Microplastics and Nanoplastics in Atheromas and Cardiovascular Events

Overview of the environmental risks of microplastics and their controlled degradation from the perspective of free radicals

Owing to the significant environmental threat posed by microplastics (MPs) of varying properties, MPs research has garnered considerable attention in current academic discourse. Addressing MPs in river-lake water systems, existing studies have seldom systematically revealed the role of free radicals in the aging/degradation process of MPs. Hence, this review aims to first analyze the pollution distribution and environmental risks of MPs in river-lake water systems and to elaborate the crucial role of free radicals in them. After that, the study delves into the advancements in free radical-mediated degradation techniques for MPs, emphasizing the significance of both the generation and elimination of free radicals. Furthermore, a novel approach is proposed to precisely govern the controlled generation of free radicals for MPs' degradation by interfacial modification of the material structure. Hopefully, it will shed valuable insights for the effective control and reduction of MPs in river-lake water systems.

Mechanisms of ingested polystyrene micro-nanoplastics (MNPs) uptake and translocation in an in vitro tri-culture small intestinal epithelium

Micro and nanoplastics (MNPs) are now ubiquitous contaminants of food and water. Many cellular and animal studies have shown that ingested MNPs can breach the intestinal barrier to reach the circulation. To date however, the cellular mechanisms involved in intestinal absorption of MNPs have not been investigated with physiologically relevant models, and thus remain unknown. We employed in vitro simulated digestion, a tri-culture small intestinal epithelium model, and a panel of inhibitors to assess the contributions of the possible mechanisms to absorption of 26 nm carboxylated polystyrene (PS26C) MNPs. Inhibition of ATP synthesis reduced translocation by only 35 %, suggesting uptake by both active endocytic pathways and passive diffusion. Translocation was also decreased by inhibition of dynamin and clathrin, suggesting involvement of clathrin mediated endocytosis (CME) and fast endophilin-mediated endocytosis (FEME). Inhibition of actin polymerization also significantly reduced translocation, suggesting involvement of macropinocytosis or phagocytosis. However, inhibition of the Na+-H+ exchanger had no effect on translocation, thus ruling out macropinocytosis. Together these results suggest uptake by passive diffusion as well as by active phagocytosis, CME, and FEME pathways. Further studies are needed to assess uptake mechanisms for other environmentally relevant MNPs as a function of polymer, surface chemistry, and size.

Polystyrene nanoplastics exert cardiotoxicity through the Notch and Wnt pathways in zebrafish (Danio rerio)

The ubiquity of micro(nano)plastics has raised significant concerns among people. Their accumulation in the cardiovascular system necessitates attention to their cardiotoxicity. However, research on the cardiotoxicity of micro(nano)plastics remains scarce. Our study exposed zebrafish embryos to four different concentrations (0, 1, 10, 100 μg/mL) of polystyrene nanoplastics (PSNPs) for a period of 7 days. The results indicated that PSNPs noticeably decreased the hatching and survival rates of zebrafish and also induced cardiac developmental abnormalities. The mRNA level analysis revealed significant upregulations of heart development-related genes nkx2.5, cmlc-2, and myh-7 in response to PSNPs. Additionally, PSNPs significantly up-regulated the mRNA level associated with the Notch signaling pathway (notch-1a, jag-1a, and her-7) while remarkably suppressing the expression of the Wnt signaling pathway gene (wnt-3a). Further research showed that PSNPs significantly increased the expression of endoplasmic reticulum stress genes atf-6 and chop, while noticeably inhibiting mitochondrial copy numbers. Moreover, PSNPs were found to decrease calcium ion level and superoxide dismutase (SOD) activity in zebrafish larvae. Additionally, prolonged exposure to PSNPs for 7 days exacerbated abnormalities in various indicators compared to a 4-day exposure. In conclusion, our study demonstrates that PSNPs induce oxidative stress in zebrafish larvae, thereby activating endoplasmic reticulum stress and inhibiting mitochondrial activity, ultimately disrupting the Notch and Wnt signaling pathways. These disruptions result in abnormalities in cardiac developmental genes, ultimately leading to cardiac developmental abnormalities in zebrafish. The present research contributes to a novel understanding of the cardiotoxicity of PSNPs.

