Project Summary The long-term objective of this proposal is to develop first-in-class, best-in-class
noncoding RNA-based gene therapeutics with a novel mechanism of action, to improve standard of care
(SOC) for a broad range of blood and vascular diseases with unmet clinical need: management of thrombotic
risk, and management of bleeding disorders. The basis for these therapeutics is our discovery of efficient,
tissue-specific, tunable, temporally-controlled, non-integrative gene suppression in platelets and
megakaryocytes (MKs) in vivo, via tissue-selective transfection with ectopic naked double-stranded (ds) short
inhibitory RNAs (siRNAs) harboring modified nucleotides, following intravenous or subdermal administration in
mice. We have shown for the first time that platelets and MK can be transfected in vivo, selectively and at high
efficiency by these approaches, resulting in suppression of target gene expression, altered gene-dependent
functions restricted to platelets and MK, and antithrombotic and antibleeding effects. SOC for thrombosis and
bleeding management continues to be plagued with undesirable counter-effects: increased risk of bleeding
with antithrombotics, and generally poor management of bleeding disorders with blunt, untargeted treatments
that increase risk for thrombosis and other morbidities. The unique ability of MK and platelets to internalize and
utilize naked ds siRNAs - without encapsulation in liposomes or other nanoparticle structures that eliminate
tissue targeting specificity, and without covalent targeting moieties that greatly reduce silencing efficiency –
provides the unprecedented opportunity to develop new antiplatelet drugs via an entirely novel approach to
disease management. The specific goals of this proposal are: 1) to select and characterize naked siRNA
oligonucleotide therapeutics with high efficacy for antithrombotic treatments with improved hemostatic
protection compared to drug blockade; 2) to select and characterize naked siRNA oligonucleotide therapeutics
for antibleeding treatments with improved efficacy over SOC; 3) to determine the timing and efficiencies of
alternative drug administration routes. In Aim 1 we will use in vivo mouse models to select and characterize
lead siRNA compounds for strongest antithrombotic effects, and determine the boundaries of dosing and
timing that do not cause unwanted bleeding (therapeutic windows). We will test two candidate siRNAs:
targeting P2y12, the primary purinergic (ADP) receptor on platelets that is the molecular target of current
frontline antiplatelet drugs, and siRNA targeting PAR4, the low-affinity thrombin receptor in human platelets
that represents a frontier of antiplatelet therapeutic targeting. We will also determine efficacies of intravenous
and subdermal administration routes in this aim. In Aim 2 we will target endogenous negative regulators of
platelet reactivity to select lead siRNAs for antibleeding therapeutics, including testing benefit in mouse models
of acquired and inherited bleeding disorders. Together, these studies will firmly establish and deeply
characterize lead siRNA compositions for pre-clinical development of novel antiplatelet therapeutics.