, about 150%, about 200%, about 250%, about 300%, about 350%, about 400%, about 450%, or about 500%higher than that of a single-targeting siRNA (e.g., any of the single-targeting siRNAs described herein) .
[0740] In some embodiments, the knock-down activity of Lp (a) , PCSK9, and / or LDL-C (e.g., using methods described herein) of the compound (e.g., any of the dual-targeting siRNAs described herein) , as determined by its PD profile, is about 50%to about 150%, about 60%to about 140%, about 70%to about 130%, about 80%to about 120%, or about 90%to about 110%as compared to that of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) , an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) , or the combination of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) . In some embodiments, the knock-down activity of Lp (a) , PCSK9, and / or LDL-C (e.g., using methods described herein) of the compound (e.g., any of the dual-targeting siRNAs described herein) , as determined by its PD profile, is at least 10%, at least 20%, at least 30%, at least 40%, at least 50%or at least 60%greater as compared to that of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) , an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) , or the combination of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) . In some embodiments, the knock-down activity is determined by the ability to exhibit a greater reduction of the serum levels of Lp (a) , PCSK9, and / or LDL-C as compared to that of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) , an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) , or the combination of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) . In some embodiments, the reduction of the serum levels of Lp (a) , PCSK9, and / or LDL-C is determined over time (e.g., over any of the days of the duration of the knock-down activity described herein.
[0741] In some embodiments, the duration of the knock-down activity of the compound, the combination, or the pharmaceutical composition thereof can last for at least 50 days, at least 55 days, at least 60 days, at least 65 days, at least 70 days, at least 75 days, at least 80 days, at least 85 days, at least 90 days, at least 95 days, at least 100 days, at least 105 days, at least 110 days, at lesat 115 days, at least 120 days, at least 125 days, at least 130 days, at least 135 days, at least 140 days, at least 145 days, at least 150 days, at least 155 days, at least 160 days, at least 165 days, at least 170 days, at least 175 days, at least 180 days, at least 185 days, at least 190 days, at least 195 days, or at least 200 days. In some embodiments, the knock-down percentage (KD%) described herein is about -100%to about -10%, about -100%to about -20%, about -100%to about -30%, about -100%to about -40%, about -100%to about -50%, about -100%to about -60%, about -100%to about -70%, about -100%to about -80%, about -100%to about -90%, about -90%to about -10%, about -90%to about -20%, about -90%to about -30%, about -90%to about -40%, about -90%to about -50%, about -90%to about -60%, about -90%to about -70%, about -90%to about -80%, about -80%to about -10%, about -80%to about -20%, about -80%to about -30%, about -80%to about -40%, about -80%to about -50%, about -80%to about -60%, about -80%to about -70%, about -70%to about -10%, about -70%to about -20%, about -70%to about -30%, about -70%to about -40%, about -70%to about -50%, about -70%to about -60%, about -60%to about -10%, about -60%to about -20%, about -60%to about -30%, about -60%to about -40%, about -60%to about -50%, about -50%to about -10%, about -50%to about -20%, about -50%to about -30%, about -50%to about -40%, about -40%to about -10%, about -40%to about -20%, about -40%to about -30%, about -30%to about -10%, about -30%to about -20%, or about -20%to about -10%after any of the days of the duration of the knock-down activity described herein.
[0742] In some embodiments, the administration is via a bolus injection. In some embodiments, the administration is via a depot injection. A depot injection may release the compound, the combination, or the pharmaceutical composition thereof in a consistent way over a prolonged time period. Thus, a depot injection may reduce the frequency of dosing needed to obtain a desired effect, e.g., a desired inhibition of PCSK9 and / or LPA, or a therapeutic or prophylactic effect. In some embodiments, the administration is via a pump. The pump may be an external pump or a surgically implanted pump. In other embodiments, the pump is an infusion pump. An infusion pump may be used for intracranial, intravenous, or epidural infusions. In certain embodiments, the pump is a surgically implanted pump that delivers the compound, the combination, or the pharmaceutical composition thereof to the liver. Pharmaceutical compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids and powders. Conventional pharmaceutical carriers, aqueous, powder or oily bases, thickeners and the like may be necessary or desirable. Suitable topical formulations include those in which the compound, the combination, or the pharmaceutical composition thereof featured in the disclosure are in admixture with a topical delivery agent such as lipids, liposomes, fatty acids, fatty acid esters, steroids, chelating agents and surfactants.
[0743] Suitable lipids and liposomes include neutral (e.g., dioleoylphosphatidyl DOPE ethanolamine, dimyristoylphosphatidyl choline DMPC, distearolyphosphatidyl choline) , negative (e.g., dimyristoylphosphatidyl glycerol DMPG) and cationic (e.g., dioleoyltetramethylaminopropyl DOTAP and dioleoylphosphatidyl ethanolamine DOTMA) . The oligonucleotides featured in the disclosure may be encapsulated within liposomes or may form complexes thereto, in particular to cationic liposomes. Alternatively, antisense oligonucleotides may be complexed to lipids, in particular to cationic lipids. Suitable fatty acids and esters include but are not limited to arachidonic acid, oleic acid, eicosanoic acid, lauric acid, caprylic acid, capric acid, myristic acid, palmitic acid, stearic acid, linoleic acid, linolenic acid, dicaprate, tricaprate, monoolein, dilaurin, glyceryl 1-monocaprate, 1-dodecylazacycloheptan-2-one, an acylcarnitine, an acylcholine, or a C1-20 alkyl ester (e.g., isopropylmyristate IPM) , monoglyceride, diglyceride or pharmaceutically acceptable salt thereof. Topical formulations are described in detail in U.S. Patent No. 6,747,014, which is incorporated herein by reference in its entirety.
