Id |
Subject |
Object |
Predicate |
Lexical cue |
T1 |
272-451 |
Epistemic_statement |
denotes |
Numerous pre-clinical studies are evaluating RNAi as a novel therapeutic modality in the battle against gain-of-function autosomal dominant diseases, cancer, and viral infections. |
T2 |
452-604 |
Epistemic_statement |
denotes |
One emerging concern is that RNAi mono-therapies might ultimately fail to control viruses that can escape silencing by mutation and/or RNAi suppression. |
T3 |
605-778 |
Epistemic_statement |
denotes |
Thus, sophisticated strategies are being developed that aim to avert viral resistance by combining RNAi effectors with each other or with further gene expression inhibitors. |
T4 |
779-1002 |
Epistemic_statement |
denotes |
Several reports already validate this new concept of "combinatorial RNAi" (coRNAi) and illustrate its versatility by describing co-expression of RNAi triggers directed against single or multiple, viral or cellular, targets. |
T5 |
1003-1115 |
Epistemic_statement |
denotes |
Other studies document the successful delivery of these triggers with additional RNA-or protein-based silencers. |
T6 |
2190-2378 |
Epistemic_statement |
denotes |
Moreover, approximately 39 million people worldwide were living with human immunodeficiency virus (HIV) in 2005, with approximately 4 million new infections and 3 million deaths that year. |
T7 |
2535-2725 |
Epistemic_statement |
denotes |
Global pandemics caused by newly emerging viral infections, such as Ebola, severe acute respiratory syndrome coronavirus, and avian influenza (H5N1), present further threats to human health. |
T8 |
2726-2832 |
Epistemic_statement |
denotes |
The reasons for the persistence of human viruses and the emergence of new infectious diseases are complex. |
T9 |
2833-3022 |
Epistemic_statement |
denotes |
Key is the extensive variation and flexibility of viral genomes, resulting from a combination of minimal generation times, notoriously inaccurate reproduction, and intra-host recombination. |
T10 |
3140-3374 |
Epistemic_statement |
denotes |
This particularly applies to RNA viruses such as HCV, whose RNA-dependent RNA polymerase incorporates the extreme number of 10 3 mutations per viral nucleotide per year (or eight per genome, 100-fold higher than for HBV, a DNA virus). |
T11 |
3739-3984 |
Epistemic_statement |
denotes |
Further shifting the balance of power is the fact that many viruses exist in genetically distinct quasi-species and subtypes and/or have developed "stealth and cunning" mechanisms to out-maneuver or evade the innate and adaptive immune response. |
T12 |
3985-4095 |
Epistemic_statement |
denotes |
4 Unfortunately, our existing treatment options for viral infections are usually ineffective and very limited. |
T13 |
5050-5144 |
Epistemic_statement |
denotes |
Fire and Craig C. Mello), RNAi is a natural phenomemon of gene silencing by small duplex RNAs. |
T14 |
5648-5820 |
Epistemic_statement |
denotes |
9 Following expression as long pri-miRNAs, they are processed by the nuclear enzyme Drosha into shorter pre-miRNAs and then transported into the cytoplasm (via Exportin-5). |
T15 |
5821-5996 |
Epistemic_statement |
denotes |
There, the adenosine triphosphate-dependent RNAse III-like Dicer enzyme generates even shorter (approximately 21 nt) double-stranded RNAs, the small interfering RNAs (siRNAs). |
T16 |
6205-6316 |
Epistemic_statement |
denotes |
10 The extreme efficiency and specificity of this process make RNAi highly attractive for anti-viral therapies. |
T17 |
6766-6946 |
Epistemic_statement |
denotes |
However, their use might naturally be limited to mucosal tissues or localized and accessible sites of viral infection (e.g., the respiratory and female genital tracts and the eye). |
T18 |
7173-7256 |
Epistemic_statement |
denotes |
14 The latter application is currently being evaluated in a phase I clinical trial. |
T19 |
7257-7423 |
Epistemic_statement |
denotes |
Conversely, a gene therapy approach involving delivery of RNAi expression cassettes is more appropriate for treatment of chronic infections such as HBV, HCV, and HIV. |
T20 |
7424-7608 |
Epistemic_statement |
denotes |
1 Typically, the trigger is a miRNAlike sequence (derived from a natural miRNA 15 or an artificial short hairpin RNA (shRNA)) under the control of an RNA polymerase II or III promoter. |
T21 |
7609-7772 |
Epistemic_statement |
denotes |
