WO2013192486A1 - Inhibitors of the mir-15 family of micro-rnas - Google Patents

Abstract

The invention provides chemically modified oligonucleotides capable of inhibiting the expression (e.g., abundance) of miR-15 family miRNAs, including miR-15a, miR-15b, miR-16, miR-195, miR-424, and miR-497. The invention provides in some embodiments, oligonucleotides capable of inhibiting, in a specific fashion, the expression or abundance of each of miR-15a, miR-15b, miR-16, miR-195, miR-424, and miR-497. The invention further provides pharmaceutical compositions comprising the oligonucleotides, and methods of treating patients having conditions or disorders relating to or involving a miR-15 family miRNA, such as a cardiovascular condition. In various embodiments, the oligonucleotides provide advantages in one or more of potency, efficiency of delivery, target specificity, toxicity, and/or stability.

Description

INHIBITORS OF THE ΜΠΜ5 FAMILY OF MICRO-RNAS

RELATED APPLICATIONS

This application claims priority to and the benefit of U.S. Provisional Application No. 61/662,772, filed June 21, 2012, and U.S. Provisional Application No. 61/780,352, filed. March 13, 2013, each of which is hereby incorporated by reference in its entirety.

DESCRIPTION OF THE TEXT FILE SUBMITTED ELECTRONICALLY

The contents of the text file submitted electronical ly herewith are incorporated herein by reference in their entirety: A computer readable format copy of the Sequence Listing (filename: MIRG-037_02US_SeqList_ST25.txt, date recorded: June 19, 2013, fi! size 10 kilobytes).

FIELD OF THE INVENTION

The present invention relates to chemical motifs for microRNA (miRNA or nilR) inhibitors. More particularly, the present invention relates to chemically modified oligonucleotides that target one or more miR- 15 family members and having advantages in potency, efficiency of delivery, target specificity, stability, and/or toxicity when administered to a patient.

BACKGROUND

MieroRNAs (miRs) have been implicated in a number of biological processes including regulation and maintenance of cardiac function (see, E. Van Rooij et a!., J. Clin, invest. 117(9): 2369-2376 (2007); K. Chien, Nature 447: 389-390 (2007)). Therefore, miRs represent a relatively new class of therapeutic targets for conditions such as cardiac hypertrophy, myocardial infarction, heart failure, vascular damage, and pathologic cardiac fibrosis, among others. miRs are small, non-protein coding RNAs of about 18 to about 25 nucleotides in length, and act as repressors of target mRNAs by promoting their degradation, when their sequences are perfectly complementary, or by inhibiting translation, when their sequences contain mismatches. The mechanism involves incorporation of the mature miRNA strand into the RNA-induced silencing complex (RISC), where it associates with its target RNAs by base-pair complementarity. miRNA function may be targeted therapeutically by antisense polynucleotides or by polynucleotides that mimic miRNA function ("miRNA mimetic"). However, targeting miRNAs therapeutically with oligomicleotide-based agents poses several challenges, including RNA-binding affinity and specificity, efficiency of cellular uptake, and nuclease resistance. For example, when polynucleotides are introduced into intact cells they are attacked and degraded by nucleases leading to a loss of activity. While polynucleotide analogues have been prepared in an attempt to avoid their degradation, e.g. by means of 2' substitutions (B. Sproat et al, Nucleic Acids Research 17: 3373-3386, (1989)), the modifications often affect the polynucleotide's potency for its intended biological action. Such reduced potency, in each case, may be due to an inability of the modified polynucleotide to form a stable duplex with the target RNA and/or a loss of interaction with the cellular machinery. Other modifications include the use of locked nucleic acid, which has the potential to improve RNA-binding affinity (see, R. Veedu et a!., RNA Biology 6(3): 321-323 (2009)).

Oligonucleotide chemistry patterns or motifs for miRNA inhibitors have the potential to improve the delivery, stability, potency, specificity, and/or toxicity profile of the inhibitors, and such are needed for effectively targeting miRNA function in a therapeutic context.

SUMMARY OF THE INVENTION The present invention provides chemically modified oligonucleotides capable for reducing or inhibiting the activity of one or more mill- 15 family members including miR- 15a, miR-15b, miR-16, miR-195, miR-424, and miR-497. The invention further provides pharmaceutical compositions comprising the oligonucleotides, and methods of treating subjects having conditions or disorders relating to, or involving, one or more miR-15 family members. In various embodiments, the disclosed oligonucleotides provide advantages in one or more of potency, efficiency of delivery, target specificity, toxicity, and/or stability. in one aspect, the invention provides a chemically modified oligonucleotide capable of reducing or inhibiting the activity of one or more mi.R-15 family members. The activity or potency of the oligonucleotide may be determined in vitro and/or in vivo. For example, the oligonucleotide may significantly inhibit {e.g., about 50% inhibition) the activity of one or more miR-15 family members (as determined, for example, in a two-step real time PGR assay or a dual luciterase assay) at a concentration of about 50 nM or less, or in other embodiments, about 40 nM or less, about 20 nM or less, or about 10 nM or less. Alternatively, or in addition, the activity of the oligonucleotide may be determined in a suitable mouse or rat model, or non-human primate model, where inhibition {e.g., by at least about 50%) of one or more miR-15 family members is observed at a dose of about 50 mg/kg or less, such as about 25 mg/kg or less, about 10 mg/kg or less, or about 5 mg kg or less. Exemplary markers for determining target de-repression are described herein. In these embodiments, the oligonucleotide may be dosed subcutaneously or intravenously (and as described herein), and may be formulated in an aqueous preparation (e.g., saline). The oligonucleotide comprises the nucleotide sequence 5'-GTGCTGCT-3' and is substantially complementary to a nucleotide sequence of one or more miR-15 family members. The oligonucleotide further contains at least one locked nucleotide. In an embodiment, the oligonucleotide contains at least eight locked nucleotides. The locked nucleotides may have a 2' to 4' bridge structure as described in WO 2012/083005, which is incorporated herein in its entirety. For example, the locked nucleotide may have a 2' to 4' bridge comprising an ethylene or methylene group. In another example, the locked nucleotide may have a 2^" to 4' methylene bridge.

Generally, the length of the oligonucleotide and number and position of locked nucleotides is such that the oligonucleotide reduces the activity of one or more miR-15 family members at an oligonucleotide concentration of about 50 nM or less in an in vitro real time PGR assay or a luciterase assay, or at a dose of about 25 mg kg or less in a suitable rodent model or non-human primate model as described herein. In an embodiment, the oligonucleotide is from about 8 to about 18 nucleotides in length. In another embodiment, the oligonucleotide is from about 12 to about 17 nucleotides in length. in an exemplary embodiment, the oligonucleotide is about 16 nucleotides in length. The oligonucleotide may comprise or consist essentially of a nucleotide sequence selected from 5 ' - ACC ATT ATGTGCTGCT-3 ' (SEQ ID NO. 1), 5 ' - ACC ATGATGTGCTGCT-

3 '(SEQ ID NO. 2), 5 '-ATATTTACGTGCTGCT-3 '(SEQ ID NO. 3), and 5 '- AT ATTTCTGTGCTGCT-3 ' (SEQ ID NO. 4). The oligonucleotide may include nine locked nucleotides and seven non- locked nucleotides. The pattern of locked nucleotides may be such that at least positions 1 , 5, 8, 10, and 16 are locked nucleotides.

In another exemplar}' embodiment, the oligonucleotide is about 12 nucleotides in length. The oligonucleotide may comprise or consist essentially of a nucleotide sequence selected from 5 '- TTATGTGCTGCT-3 '(SEQ ID NO. 5), 5 '-TTACGTGCTGCT-3 '(SEQ ID NO. 6), 5 '-TTCTGTGCTGCT-3 '(SEQ ID NO. 7), 5 '-TTCCGTGCTGCT-3 '(SEQ ID NO. 8), 5 ' -TG ATGTGCTG CT-3 ' (SEQ ID NO. 9), 5 '-TGACGTGCTGCT-3 '(SEQ ID NO. 10), 5 '-TGCTGTGCTGCT-3 '(SEQ ID NO. 1 1), and 5 '-TGCCGTGCTGCT-3 '(SEQ ID NO. 12). The oligonucleotide may include eight locked nucleotides and four non- locked nucleotides. The pattern of locked nucleotides may be such that at least positions 1 , 4, 9, and 12 are locked nucleotides.

In yet another exemplar}' embodiment, the oligonucleotide is about 8 nucleotides in length . The oligonucleotide may consist essentially of, or consists of the nucleotide sequence 5 '- GTGCTGCT-3 ', where all or substantially all (e.g., at least about 6 or at least about 7) are locked nucleotides.

In various embodiments, the region complementary to the seed region of the one or more mill- 15 family members comprises at least about four locked nucleotides, in another embodiment, the oligonucleotide does not contain a stretch of nucleotides with more than three contiguous non-locked nucleotides and/or more than three contiguous locked nucleotides.

