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Environmental Micro-Nanoplastics and Musculoskeletal Disorders: Current Research and Insights
Summary
Tiny plastic particles from packaging, water, and everyday products don't just pass through your body—research shows they can build up in your bones, cartilage, and joints, potentially damaging cells and triggering inflammation. This matters because scientists are finding links between these accumulated plastics and conditions like osteoporosis, arthritis, and spinal disc degeneration, though this review of existing studies notes we still need more research before drawing firm conclusions about long-term risks.
Cheng Ju,1,2,* Hui Dong,1,2,* Renfeng Liu,1,2,* Yanming Ma,1,2 Rongjin Luo,1,2 Huimin Hu1,2 1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, People’s Republic of China*These authors have contributed equally to this workCorrespondence: Huimin Hu; Rongjin LuoDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China, Email dochuhuimin@163.com; Rongjinluo93@163.comAbstract: In recent years, micro-nanoplastics, as globally prevalent emerging environmental pollutants, can enter the human body through oral ingestion, respiratory inhalation, and dermal contact, and widely distribute in diverse tissues including blood, placenta, lung, bone marrow, and bone, thereby arousing widespread concern regarding their health risks. As an essential functional system of the human body, the skeletal system is involved in mechanical support, metabolic homeostasis, and immune regulation. Disruption of skeletal homeostasis may induce a series of musculoskeletal diseases, such as osteoporosis, rheumatoid arthritis, intervertebral disc degeneration, and osteoarthritis. Accumulating evidence has verified that micro-nanoplastics can accumulate in human bone, cartilage, intervertebral disc, and bone marrow, and destroy skeletal homeostasis via multiple mechanisms, including inflammatory response, oxidative stress, pyroptosis, ferroptosis, cellular senescence, and epigenetic regulation, thus participating in the occurrence and development of musculoskeletal diseases. This paper systematically reviews the sources, classification, environmental distribution, human exposure pathways, and systemic toxic effects of micro-nanoplastics. It emphatically expounds the impacts and potential molecular mechanisms of micro-nanoplastics on osteoporosis, intervertebral disc degeneration, rheumatoid arthritis, osteoarthritis, lupus-related musculoskeletal lesions, and osteosarcoma progression. Furthermore, we summarize the detection methods and research limitations of micro-nanoplastics in skeletal tissues, and prospect future directions in environmental prevention and control, clinical translation, and high-risk population monitoring. This review is expected to provide novel ideas for mechanistic investigation, risk assessment, and clinical translation of micro-nanoplastic-associated skeletal diseases.Plain Language Summary: 1. This review systematically summarizes the association between environmental micro-nanoplastics and skeletal homeostasis, as well as the latest research evidence in musculoskeletal disorders. 2. This review elucidates the core mechanisms of skeletal system damage induced by micro-nanoplastics, including inflammatory responses, oxidative stress, pyroptosis, ferroptosis, cellular senescence, and epigenetic regulation. 3. This review proposes future research directions and potential strategies for micro-nanoplastics in skeletal disease studies.Graphical Abstract: The diagram illustrates the environmental sources of micro and nanoplastics, exposure routes, disruption of skeletal homeostasis and potential musculoskeletal diseases. On the left, sources include plastic packaging, drinking water, occupational exposure, food or seafood, airborne particles and synthetic textiles. Exposure routes are ingestion, inhalation and dermal contact, shown affecting a human figure. The center shows disruption of skeletal homeostasis, highlighting bone, cartilage, intervertebral disc, bone marrow and synovium, with a balance scale indicating bone formation and resorption. On the right, potential musculoskeletal diseases listed are osteoporosis, osteoarthritis, rheumatoid arthritis, intervertebral disc degeneration, lupus-related synovitis and osteosarcoma-related conditions.Diagram of MNPs sources, exposure routes, skeletal disruption and potential musculoskeletal diseases.Keywords: microplastics, nanoplastics, skeletal homeostasis, musculoskeletal diseases, ecological environment pollution