TECHNICAL FIELD

[0001 ] The invention is in the field of treatment of Respiratory Syncytial Virus (RSV) infection, and particularly methods, uses, and guanosine-rich oligonucleotide (GRO) compositions for treating RSV infection.

CROSS REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of U.S. Provisional Patent Application Serial No. 61/599,653 entitled "GUANOSINE-RICH OLIGONUCLEOTIDE (GRO) COMPOSTIONS, METHODS AND USES FOR TREATING RESPIRATORY SYNCYTIAL VIRUS INFECTION" filed on 16 February 2012.

BACKGROUND

[0003] Human respiratory syncytial virus (RSV) is an enveloped, single-stranded, negative- polarity RNA Pneumovirus of the family Paramyxoviridae. It is a common cause of respiratory tract infections worldwide, including bronchiolitis and other serious illnesses (see, for e.g., Collins and Graham, 2008; Wu et al, 2008). Control and prevention of RSV infection is a global health priority; almost all children are infected with RSV during the first two years of life (see, for e.g., Domachowske and Rosenberg, 1999). In the United States alone, over 2 million RSV-infected infants require medical attention annually (Hall et al, 2009). Infants hospitalized for RSV are also at risk for developing recurrent wheezing and asthma (Escobar et al, 2010).

[0004] Polarized, ciliated respiratory epithelial cells are a major target for RSV infection in vivo (see, for e.g., Johnson et al, 2007). RSV infection of ciliated respiratory epithelial cells in vitro occurs on the apical (luminal) aspect (see, for e.g., Zhang et al, 2002). Viral replication in a host cell initiates with attachment of the virus to the plasma membrane via receptor-mediated binding (see, for e.g., Marsh and Helenius, 2006). Candidate RSV receptors have been proposed (see, for e.g., Krusat and Streckert, 1997; Behera et al, 2001; and, Malhotra et al, 2003). Laboratory-adapted strains of RSV show increased efficiency of infection by binding to cell surface glycosaminoglycans (GAGs); however, cells deficient in GAGs are permissive to infection (see, for e.g., Feldman et al., 2000) and the role of GAGs in cellular infection by wild-type, community isolates of RSV is unclear (see, for e.g., Hallak et al., 2007).

[0005] Options for treatment are limited, vaccination poses numerous obstacles, and passive prophylactic treatment using anti-RSV antibodies (e.g., palivizumab) is expensive, is not 100% effective, and is limited to those at high risk for severe infection (Wu et al., 2008).

[0006] The RSV envelope contains three proteins: small hydrophobic (SH), glycoprotein (G) and fusion (F) (Collins and Graham, 2008). SH protein is not required for virus binding (see, for e.g., Techaarpornkul et al., 2001). RSV G, the heterogeneity of which characterizes RSV subtypes A and B, binds to cell surface glycosaminoglycans (GAGs) at high affinity (see, for e.g., Hallak et al., 2007), but is not an absolute requirement for infection, since mutant RSV deficient in G glycoprotein (RSV AG) remains infectious (see, for e.g., Techaarpornkul et al., 2002). Moreover, cells deficient in cell surface GAGs or with chemically modified GAGs are permissive to RSV, albeit at lower levels than cells expressing abundant GAGs (see, for e.g., Techaarpornkul et al., 2002; and Hallak et al., 2000).

[0007] Nucleolin is a ubiquitous nucleolar phosphoprotein involved in fundamental aspects of transcription regulation, cell proliferation and growth (see, for e.g., Tuteja et al., 1998; and Chen et al., 2008). Nucleolin has also been described as a shuttling molecule between nucleus, cytosol and the cell surface. Studies have demonstrated that surface nucleolin may serve as a receptor for various extracellular ligands, for instance those implicated in cell proliferation, differentiation, adhesion, mitogenesis and angiogenesis. Nisole et al. (1999), US20040002457A1, and US20020076693A1 disclose that nucleolin is involved in binding of HIV virus to host cells. Nucleolin peptide, nucleotide antibodies, and nucleolin RNAi have all been shown used for inhibiting RSV infection (WO/2011/123945). SUMMARY

[0008] The present invention is based in part on the discovery that nucleolin plays a role in RSV infection, and that the administration of guanosine-rich oligonucleotide (GRO) AS 1411 - 5'-GGTGGTGGTGG TTGTGGTGGTGGTGG-3 ' (SEQ ID No: 1) (also known as GR026B and AGRO100) to a cell may be useful in the treatment of RSV infection. Such a treatment may cause interference with the interaction between RSV protein F and a cells endogenous nucleolin.

[0009] In a first aspect, a method is provided for of treating Respiratory Syncytial Virus (RSV) infection in a cell, the method including administering AS 1411 to the cell.

[0010] In a further aspect, there is provided a use of AS 1411 having a sequence of SEQ ID NO: 1 for the treatment of RSV infection.

[001 1 ] In a further aspect, there is provided a use of AS 1411 having a sequence of SEQ ID NO: 1 in the preparation of a medicament for the treatment of RSV infection.

[0012] In a further aspect, AS 1411 is provided for of treating Respiratory Syncytial Virus (RSV) infection in a cell.