With respect to non-locked nucleotides, the nucleotide may contain a 2' modification with respect to a 2' hydroxy!. In some embodiments, the 2' modification may be independently selected from deoxy, O-alkyl, O-methyl, halo, and fluoro. For example, the 2' modification may be deoxy. In an embodiment, all the non-locked nucleotides in the oligonucleotide are 2' deoxy. The oligonucleotide may also contain one or more phosphorothioate linkages. For example, the oligonucleotide may be fully phosphorothioate-linked or may contain about half or ¾ phosphorothioate linkages.

Exemplary oligonucleotide inhibitors are shown in Table 1. In other embodiments, the oligonucleotide may contain a 5' and or a 3' cap structure. In yet another embodiment, the oligonucleotide may further include a pendent lipophilic group.

In another aspect, the invention provides pharmaceutical compositions and formulations comprising the oligonucleotides of the invention, which may involve incorporation of the oligonucleotide within a variety of macromolecular assemblies, micelle, or liposome compositions for cellular delivery. In certain embodiments, the oligonucleotides are formulated for conventional intravenous, subcutaneous, or intramuscular dosing. Such formulations may be conventional aqueous preparations, such as formulation in saline. In certain embodiments, the compositions are suitable or formulated for intradermal, subcutaneous, intramuscular, intraperitoneal or intravenous injection, or by direct injection into target tissue (e.g., cardiac tissue).

In still other aspects, the invention provides a method for delivering the oligonucleotide and the pharmaceutical composition to mammalian cells either in vitro or ex vivo, e.g., for treating, ameliorating, or preventing the progression of a condition in a mammalian subject. The method may comprise administering the oligonucleotide or composition comprising the same to a population of target cells or a mammalian subject at a dose effective for target de-repression of Piml . The subject may have a condition associated with, mediated by, or resulting from, the expression of one or more miR-15 family members. Such conditions include, for example, cardiac hypertrophy, myocardial infarction, heart failure (e.g., congestive heart failure), ischemia, ischemia reperfusion injury, vascular damage, restenosis, pathologic cardiac fibrosis, or conditions associated with cardiac transplantation. Thus, the invention provides a use of the modified oligonucleotides and compositions for treating such conditions, and for the preparation of medicaments for such treatments. Other aspects and embodiments of the invention will be apparent from the following detailed description of the invention.

DESCRIPTION OF THE FIGURES

Figure 1. Abundance of miR-15 family members in cardiocytes. MicroRNA copy numbers per cell are measured by real-time PGR analysis and normalized to a commercially available standard (Ambion).

Figure 2. miR-15 targets in cardiac tissue. Real-time PGR analysis demonstrates that subcutaneous delivery of 25 mg/kg of anti-miR.15b (M-10134) induces robust changes in the expression of Bcl2L2, Birc5, Grn, and Cdc2A in mice. Figure 3. Anti-miR15b (M-10134) treatment affects target gene expression in a dose- dependent manner. Real-time PCR. analysis demonstrates a dose-dependent de-repression of miR-15 targets, particularly, Birc5, Grn, and Cdc2A in mice. M-10591 is a non- targeting control oligonucleotide.

Figure 4. Efficacy of miR-15 inhibitors against miR-15 targets measured by real-time PCR analysis, inhibitors M-10670, M-1121 1 , M-11213, M-11214, M-1 1215, M-1 1220, M- 11221, and M- 11222 appear to exert the strongest effect on miR-15 target genes in mice. Error bars depict SEM. Groups where p-value <0.001 are indicated with an asterisk.

Figure 5. The TaqMan* MicroRNA Assay (Applied Biosystems) for quantifying inhibitor activity in vitro using real-time PCR. analysis.

Figure 6. Figure 6A shows miR-15 inhibitor efficacy measured by two-step real-time PCR analysis for mi.R-15a, miR-15b, mi.R-16, and miR-195. Figure 6B is a chart summarizing the efficacy of each miR-15 inhibitor.

Figure 7. The psiCHEC ™-2 construct (Promega) for quantifying inhibitor activity in vitro using the dual luciferase assay. Figure 8. Figure 8A shows miR-15 inhibitor efficacy measured by dual luciferase assay for miR-15a, miR~15b, miR-16, and miR-195. Figure 8B is a chart, summarizing the efficacy of each miR-15 inhibitor.

Figure 9. Efficacy of a panel of miR- 15 inhibitors on target gene de-repression. Figure 9A shows that a therapeutic regimen of three doses (25 mg/kg per dose) of miR-15 inhibitors induces target gene de-repression in mice. Statistically significant groups with the indicated p values are indicated with an asterisk. Figure 9B shows that a therapeutic regimen of three doses (25 mg kg per dose) of miR-15 inhibitors is more potent than a single dose regimen (25 mg/kg per dose). Figure 10. Kinetics of target gene de-repression by miR-15 inhibitors. Figure 10 shows that delivery of a single dose (25 mg/kg) of M- 1 .121.5 induces potent, silencing of miR-15 targets in mice as early as 24 hours post injection.

Figure 11. Global and specific target, gene de-repression by miR-15 inhibitors. Figure 11 shows that M- 11214 elicits target gene de-repression that is specific to the miR-15 family (p-value: 0.01). The p-value for enrichment was calculated using a hypergeometric distribution function.

Figure 12. Efficacy of a panel of miR-15 inhibitors on target gene de-repression in rats. Figure 12A. shows subcutaneous injection of a single dose of miR-15 inhibitors (25 mg/kg) induces target gene de-repression four days after treatment. In rats, the 16-mer inhibitors appear to be more potent than the 12-mer inhibitors. Figure 12B compares target gene de-repression by miR-15 inhibitors in rats versus in mice at day two after treatment. The data for the graphs on the left were generated in rats, and the data for the graphs on the right were generated in mice. In general, miR-15 inhibitors appear to have a more potent effect in rats than in mice, with the exception of 12-mer inhibitors, which do not appear to be efficacious in rats.

Figure 13. Efficacy of miR-15 inhibitors on target gene de-repression in a rat stress model. Figure 13 shows that a single dose of miR-15 inhibitors (25 mg/kg) induces target gene de -repression in a rat model of ischemia-reperfusion injur}' (n = 4; p-value < 0.05 v. baseline). The p-value was calculated using A OVA Newman-Keuls post test. Baseline represents non-infarcted controls. IR/Saline represents saline treated controls. M-10591 is a non-targeting control oligonucleotide.

Figure 14. Efficacy of miR- 15 inhibitors on the expression of inflammatory markers in a rat stress model. Figure 14 shows the effect of a single dose of miR- 15 inhibitors (25 mg kg) on the expression of various inflammatory markers in a rat model of ischemia- reperfusion injury (n = 4). Baseline represents non-infarcted controls. IR/Saline represents saline treated controls. M-10591 is a non-targeting control oligonucleotide.

Figure 15. Efficacy of miR- 15 inhibitors on myocardial infarction in a rat stress model. Figures 15A and 15B show the effects of miR- 15 inhibitors on the area of risk and the size of myocardial infarction in a rat model of ischemia-reperfusion injury, respectively (n = 10). Saline represents saline treated controls. M-10591 is a non- targeting control oligonucleotide.

Figure 16. Efficacy of miR- 15 inhibitors (M-1 121 1 and M-1 1214) on ejection fraction in a rat stress model. Figure 16 shows the effects of miR- 15 inhibitors on the ejection fraction in a rat model of ischemia-reperfusion injury. AMC represents age matched controls without injury. IR/Saline represents saline treated controls.

DETAILED DESCRIPTION OF THE INVENTION

The invention provides chemically modified oligonucleotides capable of inhibiting the expression (e.g., abundance) of miR- 15 family miR As, including miR- 15a, miR- 15b, miR- 16, miR-195, miR-424, and miR-497. The invention provides in some embodiments, oligonucleotides capable of inhibiting, in a specific fashion, the expression or abundance of each of miR-1 a, miR- 15b, mi R- 1 6, miR-195, miR-424, and miR-497. The invention further provides pharmaceutical compositions comprising the oligonucleotides, and methods of treating patients having conditions or disorders relating to or involving a miR- 15 family miRNA, such as a various cardiovascular conditions, in various embodiments, the oligonucleotides provide advantages in one or more of potency, efficiency of delivery, target specificity, toxicity, and/or stability. in one aspect, the invention provides an oligonucleotide capable of reducing the expression or abundance of miR-15 family miRNAs. The activity of the oligonucleotides may be determined in vitro and/or in vivo. For example, when inhibition of miR-15 a, miR-! 5b, miR-16, miR-195, miR-424, and miR-497 activity is determined in vitro, the activity may be determined using a two-step real-time PGR assay or a dual luciferase assay as described herein. The oligonucleotide significantly inhibits such activity, as determmed, for example, in the dual luciferase assay, at a concentration of about 75 nM or less, or in other embodiments, about 50 nM or less, about 40 nM or less, about 20 nM or less, or about 10 nM or less. For example, the oligonucleotide may have an IC50 for inhibition of miR-15 a, miR-15b, miR-16, miR-195, miR-424, and miR-497 activity of about 50 nM or less, about 40 n\1 or less, about 30 nM or less, or about 20 nM or less, as determined in the dual luciferase assay.

