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Virmani, T.; Kumar, G.; Sharma, A.; Pathak, K.; Akhtar, M.S.; Afzal, O.; Altamimi, A.S.A. Chitosan and Its Derivatives for Anticancer Drug Delivery. Encyclopedia. Available online: (accessed on 14 April 2024).
Virmani T, Kumar G, Sharma A, Pathak K, Akhtar MS, Afzal O, et al. Chitosan and Its Derivatives for Anticancer Drug Delivery. Encyclopedia. Available at: Accessed April 14, 2024.
Virmani, Tarun, Girish Kumar, Ashwani Sharma, Kamla Pathak, Md Sayeed Akhtar, Obaid Afzal, Abdulmalik S. A. Altamimi. "Chitosan and Its Derivatives for Anticancer Drug Delivery" Encyclopedia, (accessed April 14, 2024).
Virmani, T., Kumar, G., Sharma, A., Pathak, K., Akhtar, M.S., Afzal, O., & Altamimi, A.S.A. (2023, July 12). Chitosan and Its Derivatives for Anticancer Drug Delivery. In Encyclopedia.
Virmani, Tarun, et al. "Chitosan and Its Derivatives for Anticancer Drug Delivery." Encyclopedia. Web. 12 July, 2023.
Chitosan and Its Derivatives for Anticancer Drug Delivery

Chitosan is a polycationic polymer generated from chitin with various characteristics such as biocompatibility, biodegradability, non-toxicity, and mucoadhesiveness, making it an ideal polymer to fabricate drug delivery systems. However, chitosan is poorly soluble in water and soluble in acidic aqueous solutions. Furthermore, owing to the presence of reactive amino groups, chitosan can be chemically modified to improve its physiochemical properties. Chitosan and its modified derivatives can be employed to fabricate nanoparticles, which are used most frequently in the pharmaceutical sector due to their possession of various characteristics such as nanosize, appropriate pharmacokinetic and pharmacodynamic properties, non-immunogenicity, improved stability, and improved drug loading capacity. Furthermore, it is capable of delivering nucleic acids, chemotherapeutic medicines, and bioactives using modified chitosan. Chitosan and its modified derivative-based nanoparticles can be targeted to specific cancer sites via active and passive mechanisms. Based on chitosan drug delivery systems, many anticancer drugs now have better effectiveness, potency, cytotoxicity, or biocompatibility.

