SiRNA Or Short Interfering RNA Holds More Promise For Dramatic New Treatments Than Stem Cells

I rarely give stock advice. The last time I did was inmechanism of gene regulation in all cells, accelerated
the summer of 1964 when I read in the newspaperunderstanding of how RNAi works. SiRNA is an
that a new company called ComSat was having anexogenous synthetic version of the natural
IPO in September. I considered this, perhaps naively,endogenous microRNA that takes advantage of the
a sure thing. Yet being in my first job I had nocellular machinery that normally processes and
money to invest. So, I decided to watch this stockmediates the function of microRNA. Micro- or siRNA
with the fantasy of having invested $1,000 ($6,548 in(RNAi) is targeted to inhibit a specific counterpart
today's dollars). My plan was to buy at the IPO pricetranscript (messenger RNA) that serves as a
of $10 a share and then sell just before the launch oftemplate for synthesis of an individual protein, the
the first commercial communications satellite, just innatural process of gene expression. RNAi is
case the launch failed. The stock rose meteoricallyprocessed by a ribonuclease enzyme that binds to a
from $10 per share to $80 (the launch did not fail),larger precursor siRNA. The enzyme processes siRNA
then the stock split and rose again to more than $80into a 21-nucleotide base-pair double stranded
per share. I made about $240,000 from my $1,000molecule. The specificity of RNAi is governed both by
fantasy investment, equivalent to $1.5 million today.its 'complimentarity' to a particular messenger RNA
The reason I bring this up is that recently, I wasnucleic acid sequence and also by a complex of
fortunate to attend a small meeting in Boston thatproteins whose function is to mediate the binding of
focused on developments in the seemingly esotericthe RNAi to a target sequence on the messenger
field of siRNA or "short interfering RNA" used toRNA, usually in the 3'-noncoding region of the
silence genes. The promise of this technology hasmessenger RNA. This binding event leads to a
rightfully created a significant buzz in the scientific andshut-down in synthesis of the protein encoded by
investment communities over for the last two tothe messenger RNA (called "knock-down").
three years. And as I left this meeting, it occurred toThere is currently little mystery about how to design
me that in the next 10 to 20 years, siRNA, also calledsiRNA molecules and synthesize them, as this method
"RNAi", will probably dominate drug development, withis aided by readily available algorithms. In fact, Todd
many successful drugs currently targeting specificWoolf, CEO & President of RXi Pharmaceuticals,
proteins, like Genentech's Herceptin and Imclone'ssays, "Weeks instead of years to lead compounds."
Erbitux, being replaced by RNAi-based drugs.This finely tunable technique of RNAi knock-down is
Furthermore, many disease-causing proteins thoughtalso currently used in many academic research labs.
to be "undrugable", like the metastatic biomarkerFinally, many studies have been completed including
L-plastin for colon, breast, melanoma, prostate, andPhase I clinical trials that indicate the siRNA is
bladder cancer, could now be targeted by RNAiessentially non-toxic. Conventional drugs have always
drugs.required the balancing of efficacious doses with
Andrew Fire, of Stanford, and Craig Mello, at theconsideration of the drug's negative side-effects.
University of Massachusetts, discovered "geneSeveral companies and labs have shown siRNA
silencing by double-stranded RNA" in 1998, earningconjugated with cholesterol or other lipid carriers will
them the 2006 Nobel Prize in Medicine. In 2001attach to cholesterol carrier proteins in the blood and
companies started forming around RNAi. One oftransport to the liver rather than being excreted. If
them, Alnylam Pharmaceuticals filed its S-1 registrationan siRNA is used that knocks down an enzyme
with the SEC in February 2004, claiming $23,000 ininvolved in cholesterol production by the liver, then
cash assets and creating 3.2 million shares worth 28serum cholesterol levels can be diminished in mice by
cents each. Two years later, Alnylam went public30 to 40 percent without diminishing the good
with stock selling at $7.50 per share after ancholesterol (HDL) levels. The blockbuster statin drugs
unprecedented short start-up time. Alnylam's shareslike Lipitor, which are well known to produce toxic
were selling on NASDAQ at around $16 per share inside-effects in the liver, also reduce cholesterol levels
early July after hitting a 52-week high of $24.46 lastin the blood by about 30 to 40 percent. In the
December. By December or perhaps early winter,mouse model, the cholesterol-reducing effects of one
Alnylam will announce the outcome of its Phase IItreatment with siRNA lasts three to four weeks.