The two-step PCR analysis, as exemplified by the commercially available TaqMaii* MicroRNA Assay (Applied Biosystems), involves a quantitative PCR readout which can be inhibited at two steps by an oligonucleotide inhibitor: 1 ) by inhibiting the ability of the reverse transcriptase primer to elongate during cDNA synthesis; and 2) by inhibiting the ability of the PCR primer to amplify the cDNA product.

The dual luciferase assay, as exemplified by the commercially available product PsiCHEC ™ (Promega), involves placement of the miR recognition site in the 3' UTR of a gene for a detectable protein {e.g., renilla luciferase). The construct is co-expressed with the target miRNA, such that inhibitor activity can be determined by change in signal. A second gene encoding a detectable protein {e.g., firefly luciferase) can be included on the same plasmid, and the ratio of signals determined as an indication of anti-rm^'R activity .

Alternatively, or in addition, the activity of the oligonucleotide may be determined in a suitable mouse or rat model, such as those described herein, where inhibition {e.g., by at least about 50%) of a miR-15 family miRNA. is observed at an oligonucleotide dose of about 50 mg kg or less, about 25 mg/kg or less, such as about 10 mg/kg or less or about 5 mg/kg or less. In some embodiments, the activity of the oligonucleotides is determined in an animal model described in WO 2008/016924, which descriptions are hereby incorporated by reference. For example, the oligonucleotide may exhibit at least about 50% target miRNA inhibition or target de-repression at a dose of about 50 mg/kg or less, about 25 mg/kg or less, such as about 10 mg kg or less or about 5 mg/kg or less. In such embodiments, the oligonucleotide may be dosed intravenously or subcutaneously to mice or to rat, and the oligonucleotide may be formulated in saline.

In these or other embodiments, the oligonucleotides of the invention are stable after administration, being detectable in the circulation and/or target organ for at least about three weeks, at least about four weeks, at least about five weeks, or at least about six weeks, or more, following administration. Thus, the oligonucleotides of the invention have the potential to provide for less frequent admin stration, lower doses, and/or longer duration of therapeutic effect. The oligonucleotide comprises the nucleotide sequence 5 '-GTGCTGCT-3 ' and is substantially complementary to a nucleotide sequence of human miR-15a, mi.R-15b, miR- 16, miR-195, miR-424, and miR-497. The oligonucleotide further contains at least one locked nucleotide(s). For example, the oligonucleotide may contain at least eight or at least nine locked nucleotides. Generally, the length of the oligonucleotide and number and position of locked nucleotides is such that the oligonucleotide reduces the activity of miR- 15a, miR-15b, miR-16, miR-195, miR-424, and miR-497 at an oligonucleotide concentration of about 50 nM or less in the in vitro luciferase assay, or at a dose of about 50 mg/kg or less, or about 25 mg/kg or less in a suitable mouse or rat model, each as described herein. A substantially complementary oiigonucleotide may have from about 1 to about 5 mismatches (e.g., 1 or about 2 or about 3 or about 4 or about 5 mismatches) with respect to its target sequence of miR-15a, miR-15b, miR-16, miR-195, miR-424, and miR-497.

The structure and processing of miR-15 family members including miR-15a, miR- 15b, miR-16, miR-195, miR-424, and miR-497, as well as their potential for treating cardiac hypertrophy, heart failure, or myocardial infarction (among other conditions), are described in WO 2009/062169, which is hereby incorporated by reference. The pre- miR A sequences for human miR- 15 family members (e.g. stem loop sequences), which may be used for designing inhibitory miRNAs in accordance with the invention, are listed below: Human pre-miR- 15a CCUUGGAGUA AAGUAGCAGC ACAUAAUGGU UUGUGGAUUU UGAAAAGGUG

CAGGCCAUAU UGUGCUGCCU C AA AA AU AC A. AGG (SEQ ID NO. 13)

Human pre-miR-15b

UUGAGGCCUU AAAGUACUGU AGCAGCACAU CAUGGUUUAC AUGCUACAGU

CAAGAUGCGA. AUCAUUAUUU GCUGCUCUAG AAAUUUAAGG AAAUUCAU (SEQ ID 14)

Human pre-miR- 16-1

GUCAGCAGUG CCUUAGCAGC AC GUAAAUAU UGGCGUUAAG AUUCUAAAAU UAUCUCCAGU AUUAACUGUG CUGCUGAAGU AAGGUUGAC (SEQ ID NO. 15)

Human pre-miR-16-2 GUUCCACUCU AGCAGCACGU AAAIJAUUGGC GUAGIJGAAAU AUAUAUUAAA CACCAAUAUU ACUGUGCUGC UUUAGUGUGA C (SEQ ID NO. 16)

Human pre-miR-195

AGCUUCCCUG GCUCUAGCAG CACAGAAAUA UUGGCACAGG GAAGCGAGUC UGCCAAUAUU GGCUGUGCUG CUCCAGGCAG GGUGGUG (SEQ ID NO. 17) Human pre-miR-424

CGAGGGGAUA CAGCAGCAAU UCAUGUUUUG AAGUGUUCUA AAUGGUUCAA AC GU G AG G C GCUGCUAUAC CCCCUCGUGG GGAAGGUAGA AGGUGGGG (SEQ ID

NO. 18)

Human pre~miR~497

CCACCCCGGU CCUGCUCCCG CCCCAGCAGC ACACUGUGGU UUGUACGGCA CUGUGGCCAC GUCCAAACCA CACUGUGGUG UU A AG C G AG GGUGGGGGAG GCACCGCCGA GG (SEQ ID NO. 19)

Each of the pre-miRNA sequences for each miR-15 family member is processed into a mature sequence and a star sequence. The star sequence is processed from the other strand of the stem loop stnicture. The mature and star sequences for each of the miR-15 family members are given below: Human mature miR~15a

UAGCAGC A.CAUAAUGGUUUGUG (SEQ ID NO, 20) Human miR- 15a*

CAGGCCAUAUUGUGCUGCCUCA (SEQ ID NO. 21)

Human mature miR- 15b

UAGCAGCACAUCAUGGUUUACA (SEQ ID NO. 22)

Human miR- 15b*

CGAAUCAUUAUUUGCUGCUCUA (SEQ ID NO. 23)

Human mature miR - 16-1 /mi - 16-2

UAGCAGCACGIJAAAUAUUGGCG (SEQ ID NO. 24)

Human miR- 16-1 *

CCAGUAUUAACUGUGCUGCUGA (SEQ ID NO. 25) Human miR- 16-2*

CCAAUAUUACUGUGCUGCUUUA (SEQ ID NO. 26)

Human mature miR- 195

U AG C A G C AC AG A A All AU U G G C (SEQ I D NO. 27)

Human miR- 195 *

CCAAUAUUGGCUGUGCUGCUCC (SEQ ID NO. 28)

Human mature miR-424

CAGCAGCAAUUCAUGUUUUGAA (SEQ ID NO. 29)

Human miR-424* CAAAACGUGAGGCGCUGCUAU (SEQ ID NO. 30)

Human mature miR-497

CAGCAGCACACUGUGGUUUGU (SEQ ID NO. 31)

Human miR-497*

CAAACCACACUGUGGUGUUAGA (SEQ ID NO. 32)

Although the seed region (e.g. bases spanning 2 to 8 nucleotides of mature miRNA sequence) for all family members is highly conserved (AGCAGCAC), the 3 ' end of the mature miRNA differs among the different family members.

It is contemplated that multiple members of the miR- 15 family may be inhibited simultaneously by administering a single miR-15 inhibitor or by administering multiple inhibitors. For example, each inhibitor may target a single miR-15 family member or may target multiple miR-15 family members. In some embodiments, a single miR-15 inhibitor inhibits the expression or activity of two or more miR-15 family members. Such inhibitors include, but are not limited to, M- 10670, M- 1 121 1 , M-1 1213, M- 1 1214, M- 1 1215, V!- l 1 . ?..?.{⁾. M-1 1221 , and M-10222. In other embodiments, a single miR-15 inhibitor inhibits the expression or activity of three or more miR-15 family members. Such inhibitors include, but are not limited to, M- 10670, M-1 121 1 , M-1 1213, M-1 1214, M-1 1215, M-1 1220, M-1 1221 , and M- 10222. In further embodiments, a single miR-15 inhibitor inhibits the expression or activity of four or more miR-15 family members. Such inhibitors may include, but are not limited to, M-1 121 1 , M-1 1213, M-1 1214, M-1 1215, M-1 1220, and M-1 1221. The oligonucleotide contains one or more locked nucleic acid (LNAs) residues, or

"locked nucleotides". LNAs are described, for example, in US Patent 6,268,490, US Patent No. 6,316, 198, US Patent No. 6,403,566, US Patent No. 6,770,748, US Patent No. 6,998,484, US Patent No. 6,670,461 , and US Patent No. 7,034, 133, ail of which are hereby incorporated by reference in their entireties. LNAs are modified nucleotides or ribonucleotides that contain an extra bridge between the 2' and 4' carbons of the ribose sugar moiety resulting in a "locked" conformation, and/or bicyclic structure. In one embodiment, the oligonucleotide contains one or more LNAs having the structure shown by structure A below. Alternatively or in addition, the oligonucleotide may contain one or more LNAs having the structure shown by structure B below. Alternatively or in addition, the oligonucleotide contains one or more LNAs having the structure shown by structure C below.

