Polymeric micelle Recently, polymer micelles techniques have pulled in expanded consideration as a promising vehicle for inadequately dissolvable medications in modern cancer treatment. Polymer micelles are self-congregations of amphiphilic block copolymers in aqueous media. Meanwhile, many benefits of utilizing polymer micelles have been exhibited with their unique core-shell structure. The hydrophobic centers are isolated by hydrophilic shells from the aqueous exterior, so then hydrophobic medications can be solubilized into the hydrophobic center designs of polymer micelles at focuses a lot higher than their characteristic water-solvency. Polymer micelles are known to have high medication stacking limit, high water-dissolvability, and fitting size for long course in blood. The hydrophilic shell encompassing the micellar center can secure unfortunate marvels, for example, between micellar conglomeration or precipitation, protein adsorption, and cell bond. The substance organization of polymer micelles can be customized to have alluring strong compound properties for drug solubilization. In most polymer micelles, hydrophobic medications are joined into the hydrophobic center of micelles by hydrophobic collaboration just as other extra communications, for example, metal-ligand coordination holding and electrostatic connection. The drug solubility’s ability depends on the compatibility of drug and the micelle core. In this study, we are focused on the structure of polymeric micelle, the procedure of polymeric micelle formation, and the methods used to stimulated the drug delivery, which included pH-sensitive, photosensitive and reduction. 1 Introduction Polymeric micelle have a small size, normally their diameter range from 5 to 100 nm, depend on the type of head and length of function groups. Polymeric micelles are based on blockcopolymers with hydrophilic and hydrophobic units that self-assemble in an aqueous environment into structures These blocks can be arranged in different ways: A-B type, A-B-A type. In the micelle structure formation process, the hydrophobic and hydrophilic are separated due to the interaction between polar part of head group and surrounding water. This formation process result in flexible and porous structure of micelle. Now, polymer micelle are widely used as a high effectivity model of biological application and drug delivery systems, because the special function polymer micelle. For example, they can increase the drug solubility, from the targeting ability, reduce the toxicity, and enhance the penetration on tissue. Polymeric micelles are composed by the amphiphilic molecules in aqueous solution, then selfassemble into a core-shell structure that contains both hydrophobic and hydrophilic segments. For the solution, the critical concentration required in forming polymeric micelle is called critical micelle concentration (CMC). The formation of micelle occurred when CMC value higher than required concentration. The common micelle formation driven by the dehydration of the hydrophobic tails. The final structure of polymeric micelles are spherical, supramolecular molecule, and micelle have a special morphologies ability can be assembled in different sharp, for example, rods, spheres, and tubules, which depend on the temperature of environment, chain’s length, and quality of solvent. Polymeric micelle’s function not limit on the cancer therapy, but also used on different fields, such as material engineers and microelectronics. Figure 1.1. The basic structure of unimer (amphiphile) and combine polymeric micelle. Figure 1.2. The micelle morphologies under transmission electron micrographs: (A) spheres, (B) toroids, (C) worm, (D) vesicles. 2.Stimuli-responsive polymeric micelles 2.1 Nowadays, in order to improve the efficient drug release rate in the tumor cells, the targeting drug release mechanism are developed in polymeric micelle system by control the methods of drug release when reach the target cells. The stimuli-responsive of polymeric micelle have been used as a novel technology for control of drugs release. The stimuli systems can be divided into two main parts, which is internal stimuli and externa stimuli. For internal stimuli, it contains temperature, pH-value, enzymes and so on, in this method, compound thermo or pH sensitive compound releases the inside drugs after reach the targeting tumors. The external stimuli methods includes light, ultrasound, and both of two types of stimuli-responsive methods show an superior ability on cancer therapy on accuracy on location and time of drug release. 2.1.1 During the cancer therapy process, the tumor microenvironment is one of the most important factors which can influence the result of treatment. Tumor microenvironment(TME) indicates a composition of tumor part, and it has been focus as a high effective technique to enhance human immunotherapy[1]. pH-value has been consider as an ideal trigger for anticancer drugs release, based on the different pH-value between primary tumors and normal tissue[2]. In human vivo system, many intracellular components can maintain their own pH-value in normal condition, such as cytoplasm, endosomes, lysosomes, and mitochondria. When the tumor grown rapidly, the expanding population of tumor cells caused the lack of oxygen. This reaction result to hypoxia, production of lactic acid, and hydrolysis of ATP in human vivo system. Therefore, the acidic microenvironment can directed to pH-sensitive drug delivery system developed. The pHvalue in tumor cells is ~6.5, and the value of normal cells is ~7.4. And pH-value can decline further in the organelle such as endosomes and lysosomes [3]. In this way, planning the pHdelicate nanocarrier for focusing on drug conveyance to tumors that the nanocarrier is steady at physiological pH however it should be distorted to work with arrival of the medication under gentle acidic conditions at target tumors, may bring about essentially upgraded remedial adequacy and insignificant results[4]. In this manuscript, we focused on the drug delivery systems of pH-sensitive polymeric micelle trigger by protonation of carboxylic acid group. The pH value of polymeric micelle have to stable at 7.4, to reduce the probability of the disassembly and destabilization in vivo. To prepare pH-sensitive polymeric micelle, positive-charged drugs are combined with negative-charged block copolymer in order to form a core. In human vivo system which have neutral pH value, the carboxylic acid units shown as negative charge hence allowing cooperative electrostatic interactions with the encapsulated compounds[5]. Once in a mild acidic environment, protonation of the carboxylic acid gatherings brings about a net reduction in electrostatic interactions, and result in separation of the medication containing center. Another way to produce the pH-sensitive PMs is to combine a medication in the uncharged hydrophobic center of a micelle introducing an ionized polyanion shell. For this situation, protonation of the shell prompted an annoyance of the center shell structure and eventually influenced the intracellular conveyance of the medication. There are mainly two pH-stimuli polymeric micelle types that commonly used, unimolecular and multimolecular[6] Amphiphilic star-shaped polymers were a novel method to the pH-sensitive of polymeric micelle by atom transfer radical polymerization. The new polymers not only shown a tradition core-shell structure of PM, but also have the dilution stability as unimolecular polymeric micelles (UPM). UPM can be obtained from both dendrimers and star polymers. Figure 2.1.1 The structure of pH- sensitive unimolecular polymeric micelles (UPM) release hydrophobic drug. A four-armed multifunctional initiator was used for the polymerization, as the Star polymers can be produced in less steps compared with other technology. Atom transfer radical polymerization (ATRP) was used to synthesis of UPM in the previous work. A novel water-soluble UPM with an ionizable core were developed as potential carriers for the oral delivery of drugs. The compound was called Star-P(EMA-co-tBMA)-b-P(PEGMA). To tested the function of UPM, the pH-value of different concentration and percent of invitro drug release rate were test. Tirtation was used to evaluate MAA content with hydrolyzed UPM and NaOH 0.05N. The value of α shown the degree of ionization, where α = Cb/CMAA and Cb is the concentration of NaOH, CMAA is the concentration of MAA(methacrylic acid) in solution. The result shown titration curve reach the equivalent point when pH=9. Indeed, it also shown UPM can be protonated in the stomach(pH 1 to 2), Ileum(pH 7). As the drug release rate depend on drug diffusion, the stability of carrier material and polymer degradation. The introduction of pH-sensitive acidic functions was supposed to influence polarity of pH-response. In Figure 2.1.3A, the graph shown the percentage of drug release rate between free drugs and packed drugs. After 60 min, more than 80% of non-packing drug release, and the diffusion rate reach 100% after 2h. Compared with the rate of drug release from UPM, it hardly reach 20% after 60min, and the maximum of the rate is 45% in 8h. In figure 2.1.3B, the graph shown the pH-sensitive drug from UPM in pH 7 or 11 condition. The slow the rate of release at acidic pH environment and to increase the release amount of drug from the micelles at higher pH was shown from the tendency of the graph. Figure 2.1.2 The synthesis of pH-sensitive Star-shaped amphiphilic and molecule formula. Figure 2.1.3 The comparison of pH-value an UPM concentration of S_E18M17P442 (closed circles) and S_E24T23P229 (open squares). α was the ionization, and polymer solution was titrate with NaOH solution. Figure 2.1.4. (A) In pH 1.2 environment, vitro release of free (closed triangles) and S_E24M23P229-entrapped (5% w/w) (open triangles). (B)In pH 1.2, 7 (open squares) and 11 (closed circles) environment, S_E24M23P229-entrapped progesterone (5% w/w) released. 