Yaride Pérez Pacheco, Deepak Parajuli, Ricard García-Valls
Chronic diseases such as cancer, cardiovascular disorders, neurodegenerative conditions, chronic respiratory diseases, autoimmune disorders, chronic kidney disease, persistent infectious diseases, diabetes, and ocular inflammation remain leading causes of morbidity and mortality worldwide. Their complex pathophysiologies and the limitations of conventional therapies underscore the urgent need for advanced drug delivery platforms that enhance therapeutic efficacy while minimizing off-target effects and systemic toxicity leading to adverse reactions. Nanomedicine has emerged as a transformative approach, with chitosan-based nanocarriers offering advantages due to their biocompatibility, biodegradability, mucoadhesive properties, and ability to be physic-chemically modified. These nanocarriers improve solubility, stability, bioavailability, and the therapeutic index of drugs, while enabling controlled release, targeted delivery, and immune modulation. This review highlights recent advances in chitosan-based nanomedicine for the management of chronic disease. We discuss methods of synthesis such as ionic gelation and electrospray, functionalization approaches, and immunomodulatory roles that expand therapeutic potential. The evidence emphasizes that chitosan nanocarriers are a versatile, safe, and effective platform which can be used to improve clinical results, reduce adverse effects, and advance the science of personalized medicine.