Beta-cyclodextrins in infectious disease therapy: A review of their function beyond simple drug carriers

Cyclodextrins (CDs) are cyclic oligosaccharides derived from starch through enzymatic conversion. Over the past decades, CDs and their derivatives (dCDs) have attracted significant interest due to their remarkable versatility and distinctive physicochemical properties. Among them, beta-cyclodextrins (βCDs) and their derivatives (dβCDs) have emerged as particularly promising tools in the fight against infectious diseases, not only as drug delivery systems but also as active agents that modulate host-pathogen interactions. Recent studies have revealed their ability to modulate immune responses, disrupt microbial membranes, and interfere with quorum sensing, thereby limiting biofilm formation and related antimicrobial resistance. Therefore, in this review, we focus on the intrinsic properties of β-cyclodextrins and their derivatives in the context of infectious diseases. βCD-based compounds possess inherent biological activities that are increasingly being exploited for therapeutic purposes, including host-directed therapies, antimicrobial action, biofilm disruption, and vaccine development.