Dextran is a complex, branched polysaccharide consisting primarily of linear chains of D-glucose units linked by α-1,6 glycosidic bonds, with branching occurring through α-1,3 and α-1,4 linkages, resulting in molecular weights typically ranging from 40,000 to 75,000 Daltons for common commercial forms such as dextran 40 and dextran 75.[1] It is naturally produced by certain lactic acid bacteria, notably Leuconostoc mesenteroides, through the enzymatic polymerization of sucrose, yielding a high-molecular-weight glucan that is highly soluble in water and exhibits hygroscopic properties.[1]In medicine, dextran serves as a versatile colloid for plasma volume expansion, particularly in managing hypovolemia due to hemorrhage, shock, or surgical blood loss, where it osmotically draws fluid into the intravascular space to restore circulating volume and improve cardiac output.[2] It also functions as an antithrombotic agent by reducing platelet aggregation and adhesiveness, thereby decreasing the risk of thrombosis in prophylactic settings such as vascular surgery.[2] Additionally, technetium-99m-labeled dextran is employed as a radiotracer for imaging lymphatic drainage and inflammation, while lower-molecular-weight variants act as ophthalmic lubricants to alleviate dry eye symptoms by enhancing tear film viscosity and retention.[2][1]Beyond clinical applications, dextran finds use in biotechnology and industry as a stabilizer and thickener in food products, a carrier in drug delivery systems due to its biocompatibility, and a component in cosmetics for its moisturizing effects, though its medical adoption has declined in favor of safer alternatives like crystalloids amid risks such as anaphylaxis and renal complications.[1][2]
History and Discovery
Initial Identification
Dextran was first observed as a microbial slime in 1861 by Louis Pasteur during studies on wine fermentation caused by bacteria. It was later recognized as a slimy byproduct in sugar processing during the late 19th and early 20th centuries, arising from the fermentation of sucrose by contaminating lactic acid bacteria such as Leuconostoc mesenteroides. This polysaccharide was initially observed as an undesirable viscous material that interfered with sucrose extraction and crystallization in beet and cane sugar factories, with early reports linking it to bacterial growth in sucrose-rich media as far back as 1878.[3]In the 1930s and 1940s, systematic biochemical characterization advanced the understanding of dextran as a complex glucose polymer produced extracellularly by Leuconostoc species. Researchers at the U.S. Department of Agriculture (USDA), including Allene Jeanes at the Northern Regional Research Laboratory, conducted pivotal experiments by culturing Leuconostoc mesenteroides in sucrose-containing media, which led to the formation of dextran through enzymatic synthesis via dextransucrase. These studies confirmed dextran's composition primarily as α-(1→6)-linked D-glucose units with branching, distinguishing it from other polysaccharides and establishing its bacterial origin.[4]Jeanes' work not only identified key strains like L. mesenteroides NRRL B-512 for consistent dextran production but also explored the conditions of bacterial growth that promoted high yields of the polymer, laying the groundwork for its purification and analysis. These early experiments involved monitoring viscosity changes and precipitation in fermented sucrose solutions, revealing dextran's role as an exopolysaccharide that encapsulates bacterial cells during growth.[5]
Pharmaceutical Development
During World War II, the U.S. National Research Council (NRC) spearheaded efforts to develop alternative plasma expanders to address critical shortages of whole blood and plasma for treating hemorrhagic shock and other battlefield injuries.[6] Dextran emerged as a promising candidate due to its colloidal properties mimicking plasma's osmotic effects, with initial investigations in the United States building on Swedish research from the early 1940s.[7] By the late 1940s, the NRC coordinated production trials, leading to the approval of U.S.-manufactured dextran for stockpiling in 1951 and subsequent Department of Defense contracts for large-scale supply.[6]In the 1950s, the Swedish firm Pharmacia (now part of Pfizer) advanced dextran's pharmaceutical viability through rigorous standardization processes, fractionating the polysaccharide into defined molecular weight ranges to optimize safety and efficacy.