Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.

BACKGROUND Microplastics and nanoplastics (MNPs) are emerging as a potential risk factor for cardiovascular disease in preclinical studies. Direct evidence that this risk extends to humans is lacking. METHODS We conducted a prospective, multicenter, observational study involving patients who were undergoing carotid endarterectomy for asymptomatic carotid artery disease. The excised carotid plaque specimens were analyzed for the presence of MNPs with the use of pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis, and electron microscopy. Inflammatory biomarkers were assessed with enzyme-linked immunosorbent assay and immunohistochemical assay. The primary end point was a composite of myocardial infarction, stroke, or death from any cause among patients who had evidence of MNPs in plaque as compared with patients with plaque that showed no evidence of MNPs. RESULTS A total of 304 patients were enrolled in the study, and 257 completed a mean (±SD) follow-up of 33.7±6.9 months. Polyethylene was detected in carotid artery plaque of 150 patients (58.4%), with a mean level of 21.7±24.5 μg per milligram of plaque; 31 patients (12.1%) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2±2.4 μg per milligram of plaque. Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine. Patients in whom MNPs were detected within the atheroma were at higher risk for a primary end-point event than those in whom these substances were not detected (hazard ratio, 4.53; 95% confidence interval, 2.00 to 10.27; P<0.001). CONCLUSIONS In this study, patients with carotid artery plaque in which MNPs were detected had a higher risk of a composite of myocardial infarction, stroke, or death from any cause at 34 months of follow-up than those in whom MNPs were not detected. (Funded by Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale and others; ClinicalTrials.gov number, NCT05900947.).

[1]  L. Montano,et al.  First Evidence of Microplastics in Human Urine, a Preliminary Study of Intake in the Human Body , 2022, Toxics.

[2]  Zhenlie Huang,et al.  Micro- and nanoplastics: A new cardiovascular risk factor? , 2022, Environment international.

[3]  M. Sebode,et al.  Microplastics detected in cirrhotic liver tissue , 2022, EBioMedicine.

[4]  O. Carnevali,et al.  Raman Microspectroscopy Detection and Characterisation of Microplastics in Human Breastmilk , 2022, Polymers.

[5]  A. D. Vethaak,et al.  Discovery and quantification of plastic particle pollution in human blood. , 2022, Environment international.

[6]  Prosun Bhattacharya,et al.  Micro(nano)plastics pollution and human health: A carcinogenesis concern for humans. , 2022, Chemosphere.

[7]  Laura R. Sadofsky,et al.  Detection of microplastics in human lung tissue using μFTIR spectroscopy. , 2022, The Science of the total environment.

[8]  Qingrui Zhuan,et al.  Polystyrene microplastics induced female reproductive toxicity in mice. , 2021, Journal of hazardous materials.

[9]  Junchao Duan,et al.  Cardiovascular toxicity assessment of polyethylene nanoplastics on developing zebrafish embryos. , 2021, Chemosphere.

[10]  Xingfen Yang,et al.  Underestimated health risks: polystyrene micro- and nanoplastics jointly induce intestinal barrier dysfunction by ROS-mediated epithelial cell apoptosis , 2021, Particle and fibre toxicology.

[11]  A. D. Vethaak,et al.  Microplastics and human health , 2021, Science.

[12]  O. Carnevali,et al.  Plasticenta: First evidence of microplastics in human placenta. , 2021, Environment international.

[13]  D. Dionysiou,et al.  Isotope ratio mass spectrometry and spectroscopic techniques for microplastics characterization. , 2020, Talanta.

[14]  R. Saeedi,et al.  Suspended fine particulate matter (PM2.5), microplastics (MPs), and polycyclic aromatic hydrocarbons (PAHs) in air: Their possible relationships and health implications. , 2020, Environmental research.

[15]  Qian Liu,et al.  Polystyrene microplastics cause cardiac fibrosis by activating Wnt/β-catenin signaling pathway and promoting cardiomyocyte apoptosis in rats. , 2020, Environmental pollution.

[16]  Su-min Wang,et al.  Microplastic abundance, distribution and composition in the mid-west Pacific Ocean. , 2020, Environmental pollution.

[17]  Merel Kooi,et al.  Microplastics in freshwaters and drinking water: Critical review and assessment of data quality , 2019, Water research.

[18]  R. Geyer,et al.  Production, use, and fate of all plastics ever made , 2017, Science Advances.

[19]  David E Newby,et al.  Inhaled Nanoparticles Accumulate at Sites of Vascular Disease , 2017, ACS nano.

[20]  C. Lewis,et al.  Interactions of microplastic debris throughout the marine ecosystem , 2017, Nature Ecology &Evolution.

[21]  R. Woutersen,et al.  Bioavailability and biodistribution of differently charged polystyrene nanoparticles upon oral exposure in rats , 2015, Journal of Nanoparticle Research.

[22]  A. Ruder,et al.  Coronary artery disease and cancer mortality in a cohort of workers exposed to vinyl chloride, carbon disulfide, rotating shift work, and o-toluidine at a chemical manufacturing plant. , 2014, American journal of industrial medicine.

[23]  A. Goffart,et al.  Neustonic microplastic and zooplankton in the North Western Mediterranean Sea. , 2012, Marine pollution bulletin.

[24]  M. Schermerhorn,et al.  Stroke and death after carotid endarterectomy and carotid artery stenting with and without high risk criteria. , 2010, Journal of vascular surgery.

[25]  L. Rallidis,et al.  Serum interleukin‐6 is elevated in symptomatic carotid bifurcation disease , 2009, Acta neurologica Scandinavica.

[26]  E. Elm,et al.  ORIGINAL ARTICLES The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies , 2008 .

[27]  M. Ceppi,et al.  Reanalysis of updated mortality among vinyl and polyvinyl chloride workers: Confirmation of historical evidence and new findings , 2008, BMC public health.