Consensus Guidelines for the Design and In Vitro Preclinical Efficacy Testing N-of-1 Exon Skipping Antisense Oligonucleotides

Nucleic Acid Ther. 2023 Jan;33(1):17-25. doi: 10.1089/nat.2022.0060. Epub 2022 Dec 13.


Antisense oligonucleotides (ASOs) can modulate pre-mRNA splicing. This offers therapeutic opportunities for numerous genetic diseases, often in a mutation-specific and sometimes even individual-specific manner. Developing therapeutic ASOs for as few as even a single patient has been shown feasible with the development of Milasen for an individual with Batten disease. Efforts to develop individualized ASOs for patients with different genetic diseases are ongoing globally. The N = 1 Collaborative (N1C) is an umbrella organization dedicated to supporting the nascent field of individualized medicine. N1C recently organized a workshop to discuss and advance standards for the rigorous design and testing of splice-switching ASOs. In this study, we present guidelines resulting from that meeting and the key recommendations: (1) dissemination of standardized experimental designs, (2) use of standardized reference ASOs, and (3) a commitment to data sharing and exchange.

Keywords: N-of-1; antisense oligonucleotide; exon skipping; protocol.

MeSH terms

  • Exons / genetics
  • Humans
  • Oligonucleotides, Antisense* / genetics
  • Oligonucleotides, Antisense* / therapeutic use
  • Precision Medicine
  • RNA Splicing* / genetics


  • Oligonucleotides, Antisense