2.1.2 [7] pH-sensitive polymeric micelle also can be use as the pH probe for detecting acidic biological environment. pH imaging for tumor therapy was due to the special acidic environment. To monitored tumor pH-value in human vivo system, MR imaging/spectroscopy (MRI/MRS) was used as a clinical applicability. To reach a better pH sensitive system, a mixed micelle pH probe composed by polyethylene glycol (PEG)-b-poly(l-histidine) (PHis) and PEG-b-poly(l-lactic acid) (PLLA) (Figure 2.1.5B) Figure 2.1.5B. The chemical structure of polyethylene glycol (PEG)-b-poly(l-histidine) (PHis) and PEG-b-poly(l-lactic acid) (PLLA). To get a better result of tumor testing by using MRs, the pKa value of the pH probe should in a range between weak acidic and neutral (pH 6.0-7.4). The PHis material can be changed from water-soluble to hydrophobic aggregates with increasing of pH-value. As the pH-value and pass pH 7.0 condition, normalized integration percentage of H2 peak decrease sharply, as H2 represented the chemical shift imidazole ring. With the molecular weight increase, the aqueous solubility of PHis is decreased (Figure 2.1.6B) Figure 2.1.6. (A) H2 and H5 HNMR peaks in PEG2kDa-PHis2.7kDa at different pH condition. (B) pH-sensitive H2 and H5 peak’s of PEG2kDa-PHis in different MWs of PHis. The function of micelle probes was tested by using 1H-MRS to compared the pH-value and chemical shift of the H2 peaks in the graph. The pH 7.4 and 6.0 condition used to clarify the MRS data of the mixed micelles (Figure 2.1.7). At pH=6.0, H2 and H5 peaks of the mixed micelle shown a visible peak compare with pH 7.0 condition. Also, most of the peaks in blood, the mixed micelle probe peaks were coincided with the spectrum of blood itself. The results indicted the mixed micelle have the ability to provide pH-monitoring ability in tumor pH-value range. Figure 2.1.7. 1H NMR spectra of H2 and H5 peaks in mixed micelles of PEG2kDa-PHis3.3kDa (90 wt %) having PEG2kDa-PLLA3kDa (10 wt %) in different pH condition (6.0 and 7.4) 2.2 hv For the photosensitive method to control the polymeric micelle remotely and accurately, which can focus into specific areas quickly. Based on modern technology, the used of light control factor for polymeric micelle was largely unexploited. 2.2.1 https://doi.org/10.1021/ja0521019 A synthesis of an amphiphilic diblock polymer micelle was developed which can stimulate by UV light and reformed by later light exposure. In the synthesis of PM, the hydrophobic block is a side-chain liquid crystalline polymethacrylate with azobenzene mesogens (PAzo), and the hydrophilic block is a random copolymer of poly(tert-butyl acrylate-co-acrylic acid) (tBA-AA) (Figure 2.2.1). To result the polymeric micelle break under UV light, the hydrophobic, which is the core part, contains a photolabile chromophore as a pendent group. The bond-breaking reaction occurred between the chromophore and polymer under UV light, and result in transforms from hydrophobic block into a hydrophilic block. Figure 2.2.1. (A) The flow chart of the change of hydrophobic to hydrophilic due to detachment of dye pendant groups. (B) Chemical structure of the amphiphilic diblock copolymer and reaction under UV light. To detect the bond-breaking and dissociation of polymeric micelle in UV light condition, scanning (SEM) and transmission electron microscope (TEM) technology were to use to observed the reaction in the solution. The polymeric micelles were formed in the solution in nonUV light condition, and the compared group was placed under UV light. In the result, there were no micelles remained after exposure to UV light condition, which indicated the polymeric micelle probe can used to monitor the dissociation of micelle (Figure 2.2.2A). Meanwhile, as the intensity of the irradiation increased, the transmittance increase. As the dissociated of micelles under UV light, the solution turbidity rate decline which lead to the increase of transmittance rate (Figure 2.2.2B). The result shown the detachment of dye pendant groups, responded to the photosolvolysis. Figure 2.2.2. (A) The scanning image of PEO-b-PPy (left) and the dissociation of micelles under UV light in the micellar solution(right). (B) The comparison of transmittance rate and time under different irradiation intensities. 2.2.2 https://doi.org/10.1021/ja209793b For many photosensitive required a high-energy UV light during the reaction, however, high intensity may cause negative effect to human body. So longer-wavelength near-infrared (NIR) light which has less penetration into cells was a modern popular field. In the photoreaction, NaYF4:TmYb upconverting nanoparticles (UCNPs) was encapsulated in poly(ethylene oxide)block-poly(4,5-dimethoxy-2-nitrobenzyl methacrylate) micelle under 980nm light. By encapsulating NaYF4:TmYb upconverting nanoparticles (UCNPs) inside micelles of poly(ethylene oxide)-block-poly(4,5-dimethoxy-2-nitrobenzyl methacrylate) and exposing the micellar solution to 980 nm light, photons in the UV region are emitted by the UCNPs, which in turn are absorbed by o-nitrobenzyl groups on the micelle core-forming block, activating the photocleavage reaction and leading to the dissociation of BCP micelles core and release of coloaded hydrophobic species(Figure 2.2.3A and B). Figure 2.2.3. (A) The dissociation of BCP micelles in UCNPs under NIR light. (B) The photoreaction trigged by NIR light with BCP of PEO-b-PNBMA and UCNPs of NaYF4:TmYb. To ensure NIR light whether can induce release of hydrophobic species co-loaded with the UCNPs inside the micelles, micelles contained UCNPs and Nile Red (NR) were used to observed the result. The absorbance spectrum recorded the UCNP-loaded micellar solution before and after NIR light condition without NR add. No changes in absorbance without irradiation in 24h, so the result convinced the photocleaved when micelle break under NIR light (Figure 2.2.4B). For the micelles loaded contain UCNPs and NR, the normalized fluorescence intensity of NR measured under NIR light at 640nm, and result shown a hydrophobic dye is much faster under NIR light of the micellar solution (Figure 2.2.4C). Figure 2.2.4. (B) Absorption spectrum vs. time of dissociation of UCNP-loaded micelles under NIR light exposure (5W, 4h). (C) Intensity rate in the normalized fluorescence at 640nm vs. time for two micelle loaded solution contain NR and UCNPs. Black dot was subjected under NIR light condition, and red dot was not. 2.2.3 https://doi.org/10.1021/acsami.8b22516 Light-cross-linked small-molecule micelles with enediyne units are designed to increase the efficient of drug delivery rate. Gemcitabine (GEM) was chosen as hydrophilic drug, and tethered with a maleimide-based enediyne (EDY) was used as hydrophobic tail in the preparation of amphiphilic EDY–GEM under Bergman cyclization (Figure 2.2.5). It is an intramolecular cyclization of EDY under photo-triggering conditions and formed diradical type intermediates. Figure 2.2.5. The synthesis process of amphiphilic molecule (5) and light-cross-linked smallmolecule micelles chemical structure (6) Confocal laser scanning microscopy (CLSM) technology had the ability shown the drug-loaded micelles and light-cross-linked micelles. Human nonsmall cell lung cancer (A549) cells were used to reacted with light-cross-linked micelles (50 μM) in 6 h and shown the fluorescence image (Figure 2.2.6). In green and blue images (525nm and 450nm), the cellular uptake wasd shown, which indicated the successful delivery of the drug (GEM) to the cancer cells and nucleus. Figure 2.2.6 CLSM image of A549 with light-cross-linked micelles for 6 h. The cell dyed with propidium iodide (red), the micelles fluorescence in cells (green/blue), and overlapped two images into 3th column image. The concentration of [EDY–GEM] was 50 μM. 2.3 temperature Temperature plays an critical role in nearly everything in chemistry reaction and regulation. For example, reaction requirement, cell division, and gene expression. Compared with others external stimuli, such as pH-valued, light and so on, temperature control is one of the simplest method for drug release. The basic structure of thermo-sensitive polymeric micelle were formed by hydrophobic block and thermo-responsive hydrophilic block. 2.3.1 https://doi.org/10.1021/acs.nanolett.0c02163 Poly(N-isopropylacrylamide) (PIPAAm) is hydrophilic and known as a reversible temperatureresponsive phase transition when it reach the lower critical solution temperature (LCST) in aqueous. By adding hydrophilic comonomers, such as N,N-dimethylacrylamide, the value of LCST of PIPAAm could be easily controlled to a near body temperature (Figure 2.3.1). Figure 2.3.1. (A)The synthesis process of P(IPAAm-co-DMAAm)-b-PLA diblock copolymers. (B) The formation process of polymeric micelle from thermo-sensitive polymer. To ensure the efficient influenced efforts between time and temperature in the intracellular uptake, the micelles were incubated at two temperature, 37 °C (below the LCST) and 42 °C (above the LCST) (Figure 2.3.2). The result of fluorescence intensity shown the amount of intracellular increased sharply only when temperature above micelle LCST. This result caused by the enhance of the interaction between micelle and cells, due to the thermo-sensitive phase of the micelle coronas. Figure 2.3.2. Comparison of time and fluorescent intensity of (A) OG-labeled thermoresponsive micelles and (b) the OG-labeled P(IPAAm-co-DMAAm) in different temperature (37 °C, open circle) and above (42 °C, closed circle). 2.3.2 1 https://doi.org/10.1016/B978-0-12-815720-6.00009-5 2 https://doi.org/10.1016/j.jconrel.2007.03.023 3 https://cancerres.aacrjournals.org/content/49/16/4373.article-info 4. https://doi.org/10.1016/j.addr.2011.09.006 5. 10.1211/0022357011775352 6. pH-Sensitive Unimolecular Polymeric Micelles: Synthesis of a Novel Drug Carrier https://doi.org/10.1021/bc020041f 7. https://doi.org/10.1021/bm300985r UPM have been obtained from both dendrimers (3, 4) and star polymers (5−7). Advanced Drug Delivery Reviews 64 (2012) 979–992 Contents lists available at SciVerse ScienceDirect Advanced Drug Delivery Reviews journal homepage: www.elsevier.com/locate/addr pH-sensitive vesicles, polymeric micelles, and nanospheres prepared with polycarboxylates? Arnaud E. Felber 1, Marie-Hélène Dufresne 1, Jean-Christophe Leroux ? Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli Str. 10, 8093 Zurich, Switzerland a r t i c l e i n f o a b s t r a c t Article history: Received 16 July 2011 Accepted 20 September 2011 Available online 29 September 2011 Titratable polyanions, and more particularly polymers bearing carboxylate groups, have been used in recent years to produce a variety of pH-sensitive colloids. These polymers undergo a coil-to-globule conformational change upon a variation in pH of the surrounding environment. This conformational change can be exploited to trigger the release of a drug from a drug delivery system in a pH-dependent fashion. This review describes the current status of pH-sensitive vesicles, polymeric micelles, and nanospheres prepared with polycarboxylates and their performance as nano-scale drug delivery systems, with emphasis on our recent contribution to this ?eld. © 2011 Elsevier B.V. All rights reserved. Keywords: Vesicle Polymeric micelle Nanoparticle Nanosphere pH-sensitive pH-responsive Polyanion Carboxylic acid Contents 1. 2. 3. 4. Introduction . . . . . . . . Vesicles . . . . . . . . . . . 