[0744] There are many organized surfactant structures besides microemulsions that have been studied and used for the formulation of drugs. These include monolayers, micelles, bilayers and vesicles. Vesicles, such as liposomes, have attracted great interest because of their specificity and the duration of action they offer from the standpoint of drug delivery. As used in the present disclosure, the term "liposome" means a vesicle composed of amphiphilic lipids arranged in a spherical bilayer or bilayers. Liposomes are unilamellar or multilamellar vesicles which have a membrane formed from a lipophilic material and an aqueous interior. The aqueous portion contains the composition to be delivered. Cationic liposomes possess the advantage of being able to fuse to the cell wall. Non-cationic liposomes, although not able to fuse as efficiently with the cell wall, are taken up by macrophages in vivo. In order to traverse intact mammalian skin, lipid vesicles must pass through a series of fine pores, each with a diameter less than 50 nm, under the influence of a suitable transdermal gradient. Therefore, it is desirable to use a liposome which is highly deformable and able to pass through such fine pores. Further advantages of liposomes include: liposomes obtained from natural phospholipids are biocompatible and biodegradable; liposomes can incorporate a wide range of water and lipid soluble drugs; liposomes can protect encapsulated drugs in their internal compartments from metabolism and degradation (Rosoff, in Pharmaceutical Dosage Forms, Lieberman, Rieger and Banker (Eds. ) , 1988, Marcel Dekker, Inc., New York, N.Y., volume 1, p. 245) . Important considerations in the preparation of liposome formulations are the lipid surface charge, vesicle size and the aqueous volume of the liposomes.
[0745] Liposomes are useful for the transfer and delivery of active ingredients to the site of action. Because the liposomal membrane is structurally similar to biological membranes, when liposomes are applied to a tissue, the liposomes start to merge with the cellular membranes and as the merging of the liposome and cell progresses, the liposomal contents are emptied into the cell where the active agent may act. Liposomal formulations have been the focus of extensive investigation as the mode of delivery for many drugs. There is growing evidence that for topical administration, liposomes present several advantages over other formulations. Such advantages include reduced side-effects related to high systemic absorption of the administered drug, increased accumulation of the administered drug at the desired target, and the ability to administer a wide variety of drugs, both hydrophilic and hydrophobic, into the skin. Several reports have detailed the ability of liposomes to deliver agents including high-molecular weight DNA into the skin. Compounds including analgesics, antibodies, hormones and high-molecular weight DNAs have been administered to the skin. The majority of applications resulted in the targeting of the upper epidermis Liposomes fall into two broad classes. Expression of the exogenous gene was detected in the target cells (Zhou et al., Journal of Controlled Release, 1992, 19, 269-274) . One major type of liposomal composition includes phospholipids other than naturally derived phosphatidylcholine. Neutral liposome compositions, for example, can be formed from dimyristoyl phosphatidylcholine (DMPC) or dipalmitoyl phosphatidylcholine (DPPC) . Anionic liposome compositions generally are formed from dimyristoyl phosphatidylglycerol, while anionic fusogenic liposomes are formed primarily from dioleoyl phosphatidylethanolamine (DOPE) . Another type of liposomal composition is formed from phosphatidylcholine (PC) such as, for example, soybean PC, and egg PC. Another type is formed from mixtures of phospholipid and / or phosphatidylcholine and / or cholesterol. Further details on using liposomal formulations for the delivery of the compound, the combination, or the pharmaceutical composition thereof can be found, e.g., in PCT Publication No. WO2021207189A1, the entire content of which is hereby incorporated by reference.
[0746] Certain compositions of the present disclosure also incorporate carrier compounds in the formulation. As used herein, “carrier compound” can refer to a nucleic acid, or analog thereof, which is inert (i.e., does not possess biological activity per se) but is recognized as a nucleic acid by in vivo processes that reduce the bioavailability of a nucleic acid having biological activity by, for example, degrading the biologically active nucleic acid or promoting its removal from circulation. The coadministration of a nucleic acid and a carrier compound, typically with an excess of the latter substance, can result in a substantial reduction of the amount of nucleic acid recovered in the liver, kidney or other extracirculatory reservoirs, presumably due to competition between the carrier compound and the nucleic acid for a common receptor. For example, the recovery of a partially phosphorothioate antisense oligonucleotide in hepatic tissue can be reduced when it is coadministered with polyinosinic acid, dextran sulfate, polycytidic acid or 4-acetamido-4’isothiocyano-stilbene-2, 2’ -disulfonic acid (Miyao et al., DsRNA Res. Dev., 1995, 5, 115-121; Takakura et al., DsRNA &Nucl. Acid Drug Dev., 1996, 6, 177-183) .
[0747] In contrast to a carrier compound, a pharmaceutical carrier or excipient may comprise, e.g., a pharmaceutically acceptable solvent, suspending agent or any other pharmacologically inert vehicle for delivering one or more nucleic acids to an animal. The excipient may be liquid or solid and is selected, with the planned manner of administration in mind, so as to provide for the desired bulk, consistency, etc., when combined with a nucleic acid and the other components of a given pharmaceutical composition. Typical pharmaceutical carriers include, but are not limited to, binding agents (e.g., pregelatinized maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose, etc. ) ; fillers (e.g., lactose and other sugars, microcrystalline cellulose, pectin, gelatin, calcium sulfate, ethyl cellulose, polyacrylates or calcium hydrogen phosphate, etc. ) ; lubricants (e.g., magnesium stearate, talc, silica, colloidal silicon dioxide, stearic acid, metallic stearates, hydrogenated vegetable oils, corn starch, polyethylene glycols, sodium benzoate, sodium acetate, etc. ) ; disintegrants (e.g., starch, sodium starch glycolate, etc. ) ; and wetting agents (e.g., sodium lauryl sulphate, etc) .
[0748] V. Methods of treatment
[0749] The present disclosure relates to methods of inhibiting expression of PCSK9 in a cell, the method comprising: (a) contacting the cell with a compound (e.g., any of the dual-targeting siRNAs described herein) , a combination of a PCSK9-targeting dsRNA (e.g., any of the PCSK9-targeting dsRNAs described herein) and an LDL-lowering enhancer (e.g., any of the LDL-lowering enhancers described herein) , or a pharmaceutical composition thereof; and (b) maintaining the cell in step (a) for a time sufficient to reduce levels of PCSK9 mRNA and protein, thereby inhibiting expression of PCSK9 in the cell.
