The benefits of delivery of drugs to the lungs include immediate and prolonged drug delivery, high effectiveness, and the ability to accomplish both local and systemic effects. Large lung surface area, high vascularity, and a thin absorption barrier are the parameters that improve medication transport via the lungs
[27]. Chitosan has been used to enhance the effects of many medications. Rifampicin, an antitubercular medicine, was created as a dry nanoparticle powder inhalation using chitosan as the polymer. This formation demonstrated continuous drug release for up to twenty-four hours without causing any adverse effects on cells or organs
[28]. Prothionamide, an antitubercular medication, was given by Debnath et al. as chitosan-coated NPs through the lungs. This change lengthened the drug’s inhalation half-life in the lungs
[29].
3.1.3. Mucosal Drug Delivery of CS
Chitosan and its derivatives encourage mucosal delivery by increasing the absorption of hydrophilic molecules such as protein and peptide medicines. The eminently hydrated glycoproteins (lysozymes, salts, and mucins) that make mucus give it its viscoelastic characteristics
[30]. To facilitate the paracellular trafficking of macromolecular medicines, chitosan function by opening the compact intercellular junctions. The positively charged, cell-bound chitosan NPs reduce the transepithelial electrical resistance of living cell monolayers and boost paracellular permeability. Depending on the chitosan’s molecular weight and level of deacetylation, the chitosan solution enhances trans and paracellular permeability
[31].
3.1.4. Nasal Drug Delivery of CS
Using a non-invasive method like nasal delivery, medications can be administered systemically and locally without experiencing the normal gastrointestinal problems associated with oral management or the effects of hepatic metabolism
[32]. Although nasal management can cross the blood–brain barrier (BBB), which has been shown to guide drug delivery from the nose to the brain (NTB) efficiently, NTB is an alternate way of topical management for antibacterial and anti-inflammatory nasal congestion
[7]. One of three pathways (three methods of nasal absorption) allows nasally administered drugs to instantly cross the BBB: first, olfactory nerves, which are the foremost effective pathway for NTB delivery of drugs; second, trigeminal nerves, which have the presence of nerve endings in the respiratory epithelia; and third, respiratory epithelium. Some limitations of NTB delivery include the minor volume of the nasal cavity, enzymatic degradation, mucociliary clearance, short drug retention duration, potential nasomucosal toxicity, drug management and deposition technique, and the need for an appropriate delivery device
[33]. Due to their limited permeability, the nasal epithelium is challenging to penetrate with hydrophilic medicines, nucleic acids, proteins, and peptides. CS enhances their permeability. The drug’s weight, lipophilicity, and charge affect how well it is absorbed through the nose. The mucociliary system clears medications that cannot pass the nasal membrane. Due to its use in nasal delivery, CS has mucoadhesion qualities combined with low toxicity, biodegradability, and biocompatibility, which can assist in resolving this concern
[32].
To increase drug concentration in the active site, direct therapeutic material delivery to the brain is necessary for neurologic illnesses such as Parkinson’s disease (PD). In the central nervous system, PD is characterized by neurodegeneration and dopaminergic neuron loss in the CNS. The current standard of care for managing PD motor symptoms relies on the dopamine (DOPA) replacement strategy, which tries to compensate for the death of dopaminergic neurons and restore adequate neurotransmitter levels. Due to elevated hydrogen-bonding potential, complete ionization in physiological pH, and significant metabolism when administered orally, it is challenging for DOPA to penetrate the BBB. The development of DOPA-loaded nanocarriers as a novel mechanism for treating Parkinson’s disease has received the most significant attention
[34]. These nanocarriers should have the capability to traverse BBB and permit persistent transport of the neurotransmitters to the brain.
3.1.5. Transdermal Drug Delivery of CS
A transdermal drug delivery system is being evolved to overcome the shortcomings of traditional administration methods. The limited skin permeability is the fundamental obstacle to be addressed when creating transdermal dosage forms. Several techniques have been devised to get around the barrier qualities and improve the transportation of medication molecules over the skin
[35][36][37]. Numerous transdermal patches made of polysaccharides have been discovered in recent years. Transdermal preparations containing CS are becoming more widespread
[37]. NPs have been promoted as one of the prospective delivery systems that can significantly overcome the constraint of the drug’s ability to penetrate the skin.
3.1.6. Dermal Delivery of CS
The systemic unpropitious effects of traditional oral and injectable delivery could be avoided with topical treatment. Additionally, this can swiftly and directly penetrate the skin and mucous membranes at the illness site
[7]. Since they enable the regulated release of drugs and address the issue of their low skin bioavailability, NPs are seen favorably for treating acne. Nicotinamide is one of the potential cosmeceuticals/nutraceuticals lately utilized to treat acne. This medication has anti-inflammatory effects and is said to reduce sebum production.