[0013] In a further aspect, there is provided a commercial package, comprising: (a)

AS 1411 ; and (b) instruction for use in the treatment of RSV.

[0014] The cell may be a human cell. The human cell may be an epithelial cell. The human cell may be a mucosal cell. The human cell may be a cell of the respiratory tract. The human cell may be a ciliated respiratory epithelial cell. The cell may be in a subject having or at risk of developing an RSV infection. The AS 1411 molecule may be administered intravenously. The AS 1411 molecule may be topically administered to a mucosal membrane of the subject. The AS 1411 molecules may be mixed with lipid particles prior to administration. The AS 1411 molecules may be encapsulated in liposomes prior to administration. The AS 1411 molecule may also be administered via nasal spray or intramuscularly or intravenously.

[0015] The treatment may be of a human subject. The treatment may be of a bovine subject. The treatment may be of an ovine subject. The treatment may be of an equine subject. The treatment may be of a porcine subject. The treatment may be of a murine subject.

[0016] The RSV may be a human strain of RSV. The RSV may be a bovine strain of RSV. The RSV may be an ovine strain of RSV. The RSV may be an equine strain of RSV. The RSV may be a porcine strain of RSV.

BRIEF DESCRIPTION OF THE DRAWINGS

[0017] FIGURE la shows a graph of fluorescence signal over a wide dosing range of AS 1411 and CRO (control) in RSV-infected HEp-2 cells, where the cells were pre-treated with oligo (prophylactic experiment) 24 hrs before exposure to RSV (MOI = 1.0).

[0018] FIGURE lb shows a graph of fluorescence signal over a wide dosing range of AS 1411 and CRO (control) in RSV-infected HEp-2 cells, where the cells were exposed to RSV 24 hrs (MOI = 0.1) before adding the oligo (therapeutic experiment).

[0019] FIGURE 2 shows representative fluorescence micrographs of HEp-2 cells from a therapeutic experiment treated with 17.5 μΜ AS 1411 (panel A) and 17.5 μΜ CRO control (panel B), wherein the reduction in fluorescence signal is due to reduction in the overall number of infected cells (rather than a decreased amount of infection per cell).

[0020] FIGURE 3 shows a graph of the effect of increasing concentrations of AS 1411 (left column) or CRO (right column) after RSV infection of MDCK cells (n=6; two-tailed paired t test), where the cells were exposed to RSV (MOI = 0.1) 24 hrs prior to treating with AS 1411/CRO and 17.5 μΜ and 70 μΜ of AS 1411 was sufficient to get a 87% and 97% decrease in RSV fluorescence respectively, 24 hrs after addition to virus-infected MDCK cell cultures (P < 0.0001).

[0021 ] FIGURE 4 shows the effect of increasing concentrations of AS 1411 or CRO after RSV infection of MDCK cells in a therapeutic experiment, where MDCK cells were exposed to RSV (MOI = 0.1) 24 hrs prior to treating with AS 1411/CRO, and where an MTS assay was performed 24 hrs after treating with the oligos to assess cellular toxicity.

[0022] FIGURE 5 shows fluorescence micrographs of representative cell culture wells from a therapeutic experiment with MDCK treated with 17.5 μΜ AS 1411 (panel A) and 17.5 μΜ CRO control (panel B), wherein with the AS 1411 treatment, the reduction in fluorescence signal is due to reduction in the overall number of infected cells.

[0023] FIGURE 6 shows a plot of RSV lung titers following AS 1411 and a control oligo (CRO) delivery intranasally (at either 30 or 50 mg/kg and either 1 or 3 times per day) to mice who had received 5 x 10 ⁶ PFU RSV on day 0 and either AS 1411 or CRO starting day 1, when the mice were euthanized on day 4 RSV lung titres were determined.

[0024] FIGURE 7 shows a plot of lung weight for the same groups shown in FIGURE 6, where the AS 1411 groups had heavier and visibly redder lungs and no overt histopathology.

[0025] FIGURE 8 shows a graph of % initial body weight for the same groups shown in FIGURE 6, where the where the AS 1411 is associated with less recovery of weight loss.

[0026] FIGURE 9 shows a graph of RSV PFUs/g in lung tissue following treatment with clinical grade AS 1411 delivered intranasally (single doses at 20mg/kg and 50 mg/kg as compared to RSV alone). [0027] FIGURE 10 shows a graph of % initial body weight for the same groups shown in FIGURE 9, where the where the AS 1411 is associated with less recovery of weight loss especially at 50mg/kg.

FIGURE 11 shows a plot of RSV PFU/g in lung tissue following treatment with clinical grade AS 1411 delivered by intraperitoneal injection (IP).

DETAILED DESCRIPTION

[0028] Any terms not directly defined herein shall be understood to have the meanings commonly associated with them as understood within the present field of art. Certain terms are discussed below, or elsewhere in the specification, to provide additional guidance to the practitioner in describing the compositions, devices, methods and the like of embodiments, and how to make or use them. It will be appreciated that the same thing may be said in more than one way. Consequently, alternative language and synonyms may be used for any one or more of the terms discussed herein. No significance is to be placed upon whether or not a term is elaborated or discussed herein. Some synonyms or substitutable methods, materials and the like are provided. Recital of one or a few synonyms or equivalents does not exclude use of other synonyms or equivalents, unless it is explicitly stated. Use of examples in the specification, including examples of terms, is for illustrative purposes only and does not limit the scope and meaning of the embodiments described herein.

