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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Chem.</journal-id>
<journal-title>Frontiers in Chemistry</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Chem.</abbrev-journal-title>
<issn pub-type="epub">2296-2646</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fchem.2021.645297</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Chemistry</subject>
<subj-group>
<subject>Mini Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>pH-Responsive Amphiphilic Carboxylate Polymers: Design and Potential for Endosomal Escape</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name><surname>Wang</surname> <given-names>Shiqi</given-names></name>
<xref ref-type="corresp" rid="c001"><sup>&#x0002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/969252/overview"/>
</contrib>
</contrib-group>
<aff><institution>Drug Research Program, Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki</institution>, <addr-line>Helsinki</addr-line>, <country>Finland</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Chongyu Zhu, Fudan University, China</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Theoni K. Georgiou, Imperial College London, United Kingdom; Marya Ahmed, University of Prince Edward Island, Canada; Ruijiao Dong, Shanghai Jiao Tong University, China</p></fn>
<corresp id="c001">&#x0002A;Correspondence: Shiqi Wang <email>shiqi.wang&#x00040;helsinki.fi</email></corresp>
<fn fn-type="other" id="fn001"><p>This article was submitted to Polymer Chemistry, a section of the journal Frontiers in Chemistry</p></fn></author-notes>
<pub-date pub-type="epub">
<day>23</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>9</volume>
<elocation-id>645297</elocation-id>
<history>
<date date-type="received">
<day>22</day>
<month>12</month>
<year>2020</year>
</date>
<date date-type="accepted">
<day>22</day>
<month>02</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2021 Wang.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Wang</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract><p>The intracellular delivery of emerging biomacromolecular therapeutics, such as genes, peptides, and proteins, remains a great challenge. Unlike small hydrophobic drugs, these biotherapeutics are impermeable to the cell membrane, thus relying on the endocytic pathways for cell entry. After endocytosis, they are entrapped in the endosomes and finally degraded in lysosomes. To overcome these barriers, many carriers have been developed to facilitate the endosomal escape of these biomacromolecules. This mini-review focuses on the development of anionic pH-responsive amphiphilic carboxylate polymers for endosomal escape applications, including the design and synthesis of these polymers, the mechanistic insights of their endosomal escape capability, the challenges in the field, and future opportunities.</p></abstract>
<kwd-group>
<kwd>pH</kwd>
<kwd>intracellular delivery</kwd>
<kwd>amphiphilicity</kwd>
<kwd>polymeric materials</kwd>
<kwd>drug delivery and targeting</kwd>
</kwd-group>
<contract-sponsor id="cn001">Suomen Kulttuurirahasto<named-content content-type="fundref-id">10.13039/501100003125</named-content></contract-sponsor>
<contract-sponsor id="cn002">Academy of Finland<named-content content-type="fundref-id">10.13039/501100002341</named-content></contract-sponsor>
<counts>
<fig-count count="1"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="87"/>
<page-count count="8"/>
<word-count count="6338"/>
</counts>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="s1">
<title>Introduction</title>
<p>Most successfully developed biotherapeutics up to date only target extracellular receptors, because the intracellular delivery of biomacromolecules remains a key challenge (Stewart et al., <xref ref-type="bibr" rid="B69">2018</xref>; van Haasteren et al., <xref ref-type="bibr" rid="B75">2020</xref>). Such challenge resides in the natural barrier of plasma membranes, composed of a lipid bilayer and membrane proteins. The permeability of the plasma membrane is specifically selective. Therefore, biomacromolecular therapeutics, such as proteins, peptides, and genes, are blocked from free movement across the plasma membrane (Pei and Buyanova, <xref ref-type="bibr" rid="B54">2019</xref>). Instead, these biomacromolecules are mostly internalized by endocytosis. After internalization, they are trapped in endosomes, and finally degraded within lysosomes. Thus, it is critical to develop carriers to facilitate the endosomal escape and release the payloads in cytoplasm, to maximize their therapeutic potential.</p>
