Abstract
Chitosan (CS) is a biodegradable and biocompatible polysaccharide, obtained by the
deacetylation of chitin. It has gained significant attention as a versatile material for biomedical
applications due to its mucoadhesive properties, ease of chemical modification and
intrinsic pharmacological activities. This review synthesizes two decades (2005–2025) of literature,
focusing on chemical modifications of chitosan for pharmacological purposes and
their therapeutic implications in non-communicable diseases (NCDs) and wound healing.
Evidence highlights the roles of chitosan-based materials in anticancer, anti-inflammatory,
antidiabetic, antihypertensive, and neuroprotective activities, alongside their integration in
advanced wound healing strategies. Clinical trials have demonstrated the translational potential
of chitosan-based materials. In general, chitosan-based materials exhibit promising
dual functions as bioactive agents and drug carriers, necessitating additional investigation
in clinical and regulatory frameworks to accelerate therapeutic adoption. In contrast to
other studies, this study offers a mechanistic and integrative viewpoint that links chitosan’s
chemical modification techniques with their pharmacological effects and clinical
translation potential, providing novel perspectives on structure–activity correlations and
therapeutic design.