[8] Key products included dextran 40 (low molecular weight, approximately 40,000 Da) for microcirculatory improvement and dextran 70 (average molecular weight around 70,000 Da) for sustained volume expansion.[7] This culminated in U.S. Food and Drug Administration (FDA) approval in 1953 for dextran 70 as a treatment for hypovolemia resulting from surgery, trauma, or burns, marking its transition to a regulated medical product.[6]Clinical trials throughout the 1950s, including large-scale evaluations in Sweden exceeding 200,000 administrations by 1950 with no reported tissue damage, demonstrated dextran's effectiveness in managing shock and supporting surgical recovery.[7] U.S. and international studies further validated its role in restoring plasma volume and improving outcomes in hemorrhagic conditions, prompting widespread adoption in military and civilian medicine globally by the late 1950s.[9]
Chemical Structure and Properties
Molecular Composition
Dextran is a branched polysaccharide composed of D-glucose units, primarily linked through α(1→6) glycosidic bonds that form the linear backbone of the polymer.[1] This structure distinguishes dextran from other glucose-based polysaccharides like starch or cellulose, which feature different linkage patterns. The repeating unit of dextran is represented by the formula (C_6H_{10}O_5)_n, where n denotes the degree of polymerization, reflecting the anhydroglucose monomers after glycosidic bond formation.[10]Branching in dextran occurs through secondary glycosidic bonds, typically α(1→3), but also α(1→2) or α(1→4) linkages, with the degree of branching generally ranging from 5% to 10% in native forms.[11] These branches are often short, consisting of 1 to 2 glucose units, and their frequency decreases as molecular weight decreases.[12] In clinical-grade dextrans, such as those produced by Leuconostoc mesenteroides NRRL B-512F, approximately 95% of linkages are α(1→6), with the remaining 5% contributing to α(1→3) branches.[13]The molecular weight of dextran varies widely, typically spanning 1,000 to 5,000,000 Da, which affects its solubility and viscosity in applications.[14] Native dextrans can reach up to 440 million Da, but commercial and pharmaceutical grades are controlled to specific ranges, such as low-molecular-weight dextran at around 40 kDa (dextran 40) or high-molecular-weight at 70 kDa (dextran 70).[11] These variations in chain length and branching allow for tailored properties while maintaining the core D-glucan composition.[1]
Physical and Chemical Characteristics
Dextran is highly water-soluble, enabling the preparation of concentrated solutions exceeding 50% w/v at room temperature, a property attributed to its hydrophilic structure as a neutral polysaccharide primarily composed of α-1,6-linked D-glucose monomers. This neutral charge also results in low immunogenicity, minimizing immune responses in biological systems.[15][16][17]Solutions of dextran exhibit Newtonian flow behavior at low concentrations (below 30% w/w), with viscosity increasing proportionally to molecular weight due to the polymer's coiled conformation in aqueous media. Dextran maintains thermal stability up to 150°C without significant degradation, as demonstrated by its tolerance to autoclaving at 110–115°C for sterilization.[18][13][19]Chemically, dextran is prone to hydrolysis under acidic conditions, such as complete depolymerization to glucose in 1 M HCl at 100°C, but shows resistance to degradation in alkaline environments. The specific optical rotation of the D-form is +195° to +203° (measured for a 2% aqueous solution at 25°C).[13][15]
Sources and Production
Natural Microbial Sources