<p>Polymer carriers for endosomal escape purposes have been developed for years. Specifically, pH-responsive polymers have attracted significant attention (Cupic et al., <xref ref-type="bibr" rid="B19">2019</xref>; Deirram et al., <xref ref-type="bibr" rid="B21">2019</xref>), because their endosomal escape property is activated by the pH differences between the extracellular physiological environment (7.4) and the acidic endosomal environment (6.0&#x02013;6.8 in early endosomes, 5.0&#x02013;6.0 in late endosomes, and 4.5&#x02013;5.0 in lysosomes)(Mukherjee et al., <xref ref-type="bibr" rid="B48">1997</xref>; Scott et al., <xref ref-type="bibr" rid="B59">2014</xref>). According to the ionizable groups, there are two main pH-responsive polymer categories: polycations and polyanions (Bazban-Shotorbani et al., <xref ref-type="bibr" rid="B6">2017</xref>). Polycations have weak basic functional groups, such as amines, imidazole, and pyridine, which become positively charged when the pH drop below their pK<sub>a</sub>. These polymers [i.e., polyethylenimine, poly(<sub>L</sub>-lysine), poly(amino ester), poly(2-(dimethylamino)ethyl methacrylate), and polyamidoamine] can buffer the endosomal acidification by protonation, and cause osmotic swelling of endosomes, finally leading to endosomal rupture. The polycation induced &#x0201C;proton sponge&#x0201D; effect has long been studied, and reviewed recently (Bus et al., <xref ref-type="bibr" rid="B9">2018</xref>; Vermeulen et al., <xref ref-type="bibr" rid="B76">2018</xref>). In addition to the endosomal escape properties, polycations condensate genes by electrostatic interactions effectively, and thus are widely used for gene therapy (Chen et al., <xref ref-type="bibr" rid="B10">2019</xref>).</p>
<p>Polyanions use a different strategy for endosomal escape. Typically, these polymers are negatively charged at physiological pH. The negative charges make them repulsive to the negatively charged plasma membranes and show non-membrane lytic property (<xref ref-type="fig" rid="F1">Figure 1A</xref>). However, when pH drops below their pK<sub>a</sub> in the endosomes, they lose the charge and become hydrophobic. The pH-induced alterations in the overall charges, amphiphilicity, and conformation lead to enhanced interaction with endosomal membranes and finally cause membrane disruption to release the payload into the cytoplasm (<xref ref-type="fig" rid="F1">Figure 1A</xref>). Compared with polycationic polymeric carriers, anionic pH-responsive membrane permeabilizing polymers are less toxic, because of the repulsive charges against plasma membranes (Wang, <xref ref-type="bibr" rid="B77">2018</xref>; Evans et al., <xref ref-type="bibr" rid="B26">2019</xref>). Albeit less renowned, recent studies show their emerging potentials for proteins, genes, and vaccine delivery (Mukalel et al., <xref ref-type="bibr" rid="B47">2018</xref>; Qiu et al., <xref ref-type="bibr" rid="B57">2018</xref>; Evans et al., <xref ref-type="bibr" rid="B26">2019</xref>; Jacobson et al., <xref ref-type="bibr" rid="B34">2019</xref>; Kopytynski et al., <xref ref-type="bibr" rid="B39">2020</xref>).</p>
<fig id="F1" position="float">
<label>Figure 1</label>
<caption><p><bold>(A)</bold> The scheme of pH-responsive membrane permeabilizing polymers and how they facilitate endosomal escape. Created by <ext-link ext-link-type="uri" xlink:href="https://Biorender.com/">Biorender.com</ext-link> <bold>(B)</bold> The general design of carboxylated polyanions for endosomal escape applications. <bold>(C)</bold> Chronological development of carboxylated polymers for endosomal escape applications. The time plotted indicated the first application for pH-dependent membrane permeabilization, instead of the first reported synthesis of the polymer.</p></caption>
<graphic xlink:href="fchem-09-645297-g0001.tif"/>
</fig>
<p>Herein, this mini-review introduces the development of polyanions with carboxylic acid pendant groups for endosomal escape applications. These polymers usually have two units to fulfill their function, carboxylic acid unit and hydrophobic unit (<xref ref-type="fig" rid="F1">Figure 1B</xref>). The carboxylic acid unit is for pH-responsiveness, and the hydrophobic unit is for enhancing the interaction with lipid membranes. These two units could be integrated in one monomer (homopolymer), or distributed on two different monomers (copolymer) (<xref ref-type="fig" rid="F1">Figure 1B</xref>). Notable examples of homopolymers include poly(ethylacrylic acid) (PEAA) and poly(propylacrylic acid) (PPAA) (<xref ref-type="fig" rid="F1">Figure 