Antidote-mediated control of an anticoagulant aptamer in vivo

• Published in: Nature biotechnology Vol. 22; no. 11; pp. 1423 - 1428
• Main Authors: Rusconi, Christopher P, Sullenger, Bruce A, Roberts, Joseph D, Pitoc, George A, Nimjee, Shahid M, White, Rebekah R, Quick, George, Scardino, Elizabeth, Fay, William P
• Format: Journal Article
• Language: English
• Published: New York, NY Nature 01.11.2004; Nature Publishing Group
• Subjects: Animals; Anticoagulants - administration & dosage; Anticoagulants - adverse effects; Antidotes - administration & dosage; Biological and medical sciences; Blood Coagulation - drug effects; Blood Coagulation Tests; Blood. Blood coagulation. Reticuloendothelial system; Carotid Artery Thrombosis - drug therapy; Drug Interactions; Drug Therapy, Combination; Hemorrhage - chemically induced; Hemorrhage - prevention & control; Medical sciences; Mice; Oligonucleotides - administration & dosage; Oligonucleotides - adverse effects; Pharmacology. Drug treatments; Swine; Treatment Outcome; Drug; In vivo; Regulation(control); Animal; Anticoagulant; Safety; Antidote
• ISSN: 1087-0156; 1546-1696
• DOI: 10.1038/nbt1023

Patient safety and treatment outcome could be improved if physicians could rapidly control the activity of therapeutic agents in their patients. Antidote control is the safest way to regulate drug activity, because unlike rapidly clearing drugs, control of the drug activity is independent of underlying patient physiology and co-morbidities. Until recently, however, there was no general method to discover antidote-controlled drugs. Here we demonstrate that the activity and side effects of a specific class of drugs, called aptamers, can be controlled by matched antidotes in vivo. The drug, an anticoagulant aptamer, systemically induces anticoagulation in pigs and inhibits thrombosis in murine models. The antidote rapidly reverses anticoagulation engendered by the drug, and prevents drug-induced bleeding in surgically challenged animals. These results demonstrate that rationally designed drug-antidote pairs can be generated to provide control over drug activities in animals.