[0750] The present disclosure also relates to methods of treating a subject having or diagnosed with having a PCSK9 or LDL-associated disease or disorder comprising administering to the subject a therapeutically effective amount of any one of the compounds described herein, any combinations of a PCSK9-targeting dsRNA and an LDL-lowering enhancer described herein, or a pharmaceutical composition thereof, thereby treating the disorder.
[0751] In some embodiments, the subject is a human subject. In some embodiments, the disease or disorder related to PCSK9 expression and / or LDL is a cardiovascular disease or a liver disease.
[0752] In some embodiments, the compound disclosed herein, the combination of a PCSK9-targeting dsRNA and an LDL-lowering enhancer described herein, or the pharmaceutical composition thereof is administered in combination with a second therapy (e.g., one or more additional therapies) known to be effective in treating and / or preventing a disease or disorder related to PCSK9 expression, LDL level, or a symptom of such a disease or disorder. The compound, the combination, or the pharmaceutical composition thereof may be administered before, after, or concurrent with the second therapy. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered before the second therapy. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered after the second therapy. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered concurrent with the second therapy. The second therapy may be an additional therapeutic agent.
[0753] The compound disclosed herein, the combination of a PCSK9-targeting dsRNA and an LDL-lowering enhancer described herein, or the pharmaceutical composition thereof and the additional therapeutic agent can be administered in combination in the same composition or the additional therapeutic agent can be administered as part of a separate composition. In some embodiments, the second therapy is a non-oligonucleotide therapeutic agent that is effective to treat the disease or disorder, or ameliorating symptoms of the disease or disorder. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered in conjunction with a therapy.
[0754] The therapeutic amount can be, e.g., 0.05-50 mg / kg. For example, the therapeutic amount can be 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.5, 2.0, or 2.5, 3.0, 3.5, 4.0, 4.5, 5, 10, 15, 20, 25, 30, 35, 40, 45, or 50 mg / kg of the compound, the combination, or the pharmaceutical composition thereof.
[0755] In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is formulated for delivery to a target organ, e.g., to liver. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is formulated as a lipid formulation, e.g., an LNP formulation as described herein. In some such embodiments, the therapeutic amount is 0.05-5 mg / kg, e.g., 0.05, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, or 5.0 mg / kg of the compound, the combination, or the pharmaceutical composition thereof. In some embodiments, the lipid formulation, e.g., LNP formulation, is administered intravenously.
[0756] In some embodiments, the compound disclosed herein, the combination of a PCSK9-targeting dsRNA and an LDL-lowering enhancer described herein, or the pharmaceutical composition thereof is formulated as an LNP formulation and is administered (e.g., intravenously, intrathecally, intracerebrally, intracranially, or intraventricularly administered) at a dose of 0.1 to 1 mg / kg. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered by intravenous infusion over a period of time, such as over a 5 minute, 10 minute, 15 minute, 20 minute, or 25 minute period.
[0757] In some embodiments, the lipophilic conjugate is administered subcutaneously. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is in the form of a lipophilic conjugate and is administered (e.g., subcutaneously administered) at a dose of 1 to 10 mg / kg. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered subcutaneously.
[0758] In some embodiments, the administration is repeated, for example, on a regular basis, such as, daily, biweekly (i.e., every two weeks) for one month, two months, three months, four months, six months or longer. After an initial treatment regimen, the treatments can be administered on a less frequent basis. For example, after administration biweekly for three months, administration can be repeated once per month, for six months or a year or longer.
[0759] In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered in two or more doses. In some embodiments, the number or amount of subsequent doses is dependent on the achievement of a desired effect, e.g., to inhibit or reduce the expression or activity of PCSK9, to inhibit or reduce the level of LDL and / or cholesteral, or the achievement of a therapeutic or prophylactic effect, e.g., reduction or prevention of one or more symptoms associated with the disorder. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered according to a schedule. For example, the compound, the combination, or the pharmaceutical composition thereof may be administered once per week, twice per week, three times per week, four times per week, or five times per week. In some embodiments, the schedule involves regularly spaced administrations, e.g., hourly, every four hours, every six hours, every eight hours, every twelve hours, daily, every 2 days, every 3 days, every 4 days, every 5 days, weekly, biweekly, or monthly. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is administered at the frequency required to achieve a desired effect. In some embodiments, the schedule involves closely spaced administrations followed by a longer period of time during which the compound, the combination, or the pharmaceutical composition thereof is not administered. For example, the schedule may involve an initial set of doses that are administered in a relatively short period of time (e.g., about every 6 hours, about every 12 hours, about every 24 hours, about every 48 hours, or about every 72 hours) followed by a longer time period (e.g., about 1 week, about 2 weeks, about 3 weeks, about 4 weeks, about 5 weeks, about 6 weeks, about 7 weeks, or about 8 weeks) during which the compound, the combination, or the pharmaceutical composition thereof is not administered.
[0760] In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is initially administered hourly and is later administered at a longer interval (e.g., daily, weekly, biweekly, or monthly) . In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is initially administered daily and is later administered at a longer interval (e.g., weekly, biweekly, or monthly) . In certain embodiments, the longer interval increases over time or is determined based on the achievement of a desired effect. Before administration of a full dose of the compound, the combination, or the pharmaceutical composition thereof, patients can be administered a smaller dose, such as a 5%infusion dose, and monitored for adverse effects, such as an allergic reaction, or for elevated lipid levels or blood pressure. In another example, the patient can be monitored for unwanted effects.
[0761] In some aspects, the disclosure provides a method for modulating (e.g., inhibiting or activating) the expression of PCSK9 and / or modulating (e.g., inhibiting or activating) the level of LDL and / or cholesteral, e.g., in a cell, in a tissue, or in a subject. In some embodiments, the cell or tissue is ex vivo, in vitro, or in vivo. In some embodiments, the cell or tissue is in the liver. In some embodiments, the cell or tissue is in a subject (e.g., a mammal, such as, for example, a human) . In some embodiments, the subject (e.g., the human) is at risk, or is diagnosed with a disorder related to PCSK9 expression, the LDL level, and / or cholesteral level, as described herein.