1C</xref>), which have been developed for two decades for gene and protein delivery. Copolymers could be developed by copolymerization of methacrylic acid (MAA) or acrylic acid (AA) as the carboxylic acid unit, and hydrophobic methacrylates (<xref ref-type="fig" rid="F1">Figure 1C</xref>). Alternatively, copolymers with different backbones, such as polypeptides and pseudopeptides, could be developed by post-polymerization modification of hydrophobic units (<xref ref-type="fig" rid="F1">Figure 1C</xref>). In the following sections, the endosomal escape capability of these polymers and their functionalized derivatives in drug delivery applications are analyzed. Finally, the current challenges of pH-responsive endosomal escape polyanions development are discussed, as well as the future opportunities to be exploited.</p>
</sec>
<sec id="s2">
<title>Amphiphilic Carboxylate Polymers: History and Recent Development</title>
<sec>
<title>PEAA, PPAA, and Their Derivatives</title>
<p>Amphiphilic carboxylate polymers were first found to have pH-dependent membrane permeabilizing capability on liposomal membranes made of egg phosphatidylcholine (PC) lipids in the 1980s (Seki and Tirrell, <xref ref-type="bibr" rid="B60">1984</xref>). This effect was initially studied using PEAA, which showed significant membrane disruptive activity at its pK<sub>a</sub> (6.5), without disrupting the membrane at physiological pH (Thomas and Tirrell, <xref ref-type="bibr" rid="B72">1992</xref>). The membrane disruption was attributed to the pH-dependent coil-to-globule conformational transition, evidenced by hydrodynamic size variation and the desolvation of a hydrophobic fluorescent probe pyrene (Eum et al., <xref ref-type="bibr" rid="B25">1989</xref>). The uncharged polymer with globule conformation could associate with the lipid membrane and even lysed the membrane completely at high polymer/lipid ratios (Thomas et al., <xref ref-type="bibr" rid="B71">1994</xref>). Although these early studies based on PEAA interaction with liposomes did not explore the pH-dependent membrane permeabilizing effects on mammalian cells for intracellular delivery purposes, such findings and the coil-to-globule conformational transition mechanism laid the foundation of membrane permeabilizing polyanions. Furthermore, the research methods used by Tirrell et al. (such as pyrene fluorescent probes, interactions with model liposomal membranes, etc.) to evaluate the polymer conformation, critical pH, and to quantify membrane permeability, have been widely adopted in the following studies within the field.</p>
<p>PPAA (or PPAAc in some literature) has been developed in the late 1990s (Murthy et al., <xref ref-type="bibr" rid="B49">1999</xref>). Compared with PEAA, PPAA has a slightly longer pendant alkyl group on the monomer, which makes it more hydrophobic (<xref ref-type="fig" rid="F1">Figure 1C</xref>). Murthy et al. used red blood cells, instead of simple liposomes, to evaluate the pH-dependent membrane permeability of PPAA. Compared with liposomal membrane models, red blood cell membranes are more complicated, composed of not only lipids but also proteins and polysaccharides. The hemolytic activity, thus, was considered to better reflect the permeabilization capability toward biological membranes (Evans et al., <xref ref-type="bibr" rid="B29">2013</xref>). PPAA showed higher hemolytic activity at acidic pH than PEAA without hemolytic activity at physiological pH at equivalent concentrations. It was speculated that PPAA could form pores on red blood cell membranes only at acidic pH which caused hemolysis (Murthy et al., <xref ref-type="bibr" rid="B49">1999</xref>).</p>
<p>PPAA has been explored on mammalian cells, to enhance the gene transfection efficiency and to enhance the stability of cationic lipid gene vectors in serum (Cheung et al., <xref ref-type="bibr" rid="B14">2001</xref>). The conjugation of PPAA on proteins, peptides, or antibodies by biotin-streptavidin ligation facilitated the intracellular delivery of these macromolecular cargos into the cytoplasm (Lackey et al., <xref ref-type="bibr" rid="B42">2002</xref>; Albarran et al., <xref ref-type="bibr" rid="B5">2011</xref>; Berguig et al., <xref ref-type="bibr" rid="B7">2012</xref>). Other than chemical ligation, PPAA could form nano-polyplex by simply mixing with positively charged peptide cargos in PBS buffer (Evans et al., <xref ref-type="bibr" rid="B27">2015a</xref>; Qiu et al., <xref ref-type="bibr" rid="B57">2018</xref>). This approach was applicable to larger cationic cargos, including nucleic acids, gene editing ribonucleoproteins, and even nanoparticles (Evans et al., <xref ref-type="bibr" rid="B26">2019</xref>). PPAA could also be formulated as polymer blends with poly(lactic-co-glycolic acid) (PLGA), to deliver antigens for T cell activation (Yang et al., <xref ref-type="bibr" rid="B83">2017</xref>; Fernando et al., <xref ref-type="bibr" rid="B31">2018</xref>). A detailed summary of PPAA related bioapplications is listed in <xref ref-type="table" rid="T1">Table 1</xref>.</p>