[0029] A method is provided for "treating" Respiratory Syncytial Virus (RSV) infection in a cell, wherein treating is meant to encompass preventing RSV infection, ameliorating RSV infection, and eradicating RSV infection. The term "treating" as used herein is also meant to include the prophylactic administration of a compound prior to infection of RSV or in anticipation of RSV infection, the administration of a compound when there is an ongoing infection with RSV, or if the RSV is in a latent state. Those skilled in the art would appreciate that the term "preventing" would include the avoidance of infection with RSV or minimizing RSV infection once an exposure to RSV occurs. A person of skill in the art would appreciate that the term "ameliorating" is meant to include the prospect of making an infection more tolerable for a subject afflicted with an RSV infection (for example, by reducing viral load in a subject). A person of skill in the art would also appreciate that the term "eradication" with regards to RSV infection would include elimination of the RSV from a subject or removal of the infection (for example by the treatment itself or in conjunction with another treatment(s) and/or the subjects immune response). Accordingly, as used herein "treatment" may refer to the prevention of an RSV infection, the amelioration of an RSV infection, the eradication of RSV from a subject, or combinations thereof. Furthermore, a "treatment" may be prophylactic, whereby the treatment is administered prior to infection or the appearance of symptoms in a subject or in anticipation of an exposure to RSV. Similarly, "treatment" may be administered following RSV infection or the onset of RSV infection symptoms.

[0030] As used herein, the term "RSV" refers to Respiratory Syncytial Virus, which is an enveloped, single-stranded, negative-polarity RNA Pneumovirus of the family Paramyxoviridae. Human RSV strains are significant causes of bronchiolitis and other serious lower respiratory tract infections worldwide, especially in children, the elderly, and in immunocompromised adults. The term RSV may include, without limitation, respiratory syncytial viruses of the Pneumovirus genus which have specificity for other host species, such as bovine respiratory syncytial virus, ovine respiratory syncytial virus and murine pneumonia virus, which is also known in the art as PVM (see, for e.g., Bern et al, 2009). As used herein, the term "infection" refers to a state in which an infectious agent, such as a virus, and including without limitation RSV, is established within a cell or within a subject, as the case may be. In certain embodiments, the compounds may be used for treating RSV infection. Such methods and compounds are described herein.

[0031 ] Human RSV strains may be classified as A or B group viruses (i.e., RSV-A and RSV-B) based on MAb binding to the RSV glycoprotein (G protein) (see, for e.g., (Anderson et al, 1985; Coates et al, 1966; Hendry et al, 1986; Mufson et al, 1985) and by genetic analysis (see, for e.g., Garcia et al, 1994; Sullender et al, 1991; Sullender et al, 1993). The RSV G protein is thought to be the most variable of the RSV proteins (see, for e.g., Garcia-Barreno et al, 1989; Johnson et al, 1987; Mufson et al, 1985), and its C-terminal region (the second hypervariable region) accounts for strain- specific epitopes (see, for e.g., Cane, 1997; Cane, 2001; Cane and and Pringle, 1995; Garcia et al, 1994; Johnson et al, 1987; Peret et al, 1998; Rueda et al, 1991). By contrast the F protein of RSV is much less variable between strains and is thus a more attractive target for a broad based RSV treatment.

[0032] Nucleolin is a ubiquitous nucleolar phosphoprotein involved in fundamental aspects of transcription regulation, cell proliferation and growth (see, for e.g., Tuteja et al, 1998; and Chen et al, 2008). Nucleolin has also been described as a shuttling molecule between nucleus, cytosol and the cell surface. Studies have demonstrated that surface nucleolin may serve as a receptor for various extracellular ligands, for instance those implicated in cell proliferation, differentiation, adhesion, mitogenesis and angiogenesis.

[0033] The term "nucleolin" refers, in part, to the polypeptide expression product of the nucleolin gene, the human orthologue corresponding to EntrezGene # 4691, GenPept Protein Accession #P19338.3. Homologous nucleolin proteins are found in other species which bear sequence similarity to human nucleolin and may thus find utility herein, including but not limited to mouse (EntrezGene # 17975; GenPept # P09405.2), Guinea Pig (EntrezGene # 100735210; GenPept # XP_003474646) and rat (EntrezGene # 25135; GenePept # P13383.3). The term "nucleolin" also refers to the nucleolin gene itself, and includes reference to the nucleolin gene as it is present in a variety of genomes including, without limitation, human, bovine, ovine, equine, porcine, and murine. The term "nucleolin" also includes gene products (e.g., mRNA, protein) produced from the underlying nucleolin gene. It will be appreciated by a person skilled in the art that the term "nucleolin peptide" qualifies the understanding of the term "nucleotide" by making specific reference to a "peptide" as it is defined herein. For example, SEQ ID NO:2 provides an amino acid sequence of human nucleolin. The term "nucleolin" also includes post-translationally modified forms of the protein.

