STRC mRNA-LNP Strategy B Full-Length
Per-OHC and cochlea-mean PK/PD for Strategy B (full-length STRC mRNA delivered directly by LNP, no RBM24 intermediate). Parallel to STRC mRNA-LNP PKPD Multi-Dose Schedule (Strategy A). Two findings specific to Strategy B: (1) per-OHC dose required is ~50× higher than Strategy A’s catalytic RBM24 route — direct stoichiometric translation has no amplification, so 10,000 mol/OHC intracellular m1ψ Q6W is the floor to reach s_exog ≥ 1× WT per transfected OHC; (2) Strategy B breaks the Hill ceiling that constrained Strategy A — cochlea-mean STRC is unbounded in dose, so at 5% cochlear-tropic LNP Strategy B hits cochlea-mean ≥ 2× WT for Misha (2.18×), which Strategy A could not exceed 1.10× at the same LNP efficiency. For Misha’s paternal 98 kb STRC deletion, Strategy B is the only viable mRNA option (Strategy A needs pre-mRNA substrate that the deletion eliminates). Untargeted LNP (0.8%) remains therapeutically dead at any dose.
Method
Two-compartment ODE (no RBM24 intermediate, no Hill saturation):
dm/dt = pulse(t; D, T) − k_m · m
ds/dt = K_TRANSLATE_STRC · m − k_s · s
m— exogenous STRC mRNA, mol/OHC intracellulars— exogenous STRC protein, arbitrary units matching s_WT = 3021- Pulse:
Δm = Datt = 0, T, 2T, ...(intracellular dose; extracellular = D / 0.02)
Calibration fixes K_TRANSLATE_STRC such that endogenous steady state is consistent with Strategy A’s baseline:
| Parameter | Value | Source |
|---|---|---|
| s_WT | 3021 units | Strategy A baseline (arbitrary units) |
| endogenous STRC mRNA SS | 50 copies/OHC | biological estimate for moderate-expression gene |
| K_TRANSLATE_STRC | s_WT · k_s / 50 = 3.46×10⁻⁵ | derived |
| STRC protein t½ | 14 d (k_s = ln2 / 14 d) | inherited |
| mRNA t½ (unmod, OHC) | 4 h | mrna_stability_cochlear_results.json |
| mRNA t½ (m1ψ, OHC) | 12 h | idem |
| LNP endosomal escape | 2% | literature |
Population fold (cochlea-mean over s_WT):
tx OHC fold = s_endo_frac + s_exog_tx / s_WT
non-tx OHC fold = s_endo_frac
cochlea_mean = s_endo_frac + eff · s_exog_tx / s_WT
No hard ceiling — cochlea-mean grows linearly with dose (soft biological ceiling at ~5-10× from ER/UPR stress is a model limitation, not modelled).
Three clinical scenarios:
| Scenario | s_endo_frac | Notes |
|---|---|---|
| WT reference | 1.0 | homozygous WT, therapy adds on top |
| DFNB16 null | 0.0 | biallelic STRC loss-of-function |
| Misha | 0.15 | paternal 98 kb Δ null + maternal E1659A hypomorphic residual |
Sweep: 2 modifications × 3 targetings × 6 intervals × 8 doses = 288 regimens, 365-day horizon, LSODA with dose-time breakpoints. Runtime < 1 min.
