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Antibody Oligonucleotide Conjugates as a New Frontier in Genetic Disease Therapy

Download the full article (PDF) Introduction Antibody oligonucleotide conjugates (AOCs) represent an emerging class of biotherapeutics that combine the cell-targeting precision of antibodies with the gene-modulating capabilities of oligonucleotides. Structurally, AOCs consist of a monoclonal antibody (or antibody fragment) covalently linked to an oligonucleotide, such as small interfering RNA (siRNA), antisense oligonucleotide (ASO), or splice-switching […]

Therapeutic oligonucleotide delivery remains a central challenge in genetic medicine, with existing systems—including GalNAc conjugates, lipid nanoparticles, polymeric carriers, viral vectors, and localized administration—often limited by tissue specificity, immunogenicity, manufacturing complexity, or inefficient endosomal escape. Antibody–oligonucleotide conjugates (AOCs) offer a promising alternative by leveraging antibody specificity to enable targeted intracellular delivery of oligonucleotides into extrahepatic tissues such as skeletal muscle, heart, and the central nervous system. Through engagement of cell-surface receptors including TfR1, IGF2R, ASGR1, LRP1, and INSR, AOCs achieve enhanced internalization and improved gene modulation using RNA interference, antisense, splice-switching, or transcriptional inhibition mechanisms. While challenges remain in optimizing linker chemistry, receptor selection, and manufacturability, AOCs address key limitations of traditional platforms and represent a versatile, scalable, and highly targeted delivery strategy poised to broaden the clinical impact of oligonucleotide therapeutics.

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