C

Other suitable locked nucleotides that can be incorporated in the oligonucleotides of the invention include those described in US Patent No. 6,403,566 and US Patent No. 6,833,36! , both of which are hereby incorporated by reference in their entireties.

In exemplary embodiments, the locked nucleotides have a 2' to 4' methylene bridge, as shown in structure A, for example. In stil l other embodiments, the locked nucleotides have a bridge comprising an ethylene group, which may or may not contain an ether linkage at the 2" position.

The oligonucleotide may comprise, consist essentially of, or consist of, a full length or truncated antisense sequence of a miR-15 family member. As used herein, the term "full length" in reference to a miRNA sequence refers to the length of the mature miRNA antisense counterpart. Thus, the inhibitors described herein may be truncated or full-length, antisense, mature miRNA sequences, or may comprise these sequences in combination with other polynucleotide sequences. In certain embodiments, the chemical modification motif described herein renders full length antisense miRNA (mature) sequences unnecessary. In these embodiments, the oligonucleotide is from about 8 to about 20 nucleotides in length, or is from about 8 to about 18 nucleotides in length, or is from about 12 to about 17 nucleotides in length. The oligonucleotide in some embodiments is about 8, about 9, about 10, about 1 1 , about 12, about 13, about 14, about 15, about 16 nucleotides in length. The truncated oligonucleotide may have a sequence that targets, by antisense inhibition, a miR-15a sequence within 5'- UAGCAGCACAUAAUGGU-3 ' (SEQ ID NO. 33), a miR-15b sequence within 5 '- UAGCAGCACAUCAUGGU-3 ' (SEQ ID NO. 34), a miR- 16 sequence within 5 '- UAGCAGCACGUAAAUAU-3 ' (SEQ ID NO. 35), a miR-195 sequence within UAGC AGCAC AGAAAUAU-3 ' (SEQ ID NO. 36), a miR-424 sequence within 5'- CAGCAGCAAUUCAUGUU-3 ' (SEQ ID NO. 37), or a miR-497 sequence within 5'- CAGCAGCACACUGUGGU-3 ' (SEQ ID NO. 38). The oligonucleotide generally has a nucleotide sequence designed to target mature miR-I5a, miR-15b, miR-16, miR-195, miR-424, and miR-497. The oligonucleotide may, in these or other embodiments, also or alternatively be designed to target the pre- or pri- miRNA forms. In certain embodiments, the oligonucleotide may be designed to have a sequence containing from about 1 to about 5 (e.g., about 1 , about 2, about 3, or about 4) mismatches relative to the fully complementary (mature) miR- 15 sequence. In certain embodiments, such antisense sequences may be incorporated into shRNAs or other R A structures containing stem and loop portions, for example.

In an exemplar}' embodiment, the oligonucleotide is about 16 nucleotides in length. The oligonucleotide may comprise or consist essentially of a nucleotide sequence selected from 5 ' - ACCATT ATGTGCTGCT-3 ' (SEQ ID NO. 1), 5 ' - ACC ATGATGTGCTGCT-3 ' (SEQ ID NO. 2), 5 '-ATATTTACGTGCTGCT-3 ' (SEQ ID NO. 3), and 5 '- ATATTTCTGTGCTGCT-3 ' (SEQ ID NO. 4). The oligonucleotide may include a mix of locked and non-locked nucleotides. For example, the oligonucleotide may include nine locked nucleotides and seven non-locked nucleotides. The pattern of locked nucleotides may be such that at least positions 1 , 5, 8, 10, and 16 are locked nucleotides. in another exemplary embodiment, the oligonucleotide is about 12 nucleotides in length. The oligonucleotide may comprise or consist essentially of a nucleotide sequence selected from 5'- TT ATGTGCTGCT-3 ' (SEQ ID NO. 5), 5 ' -TT ACGTGCTGCT-3 ' (SEQ ID NO. 6), 5 ' -TTCTGTGCTGCT-3 ' (SEQ ID NO. 7), 5'-TTCCGTGCTGCT-3' (SEQ ID NO. 8), 5 '-TG ATGTGCTGCT-3 ' (SEQ ID NO. 9), 5 '-TGACGTGCTGCT-3 ' (SEQ ID NO. 10), 5 '-TGCTGTGCTGCT-3 ' (SEQ ID NO. 11), and 5'-TGCCGTGCTGCT-3' (SEQ ID NO. 12). The oligonucleotide may include a mix of locked and non-locked nucleotides. For example, the oligonucleotide may include eight locked nucleotides and four non-locked nucleotides. The pattern of locked nucleotides may be such that at least positions 1, 4, 9, and 12 are locked nucleotides. in yet another exemplary embodiment, the oligonucleotide is about 8 nucleotides in length. The oligonucleotide may consist essentially of, or consists of the nucleotide sequence 5'- GTGCTGCT-3', where all or substantially all (e.g., at least about 6 or at least about 7) are locked nucleotides. The oligonucleotide generally contains at least about 8 locked nucleotides, but in various embodiments is not fully comprised of locked nucleotides. Generally, the number and position of locked nucleotides is such that the oligonucleotide reduces the activity of miR~15a, miR-15b, miR-16, miR-195, miR-424, and miR-497 as determined in vitro or in vivo as described. In certain embodiments, the oligonucleotide does not contain a stretch of nucleotides with more than about four, or more than about three, contiguous non-locked nucleotides, in these or other embodiments, the region complementary to the miR-15a, miR-15b, miR-16, miR-195, miR-424, and miR-497 seed region comprises at least three or at least four locked nucleotides.

For non-locked nucleotides, the nucleotide may contain a 2^" modification with respect to a 2' hydroxy!. For example, the 2' modification may be 2' deoxy. Incorporation of 2 -modified nucleotides in antisense oligonucleotides may increase both resistance of the oligonucleotides to nucleases and their thermal stability with complementary RNA. Various modifications at the 2' positions may be independently selected from those that provide increased nuclease sensitivity, without compromising molecular interactions with the RNA target or cellular machinery. Such modifications may be selected on the basis of their increased potency in vitro or in vivo. Exemplary methods for determining increased potency (e.g., IC50) for miRNA inhibition are described herein, including the dual luciferase assay and in vivo miRNA expression or target de-repression.

In some embodiments the 2' modification may be independently selected from O- alkyl (which may be substituted), halo, and deoxy (H). Substantially all, or ail, nucleotide 2' positions of the non-locked nucleotides may be modified in certain embodiments, e.g., as independently selected from O-aikyi (e.g., O-methyl), halo (e.g., fluoro), deoxy (H), and amino. For example, the 2^" modifications may each be independently selected from O-methyl and fluoro. In exemplary embodiments, purine nucleotides each have a 2' OMe and pyrimidine nucleotides each have a 2'-F. In certain embodiments, from one to about five 2' positions, or from about one to about three 2' positions are left unmodified (e.g., as hydroxyls).

2' modifications in accordance with the invention also include small hydrocarbon substituents. The hydrocarbon substituents include alkyl, alkenyl, alkynyl, and alkoxyalkyl, where the alkyl (including the alkyl portion of aikoxy), alkenyl and alkynyl may be substituted or unsubstituted. The alkyl, alkenyl, and alkynyl may be CI to CIO alkyl, alkenyl or alkynyl, such as CI, C2, or C3. The hydrocarbon substituents may include one or two or three non-carbon atoms, which may be independently selected from N, O, and/or S. The 2' modifications may further include the alkyl, alkenyl, and alkynyl as O-alkyl, O-alkenyl, and O-alkynyl.

Exemplary modifications in accordance with the invention include 2' -O-alkyl (CI -3 alkyl, such as 2'OMe or 2'OEt), 2'-0-methoxyethyl (2'-0~MOE), 2'-0-ammopropyl (2'-0-AP), 2'-0-dimemylaminoethyl (2'-0-DMAOE), 2'-0-dime laminopropyl (2'-0- DMAP), 2'-0-dimethyiaminoethyloxyethyi (2 -O-DMAEOE), or 2'-0-N-methyiacetamido (2'-0-NMA) substitutions.

