Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Carbohydrate doai
Patent
1996-04-16
1998-09-15
Campell, Bruce R.
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Carbohydrate doai
536 245, 935 8, 935 34, A61K 4800, C07H 2104
Patent
active
058078380
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
This invention relates to diagnostics, research reagents and therapies for multidrug resistance and for disease states which respond to modulation of the phenomenon of multidrug resistance. In particular, this invention relates to antisense oligonucleotide interactions with certain messenger ribonucleic acids (mRNAs) or DNAs involved in the synthesis of the multidrug resistance-associated protein (MRP). Antisense oligonucleotides designed to hybridize to the MRNA encoding MRP are provided. These oligonucleotides have been found to lead to the modulation of the activity of the RNA or DNA, and thus to the modulation of the synthesis and metabolism of MRP. Palliation and therapeutic effect result. These oligonucleotides can also be used in assays and diagnostics, and can be useful in distinguishing MRP-associated multidrug resistance from other multidrug resistance pathways.
BACKGROUND OF THE INVENTION
Acquired resistance to chemotherapy is a major problem in treatment of cancer by conventional cytotoxic drugs. Tumors may initially respond well to chemotherapy but later become resistant to a variety of unrelated drugs, leading to relapse. Multidrug resistance can arise via one of several independent pathways, any or all of which may be amenable to inhibition. One cause of multidrug resistance is believed to be overexpression of a transmembrane transport protein known as P-glycoprotein or MDR protein. Another distinct cause of multidrug resistance is believed to be overexpression of a member of the ATP-binding cassette transmembrane transporter superfamily known as multidrug resistance-associated protein (MRP). This protein is overexpressed in certain tumor cell lines which are multidrug resistant but do not overexpress P-glycoprotein. Cole et al. Science 1992, 258, 1650-1654; Slovak et al. Cancer Res. 1993, 53, 3221-3225. The gene encoding MRP was initially isolated from a multidrug-resistant small-cell lung cancer cell line. Small-cell lung cancer accounts for 20-25% of all lung cancer. Up to 90% of small-cell lung cancers respond initially to chemotherapy, but nearly all become multidrug resistant, leading to relapse. Compositions and methods for modulating and detecting MRP are the subject of this invention.
Agents capable of reversing the phenomenon of multidrug resistance and thus "sensitizing" the drug resistant tumors to chemotherapy are desired. Cyclosporin A and other agents are able to reverse doxorubicin resistance in cells which overexpress MDR, but clinical use of these compounds is limited by their cytotoxicity. Further, these reversing agents do not work in cells which overexpress MRP. Antisense oligonucleotides targeted to the MDR mRNA encoding P-glycoprotein have been used to partially reverse the multidrug resistance phenotype. Thierry et al. Biochem. Biophys. Res. Comm. 1993, 190, 952-960. Others have demonstrated complete inhibition of P-glycoprotein (MDR protein) synthesis by 15-mer antisense methylphosphonate oligonucleotides. They have further shown that oligonucleotides complementary to the initiation codon and a few codons upstream of the mdrl gene are most effective, but lead to only a partial decrease in drug resistance. Larger oligonucleotides, such as 21-mers, showed decreased solubility and permeability. Vasanthakumar, G. and N. K. Ahmed Cancer Commun. 1989, 1, 225-232.
While compositions and methods for reversing P-glycoprotein (MDR)-associated multidrug resistance or MDR synthesis have shown limited success, there remains a long-felt need for compositions and methods for modulation and diagnosis of other types of multidrug resistance. Oligonucleotides that are specifically hybridizable with MRP mRNA are desired for their diagnostic and therapeutic utility. Interference with MRP expression is desired as a means of reversing the multidrug resistance phenomenon, and making a distinction between multidrug resistance due to MRP and that due to other causes. Interference with MRP expression is also desired for improving the efficacy of conventional methods
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Baracchini, Jr. Edgardo
Bennett Clarence Frank
Campell Bruce R.
ISIS Pharmaceuticals Inc.
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