Antisense Oligonucleotide Therapies for Neurodegenerative Diseases

Annu Rev Neurosci. 2019 Jul 8:42:385-406. doi: 10.1146/annurev-neuro-070918-050501.

Abstract

Antisense oligonucleotides represent a novel therapeutic platform for the discovery of medicines that have the potential to treat most neurodegenerative diseases. Antisense drugs are currently in development for the treatment of amyotrophic lateral sclerosis, Huntington's disease, and Alzheimer's disease, and multiple research programs are underway for additional neurodegenerative diseases. One antisense drug, nusinersen, has been approved for the treatment of spinal muscular atrophy. Importantly, nusinersen improves disease symptoms when administered to symptomatic patients rather than just slowing the progression of the disease. In addition to the benefit to spinal muscular atrophy patients, there are discoveries from nusinersen that can be applied to other neurological diseases, including method of delivery, doses, tolerability of intrathecally delivered antisense drugs, and the biodistribution of intrathecal dosed antisense drugs. Based in part on the early success of nusinersen, antisense drugs hold great promise as a therapeutic platform for the treatment of neurological diseases.

Keywords: Huntington's disease; RNA; amyotrophic lateral sclerosis; antisense oligonucleotides; spinal muscular atrophy.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Brain / metabolism
  • Brain / pathology
  • Humans
  • Muscular Atrophy, Spinal / drug therapy*
  • Neurodegenerative Diseases / drug therapy*
  • Neurodegenerative Diseases / genetics
  • Oligonucleotides / pharmacology*
  • Oligonucleotides, Antisense / therapeutic use*
  • Tissue Distribution / genetics*

Substances

  • Oligonucleotides
  • Oligonucleotides, Antisense
  • nusinersen