2.1. Liposomes . . . . . . 2.1.1. Description . 2.1.2. Applications . 2.2. Niosomes . . . . . . 2.3. Lipoplexes . . . . . . 2.4. Polymersomes . . . . Polymeric micelles . . . . . . 3.1. Parenteral drug delivery 3.2. Oral drug delivery . . Polymeric nanospheres . . . 4.1. Oral drug delivery . . 4.2. Vaginal drug delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 980 980 980 980 982 984 984 985 985 985 986 987 987 988 Abbreviations: AA, acrylic acid; Al(M)A, alkyl(meth)acrylate; AlClPc, aluminum chloride phthalocyanine; AON, antisense oligonucleotide; AUC, area under the blood (plasma) concentration vs. time curve; BMA, butyl methacrylate; CMC, critical micelle concentration; DMAA, dimethylacrylamide; DOPE, dioleoylphosphatidylethanolamine; EA, ethyl acrylate; EMA, ethyl methacrylate; GI, gastrointestinal; HEMA, 2-hydroxyethyl methacrylate; HIV, human immunode?ciency virus; iBA, iso-butyl acrylate; LCST, lower critical solution temperature; MAA, methacrylic acid; MMA, methyl methacrylate; nBA, n-butyl acrylate; NIPAM, N-isopropylacrylamide; ODA, octadecyl acrylate; PAA, poly(acrylic acid); PAMAM, poly (amido amine); PAsp, poly(L-aspartic acid); PCL, poly(ε-caprolactone); PDMAEMA, poly(N,N-dimethylaminoethyl methacrylate); PEG, poly(ethylene glycol); PEGMA, PEG methacrylate; PG, poly(glycidol); PGA, poly(L-glutamic acid); PICM, polyion complex micelle; PLA, poly(D,L-lactide); PMAA, poly(methacrylic acid); PM, polymeric micelle; PrMA, propyl methacrylate; PUA, poly(10-undecenoic acid); siRNA, small interfering RNA; UA, 10-undecenoic acid; VBODENA, 4-(2-vinylbenzyloxy)-N,N-(diethylnicotinamide); VP, N-vinyl-2-pyrrolidone. ? This review is part of the Advanced Drug Delivery Reviews theme issue on “Stimuli-Responsive Drug Delivery Systems”. ? Corresponding author at: Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli Str. 10, 8093 Zurich, Switzerland. Tel.: + 41 44 633 7310; fax: + 41 44 633 1314. E-mail address: jleroux@ethz.ch (J.-C. Leroux). 1 AEF and MHD contributed equally to this manuscript. 0169-409X/$ – see front matter © 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.addr.2011.09.006 980 A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 5. Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Introduction Drug delivery systems capable of releasing their payload in response to stimuli have received much attention in recent years, whether to target tissues, to reach speci?c intracellular locations, or to promote drug release. Of the many stimuli that can be exploited, changes in pH are particularly interesting because pH gradients relevant for drug targeting can be found physiologically. For instance, gradients between normal tissues and some pathological sites, between the extracellular environment and some cellular compartments, and along the gastrointestinal (GI) tract are well characterized. Some pathological states are associated with pH pro?les different from that of normal tissues. Examples include ischemia, infection, in?ammation, and tumor acquisition, which are often associated with acidosis [1–4]. For instance, compared to the normal blood pH of 7.4, extracellular pH values in cancerous tissues can be as low as 5.7 (though on average 6.8–7.0) [3]. This in part results from the fact that, because tumors proliferate rapidly, their vasculature is often disorganized and may be insuf?cient to ful?ll the nutritional and oxygen needs of the expanding population of tumor cells, leading to hypoxia, production of lactic acid, and hydrolysis of ATP in an energy-de?cient manner [2,4]. Furthermore, whether in a state of deprived oxygen or not, many tumors have high rates of glycolysis, contributing to increased proton production [4]. Together with increased proton production, the poor lymphatic drainage and elevated interstitial pressure of tumors may lead to poor proton clearance, thus participating in the build-up of an acidic microenvironment, that can be exploited in the design of pH-sensitive drug delivery systems. Even greater pH differences can be found at the cellular level between the extracellular environment (pH 7.4) and intracellular compartments such as the endosomes and lysosomes (pH 4.5–6.5) [5]. This pH gradient is of particular importance since several drugs and drug carriers are taken up by endocytosis and found/trapped within endosomes and lysosomes [6–9]. Endocytosis is a process by which cells internalize macromolecules into membrane-bound transport vesicles that form following invagination and pinching off of the plasma membrane [10]. Depending on the exact route of entry and proteins involved, the internalized material will have different fates. For instance, material internalized via clathrin-coated vesicles will undergo acidi?cation as the vesicles mature into early and late endosomes (pH 5.0–6.5) [5]. The material will then be traf?cked to lysosomes, the terminal degradation compartments of the endocytic pathway, by various processes of content mixing between late endosomes and lysosomes [11,12]. Lysosomes not only maintain an internal acidic pH (pH 4.5–5.0) but also contain a great number of hydrolytic enzymes (e.g., nucleases, proteases, phospholipases, esterases, and glycosidases) to degrade the entrapped molecules [13]. It is easily seen how drug delivery systems capable of exploiting the acidic pH of endosomes and lysosomes to evade these organelles and achieve substantial drug release to the cytosol would be valuable. Alternatively, drugs administered by the oral route experience a pH gradient as they transit from the stomach (pH 1–2, fasted state) to the duodenum (pH of about 6), and along the jejunum and ileum (pH 6–7.5) [14,15]. The oral route is the route of choice for the delivery of drugs because it is simple to implement and improves patient compliance and quality of life. However, not all drugs possess desirable properties for this route of administration. Notably, peptides, proteins, and nucleic acid drugs administered orally are subject to inactivation 988 989 989 in the acidic environment of the stomach and to degradation by digestive enzymes [16,17]. In addition, poor transport of these highly hydrophilic and large drug molecules across the epithelial membrane limits their absorption and oral bioavailability. Aside from poor permeability, poor water solubility may also greatly restrict the oral bioavailability of drugs [16]. Strategies to prevent GI degradation and/or to promote absorption in the intestine by making use of the pH gradient found along the GI tract appear promising. In this manuscript, we review drug delivery systems in which protonation (or deprotonation) of free carboxylic acid groups from a polymer triggers drug release. Depending on the intended route of administration and the physical barriers to overcome, three potentially interrelated pH-responsive drug release approaches/strategies can be envisaged. These are based on either i) dissociation or ii) destabilization (via collapse or swelling) of drug delivery systems upon changes in pH, or on iii) pH-dependent changes in partition coef?cient between the drug and the delivery vehicle (Fig. 1). Typically, such systems are stable in their storage conditions but respond quickly when their trigger pH is reached. A prompt response is crucial when the residing time at the target site is short (e.g., endosomes fuse with lysosomes within 30 min of cellular uptake) or to achieve suf?cient drug concentrations at the target site. In that respect, titratable drug delivery systems might be advantageous over systems in which drug release is promoted by hydrolysis of a pH-sensitive linkage. Indeed, drug release kinetics from hydrolyzable drug delivery systems is often dif?cult to adjust, with the systems being either too labile or overly stable. Hydrolyzable drug delivery systems will not be further addressed in this review and readers are invited to read the following contributions for more information on this topic [18,19]. Furthermore, this topic is also reviewed by Yang and co-workers in this issue of Advanced Drug Delivery Reviews. Of the available titratable anions, we will focus on carboxylic acids as they are the most commonly used. This is because the transition pH of polycarboxylates (typically around 4–6) is particularly ?tting for drug delivery applications. Furthermore, by adjusting the nature of the polymer backbone, the length of the polymer, the nature of co-monomers, etc., it is possible to ?ne-tune the transition pH and the sharpness of the pH-response. The physico-chemical aspects of the coil-to-globule transition of polymers containing carboxylic acids have been reviewed elsewhere [20]. The following sections will review in turn pH-sensitive vesicles, polymeric micelles (PMs), and nanospheres by providing for each system a description of the drug release mechanism(s) involved and examples illustrating their applicability. 2. Vesicles 2.1. Liposomes 2.1.1. Description Liposomes are vesicles composed mainly of phospholipids arranged in a bilayer membrane structure. They are commonly used as drug carriers because of their capability to either encapsulate water-soluble drugs in their cavity or to solubilize lipophilic drugs in their bilayer. Different classes of pH-sensitive liposomes have been described [19,21–23]. A ?rst class comprises liposomes that release their cargo following a pH-triggered change in the long-range order of their lipids. Other studies describe the use of either pH-sensitive (hydrolyzable) lipids or fusogenic peptides/proteins to trigger drug release. The latter A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 981 Fig. 1. Schematic representation of drug release mechanisms from liposomes, multimolecular PMs, and cross-linked polymeric nanospheres prepared with polycarboxylates. (A) Collapse of the polyanion makes the liposomal membrane leaky and promotes ef?ux of the drug from the liposomes. (B) Protonation-induced (left) and ionization-induced (right) destabilization of multimolecular PMs. (C) Ionization-induced swelling leads to drug release from cross-linked polymeric nanospheres. act by promoting fusion between liposomes and the endosomal membrane. Finally, liposomes can be made pH-sensitive by anchoring polymers capable of rendering phospholipid bilayers responsive to a drop in pH (Fig. 1A) [19]. In most cases, the polymers present alkyl chains for association with the lipid bilayer, carboxylic acid groups for pH-sensitivity, and an amphiphilic character for achieving membranolytic properties [24,25]. Examples of membrane-active pH-sensitive polymers that have been anchored to liposomes include copolymers of N-isopropylacrylamide (NIPAM), poly(alkyl acrylic acid)s, modi?ed poly(glycidol)s (PGs), polyphosphazenes, and poly(malic acid)s. The exact mechanism of release from pH-sensitive liposomes depends on the polymer used, with some polymers simply destabilizing the bilayer (to promote drug ef?ux to the endosome) and others leading to fusion between the liposome and endosome/lysosome membranes (to promote drug ef?ux to the cytosol) [19,26]. NIPAM-based copolymers are among the most widely used to prepare pH-sensitive liposomes. NIPAM homopolymers are characterized by a lower critical solution temperature (LCST) of approximately 32 °C in water [27]. By randomly introducing titratable monomers such as acrylic acid (AA), methacrylic acid (MAA), propylacrylic acid, and N-glycidylacrylamide into the polymer chain, the LCST rises above 37 °C and the polymer also becomes pH-responsive. In the bloodstream, at neutral pH, the carboxylic acid groups of the copolymer are ionized and the polymer chain adopts an extended conformation (Fig. 1A). In the endosome, the pH drops and protonation of the carboxylic acid units reduces the solubility of the polymer, thus lowering the temperature at which coil-to-globule phase transition occurs [28]. At this point, hydrophobic interactions dominate, enabling the NIPAM copolymers to interact with and destabilize the lipid bilayer (Fig. 1A). Liposomes bearing NIPAM copolymers do not fuse at acidic pH in the absence of fusogenic lipids [29,30]. Rather, studies indicate that the globular and insoluble NIPAM copolymer chains interact with the lipid bilayer and introduce curvature in the bilayer plane, thus making the liposomes leaky and promoting drug release (Fig. 1A) [28,31]. Recently, the formation of transient hydrophilic pores with a diameter of a few nanometers has been proposed to explain the permeabilization of vesicles by pH-sensitive NIPAM and related copolymers [32,33]. Numerous studies have been conducted to elucidate the interaction of poly(alkyl acrylic acid)s with liposomes and membranes following the pioneering work of Tirrell et al. [34] (for reviews, see [20, 35]). Fewer studies, however, have described the use of liposomes anchored with poly(alkyl acrylic acid)s as pH-responsive drug delivery systems. Poly(alkyl acrylic acid)-modi?ed liposomes release their contents following membrane-destabilization and possibly fusion [36,37]. Poly(alkyl acrylic acid)s are able to destabilize membranes at low pH values because protonation of the carboxylate ions increases the hydrophobicity of the polymers, allowing the hydrophobic segments to penetrate the lipid bilayer and to introduce defects in the membrane. Fusion, on the other hand, would result from the insertion of the hydrophobic segments of the polymer into the membrane of neighboring liposomes and/or endosomes. This would lead to close vesicle–vesicle contacts, facilitating local dehydration at the contact site, causing defects in the packing of the membrane lipids, and eventually promoting fusion [36]. Egg phosphatidylcholine liposomes covalently conjugated to poly(ethyl acrylic acid) have indeed been found to fuse with erythrocyte ghosts at pH 5.0 [36]. The pH at which the polymers destabilize and/or fuse membranes is related to but not strictly dictated by the pKa of the carboxylic acid groups. Rather, the hydrophilicity/hydrophobicity balance of the polymers at a given pH, in?uenced by the extent of ionization but also by factors such as the nature of the monomers, promotes the transition. Similarly to poly(alkyl acrylic acid)s, anchoring of PG copolymers also imparts fusogenic properties to liposomes [38–43]. While the exact mechanism by which pH-sensitive PGs destabilize membranes has not been directly studied, it is assumed that protonation of the carboxylic acid groups and subsequent H-bond formation with the phosphate groups of the phospholipids are responsible for bringing 982 A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 the polymer in contact with the bilayer in a pH-dependent fashion. Once in close contact with the liposome, the oxyethylene units of the PG backbone would be responsible for dehydration of the membrane and fusion per se [38]. Polyphosphazenes were recently introduced as a new class of pH-sensitive polymers for the design of stimuli-responsive vesicles [44]. Polyphosphazenes are inorganic polymers with a backbone consisting of alternating nitrogen and phosphorus atoms. Each of the phosphorus atoms can be modi?ed with two side groups, whether organic or organometallic, to tune the properties of the copolymer. As for pH-sensitive NIPAM copolymers, pH-sensitive polyphosphazenes have been synthesized to present a LCST that rises as pH is increased. In this case, ethoxy groups are responsible for the thermoresponsive behavior while amino butyric acid units confer pH-sensitivity [44]. To date, no information is available on the mechanism of release from pH-sensitive liposomes modi?ed with polyphosphazenes. While much work still needs to be done with this class of polymer, a potential advantage is that polyphosphazenes can be rendered biodegradable by introducing substituents such as amino acid esters on their backbone [45]. Biodegradability can also be achieved with hydrophobized poly(β-malic acid), which has been used to produce fusogenic pH-responsive vesicles [46,47]. 2.1.2. Applications pH-sensitive liposomes prepared with membrane-anchored polyanions have found applications in the delivery of membrane impermeable drugs (e.g., DNA, proteins, etc.) that are labile under the conditions encountered in the lysosomes. In addition to addressing issues of chemical stability, pH-sensitive liposomes may advantageously in?uence the release rate of drugs, helping for instance in the treatment of drug resistant tumors. In this case, rapid release of an anticancer agent may overwhelm the capacity of drug transporters located at the surface of cells. The release mechanism afforded by the polymer will closely in?uence the choice of drug to be encapsulated in the pH-sensitive liposomes and the appropriate application. For instance, small molecules such as 1-β-D-arabinofuranosylcytosine, which reach the cytoplasm via nucleoside transporters located in the endosomal membrane, may bene?t from simple destabilization of the liposome and endosomal release. In contrast, fusion with or disruption of the endosomal membrane is essential for large molecules such as proteins or DNA to reach the cytosol. Numerous in vitro studies have been conducted in view of optimizing pH-sensitive liposomes for the intracellular delivery of drugs. Fewer studies, however, actually evaluate their in vivo performance. The following lines will ?rst describe the in vitro results that have shaped and guided the design of optimized pH-sensitive liposomes. An evaluation of the results obtained in vivo will then be presented. 2.1.2.1. In vitro results 2.1.2.1.1. Polymer composition and pH-responsiveness. The extent of polymer anchoring affects the performance of pH-sensitive liposomes. This is seen from the fact that content leakage from polymer-modi?ed liposomes can be enhanced by increasing the copolymer to lipid ratio in the liposome [25,28,30,38,48]. Such enhanced content leakage may be explained by the work of Cho et al. who found that lipid–lipid cohesion was weakened as more polymer was anchored in the liposome bilayer [49]. Likewise, randomly-alkylated copolymers, which are better anchored to the lipid bilayer than copolymers of equivalent molecular weight but that are alkylated at one chain end, destabilize liposomes more ef?ciently [25]. The anchoring of pH-sensitive copolymers can be improved by carefully adjusting the proportion of the alkyl chain of the copolymer, whether by decreasing the molecular weight of terminally-alkylated polymers or by incorporating more alkyl groups along longer polymer chains [30,37,45,50]. However, as shown for pH-sensitive liposomes modi?ed with polyphosphazenes, the alkyl chain content should be kept low enough to ensure solubility of the polymer during liposome preparation in order to favor interaction with liposomes over self-association via hydrophobic interactions [44,45]. Also, care should be taken when modifying the molecular weight of polymers as this parameter also affects their biological fate. When polymers are non-degradable, the molecular weight should be kept low enough (e.g., b32 kDa in case of NIPAM copolymers) to ensure excretion by the renal route [51]. In addition to the alkyl chain content and the molecular weight, the hydrophobicity of the polymer main chain also affects the responsiveness of pH-sensitive liposomes. Increasing the hydrophobicity of the acidic moiety of PGs and of NIPAM copolymers shifted the precipitation pH to higher values [52,53]. Liposomes prepared with these polymers could respond to pH changes occurring earlier in the endocytic process and could even target tumor acidosis. Recently, it was shown that the architecture of the pH-sensitive copolymer also affected pH-responsiveness, with liposomes modi?ed with hyperbranched PGs promoting increased fusion with the endosomal membrane in vitro compared to liposomes modi?ed with their linear equivalents (Fig. 2) [42]. 2.1.2.1.2. Lipid composition and pH-responsiveness. One of the advantages of using polymers to prepare pH-sensitive liposomes is the possibility to render almost any liposomal composition sensitive to pH. Polycarboxylates can trigger content leakage from neutral as well as from charged liposomes, from liposomes composed of ?uid phase lipids, and from liposomes made of lipids presenting high phase transition temperatures [19,26,54]. When the lipids are positively charged, electrostatic interactions between the lipid membrane and acid groups can enhance the binding strength of the polymer to the liposome [54,55]. pH-Sensitive copolymers can even stabilize lipids such as dioleoylphosphatidylethanolamine (DOPE), which alone form a hexagonal phase (HII), into a lamellar vesicle at physiological pH while inducing content leakage at acidic pH [48]. A potential advantage of introducing DOPE in the membrane composition is to confer and/or improve the fusogenic properties of polymer-based pH-sensitive liposomes [42]. 2.1.2.1.3. Formulation method and pH-responsiveness. The preparation method of the pH-sensitive liposomes, i.e., whether the pH-sensitive copolymer is simply incubated with pre-formed vesicles or incorporated during the liposome preparation procedure, affects polymer binding and content release from pH-sensitive liposomes [45,54]. Formulations in which the polymer was added during liposome preparation incorporated more polymer and triggered more contents release at acidic pH [45,54]. It is to be kept in mind, however, that this method may not be compatible with liposomal technologies using pH or ammonium sulfate gradients for drug loading and with formulations containing lipids with high phase transition, as premature precipitation of the polymer might occur. 