chitosan modified chitosan chitosan nanoparticles cancer

1. Introduction

Cancer is the most confounding illness of the 21st century and is growing enormously without any discernment based on cell type, age, or gender [1]. Although incredible advancements in cancer treatment have been achieved, the prevalence and mortality rates are still the highest across the world. The World Health Organization estimated that 10 million deaths in 2020 were credited to cancer, and 400,000 children are diagnosed with cancer annually. It is anticipated that there will be 29.5 million new cases and 16.4 million cancer-related deaths by 2040, which is a serious health burden around the globe [2]. An additional fact is that about one in six deaths is attributed to cancer across the globe. This exceedingly endemic disease is currently estimated to be the second most prevalent cause of mortality after cardiovascular diseases [3]. Approximately 70% of cancer deaths belong to low and middle-income nations, depicting a significant impact on low and middle-income nations both physically and economically [4]. However, making little lifestyle changes, abstaining from drinking, and quitting chewing tobacco can lower cancer cases by around 30% to 50% [5].
The treatment of cancer is challenging and necessitates a combination of several parallel and subsequent therapies, such as surgery with chemotherapy and surgery with radiotherapy, depending on the type and stage of the cancer. Although chemotherapy is mainly employed to treat cancer, there are various alternative treatment options for cancer, as depicted in Figure 1.
Figure 1. Various treatment modalities for the management of cancer.
The Food and Drug Administration (FDA) has permitted the use of more than 300 chemotherapeutic agents to treat cancer. But the heterogeneous nature of cancer has limited the efficacy of all these chemotherapeutic agents [6]. These agents encounter several difficulties, such as drug-related adverse effects, drug resistance, the insensitivity of cancer cells to treatments, and a lack of drug targeting [7][8]. In addition, more crucially, some of the key downsides of chemotherapeutic agents include the need for high doses, poor absorption, a low selectivity index, non-specific interactions, and patient discomfort [9][10]. Furthermore, chemotherapeutic agents demonstrate their effectiveness in treating cancer by specifically targeting cell proteins, nucleic acids, and carcinogenic signaling pathways that drive cancerous cells to adapt to changes in their environment and promote the spread of cancer [8]. Therefore, it is necessary to look for novel and advanced treatment alternatives for boosting the therapeutic efficiency of chemotherapeutic agents.
Advanced treatment options involve the nanotechnology approach, a rapidly evolving cutting-edge scientific area that integrates a variety of fields like chemistry, physics, and biology, as well as the creation of novel nano-dimension structures with therapeutic uses in pharmacology and the biomedical industry [11][12]. Numerous characteristics of the nanodimension, including optical, magnetic, and structural surface area ratios, make it an exciting subject for research in every way [13][14]. Due to the increased surface area of nanoscale medicines or devices, they serve as nanocarriers and nanoadsorbents and transport therapeutic substances, proteins, or probes [15][16]. These nanoscale methods comprise solid lipid nanoparticles (SLNs), liposomes, nanostructured lipid carriers (NLCs), nanoemulsions (NEs), polymeric nanoparticles (PNPs), polymeric micelles (PMs), carbon nanotubes (CNTs), and dendrimers [17][18]. Among the numerous kinds of nanocarriers, polymeric nanoparticles (PNPs) have been widely exploited for the delivery of anticancer drugs owing to various characteristics such as biodegradability, biocompatibility, reduced size, amplified surface volume ratio, and easier reformation of structure and surface [19] PNPs enable the protection of enveloping drug molecules and control or sustain the release of embedded drugs. The potential of PNPs to transport chemotherapeutic agents is unremittingly growing due to their capability to target the chemotherapeutic agents only on cancer cells [20]. Numerous polymers have been employed for the fabrication of PNPs, which include natural (cellulose, chitosan, gelatin, lysozyme, dextran, collagen, and albumin), synthetic (poly lactide-co-glycolide (PLGA), polylactic acid (PLA), thiolated poly methacrylic acid), and semisynthetic (methylcellulose) polymers [21].
Natural polymers have received a great deal of attention for the fabrication of PNPs for the delivery of anticancer drugs due to their possession of numerous characteristics: higher biocompatibility, biodegradability, interactions with biomolecules, controlled enzyme degradation, low immunogenicity, ease of surface modification, and economics [22][23]. Amongst these natural polymers, chitosan has received the courtesy of researchers as a drug delivery system to deliver chemotherapeutic agents due to distinct characteristics like great drug loading capability, sustained circulation capacity, multifunctionality, drug release at cancerous sites in an efficient manner, removal of cytotoxicity to non-cancerous cells, auspicious targeting, and permeability of cell membranes owing to the presence of a primary amine group in their chemical structure [24][25]. Chitosan provides specific targeting to cancerous cells due to functionalization with various specific polymers such as hyaluronic acid (HA), polyethylene glycol (PEG), folic acid (FA), RGD, etc. In a study, Almutairi FM et al. prepared hyaluronic acid-decorated chitosan nanoparticles loaded with raloxifene to treat lung cancer and found that raloxifene-hyaluronic acid-chitosan (RX-HA-CS) nanoparticles exhibited greater cytotoxicity against A549 cancer cells than raloxifene-hyaluronic acid (RX-HA) nanoparticles and raloxifene-chitosan (RX-CS) nanoparticles. This noteworthy dominance of A549 cell viability was attained through glucose uptake lessening, which resulted in reduced bioenergetics of cancer cells and stimulation of apoptosis through nitric oxide level elevation [26]. In another study, Ullah et al. prepared folic acid-decorated chitosan nanoparticles embedded with 5-fluorouracil and investigated whether cytotoxic potential was improved in the presence of folic acid. The folic acid-decorated chitosan nanoparticles showed greater cytotoxicity than plain, undecorated chitosan nanoparticles in colon cancer [27]. This depicts that functionalization of chitosan nanoparticles with specific molecules improves the site-specific potential of drug molecules embedded in them. The chemical structure of chitosan and its properties as an ideal drug delivery system are depicted in Figure 2.
Figure 2. Chemical structure of chitosan along with model pharmaceutical properties.