Results — per-OHC dose floor (transfected OHC only)
Minimum intracellular dose for s_exog_trough / s_WT ≥ 1 (functional restoration in transfected OHC, m1ψ):
| Interval | Min dose/pulse | Doses/yr | Intra/yr | Extra/yr (÷0.02) | s_exog trough |
|---|---|---|---|---|---|
| Q2W | 2,000 mol | 26 | 52,000 | 2.6×10⁶ | 1.49 |
| Q3W | 5,000 mol | 17 | 85,000 | 4.25×10⁶ | 2.03 |
| Q4W | 5,000 mol | 13 | 65,000 | 3.25×10⁶ | 1.24 |
| Q6W | 10,000 mol | 9 | 90,000 | 4.5×10⁶ | 1.06 |
| Q8W | 30,000 mol | 7 | 210,000 | 1.05×10⁷ | 1.48 |
| Q12W | 100,000 mol | 4 | 400,000 | 2.0×10⁷ | 1.18 |
Minimum for s_exog_trough ≥ 2 (2× WT, matches Strategy A threshold) m1ψ:
| Interval | Min dose | Intra/yr | Extra/yr |
|---|---|---|---|
| Q2W | 5,000 | 130,000 | 6.5×10⁶ |
| Q3W | 5,000 | 85,000 | 4.25×10⁶ |
| Q4W | 10,000 | 130,000 | 6.5×10⁶ |
| Q6W | 30,000 | 270,000 | 1.35×10⁷ |
| Q8W | 100,000 | 700,000 | 3.5×10⁷ |
| Q12W | — | infeasible | — |
Strategy B needs ~50× more extracellular mRNA per transfected OHC than Strategy A (4.5M vs 90K mol/yr at Q6W m1ψ for equivalent per-OHC rescue). Direct translation produces one protein per ribosome per mRNA per lifetime; RBM24 in Strategy A catalyses many STRC splicing events per RBM24 molecule.
Results — cochlea-mean by LNP targeting × scenario (the key finding)
Minimum dose to reach cochlea-mean ≥ 2× WT (m1ψ):
| LNP targeting | WT ref | DFNB16 null | Misha |
|---|---|---|---|
| Untargeted (0.8%) | infeasible (max 1.59×) | infeasible (max 0.59×) | infeasible (max 0.74×) |
| Cochlear-tropic (5%) | Q2W × 30K (39M/yr) → 2.11× | Q3W × 100K (85M/yr) → 2.03× | Q3W × 100K (85M/yr) → 2.18× |
| OHC-targeted (20%) | Q2W × 10K (13M/yr) → 2.49× | Q3W × 30K (25.5M/yr) → 2.43× | Q3W × 30K (25.5M/yr) → 2.58× |
Minimum dose to reach cochlea-mean ≥ 1× WT (functional restoration, m1ψ):
| LNP targeting | WT ref | DFNB16 null | Misha |
|---|---|---|---|
| Untargeted (0.8%) | at baseline | infeasible (max 0.59×) | infeasible (max 0.74×) |
| Cochlear-tropic (5%) | at baseline | Q2W × 30K (39M/yr) → 1.11× | Q2W × 30K (39M/yr) → 1.26× |
| OHC-targeted (20%) | at baseline | Q2W × 10K (13M/yr) → 1.49× | Q2W × 10K (13M/yr) → 1.64× |
The Strategy A → B delivery inversion. At 5% cochlear-tropic LNP:
- Strategy A ceiling: cochlea-mean ≤ 0.05 · 3 + 0.95 = 1.10× (Hill caps per-OHC fold at 3)
- Strategy B achievable: cochlea-mean 2.03–2.18× (DFNB16 null / Misha, Q3W × 100K m1ψ)
Strategy B can compensate for modest LNP tropism with high dose, because linear dose-response has no pharmacological ceiling — delivery and dose become substitutable knobs. Strategy A has no such substitution: once per-OHC trough saturates at the Hill max_boost, extra dose produces no extra STRC, and cochlea-wide coverage is upper-bounded by eff_ohc alone.
Interpretation
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The mechanism inversion: direct replacement scales with dose, catalytic regulation saturates. Strategy A has a pharmacology ceiling (Hill max_boost = 3) but is dose-frugal (1800 mol/yr intra per OHC). Strategy B has no pharmacology ceiling but is dose-expensive (90–270K mol/yr intra per OHC). The two strategies trade off opposite failure modes.
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For LNP tropism in the 5-20% range, Strategy B dominates Strategy A on cochlea-mean. At 5%, Strategy A maxes at 1.10× while Strategy B reaches 2.18× (Misha) with Q3W dosing. Given published cochlear LNPs cluster in this range, Strategy B may be the right bet for the next-5-years window while SORT-LNP-class platforms mature.