<table-wrap position="float" id="T1">
<label>Table 1</label>
<caption><p>Bioapplications of PPAA and its derivatives.</p></caption>
<table frame="hsides" rules="groups">
<thead><tr>
<th valign="top" align="left"><bold>Polymer</bold></th>
<th valign="top" align="left"><bold>Therapeutic payloads</bold></th>
<th valign="top" align="left"><bold>Loading method</bold></th>
<th valign="top" align="left"><bold>Bioapplications</bold></th>
<th valign="top" align="left"><bold>References</bold></th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">PPAA</td>
<td valign="top" align="left">DNA plasmids, antisense DNA</td>
<td valign="top" align="left">Mixture with cationic lipids via electrostatic interaction</td>
<td valign="top" align="left">Gene transfection <italic>in vitro</italic> and <italic>in vivo</italic></td>
<td valign="top" align="left">Cheung et al., <xref ref-type="bibr" rid="B14">2001</xref>; Kyriakides et al., <xref ref-type="bibr" rid="B41">2002</xref>; Jones et al., <xref ref-type="bibr" rid="B35">2003</xref>; Lee et al., <xref ref-type="bibr" rid="B43">2006</xref></td>
</tr>
<tr>
<td valign="top" align="left">PPAA</td>
<td valign="top" align="left">Antibodies and peptides</td>
<td valign="top" align="left">Chemical ligation via biotin-streptavidin</td>
<td valign="top" align="left">Protein and peptide intracellular delivery <italic>in vitro</italic></td>
<td valign="top" align="left">Lackey et al., <xref ref-type="bibr" rid="B42">2002</xref>; Albarran et al., <xref ref-type="bibr" rid="B5">2011</xref>; Berguig et al., <xref ref-type="bibr" rid="B7">2012</xref></td>
</tr>
<tr>
<td valign="top" align="left">PPAA</td>
<td valign="top" align="left">Cationic MAPKAP kinase 2 inhibitor peptide</td>
<td valign="top" align="left">Electrostatic interaction</td>
<td valign="top" align="left">Inhibit pathological vasoconstriction <italic>in vitro</italic> and <italic>in vivo</italic></td>
<td valign="top" align="left">Evans et al., <xref ref-type="bibr" rid="B27">2015a</xref>,<xref ref-type="bibr" rid="B28">b</xref></td>
</tr>
<tr>
<td valign="top" align="left">PPAA</td>
<td valign="top" align="left">Peptide antigens with oligolysine tails</td>
<td valign="top" align="left">Electrostatic interaction</td>
<td valign="top" align="left">Induce cellular immunity as cancer vaccines <italic>in vivo</italic></td>
<td valign="top" align="left">Qiu et al., <xref ref-type="bibr" rid="B57">2018</xref></td>
</tr>
<tr>
<td valign="top" align="left">PPAA</td>
<td valign="top" align="left">Ovalbumin</td>
<td valign="top" align="left">Blend with PLGA, double emulsion</td>
<td valign="top" align="left">Induce cellular immunity <italic>in vitro</italic></td>
<td valign="top" align="left">Yang et al., <xref ref-type="bibr" rid="B83">2017</xref></td>
</tr>
<tr>
<td valign="top" align="left">PPAA</td>
<td valign="top" align="left">Cationic peptides, recombinant proteins, morpholinos, and nanoparticles</td>
<td valign="top" align="left">Electrostatic interaction</td>
<td valign="top" align="left">Intracellular delivery <italic>in vitro</italic></td>
<td valign="top" align="left">Evans et al., <xref ref-type="bibr" rid="B26">2019</xref></td>
</tr>
<tr>
<td valign="top" align="left">Co-polymer of PAA, BMA, DMAEMA</td>
<td valign="top" align="left">siRNA</td>
<td valign="top" align="left">Electrostatic interaction</td>
<td valign="top" align="left">Gene knockdown <italic>in vitro</italic></td>
<td valign="top" align="left">Convertine et al., <xref ref-type="bibr" rid="B16">2009</xref>, <xref ref-type="bibr" rid="B17">2010</xref>; Palanca-Wessels et al., <xref ref-type="bibr" rid="B50">2011</xref></td>
</tr>
<tr>
<td valign="top" align="left">Co-polymer of PAA, BMA, DMAEMA</td>
<td valign="top" align="left">Ovalbumin</td>
<td valign="top" align="left">Blend with PLGA, double emulsion</td>
<td valign="top" align="left">Induce humoral and cellular immunity <italic>in vivo</italic></td>
<td valign="top" align="left">Tran et al., <xref ref-type="bibr" rid="B73">2014</xref>; Zhan and Shen, <xref ref-type="bibr" rid="B87">2015</xref></td>
</tr>
<tr>
<td valign="top" align="left">Co-polymer of PAA, and PDSEMA</td>