[0034] Active GROs have been shown to bind to cell surface Nucleolin and are often referred to as "Nucleolin aptamers." Encompassed herein is the use of a guanosine-rich oligonucleotide (GRO) called AS1411 for administration to a cell. AS 1411 (as described in WO2009098464) has the sequence 5'-GGTGGTGGTGGTTGTGGTGGTGGTGG-3' (SEQ ID No: 1) and is also known as GR026B and AGRO100. AS 1411 is a 26-mer DNA aptamer, which is currently undergoing clinical evaluation in acute myeloid leukemia (AML). AS 1411 is a guanine-rich aptamer has unmodified phosphodiester linkages and forms a G-quadruplex structure (Dapic, V. et al. 2003) that is resistant to degradation by serum enzymes (Dapic, V. et al. 2002). AS 1411 shows high affinity and specificity for nucleolin.

[0035] Since the identification of Nucleolin as a receptor for RSV infection (Tayyari, F. et al, 2011) AS 1411 was tested for an effect on RSV infection using a fluorescence focus assay (FFA). In FFA, the amount of infected cells per well after 24 hrs exposure to the virus is converted to a fluorescent signal.

[0036] The compounds, as described herein, may be in isolation, or may be linked to or in combination with tracer compounds, liposomes, carbohydrate carriers, polymeric carriers or other agents or excipients as will be apparent to one of skill in the art. In alternate embodiments, such compounds may further comprise an additional medicament, wherein such compounds may be present in a pharmacologically effective amount.

[0037] The term "medicament" as used herein refers to a composition that may be administered to a patient or test subject and is capable of producing an effect in the patient or test subject. The effect may be chemical, biological or physical, and the patient or test subject may be human, or a non-human animal, such as a rodent or transgenic mouse, or a, mouse, rat, dog, cat, cow, sheep, horse, hamster, guinea pig, rabbit, cotton rat, or pig. The medicament may be comprised of the effective chemical entity alone or in combination with a pharmaceutically acceptable excipient.

[0038] The term "pharmaceutically acceptable excipient" may include any and all solvents, dispersion media, coatings, antibacterial, antimicrobial or antifungal agents, isotonic and absorption delaying agents, and the like that are physiologically compatible. An excipient may be suitable for intravenous, intraperitoneal, intramuscular, subcutaneous, intrathecal, topical or oral administration. An excipient may include sterile aqueous solutions or dispersions for extemporaneous preparation of sterile injectable solutions or dispersion. Use of such media for preparation of medicaments is known in the art.

[0039] Compositions or compounds according to some embodiments described herein may be administered in any of a variety of known routes. Examples of methods that may be suitable for the administration of a compound include orally, intravenous, inhalation, intramuscular, subcutaneous, topical, intraperitoneal, intra-rectal or intra-vaginal suppository, sublingual, and the like. The compounds described herein may be administered as a sterile aqueous solution, or may be administered in a fat-soluble excipient, or in another solution, suspension, patch, tablet or paste format as is appropriate. A composition comprising the compounds described herein may be formulated for administration by inhalation. For instance, a compound may be combined with an excipient to allow dispersion in an aerosol. Examples of inhalation formulations will be known to those skilled in the art. Other agents may be included in combination with the compounds described herein to aid uptake or metabolism, or delay dispersion within the host, such as in a controlled-release formulation. Examples of controlled release formulations will be known to those of skill in the art, and may include microencapsulation, embolism within a carbohydrate or polymer matrix, and the like. Other methods known in the art for making formulations are found in, for example, "Remington's Pharmaceutical Sciences", (19th edition), ed. A. Gennaro, 1995, Mack Publishing Company, Easton, Pa.

[0040] The dosage of the compositions or compounds of some embodiments described herein may vary depending on the route of administration (oral, intravenous, inhalation, or the like) and the form in which the composition or compound is administered (solution, controlled release or the like). Determination of appropriate dosages is within the ability of one of skill in the art. As used herein, an "effective amount", a "therapeutically effective amount", or a "pharmacologically effective amount" of a compound refers to an amount of the AS 1411 present in such a concentration to result in a therapeutic level of the compound delivered over the term that the compound is used. This may be dependent on the mode of delivery, time period of the dosage, age, weight, general health, sex and diet of the subject receiving the compound. Methods of determining effective amounts are known in the art. It is understood that it could be potentially beneficial to restrict delivery of the compounds described herein to the target tissue or cell in which inhibition of RSV infection is desired. It is also understood that it may be desirable to target the compounds described herein to a desired tissue or cell type. The compounds described herein may thus be coupled to a targeting moiety. The compounds may be coupled to a cell uptake moiety. The targeting moiety may also function as the cell uptake moiety.

METHODS AND MATERIALS

[0041 ] The following methods and materials were employed with respect to the Examples described herein.