[0762] In some embodiments, the method includes contacting the cell, tissue, or subject with the compound disclosed herein, the combination of a PCSK9-targeting dsRNA and an LDL-lowering enhancer described herein, or the pharmaceutical composition thereof, in an amount effective to decrease the expression of PCSK9 and / or the LDL level in the cell, tissue or subject. In some embodiments, contacting a cell with the compound, the combination, or the pharmaceutical composition thereof includes contacting a cell in vitro with the compound, the combination, or the pharmaceutical composition thereof, or contacting a cell in vivo with the compound, the combination, or the pharmaceutical composition thereof. In some embodiments, the compound, the combination, or the pharmaceutical composition thereof is put into physical contact with the cell by the individual performing the method, or the compound, the combination, or the pharmaceutical composition thereof may be put into a situation that will permit or cause it to subsequently come into contact with the cell. Contacting a cell in vitro may be done, for example, by incubating the cell with the compound, the combination, or the pharmaceutical composition thereof. Contacting a cell in vivo may be done, for example, by injecting the compound, the combination, or the pharmaceutical composition thereof into or near the tissue where the cell is located, or by injecting the compound, the combination, or the pharmaceutical composition thereof into another area, e.g., liver.
[0763] Combinations of in vitro and in vivo methods of contacting are also possible. For example, a cell may also be contacted in vitro with the compound, the combination, or the pharmaceutical composition thereof and subsequently transplanted into a subject.
[0764] The expression of PCSK9 may be ass...
Claims
1.A compound of formula (V) or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof: G1-L-G2 (V) ,wherein G1 is a first oligonucleotide targeting PCSK9; L is a bond or a linker; and G2 is an LDL-lowering enhancer.2.The compound of claim 1, wherein G2 is a second oligonucleotide targeting LPA.3.The compound of claims 1 or 2, whereinG1 is a first dsRNA for inhibiting PCSK9 gene expression, comprising a first sense strand and a first antisense strand forming a first duplex region, wherein the first sense strand and the first antisense strand are independently 15-30 nucleotides in length;G2 is a second dsRNA for inhibiting LPA gene expression, comprising a second sense strand and a second antisense strand forming a second duplex region, wherein the second sense strand and the second antisense strand are independently 15-30 nucleotides in length.4.The compound of claim 3, wherein the first antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence as set forth in SEQ ID NO: 1, and the second antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence as set forth in SEQ ID NO: 2.5.The compound of claim 4, wherein the first antisense strand comprises at least 15 contiguous nucleotides from a nucleotide sequence complementary to nucleotides 3529-3618 of SEQ ID NO: 1, preferably nucleotides 3529-3576 of SEQ ID NO: 1, more preferably nucleotides 3535-3566 of SEQ ID NO: 1.6.The compound of any one of claims 3-5, wherein the first antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78, preferably the first antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78.7.The compound of any one of claims 3-6, wherein the second antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164, preferably the second antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164.8.The compound of any one of claims 3-7, wherein the first sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40, preferably the first sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40.9.The compound of any one of claims 3-8, wherein the second sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121, preferably the second sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121.10.The compound of any one of claims 3-9, wherein1) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;2) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;3) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;4) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;5) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;6) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;7) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;8) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;9) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;10) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;11) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;12) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;13) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;14) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;15)G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;16) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;17) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;18) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;19) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;20) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;21) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;22) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;23) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;24) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;25) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;26) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;27) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;28) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;29) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;30) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 13831) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;32) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;33) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;34) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;35) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 14336) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;37) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;38) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;39) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;40) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;41) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;42) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;43) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;44) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;45) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;46) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;47) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;48) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;49) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;50) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;51) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;52) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;53) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;54) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;55) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;56) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;57) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;58) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;59) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;60) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;61) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 104 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 147;62) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 105 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 148;63) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 106 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 149;64) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 107 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 150; or65) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 108 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 151.11.The compound of any one of claims 3-10, wherein G1 and G2 each independently is a siRNA.12.The compound of any one of claims 