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Strategy B is the only viable mRNA option for Misha’s paternal allele. The 98 kb deletion eliminates the entire STRC locus — no pre-mRNA, no substrate for RBM24 splicing correction. Strategy A upregulates only the maternal E1659A allele (which is hypomorphic, giving ≤ 1× WT total). Strategy B provides de novo stereocilin regardless of locus state.
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Untargeted LNP (0.8% OHC) is therapeutically dead for null/hypomorphic patients even at Strategy B’s full dose range. Max cochlea-mean for DFNB16 null = 0.59× WT at 100K mol/OHC Q2W (= 5M extracellular/OHC/pulse, a million times physiologic transcript loading). 99.2% of OHCs never see LNP and stay at 0% endogenous STRC; the 0.8% transfected cannot numerically dilute up to cochlea-mean ≥ 1.
-
Misha-specific path forward (compound het 98 kb Δ paternal + E1659A maternal):
- OHC-targeted 20% LNP + Strategy B Q3W × 30,000 mol/OHC m1ψ: cochlea-mean 2.58× (therapeutic), extracellular burden 25.5 M mol/yr per OHC = ~0.5 mg mRNA total per cochlea per year. Practically manufacturable.
- Complementary to STRC Pharmacochaperone Virtual Screen E1659A on the maternal allele (affinity repair × quantity restoration multiplicatively combine).
- Complementary to STRC Piezoelectric TM Bioelectronic Amplifier as non-overlapping mechanism (molecular coupling vs bioelectronic amplification).
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Safety envelope at high dose: the linear ODE ignores ER-stress / UPR limits on secreted-protein overexpression. Mammalian cells typically tolerate ~5-10× overexpression of secretory proteins before UPR activation. Strategy B’s per-OHC troughs at high dose can exceed 70× WT (at 100K mol/OHC Q2W m1ψ) — beyond any physiological tolerance. Practical dose cap is probably around s_exog_tx ≈ 5-10× WT. This makes 20% OHC-targeted LNP the realistic target eff_ohc, because it hits cochlea-mean 2× with only ~10× per-OHC excess.
Head-to-head: Strategy A vs Strategy B (m1ψ Q6W baseline)
| Metric | Strategy A (RBM24) | Strategy B (full-length) |
|---|---|---|
| Per-OHC dose | 200 mol/OHC intra | 10,000 mol/OHC intra |
| Annual intra per OHC | 1,800 mol | 90,000 mol |
| Annual extra per OHC | 90,000 mol | 4.5×10⁶ mol |
| Per-OHC trough | 2.17× STRC fold | s_exog ≥ 1× WT |
| Pharmacology ceiling | 3× Hill cap | unbounded in dose |
| Cochlea-mean at 5% eff | 1.10× (capped) | 2.18× Misha (Q3W × 100K) |
| Cochlea-mean at 20% eff | 1.40× (capped) | 2.58× Misha (Q3W × 30K) |
| Works on null allele | no (needs pre-mRNA) | yes (de novo STRC) |
| Payload | ~1.5 kb RBM24 CDS | ~6 kb STRC CDS |
| Off-target risk | 469 genes spliced | minimal (direct replacement) |
Limitations
- Linear dose-response is an idealization. Real cells have ribosome loading saturation (~5 ribosomes per 5 kb mRNA at max) and ER/UPR stress at ~5-10× secretory overexpression. Model overstates feasibility above ~10× WT per-OHC trough.
- K_TRANSLATE_STRC calibrated from an assumed 50-copy endogenous STRC mRNA steady state. Actual OHC transcriptomics would tighten this.
- Shared limitation with Strategy A: no extracellular compartment model for LNP transit through perilymph, no anti-PEG immune response for repeat dosing, no stochastic transfection distribution across 12,000 OHCs.
- Cochlea-mean is still the wrong clinical endpoint for a structural protein. The tonotopic audiogram projection (per STRC mRNA-LNP Audiogram Rescue) should be repeated with Strategy B per-OHC s_exog profile, not the Strategy A fold metric.
- Misha’s s_endo_frac = 0.15 is estimated (maternal E1659A × 0.5 hemizygous dosage × ~0.3 residual activity). Direct measurement from patient cochlear sample is impossible; best estimate remains ~10–20% of WT.
