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Considerations for the Characterization and Interpretation of Results Related to Alternative Complement Activation in
Scott P Henry1, Rosanne Seguin2, Joy Cavagnaro3
11 Preclinical Development, Ionis Pharmaceuticals, Inc. , Carlsbad, California.
Abstract:
This article provides an overview of the discussions held by the Immunomodulatory Subcommittee of the Oligonucleotide Safety Working Group on complement activation induced by oligonucleotides, most notably the phosphorothioate-containing oligonucleotides. Alternative complement pathway activation in monkeys is a common effect of single-stranded phosphorothioate backbone oligonucleotides in toxicology studies. This article discusses the mechanism for activation, general investigational strategy, and the impact of various chemical modifications. The goal is to provide the best practice approach to characterizing this effect, understanding the implication of the species specificity, and the interpretation of clinical relevance.
Insights
Phosphorothioate oligonucleotides can activate the alternative complement pathway, particularly in monkeys. This review details the mechanism, investigation strategies, and implications for clinical relevance.
Area of Science:
- Pharmacology
- Immunology
- Toxicology
Background:
- Phosphorothioate oligonucleotides are known to induce immune responses.
- Complement activation is a significant concern in oligonucleotide safety studies.
- The alternative complement pathway is frequently implicated.
Purpose of the Study:
- To summarize discussions on oligonucleotide-induced complement activation.
- To outline best practices for characterizing this effect.
- To clarify clinical relevance and species specificity.
Main Methods:
- Review of subcommittee discussions.
- Analysis of toxicology study data.
- Examination of chemical modification impacts.
Main Results:
- Alternative complement pathway activation is common in monkeys with single-stranded phosphorothioate oligonucleotides.
- Species specificity is a key consideration.
- Chemical modifications can influence activation.
Conclusions:
- Characterizing complement activation requires a strategic approach.
- Understanding species differences is crucial for interpreting results.
- Clinical relevance assessment is essential for oligonucleotide safety.
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