Dextran is primarily produced by certain Gram-positive lactic acid bacteria (LAB), with Leuconostoc mesenteroides subspecies mesenteroides and dextranicum serving as the most prominent producers due to their high yields of the exopolysaccharide.[20] Other notable contributors include species from the genera Lactobacillus and Streptococcus, which synthesize dextran or dextran-like polysaccharides under suitable environmental cues.[21] These bacteria thrive in carbohydrate-rich habitats, where dextran production facilitates adhesion and community formation.The biosynthesis of dextran occurs via the action of the extracellular enzyme dextransucrase (EC 2.4.1.5), which catalyzes the polymerization of glucose units from sucrose to form linear α-(1→6)-linked chains, concomitantly releasing free fructose.[22] This enzyme, secreted by the producing bacteria, initiates polymerization by attaching the first glucosyl unit to an acceptor site on the enzyme itself, followed by sequential addition of glucose monomers from sucrose without requiring primers in many cases.[23] Optimal synthesis requires mildly acidic conditions (pH 5–6), moderate temperatures (25–30°C), and elevated sucrose concentrations exceeding 5%, which enhance enzyme activity and substrate availability.[22]In natural settings, dextran-producing bacteria play key ecological roles by forming protective biofilms in sugar-abundant environments. For instance, Leuconostoc mesenteroides contributes to dextran accumulation on sugarcane surfaces, where it aids microbial colonization but can complicate juice processing by increasing viscosity.[24] Similarly, in wine vats during fermentation, strains like Leuconostoc pseudomesenteroides produce dextran to stabilize bacterial communities amid fluctuating sugar levels.[25] In the oral cavity, Streptococcus species utilize dextransucrase to generate dental plaque biofilms, shielding pathogens from host defenses and promoting cariogenic conditions.[26]
Commercial Production Methods
Commercial production of dextran primarily involves the controlled fermentation of the bacterium Leuconostoc mesenteroides, particularly strains like NRRL B-512F, which synthesize the polysaccharide through the action of dextransucrase enzymes. The process typically employs batch or fed-batch fermentation in media containing 10-20% w/v sucrose as the primary carbon source, with incubation at 25-30°C for 16-24 hours to maximize yield.[11][27]Sucrose is hydrolyzed by the enzyme to release glucose units that polymerize into dextran, while fructose is released as a byproduct; fed-batch strategies enhance productivity by gradually adding sucrose to maintain optimal concentrations and prevent substrate inhibition.[11] Yields can approach 50% of the initial sucrose weight under highly optimized conditions, producing high-molecular-weight dextran exceeding 100 kDa.[11][28]To achieve desired molecular weights for specific applications, such as the low-molecular-weight dextran 40 used in pharmaceuticals, production incorporates strategies for chain length regulation. Acceptor molecules like maltose are added during fermentation to competitively inhibit elongation, redirecting glucose transfer to form shorter oligosaccharides and limit dextran polymerization, resulting in more uniform distributions around 40 kDa.[11] For even finer control, initial high-molecular-weight dextran (up to around 500 MDa) is subjected to partial acid hydrolysis post-fermentation, followed by fractional precipitation to isolate clinical-grade fractions.[11][13]Following synthesis, crude dextran is isolated via ethanol precipitation to separate the polymer from cells and media components, achieving initial recovery rates of 80-90%. Subsequent purification includes dialysis to remove low-molecular-weight impurities and salts, followed by ion-exchange chromatography to eliminate charged contaminants and ensure high purity (>95%) suitable for medical use.[22] The final product undergoes sterilization, typically by autoclaving or filtration, to meet pharmaceutical standards. Global production has been dominated by companies like Pharmacia Fine Chemicals since the 1950s, when they pioneered large-scale manufacturing in Sweden, establishing dextran as the first industrially produced microbial polysaccharide.[22]
Medical Applications
Plasma Volume Expansion
Dextran serves as a synthetic colloid for plasma volume expansion in acute hypovolemic states, functioning through its hyperoncotic properties to draw fluid into the intravascular space without providing oxygen-carrying capacity.[2] The preferred formulation is 6% dextran 70, a high-molecular-weight polysaccharide (average 70,000 Da) that achieves sustained expansion lasting up to 24 hours due to its slower renal clearance compared to lower-molecular-weight variants.[29] This mechanism restores circulating volume, improves cardiac output, and enhances microcirculatory perfusion in conditions where rapid hemodynamic stabilization is required.