3-11, wherein the first sense strand connects to L at its 3’ end and the second sense strand connects to the L at its 5’ end.13.The compound of any one of claims 3-12, wherein substantially all nucleotides of the first sense strand, substantially all nucleotides of the first antisense strand, substantially all nucleotides of the second sense strand and / or substantially all nucleotides of the second antisense strand are modified nucleotides, or all nucleotides of the first sense strand, all nucleotides of the second sense strand, all nucleotides of the first antisense strand and / or all nucleotides of the second antisense strand are modified nucleotides.14.The compound of claim 13, wherein the first sense strand, the first antisense strand, the second sense strand, and the second antisense strand each independently comprises one or more modified nucleotides selecting from the group consisting of 2'-O-alkyl modified nucleotide (e.g., a 2'-O-methyl modified nucleotide) , a 2’-methoxyethyl modified nucleotide, a 2'-fluoro modified nucleotide, a 2'-deoxy modified nucleotide, an inosine ribonucleotide, an abasic nucleotide, an inverted abasic deoxyribonucleotide, a phosphorothioate internucleotide linkage modification, a vinylphosphonate modified nucleotide, a locked nucleotide, a unlocked nucleotide, a 2'-amino modified nucleotide, a 2'-C-alkyl modified nucleotide, a 2'‐O‐allyl modified nucleotide, a morpholino nucleotide, a phosphoramidate, a non-natural base containing nucleotide, a terminal nucleotide linked to a cholesteryl derivative or a dodecanoic acid bisdecylamide group, deoxyribonucleotide, a 3'‐terminal deoxythymine (dT) nucleotide, a conformation-restricted nucleotide, a restricted ethyl nucleotide, a 2'-hydroxyl-modified nucleotide, a nucleotide containing methylphosphonic acid groups, a nucleotide containing 5'-phosphate, a nucleotide containing 5'-phosphate mimics, a glycol-modified nucleotide (GNA) , a 2’-O- (N-methylacetamide) -modified nucleotide, a 2’-methoxyethoxyethoxyl modified nucleotide, a 2’-methoxyethoxyl modified nucleotide, and a SCP modified nucleotide.15.The compound of claim 14, wherein the first sense strand, the first antisense strand, the second sense strand, and the second antisense strand each independently comprises one or more modified nucleotides selecting from the group consisting of 2’-O-methyl modified nucleotides, 2’-fluoro modified nucleotides, 2’-deoxy modified nucleotides, nucleotides containing phosphorothioate internucleotide linkages, and SCP modified nucleotides.16.The compound of claim 15, wherein the first antisense strand and / or the second antisense strand have two to eight 2’-fluoro modified nucleotides, preferably four to six 2’-fluoro modified nucleotides, more preferably five 2’-fluoro modified nucleotides.17.The compound of claims 15 or 16, wherein the first antisense strand and / or the second antisense strand have 4-12 phosphorothioate internucleotide linkages, preferably 6-10 phosphorothioate internucleotide linkages, more preferably 7 or 8 phosphorothioate internucleotide linkages.18.The compound of any one of claims 15-17, wherein the first sense strand and / or the second sense strand have 4-12 phosphorothioate internucleotide linkages, preferably 5-10 phosphorothioate internucleotide linkages, more preferably 5-8 phosphorothioate internucleotide linkages.19.The compound of any one of claims 15-18, wherein the internucleotide linkage between nucleotide positions 1 and 2 (counting from the 5’ end) of the first antisense strand and / or the second antisense strand is a natural phosphodiester linkage.20.The compound of any one of claims 15-19, wherein each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise:(i) (counting from the 5' end) an SCP modification at position 1;(ii) (counting from the 5' end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;(iii) (counting from the 5' end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or(iv) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.21.The compound of any one of claims 15-19, wherein each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise:(i) (counting from the 5' end) an SCP modification at position 1;(ii) (counting from the 5' end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;(iii) (counting from the 5' end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or(iv) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.22.The compound of any one of claims 15-19, wherein each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise:(i) (counting from the 5' end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or(ii) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 18 and 19.23.The compound of any one of claims 15-19, wherein each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise:(i) (counting from the 5' end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or(ii) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, and between nucleotide positions 18 and 19.24.The compound of any one of claims 2-23, wherein each or both of the first sense strand and the second sense strand optionally contain at their 5' end and / or 3' end one or more terminal modifications.25.The compound of any one of claims 2-24, wherein the 3' end of the first sense strand and the 5' end of the second sense strand each contains a terminal modification, preferably the 3' end of the first sense strand contains a terminal modification.26.The compound of any one of claims 2-25, wherein the terminal modification is selected from an abasic nucleotide (e.g., IB) , an inverted nucleotide, and an optionally substituted preferably the optionally substituted is substituted with a GalNAc-containing side chain substituent.27.The compound of claim 25, wherein the terminal modification is IB.28.The compound of any one of claims 3-27, wherein the 3' ends of the first antisense strand and the second antisense strand are a blunt end or overhang, preferably an overhang, more preferably an overhang of two nucleotides.29.The compound of any one of claims 1-28, wherein the compound is further conjugated with a ligand moiety;preferably, the compound is conjugated with a GalNAc-containing ligand moiety, more preferably with a GalNAc-containing ligand moiety through a phosphate group or a phosphorothioate group;preferably the second sense strand is conjugated with the ligand moiety; more preferably the 3’ end of the second sense strand is conjugated with the ligand moiety;preferably, the ligand moiety has the following structure:whereinrepresents a position linked to siRNA through a phosphate group or a phosphorothioate group.30.The compound of any one of claims 1-29, wherein the compound is formula (I) or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof: G1——S1——X——S2——G2 (I)S1 and S2 are each independently a bond, - (OCH2CH2) k-, - (CH2CH2O) k-, -O (CH2CH2O) k-, or - (CH2) k-;k is 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10;X is a bond or a linker;preferably, S1 and S2 are each independently a bond or -O (CH2CH2O) k-, wherein k is 1, 2, 3, 4, 5, 6, 7, or 8; preferably, S1 and S2 are each independently a bond, -O (CH2CH2O) 3-, or -O (CH2CH2O) 6-.31.The compound of claim 30, wherein X comprises one or more compounds selected from formula (I-1) or formula (I-2) , or a tautomer or stereoisomer thereof: wherein,ring A is selected from C5-10 cycloalkyl, 5-membered to 10-membered heterocyclyl, C6-10 aryl, or 5-membered to 10-membered heteroaryl, preferably C6-10 aryl or 5-membered to 10-membered heteroaryl;Tg is selected from -S-Rt, -S-S-Rt, -OCH2-S-S-Rt, a sugar moiety, or a polypeptide;Rt is selected from H, C1-6 alkyl, or C1-6 haloalkyl;the sugar moiety is a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar;the polypeptide is a group comprising 1, 2, 3, 4, or 5 amino acid residues;L0 is selected from -NRc-, C (O) , -OC (O) NRc-, -C (O) NRc-, -NRcC (O) -, -NRc-C (O) O-, or -C (O) NRc-C (O) -;L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (CH2) q- (OCH2CH2) p-, - (CH2CH2O) p-, -O (CH2CH2O) p-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;L1 and L2 are optionally substituted with 1, 2, or 3 substituents selected from halogen, OH, NH2, -C1-6 