These cassettes are small and thus readily incorporated into any of the established gene therapy vectors, such as lentiviruses and AAVs (adeno-associated viruses). |
T22 |
7957-8103 |
Epistemic_statement |
denotes |
16 Another general advantage of RNAi as an anti-viral therapy is that triggers with perfect viral sequence complementarity induce target cleavage. |
T23 |
8326-8476 |
Epistemic_statement |
denotes |
11, 12 Last but not least, RNAi silencing requires a minimal target of only 19-21 nt, which might be sufficient to co-suppress related viral isolates. |
T24 |
9131-9189 |
Epistemic_statement |
denotes |
This has already been illustrated by a variety of reports. |
T25 |
9221-9352 |
Epistemic_statement |
denotes |
noted that prolonged incubation of poliovirusinfected, siRNA-treated cells resulted in enrichment of an RNAiresistant point mutant. |
T26 |
9963-10020 |
Epistemic_statement |
denotes |
23 HIV's propensity to escape was confirmed by Das et al. |
T27 |
10118-10150 |
Epistemic_statement |
denotes |
Interestingly, Westerhout et al. |
T28 |
10880-11081 |
Epistemic_statement |
denotes |
This should not be surprising, as double-stranded RNA is often generated during viral replication, exposing the virus to host RNAi and likely exerting pressure to evolve an anti-RNAi counter-mechanism. |
T29 |
11465-11606 |
Epistemic_statement |
denotes |
29 However, their main function is inhibition of protein kinase R, and RNAi suppression has been shown only in non-vertebrate cells thus far. |
T30 |
12274-12450 |
Epistemic_statement |
denotes |
35 On the other hand, it is striking to note that some human viruses hijack the RNAi machinery to carry out their own replication strategies, which might seem counterintuitive. |
T31 |
12451-12575 |
Epistemic_statement |
denotes |
[26] [27] [28] One remarkable example is again HCV, which subverts a liver-specific miRNA (miR-122) for its gene expression. |
T32 |
12576-12762 |
Epistemic_statement |
denotes |
36 Moreover, other viruses were recently found to encode their own miRNAs, albeit in most cases (e.g., HIV or Epstein-Barr virus) without evidence for functional or genetic significance. |
T33 |
13002-13004 |
Epistemic_statement |
denotes |
42 |
T34 |
13005-13141 |
Epistemic_statement |
denotes |
As our knowledge of the interactions between viruses and the RNAi pathway expands, it will continue to shape our therapeutic strategies. |
T35 |
13634-13805 |
Epistemic_statement |
denotes |
The emerging solution to thwart viral evolution and circumvent the related issues is to multiplex RNAi triggers or to combine them with other silencers of gene expression. |
T36 |
14989-15130 |
Epistemic_statement |
denotes |
Such a mix of RNAi and unrelated silencers will also minimize the potential risks associated with high-level mi/shRNA expression in the cell. |
T37 |
15407-15499 |
Epistemic_statement |
denotes |
We also include a few examples for functional genomics and treatment of non-viral disorders. |
T38 |
15599-15736 |
Epistemic_statement |
denotes |
Examples include a study by Kronke et al., who used a library of endoribonuclease-prepared siRNAs to block HCV replicons in cell culture. |
T39 |
16167-16182 |
Epistemic_statement |
denotes |
[45] [46] [47] |
T40 |
16183-16322 |
Epistemic_statement |
denotes |
Concatemerization of single RNAi triggers (Figure 1a) represents the simplest example of coRNAi and has been reported sporadically to date. |
T41 |
16323-16502 |
Epistemic_statement |
denotes |
Intended to raise intra-cellular sh/miRNA levels, it might be especially useful against viral targets that replicate and spread at high enough rates to out-compete low-level RNAi. |
T42 |
17082-17097 |
Epistemic_statement |
denotes |
Gonzalez et al. |
T43 |
18581-18668 |
Epistemic_statement |
denotes |
Instead, the authors noted decreased RNAi from the tandem plasmid, for reasons unclear. |
T44 |
18859-19022 |
Epistemic_statement |
denotes |
50 Plasmids expressing anti-SOD2 mIR-30 from a ubiquitin C promoter were injected into fertilized eggs, yielding two lines carrying a single or three miRNA copies. |
T45 |
19023-19106 |
Epistemic_statement |
denotes |
The singlecopy line had higher siRNA levels, correlating with better SOD knockdown. |
T46 |
19107-19239 |
Epistemic_statement |
denotes |
Crossing both lines yielded bigenic heterozygous mice expressing even higher siRNA levels and showing a near SOD knockout phenotype. |
T47 |
19438-19448 |
Epistemic_statement |
denotes |
Sun et al. |
T48 |
19449-19583 |