[2]Clinically, dextran 70 is indicated for hypovolemic shock from hemorrhage, burns, or perioperative blood loss, particularly when whole blood or crystalloids alone are insufficient.[2] Typical dosing involves administering 500-1000 mL of a 6% intravenous solution over 1-2 hours, with a maximum of 20 mL/kg in the first 24 hours to avoid overexpansion.[30] Its use draws from historical wartime trials demonstrating efficacy in emergency volume resuscitation, though modern protocols prioritize it as an adjunct.[31]Evidence from meta-analyses supports dextran's role in trauma, with hypertonic saline-dextran 70 combinations showing a 3.5% absolute increase in survival rates (odds ratio 1.20, 95% CI 0.94-1.57) compared to isotonic fluids in hypotensive patients.[32] It provides approximately 20-25 mL of plasma expansion per gram infused, enabling effective replacement of 20-30% of lost volume in acute settings and reducing mortality in short-term hypovolemia.[29] However, it lacks benefit for long-term anemia management, as it does not address oxygen delivery deficits.[2]
Other Therapeutic Uses
Beyond its role in plasma volume expansion, low-molecular-weight dextran, particularly dextran 40 (average molecular weight 40 kDa), serves as an anticoagulant in microsurgical procedures to mitigate thrombosis risks. By reducing platelet aggregation and improving microcirculatory blood flow, it helps prevent vascular complications such as flap failure in reconstructive surgeries like head and neck free flap reconstruction. A systematic review of postoperative administration in such cases demonstrated a relative risk reduction of 0.535 for partial flap failure, though it did not significantly impact overall flap survival rates. In these applications, dextran 40 is typically infused intravenously starting on the day of surgery at 10 mL/kg (500–1000 mL of 10% solution), followed by 5 mL/kg daily for 2–3 additional days to inhibit erythrocyte aggregation and maintain graft patency.[33][34]Conjugated forms of dextran have found utility in diagnostic imaging, particularly as contrast agents in magnetic resonance imaging (MRI). For instance, gadolinium-DTPA-dextran acts as a macromolecular blood pool agent, enabling enhanced visualization of vascular structures and tumors due to its prolonged intravascular retention compared to small-molecule contrasts. Similarly, iron-dextran, traditionally used for iron supplementation, has shown promise as an alternative iron-based MRI contrast for imaging arterial and venous vessels in the brain, offering a cost-effective option with good tolerability in preliminary studies. These applications leverage dextran's biocompatibility and ability to carry high densities of imaging moieties without rapid renal clearance.[36][37][38]Dextran-based eye drops, often combined with hypromellose (e.g., 0.1% dextran 70), provide symptomatic relief for dry eye syndrome by lubricating the ocular surface and stabilizing the tear film. Clinical trials have confirmed their efficacy in alleviating irritation, burning, and discomfort post-cataract surgery or in chronic dry eye, with preservative-free formulations showing significant improvements in ocular surface disease indices comparable to other artificial tears like sodium hyaluronate. Limited evidence also supports the use of dextran-sulfate in plasma adsorption apheresis for drug-resistant nephrotic syndrome, where it selectively removes lipoproteins and immune complexes, leading to reductions in proteinuria in responsive patients, though this remains an adjunctive therapy due to procedural complexity.[39][40][41][42]
Non-Medical Applications
Laboratory Separation Techniques
Dextran plays a crucial role in laboratory separation techniques for biomolecules, leveraging its biocompatibility, solubility in aqueous buffers, and tunable molecular weight distribution to facilitate precise analytical methods. In size-exclusion chromatography (SEC), also known as gel filtration, dextran serves as a standard for column calibration due to its narrow molecular weight distribution and inert nature. Commercial dextran standards, typically ranging from 10 to 500 kDa (such as those in the T-series from Pharmacia), are used to establish calibration curves for determining the molecular weights of proteins, polysaccharides, and other macromolecules by correlating elution volumes with hydrodynamic radii.