2. Chitosan and Its Derivatives for Anticancer Drug Delivery

Chitosan is a versatile polycationic, linear natural polysaccharide composed of N-acetyl-β-(1-4)-D-glucosamine and β-(1-4)-D-glucosamine units and originated from chitin employing the process of deacetylation [28]. Chitosan has drawn distinct attention as a drug delivery system because of its superior chemical and biological characteristics. Owing to its polycationic makeup, chitosan is a bioadhesive polymer that rapidly adheres to negatively charged surfaces like mucosal membranes. In this manner, it strengthens the adherence to the mucosal surfaces, thereby lengthening the duration that drug molecules are in contact with them [29]. The complex characteristics of chitosan facilitate the delivery of anionic drugs, low molecular weight drugs, and polyanionic compounds like SiRNA and DNA [30]. Chitosan possesses a positive charge, and cyclodextrin has a negative charge. The gelation of chitosan with cyclodextrin provides a modified chitosan drug carrier with the capability to carry hydrophilic as well as hydrophobic drugs. Cyclodextrin has a truncated cone structure with a hydrophilic outer surface and a hydrophobic interior cavity. As a result of hydrophobic interactions, a variety of lipophilic drugs can be loaded into the hydrophobic cavity of β-cyclodextrin, leading to improved solubility, loading efficiency, and stability of lipophilic drugs [31]. The drug-carrying capacity of chitosan increases with an increase in charge, which shows its ability to act as a pH-dependent drug carrier [32].
Chitosan also possesses permeation enhancement property which depends upon the positive charge of the polymer. Chitosan, having a high molecular weight and a great degree of deacetylation, provides improved epithelial permeability and hence causes the passage of polar drugs through epithelial surfaces [33]. It has better biocompatibility and poor toxicity. It is a biodegradable polymer that breaks down into harmless compounds that are fully absorbed by the body [34]. It also possesses efflux pump inhibitory properties due to which it blocks certain transporter proteins on the membrane of intestinal epithelial cells or enterocytes that release xenobiotics, primarily drugs, making these transporters one of the key elements of drug resistance mechanisms [35]. The presence of hydroxyl and amino groups in their structure provides prominent properties like pH sensitivity, gelation capability, improved permeability, and antimicrobial activity, which possess significant consequences for controlled drug release and targeted drug delivery [36][37]. These incredibly alluring qualities have increased interest in chitosan and its derivatives in recent years, leading to the development of safe and effective drug or gene carriers for cancer-targeted delivery systems.
The properties of chitosan can be modified by employing physical and chemical modifications of the hydroxyl groups and free amino groups present in its structure [38]. Due to the presence of ridiculous functional groups, namely the amino group, primary hydroxyl, and secondary hydroxyl group at C-2, C-3, and C-6 positions, respectively, the parent structure of chitosan can be modified through acylation, alkylation, esterification, etc. to get modified chitosan derivatives having desirable physical, chemical, and biological characteristics, as depicted in Figure 3 [39].
Figure 3. Modified chitosan along with their characteristics for improved drug delivery.
By providing modifications in molecular weight, crosslinking, degree of deacetylation (DD), functional groups and moieties, synchronized anions or polyanions, etc., the modified chitosan has improved properties [32]. For instance, the solubility of chitosan can be significantly increased by adding tiny chemical groups like hydroxypropyl or carboxymethyl groups to its structure [40]. To introduce an anionic character with water-soluble properties, superior paste fluidity, a high water-reducing ratio, and anticoagulant properties, the cationic property can be reversed via sulfonation. With an increase in the crosslinking of chitosan, the mechanical strength of particles also increases [41]. Particles with a high degree of crosslinking exhibit decreased swelling, inner water infiltration, and outside drug diffusion. Drug release can be slowed by crosslinking, and burst releases can be avoided [42].
The mucoadhesive characteristic of chitosan can be enhanced by employing trimethylation of the primary amino group, PEGylation, or immobilization of the thiol groups present in its structure [43]. Amino groups in the structure of chitosan provide cationic properties, which are responsible for its solubility. This weak base is only soluble in diluted acidic solutions and insoluble in water and organic solvents because of the protonation of amine groups [44]. The higher amino group counts result in decreased molecular weight and improved solubility.
The viscosity of chitosan rises with a rise in molecular weight. Because hydrogen interactions across chains have a greater impact as molecular weight increases, solubility decreases [45]. The limited aqueous solubility restricts its application, whereas its solubility in acidic pH provides an opportunity to explore chitosan [46]. The reactive amine and hydroxyl functional groups of this biopolymer also render it vulnerable to chemical modification to enhance or acquire new features. To get around this obstacle, several derivatives of chitosan have been developed, which has multiplied its uses in the field of biomedicine for the delivery of active pharmaceutical ingredients by means of chemotherapy, immunotherapy, phytotherapy, and gene therapy [47]. At present, numerous drug delivery systems, namely microspheres, films, particles, nanofibers, nanocapsules, and nanocomposites, have been developed employing chitosan, which can be administered within the body via various routes like oral, intravenous, topical, nasal, and ocular routes [48].
Some immune checkpoints, such as Sting and CTLA-4, and programmed death-ligand 1 (PD-L1), are also affected by chitosan and its derivatives. Chitosan and its derivatives cause activation of the mitochondrial DNA-mediated cGAS-STING (Cyclic GMP-AMP synthase-Stimulator of Interferon Genes) pathway followed by the release of type I interferon, resulting in the immunostimulatory effect of chitosan [49]. Oral PD-L1 Binding Peptide 1 (OPBP-1), a proteolysis-resistant oral PDL-1 inhibitor that could specifically bind PD-L1 and disrupt its interaction with PD-1, was created using trimethyl chitosan. When loaded with trimethyl chitosan hydrogel, OPBP-1 demonstrated favorable oral bioavailability and a long half-life in rats and dramatically reduced tumor growth in mouse colorectal CT26 and melanoma B16-OVA models [50]. Cytotoxic T-lymphocyte antigen 4 (CTLA-4) molecules are one of the main barriers to priming T cells by dendritic cells (DCs). Therefore, it seems that blockade of such molecules facilitates T cell activation. In a study, suppression of the expression of the CTLA-4 molecule on tumor-infiltrating T cells by siRNA-loaded chitosan-lactate (CL) nanoparticles was facilitated [51].


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Update Date: 13 Jul 2023