Epistemic_statement |
denotes |
concatenated mIR-30-based anti-S-phase kinaseassociated protein 2 or anti-androgen receptor hairpins under a cytomegalovirus promoter. |
T49 |
19771-19874 |
Epistemic_statement |
denotes |
However, addition of a third copy yielded only a marginal further (disproportionally smaller) increase. |
T50 |
20279-20417 |
Epistemic_statement |
denotes |
52 Concatemerization of up to eight anti-luciferase miRNAs under a single ubiquitin C promoter resulted in a progressive increase in RNAi. |
T51 |
21169-21361 |
Epistemic_statement |
denotes |
Together, these few studies already clearly highlight the feasibility of expressing multiple sh/miRNAs from a single construct, although there exist few therapeutic applications at this point. |
T52 |
21362-21552 |
Epistemic_statement |
denotes |
Vectors employing miRNAs appear to be preferred for expression of multiple hairpins as they allow the use of a single promoter, which offers the potential for spatio-temporal coRNAi control. |
T53 |
21955-22367 |
Epistemic_statement |
denotes |
In brief, there were two different goals: (i) to establish coRNAi as a surrogate genetic tool for basic studies, allowing the dissection of overlapping functions of individual factors to biochemical pathways; (ii) more relevant in the context of this review, to elucidate the usefulness of coRNAi for the treatment or prevention of viral infection and escape by co-targeting multiple viral and/or cellular genes. |
T54 |
22378-22514 |
Epistemic_statement |
denotes |
were among the first to apply a coRNAi approach to the study of gene function, via simultaneous inhibition of multiple endogenous mRNAs. |
T55 |
22515-22713 |
Epistemic_statement |
denotes |
53 They designed two shRNAs (under separate U6 promoters) to target the αand β-isoforms of glycogen synthase kinase 3, two related enzymes involved in various cellular processes and human disorders. |
T56 |
22714-22918 |
Epistemic_statement |
denotes |
In stably co-transfected cells, coRNAi of both isoforms led to an additive increase in expression of the glycogen synthase kinase 3 target β-catenin, as compared with inhibition of the individual enzymes. |
T57 |
23716-23942 |
Epistemic_statement |
denotes |
Similar to the results of Gonzalez et al., 48 shRNA expression and Smad knockdown could be maintained for at least 20 passages, likely owing to the small shRNA number and the low expression levels from the integrated plasmids. |
T58 |
23943-24168 |
Epistemic_statement |
denotes |
As hoped, phenotypic analyses of their various cell lines revealed different contributions of all three Smads to parameters such as wound closure and cell migration, providing further insight into the role of Smads in cancer. |
T59 |
24600-24747 |
Epistemic_statement |
denotes |
56 In detail, the group engineered lentiviruses conditionally to express two mIR-30 hairpins targeting the heterotrimeric G proteins Gα12 and Gα13. |
T60 |
24748-24952 |
Epistemic_statement |
denotes |
Analyses of reporter gene expression (luciferase fused with a serum response element) allowed them to delineate a specific role of Gα13 of transmitting receptor-mediated serum response element activation. |
T61 |
24953-25098 |
Epistemic_statement |
denotes |
This study is thus another illustration of coRNAi as a powerful experimental platform for analysis of potential redundancy in signaling pathways. |
T62 |
25099-25202 |
Epistemic_statement |
denotes |
From a clinical standpoint, two of the most interesting targets for therapeutic coRNAi are HCV and HIV. |
T63 |
25909-26120 |
Epistemic_statement |
denotes |
used adenovirally delivered, U6-driven shRNAs against cellular La, polypyrimidine tract-binding protein, and human vesicle-associated membrane protein-associated protein of 33 kd, all known to interact with HCV. |
T64 |
26512-26670 |
Epistemic_statement |
denotes |
However, a fundamental concern with this strategy is that knocking down endogenous genes could create an unacceptable loss-of-function pathology for the cell. |
T65 |
26810-27147 |
Epistemic_statement |
denotes |
This is exemplified by a report by Korf et al., who co-targeted the two cellular HCV co-factors HuR (Hu antigen R, binds to the HCV 3 -untranslated region, resulting in its stabilization) and PSMA7 (proteasome α-subunit 7, modulates HCV-internal ribosome entry site activity), together with the HCV genome (5 -or 3 -untranslated region). |
T66 |
28222-28414 |
Epistemic_statement |