[43][44] This approach ensures accurate size-based separation without interactions with the stationary phase, which is often composed of cross-linked dextran beads like Sephadex.Another key application is in density gradient centrifugation, where dextran forms stable, linear density gradients for isolating cellular components. Solutions of 5-20% (w/v) dextran, such as Dextran-40, create gradients with densities around 1.03-1.10 g/mL, enabling the separation of organelles, viruses, and cell subpopulations based on buoyant density.[45][46] For instance, mitochondrial populations from plant tissues have been effectively fractionated using Dextran-40 gradients, outperforming sucrose in resolution due to dextran's lower osmotic pressure and reduced sedimentation artifacts.[45] These gradients are typically prepared by layering solutions of varying concentrations in ultracentrifuge tubes and centrifuging at moderate speeds (e.g., 450-100,000 g), allowing components to band at their isopycnic points.[47]Standard protocols for dextran in these techniques involve preparing 1-10% (w/v) solutions in physiological buffers like phosphate-buffered saline (PBS) or Tris-HCl, with gentle stirring or autoclaving to ensure homogeneity and sterility.[48] For SEC, a 1 mg/mL solution of high-molecular-weight Blue Dextran (2,000 kDa) is often applied as a void volume marker.[49] In electrophoresis applications, such as capillary gel electrophoresis (CGE) for DNA or protein analysis, dextran solutions (e.g., 0.5-2%) are used in sieving matrices.[50]
Industrial and Research Uses
In the food industry, dextran serves as a stabilizer and thickener, enhancing texture and moisture retention in products such as bakery items, candies, and ice cream. In Europe, it is approved for incorporation in bakery products up to a maximum of 5%.[51]Dextran finds application in cosmetics as a humectant and moisturizing agent, promoting skin hydration through its water-binding properties and aiding in the delivery of active ingredients.[52] Its hygroscopic nature helps maintain moisture levels, contributing to formulations for anti-aging and soothing effects.[52]In adhesive formulations, dextran derivatives, such as esters, are utilized for their bonding capabilities on substrates like wood, glass, and biological tissues, offering biodegradable alternatives to synthetic adhesives.[53] These bio-based materials exhibit strong adhesion due to hydrogen bonding and ester linkages, with applications in both industrial and medical-grade sealants.[54]As a cryoprotectant, dextran protects cells and tissues during freezing by stabilizing membranes and reducing ice crystal formation, commonly used in the preservation of stem cells, red blood cells, and corneas at concentrations of 5-10%.[55] It serves as an effective alternative or supplement to dimethyl sulfoxide in cryopreservation protocols for biological samples.[56]In research settings, cross-linked dextran hydrogels are employed as scaffolds for controlled drug release, leveraging their biocompatibility and tunable degradation to encapsulate and deliver therapeutic agents.[57] These structures support tissue engineering applications, including 3D bioprinting bioinks that mimic extracellular matrices for vascularized constructs.[58]Global annual production of dextran is estimated at 2,000 to 100,000 tons, primarily through microbial fermentation to meet demands across industrial sectors.[59]
Safety Profile
Adverse Reactions
Dextran administration, particularly as a plasma volume expander, is generally well-tolerated but can elicit a range of adverse reactions, primarily immune-mediated or related to its physicochemical properties. Common mild reactions include urticaria, fever, and infusion-related hypotension. These symptoms are typically self-limiting and resolve upon discontinuation of the infusion.[2]Serious risks encompass anaphylaxis, attributed to the formation of anti-dextran antibodies that trigger immune complex-mediated reactions. Anaphylactic events may manifest as bronchospasm, hypotension, and cardiovascular collapse, necessitating immediate intervention. Additionally, excessive doses can precipitate renal failure through osmotic nephrosis, where dextran accumulation in proximal tubules causes vacuolization and impaired renal function, particularly in patients with preexisting dehydration or renal impairment (maximum recommended dose: 20 mL/kg in the first 24 hours).[2][60]Bleeding diathesis represents another significant concern, driven by dose-dependent platelet inhibition that reduces aggregation and adhesiveness, leading to prolonged bleeding time. This effect can potentially result in excessive surgical bleeding or gastrointestinal hemorrhage at cumulative doses over 1 L.[2][60]
