Microplastics release from infusion sets during intravenous infusion induces cardiovascular toxicity

Plastic products are extensively utilized in the medical sector, with the global annual usage of single-use plastic infusion sets surpassing one million units. However, mounting evidence indicates that these infusion sets may release microplastic particles during intravenous administration, which could potentially accumulate in the cardiovascular system. In this study, by simulating specific clinical infusion conditions, including acidic, alkaline drugs and hypertonic infusions under different temperatures, we observed that irritating drugs and elevated temperatures significantly increased microplastic release. We collected the released microplastics (C-MPs) and exposed them to human umbilical vein endothelial cells (HUVECs) and transgenic zebrafish models. The results revealed that C-MPs could be internalized by cells, subsequently leads to a maximum increase in ROS production of approximately 12-fold, activating NLRP3 inflammasomes, and inhibiting angiogenesis. Transgenic zebrafish experiments further confirmed that C-MPs accumulation led to a significant decrease in survival rates, accompanied by distinct cardiovascular malformations, such as cardiac dilation, pericardial edema, abnormal angiogenesis and profound oxidative damage. In summary, our findings indicate the existence of potential health risks to the cardiovascular system from microplastics released by medical devices, thereby emphasizing the necessity to address the impact of infusion conditions.