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Environmental microplastics and liver health: Brief review on human exposure and accumulation, hepatotoxicity mechanism, and intervention strategies
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This review links human exposure to microplastics, their accumulation in the liver and proposed mechanisms of liver toxicity, including oxidative stress, inflammation and cell death. Most of the evidence comes from cell, animal and organoid studies. It also discusses candidate interventions that are still at the research stage.
Environmental microplastics (MPs) are ubiquitous contaminants arising from the weathering and disposal of widely used polymers. Increasing experimental and emerging clinical data implicate MPs in a spectrum of liver disorders, including fibrosis, non-alcoholic fatty liver disease (NAFLD), cholestatic liver disease (CLD), and potentially hepatocellular carcinoma (HCC). Unlike previous reviews that often discuss MPs exposure, toxicological mechanisms, or analytical/detection methods in isolation, this review proposes a comprehensive, integrative framework that links human exposure pathways, hepatic accumulation and clearance, toxicity mechanisms, and potential interventions. This framework systematically synthesizes mechanistic evidence from in vitro , animal, and organoid studies, encompassing oxidative stress, inflammation, metabolic reprogramming, and regulated cell death (e.g., ferroptosis and apoptosis). It also provides an in-depth discussion of diverse intervention strategies targeting gut-liver translocation, hepatic clearance, and downstream pathological processes. Although numerous studies demonstrate plausible biological mechanisms, human epidemiological data remain sparse and largely cross-sectional; only limited clinical samples have confirmed the presence of intrahepatic MPs, and causal inference at environmental exposure levels is unresolved. We identify critical knowledge gaps, including the overreliance on polystyrene model particles and the inadequate assessment of the "carrier effect" through which MPs enhance the bioavailability and hepatic accumulation of co-adsorbed pollutants, and consequently propose research priorities that emphasize environmentally relevant exposure paradigms, broader polymer physicochemical properties, and longitudinal cohort studies. This comprehensive approach enables this review to serve as a reference for future experimental design, clinical research, and the formulation of evidence-based policies for protecting liver health.
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