Contraindications and Precautions
Dextran is contraindicated in patients with known hypersensitivity to the drug, as severe anaphylactoid reactions may occur.[61] It is also absolutely contraindicated in those with marked hemostatic defects, such as thrombocytopenia or hypofibrinogenemia, due to the risk of prolonged bleeding time and excessive hemorrhage.[2] Additionally, dextran should not be used in patients with severe congestive heart failure or marked cardiac decompensation, where the plasma volume expansion could lead to circulatory overload.[61] Severe renal insufficiency with oliguria or anuria represents another absolute contraindication, as dextran may exacerbate renal impairment through osmotic effects.[60]To minimize risks, pretreatment with a hapten inhibitor such as dextran 1 (20 mL intravenously for adults, administered 1-2 minutes prior to dextran infusion) is recommended, as it significantly reduces the incidence of severe anaphylactoid reactions by blocking dextran-reactive antibodies—achieving a 35-fold decrease in severe reactions based on clinical data from over 8 million doses.[62] Close monitoring of renal function is essential during administration, particularly in patients with preexisting renal disease, and total daily doses should not exceed 2 g/kg (equivalent to 20 mL/kg of 10% solution) in the first 24 hours to avoid volume overload or renal tubular obstruction.[60] Subsequent daily doses are limited to 1 g/kg (10 mL/kg) for up to 5 days, with infusion rates not exceeding 20-40 mL/hour initially to allow for observation of adverse effects.[61]In special populations, caution is advised during pregnancy (FDA Category C), where dextran should be used only if the potential benefit justifies the risk to the fetus, as animal studies have shown embryocidal effects at high doses but human data are limited.[63] Elderly patients require careful dosing due to potential declines in renal and cardiac function, increasing susceptibility to fluid overload.[2] For those with renal impairment, reduced doses and frequent monitoring of urine output and serum creatinine are necessary to prevent acute kidney injury.[61] Compatibility with blood transfusions is limited; while small volumes of dextran can be co-administered with blood, larger amounts may interfere with blood grouping and cross-matching, so pre-infusion blood samples are recommended.[60]
Current Research
Advances in Production
Recent advances in enzymeengineering have focused on modifying dextransucrase to enhance stability, control molecular weight, and improve productionefficiency. For instance, artificial extension of the C-terminal variable domain with ferredoxin sequences in recombinant dextransucrase variants, such as D-F (dexYG-fdx), has increased half-life by 280% at 35°C and 200% at 45°C compared to the wild-type enzyme, while raising the optimum temperature by 10°C and broadening pH tolerance.[64] Truncation of the N-terminal variable region in enzymes like DsrS and LaniDSΔN enables synthesis of low-molecular-weight dextran (10–40 kDa) with yields up to 215 g/L.[11] Fusion of dextransucrase with dextranase produces homogeneous dextran of 10–20 kDa, addressing polydispersity issues in traditional production.[11]Disulfide bridge engineering further elevates thermal stability, increasing the temperature optimum by 10°C.[11] These modifications, often implemented via recombinant expression in Escherichia coli, facilitate tailored branching and higher efficiency in dextran synthesis from sucrose.[65] As of November 2025, optimization using cane molasses distillate and soy hydrolysate has further improved dextran yields and molecular mass uniformity in cost-effective production.[66]Process optimization efforts have emphasized continuous and semi-continuous fermentation strategies to boost yields and reduce operational costs. Immobilized dextransucrase on Fe3O4 nanoparticles enables reusable biocatalysis, achieving dextran yields of 191.9 g/L with molecular weights up to 2.45 × 10^6 Da through controlled sucrose-to-enzyme ratios.[67] Adjusting these ratios has produced dextran ranging from 4.7 to 1320 kDa at yields of up to 110 g/L, enhancing scalability.