In certain embodiments, the oligonucleotide contains at least one 2 '-halo modification (e.g., in place of a hydroxy!), such as 2' -fluoro, 2'-chloro, 2'-bromo, and 2'-iodo. In some embodiments, the 2' halo modification is fluoro. The oligonucleotide may contain from 1 to about 5 2' -halo modifications (e.g., fluoro), or from 1 to about 3 2'- halo modifications (e.g., fluoro). In some embodiments, the oligonucleotide contains all 2 ^'- Hiioro nucleotides at non-locked positions, or 2'-fluoro on all non-locked pvrimidine nucleotides. In certain embodiments, the 2'~fluoro groups are independently di-, tri-, or un-methylated.

The oligonucleotide may have one or more 2'-deoxy modifications (e.g., H for 2' hydroxy 1), and in some embodiments, contains from about 2 to about 10 2'-deoxy modifications at non-iocked positions, or contains 2'deoxy at ail non-locked positions.

In exemplary embodiments, the oligonucleotide contains 2' positions modified as 2'OMe in non-locked positions. Alternatively, non-iocked purine nucleotides are modified at the 2' position as 2'OMe, with non-iocked pvrimidine nucleotides modified at the 2" position as 2'-fluoro.

In certain embodiments, the oligonucleotide further comprises at least one terminal modification or "cap". The cap may be a 5' and/or a 3 -cap structure. The terms "cap" or "end-cap" include chemical modifications at either terminus of the oligonucleotide (with respect to terminal ribonucleotides), and including modifications at the linkage between the last two nucleotides on the 5' end and the last two nucleotides on the 3' end. The cap structure as described herein may increase resistance of the oligonucleotide to exonucleases without compromising molecular interactions with the RNA. target or cellular machinery. Such modifications may be selected on the basis of their increased potency in vitro or in vivo. The cap can be present at the 5'-terminus (5'-cap) or at the 3 - terminus (3 -cap) or can be present on both ends. In certain embodiments, the 5'- and/or 3 '-cap is independently selected from phosphorothioate monophosphate, abasic residue (moiety), phosphorothioate linkage, 4'-thio nucleotide, carbocyclic nucleotide, phosphorodithioate linkage, inverted nucleotide or inverted abasic moiety (2'-3' or 3 '-3'), phosphorodithioate monophosphate, and methylphosphonate moiety. The phosphorothioate or phosphorodithioate linkage(s), when part of a cap structure, are generally positioned between the two terminal nucleotides on the 5' end and the two terminal nucleotides on the 3 ' end. in certain embodiments, the oligonucleotide has at least one terminal phosphorothioate monophosphate. The phosphorothioate monophosphate may support a higher potency by inhibiting the action of exonucleases. The phosphorothioate monophosphate may be at the 5' and/or 3' end of the oligonucleotide. A phosphorothioate monophosphate is defined by the following structures, where B is base, and R is a 2' modification as described above:

5' phosphorothioate monophosphate

3' phosphorothioate monophosphate Where the cap structure can support the chemistry of a locked nucleotide, the cap structure may incorporate a locked nucleotide as described herein,

Phosphorothioate linkages may be present in some embodiments, such as between the last two nucleotides on the 5' and the 3' end (e.g., as part of a cap structure), or as alternating with phosphodiester bonds. In these or other embodiments, the oligonucleotide may contain at least one terminal abasic residue at either or both the 5' and 3' ends. An abasic moiety does not contain a commonly recognized purine or pyrimidine nucleotide base, such as adenosine, guanine, cytosine, uracil or thymine. Thus, such abasic moieties lack a nucleotide base or have other non-nucleotide base chemical groups at the 1 ' position. For example, the abasic nucleotide may be a reverse abasic nucleotide, e.g., where a reverse abasic phosphoramidite is coupled via a 5' amidite (instead of 3' amidite) resulting in a 5 '-5' phosphate bond . The structure of a reverse abasic nucleoside for the 5' and the 3' end of a polynucl eotide is shown below.

The oligonucleotide may contain one or more phosphorothioate linkages. Phosphorothioate linkages have been used to render oligonucleotides more resistant to nuclease cleavage. For example, the polynucleotide may be partially phosphorothioate- linked, for example, phosphorothioate linkages may alternate with phophodiester linkages. In certain embodiments, however, the oligonucleotide is fully phosphorothioate-linked , In other embodiments, the oligonucleotide has from about one to about five or about one to about three phosphate linkages.

In some embodiments, the nucleotide has one or more earboxamido-modified bases as described in WO 2012/061810, which is hereby incorporated by reference, including with respect to all exemplary pyrrolidine carboxamido modifications disclosed therein with heterocyclic substituents.

In exemplary embodiments, the oligonucleotide has the structure of a compound listed in Table 1 , below. As depicted in Table 1 , a plus sign (e.g., +A) indicates a LNA base. All other bases are DNA. Each miR-I5 inhibitor has a folly phosphorothioate linked backbone. Table 1 : Exemplaiy Oligonucleotides

The synthesis of oligonucleotides, including modified polynucleotides, by solid phase synthesis is well known and is reviewed in New Chemical Methods for Synthesizing Polynucleotides. Caruthers MH, Beaucage SL, Efcavitch JW, Fisher EF, Matteucci MD, Stabinsky Y. Nucleic Acids Symp. Ser. (7):215-23, (1980).

The oligonucleotide may be incorporated within a variety of macromolecular assemblies or compositions. Such complexes for delivery may include a variety of liposomes, nanoparticles, and micelles, formulated for delivery to a patient. The complexes may include one or more fusogenic or lipophilic molecules to initiate cellular membrane penetration. Such molecules are described, for example, in US Patent No. 7,404,969 and US Patent No. 7,202,227, which are hereby incorporated by reference in their entireties. Alternatively, the oligonucleotide may further comprise a pendant lipophilic group to aid cellular delivery, such as those described in WO 2010/129672, which is hereby incorporated by reference.

The composition or formulation may employ a plurality of therapeutic oligonucleotides, including at least one described herein. For example, the composition or formulation may employ at least about 2, about 3, about 4, or about 5 miRNA inhibitors described herein.

The oligonucleotides of the invention may be formulated as a variety of pharmaceutical compositions. Pharmaceutical compositions will be prepared in a form appropriate for the intended application. Generally, this will entail preparing compositions that are essentially free of pyrogens, as well as other impurities that could be harmful to humans or animals. Exemplary delivery/formulation systems include colloidal dispersion systems, macromolecule complexes, nanocapsules, microspheres, beads, and lipid-based systems including oil-in- water emulsions, micelles, mixed micelles, and liposomes. Commercially available fat emulsions that are suitable for delivering the nucleic acids of the invention to cardiac and skeletal muscle tissues include Intralipid®, Liposyn®, Liposyn® II, Liposyn® III, Nutrilipid, and other similar lipid emulsions. A preferred colloidal system for use as a deliver}' vehicle in vivo is a liposome (i.e., an artificial membrane vesicle). The preparation and use of such systems is well known in the art. Exemplary formulations are also disclosed in US Patent No. 5,981 ,505; US Patent No. 6,217,900; US Patent No. 6,383,512; US Patent No. 5,783,565; US Patent No. 7,202,227; US Patent No. 6,379,965; US Patent No. 6,127,170; US Patent No. 5,837,533; US Patent

77 No. 6,747,014; and WO 2003/093449, which are hereby incorporated by reference in their entireties.

In some embodiments, the oligonucleotide is formulated for conventional subcutaneous or intravenous administration, for example, by formulating with appropriate aqueous diluent, including sterile water and normal saline.

The pharmaceutical compositions and formulations may employ appropriate salts and buffers to render delivery vehicles stable and allow for uptake by target cells. Aqueous compositions of the present invention comprise an effective amount of the delivery vehicle comprising the inhibitor oligonucleotide (e.g. liposomes or other complexes), dissolved or dispersed in a pharmaceutically acceptable carrier or aqueous medium. The phrases "pharmaceutically acceptable" or "pharmacologically acceptable" refers to molecular entities and compositions that do not produce adverse, allergic, or other untoward reactions when administered to an animal or a human. As used herein, "pharmaceutically acceptable carrier" may include one or more solvents, buffers, solutions, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents and the like acceptable for use in formulating pharmaceuticals, such as pharmaceuticals suitable for administration to humans. The use of such media and agents for pharmaceutically active substances is well known in the art. Supplementary active ingredients also can be incorporated into the compositions. Administration or delivery of the pharmaceutical compositions according to the present invention may be via any route so long as the target tissue is available via that route. For example, admin stration may be by intradermal, subcutaneous, intramuscular, intraperitoneal or intravenous injection, or by direct injection into target tissue (e.g., cardiac tissue). The stability and/or potency of the oligonucleotides disclosed herein allows for convenient routes of administration, including subcutaneous, intradermal, and intramuscular. Pharmaceutical compositions comprising miRNA inhibitors may also be administered by catheter systems or systems that isolate coronary circulation for delivering therapeutic agents to the heart. Various catheter systems for delivering therapeutic agents to the heart and coronary vasculature are known in the art. Some non-limiting examples of catheter-based delivery methods or coronary isolation methods suitable for use in the present invention are disclosed in U.S. Patent No. 6,416,510; U.S. Patent No. 6,716,196; U.S. Patent No. 6,953,466, WO 2005/082440, WO 2006/089340, U.S. Patent Publication No. 2007/0203445, U.S. Patent Publication No. 2006/0148742, and U.S. Patent Publication No. 2007/0060907, which are all hereby incorporated by reference in their entireties. The compositions or formulations may also be administered parenteral!}' or intraperitoneal [y. By way of il lustration, solutions of the conjugates as free base or pharmacologically acceptable salts can be prepared in water suitably mixed with a surfactant, such as hydroxypropylcellulose. Dispersions can also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof and in oils. Under ordinary conditions of storage and use, these preparations generally contain a preservative to prevent the growth of microorganisms.