2.1.2.1.4. PEGylation and pH-responsiveness. Poly(ethylene glycol) (PEG) is a hydrophilic polymer that is often coupled at the surface of liposomes to increase their circulation time. This is because PEG forms a steric barrier that decreases and/or slows down protein adsorption, thus decreasing clearance by the mononuclear phagocyte system [56]. The corresponding downside, however, is that PEG generally reduces the fusogenicity and pH-responsiveness of the liposomes. This is evident from the literature on pH-sensitive liposomes composed of polymorphic lipids such as DOPE, which shows that PEGylation signi?cantly decreases the pH-dependent release of calcein in vitro [21]. Even for pH-sensitive liposomes that do not fuse, incorporation of PEG in the formulation may be deleterious as PEG hinders the anchoring of the pH-sensitive polymer, increases the stability of the bilayer, and interferes with the aggregation of the copolymer, thereby reducing the extent of destabilization of the liposomal membrane. Many studies have shown that pH-sensitive liposomes anchored with NIPAM copolymers lost their pH-sensitivity when PEG was included in the liposomal formulation [25,28,30]. When the NIPAM copolymer was A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 983 Fig. 2. Confocal laser scanning microscopic images of immature murine dendritic cells (DC2.4) treated with egg yolk phosphatidylcholine/DOPE (1/1, mol/mol) liposomes. (A) Plain liposomes, (B) liposomes anchored with an hyperbranched PG, and (C) liposomes anchored with a linear PG. All liposomes were doped with two ?uorescent lipids. Fusion of the labeled liposomes with endosomal membranes causes dilution of the ?uorescent lipids and results in a decrease of the energy transfer ef?ciency between the ?uorescent probes. Intact liposomes are detected at λem N 560 nm while fusion is observed at λem = 500–530 nm. Scale bar represents 10 μm. Reproduced from Yuba et al., with permission from Elsevier [42]. inserted by simple incubation with pre-formed PEGylated vesicles, the loss of pH-responsiveness was in part attributed to poor anchoring of the polymer into the lipid bilayer [25,30]. In those cases, decreasing the molecular weight of the polymer and increasing the alkyl chain content permitted the recovery of some pH-sensitivity. Interestingly, it was found that including the NIPAM copolymers in the hydration buffer during liposome preparation, as opposed to simple incubation with pre-formed vesicles, greatly improved binding of the polymer to the sterically-stabilized liposomes and helped maintain pH-responsiveness [30]. Using optimal preparation conditions, good pH-sensitivity can be achieved with PEGylated formulations [57,58]. 2.1.2.1.5. Stability in serum. A key aspect in the development of pH-sensitive liposomes is their stability in biological ?uids. The formulations should, on the one hand, present minimal leakage while circulating and, on the other hand, maintain their pH-responsiveness. Anchoring of alkylated NIPAM copolymers was reported to stabilize the lipid bilayer and reduce drug leakage from liposomes in the presence of serum [25]. This stabilizing effect, however, was compromised when a targeting antibody was added to the formulation, with drug leakage from immuno pH-sensitive liposomes bearing a whole monoclonal antibody being greater in vivo compared to non-targeted pH-sensitive liposomes [59]. In turn, the pH-sensitivity of the vesicles can be lost in biological ?uids [26]. Extraction of the polymer from the bilayer by serum components and/or a shift in transition pH due to protein adsorption have been put forth to explain this loss of sensitivity [26]. Examination of the existing body of literature on NIPAM copolymer-based pH-sensitive liposomes indicated that loss of pH-sensitivity in presence of serum was mainly observed when the pH-sensitive copolymer was simply incubated with pre-formed vesicles (as in [26]) as opposed to when the polymer was incorporated during the liposome preparation procedure (as in [28,54,57,60]). This might be because the polymer anchored during liposome preparation is located in both the internal and external leaflets of the bilayer, with only the external chains being subject to desorption. This correlation, however, is only tentative since liposomes in reference [26] were prepared with a high transition temperature lipid while all others were prepared with egg phosphatidylcholine. Strategies aiming at increasing the af?nity of the polymer for the lipid bilayer have also been tested to help maintain the pH-sensitivity of liposomes in serum. Polymers with either a high proportion of alkyl chain anchors distributed along the polymer chain or with an increased number of terminal alkyl chains (two vs. one) and low molecular weight all afforded minimal loss of pH-sensitivity in serum [28,54]. However, from lack of systematic studies in the literature establishing relationships between pH-sensitivity in serum and polymer composition, the importance of those parameters remains unclear. Recently, serum-stable pH-responsive liposomes were prepared by cross-linking poly(acrylic acid) (PAA) chains anchored in the lipid bilayer via a terminal cholesterol [61]. While this approach was highly ef?cient in stabilizing the vesicles, it remains unknown whether such a non-biodegradable cross-linked coating can be readily eliminated from the body after parenteral administration. 984 A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 2.1.2.1.6. Ef?cacy on cells. In numerous studies, pH-sensitive liposomes prepared with anionic polymers have been found to maintain their activity in cells. This was shown either by monitoring lipid mixing between liposomes and endosomal/lysosomal membranes (Fig. 2) [39,42,43] or by imaging the delivery of ?uorescent molecules to the cytosol [26,37,39,41,42,50,52]. When 1-β-D-arabinofuranosylcytosine was used as anticancer drug, the increased cytosolic delivery achieved with pH-sensitive liposomes translated into an increase in the cytoxicity compared to plain liposomes in both macrophage-like and leukemia cell lines [26,50,54]. Ef?cient delivery of α-ketoglutaric acid was also achieved by pH-sensitive liposomes, and promoted procollagen production in human dermal ?broblasts [62]. More notably, the administration of pH-sensitive liposomes loaded with ovalbumin (a large molecule, ca. 45 kDa) promoted antigen presentation on bone marrow-derived dendritic cells via major histocompatibility complex class I molecules compared to unmodi?ed liposomes. In this case, only the most hydrophobic (and consequently most pH-responsive) polymer was able to ef?ciently transfer the ovalbumin to the cytosol [41]. 2.1.2.2. In vivo results 2.1.2.2.1. Pharmacokinetics and in vivo ef?cacy of pH-sensitive liposomes. Liposomes not only need to be stable in biological ?uids but should exhibit long circulation times when administered intravenously in order to reach target cells and mediate cytoplasmic delivery. Therefore, any premature uptake by the mononuclear phagocyte system could compromise their therapeutic value. Indeed, it has been found that negatively charged PAA-and PG-conjugated liposomes were taken up by phagocytic cells, probably via the scavenger receptor [63,64]. Yamazaki et al. reported that the anchoring of terminally-alkylated NIPAM copolymers could reduce the adsorption of plasma proteins on liposomes below the LCST [65]. Since low protein adsorption is typically correlated with increased circulation times in vivo and accumulation of liposomal formulations at tumor sites, the pharmacokinetic pro?les of liposomes coated with randomly- and terminally-alkylated pH-sensitive NIPAM copolymers were evaluated [28,57,60]. It was shown that the pH-sensitive NIPAM copolymers conferred some steric protection in vivo, increasing the area under the blood concentration vs. time curve (AUC) by 1.2- to 1.9-fold compared to naked liposomes. This protection, however, was marginal compared to what can be achieved with PEG. A recent study by Bertrand et al. indicated that there was minimal polymer desorption of a terminally-alkylated NIPAM copolymer occurring from pH-sensitive liposomes in vivo, ruling out this phenomenon as a possible explanation for the limited steric protection offered by NIPAM copolymers [51]. Rather, the weak steric protection may be explained by the fact that the copolymers were actually not in a fully random coil conformation at neutral pH [28]. The addition of PEG to pH-sensitive liposomes permitted to prolong their AUCs by an additional 2- to 3.4-fold [28,57]. Finally, the in?uence of the presence of an antibody, whether whole or fragmented (fragment antigen-binding (Fab')), on the pharmacokinetic pro?le and biodistribution of PEGylated pH-sensitive liposomes was evaluated [59]. Compared to the non-targeted pH-sensitive PEGylated formulation, the presence of a whole antibody resulted in a substantial decrease of liposomal blood levels while the Fab' fragment had a lesser impact on clearance and AUC values. An in vivo ef?cacy study conducted by Simard et al. completed the picture for pH-sensitive liposomes based on NIPAM copolymers [59]. The capability of PEGylated pH-sensitive liposomes decorated with the anti-CD33 Fab' fragment at improving the survival of leukemic immunodepressed mice treated with 1-β-D-arabinofuranosylcytosine was tested. Unfortunately, while Fab'-PEGylated liposomes were able to prolong the survival of leukemic mice, the addition of the pH-sensitive polymer did not have any further bene?t. Overall, it appears that the marginal advantage of the pH-sensitive liposomes seen in vitro was offset by the less favorable pharmacokinetics of the formulation in vivo [50]. More promising in vivo results have been obtained using ovalbumin-loaded pH-sensitive PG liposomes to immunize mice [41]. In this case, pH-sensitive liposomes administered via the nasal cavity induced a stronger cellular immune response than plain liposomes. The immune response achieved with the liposomes was comparable to that of Freund's complete adjuvant. Therefore, it appears that future studies on pH-sensitive liposomes should focus on systems capable of fusion so as to ensure ef?cient drug delivery to the cytosol. Furthermore, the applicability of systems capable of fusion is extendable to large molecules such as peptides and nucleic acids. 