Exploring developmental toxicity of microplastics and nanoplastics (MNPS): Insights from investigations using zebrafish embryos

Microplastics and nanoplastics (MNPs) have received increasing attention due to their high detection rates in human matrices and adverse health implications. However, the toxicity of MNPs on embryo/fetal development following maternal exposure remains largely unexplored. Zebrafish, sharing genetic similarities with human, boast a shorter life cycle, rapid embryonic development, and the availability of many transgenic strains, is a suitable model for environmental toxicology studies. This review comprehensively explores the existing research on the impacts of MNPs on zebrafish embryo development. MNPs exposure induces a wide array of toxic effects, encompassing neurodevelopmental toxicity, immunotoxicity, gastrointestinal effects, microbiota dysbiosis, cardiac dysfunctions, vascular toxicity, and metabolic imbalances. Moreover, MNPs disrupt the balance between reactive oxygen species (ROS) production and antioxidant capacity, culminating in oxidative damage and apoptosis. This study also offers insight into the current omics- and multi-omics based approaches in MNPs research, which greatly expedite the discovery of biochemical or metabolic pathways, and molecular mechanisms underlying MNPs exposure. Additionally, this review proposes a preliminary adverse outcome pathway framework to predict developmental toxicity caused by MNPs. It provides a comprehensive overview of pathways, facilitating a clearer understanding of the exposure and toxicity of MNPs, from molecular effects to adverse outcomes. The compiled data in this review provide a better understanding for MNPs effects on early life development, with the goal of increasing awareness about the risks posed to pregnant women by MNPs exposure and its potential impact on the health of their future generations.

A QSAR prediction model for adsorption of organic contaminants on microplastics: Dubinin-Astakhov plus linear solvation energy relationships

Numerous pharmaceuticals and personal care products (PPCPs) co-exist with various types of microplastics (MPs) in the environment, making it extremely hard to experimentally measure all their adsorption interactions. Thus, a precise prediction model is on demand. In this study, we combined the commonly used Dubinin-Astakhov (DA) model and the linear solvation energy relationships (LSERs) model to predict the adsorption capacity (Q0) and adsorption affinity (E) of MPs for PPCPs, including the key parameters of MP (specific surface area, oxygen-containing functional groups), and the Kamlet-Taft solvation parameters of organic contaminants. The model was validated with the experimental data of 8 PPCPs and 8 MPs (i.e. pristine and aged PE, PET, PS, PVC) plus some published adsorption data. This new model also indicated that the adsorption of PPCPs on those MPs was primarily governed by hydrophobic interaction and hydrogen bonding. The developed model can predict the adsorption of PPCPs onto MPs with a high accuracy and can also provide insights into the understanding of interaction forces in the adsorption process.

Toy building bricks as a potential source of microplastics and nanoplastics

Microplastics and nanoplastics have become noteworthy contaminants, affecting not only outdoor ecosystems but also making a notable impact within indoor environments. The release of microplastics and nanoplastics from commonly used plastic items remains a concern, and the characterisation of these contaminants is still challenging. This study focused on evaluating the microplastics and nanoplastics produced from plastic building bricks. Using Raman spectroscopy and correlation analysis, the plastic material used to manufacture building blocks was determined to be either acrylonitrile butadiene styrene (correlation value of 0.77) or polycarbonate (correlation value of 0.96). A principal component analysis (PCA) algorithm was optimised for improved detection of the debris particles released. Some challenges in microplastic analysis, such as the interference from the colourants in the building block materials, was explored and discussed. Combining Raman results with scanning electron microscopy - energy-dispersive X-ray spectroscopy, we found the scratches on the building blocks to be a significant source of contamination, estimated several thousand microplastics and several hundred thousand nanoplastics were generated per mm2 following simulated play activities. The potential exposure to microplastics and nanoplastics during play poses risks associated with the ingestion and inhalation of these minute plastic particles.

Effects and molecular mechanisms of polyethylene microplastic oxidation on wheat grain quality

Polyethylene microplastics (PE MPs) are the main MPs in agricultural soils and undergo oxidation upon environmental exposure. However, the influence of MP oxidation on phytotoxicity (especially for crop fruit) is still limited. This study aimed to explore the effect of PE MP oxidation on crop toxicity. Herein, a combination of plant phenotyping, metabolomic, and transcriptomic approaches was used to evaluate the effects of low-oxidation PE (LOPE) and high-oxidation PE (HOPE) on wheat growth, grain quality, and related molecular mechanisms using pot experiments. The results showed that HOPE induced a stronger inhibition of wheat growth and reduction in protein content and mineral elements than LOPE. This was accompanied by root ultrastructural damage and downregulation of carbohydrate metabolism, translation, nutrient reservoir activity, and metal ion binding gene expression. Compared with HOPE, LOPE activated a stronger plant defense response by reducing the starch content by 22.87 %, increasing soluble sugar content by 44.93 %, and upregulating antioxidant enzyme genes and crucial metabolic pathways (e.g., starch and sucrose, linoleic acid, and phenylalanine metabolism). The presence of PE MPs in the environment exacerbates crop growth inhibition and fruit quality deterioration, highlighting the need to consider the environmental and food safety implications of MPs in agricultural soils.

