An Endosomal Escape Trojan Horse Platform to Improve Cytosolic Delivery of Nucleic Acids

Endocytosis is a major bottleneck toward cytosolic delivery of nucleic acids, as the vast majority of nucleic acid drugs remain trapped within endosomes. Current trends to overcome endosomal entrapment and subsequent degradation provide varied success; however, active delivery agents such as cell-penetrating peptides have emerged as a prominent strategy to improve cytosolic delivery. Yet, these membrane-active agents have poor selectivity for endosomal membranes, leading to toxicity. A hallmark of endosomes is their acidic environment, which aids in degradation of foreign materials. Here, we develop a pH-triggered spherical nucleic acid that provides smart antisense oligonucleotide (ASO) release upon endosomal acidification and selective membrane disruption, termed DNA EndosomaL Escape Vehicle Response (DELVR). We anchor i-Motif DNA to a nanoparticle (AuNP), where the complement strand contains both an ASO sequence and a functionalized endosomal escape peptide (EEP). By orienting the EEP toward the AuNP core, the EEP is inactive until it is released through acidification-induced i-Motif folding. In this study, we characterize a small library of i-Motif duplexes to develop a structure-switching nucleic acid sequence triggered by endosomal acidification. We evaluate antisense efficacy using HIF1a, a hypoxic indicator upregulated in many cancers, and demonstrate dose-dependent activity through RT-qPCR. We show that DELVR significantly improves ASO efficacy in vitro. Finally, we use fluorescence lifetime imaging and activity measurement to show that DELVR benefits synergistically from nuclease- and pH-driven release strategies with increased ASO endosomal escape efficiency. Overall, this study develops a modular platform that improves the cytosolic delivery of nucleic acid therapeutics and offers key insights for overcoming intracellular barriers.

Site-Selective RNA Splicing Nanozyme: DNAzyme and RtcB Conjugates on a Gold Nanoparticle

Modifying RNA through either splicing or editing is a fundamental biological process for creating protein diversity from the same genetic code. Developing novel chemical biology tools for RNA editing has potential to transiently edit genes and to provide a better understanding of RNA biochemistry. Current techniques used to modify RNA include the use of ribozymes, adenosine deaminase, and tRNA endonucleases. Herein, we report a nanozyme that is capable of splicing virtually any RNA stem-loop. This nanozyme is comprised of a gold nanoparticle functionalized with three enzymes: two catalytic DNA strands with ribonuclease function and an RNA ligase. The nanozyme cleaves and then ligates RNA targets, performing a splicing reaction that is akin to the function of the spliceosome. Our results show that the three-enzyme reaction can remove a 19 nt segment from a 67 nt RNA loop with up to 66% efficiency. The complete nanozyme can perform the same splice reaction at 10% efficiency. These splicing nanozymes represent a new promising approach for gene manipulation that has potential for applications in living cells.

The learning curve for radiofrequency ablation of tachyarrhythmias in pediatric patients. Participating members of the Pediatric Electrophysiology Society

The results of radiofrequency ablation for treatment of supraventricular tachyarrhythmias have been reported to improve with increasing experience; however, the precise nature of the learning curve in children is unknown. From November 1990 to October 1993, 1,546 consecutive procedures from the Pediatric Radiofrequency Ablation Registry were categorized into deciles based on number of prior pediatric procedures at the submitting institution. Negative exponential models were tested for strength of relation between volume of prior experience and 4 measures of outcome: success rate, complication rate, fluoroscopy time, and procedure time. Negative exponential curves described the experience-outcome relations well (r = 0.81 to 0.97). Learning rates were most rapid for successful ablation of left free wall accessory pathways, and slowest for right free wall pathway ablation. These models suggest that, given enough experience, procedural success rates > 90% (regardless of pathway location) and fluoroscopy and procedure times averaging < 40 minutes and 250 minutes, respectively, can be achieved in pediatric patients.

Effectiveness of radiofrequency catheter ablation for treatment of atrial tachycardia

Catheter ablation has been used to treat atrioventricular node reentrant and atrioventricular reentrant tachycardias with extremely high success rates. The suitability of catheter ablation for treatment of atrial tachycardia, a much less common type of supraventricular tachycardia, has not been well addressed. Fifteen patients (8 females) ranging from 10 to 83 years (mean 38 +/- 22) were referred for catheter ablation of supraventricular tachycardia. The diagnosis of atrial tachycardia was established by standard electrophysiologic techniques. A combination of activation and pace mapping was used to identify a suitable site for radiofrequency current catheter ablation. Medical therapy was unsuccessful in all but 1 patient. Two patients had surgically corrected congenital heart disease, 2 had coronary artery disease and 1 had dilated cardiomyopathy. Seven patients had depressed left ventricular function. Six patients had incessant tachycardias. Presumed tachycardia mechanism was automatic in 11 patients and reentrant in 4. Mean tachycardia cycle length was 372 +/- 74 ms. Catheter ablation was acutely successful in 12 patients (80%) with application of 11.1 +/- 6.6 lesions at a mean voltage of 60 +/- 9 V. In the other 3 patients, 16 to 38 lesions were applied. At a mean follow-up of 18.5 +/- 6.5 months, 2 patients have had recurrences with different P-wave morphologies and underwent a second successful catheter ablation procedure. An additional 2 patients had recurrences with the same P-wave morphology and 1 underwent a second successful catheter ablation procedure. Thus, radiofrequency ablation can be used in a diverse population of patients with atrial tachycardia with an acute success rate of 80% and a long-term success rate of 73%.