alkylene OH, -C1-6 alkylene NH2, C1-6 alkyl, or C1-6 haloalkyl;w is selected from 0, 1, 2, 3, or 4;p and q are each independently 1, 2, 3, 4, 5, or 6;whereinin formula (I-1) or formula (I-2) are connected to G1 or G2 via a bridged linkage; preferablyrepresents connection to G1 via a bridged linkage (S1) , and in formula (I-1) or formula (I-2) represents connection to G2 via a bridged linkage (S2) ;Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated.32.The compound of claim 30, wherein X comprises one or more compounds of formula (II) , or a tautomer or stereoisomer thereof: wherein Tg is -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide;the sugar moiety is preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;the polypeptide is selected from - (AA) a-R, -NH (AA) a-R, - (AA) a-C (O) R, -NH (AA) a-C (O) R, or -C (O) -NH (AA) a-C (O) NR;wherein each AA is independently selected from amino acid residues, preferably each AA is independently selected from natural amino acid residues;a is selected from 1, 2, 3, or 4;R is selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, wherein R may be optionally deuterated or fully deuterated;Ra, Rb, and Rc are independently selected from H, D, halogen, C1-6 alkyl, or C1-6 haloalkyl, and are optionally deuterated or fully deuterated;each Rd is independently selected from H, D, C1-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, or a GalNAc-containing chain, and is optionally deuterated or fully deuterated;wherein L1 and L2 are linkers, preferably each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, -O (CH2CH2O) p-, -NHC (O) -, -C (O) NH-, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;wherein p and q are each independently 1, 2, 3, 4, 5, or 6;whereinin formula (II) are connected to G1 or G2 via a bridged linkage; preferablyrepresents connection to G1 via a bridged linkage (S1) , andin formula (II) represents connection to G2 via a bridged linkage (S2) ;preferably,Tg is selected from -S-S-C (Rd) 3, -OCH2-S-S-C (Rd) 3, a sugar moiety, or a polypeptide;the sugar moiety is selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;the polypeptide is -NH (AA) a-C (O) R;each AA is independently selected from a valine residue, an alanine residue, a glycine residue, a leucine residue, or an isoleucine residue, more preferably from a valine residue or an alanine residue;a is selected from 1, 2, or 3, preferably 2 or 3;R is selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as CH3;Ra, Rb, and Rc are each independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably H or C1-6 alkyl, such as H or CH3;each Rd is independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as CH3;L1 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-;L2 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably - (CH2) p-O-;each p is independently selected from 2, 3, 4, 5, or 6, preferably 4, 5, or 6;each p is independently selected from 1, 2, 3, 4, or 5, preferably 1, 2, or 3;represents connection to G1 via a bridged linkage (S1) , and in formula (II) represents connection to G2 via a bridged linkage (S2) ;more preferably,Tg is selected from N-acetylgalactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;Ra, Rb, and Rc are each independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably H or C1-6 alkyl, such as H or CH3;each Rd is independently selected from H, D, C1-6 alkyl, or C1-6 haloalkyl, preferably C1-6 alkyl, such as C (CH3) 3;L1 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-;L2 is selected from - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, -O- (CH2) p-NHCO-, - (OCH2CH2) p-, - (CH2CH2O) p-, or -O (CH2CH2O) p-, preferably - (CH2) p-O-;each p is independently selected from 2, 3, 4, 5, or 6, preferably 4, 5, or 6;each p is independently selected from 1, 2, 3, 4, or 5, preferably 1, 2, or 3;represents connection to G1 via a bridged linkage (S1) , andin formula (II) represents connection to G2 via a bridged linkage (S2) .33.The compound of claim 32, provided that:i) Tg is -S-S-C (CH3) 3;ii) Tg is galactose, glucose, N-acetylgalactosamine, or N-acetylglucosamine, preferably galactoseor N-acetylgalactosamineor3) Tg is -NH (AA) a-C (O) R, such aswherein each AA is independently selected from valine or alanine;a is selected from 1, 2, or 3, preferably 2 or 3;R is selected from H or C1-6 alkyl, such as CH3.34.The compound of any one of claims 31-33, wherein Ra, Rb, and Rc are each independently selected from H, D, halogen, or C1-6 alkyl, L1 and L2 are each independently selected from a bond, - (CH2) p-, -O- (CH2) p-, - (CH2) p-O-, -O- (CH2) p-O- (CH2) q-, or -O- (CH2) p-NHCO-, and p and q are each independently 1, 2, 3, 4, 5, or 6.35.The compound of claim 30, wherein X comprises one or more compounds of formula (III) , or a tautomer or stereoisomer thereof: wherein Sg is a sugar moiety, preferably a sugar that can be cleaved in the inclusion or lysosome, preferably a five-or six-membered sugar, more preferably a six-membered sugar, more preferably selected from N-acetylgalactosamine, galactosamine, galactose, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose;L3 and L4 are linkers, preferably each independently selected from a bond, - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, - (CH2) j- (OCH2CH2) i-, -NHC (O) -, -C (O) NH-, -C (O) -, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, -OC (O) NH-, -O-CH (CH (OH) CH2OH) -, -O-CH (CH (NH2) CH2OH) -, -O-CH (CH2OH) CH (OH) -, -NH-CH (CH2OH) CH (OH) -, -O-CH2CH (OH) CH (OH) -, -O-CH2CH (NH2) CH (OH) -, -NHC (O) -CH2-O-CH (CH (OH) CH2OH) -, -NHC (O) -CH2-O-CH (CH (NH2) CH2OH) -, -NHC (O) -CH2-O-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-NH-CH (CH2OH) CH (OH) -, -NHC (O) -CH2-O-CH2CH (OH) CH (OH) -, or -NHC (O) -CH2-O-CH2CH (NH2) CH (OH) -;wherein i and j are each independently 1, 2, 3, 4, 5, or 6;L5 is a linker, preferably selected from a bond, C3-7 cycloalkyl, C6-10 aryl, 3-membered to 7-membered heterocyclyl, or 5-membered to 10-membered heteroaryl, more preferably, L5 is selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;whereinin formula (III) are connected to G1 or G2 via a bridged linkage; preferablyrepresents connection to G1 via a bridged linkage (S1) , andin formula (III) represents connection to G2 via a bridged linkage (S2) ;preferably,Sg is selected from N-acetylgalactosamine, galactose, galactosamine, N-acetylglucosamine, glucose, mannose, glucuronic acid, neuraminic acid (sialic acid) , xylose, or fucose, e.g. N-acetylgalactosamine orL3 is selected from a bond, - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, or - (CH2) j- (OCH2CH2) i-;L4 is selected from a bond , - (CH2) i-, -O- (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, -O- (CH2) i-NHCO-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, -NHC (O) -, -C (O) NH-, -C (O) -, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, or -OC (O) NH-;each i is independently selected from 1, 2, 3, 4, 5, or 6;each j is independently selected from 1, 2, 3, 4, 5, or 6;L5 is selected from a bond, C5-6 cycloalkyl, C6-10 aryl, 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, or 5-membered to 6-membered heteroaryl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;represents connection to G1 via a bridged linkage (S1) , andin formula (III) represents connection to G2 via a bridged linkage (S2) .36.The compound of claim 35, wherein X comprises one or more compounds of formula (IIIa) , or a tautomer or stereoisomer thereof: L3 is selected from a bond, - (CH2) i-, - (CH2) i-O-, -O- (CH2) i-O- (CH2) j-, - (OCH2CH2) i-, - (CH2CH2O) i-, -O (CH2CH2O) i-, or - (CH2) j- (OCH2CH2) i-;L4 is selected from a bond, -NHC (O) -, -C (O) NH-, -C (O) -, -OC (O) -, -C (O) O-, -S-S-, -NHC (O) O-, -NHC (O) NH-, -OC (O) O-, or -OC (O) NH-;L5 is selected from a bond, C5-6 cycloalkyl, or 5-membered to 6-membered heterocyclyl containing 1 to 3 heteroatoms, wherein the heteroatom is N or O;wherein i and j are each independently 1, 2, 3, 4, 5, or 6;represents connection to G1 via a bridged linkage (S1) , andin formula (IIIa) represents connection to G2 via a bridged linkage (S2) ;optionally, wherein:i) L3 is - (CH2) 4-, L4 is a bond, and L5 is a bond;ii) L3 is - (CH2) 