[11] Semi-continuous fermentation with strains like Weissella cibaria optimizes oligosaccharide-related processes, adaptable to dextran for sustained production.[68] Quality control has advanced with high-performance liquid chromatography coupled with charged aerosol detection (HPLC-CAD), which quantifies residual fructose and sucrose in dextran 40 at levels varying by purification method—e.g., lower residues in membrane-filtered samples versus ethanol-precipitated ones—ensuring compliance with pharmacopeial standards like bacterial endotoxins below 16 IU/g.[69][11]Sustainability improvements include shifting to renewable sucrose sources such as treated sugarcane molasses, an agricultural byproduct that supports dextran yields of 17.18 ± 0.08 g/L after optimization of sugar concentration, pH, and nitrogen sources, significantly lowering costs compared to refined sucrose.[70] Cell-free enzymatic processes minimize waste, retaining over 50% more dextran than hydrolytic methods.[11] Strain selection, such as co-cultures of Leuconostoc mesenteroides and Lipomyces starkeyi, promotes higher molecular weight uniformity (e.g., 75 ± 25 kDa), while immobilized systems improve reusability and environmental impact.[11] These 2024–2025 developments underscore a move toward efficient, eco-friendly manufacturing.[11]
Emerging Derivatives and Applications
Acetalated dextran (Ac-DEX), a pH-responsive derivative, forms biodegradable nanoparticles that degrade selectively in the acidic microenvironment of tumors, facilitating targeted delivery of anticancer drugs such as doxorubicin and paclitaxel. This controlled release mechanism minimizes off-target effects and enhances therapeutic precision, with formulations achieving high encapsulation efficiency (>80%) and stability for over a year post-lyophilization. In preclinical studies, Ac-DEX nanoparticles loaded with podophyllotoxin and paclitaxel demonstrated synergistic cytotoxicity against breast cancer cells, outperforming free drug combinations by inducing higher apoptosis rates through improved cellular uptake and endosomal escape. Recent 2025 analyses emphasize Ac-DEX's versatility in immunotherapy, where it encapsulates immunomodulators like cGAMP to boost antigen-specific responses in mouse models of influenza and cancer.[71][72]Iron oxide-dextran nanoparticles represent another promising modification for hyperthermia therapy, leveraging the superparamagnetic properties of iron oxide cores coated with crosslinked dextran to generate localized heat under alternating magnetic fields, thereby ablating tumor cells. These composites exhibit biocompatibility and efficient tumor accumulation, often combined with chemotherapeutic agents to amplify efficacy in solid tumors like gliomas and breast cancer. Preclinical evaluations show that dextran-coated iron oxide nanoparticles achieve therapeutic temperatures (42–45°C) with minimal systemic toxicity, enhancing overall treatment outcomes when integrated with multimodal approaches.[73] Diverse dextran configurations, including linear α-(1→6)-linked chains and branched variants with molecular weights from 40–70 kDa, are being optimized for next-generation blood substitutes, where low-branching forms reduce viscosity and improve hemodynamic stability in trauma and sepsis models.[74]At the research frontier, dextran derivatives serve as non-viral vectors in gene therapy, with hybrids like dextran-spermine polycations and peptide-grafted dextrans enabling efficient DNA condensation and transfection in mammalian cells, achieving up to 80% expression levels in vitro with reduced cytotoxicity compared to polyethylenimine.[75] In vaccine development, acetalated dextran microparticles act as tunable adjuvants, controlling the release of antigens like ovalbumin to modulate adaptive immunity; fast-degrading particles (20% cyclic acetal coverage) elicit robust early humoral responses, while slower variants sustain long-term cellular immunity in murine studies.[76] Preclinical data further highlight dextran's role in immunotherapy by lowering immunogenicity of conjugates, as in dextran-modified hyaluronidase nanoparticles that extend circulation half-life and amplify immunogenic cell death without eliciting strong anti-drug antibodies.[71] These advancements underscore dextran's potential in personalized biomedicine as of 2025.