denotes |
59 In HCV replicon cells, all individual shRNAs (under separate H1 promoters, delivered by a lentivirus) efficiently reduced replication or expression of their specific target by at least 80%. |
T67 |
28415-28555 |
Epistemic_statement |
denotes |
Similar results (with respect to the individual targets) were obtained for coRNAi vectors expressing two or all three shRNAs simultaneously. |
T68 |
28556-28694 |
Epistemic_statement |
denotes |
Important conclusions were the lack of competition among the individual shRNAs and the absence of non-specific effects from their vectors. |
T69 |
29578-29768 |
Epistemic_statement |
denotes |
60 Accordingly, the authors used a plasmid encoding a 51-bp-long, U6-driven shRNA for the efficient co-targeting of the NS5B gene from two distinct HCV strains differing in nine nucleotides. |
T70 |
29769-29903 |
Epistemic_statement |
denotes |
Compared with a conventional 20-mer shRNA, the longer hairpin not only suppressed both isolates but also yielded more rapid knockdown. |
T71 |
29904-30105 |
Epistemic_statement |
denotes |
Although this was not strictly a coRNAi approach, this study is notable because the results implied the generation of multiple different siRNAs from the long precursor (albeit not truly characterized). |
T72 |
30269-30281 |
Epistemic_statement |
denotes |
Boden et al. |
T73 |
32097-32232 |
Epistemic_statement |
denotes |
Virus challenge assays showed a marked protection of the transfected cells from HIV, in particular by the combined CXCR4/CD4 construct. |
T74 |
32945-33119 |
Epistemic_statement |
denotes |
One concern is that inhibiting a specific receptor may select for viral variants that use a non-targeted, different (co-)receptor, ultimately negating any therapeutic effect. |
T75 |
33235-33354 |
Epistemic_statement |
denotes |
62 In contrast, CCR5 might be dispensable for life, as there are asymptomatic individuals homozygous for CCR5 mutation. |
T76 |
33465-33618 |
Epistemic_statement |
denotes |
Nevertheless, CXCR4 knockdown is critical in stem cells (a major target for HIV therapies) as this molecule plays a role in cell homing into bone marrow. |
T77 |
33717-33729 |
Epistemic_statement |
denotes |
Chang et al. |
T78 |
33821-34066 |
Epistemic_statement |
denotes |
65 A critical finding was that a combination of three vectors, directed against highly conserved regions in the viral pol, int, and vpu genes, outperformed the individual shRNAs in terms of suppressing HIV in a stable virus-producer T-cell line. |
T79 |
34067-34197 |
Epistemic_statement |
denotes |
Despite the increased efficacy, the possible formation or prevention of escape mutants was not evaluated in this short-term study. |
T80 |
34198-34294 |
Epistemic_statement |
denotes |
It was instead addressed in a more comprehensive, very recent study by ter Brake and colleagues. |
T81 |
34295-34436 |
Epistemic_statement |
denotes |
66 In a screen of all HIV-1 subtypes (including the LAI prototype) for highly conserved regions, the authors identified 19 potential targets. |
T82 |
34437-34549 |
Epistemic_statement |
denotes |
Of a battery of 86 shR-NAs against these targets, 21 were found to be transiently effective from an H1 promoter. |
T83 |
34769-34878 |
Epistemic_statement |
denotes |
Intriguingly, all three shRNAs combined in one lentiviral vector conferred nearresistance to viral infection. |
T84 |
34879-35019 |
Epistemic_statement |
denotes |
Most important, the group also studied the emergence of viral resistance in cells expressing only one or two of their most effective shRNAs. |
T85 |
35020-35179 |
Epistemic_statement |
denotes |
As hoped, viral inhibition was more durable in the coRNAi cell line, although eventually (day 22) most cultures were positive, regardless of shRNA copy number. |
T86 |
35180-35391 |
Epistemic_statement |
denotes |
Although they do not show the data, the authors also mentioned an improved vector expressing four different shRNAs (from separate and distinct promoters) and able to further delay viral escape for up to 60 days. |
T87 |
35533-35696 |
Epistemic_statement |
denotes |
It is also particularly noteworthy that the shRNAs were carefully chosen to concurrently target all HIV-1 subtypes, although this was not confirmed experimentally. |
T88 |
35697-35915 |
Epistemic_statement |
denotes |
Important for future use of this particular system will be to investigate the genetic stability of the threefold or fourfold shRNA lentiviral vectors, as well as the potential side effects from these unique constructs. |
