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Publication : Phosphorothioate backbone modifications of nucleotide-based drugs are potent platelet activators.

First Author  Flierl U Year  2015
Journal  J Exp Med Volume  212
Issue  2 Pages  129-37
PubMed ID  25646267 Mgi Jnum  J:219785
Mgi Id  MGI:5629753 Doi  10.1084/jem.20140391
Citation  Flierl U, et al. (2015) Phosphorothioate backbone modifications of nucleotide-based drugs are potent platelet activators. J Exp Med 212(2):129-37
abstractText  Nucleotide-based drug candidates such as antisense oligonucleotides, aptamers, immunoreceptor-activating nucleotides, or (anti)microRNAs hold great therapeutic promise for many human diseases. Phosphorothioate (PS) backbone modification of nucleotide-based drugs is common practice to protect these promising drug candidates from rapid degradation by plasma and intracellular nucleases. Effects of the changes in physicochemical properties associated with PS modification on platelets have not been elucidated so far. Here we report the unexpected binding of PS-modified oligonucleotides to platelets eliciting strong platelet activation, signaling, reactive oxygen species generation, adhesion, spreading, aggregation, and thrombus formation in vitro and in vivo. Mechanistically, the platelet-specific receptor glycoprotein VI (GPVI) mediates these platelet-activating effects. Notably, platelets from GPVI function-deficient patients do not exhibit binding of PS-modified oligonucleotides, and platelet activation is fully abolished. Our data demonstrate a novel, unexpected, PS backbone-dependent, platelet-activating effect of nucleotide-based drug candidates mediated by GPVI. This unforeseen effect should be considered in the ongoing development programs for the broad range of upcoming and promising DNA/RNA therapeutics.
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