<td valign="top" align="left">Ovalbumin</td>
<td valign="top" align="left">Disulfide linkage with PDSEMA</td>
<td valign="top" align="left">Induce humoral and cellular immunity <italic>in vivo</italic></td>
<td valign="top" align="left">Foster et al., <xref ref-type="bibr" rid="B32">2010</xref></td>
</tr>
<tr>
<td valign="top" align="left">Co-polymer of PAA, BMA, PDSEMA, HPMA</td>
<td valign="top" align="left">siRNA or ovalbumin</td>
<td valign="top" align="left">Disulfide linkage with PDSEMA</td>
<td valign="top" align="left">Gene knockdown or induce cellular immunity <italic>in vivo</italic></td>
<td valign="top" align="left">Lundy et al., <xref ref-type="bibr" rid="B45">2013</xref>; Keller et al., <xref ref-type="bibr" rid="B36">2014</xref></td>
</tr>
<tr>
<td valign="top" align="left">Co-polymer of PAA, BMA, PDSEMA, DMAEMA</td>
<td valign="top" align="left">CpG oligonucleotide (ODN) as adjuvants and ovalbumin</td>
<td valign="top" align="left">CpG ODN via electrostatic interaction and ovalbumin via disulfide linkage</td>
<td valign="top" align="left">Induce humoral and cellular immunity <italic>in vivo</italic></td>
<td valign="top" align="left">Wilson et al., <xref ref-type="bibr" rid="B81">2013</xref>; Knight et al., <xref ref-type="bibr" rid="B38">2019</xref></td>
</tr>
<tr>
<td valign="top" align="left">PEG or Jeffamine conjungated PPAA</td>
<td valign="top" align="left">ODNs</td>
<td valign="top" align="left">Mixture with cationic lipids via electrostatic interaction</td>
<td valign="top" align="left">Gene knockdown <italic>in vitro</italic> and <italic>in vivo</italic></td>
<td valign="top" align="left">Peddada et al., <xref ref-type="bibr" rid="B53">2009</xref>, <xref ref-type="bibr" rid="B52">2014</xref></td>
</tr>
</tbody>
</table>
</table-wrap>
<p>The mechanism of PPAA mediated endosomal escape is closely associated with endosomal acidification since the escape process was prone to H<sup>&#x0002B;</sup>-ATPase inhibition on the endosomal membrane (Jones et al., <xref ref-type="bibr" rid="B35">2003</xref>; Evans et al., <xref ref-type="bibr" rid="B27">2015a</xref>). Without endosomal acidification, the carboxylic acid groups of PPAA kept deprotonated, making the polymer negatively charged and non-lytic to endosomal membranes. This means the endosomal escape property of PPAA is dependent on the pH-induced membrane permeabilization. Further studies by real-time imaging showed the intracellular delivery was correlated with galectin-8 (Gal8) recruitment, which confirms endosomal membrane damage by PPAA (Kilchrist et al., <xref ref-type="bibr" rid="B37">2016</xref>). The damaged endosomes were subsequently autophaged by a &#x0201C;self-repaired&#x0201D; mechanism to avoid cell death caused by accidental endosomolytic reagents (Skowyra et al., <xref ref-type="bibr" rid="B68">2018</xref>). This Gal8-mediated endosomal autophage suggests although PPAA caused damage to endosomal membranes to release the cargos intracellularly, the damage could be repaired by cells using an existing toolset.</p>
<p>PPAA functional derivatives, either by co-polymerization with other monomers or by changing the polymer architecture via end-to-end chemical ligations, have been widely reported for different intracellular delivery applications (<xref ref-type="table" rid="T1">Table 1</xref>). One of the most studied PPAA derivatives is the co-polymer of propylacrylic acid (PAA), dimethylaminoethyl methacrylate (DMAEMA), and butyl methacrylate (BMA). DMAEMA has a tertiary amine group, which is cationic at physiological pH (Agarwal et al., <xref ref-type="bibr" rid="B1">2012</xref>). Therefore, it allows for binding with negatively charged DNA or RNA by electrostatic interaction. BMA has a butyl pendent group, which could enhance the hydrophobicity and membrane permeabilization capability at acidic pH (El-Sayed et al., <xref ref-type="bibr" rid="B24">2005</xref>). A systematic investigation of the ratio of BMA in the final polymer suggested BMA-rich polymer not only showed higher hemolytic activity at pH 5.8 but also elevated the gene delivery efficiency (Convertine et al., <xref ref-type="bibr" rid="B16">2009</xref>). Further studies used DMAEMA and BMA copolymerized PAA for vaccine deliveries, by covalently conjugating antigen on a thiol-reactive pyridyl disulfide monomer (PDSEMA) (Wilson et al., <xref ref-type="bibr" rid="B81">2013</xref>; Knight et al., <xref ref-type="bibr" rid="B38">2019</xref>). Even without adjuvant, this carrier can promote antigen presenting on dendritic cells, and enhanced antigen-specific cytotoxic T cell responses (Keller et al., <xref ref-type="bibr" rid="B36">2014</xref>).</p>
