Antisense Drugs Make Sense for Neurological Diseases

Annu Rev Pharmacol Toxicol. 2021 Jan 6:61:831-852. doi: 10.1146/annurev-pharmtox-010919-023738. Epub 2020 Oct 9.

Abstract

The genetic basis for most inherited neurodegenerative diseases has been identified, yet there are limited disease-modifying therapies for these patients. A new class of drugs-antisense oligonucleotides (ASOs)-show promise as a therapeutic platform for treating neurological diseases. ASOs are designed to bind to the RNAs either by promoting degradation of the targeted RNA or by elevating expression by RNA splicing. Intrathecal injection into the cerebral spinal fluid results in broad distribution of antisense drugs and long-term effects. Approval of nusinersen in 2016 demonstrated that effective treatments for neurodegenerative diseases can be identified and that treatments not only slow disease progression but also improve some symptoms. Antisense drugs are currently in development for amyotrophic lateral sclerosis, Huntington's disease, Alzheimer's disease, Parkinson's disease, and Angelman syndrome, and several drugs are in late-stage research for additional neurological diseases. This review highlights the advances in antisense technology as potential treatments for neurological diseases.

Keywords: Huntington's disease; amyotrophic lateral sclerosis; antisense oligonucleotide; neurodegenerative disease; siRNA; spinal muscular atrophy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Neurodegenerative Diseases*
  • Oligonucleotides, Antisense
  • Parkinson Disease*
  • Pharmaceutical Preparations*
  • RNA

Substances

  • Oligonucleotides, Antisense
  • Pharmaceutical Preparations
  • RNA