5-, L4 is -OC (O) -, and L5 is (such as) ;iii) L3 is - (CH2) 4-, L4 is -C (O) -, and L5 is (such as) ;iv) L3 is -CH2CH2- (OCH2CH2) 2-, L4 is -NHC (O) -, and L5 is (such as); orv) L3 is -CH2CH2- (OCH2CH2) 2-, L4 is -OC (O) -, and L5 is (such as) .37.The compound of claim 30, wherein X comprises one or more of the following compounds: whereinrepresents connection to G1 via a bridged linkage (S1) , andrepresents connection to G2 via a bridged linkage (S2) .38.The compound of claim 30, wherein X is a nucleotide linker, the nucleotide is selected from one or more of a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, a 2'-5' ribonucleotide, and a 2'-5' deoxyribonucleotide.39.The compound of claim 38, wherein X is Nt (dN) m, wherein Nt is selected from a bond, a deoxyribonucleotide, a ribonucleotide, a 2'-deoxy-2'-fluororibonucleotide, or a 2'-5' ribonucleotide, each dN is independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, 5, 6, 7, or 8, preferably m is 1, 2, 3, 4, or 5.40.The compound of claim 39, wherein X is selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, -GfAfUf-, dTdTdTdT, and dTdTdTdTdT, preferably selected from (G2p) dAdT, rGdAdT, dCdA, dAdT, dAdCdA, dTdCdA, dAdAdA, dTdTdT, dTdTdTdT, and dTdTdTdTdT.41.The compound of claim 30, wherein X is - (BL) p (dN) m-;wherein each BL is independently selected from a compound of formula (I-1) or (I-2) as defined in claim 2, a compound of formula (II) as defined in any one of claims 3 to 5, a compound of formula (III) as defined in any one of claims 6 to 8 or a tautomer or stereoisomer thereof, or BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12 as defined in claim 9 or a tautomer or stereoisomer thereof;each dN is independently selected from dA, dT, dG, or dC;p is selected from 0, 1, 2, 3, 4, 5, or 6, preferably 0, 1, 2, or 3;m is selected from 0, 1, 2, 3, 4, 5, 6, 7, or 8, preferably 0, 1, 2, 3, 4, or 5;p and m are not both 0;preferably, X is - (BL) p-;each BL is independently selected from a compound of formula (I-1) or (I-2) as defined in claim 2, a compound of formula (II) as defined in any one of claims 3 to 5, a compound of formula (III) as defined in any one of claims 6 to 8 or a tautomer or stereoisomer thereof, or BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12 as defined in claim 9 or a tautomer or stereoisomer thereof;p is selected from 0, 1, 2, 3, 4, 5, or 6, preferably 0, 1, 2, or 3.42.The compound of claim 41, provided that:i) X is BL (dN) m, wherein BL is selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, BL9, BL10, BL11, or BL12, preferably BL1, dN is each independently selected from dA, dT, dG, or dC, and m is 1, 2, 3, 4, or 5;ii) X is selected from BL1-dTdTdT or BL1-dCdA;iii) X is (BL) p, wherein each BL is independently selected from BL1, BL2, BL3, BL4, BL5, BL6, BL7, BL8, or BL9, preferably BL7 or BL8, and p is 1, 2, or 3; oriv) X is BL1, -BL1-BL1-BL1-, BL5, BL7, BL8, BL9, BL10, BL11, BL12, BL7-BL7-BL7, BL8-BL8-BL8, or BL9-BL9-BL9, preferably X is BL7, BL7-BL7-BL7, BL8, BL8-BL8-BL8, BL9, or BL9-BL9-BL9.43.The compound of any one of claims 1-42, wherein the compound is DR014023, DR014027, DR014028, DR014192, DR014193, DR014194, DR014195, DR013525, DR013526, DR013527, DR014017, DR014220, DR014222, DR014270, DR014271, or DR014278.44.A cell comprising the compound of any one of claims 1-43 or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof.45.A pharmaceutical composition comprising the compound of any one of claims 1-43 or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof, or the cell of claim 42, and optionally a pharmaceutically acceptable carrier or excipient.46.A kit comprising the compound of any one of claims 1-43 or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof, or the cell of claim 44.47.A method of decreasing the LPA, PCSK9, and / or LDL level in a subject, or decreasing the LPA, PCSK9, and / or LDL-C (low-density lipoprotein-cholesterol) levels in a cell, comprising introducing the compound of any one of claims 1-43, or the pharmaceutically acceptable salt, tautomer, or stereoisomer thereof, to the subject or cell.48.The use of a compound according to any one of claims 1-43 or a pharmaceutically acceptable salt, tautomer, or stereoisomer thereof for the manufacture of a medicament for treating and / or preventing a disease or disorder.49.The use of claim 48, wherein the disease or disorder is a cardiovascular disease, a liver disease, an infection, an autoimmune disorder, a neurocognitive disorder, or a cancer.50.A method of treating and / or preventing a disease or disorder in a subject, comprising administering an effective amount of a composition comprising a first oligonucleotide targeting PCSK9 (G1) and an LDL-lowering enhancer to the subject.51.The method of claim 50, wherein the LDL-lowering enhancer is a second oligonucleotide targeting LPA (G2) .52.The method of claim 51, whereinG1 is a first dsRNA for inhibiting PCSK9 gene expression, comprising a first sense strand and a first antisense strand forming a first duplex region, wherein the first sense strand and the first antisense strand are independently 15-30 nucleotides in length;G2 is a second dsRNA for inhibiting LPA gene expression, comprsing a second sense strand and a second antisense strand forming a second duplex region, wherein the second sense strand and the second antisense strand are independently 15-30 nucleotides in length.53.The method of claim 52, wherein:(a) the first antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78, preferably the first antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 41-78;(b) the second antisense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164, preferably the second antisense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 122-164;(c) the first sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40, preferably the first sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 3-40; and / or(d) the second sense strand comprises at least 16 contiguous nucleotides, at least 17 contiguous nucleotides, at least 18 contiguous nucleotides, at least 19 contiguous nucleotides, or at least 20 contiguous nucleotides from a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121, preferably the second sense strand comprises a nucleotide sequence as set forth in any one of SEQ ID NOs: 79-121.54.The method of claim 52 or 53, wherein1) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;2) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;3) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 4 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 42, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;4) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 79 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 122;5) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 80 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 123;6) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 5 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 43, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 81 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 124;7) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;8) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;9) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;10) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;11) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;12) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;13) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;14) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;15) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;16) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 10 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 48, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;17) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;18) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;19) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;20) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 138;21) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;22) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;23) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;24) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;25) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 