<p>Another common type of derivatives involves the incorporation of hydrophilic blocks in the copolymer, such as poly(N-(2-hydroxypropyl) methacrylamide) (HPMA), polyethylene glycol (PEG also named as PEO), or poly(oxyalkylene amine) (Jeffamine). The PEG block could enhance polymer solubility by forming micelles and increase the resistance to serum proteins (Peddada et al., <xref ref-type="bibr" rid="B52">2014</xref>; Porfiryeva et al., <xref ref-type="bibr" rid="B56">2020</xref>). However, both PEG and Jeffamine conjugated PPAA showed reduced the pH-dependent membrane-lytic activity (Peddada et al., <xref ref-type="bibr" rid="B53">2009</xref>). This means the endosomal membrane disruption of these PEG and Jeffamine modified derivative polymers is less than PPAA itself. In the <italic>in vivo</italic> study, Jeffamine conjugated PPAA showed better overall gene delivery efficiency than PPAA, probably due to the enhanced serum stability (Peddada et al., <xref ref-type="bibr" rid="B52">2014</xref>). These results suggest that selecting the polymer with the best endosomal escape capability does not always end up with the most optimal delivery performance <italic>in vivo</italic>. Instead, balancing the endosomal escape and serum stability in the PPAA derivative polymer is important to the delivery system.</p>
<p>Besides linear PPAA, hyperbranched and brush-like PPAA derivatives have been developed to study the effect of polymer architecture on pH-dependent membrane permeabilizing activity. Introducing multivinyl branching monomer poly(ethylene glycol diacrylate) in the polymerization with PAA monomer generated hyperbranched PPAA, which showed lower hemolytic activity than linear PPAA at endosomal pH conditions (Tai et al., <xref ref-type="bibr" rid="B70">2012</xref>). This is probably due to the limitation of conformational changes from the branching points, which weakened the membrane interaction. Brush-like PPAA, synthesized by a &#x0201C;graft-to&#x0201D; strategy after polymerization by click chemistry, showed similar pH-dependent hemolytic activity at the same mass concentration (Crownover et al., <xref ref-type="bibr" rid="B18">2011</xref>).</p>
</sec>
<sec>
<title>Copolymers of MAA or AA With Hydrophobic Moieties</title>
<p>Similar to PPAA, the amphiphilic copolymers of MAA (or AA) with hydrophobic methacrylates have the coil-to-globule conformational transition, when the pH decreases from neutral to acidic ranges (Kusonwiriyawong et al., <xref ref-type="bibr" rid="B40">2003</xref>; Yessine et al., <xref ref-type="bibr" rid="B84">2003</xref>). These polymers have pH-responsive carboxylate pendant groups from MAA, and hydrophobicity from non-ionizable methacrylates, such as BMA, dodecyl methacrylate (DMA), lauryl methacrylate (LMA), and cholesteryl methacrylate (CMA). Previous studies found that incorporating a small portion of hydrophobic monomers (i.e., 1% DMA, 2% CMA or 10% LMA) in PMAA copolymers could enhance the interaction with lipid membranes significantly, compared with PMAA homopolymer (Cho et al., <xref ref-type="bibr" rid="B15">2016</xref>; Sevimli et al., <xref ref-type="bibr" rid="B63">2017</xref>; Wannasarit et al., <xref ref-type="bibr" rid="B80">2019</xref>). However, a further increase of the hydrophobic moieties (i.e., 8% CMA and 40% LMA) in the copolymer led to decreased solubility and enhanced supermolecular assembly in aqueous solutions, which in turn decreased the interaction between polymer and lipid membranes (Sevimli et al., <xref ref-type="bibr" rid="B62">2012</xref>; Wannasarit et al., <xref ref-type="bibr" rid="B80">2019</xref>). Therefore, it is critical to find the balance between the hydrophobic and hydrophilic monomers in the copolymer, to maximize the membrane association.</p>
<p>Regarding the applications of these MAA or AA-containing amphiphilic copolymers, a common approach is to decorate these polymers on the surface of liposomes and boost the delivery efficiency by enhancing the endosomal escape (Yessine et al., <xref ref-type="bibr" rid="B85">2006</xref>; Yamazaki et al., <xref ref-type="bibr" rid="B82">2017</xref>). Due to the anionic nature of these polymers, it is difficult to condensate DNA or RNA directly, but adding a cationic polymer in the formulation such as polylysine solves the problem by forming tertiary polyplexes via electrostatic interactions (Sevimli et al., <xref ref-type="bibr" rid="B64">2013</xref>). A recent study indicated that these polymers can modify cell membranes by hydrophobic interactions and facilitate the delivery of cationic peptides (Dailing et al., <xref ref-type="bibr" rid="B20">2020</xref>).</p>