The pharmaceutical forms suitable for injectable use or catheter deliveiy include, for example, sterile aqueous solutions or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. Generally, these preparations are sterile and fluid to the extent that easy injectabiiity exists. Preparations should be stable under the conditions of manufacture and storage and should be preserved against the contaminating action of microorganisms, such as bacteria and fungi. Appropriate solvents or dispersion media may contain, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyethylene glycol, and the like), suitable mixtures thereof!, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants. The prevention of the action of microorganisms can be brought about by various antibacterial or antifungal agents, for example, parabens, ciilorobutanol, phenol, sorbic acid, thimerosai, and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars or sodium chloride. Prolonged absorption of the injectable compositions can be brought about by the use in the compositions of agents delaying absorption, for example, aluminum monostearate and gelatin.

Sterile injectable solutions may be prepared by incorporating the conjugates in an appropriate amount into a solvent along with any other ingredients (for example as enumerated above) as desired. Generally, dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the desired other ingredients, e.g., as enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation include vacuum-drying and freeze-drying techniques which yield a powder of the active ingredient(s) plus any additional desired ingredient from a previously sterile-filtered solution thereof.

Upon formulation, solutions are preferably administered in a manner compatible with the dosage formulation and in such amount as is therapeutically effective. The formulations may easily be administered in a variety of dosage forms such as injectable solutions, drug release capsules and the like. For parenteral administration in an aqueous solution, for example, the solution generally is suitably buffered and the liquid diluent first rendered isotonic for example with sufficient saline or glucose. Such aqueous solutions may be used, for example, for intravenous, intramuscular, subcutaneous and intraperitoneal administration. Preferably, sterile aqueous media are employed as is known to those of skill in the art, particular!)' in light of the present disclosure. By way of illustration, a single dose may be dissolved in 1 ml of isotonic NaCl solution and either added to 1000 ml of hypodermoc lysis fluid or injected at the proposed site of infusion, (see for example, "Remington's Pharmaceutical Sciences" 15th Edition, pages 1035-1038 and 1570-1580). Some variation in dosage will necessarily occur depending on the condition of the subject being treated. The person responsible for administration will, in any event, determine the appropriate dose for the individual subject. Moreover, for human administration, preparations should meet sterility, pyrogenicity, general safety and purity standards as required by FDA Office of Biologies standards.

The invention provides a method for delivering oligonucleotides to a mammalian cell (e.g., as part of a composition or formulation described herein), and methods for treating, ameliorating, or preventing the progression of a condition in a mammalian patient. The oligonucleotide or pharmaceutical composition may be contacted in vitro or in vivo with a target cell (e.g., a mammalian cell). The cell may be a heart cell.

The method generally comprises administering the oligonucleotide or composition comprising the same to a mammalian patient or population of target cells. The oligonucleotide, as already described, is a iR A inhibitor (e.g., having a nucleotide sequence designed to inhibit expression or activity of a miR-15 family miRNA). Thus, the patient may have a condition associated with, mediated by, or resulting from, miR-15 family expression. Such conditions are described in WO 2009/062169, which is hereby incorporated by reference. These include, for example, cardiac hypertrophy, myocardial infarction, heart failure (e.g., congestive heart failure), vascular damage, ischemia, ischemia reperfusion injury, restenosis, or pathologic cardiac fibrosis as well as conditions associated with cardiac transplantation. Thus, the invention provides a use of the modified oligonucleotides and compositions of the invention for treating such conditions, and for the preparation of medicaments for such treatments. In certain embodiments, the patient (e.g. , human patient) has one or more risk factors including, for example, long standing uncontrolled hypertension, uncorrected valvular disease, chronic angina, recent myocardial infarction, congestive heart, failure, congenital predisposition to heart disease and pathological hypertrophy. Alternative!)' or in addition, the patient may have been diagnosed as having a genetic predisposition to, for example, cardiac hypertrophy, or may have a familial history of, for example, cardiac hypertrophy.

In this aspect, administration of an mhibitor of a miR-15 family member results in the improvement of one or more symptoms of, for example, cardiac hypertrophy, heart failure, ischemia, ischemia reperfusion injury, or myocardial infarction in the subject, or in the delay in the transition from cardiac hypertrophy to heart failure. The one or more improved symptoms may be, for example, increased exercise capacity, increased cardiac ejection volume, decreased left ventricular end diastolic pressure, decreased pulmonary capil lary wedge pressure, increased cardiac output, increased cardiac index, lowered pulmonary artery pressures, decreased left ventricular end systolic and diastolic dimensions, decreased left and right ventricular wail stress, decreased wall tension, increased quality of life, and decreased disease related morbidity or mortality. In addition, use of inhibitors of miR-15 family members may prevent cardiac hypertrophy and its associated symptoms from arising.

In some embodiments of the invention, an mhibitor of the miR- 15 family members may be administered in combination with other therapeutic modalities. For example, a miR-15 inhibitor of the invention may be administered in conjunction with other types of therapeutic agents such as anti-hyperlipoproteinemic agents, anti-arteriosclerotic agents, an ti-thrombotic/fibrino lytic agents, blood coagulants, anti-arrhythmic agents, antihypertensive agents, treatment agents for congestive heart failure, anti-anginal agents, anti-bacterial agents, vasodilators, hormone antagonists, iontropes, diuretics, endothelin receptor antagonists, calcium channel blockers, phosphodiesterase inhibitors, angiotensin II converting enzyme (ACE) inhibitors, cytokine blockers/ nhibitors, HDAC inhibitors or a combination thereof. The combination therapy also may involve inhibiting the expression or activity of additional miRNAs involved in cardiac remodeling such as miR- 499, miR-208, miR-208b and miR-21, which are described in WO 2012/083005 and WO2009/058818, the contents of which are hereby incorporated by reference. Further, a miR- 15 inhibitor may be administered in conjunction with surgery. A miR-! 5 inhibitor may also be administered together with non-pharmacological means of treatment. For example, with respect to cardiac disorders, non-pharmacological treatment may involve reducing sodium in the diet, In various embodiments, the pharmaceutical composition is administered by parenteral administration or by direct injection into heart tissue. The parenteral administration may be intravenous, subcutaneous, or intramuscular. In some embodiments, the composition is administered by oral, transdermal, sustained release, controlled release, delayed release, suppository, catheter, or sublingual administration. In certain embodiments, the oligonucleotide is administered at a dose of about 25 mg/kg or less, or a dose of about 10 mg/kg or less, or a dose of about 5 mg/kg or less. In these embodiments, the oligonucleotide or composition may be administered by intramuscular or subcutaneous injection, or intravenously.

In certain embodiments, the activity of miR- 15a, miR- 15b, miR- 16, miR- 195, miR-424, and miR-497 in cardiac tissue, or as determined in patient serum, is reduced or inhibited. in an embodiment, the method of the invention may comprise administering a miR- 15 family inhibitor, which may be an oligonucleotide described herein, to a population of target cells or a mammalian subject at a dose effective for target de- repression of Piml . In a further embodiment, the present invention also provides method of regulating expression of Piml and other target genes such as Bcl2L2, Birc5, Grn, and Cdc2A in a cell comprising contacting the cell with a miR- 15 inhibitor. In an embodiment, the expression of Pim! , Bcl2L2, Birc5, Grn, and Cdc2A are increased following administration of a miR- 15 inhibitor. Expression of Piml and/or other markers described herein may be monitored before, during, or after treatment to determine treatment response.

In some embodiments, the methods further comprise scavenging or clearing the miRNA inhibitors following treatment. For example, an oligonucleotide having a nucleotide sequence that is complementary to the inhibitor may be administered after therapy to attenuate or stop the function of the inhibitor. The present invention is further illustrated by the following examples that should not be construed as limiting. The contents of all references, patents, and published patent applications cited throughout this application, as well as the Figures, are incorporated herein by reference in their entirety for all purposes. EXAMPLES

Example 1 : Abundance of miR- 15 family members in cardiac tissue

The abundance of miR- 15 family members in cardiac tissue was assessed by realtime PGR analysis. Specifically, total RNA was extracted from human (n-6), porcine (n=6), and mouse (n=30) cardioeytes. MicroR A copy numbers per cell was then determined, using real-time PGR and normalized to a commercially available standard (Ambion).