[0042] Cells. HEp-2 (product # is ATCC CCL-23) and MDCK cells (product number is ATCC CCL-34) were obtained from (American Type Culture Collection (ATCC), Rockville, MD) were maintained in Dulbecco's modified essential medium (Invitrogen™, Carlsbad, CA) supplemented with 1% L-glutamine (Invitrogen™) and 10% (v/v) heat-inactivated fetal bovine serum (FBS) (Invitrogen™), at 37°C. All cell cultures were kept in a humidified incubator containing 5% C0 ₂ .

[0043] Viruses. Working stocks of RSV A2 and RSV B (ATCC), RSV lacking G protein (RSV AG) (gift of Dr. P.L. Collins, National Institutes of Health, Bethesda, MD), RSV expressing GFP (Hallak et al, 2000) were prepared as previously described (Kaan and Hegele, 2003).

[0044] RSV propagation (in vivo experiments). Cells involved with RSV propagation were routinely screened for mycoplasma and LPS. 2 x 10 ⁷ HEp-2 cells (ATCC) were seeded in 10% FBS EMEM in a T-150 tissue culture flask. Cells were left to grow in 37 ^° C, 5% C0 ₂ incubator overnight. The next day (Day 0), cells were rinsed twice with clean PBS. RSV-A2 (ATCC) was added in 12 mL of serum free EMEM at an MOI ~ 0.1. Cells/RSV underwent incubation for 2 to 4 h while rotating flask every 15 to 30 min. Twenty-eight mL 6% FBS EMEM were added to flasks and cells incubated for 3 to 4 days. By day 4, 50% cells usually detached and virus was harvested and purified.

[0045] RSV harvesting and purification. Infected HEp-2 cells were scraped and collected with media into 50mL Falcon tubes, and then underwent centrifugation at 820 x g for 10 min. All solutions and cells were kept on ice or at 4°C unless otherwise stated. Supernatant was decanted and placed in a cold 50 mL falcon tube. The cell pellet was resuspended with 5 mL medium, then quick frozen in liquid nitrogen, and melted at 37°C with constant agitation. This freeze-thaw cycle was repeated once. The resuspended pellet underwent sonication on ice for 20 s twice and centrifugation at 820 x g for 10 min. The cell pellet was discarded and the supernatant was combined with the original decanted media for ultracentrifugation (SW28 rotor) at 110,000 x g for 45 min, over a sucrose cushion (30% sucrose in 0.1 M sodium chloride, 0.01 M Tris-HCl, 0.001 M EDTA, 1 M urea, pH = 7.5). After this spin a virus pellet was clearly visible and supernatant was decanted and disposed. The pellet was resuspended in 100-150 LPS-free PBS per T-150 flask (yield: 2x108 PFU RSV/mL) and stored at -80°C or in liquid nitrogen.

[0046] Aptamers. A guanosine-rich oligonucleotide (GRO) called AS1411 having the sequence 5'-GGTGGTGGTGGTTGTGGTGGTGGTGG-3' (SEQ ID No: 1) was used herein. As a negative control the same oligo, but with all the guanosines substituted with cytosine residues (CRO) 5'-CCTCCTCCTCCTTCTCCTCCTCCTCC-3' (SEQ ID No: 3) was used. Others have already shown that CRO serves as a negative control for AS 1411 's anti-cancer cell activity. AS 1411 and CRO were obtained from Life Technologies™.

[0047] Fluorescence focus assay (Malhotra et al., 2003): Briefly, HEp-2 cells cultured in EMEM supplemented with 10% foetal bovine serum (FBS) and antibiotics are plated onto black flat clear-bottomed 96 well plates (1 x 10 ⁴ cells/well). The next day virus is added and incubated for 24 hrs at 37°C and 5% C0 ₂ to allow at least one full round of virus replication. The cells are then fixed with 75% cold acetone in PBS for 5 minutes. Following 3 washes with PBS/ 0.1% Tween-20™ (PBS-Tween) cells were incubated with a 1: 10 dilution of NCL-RSV3 (Novacastra™; mouse anti-RSV monoclonal pool) in PBS-Tween/10% FBS for 30 minutes at room temperature. Cells were washed again as before and incubated with 1:400 dilution (5 μg/mL) of Alexa Fluor 488™ anti-mouse IgG (Life Technologies™) in PBS-Tween/10% FBS. After washing again as before with PBS-Tween, cells were counterstained with 0.1% naphthol blue black for 10 minutes at room temperature. Then, after a final washing, fluorescence was detected with a Tecan Infinite M200Pro™ plate reader (ex. 488 nm, em. 519 nm).

[0048] In this assay the amount of infected cells per well after 24 hrs exposure to RSV is converted to a fluorescent signal. AS 1411 was applied to the wells in triplicate starting at 70 μΜ with serial dilutions down to 0.55 μΜ. As a negative control we used a derivative of the same compound that does not interact with Nucleolin (CRO). In "prophylactic" experiments we pre-treated cells with oligo 24 hrs before exposure to RSV (MOI = 1.0). In "therapeutic" experiments we exposed cells to RSV (MOI = 0.1) 24 hrs before adding the compound.

[0049] In experiments with MDCK cells, cells were plated at 4 x 10 ⁴ cells/well and maintained for 4-5 days with daily medium changes to allow cells to polarize before using them in our assay.

[0050] To assay cellular toxicity, MTS assay (Promega™) was performed according to manufacturer instructions.