clinical trial on their lead product for treating the infantIn a mouse model for intestinal adenomatous
respiratory disease caused by Respiratory Syncytialpolyposis, the mice develop a high density of benign
Virus (RSV infections). Alnylam has multiplepolyps that ultimately block the intestines,
collaborations funded by Merck, and about 20 pipelinesubsequently leading to death. In humans, such polyps
products. At the same time Merck bought Sirnaare precursors to malignant colon cancer. Johannes
Therapeutics, another RNAi company with strong IPFruehauf of Cequent Pharmaceuticals and Harvard
for this technology. During the last year, in order toMedical School described a novel method for
acquire additional RNAi-relevant IP, Hoffmann-Ladelivering siRNA to the intestinal tract which targeted
Roche bought 454, Sigma Chemicals bought Proligo,beta-catenin synthesized by polyp cells. Increased
Alnylam bought Ribopharma, Acuity Pharmaceuticalsexpression of beta-catenin is associated with
merged with two other companies to form Opko,proliferation of polyp cells but not by itself in the
Dharmacon became part of Thermo-Fisher Scientific,conversion of benign polyps to malignancy. Cequent
and RXi Pharmaceuticals was spawned by CytRx.has demonstrated that bacteria, such as E. coli,
Also Pfizer, GlaxoSmithKline, Novartis, Bristol-Myerscarrying about 100 copies of recombinant siRNA in a
Squibb, and Abbott Labs have started R&Dplasmid vector, can simply be fed to polyposis mice
programs around RNAi.whose intestines are clogged with polyps.
Santaris Pharma, a Danish company formed in 2003,Administration of these bacteria containing the siRNA
has a novel method for making and stabilizing RNAicopies killed the polyps and cleared up the problem
and drug products in Phase II clinical development.completely; the histopathology pictures established
Santaris is strategically partnered through licensingclearly that the intestines were cleansed of the
agreements with Enzon, a leading clinical researchpolyps. The explanation for this efficacy is that
organization that is conducting clinical trials in the U.S.thousands of these bacteria were engulfed by the
for many Santaris' drug candidates. Santaris haspolyp cells by the natural process of endocytosis.
completed Phase I/II clinical trials in Denmark, France,The bacteria were dissolved in the endosomes, the
the U.K. and the U.S. for an RNAi drug for treatingplasmids carrying the siRNA insert were fragmented,
chronic lymphocytic leukemia (CLL) and Phase I trialsand the liberated siRNA inhibited beta-catenin
for a second product treating renal and colonsynthesis in the polyps. This last step causes the
carcinoma and multiple myeloma. The CLL productpolyps to self-destruct by the natural mechanism of
should compete favorably with Genta's BCL-2apoptosis, or programmed cell death.
antisense (RNA) product in development for over aThe prospect for siRNA as a therapy seems unlimited
decade, through phase III clinical development, and inin that any and every gene can become a target for
pre-registration for CLL and malignant melanoma.this therapy. Before siRNA, many potential disease
As an aside, it's worth noting that several of thesetargets were considered "undrugable," meaning that
companies are Nerac clients.virtually every disease can be considered for siRNA
RNAi therapy is not like stem cell therapy, which willtherapy, including all forms of cancer, metabolic
take decades to develop. Approval of the first RNAidiseases like diabetes, and cardiovascular disease. One
drugs is expected in three to five years. This isspeaker at the meeting predicted that when the first
because stem cell therapy is complex and the sciencesiRNA proved its efficacy in a Phase III clinical trial,
is still in its infancy. By contrast RNAi is wellthis event would lead to an explosion of interest in
developed because of the advanced understandingsiRNA by Big Pharma and the investment community.
of genetics and gene expression. In fact RNAi will beIt seems inevitable that this will happen in the not
used to make stem cell therapy work.too distant future.
The 1993 discovery of microRNA, a natural