T89 |
36105-36308 |
Epistemic_statement |
denotes |
67 When transduced via lentiviral vectors into CD4 + T cells, the individual shRNAs showed a more potent inhibitory effect on HIV replication than an anti-tat construct (the same one used by Boden et al. |
T90 |
36309-36315 |
Epistemic_statement |
denotes |
23 ) . |
T91 |
36316-36519 |
Epistemic_statement |
denotes |
Remarkably, at a higher HIV dose where the single shRNAs were no longer able to control the virus, a combination of the intand att-specific shRNA vectors still gave strong suppression for almost 3 weeks. |
T92 |
36520-36658 |
Epistemic_statement |
denotes |
In line with previous work, the group noted the emergence of resistant point mutants after HIV infection of single shRNA-expressing cells. |
T93 |
36659-36857 |
Epistemic_statement |
denotes |
Subsequently generated shRNAs specific for these mutants could suppress their replication, but, unexpectedly, a combination of wild-type and mutant shRNAs had less effect on preventing viral escape. |
T94 |
36858-36997 |
Epistemic_statement |
denotes |
The authors hypothesized intra-cellular competition of the various shRNA vectors for the same target site, but this idea was not validated. |
T95 |
36998-37036 |
Epistemic_statement |
denotes |
As in the HCV studies by Akashi et al. |
T96 |
37037-37164 |
Epistemic_statement |
denotes |
60 and Watanabe et al., 61 the group also tested a long (50-nt) hairpin RNA covering the target region of their anti-int shRNA. |
T97 |
37165-37322 |
Epistemic_statement |
denotes |
Interestingly, this construct was able to co-suppress both wild-type and mutant HIV strains, but the effect was weak and only transient, for reasons unknown. |
T98 |
37323-37581 |
Epistemic_statement |
denotes |
Nonetheless, these articles together suggest that when the technical problems have been overcome and the safety of long hairpins can be guaranteed, combining multiple short and long RNAs might further increase the power of coRNAi to control viral resistance. |
T99 |
37582-37701 |
Epistemic_statement |
denotes |
Collectively, the studies reviewed above clearly validate the promise of coRNAi to suppress viral infection and escape. |
T100 |
37702-37847 |
Epistemic_statement |
denotes |
However, they also provide evidence for potential setbacks from co-expression of multiple hairpin RNAs in the same cell and from the same vector. |
T101 |
37848-37969 |
Epistemic_statement |
denotes |
The issues include genetic instabilities, promoter or hairpin interference, and toxic side effects (see also Conclusion). |
T102 |
38517-38701 |
Epistemic_statement |
denotes |
As hoped for, the coRNAi approach produced synergistic effects in terms of P2X 3 knockdown in cultured cells, but, interestingly, only when both agents targeted non-homologous regions. |
T103 |
38702-38842 |
Epistemic_statement |
denotes |
The reasons for this competition remain elusive, but the findings are reminiscent of the study by Nishitsuji and colleagues described above. |
T104 |
38843-39032 |
Epistemic_statement |
denotes |
67 It is unclear whether the molecular mechanisms are related or even identical, but these two studies certainly prompt caution in attempts to target a single site with multiple inhibitors. |
T105 |
39033-39047 |
Epistemic_statement |
denotes |
Jarczak et al. |
T106 |
39048-39154 |
Epistemic_statement |
denotes |
were among the first to suggest a combination of shRNAs with hammerhead ribozymes (Rzs) for HCV treatment. |
T107 |
39155-39305 |
Epistemic_statement |
denotes |
69 The group targeted the highly conserved 5 -and 3 -viral untranslated regions with various U6-driven shRNAs or Rzs (under U6 or tRNA Val promoters). |
T108 |
39306-39460 |
Epistemic_statement |
denotes |
After individual transfection into HCV replicon cell lines, their best candidates inhibited HCV NS5B expression by approximately 30% (Rzs) or 50% (shRNA). |
T109 |
39461-39741 |
Epistemic_statement |
denotes |
Although mixing various Rzs increased overall inhibition marginally, it was most notable that combining the best Rzs and shR-NAs gave an approximately 25% additive effect to each shRNA, irrespective of its initial potential (however, combinations of shRNAs alone were not tested). |
T110 |
39742-39929 |
Epistemic_statement |
denotes |