The results ( Figure 1) show that miR- 16 is the most abundant of the mi.R-15 family members in cardiac tissue, with approximately 10,000 copes per cell. Other miR- 15 family members including miR-15a, miR-15b, miR-195, miR-497, miR-424, and miR- 322 are expressed at approximately 1,000 copies per cell. In addition, miR-322 appears to be only expressed in rodents while miR-424 expression appears to be restricted to larger animals (e.g., human and pigs).

Example 2: Identification of gene targets regulated by miR- 15 family members A panel of miRNA inhibitors (single stranded oligonucleotides) was synthesized targeting the miR-15 family (miR-15a, mi.R-15b, miR-16, miR-195, miR-497, miR-424, and miR-322). The sequences and modification patterns are shown in Table 1. The panel included multiple lengths of reverse complement inhibitors ranging from 8 nucleotides to 16 nucleotides. The number of LNA modifications was varied as well as the location of the LNA modifications in the oligonucleotide.

Previous studies have identified potential gene targets regulated by the miR-15 family members. To identit specific miR-15 family targets in cardiac tissue, wild-type C57BL6 mice were subcutaneously injected with either saline, or 25 mg/kg of a control oligonucleotide or an anti-miRl 5b oligonucleotide (M-10134). Three doses were given during a treatment period of three days. Cardiac tissue was harvested at 24 hours following the last injection, and target gene expression was assessed by real-time PGR.. The results (Figure 2) show that expression of Bel2L2, Birc5, Grn, and Cdc2A increases significantly following miR15b inhibition, suggesting that these genes are regulated by mi.R-15 family members in cardiac tissue.

To further verify miR-15 family targets, wild-type C57/BL6 mice were subcutaneously injected with either saline, or 2.8 mg/kg, 10 mg/kg, or 25 mg kg of a control oligonucleotide or an anti-miRl 5b oligonucleotide (M-10134). Three doses were given during a treatment period of three days. Cardiac tissue was harvested at 24 hours following the last injection, and target gene expression was assessed by real-time PCR.

The results (Figure 3) show that BircS, Cdc2A, and Grn are particularly sensitive to miR- 15b inhibition. Specifically, expression of these genes increases in response to miR-15b inhibition in a dose-dependent manner.

Example 3 : Activit of mi RN A inhibitors targeting the mill- 15 fami ly Twenty five miRNA inhibitors (as shown in Table 1 ) were tested for their ability to inhibit miR-15 family members.

A. In vivo inhibition of miR-1 family members by miRNA inhibitors

To determine the efficacy of miR15 inhibitors on miR15 target gene expression, wild-type C57/BL6 mice were subcutaneously injected with either saline, or 25 mg/kg of a control oligonucleotide or individual anti-miR15 oligonucleotides. Three doses were given during a treatment period of three days. Cardiac tissue was harvested at 24 hours following the last injection, and target gene expression was assessed by real-time PCR. As shown in Figure 4, the length of the rniRNA inhibitor as well, as LNA patterns impart distinct inhibitory activities. Particularly, inhibitors M-10670, M-1121 1 , M-1 1213, M- 11214, M-11215, M-11220, M-11221, M-11222 strongly affect the expression of miR- 15 target genes such as Birc5, Cdc2A, Grn, CcnDl, and CcnD2. These inhibitors vary from 12 nucleotides in length to 16 nucleotides in length. Of these, the 12-mer inhibitor M- 1 1211 appears to exhibit the most potent inhibitory activity, affecting the expression of four out of five miR- 15 target genes.

A two-step real-time PCR assay (Applied Biosystems) was utilized to assess the ability of rniRNA. inhibitors to inhibit individual miR- 15 family members. Specifically, the potent compounds identified previously including M-10670, M-1 1211, M-11213, M- 11214, M-11215, M-11220, M-11221, M-11222 were tested for their effects on miR- 15a, miR- 15b, miRl 6, and mi.R-195 expression. Wild-type C57/BL6 mice were

subcutaneously injected with either saline, or 25 mg/^'kg of a control oligonucleotide or anti-miR15 oligonucleotides as previously described. Three doses were given during a treatment period of three days. The results (Figures A and 6B) show that the 12-mer inhibitor M-1 1220 is the best inhibitor tested and inhibits all four miR- 15 family members including miR- 15a, miR- 15b, miR16, and miR195. The 16-mer inhibitors (i.e., M-10670, M-11211, M-11213, M-1 1214, and M-1 1215) inhibit three or more family members to varying degrees.

B. In vitro inhibition of miR- 15 family members by rniRNA inhibi tors

Activities of the rniRNA inhibitors were tested in vitro utilizing a dual-l ciferase assay. Specifically, HeLa cells were transfected with varying concentrations of a miR- 15 inhibitor as well as 25 ng/well of a reporter plasmid. In particular, the miR- 195 dual luciferase construct did not appear to be as sensitive as the other constmcts with regard to microRNA inhibition, as demonstrated by the need to transfect inhibitor concentrations in the range of 2 to 50 nM, compared to 0.31 to 8.3 iiM for the other constmcts. The results (Figures 8 A and 8B) show that the 12-mer inhibitor M-11220 is the best inhibitor tested and inhibited all four miR- 15 family members. The 16-mer inhibitors (i.e., M-10670, M- 1 1211, M-11213, M-1 1214, and M-1 1215) inhibit three or more family members to varying degrees.

Example 4: In vivo activity of miRNA inhibitors targeting the miR-15 family

A. Dosage-dependent de -repression of miR-15 targets by ml RNA inhibitors A study was performed to compare different dosage regimens of miR-15 inhibitors. Specifically, one group of mice was subcutaneously injected with inhibitors M- 10670, M-11211, M-11213, M-11214, M-11215, M-11220, M-11221, or M-11222 at a dosage of 25 mg/kg. The inhibitors were administered three times over a course of three days (3x25MPK regimen) (Figure 9A). In comparison, a second group of mice was treated with only a single dose of the miR-15 inhibitors at 25 mg/kg (lx25MPK regimen). The results (Figure 9B) show that the 3x25MPK regimen is more potent in affecting target gene expression than the 1 x25MP regimen.

B. Kinetics of target de-repression by miRNA inhibitors

A time-course study was performed to determine the kinetics of target de- repression by mi.R-15 inhibitors. Specifically, mice were subcutaneously injected with 25 mg/kg of M-11215. Only a single dose was administered. Cardiac tissue was harvested at either 24 hours, 48 hours, 72 hours, or 98 hours post injection. As shown in Figure 10, a single dose of M-11215 elicits de-repression of target genes such as Birc5 as early as 24 hours post treatment. C. Global and specific target de-repression by miRNA. inhibitors

Whole genome microarray profiling was performed to determine the specificity of target de -repression by the mi.R-15 inhibitors. Specifically, total RNA was extracted from the cardiac tissue of M-11214 treated mice and saline treated mice. The RNA was subsequently subjected to whole genome microarray profi ling. Of the genes that were upregulated when M-11214-treated cardiac total RNA was compared to saline -treated total RNA, miR-15 seed-containing genes were enriched in the upregulated gene signature (p- value: 0.01; Figure 11). This result demonstrates that M-11214 elicits target gene derepression that is specific to the miR-15 family. Example 5 : In vivo activity of miR-15 inhibitors in rats

The in vivo activities of the miR-15 inhibitors were further tested in rats. More specifically, Sprague-Dawley rats (49 to 52 days of age) were injected with 25 mg/kg of miR-15 inhibitors including M- 10670, M-l 121 1 , M- 1 1213, M-1 1214, M-l 1215, M- 1 1220, M-l 1221 , or M-l 1222. Only a single dose was administered. Cardiac tissues were harvested at day four post injection, and target gene expression was analyzed. The results show (Figure 12A) that 16-mer inhibitors appear to have a more potent effect on target gene expression in rats.

Results also suggest Piml to be a novel gene target of the miR-15 family.

Overexpression of Pirn 1 has previously been shown to result in increased proliferative activity of cardiac progenitor cel ls (CPCs). CPCs are self-renewing cel ls that produce daughter cells which supply the heart with new myocytes and vessels, thereby stimulating myocardial regeneration. The link between miR-15 and Piml suggests that inhibition of miR-15 results in the production of new cardiomyocytes, which can potential ly be beneficial for repairing cardiac damage.

Further, a comparison study was conducted to examine the efficacy of the miR-15 inhibitors in rats and in mice. Sprague-Dawley rats were treated with miR-15 inhibitors as previously described, and cardiac tissue was analyzed for miR-15 target gene expression at 48 hours post injection. As shown in Figure 12B, miR-1 inhibitors appear to have a more potent effect in rats than in mice with the exception of the 12-mer inhibitors which do not appear to be effective in rats.

Example 6: In vivo activity of miR-15 inhibitors in a rat ischemia-reperfusion injury model

A . Tar get gene de-repressio b miR- 1 mhibi tors The in vivo activities of the miR-15 inhibitors were tested in a rat ischemia- reperfusion injury model. Specifically, in the ischemia-reperfusion model, the rats were injected intravenously with a single dose (25 mg/kg) of miR-15 inhibitors including M~ 10670, M-l 121 1 , M-1 1214, or M-10591. The rats were sacrificed at 72 hours after reperfusion, and tissues were harvested and analyzed for target gene expression (as measured by real-time PGR). As shown in Figure 13, all miR-15 mhibitors induced significant de-repression of target genes including Birc5, Cdc2a, and Granulin when compared to non-infarcted controls (baseline).