</sec>
<sec>
<title>Amphiphilic Carboxylated Polypeptides and Pseudopeptides</title>
<p>Apart from acrylic and acrylate polymers, there are also amphiphilic carboxylated polypeptides reported for pH-responsive membrane permeabilizing applications. These polypeptides are considered to be more biocompatible and biodegradable than their vinyl polymer counterparts (Akagi et al., <xref ref-type="bibr" rid="B2">2006</xref>; Liu et al., <xref ref-type="bibr" rid="B44">2019</xref>). A systematically investigated example is poly(&#x003B3;-glutamic acid) (&#x003B3;PGA) and its derivatives grafted by different amino acids as pedant groups (Shima et al., <xref ref-type="bibr" rid="B65">2014a</xref>). The protonation/deprotonation of glutamic acid units of PGA enabled the pH-dependent conformation changes, while the hydrophobic amino acids (e.g., leucine, methionine, phenylalanine, valine, and tryptophan) enhanced the hydrophobicity and interaction with membranes. Unlike PPAA, &#x003B3;PGA with sufficient hydrophobic amino acid group grafting (53% phenylalanine, 71% tryptophan, and 87% leucine) formed stable nanoparticle in PBS buffer, and the nanoparticles maintained pH-responsive hemolytic activity similar to polymers (Akagi et al., <xref ref-type="bibr" rid="B3">2010</xref>; Shima et al., <xref ref-type="bibr" rid="B65">2014a</xref>). Furthermore, phenylalanine modified &#x003B3;PGA could encapsulate protein during its self-assembly and delivered protein payload to antigen presenting cells efficiently both <italic>in vitro</italic> and <italic>in vivo</italic> (Yoshikawa et al., <xref ref-type="bibr" rid="B86">2008</xref>; Akagi et al., <xref ref-type="bibr" rid="B4">2011</xref>). As a natural polymer derived from <italic>Bacillus</italic>, &#x003B3;PGA itself acted as an adjuvant for both innate and adaptive immunity activation and showed promising potentials for vaccine development (Uto et al., <xref ref-type="bibr" rid="B74">2011</xref>). Interestingly, it was found that both the hemolytic activity at endosomal pH, and the activation potential of antigen presenting cells increased proportionally to the hydrophobicity of the nanoparticles (Shima et al., <xref ref-type="bibr" rid="B67">2013</xref>, <xref ref-type="bibr" rid="B66">2014b</xref>).</p>
<p>A similar series of studies, using amphiphilic synthetic pseudopeptides namely poly (<sub>L</sub>-lysine isophthalamide) (PLP), also confirm that pH-dependent membrane-permeabilizing capability could be adjusted by grafting amino acids with different hydrophobicity or alkyl chains (Eccleston et al., <xref ref-type="bibr" rid="B23">2000</xref>; Chen et al., <xref ref-type="bibr" rid="B11">2009</xref>, <xref ref-type="bibr" rid="B12">2017</xref>). Increasing the hydrophobicity moieties or changing the polymer structure from linear to branched could increase the interaction with lipid membranes (Wang and Chen, <xref ref-type="bibr" rid="B78">2017</xref>; Chen et al., <xref ref-type="bibr" rid="B13">2020</xref>). Mechanistic insights suggest that phenylalanine modified PLP induced red blood cell membrane thinning of 35&#x02013;40% normal thickness at endosomal pH, thus facilitating the transport of membrane-impermeable small molecular cargos (Lynch et al., <xref ref-type="bibr" rid="B46">2011</xref>). Further real-time imaging showed that even large molecules such as FITC-labeled dextran of different molecular weights (10&#x02013;500 kDa) and green fluorescence protein could be delivered to different mammalian cells after co-incubation with phenylalanine modified PLP at pH 6.5 (Kopytynski et al., <xref ref-type="bibr" rid="B39">2020</xref>). Such a convenient and flexible method provides a versatile platform for cell engineering <italic>ex vivo</italic>.</p>
</sec>
</sec>
<sec id="s3">
<title>Discussions and Future Opportunities</title>