3.1.7. CS Administration for Wound Healing
Various bacteria can infect and colonize injured skin, making it easier for them to get to the underlying tissues
[38]. One crucial element that is thought to slow the healing of wounds is infection. In addition to providing a moist surrounding to prevent wound dryness, reducing wound surface necrosis, being oxygen penetrable without dehydrating the wound, and being congenial, wound dressings should also prevent mechanical damage
[39]. Less toxicity, biocompatibility, and biodegradability are further important requirements for a material used to make wound dressing
[40]. It has been demonstrated that the N-acetyl glucosamine, which is a monomer unit of CS, promotes cell growth, promotes hemostasis, as well as speeds up the healing of wounds.
45. Chitin and Chitosan for Drug Delivery and Cancer Treatment
Drug development and delivery have seen significant breakthroughs due to nanotechnology. For instance, the utility of NPs in the treatment and diagnosis of cancer has advanced to the point where it can now detect and target a single cancer cell with the delivery of a carrier to treat it. Traditional cancer therapeutic techniques include side effects, and diagnostic procedures are expensive and time-consuming. Due to their large size, surface charge, and morphology, NPs such as carbon nanotubes (CNTs), calcium NPs (CaNPs), graphene, and polymeric NPs (including chitin and chitosan) have improved cancer diagnostics and treatments. These NPs functionalization with various biological molecules, such as antibodies, aids in the transportation of drugs and the detection of cancerous cells
[41]. Chitin holds the ability to generate as a drug delivery system and anticancer agent. It has been demonstrated that chitin can suppress chitinase-3-like protein-1 (CHI3L1), which is overexpressed and stimulates proinflammatory mediators in breast cancer cells
[42]. Moreover, the synthesis of vascular endothelial growth factor C (VEGF-C), associated with tumor angiogenesis, can be downregulated with chitin
[43]. Chitin has been formed in several kinds that can counteract cancer. For example, cytotoxicity was promoted in human breast cancer cells (MCF-7 Cells) with chitin nanocomposites embedded with silver
[44]. Curcumin is an active turmeric substance with anticancer, antibacterial, and antifungal properties
[45]. Curcumin-loaded chitin nanogels (CCNGs) is an anticancer drug with chitin and curcumin and are insoluble in water. It has been seen that CCNGs-prepared materals, when treated on porcine skin samples, showed easy penetration in the epidermis od the skin with no signs of inflammation. This shows that the formulation of CCNGs can treat melanoma, which is one of the most serious and common types of skin cancer
[46]. Cancer vaccine has evolved as a unique cancer treatment method with the emergence of cancer immunotherapy, and the significance of adjuvants has lately been recognized. Adjuvants are chemical compounds that boost immunity and promote a vaccine’s potency without exhibiting any direct antigenic consequences of their own
[47]. In addition to the previously listed applications, chitin and chitosan are essential adjuvants for immunotherapy. Many studies have investigated the adjuvant characteristics of chitin and chitosan due to their immunostimulant capability and structural resemblances to glucans, a subsidiary type of natural polysaccharides
[48]. Chitin and chitosan’s antiviral and anticancer properties were first described decades ago. Suzuki et al. initially showed the adjuvant action of chitin and chitosan in the 1980s
[49]. Chitin and chitosan are frequently used for non-invasive mucosal management routes, such as oral, intranasal, and ocular mucosa, due to their mucoadhesive characteristics
[50]. Specific antigens have been demonstrated to boost adaptive immune responses
[50]. Recent studies have shown that chitosan is a potential adjuvant for intranasal vaccination
[51].
Moreover, chitin has a size-dependent and complex effect on adaptative and innate immune response, including the capability to activate and recruit innate immune cells, which stimulates chemokine and cytokine production
[52]. It has been seen that IL-12 is an antitumor cytokine that induces toxicity upon systematic administration. IL-12 can be formulated with chitosan (chitosan/IL-12) and administrated (intratumorally) in tumor mice model, could help in limiting the systematic toxicity by enhancing the local retention in the tumor microenvironment of the IL-12
[53]. Moreover, the delivery of most of the NPs or nanocarriers, including chitin and chitosan, is of two types: the passive targeting of NPs for drug delivery and the active targeting by NPs for drug delivery. The passive drug delivery of chitosan for cancer treatment is explained in (
Figure 23) and the active drug delivery of chitosan for the treatment of cancer is explained in (
Figure 34).
Figure 23.
Shows passive targeting of CS nanocarriers for drug delivery against cancer cells.
Figure 34. The functionalization of the surface of NPs specific to the ligand is one of the critical features of active targeting. The ligand selected should be specific to the overexpressed receptor at the surface of cancer cells. The figure shows that the ligand of chitosan nanocarriers binds to the overexpressed receptor of cancer cells; after binding, the receptor-mediated endocytosis takes place, leading to the formation of the endosome, and then the dependent release of drugs will happen. Once the pill is released, the cell will proceed under apoptosis through DNA damage, translation block, and cell cycle arrest.