[0051 ] In vivo experiments: Animal studies were approved by the Hospital for Sick Children Animal Care Committee with the regulation of the Canadian Council on Animal Care. Female Balb/C mice, age 6 to 8 weeks old were obtained from Charles River Laboratories (St. Constant, QC, Canada). Animals were kept in a specific pathogen free environment and fed food and water ad libitum.

[0052] For all intra-nasal instillation, lightly sedated mice (isoflurane) readily inhaled 50μΙ. of instillate applied to their nares with a P-200 pipetter while their mouth was held closed. On day 0 mice received 5 x 10 ⁶ PFU of RSV via intranasal installation (n = 4 to 6 per group). Mice were monitored and weighed daily.

[0053] For the AS 1411 intraperitoneal (IP) injection, the methods were the same as for the intranasal instillations, with the exception of the AS 1411 administration (standard mouse IP injection protocols were followed without sedation).

[0054] The RSV used (RSV-A2, ATCC) was amplified in HEp-2 cells and purified over sucrose in an ultracentrifuge.

[0055] On day 1, mice received AS-1411 via intranasal installation (at indicated dose; ranged from 10 mg/kg to 50 mg/kg) diluted in PBS. Control group received 50 mg/kg of CRO. In one experiment, AS-1411 administration was repeated on day 2 and 3. On day 4, mice were euthanized and the lungs removed, weighed and homogenized for viral titres. Titres were determined by standard plaque assay on HEp-2 cells.

[0056] The following examples are provide for illustrative purposes and are not intended to be limiting, as such:

EXAMPLES

[0057] EXAMPLE 1: Effect of Increased Concentration of AS1411 on Viral Infection of HEp-2 Cells.

[0058] In prophylactic experiments conducted over a wide dosing range of AS 1411, the RSV- associated fluorescence signal was reduced by -70%, without overt cytotoxicity (FIGURE la; P = 0.004). In therapeutic experiments we found that treating RSV-infected HEp-2 cell cultures with as little as 17.5 μΜ AS 1411 resulted in a 50% decrease in fluorescence signal (FIGURE lb; P = 0.0014), attributable to a reduction in the overall number of infected cells relative to the control (FIGURE 2 panels A and B). Furthermore, CRO-treated control wells had more clusters of positive cells (FIGURE 2, right panel B), indicative of cell- to-cell spread of RSV infection. These findings suggest that AS 1411 acts in vitro not only to stop new infection events, but also to slow the spreading of infection outward from an initial focus of infection.

[0059] In both experiments (1 and 2 - FIGURES la and lb) 35 μΜ of AS1411 was sufficient to get a 60-70% decrease in fluorescent foci. In these experiments, the HEp-2 cells were pre-treated with the oligos for 24 hrs prior to adding the virus. Fluorescent foci where then detected 24 hrs after adding the virus.

[0060] EXAMPLE 2: Effect of Increased Concentration of AS1411 on Viral Infection of MDCK Cells

[0061 ] Similar to EXAMPLE 1, the effect of increasing concentrations of AS 1411 or CRO after RSV infection was tested on MDCK cells (therapeutic experiment; n=6; two-tailed paired t test). MDCK cells were exposed to RSV (MOI = 0.1) 24 hrs prior to treating with AS 1411/CRO. FIGURE 3 shows that 17.5 μΜ and 70 μΜ of AS 1411 is sufficient to get a 87% and 97% decrease in RSV fluorescence respectively, 24 hrs after addition to virus- infected MDCK cell cultures (P < 0.0001).

[0062] FIGURE 4 shows the effect of AS 1411 or CRO on MDCK cellular toxicity as measured by MTS assay (Promega™) performed 24 hrs after treating with the oligos. MDCK cells were exposed to RSV (MOI = 0.1) 24 hrs prior to treating with AS 1411/CRO. No difference is seen between AS 1411 and CRO in terms of cellular proliferation and cellular health.

[0063] FIGURE 5 shows fluorescence images of cell culture wells from MDCK therapeutic experiment treated with 17.5 μΜ of AS 1411 and CRO, respectively. As with FIGURE 2, AS 1411 treatment resulted in the reduction in fluorescence signal is due to reduction in the overall number of infected cells. Wells containing CRO show more clusters of virus-positive cells. [0064] EXAMPLE 3: Effect of AS1411 (Intranasal) on Viral Infection of Mouse Lung Tissue

[0065] AS 1411 was also tested in live mice tissues to determine the effectiveness against RSV infection. FIGURE 6 shows mice that were administered AS 1411 or CRO delivered intranasally, following receipt of 5 x 10 ⁶ PFU RSV on day 0 and treatment with AS 1411 or CRO on day 1. Mice given AS 1411 showed reduced RSV titres and repeated dosing had only a modest effect on lung titers. The mice given 50mg/kg showed the most pronounced effect.

[0066] Furthermore, the AS 1411 groups had heavier and visibly redder lungs, without any overt histopathology (FIGURE 7). However, the AS 1411 groups also were associated with less recovery of weight loss (see FIGURE 8). In most cases, such body weight recovers when the animal recovers from the illness.