This study is an important proofof-concept, in particular as it further confirms the need to target different sites in the viral genome for maximum efficacy, in line with Watanabe's work. |
T111 |
40112-40263 |
Epistemic_statement |
denotes |
At this point, relevant anti-HIV coRNAi approaches have been mostly reported by John Rossi's group, which is currently also preparing a clinical trial. |
T112 |
40437-40455 |
Epistemic_statement |
denotes |
Instead, Li et al. |
T113 |
40456-40704 |
Epistemic_statement |
denotes |
64 used an anti-CCR5 ribozyme (driven by an adenoviral VA1 promoter) together with a trans-activation response region decoy (U6-promoted and embedded in small nucleolar RNA U16, to ensure co-localization with HIV Tat in nucleoli of infected cells). |
T114 |
40705-40874 |
Epistemic_statement |
denotes |
The resulting vector provided a substantially greater survival advantage to HIV-challenged primary T or CD34 + stem cells compared with the individual ribozyme or decoy. |
T115 |
40875-41091 |
Epistemic_statement |
denotes |
An shRNA against rev and tat tested in parallel was shown to reduce HIV p24 substantially in the same cell types, over the same period, but the results were not directly compared and the constructs were not combined. |
T116 |
41092-41269 |
Epistemic_statement |
denotes |
Construct combination was reported in a follow-up study in which Rossi's group presented a lentiviral vector combining all three inhibitors from their earlier work (Figure 1e) . |
T117 |
41604-41769 |
Epistemic_statement |
denotes |
Importantly, there was no evidence for evolution of escape mutants with the triple vector, although additional validation might be needed in view of the assays used. |
T118 |
42235-42378 |
Epistemic_statement |
denotes |
Nevertheless, the overall impressive results with this unique and ingenious construct clearly illustrate the power of coRNAi for HIV therapies. |
T119 |
42379-42624 |
Epistemic_statement |
denotes |
Consequently, a slightly modified vector (deleted for a gfp marker gene) will soon be tested in a clinical trial using autologous hematopoietic stem cells from acquired immunodeficiency syndrome/lymphoma patients and bone marrow transplantation. |
T120 |
43197-43315 |
Epistemic_statement |
denotes |
created a lentiviral vector in which an anti-rev shRNA was expressed from an HIV-inducible RNA polymerase II promoter. |
T121 |
43499-43707 |
Epistemic_statement |
denotes |
In stably transduced and HIV-challenged T cells, the double vector mediated 90% inhibition of HIV p24 protein and a high cell survival rate (although a direct comparison with single vectors was not provided). |
T122 |
44100-44278 |
Epistemic_statement |
denotes |
70 Last but not least, in addition to co-expression of transdominant anti-viral proteins, one can also envision synergistic gene silencing/addition in other therapeutic contexts. |
T123 |
44279-44321 |
Epistemic_statement |
denotes |
One remarkable example by Samakoglu et al. |
T124 |
45388-45639 |
Epistemic_statement |
denotes |
It is emerging as a powerful modality to battle some of the most notoriously challenging clinical targets (HCV, HIV, and other human viruses), and initial studies also affirm its great potential for treatment of metabolic or blood disorders or cancer. |
T125 |
45640-45780 |
Epistemic_statement |
denotes |
Concurrently, coRNAi is quickly exceeding our expectations for its use in the study of basic processes, such as signaling or transformation. |
T126 |
46074-46279 |
Epistemic_statement |
denotes |
The safety concern is based on a plethora of earlier reports on unexpected and adverse side effects from mono-RNAi treatments, including "off-target" silencing, IFN responses, and translational inhibition. |
T127 |
46280-46451 |
Epistemic_statement |
denotes |
73 Although it is obvious that these risks may increase proportionally with a coRNAi approach, another specific concern is oversaturation of the endogenous RNAi machinery. |
T128 |
46452-46612 |
Epistemic_statement |
denotes |
This might at least result in competitive reduction of the effects of the individual silencers, which could indeed explain some of the findings described above. |
T129 |
48419-48641 |
Epistemic_statement |
denotes |
Unfortunately, no published work has yet defined the limit to the number of exogenous hairpin RNAs that can be effectively incorporated into a (co)RNAi treatment, and it will likely vary with the types of cells and organs. |
T130 |
49119-49330 |
Epistemic_statement |
denotes |
