Integration of cyclodextrins and associated toxicities: A roadmap for high quality biomedical applications

Cyclodextrins are extensively employed in drug delivery systems like inclusion complexes, metal-organic frameworks, functionalized or PEGylated conjugates, and other nanocarrier systems such as nanosponges or hydrogel nanoparticles for targeted effect or prolonged release action. Applications of CDs range from drug-loaded nanocarrier systems useful for disease conditions (such as cancer, diabetes, and bacterial infections, etc.) to supramolecular chemistry, diagnostics, imaging, biosensors, and medical devices. However, there is a limited data and information on the adverse effects caused by cyclodextrins and their toxicities in the medical field. Various in-vitro and ex-vivo toxic effects such as cytotoxicity, ototoxicity, etc. as well as the adverse and toxic effects depend on the role of administration of cyclodextrins. This review article focuses on the advancement of characteristics, properties and chemistry of cyclodextrins and addresses the new challenges faced in cyclodextrin-based delivery systems and the various toxicities induced by them.