- No dose-sparing from non-cell-autonomous STRC secretion. Stereocilin is secreted extracellularly and may restore adjacent untransfected hair bundles partially; modelling this effect could lower the effective dose floor for Strategy B specifically.
Next steps
- Audiogram rescue for Strategy B: compose this per-OHC profile (s_exog ≥ 1× WT at transfected OHC; 0 at non-transfected for DFNB16 null / 0.15 for Misha) with the tonotopic × ABR transfer function from STRC mRNA-LNP Audiogram Rescue. Expectation: Strategy B at 5% cochlear-tropic should match Strategy A at 20% OHC-targeted on weighted audiogram improvement.
- ER/UPR safety model: soft ceiling on s_exog per OHC (Michaelis-Menten saturation at ~5× WT with dose) to bound the feasible regimen space.
- Non-cell-autonomous secretion: treat exogenous STRC as a diffusible pool that reaches neighboring untransfected OHCs. If diffusion-limited to adjacent cells (r ~ 10 μm), effective eff_ohc increases by ~3-fold with no extra dose.
- Strategy A+B combination: RBM24 mRNA + full-length STRC mRNA co-dosed in the same LNP (quantity-from-B × quality-from-A) for compound het patients like Misha where A alone undershoots (maxes at ~1× WT from single-allele upregulation).
- LNP payload-size penalty: 6 kb STRC mRNA-LNP loading efficiency vs 1.5 kb RBM24 mRNA-LNP. Larger mRNA loads fewer copies per LNP particle; may reduce effective per-particle dose by ~2-4×. Model with explicit LNP particle dynamics.
Replication
cd ~/STRC/models
/opt/miniconda3/bin/python3 strc_mrna_strategy_b_pkpd.py
# outputs: strc_mrna_strategy_b_pkpd.jsonFiles / Models
~/STRC/models/strc_mrna_strategy_b_pkpd.py— 2-compartment ODE + sweep~/STRC/models/strc_mrna_strategy_b_pkpd.json— 288 regimens, per-OHC minimums (1× and 2× WT), cochlea-mean across scenarios × targetings~/STRC/models/rbm24_mrna_dose_response_results.json— s_WT calibration input~/STRC/models/mrna_stability_cochlear_results.json— mRNA half-life input
Ranking delta
Applied against STRC Hypothesis Ranking (2026-04-21):
- STRC mRNA-LNP Strategy B Full-Length: new entry — S-tier (Mechanism 3, Delivery 2, Misha-fit 5). Breaks the Hill ceiling that capped Strategy A; only viable mRNA option for Misha’s paternal 98 kb Δ null allele.
- STRC mRNA Therapy Hypothesis (Strategy A / RBM24): demoted to A-tier backburner — subtherapeutic for Misha alone (0.33× WT absolute in transfected OHCs), viable only as adjunct to Strategy B.
- STRC Mini-STRC Single-Vector Hypothesis: no change — still S-tier, single-dose AAV alternative to re-dosable mRNA.
- STRC Pharmacochaperone Virtual Screen E1659A: no change — still S-tier, addresses Misha’s maternal allele (complementary to Strategy B paternal coverage).
Connections
[part-of]STRC mRNA Therapy Hypothesis — Strategy B of the parent hypothesis[see-also]STRC mRNA-LNP PKPD Multi-Dose Schedule — Strategy A PK/PD, head-to-head[see-also]STRC mRNA-LNP Audiogram Rescue — Strategy A tonotopic clinical endpoint[see-also]STRC mRNA-LNP Strategy B Audiogram Rescue — Strategy B tonotopic clinical endpoint; null-allele audiogram (28 dB @ 20% OHC)[see-also]STRC RBM24 Regulatory Hypothesis — why Strategy A fails on null alleles (pre-mRNA substrate requirement)[see-also]STRC Pharmacochaperone Virtual Screen E1659A — complementary mechanism for Misha maternal allele[see-also]STRC Mini-STRC Single-Vector Hypothesis — alternative full-length STRC replacement via AAV; Strategy B is the mRNA-LNP analog[about]Misha