<p>Since the pioneering studies of PEAA with artificial lipid membranes, there have been almost 40 years of investigation into amphiphilic carboxylate polymers for endosomal escape applications. During these years, we have witnessed significant achievements in polymer synthesis and functionalization, which enables more control over the polymer structure. One of the biggest achievements is the development of controlled radical polymerization, especially reversible addition-fragmentation chain transfer (RAFT) polymerization (Fairbanks et al., <xref ref-type="bibr" rid="B30">2015</xref>; Perrier, <xref ref-type="bibr" rid="B55">2017</xref>). Because RAFT polymerization is compatible with carboxylate monomers and suitable at various conditions (such as in aqueous solutions or at ambient temperature), it has been widely adopted in the amphiphilic carboxylate polymers synthesis, including PPAA derivatives and copolymers of MAA or AA mentioned in the previous section (Convertine et al., <xref ref-type="bibr" rid="B16">2009</xref>; Tai et al., <xref ref-type="bibr" rid="B70">2012</xref>; Sevimli et al., <xref ref-type="bibr" rid="B64">2013</xref>; Wannasarit et al., <xref ref-type="bibr" rid="B80">2019</xref>; Dailing et al., <xref ref-type="bibr" rid="B20">2020</xref>; Wang et al., <xref ref-type="bibr" rid="B79">2020</xref>).</p>
<p>Meanwhile, the mechanism of polymer-mediated endosomal escape has been intensively explored, along with the advances in the basic understanding of the endocytosis process itself (Skowyra et al., <xref ref-type="bibr" rid="B68">2018</xref>; Vermeulen et al., <xref ref-type="bibr" rid="B76">2018</xref>; Brock et al., <xref ref-type="bibr" rid="B8">2019</xref>; Patel et al., <xref ref-type="bibr" rid="B51">2019</xref>; Pei and Buyanova, <xref ref-type="bibr" rid="B54">2019</xref>). Molecular dynamics simulation and biophysical characterizations are commonly used to provide mechanistic insights into the interaction between polymers and artificial membranes at the molecular level (Scoppola and Schneck, <xref ref-type="bibr" rid="B58">2018</xref>; Sen et al., <xref ref-type="bibr" rid="B61">2018</xref>), while live imaging by fluorescence microscopy captures the endosomal escape on mammalian cells (Deprey et al., <xref ref-type="bibr" rid="B22">2019</xref>). The imaging gives a direct visual presentation of the polymer and the endosomes labeled by fluorescent probes with a temporal-spatial resolution. Furthermore, incorporating different endocytosis inhibitors can help to investigate which endocytosis pathway the polymers utilize and whether endosomal acidification is required for the escape (Guo et al., <xref ref-type="bibr" rid="B33">2015</xref>).</p>
<p>Notwithstanding the great achievements in both polymer synthesis tools and endosomal escape mechanism investigation, many fundamental issues remain to be addressed in this field. For example, the fate of the amphiphilic carboxylate polymers within the cells after the endosomal escape is rarely covered in the previous publications. It is not known whether the polymer carrier itself undergoes degradation in the cell, or gets expelled from the cell somehow. This issue is critical for biomedical applications, because of the long-term biosafety concerns. Further investigations are expected to result in an improved understanding of the degradative pathways of these polymers within the cells.</p>
<p>In summary, carboxylated amphiphilic polymers with pH-responsive endosomolytic activities demonstrate promising potentials for the intracellular delivery of macromolecules. From a retrospective view, this field has continuously progressed with the application of new synthetic techniques, mechanistic understanding of endocytic trafficking, and better methods for endosomal escape characterization. Up to date, various designs have been made to adapt these polymers for biomedical applications, i.e., the delivery of antigens, genes, and therapeutic peptides. Nevertheless, it is still early to expect clinical translations, due to the lack of biodegradability and long-term biosafety concerns. It would require joint efforts from polymer chemists, biologists, and pharmaceutical scientists to understand how polymers interact with endosomal membranes at the molecular level; how the endosomal escape happens at the cellular level; and finally the delivery in the complicated <italic>in vivo</italic> environment.</p>
</sec>
<sec id="s4">
<title>Author Contributions</title>
<p>SW constructed the idea, designed the article, drafted and revised the manuscript. The author has agreed to publish the content of the work.</p>
</sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>The author declares that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.</p>
</sec>
</body>
<back>
<ack><p>The author thanks Helsinki University Library for covering the open access publication fees.</p>
</ack>
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<fn-group>
<fn fn-type="financial-disclosure"><p><bold>Funding.</bold> SW acknowledged the financial support from Finnish Culture Foundation (grant no. 00201144) and from Academy of Finland (decision no. 331106).</p>
</fn>
</fn-group>
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