78 Some exciting recent examples include promoters that are specifically activated in HCV-or HIV-infected cells 79, 80 or can be epigenetically and reversibly controlled using exogenous drugs or small molecules. |
T131 |
49331-49504 |
Epistemic_statement |
denotes |
81, 82 The use of these alternative promoters might concurrently help to circumvent the second concern with coRNAi, i.e., genetic instability of the multi-component vectors. |
T132 |
49505-49827 |
Epistemic_statement |
denotes |
Although it is technically feasible to accommodate multiple sh/miRNA cassettes into virtually any present viral vector (including the smallest of all, AAV), there are hardly any data at this point on the likely risks of recombination or deletion caused by sequence similarities or identities among the individual elements. |
T133 |
49828-50037 |
Epistemic_statement |
denotes |
Anecdotal evidence suggests this problem exists and could hamper the approach, as it might, for instance, explain the reported difficulties in implementing more than six identical shRNAs into a single plasmid. |
T134 |
50208-50368 |
Epistemic_statement |
denotes |
However, the resulting disproportional expression levels (based on promoter strength) might inadvertently obscure the contribution of the individual components. |
T135 |
50369-50538 |
Epistemic_statement |
denotes |
Alternatively, as already demonstrated and perhaps preferred, vectors can be engineered to express multiple miRNA-like hairpins from a single RNA polymerase II promoter. |
T136 |
50620-50876 |
Epistemic_statement |
denotes |
On the other hand, the discrepant findings available on the efficiency of multi-miRNA vectors clearly indicate that implementation of this strategy requires an improved understanding of the cellular mechanisms that govern processing of hairpin concatemers. |
T137 |
50877-51042 |
Epistemic_statement |
denotes |
As with any novel therapy, a stringent test for coRNAi strategies will be their evaluation in animal models of innate or acquired genetic disease or viral infection. |
T138 |
51043-51260 |
Epistemic_statement |
denotes |
Importantly, in vivo trials will not only allow us to evaluate the efficacy of the new vectors directly but also provide us with better clues on the physiological role of the putative virally encoded RNAi suppressors. |
T139 |
51261-51543 |
Epistemic_statement |
denotes |
Thus far, the majority of related findings have been obtained in artificial systems, using either robust plasmids for SRS expression (as opposed to perhaps low-level expression from the intact virus) or heterologous read-outs (e.g., using nonvertebrate cells for mammalian factors). |
T140 |
51890-52142 |
Epistemic_statement |
denotes |
One example is HCV, and as we are now fortunate to have the first replication-competent wild-type isolate available, it will be possible and exciting to study the seemingly intricate interplay of the virus with the RNAi machinery in a natural scenario. |
T141 |
52143-52283 |
Epistemic_statement |
denotes |
1 The lessons learned will certainly influence the future design of coRNAi vectors with respect to the importance of SRS-specific silencers. |
T142 |
52912-53137 |
Epistemic_statement |
denotes |
In conclusion, we anticipate with excitement the elucidation of whether coRNAi technology will live up to its promise in clinical studies and ultimately prove to be our winning strategy in the battle against evolving targets. |
T143 |
53549-53716 |
Epistemic_statement |
denotes |
Particularly exciting candidates emerging as potential future RNAi partners are aptamers, RNA oligonucleotides able to bind ligands with high specificity and affinity. |
T144 |
53717-53934 |
Epistemic_statement |
denotes |
In fact, recent work demonstrates that RNA aptamers can be expressed from RNA polymerase III promoters, identical to shRNAs, opening up the possibility of combining them with RNAi triggers in a multi-component vector. |
T145 |
53935-54082 |
Epistemic_statement |
denotes |
83 Moreover, aptamers can be fused with siRNAs to permit targeted RNAi delivery 84 or can be incorporated into shRNA loops as a regulatory element. |
T146 |
54083-54343 |
Epistemic_statement |
denotes |
81 Last but not least, by drawing upon our growing knowledge of endogenous RNAi pathways, the improvements in viral vector design, and the refinement of bioinformatical models of viral infection, we will be able further to enhance the efficacy of the approach. |