143;26) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 11 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 49, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;27) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 92 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 135;28) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 93 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 136;29) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 94 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 137;30) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 95 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 13831) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 96 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 139;32) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 97 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 140;33) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 98 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 141;34) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 99 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 142;35) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 100 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 14336) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 12 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 50, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 101 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 144;37) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;38) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;39) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 20 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 58, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;40) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;41) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;42) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 21 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 59, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;43) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 109 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 152;44) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 110 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 153;45) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 22 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 60, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 111 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 154;46) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;47) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;48) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;49) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;50) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 23 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 61, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;51) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;52) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;53) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;54) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;55) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 24 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 62, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;56) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 87 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 130;57) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 88 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 131;58) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 89 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 132;59) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 90 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 133;60) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 25 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 63, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 91 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 134;61) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 104 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 147;62) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 105 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 148;63) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 106 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 149;64) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 107 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 150; or65) G1 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 26 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 64, and G2 comprises a sense strand comprising a nucleotide sequence set forth in SEQ ID NO: 108 and an antisense strand comprising a nucleotide sequence set forth in SEQ ID NO: 151.55.The method of any one of claims 52-54, wherein G1 and G2 each independently is a siRNA.56.The method of any one of claims 52-55, wherein substantially all nucleotides of the first sense strand, substantially all nucleotides of the first antisense strand, substantially all nucleotides of the second sense strand and / or substantially all nucleotides of the second antisense strand are modified nucleotides, or all nucleotides of the first sense strand, all nucleotides of the second sense strand, all nucleotides of the first antisense strand and / or all nucleotides of the second antisense strand are modified nucleotides.57.The method of any one of claims 52-56, wherein each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise:(i) (counting from the 5' end) an SCP modification at position 1;(ii) (counting from the 5' end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;(iii) (counting from the 5' end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or(iv) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.58.The method of any one of claims 52-56, wherein each or both of the first antisense strand and the second antisense strand have a length of 21 nucleotides and comprise:(i) (counting from the 5' end) an SCP modification at position 1;(ii) (counting from the 5' end) 2'-fluoro modifications at positions 2, 5, 7, 12, and 14;(iii) (counting from the 5' end) 2'-O-methyl modifications at positions 3, 4, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 19, 20, and 21; and / or(iv) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 2 and 3, between nucleotide positions 19 and 20, and between nucleotide positions 20 and 21.59.The method of any one of claims 52-56, wherein each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise:(i) (counting from the 5' end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or(ii) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, and between nucleotide positions 18 and 19.60.The method of any one of claims 52-56, wherein each or both of the first sense strand and the second sense strand have a length of 19 nucleotides and comprise:(i) (counting from the 5' end) 2'-O-methyl modified nucleotides at positions 1 to 6 and 10 to 19, and 2'-fluoro modified nucleotides at positions 7 to 9; and / or(ii) (counting from the 5' end) phosphorothioate internucleotide linkages between nucleotide positions 1 and 2, between nucleotide positions 2 and 3, and between nucleotide positions 18 and 19.61.The method of any one of claims 52-60, wherein each or both of the first sense strand and the second sense strand optionally contain at their 5' end and / or 3' end one or more terminal modifications.62.The method of any one of claims 52-61, wherein the 3' ends of the first antisense strand and / or the second antisense strand are a blunt end or overhang.63.The method of any one of claims 52-62, wherein G1 and / or G2 are further conjugated with a ligand moiety.64.The method of any one of claims 52-63, wherein G1 is DR011740 or DR005672, and G2 is DR011826, DR014067, or DR011666.65.A multivalent (e.g., bivalent or trivalent) siRNA compound comprising a first oligonucleotide and a second oligonucleotide, wherein the first oligonucleotide is G1 in any one of claims 1-43, and the second nucleotide is G2 in any one of claims 1-43.