B. Suppression of inflammatory markers by miR-15 inhibitors

Ischemia-reperfusion injur}' elevated the m NA expression of various

inflammatory markers including VCAM, IT GAM, and CD40 in the border zone of the myocardial infarction. The effects of the miR-15 inhibitors on inflammatory marker expression in the border zone are shown in Figure 14.

C. Reduction of myocardial infarction by miR-15 inhibitors

This study evaluates the effect of miR-15 inhibitors on myocardial infarction. Specifically, the area of risk as well as the size of myocardial infarction were analyzed at three days post ischemia-reperfusion injury. The effects of the miR-15 inhibitors on the area of risk and the size of myocardial infarction are shown in Figures 15A and 15B, respectively.

D. Improvement of ejection fraction b miR-1 inhibitors

This study evaluates the effects of miR-15 inhibitors on ejection fraction using a rat ischemia-reperfusion injury model. Specifically, the rats were injected intravenously with a single dose (25 mg/kg) of miR-1.5 inhibitors including M-l 1211 and M-l 1214 at the time of reperfusion as well as one, two, and three weeks after reperfusion (total of four injections). As shown in Figure 16, miR-15 inhibitors significantly improved the ejection fraction at four weeks following ischemia-reperfusion injury when compared to saline treated animals.

Claims

CLAIMS:

1, An oligonucleotide containing at least one locked nucleotide, wherein said oligonucleotide comprises the nucleotide sequence 5'-GTGCTGCT- 3' and is substantially complementary to a nucleotide sequence of one or more miR-15 family members, and wherein said oligonucleotide reduces or inhibits the activity of one or more miR-15 family members at an oligonucleotide concentration of about 50 nM or less in an in vitro luciferase assay, or at a dose of about 25 mg/kg or less in a rodent model.

2. The oligonucleotide of claim I, wherein said one or more miR-15 family members is selected from mi -15a, mi -15b, miR-16, miR-195, miR-424, and mi.R-497.

3. The oligonucleotide of claim 1 or 2, containing at least eight locked nucleotides.

4. The oligonucleotide of any one claims 1-3, wherein said oligonucleotide is from about 8 to about 18 nucleotides in length.

5, The oligonucleotide of claim 4, wherein said oligonucleotide is from about 12 to about 17 nucleotides in length.

6, The oligonucleotide of claim 5, wherein said oligonucleotide is about 16 nucleotides in length.

7. The oligonucleotide of claim 5 or 6, comprising a nucleotide sequence selected from 5 ' - ACC ATTATGTGCTGCT-3 ' (SEQ ID NO. 1 ), 5 ' -ACCATGATGTGCTGCT-3 ' (SEQ ID NO. 2), 5 '-AT ATTTACGTGCTGCT-3 ' (SEQ ID NO. 3), and 5'- ATATTTCTGTGCTGCT-3 ' (SEQ ID NO. 4).

8. The oligonucleotide of claim 6 or 7, containing nine locked nucleotides and/or seven non-locked nucleotides,

9. The oligonucleotide of any one of claims 6-8, wherein at least positions I , 5, 8, 10, and 16 are locked nucleotides.

10. The oligonucleotide of claim 4, wherem said oligonucleotide is about 12 nucleotides in length.

11. The oligonucleotide of claim 4 or 10, comprising a nucleotide sequence selected from 5 '- TTATGTGCTGCT-3 ' (SEQ ID NO. 5), 5 ' -TTACGTGCTGCT-3 ' (SEQ ID NO. 6), 5 '-TTCTGTGCTGCT-3 ' (SEQ ID NO. 7), 5 '-TTCCGTGCTGCT-3 ' (SEQ ID NO. 8), 5 ' -TGATGTGCTGCT-3 ' (SEQ ID NO. 9), 5 '-TGACGTGCTGCT-3 ' (SEQ ID NO. 10), 5 ' -TGCTGTGCTGCT-3 ' (SEQ ID NO. I I), and 5 '-TGCCGTGCTGCT-3 ' (SEQ ID NO. 12).

12. The oligonucleotide of claim 10 or 1 1 , containing eight locked nucleotides and/or four non-locked nucleotides.

13. The oligonucleotide of any one of claims 10-12, wherein at least positions 1, 4, 9, and 12 are locked nucleotides.

14. The oligonucleotide of claim 4, wherem said oligonucleotide is about 8 nucleotides in length.

15. The oligonucleotide of claim 14, having substantially al l locked nucleotides and a nucleotide sequence of 5 '- GTGCTGCT-3 ' .

16. The oligonucleotide of any one of claims 1 -15, wherein the region complementary to the seed region of the one or more miR-15 family members comprises at least four locked nucleotides.

17. The oligonucleotide of any one of claims 1-16, wherein said oligonucleotide does not contain a stretch of nucleotides with more than three contiguous non-locked nucleotides and/or more than three contiguous locked nucleotides.

18. The oligonucleotide of any one of claims 1-17, wherein at least one non-locked nucleotide is selected from 2' deoxy, 2'-0-methyl, 2'-0-alkyl, 2 '-halo, and 2 '-fluoro nucleotides.

19. The oligonucleotide of claim 18, wherein at least one non-locked nucleotide is 2' deoxy.

20. The oligonucleotide of claim 19, wherein all non-locked nucleotides are 2' deoxy.

21. The oligonucleotide of any one of claims 1-20, wherein the locked nucleotide has a 2' to 4' bridge comprising an ethylene or methylene group.

22. The oligonucleotide of claim 21 , wherein the locked nucleotide has a 2" to 4' methylene bridge.

23. The oligonucleotide of any one of claims 1-22, having a 5 ' and/or 3 ' cap structure.

24. The oligonucleotide of any one of claims 1-23, containing one or more phosphorothioate linkages.

25. The oligonucleotide of claim 24, wherein the oligonucleotide is fully phospborothioate-linked.

26. The oligonucleotide of claim 24, having from one to three phosphate linkages.

27. The oligonucleotide of claim 1, having the structure of compound M-10113, M- 10134, M-10564, M-10566, M-10567, VI- 10670. M-l 1206, M-l 1207, M-l 1208, M- 11209, M-l 1210, M-1121 1 , M-l 1212, M-11213, M-1 1214, M-1 1215, M-11216, .^'vi - 1 1217, M-l 1218, M-l 1219, M-l 1220, M-l 1221 , M-l 1222, M-l 1223, or M-l 1224.

28. The oligonucleotide of any one of claims 1 -27, further comprising a pendent lipophilic group.

29. A pharmaceutical composition comprising an effective amount of the oligonucleotide of any one of claims 1-28, or a pharmaceutically-acceptable salt thereof, and a pharmaceutically-acceptable carrier or diluent.

30. The pharmaceutical composition of claim 29, wherein the pharmaceutically- acceptable carrier comprises a colloidal dispersion system, macromolecular complex, nanocapsule, microsphere, bead, oil-in-water emulsion, micelle, mixed micelle, or liposome,

31. The pharmaceutical composition of claim 29, wherein the pharmaceutically- acceptable carrier or diluent consists essentially of saline.

32. A method of reducing or inhibiting the activity of one or more miR-15 family members in a cell comprising contacting said cell with the oligonucleotide of any one of claims 1 -28 or the composition of any one of claims 29-31.

33. The method of claim 32, wherem said cell is a mammalian cell.

34. The method of claim 33, wherein said cell is a heart cell.

35. The method of claim 32, wherein said cell is in vivo or ex vivo.

36. A method of preventing or treating a condition in a subject associated with or mediated by one or more miR~15 family members, comprising administering to the subject at least one miR-15 family inhibitor at a dose sufficient for target de -repression of Pirn 1.

37. The method of claim 36, wherem the miR15 family inhibitor is an oligonucleotide of any one of claims 1 -28.

38. The method of claim 36, comprising administering to the subject the pharmaceutical composition of any one of claims 29-31.

39. The method of claim 38, wherein said pharmaceutical composition is administered by parenteral administration or by direct injection into heart tissue.

40. The method of claim 39, wherein said parenteral administration is intravenous, subcutaneous, intraperitoneal, or intramuscular.

41. The method of any one of claims 38-40, wherem said composition is administered by oral, transdermal, sustained release, controlled release, delayed release, suppository, catheter, or sublingual administration.

42. The method of any one of claims 36-41, wherem the condition is a heart condition.

43. The method of claim 42, wherem the heart condition is pathologic cardia hypertrophy, myocardial infarction, heart failure, ischemia, or ischemia repertusion injury

44. The method of claim 42, wherein the heart condition is associated with cardia* transplantation.

45. The method of any one of claims 36-44, wherem said subject is human.