2.2. Niosomes Niosomes are vesicles composed of non-ionic surfactants. They have been investigated as alternatives to liposomes to obtain pH-sensitive vesicles that better retain the anchored pH-sensitive polymers in presence of serum. This is because the binding of pH-sensitive polymers to niosomes is thought to be stronger as it involves cooperative hydrogen bonds in addition to hydrophobic and/or electrostatic interactions [55]. The results, however, showed that polymer-coated vesicles were leaky in presence of serum at neutral pH, and lost pH-sensitivity after incubation in serum [29,54]. Furthermore, pH-sensitive niosomes failed to deliver calcein to the cytoplasm of macrophage-like cells [29,54]. Accordingly, despite the pH-sensitive polymer binding strongly to niosomes, the overall stability of the formulation remains inadequate in physiological ?uids for in vivo applications. 2.3. Lipoplexes Lipoplexes result from the interaction of cationic lipids with nucleic acids to form either nucleic acid-coated vesicles or aggregates. The exact morphology of lipoplexes is often ill-characterized and both systems will therefore be discussed jointly in this section on vesicles. To date, two approaches have been tested to confer pH-sensitivity to lipoplexes using polyanions. In the ?rst approach, pH-sensitive membrane-active polyanions are directly incorporated in the preparation of lipoplexes, leading to so-called ternary complexes. Ternary complexes prepared with either poly(propylacrylic acid) or copolymers of MAA/ethyl acrylate (EA)/butyl methacrylate (BMA) have both been able to increase transfection ef?ciency compared to the parent, polymer-free complexes [66–68]. The role of the polymer is several folds and includes transfer of the nucleic acid from late endosomes to the cytoplasm in a pH-dependent manner [66,68]. Upon the decrease in pH met in the endosomes, the carboxylate ions of the polymer became protonated, promoting dissociation of the polymer from the complex, interaction with the endosomal membrane, and membrane destabilization. In this process, the MAA/EA/BMA polymer remained trapped/bound to the endosomal vesicles, suggesting that the organelles are not destroyed but rather that defects in the membrane allow for permeation of the nucleic acids to the cytosol [66]. The polymers also appear to improve transfection by stabilizing the ternary complexes toward dissociation in presence of serum components [69]. Finally, the presence of poly (propylacrylic acid) in ternary complexes was shown to enhance cellular uptake [67, 69]. This bene?cial effect, however, was not seen by Yessine et al. [66]. On the contrary, they observed a decrease in cellular uptake of the ternary complexes compared to plain lipoplexes. Without additional information on the physicochemical properties (i.e., size, zeta potential) of the poly(propylacrylic acid) complexes, it is dif?cult to explain this inconsistency. Poly(propylacrylic acid)-based ternary complexes have been tested in vivo in a mouse wound healing model and compared to polymer-free complexes [70]. While quanti?cation of the regulation of the target protein in tissues was found to be dif?cult, biological changes in the healing response were seen and indicated successful transfection by the ternary complexes only [70]. The second strategy undertaken to prepare pH-sensitive lipoplexes consists in adding pH-sensitive liposomes to lipoplexes. Such A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 assemblies have been prepared with PG-based pH-sensitive liposomes. In this case, a decrease in pH not only promoted fusion between liposomes and endosomes/lysosomes (as described in Section 2.1), but also between the liposomes and the lipoplexes, potentially detaching the nucleic acid from the assemblies [71]. The approach led to increased transfection ef?cacy, which was correlated to the fusion ability of the parent pH-sensitive liposomes [40,64,71,72]. 2.4. Polymersomes Polymersomes are vesicular structures composed of a polymeric membrane surrounding an aqueous internal compartment. The membrane generally comprises an entangled hydrophobic layer with two hydrophilic polymer brushes [73]. Owing to their thicker membranes, they are often viewed as being more stable than lipid-based vesicles, and are therefore receiving increased interest among the drug delivery community [74]. While important for storage and pharmacokinetic considerations, the robustness of the membrane can be questionable if the latter impedes drug release at the target site. Moreover, depending on the dimensions and hydrophobicity of the amphiphilic polymer, the hydration of the latter and subsequent formation of polymersomes in aqueous media can be problematic, often requiring the use of organic solvents, sonication or high temperature. For the above reasons, the possibility of controlling the assembly and disassembly of polymeric vesicles, and thereby the encapsulation and release of drugs, following changes in pH is particularly attractive [75]. In the area of drug formulation, pH-sensitive polymersomes based on polyanions have been less studied than those relying on cationic polymers [75]. Polyanionic polymersomes can be obtained from diblock copolymers consisting of a hydrophobic block forming the inner lea?et of the membrane and an ionized block polyacid such as PAA or poly(L-glutamic acid) (PGA) forming the outer hydrophilic brushes [76–78]. At low pH values, the polyanionic block can, however, also form the inner lea?et when the other block is hydrophilic [79]. As previously reported for polycationic systems, the ability of polyanionic block copolymers to spontaneously self-assemble in water could, in principle, be exploited to load sensitive drugs (e.g., proteins, nucleic acids) in the absence of organic solvent by simply adjusting the pH to the value where vesicle formation occurs [80]. In the case of biodegradable polymersomes prepared from poly (trimethyl carbonate)-b-PGA, it was shown that the release rate of doxorubicin increased upon lowering the pH from 7.4 to 5.5 [81]. Although the faster release was attributed to the increase in the drug's hydrophilicity following its protonation, it is possible that the coil to α-helical transition of PGA may have facilitated drug escape by transiently affecting the membrane's permeability and/or increasing the inner pressure. Indeed, at acidic pH, the vesicular structure remained but size decreased [82]. The same phenomenon occurred with polymersomes composed of poly(butadiene)-b-PGA, where it was shown that the protonation of the PGA block induced a strong decrease in vesicle size and membrane thickness [83]. PGA-based polymersomes loaded with doxorubicin have been recently tested in vivo and found to be more ef?cient than the free drug on a murine tumor model [84]. Apart from block copolymers, polyanion-based pH-responsive polymersomes have been prepared from hyperbranched and graft polymers (e.g., hydroxyethylcellulose-g-PAA) [85]. The introduction of chemical cross-links in such systems has also been investigated as a means to prevent disassembly and control vesicle swelling upon the ionization of the cross-linked polyacid [86,87]. Recently, Koide et al. have described the preparation of pH-sensitive polyion complex vesicles [88]. These vesicles formed at neutral pH upon the self-assembly of oppositely-charged PEG block polyanions (i.e., PEG-b-poly(L-aspartic acid) (PEG-b-PAsp)) and homo or PEG block polycations, and encapsulated water-soluble compounds. After the acidi?cation of the external medium to pH values corresponding to 985 that of the endosomes, the membrane permeability increased as a result of the neutralization of the PAsp block and, eventually, fragmentation of the vesicles into smaller particles [89]. Pharmacokinetic studies demonstrated that such vesicles exhibited long circulation times and tumor deposition, but only after cross-linking of the vesicle membrane [90]. Finally, polymersomes with pH-responsive transmembrane channels have been described by Chiu et al. [91]. These vesicles consisted of PAA partially esteri?ed with distearin. Upon raising the pH from 5 to 8, the globule-to-coil phase transition of PAA domains resulted in the formation of permeable channels, through which the ?uorescent probe calcein could diffuse. Such vesicles may ?nd practical applications in oral drug delivery by protecting drugs from the harsh acidic environment in the stomach and allowing release in the intestine. For systems exhibiting a strong negative zeta potential and which are intended to be administered by intravenous injection, it will be important to determine the impact of surface charge on the opsonization of vesicles and clearance by the mononuclear phagocyte system [92,93]. 3. Polymeric micelles As classically de?ned, PMs are nanoscopic constructs that possess a core/shell architecture. They are obtained from the self-assembly of amphiphilic block copolymers in aqueous media above the critical micelle concentration (CMC). The core, consisting of the hydrophobic domain, acts as a reservoir and protects the drug payload whereas the hydrophilic shell mainly confers aqueous solubility and steric stability to the ensemble [94,95]. The self-association of polymeric chains can involve other forces than hydrophobic interactions. For example, the cooperative electrostatic interactions between oppositely-charged polymers were shown to produce a subclass of PMs known as polyion complex micelles (PICMs). Both PMs and PICMs typically exhibit a narrow size distribution, with diameters ranging from 10 to 100 nm. In the following section, PMs responding to a change in pH will be discussed according to their intended administration route (and, by extension, their drug release mechanism) (Fig. 1B). pH-Responsive micellar structures prepared with polyanions that were derivatized with acid-labile linkages such as cyclic acetals [96], hydrazones [97,98], or β-thiopropionate [99] will not be covered in this review. 