[0067] The mouse experiment was repeated using clinical grade AS 1411 (see FIGURE 9 - also, delivered intranasally) and showed results similar to those shown in FIGURE 6.

[0068] TABLE 1: Tukey's Multiple Comparison

[0069] Similarly, FIGURE 10 shows that the % of initial weight is similar for clinical grade AS 1411 as it is for non-clinical grade AS 1411.

[0070] EXAMPLE 4: Effect of AS1411 (Intraperitoneal Injection (IP)) on Viral Infection of Mouse Lung Tissue

[0071 ] For comparison purposes, FIGURE 11 shows that IP injections of AS 1411 (at 50mg/kg) have no effect on RSV lung titers when compared to CRO control.

[0072] Although embodiments described herein have been described in some detail by way of illustration and example for the purposes of clarity of understanding, it will be readily apparent to those of skill in the art in light of the teachings described herein that changes and modifications may be made thereto without departing from the spirit or scope of the appended claims.

REFERENCES

Anderson et al. (1985). Antigenic characterization of respiratory syncytial virus strains with monoclonal antibodies. J. Infect. Dis. 151, 626-633.

Behera et al. (2001). Blocking intercellular adhesion molecule- 1 on human epithelial cells decreases respiratory syncytial virus infection. Biochem. Biophys. Res. Commun. 280, 188-195.

Bern et al. (2009). Mechanical ventilation enhances lung inflammation and caspase activity in a model of mouse pneumovirus infection. AJP - Lung Physiol. 296, L46-L56.

Cane, P. A. and Pringle, C.R. (1995). Evolution of subgroup A respiratory syncytial virus: evidence for progressive accumulation of amino acid changes in the attachment protein. J. Virol. 69, 2918- 2925. Cane P.A. (1997). Analysis of linear epitopes recognised by the primary human antibody response to a variable region of the attachment (G) protein of respiratory syncytial virus. J. Med. Virol. 51, 297- 304.

Cane, P.A. (2001). Molecular epidemiology of respiratory syncytial virus. Rev. Med. Virol. 11:103- 116.

Chen et al. (2008). Cell surface nucleolin serves as receptor for DNA nanoparticles composed of pegylated polylysine and DNA. Mol. Ther. 16, 333-342.

Coates et al. (1966). An antigenic analysis of respiratory syncytial virus isolates by a plaque reduction neutralization test. Am. J. Epidemiol. 83, 299-313.

Collins, P.L. & Graham, B.S. (2008). Viral and host factors in human respiratory syncytial virus pathogenesis. J Virol. 82, 2040-2055.

Dapic, V. et al. (2002) Antiproliferative activity of G-quartet-forming oligonucleotides with backbone and sugar modifications. Biochemistry 41: 3676-85.

Dapic, V. et al. (2003) Biophysical and biological properties of quadruplex oligodeoxyribonucleotides. Nucleic Acids Res 31: 2097-107.

Domachowske, J.B. and Rosenberg, H.F. (1999). Respiratory syncytial virus infection: immune response, immunopathogenesis, and treatment. Clinical Microbiol. Rev. 12, 298-309.

Escobar, G.J., et al. (2010). Recurrent wheezing in the third year of life among children bom at 32 weeks' gestation or later: relationship to laboratory-confirmed, medically attended infection with respiratory syncytial virus during the first year of life. Arch. Pediatr. Adolesc. Med. 164, 915-922. Feldman et al. (2000). The fusion glycoprotein of human respiratory syncytial virus facilitates virus attachment and infectivity via an interaction with cellular heparan sulfate. J. Virol. 74, 6442-6447.

Garcia et al. (1994). Evolutionary patterns of human respiratory syncytial virus (subgroup A): cocirculating lineages and correlation of genetic and antigenic changes in the G glycoprotein. J. Virol. 68, 5448-5459.

Garcia-Barreno et al. (1989). Marked differences in the antigenic structure of human respiratory syncytial virus F and G glycoproteins. J. Virol. 63, 925-932.

Hall, C.B., et al. (2009). The burden of respiratory syncytial virus infection in young children. N. Engl. J. Med. 360, 588-598.

Hallak et al. (2000). Glycosaminoglycan sulfation requirements for respiratory syncytial virus infection. J. Virol. 74, 10508-10513.

Hallak, L.K., Kwilas, S.A. & Peeples, M.E. (2007). Interaction between respiratory syncytial virus and glycosaminoglycans, including heparan sulfate. Methods Mol Biol 379, 15-34.

Hendry et al. (1986). Concurrent circulation of antigenically distinct strains of respiratory syncytial virus during community outbreaks. J. Infect. Dis. 153, 291-297.

Johnson et al. (1987). The G glycoprotein of human respiratory syncytial viruses of subgroups A and B: extensive sequence divergence between antigenically related proteins. Proc. Natl. Acad. Sci. USA 84, 5625-5629.

Johnson et al. (2007). The histopathology of fatal untreated human respiratory syncytial virus infection. Mod. Pathol. 20, 108-119. Kaan, P.M. and Hegele R.G. (2003). Interaction between respiratory syncytial virus and particulate matter in guinea pig alveolar macrophages. Am. J. Respir. Cell. Mol. Biol. 28, 697-704.