3.1. Parenteral drug delivery As seen for pH-sensitive vesicles, the mildly acidic pH encountered in tumors, in?ammatory tissues, as well as in the endosomal and lysosomal compartments of the cells offers an opportunity to trigger the disassembly and/or destabilization of pH-sensitive PMs. PMs prepared for parenteral administration have to be stable at pH 7.4. A ?rst approach to prepare pH-sensitive PMs is to combine positivelycharged drugs (such as doxorubicin) with an oppositely charged block copolymer to form a polyion complex core (Table 1) (Fig. 1B, left). At neutral pH (e.g., bloodstream), above pKa of the polymer, the carboxylic acid units are negatively charged hence allowing cooperative electrostatic interactions with the encapsulated compounds. Once in a mildly acidic environment, protonation of the carboxylic acid groups results in a net decrease in electrostatic interactions and dissociation of the drug-containing core (Fig. 1B, left). Another approach to prepare pH-sensitive PMs is to incorporate a drug in the uncharged hydrophobic core of a micelle presenting an ionized polyanion shell [100]. In this case, protonation of the shell induced a perturbation of the core–shell structure and ultimately affected the intracellular distribution of the drug [100]. The principal drawbacks of PMs are their relative instability upon dilution in body ?uids and sensitivity to increased ionic strength, both rapidly leading to premature drug release [18,101]. Bronich et al. were able to produce stable nanoscale ionic gels by cross-linking the micelle core of PEG-b-poly(methacrylic acid) (PEG-b-PMAA) micelles with 986 A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 Table 1 pH-sensitive polyanions typically used to prepare PMs for parenteral drug delivery. Polyanion Drug/compound Size (nm)[a] Ref. PEG-b-PMAA Doxorubicin Cisplatin Lysozyme Zinc porphyrin dendrimer AlClPc AlClPc Doxorubicin Doxorubicin Doxorubicin 150 100–200 50–100 55 [164] [103,104] [105,165] [166] 13–35 20–34 120–200 250–300 200 [100,167] [168] [169] [170] [171] 160 160 100–120 30–100 30 50–60 50–60 45 [172] [173] [174] [175] [108] [111] [110,111] [176] PEG-b-PAsp P(NIPAM-co-MAA-co-ODA) P(NIPAM-co-MAA-co-ODA-co-VP) P(NIPAM-co-MAA)-g-PLA P(NIPAM-co-DMAA-co-UA) P(NIPAM-co-DMAA-co-UA)g-cholesterol P(NIPAM)-b-PUA P(NIPAM)-b-PAA P(NIPAM-co-AA-co-HEMA)-g-PCL PSMA-alkylamide derivative P(MAA-co-EA-co-BMA) PEG-b-P(PrMA-co-MAA) Prednisone acetate Doxorubicin Doxorubicin Doxorubicin/ siRNA AON AON siRNA PDMAEMA-b-P(BMA-co-DMAEMA- siRNA co-PropylAA) ODA, octadecyl acrylate; VP, N-vinyl-2-pyrrolidone; PLA, poly(D,L-lactide); DMAA, dimethylacrylamide; UA, 10-undecenoic acid; PUA, poly(10-undecenoic acid); HEMA, 2-hydroxyethyl methacrylate; PCL, poly(ε-caprolactone); PSMA, poly(styrene-alt-maleic anhydride); AlClPc, Aluminum chloride phthalocyanine; PDMAEMA, poly(N,Ndimethylaminoethyl methacrylate). [a] Determined by dynamic light scattering with drug-loaded PMs. divalent metal cations (e.g., Ca 2+) [102]. The resulting PMs were loaded with chemotherapeutic agents such as doxorubicin and cisplatin [103,104]. Similarly, Yuan et al. were able to entrap and stabilize lysozyme in chemically cross-linked micelles of PEG-b-PAsp [105]. Nucleic acids have also been loaded into polyanion-based PMs (Table 1). Incorporation of genetic material into PMs prepared with a pH-sensitive polyanion necessitates the introduction of a polycationic molecule to allow bridging of the negatively-charged macromolecules. The optimal cationic polymer should be non-toxic, ef?cient in condensing the polyanions, and eventually exhibit endosomolytic properties to maximize transfection [106,107]. Such assemblies have been referred to as ternary PICMs and have, for instance, been prepared by combining an endosomolytic copolymer of MAA and PEG-b-poly(aminoethyl methacrylate) or PEG-b-poly(propyl methacrylate-co-methacrylic acid) (PEG-b-P(PrMA-co-MAA)) and poly(amido amine) (PAMAM) dendrimers [108–111]. In the presence of a PAMAM dendrimer, PEG-b-P(PrMA-co-MAA) formed discrete 50–60 nm core–shell type PICMs at physiological pH (Fig. 3) [111]. These nanocomplexes could accommodate antisense oligonucleotides (AONs) and small interfering RNAs (siRNAs) in their core [111]. The ternary PICMs are designed to disassemble and release the nucleic acid/polycation core in the mildly acidic milieu of the endosomes after protonation of the carboxylic acid groups of the polyanion, leaving excess positive charges available to interact with the endosomal membrane [111]. The extent of this disassembly was investigated by tracking the siRNA release from PICMs conditioned at pH 5.0 or 7.4 (Fig. 4). At pH 5.0 and after a 24-h period, ca. 85% of the initially loaded siRNA was available to diffuse through a size-restrictive membrane whereas PICMs conditioned at pH 7.4 remained stable, hence preventing siRNA diffusion through the membrane. Such micellar constructs exhibited good stability in the presence of serum and ef?ciently protected their nucleic acid cargo against enzymatic degradation [110,111]. In order to trigger PICM uptake by receptor-mediated endocytosis, the micelles were decorated with an antibody fragment directed against the transferrin receptor (CD71), via either disul?de or thioether linkages [110,111]. It was found that the targeted PICMs could ef?ciently downregulate in vitro the oncoprotein Bcl-2 in human prostate adenocarcinoma (PC-3) cells, especially when using a 2′F-modi?ed siRNA [110]. Fig. 3. (A) Schematic representation of the different components needed to prepare targeted ternary PICMs. (B) At physiological pH, these components self-assemble to form PICMs. (C) Following acidi?cation of the milieu, the PEG-b-polyanion is displaced from the core resulting in the dissociation of the PICM. Insets represent PICMs as observed by transmission electron microscopy at pH 7.4 (B) and 5.0 (C), respectively. For transmission electron microscopy, samples were adsorbed to glow discharged carbon-coated copper grids for 2 min and negatively stained with 2% (w/v) uranyl acetate solution for 30 s. The specimens were examined with a Philips CM12 (FEI, Hillsboro, OR) electron microscope operating at 100 kV and images were recorded with a Gatan CCD 794 camera (Gatan Inc., Pleasanton, CA). Felber et al., unpublished data. 3.2. Oral drug delivery The oral route is the most convenient and economical drug administration pathway. Class II drug molecules (i.e., highly permeable and poorly water-soluble) often exhibit a low oral bioavailability due to incomplete dissolution in the GI tract. If the poor solubility behavior of Class II drugs in GI ?uids remains the main hurdle to their ef?cient oral absorption, drug expulsion by the intestinal permeability glycoprotein is also of concern. The intestinal permeability glycoprotein, a membrane-associated protein present on the intestinal epithelium, acts as a pump modulating the outward (ef?ux) transport of drugs [112,113]. Over the past decade, PMs have been extensively studied as potential oral delivery systems for Class II drugs [1,16,114–116]. Unfortunately, vehicles designed to increase the oral bioavailability of these drugs often exhibit release times that exceed the transit time in the small intestine [117,118]. Camilleri et al. studied the stomach emptying and the small bowel transit times in healthy human volunteers by monitoring the migration of a radiolabeled marker previously mixed in their meal [119]. They observed half times of ca. 177 min and ca. 168 min for stomach emptying and small bowel transit times, respectively [119]. Hence, state of the art oral PM formulations should exhibit adequate drug release behaviors in order to avoid i) precipitation upon administration and ii) sequestration within the micellar phase, both leading to incomplete absorption. A promising strategy to A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 987 Table 2 pH-sensitive polyanions typically used to prepare PMs for oral drug delivery. Polyanion[a] Drug Size (nm)[b] Ref. Star-P(EMA-co-MAA)-b-P(PEGMA) PEG-b-P(VBODENA-co-AA)) PEG-b-P(Al(M)A-co-MAA) Progesterone Paclitaxel Indomethacin Feno?brate Candesartan cilexetil Ibuprofen Prednisone acetate Naproxen BMS-A 10–16 85–90 180–380 30–380 40–50 120–250 200 230 150 [120] [122] [121] [121] [124] [177] [178] [127] [128] P(MMA-co-MAA)-b-P(PEGMA) PAA-b-PLA PEG-b-PMAA EMA, ethyl methacrylate; MMA, methyl methacrylate; BMS-A, Proprietary compound from Brystol-Myers Squibb Company. [a] For PEG-b-P(Al(M)A-co-MAA), the Al(M)A unit is either EA, nBA, iBA or PrMA. [b] Determined by dynamic light scattering with drug-loaded PMs. Fig. 4. In vitro siRNA release from siRNA-loaded PICM at different pH values. (A) Schematic representation of the experimental set-up. The PICM formulation was loaded into the donor chamber X and diffusion of dissociated PICM components was monitored in acceptor chamber Y by spectrophotometry at 260 nm. Both chambers were conditioned at pH 7.4 or 5.0 (10 mM Tris buffer). Membrane was size restrictive and only allowed the diffusion of free-siRNA and siRNA/PAMAM G5 dendrimer complexes. (B) siRNA/PAMAM release from PICMs at pH 5.0 (?) and 7.4 (?). Diffusion of control free-siRNA is also represented (?). Results are expressed as mean± SD (n = 3). Felber et al., unpublished data. circumvent these problems is the encapsulation of drugs in PMs responding to a change in pH. Upon an increase in pH, pH-sensitive PMs ionize/dissociate to release the loaded drug in a molecularly dispersed form (Fig. 1B, right). Such assemblies are stable at acidic pH and can ef?ciently dissolve hydrophobic drugs, thereby minimizing the burst release and possible drug precipitation in the stomach. The use of this type of PMs for oral drug delivery is still fairly recent, and only few systems have been investigated (Table 2). pH-sensitive PMs can be either unimolecular or multimolecular [120–122]. Upon pH increase, the core of the unimolecular micelles became more polar hence promoting the release of the hydrophobically incorporated drug [120]. As these micelles do not possess a CMC, they have the advantage of being intrinsically stable upon dilution. Conversely to unimolecular micelles that maintain their integrity upon a change in pH, pH-sensitive multimolecular PMs based on ionizable polyanions disassemble following an increase in environmental pH. For instance, Kim et al. developed a hydrotropic polymer, PEG-b-(4(2-vinylbenzyloxy)-N,N-(diethylnicotinamide)) (PEG-b-VBODENA), doped with AA units (≤50 mol%) to confer pH-sensitivity to PMs (Table 2) [122]. They observed that the loading content and ef?ciency of paclitaxel was governed by the pH of the loading medium, with both maxima at pH≤ 4 [122]. Increasing the pH above the pKa of the polymers provoked a rapid dissociation of the complexes [122]. Alternatively, PEG-b-poly(alkyl(meth)acrylate-co-methacrylic acid)s (PEG-b-P(Al(M)A-co-MAA)s) are diblock copolymers displaying a pH-dependent micellization behavior in aqueous media (Table 2). The self-association into well-de?ned micellar structure is facilitated by the hydrophobic non-ionizable Al(M)A units, whereas the pH-sensitivity is conferred by the carboxylic acid groups of the MAA moieties [121,123,124]. It has been observed that diblock copolymers devoid of Al(M)A led to the formation of large aggregates, most likely resulting from extensive hydrogen bonding between the MAA groups and the PEG chains (Table 2) [123,125–128]. Furthermore, the nature and abundance of Al(M)A moieties played a critical role on the particle size, CMC, and stability. Small alkyl side groups such as EA yielded larger particles that associated at higher concentration compared to more hydrophobic units such as n-butyl acrylate (nBA), iso-butyl acrylate (iBA), or PrMA (Table 2) [121,124,125]. Depending on their composition, these copolymers self-assembled in PMs at pH values lower than 4.5 to 5.5 and dissociated into unimers and/or smaller aggregates upon an increase in pH [121]. PEG-b-P(Al(M)A-co-MAA)-based PMs have been investigated notably for the solubilization of candesartan cilexetil, an ionizable poorly water-soluble drug used for the treatment of hypertension [124]. The release pro?les of candesartan cilexetil from pH-sensitive PEG-b-P(iBA-co-MAA) and pH-insensitive PEG-b-P(iBA-co-tert-butyl methacrylate) micelles were studied in vitro [124]. The PMs were ?rst immersed in simulated gastric ?uid for 2 h and then exposed to pH 7.2 for an additional 7 h. Both formulations showed relatively low drug leakage at acidic pH. However, sudden increase in the release rate occurred when raising the pH to 7.2 for the PEG-b-P(iBA-coMAA), eventually leading to the complete release of the loaded drug after 9 h [124]. In vivo testing on rats showed that such micelles yielded ca. 25% greater drug exposure than both their pH-insensitive counterpart and a commercial formulation [16]. Finally, these PMs mainly addressed the solubility problems of candesartan cilexetil, as PEG-b-P(iBA-co-MAA) was reported to have almost no effect on the activity of the permeability glycoprotein and on transepithelial permeability at intestinal pH [16]. Recently, novel pH-responsive polymers composed of an anionic polypeptide and a low molecular weight nonionic surfactant (Brij®) have been found to form reversible nanoscopic assemblies in acidic media [129,130]. Further experiments are needed to determine if such systems would be adequate to ef?ciently encapsulate drugs and deliver them in the GI tract. 4. Polymeric nanospheres 4.1. Oral drug delivery Of all the pH-sensitive drug delivery systems described so far, polymeric nanospheres intended for oral applications have the greatest chance of success on a short-term basis. Indeed, such particles are easy to formulate and can be prepared from polymers already 988 A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 commonly used in drug formulation. Furthermore, the nanospheres are not absorbed by the GI tract, diminishing toxicity issues. Polymeric nanospheres are generally de?ned as insoluble colloidal systems having sizes ranging from about 10 to 1000 nm and a solid polymeric core [131]. pH-sensitive polymeric nanospheres were initially developed by Gurny and co-workers in the mid/late 90's to improve the bioavailability of peptidic and peptidomimetic drugs [132–136]. They were produced with MAA copolymers of the Eudragit® (L100–55, L100, and S100) family, which were originally marketed as gastro-resistant coating agents. Particles prepared with these polymers had a size in the range of 250–300 nm, and were obtained by an emulsi?cation-diffusion procedure [133,136]. It was demonstrated that the dissolution pH of the particles could be ?nely tuned by selecting the appropriate Eudragit® polymer [132–134]. In rodents and dogs, these pH-sensitive nanospheres were shown to improve the oral absorption of human immunode?ciency virus (HIV) type 1 protease inhibitors compared to the crude suspensions [132,133,135]. Discrepancies between the studies with respect to the impact of food on the extent of absorption were observed. However, they could be related to the nature of protease inhibitor used. More recently, the oral delivery of different molecules using various Eudragit®-based nanospheres was examined [137–142]. It was found that the formulation of cyclosporine A into Eudragit® S100 nanospheres improved its bioavailability compared to the Neoral® microemulsion system [139]. This increase in absorption was attributed to a shorter transit time in the stomach, greater bioadhesiveness, and better protection against degradation [139]. In addition to the dissolution pH of the particles, it was demonstrated using Rhodamine 6G as a model compound that the nature of polymer used in?uenced the release rate, as well as adhesion to the GI mucosa [140]. Apart from Eudragit® copolymers, nanospheres have been obtained from mixtures of chitosan (a positively-charged absorption enhancer capable of opening the tight junctions) and pH-sensitive polyanions. Among these carriers, insulin-loaded nanospheres made from chitosan and γ-PGA, and cross-linked with sodium tripolyphosphate and magnesium sulfate, have been well-characterized for oral delivery [143–146]. The pKa values of chitosan and γ-PGA are 6.5 and 2.9, respectively [147]. At pH values comprised between 2.5 and 6.5, both macromolecules are ionized and polyelectrolyte complexes with a spherical structure were obtained [143]. At pH 7.0–7.4, the chitosan is deprotonated, resulting in the disintegration of the nanospheres and expected drug release in the intestine. However, at pH 1.2–2.0, which would correspond to the pH of the stomach in the fasted state, most of the carboxyl groups of γ-PGA are protonated, and nanospheres were found to be unstable due to reduced electrostatic interactions. To circumvent this problem, the nanospheres were freeze-dried and ?lled in an enteric-coated capsule [145,148]. As shown in Fig. 5, the coated-capsule ?lled with insulin-loaded pH-sensitive nanospheres exhibited increased plasmatic drug levels after oral gavage to rats compared to the free form of insulin encapsulated in the coated capsule [145]. Peppas and co-workers also described pH-responsive nanospheres capable of augmenting the bioavailability of peptides and proteins [149–151]. Their system consisted of crosslinked nanosized (200–400 nm) hydrogels of PEG methacrylate (PEGMA) and either AA or MAA. Under acidic conditions, these gels formed collapsed networks as a result of hydrogen bonding between the carboxylic acid groups and the grafted PEG chain, but ionized and swelled upon raising the pH, thereby allowing the release of the entrapped drug (Fig. 1C) [150]. Previous work conducted on similar but larger hydrogels showed that these systems could inhibit proteolytic enzymes in the GI tract and open the tight junctions of intestinal epithelium [152,153]. After oral gavage in rats, the pH-responsive nanospheres were found to signi?cantly reduce the serum glucose levels with respect to that of a control animal [150]. Recent in vitro data suggested that the permeability of insulin through the intestinal epithelial barrier could be further increased by conjugating insulin to a targeting ligand [154,155]. These Fig. 5. Plasma insulin level vs. time pro?les of diabetic rats following the administration of different insulin formulations. The dose for oral and subcutaneous administration was 30 and 5 IU/kg, respectively. Results are expressed as mean ± SD (n = 5). Reproduced from Sonaje et al., with permission from Elsevier [145]. ?ndings illustrate the potential of orally delivered labile drugs using smart pH-sensitive nanospheres. Nevertheless, more work using these nanoparticles is needed to assess the safety and potential risk of letting other potentially immunogenic peptides bene?t from the loosened junctions and enter the systemic circulation. 4.2. Vaginal drug delivery Microbicides are drug delivery systems for the prevention of HIV and other sexually transmitted diseases. pH-sensitive microbicides, exploiting the pH difference between human vagina (pH 4–5) [156] and human semen (pH ~7.5) [157] have been developed for sementriggered vaginal drug delivery [158,159]. Polymeric nanospheres composed of a blend of Eudragit® and biodegradable poly(lactic-coglycolic acid) were prepared for the vaginal delivery of HIV reverse transcriptase inhibitors [159]. An in vitro release study demonstrated that over 40% of the loaded drug was released within the ?rst 24 h after contact with simulated semen ?uid, whereas ca. 10% was released in simulated vaginal ?uid after the same period [159]. Even if the observed release time of such pH-sensitive nanospheres may, at ?rst, appear unsuitable for clinical applications, it has been proven that human semen can be detected in the vaginal tract up to 48 h after sexual intercourse, and that the cervicovaginal pH remains at a relatively high level during this period [160]. However, these Eudragit®/ poly(lactic-co-glycolic acid) nanospheres showed relatively low encapsulation ef?ciencies and further studies are needed to characterize conditions for optimal formulation stability, as well as their in vivo safety and ef?cacy. 5. Concluding remarks In the ?eld of drug delivery, nanosized systems ef?ciently responding to changes in the external pH have a wide range of applications. Compared to formulations that rely on the chemical cleavage of a hydrolyzable bond, systems based on titratable polyanions have the advantage of being able to undergo a quick and controllable change in conformation upon a change in pH, while exhibiting a good chemical stability. They are, however, sensitive to the ionic strength of the environment, which ultimately can impact on their pH-responsiveness. Furthermore, depending on the sharpness of their transition pH, systems based on polycarboxylates may not be sensitive enough to respond to the small pH gradient typically found between tumoral and normal tissues. Sulfonamide-based drug delivery systems, which sharply respond to pH changes around A.E. Felber et al. / Advanced Drug Delivery Reviews 64 (2012) 979–992 the physiological pH, might be able to address this issue [161–163]. Finally, polyanions can also impart the colloidal carrier with a strong negative zeta potential, which in the case of parenteral dosing carries the risk of altering the pharmacokinetic pro?le and biodistribution of the transported drug. As of today, most pH-sensitive polyanion-based colloids have only been studied in vitro and there is a critical lack of solid in vivo data supporting their potential viability in a clinical context. In the future, it will be of prime importance to study in more systematic fashion their interaction with the biological milieu in order to develop formulations which will demonstrate a substantial improvement of the drug's activity, while maintaining a good shelf-life, simple manufacturing process, and adequate safety pro?le. Acknowledgments This work was ?nancially supported by an ETH Research Grant to J.-C. Leroux (ID ETH-0209-3). The authors acknowledge support from the Electron Microscopy Center of ETH Zurich (EMEZ). References [1] G. Gaucher, M.-H. 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