Krusat, T. and Streckert, HJ. (1997). Heparin-dependent attachment of respiratory syncytial virus (RSV) to host cells. Arc/?. Virol. 142, 1247-1254.

Malhotra et al. (2003). Isolation and characterisation of potential respiratory syncytial virus receptor(s) on epithelial cells. Microbes Infect 5, 123-133.

Marsh, M. and Helenius, A. (2006). Virus Entry: Open Sesame. Cell 124, 729-740.

Mufson et al. (1985). Two distinct subtypes of human respiratory syncytial virus. J. Gen. Virol. 66, 2111-2124.

Nisole et al. (1999). The anti-HIV pseudopeptide HB-19 forms a complex with the cell-surface- expressed nucleolin independent of heparan sulfate proteoglycans. J. Biol. Chem. 274, 27875-84.

Peret et al. (1998). Circulation patterns of genetically distinct group A and B strains of human respiratory syncytial virus in a community. J. Gen. Virol. 79, 2221-2229.

Rueda et al. (1991). Premature stop codons in the G glycoprotein of human respiratory syncytial viruses resistant to neutralization by monoclonal antibodies. J. Virol. 65, 3374-3378.

Sullender et al. (1991). Genetic diversity of the attachment protein of subgroup B respiratory syncytial viruses. J. Virol. 65, 5425-5434.

Sullender et al. (1993). Analysis of respiratory syncytial virus genetic variability with amplified cDNAs. J. Clin. Microbiol. 31, 1224-1231. Tayyari, F. et al. (2011). Identification of nucleolin as a cellular receptor for human respiratory syncytial virus. Nat Med. 17(9): 1132-5.

Techaarpornkul, S., Barretto, N. & Peeples, M.E. (2001). Functional analysis of recombinant respiratory syncytial virus deletion mutants lacking the small hydrophobic and/or attachment glycoprotein gene. J. Virol. 75, 6825-6834.

Techaarpornkul, S., Collins, P.L. & Peeples, M.E. (2002). Respiratory syncytial virus with the fusion protein as its only viral glycoprotein is less dependent on cellular glycosaminoglycans for attachment than complete virus. Virology 294, 296-304.

Tuteja et al. (1998). Nucleolin: a multifunctional major nucleolar phosphoprotein. Crit. Rev. Biochem. Mol. Biol. 22, 407-436.

Wu, H., Pfarr, D.S., Losonsky, G.A. & Kiener, P.A. (2008). Immunoprophylaxis of RSV infection: advancing from RSV-IGrV to palivizumab and motavizumab. Curr Top Microbiol Immunol 317, 103-123.

Zhang, L., Peeples, M.E., Boucher, R.C., Collins, P.L. & Pickles, RJ. (2002). Respiratory syncytial virus infection of human airway epithelial cells is polarized, specific to ciliated cells, and without obvious cytopathology. J Virol 76, 5654-5666.

INFORMAL SEQUENCE LISTINGS

SEQ ID NO: 1: Description: AS 1411

1 GGTGGTGGTG GTTGTGGTGG TGGTGG 26

SEQ ID NO: 2: Description: human nucleolin

1 MVKLAKAGKN QGDPKKMAPP PKEVEEDSED EEMSEDEEDD SSGEEVVIPQ KKGKKAAATS 61 AKKVVVSPTK KVAVATPAKK AAVTPGKKAA ATPAKKTVTP AKAVTTPGKK GATPGKALVA 121 TPGKKGAAIP AKGAKNGKNA KKEDSDEEED DDSEEDEEDD EDEDEDEDEI EPAAMKAAAA 181 APASEDEDDE DDEDDEDDDD DEEDDSEEEA METTPAKGKK AAKVVPVKAK NVAEDEDEEE

241 DDEDEDDDDD EDDEDDDDED DEEEEEEEEE EPVKEAPGKR KKEMAKQKAA PEAKKQKVEG

301 TEPTTAFNLF VGNLNFNKSA PELKTGI SDV FAKNDLAVVD VRIGMTRKFG YVDFESAEDL 361 EKALELTGLK VFGNEIKLEK PKGKDSKKER DARTLLAKNL PYKVTQDELK EVFEDAAEIR 421 LVSKDGKSKG IAYIEFKTEA DAEKTFEEKQ GTEIDGRSIS LYYTGEKGQN QDYRGGKNST 481 WSGESKTLVL SNLSYSATEE TLQEVFEKAT FIKVPQNQNG KSKGYAFIEF ASFEDAKEAL 541 NSCNKREIEG RAIRLELQGP RGSPNARSQP SKTLFVKGLS EDTTEETLKE SFDGSVRARI 601 VTDRETGSSK GFGFVDFNSE EDAKAAKEAM EDGEIDGNKV TLDWAKPKGE GGFGGRGGGR 661 GGFGGRGGGR GGRGGFGGRG RGGFGGRGGF RGGRGGGGDH KPQGKKTKFE

SEQ ID NO: 3: Description: CRO

1 CCTCCTCCTC CTTCTCCTCC TCCTCC