Case report of plastic nurdles pollution in Galicia (NW Atlantic) following the Toconao's spill in December 2023: The VIEIRA Collaborative

Plastic nurdles pose a significant environmental threat due to recurrent accidental spills into marine ecosystems. This report examines the nurdle pollution over the 1498 km of the Galician coastline (Spain) following the spill of 25 t of nurdles into the Northwest Atlantic after the loss of six containers from the Toconao vessel in December 2023. This accident highlights the urgent need for proactive, effective measures in maritime transport to prevent and mitigate such environmental catastrophes. The complexity of nurdle dispersion challenges the evaluation of their fate at sea, and the potential long-term consequences on the marine ecosystem and food web remain uncertain and yet to be investigated. This report also presents the VIEIRA collaborative and underscores the critical role of citizen-led initiatives in responding to such environmental disasters, and advocates for efficient policy reforms, involving cross-border collaboration. Furthermore, we call for greater international cooperation to underpin effective regulatory frameworks to address the growing hazard of plastic nurdle pollution worldwide.

Microplastics: Omnipresent and an ongoing challenge for medical science

Micro- and nanoplastics are omnipresent not only in the environment, but have also been detected in human body fluids and tissue. The subsequent commentary provides a perspective about potential risks for human health as well as resulting challenges for medical science.

Microplastics dysregulate innate immunity in the SARS-CoV-2 infected lung

Introduction

Global microplastic (MP) pollution is now well recognized, with humans and animals consuming and inhaling MPs on a daily basis, with a growing body of concern surrounding the potential impacts on human health.

Methods

Using a mouse model of mild COVID-19, we describe herein the effects of azide-free 1 μm polystyrene MP beads, co-delivered into lungs with a SARS-CoV-2 omicron BA.5 inoculum. The effect of MPs on the host response to SARS-CoV-2 infection was analysed using histopathology and RNA-Seq at 2 and 6 days post-infection (dpi).

Results

Although infection reduced clearance of MPs from the lung, virus titres and viral RNA levels were not significantly affected by MPs, and overt MP-associated clinical or histopathological changes were not observed. However, RNA-Seq of infected lungs revealed that MP exposure suppressed innate immune responses at 2 dpi and increased pro-inflammatory signatures at 6 dpi. The cytokine profile at 6 dpi showed a significant correlation with the 'cytokine release syndrome' signature observed in some COVID-19 patients.

Discussion

The findings are consistent with the recent finding that MPs can inhibit phagocytosis of apoptotic cells via binding of Tim4. They also add to a growing body of literature suggesting that MPs can dysregulate inflammatory processes in specific disease settings.

The triple exposure nexus of microplastic particles, plastic-associated chemicals, and environmental pollutants from a human health perspective

The presence of microplastics (MPs) is increasing at a dramatic rate globally, posing risks for exposure and subsequent potential adverse effects on human health. Apart from being physical objects, MP particles contain thousands of plastic-associated chemicals (i.e., monomers, chemical additives, and non-intentionally added substances) captured within the polymer matrix. These chemicals are often migrating from MPs and can be found in various environmental matrices and human food chains; increasing the risks for exposure and health effects. In addition to the physical and chemical attributes of MPs, plastic surfaces effectively bind exogenous chemicals, including environmental pollutants (e.g., heavy metals, persistent organic pollutants). Therefore, MPs can act as vectors of environmental pollution across air, drinking water, and food, further amplifying health risks posed by MP exposure. Critically, fragmentation of plastics in the environment increases the risk for interactions with cells, increases the presence of available surfaces to leach plastic-associated chemicals, and adsorb and transfer environmental pollutants. Hence, this review proposes the so-called triple exposure nexus approach to comprehensively map existing knowledge on interconnected health effects of MP particles, plastic-associated chemicals, and environmental pollutants. Based on the available data, there is a large knowledge gap in regard to the interactions and cumulative health effects of the triple exposure nexus. Each component of the triple nexus is known to induce genotoxicity, inflammation, and endocrine disruption, but knowledge about long-term and inter-individual health effects is lacking. Furthermore, MPs are not readily excreted from organisms after ingestion and they have been found accumulated in human blood, cardiac tissue, placenta, etc. Even though the number of studies on MPs-associated health impacts is increasing rapidly, this review underscores that there is a pressing necessity to achieve an integrated assessment of MPs' effects on human health in order to address existing and future knowledge gaps.

The cardiovascular toxicity of polystyrene microplastics in rats: based on untargeted metabolomics analysis

Background

Polystyrene microplastics (PS-MPs) exhibit multi-target, multi-dimensional, chronic, and low toxicity to the cardiovascular system. They enter the bloodstream through the gastrointestinal tract and respiratory system, altering blood parameters and conditions, inducing thrombotic diseases, and damaging myocardial tissue through the promotion of oxidative stress and inflammatory responses in myocardial cells. However, many of the links and mechanisms remain unclear.

Methods

In this study, 48 wistar rats were randomly divided into four groups and exposed to different concentrations of PS-MPs: control group (0 mg/kg/d), low dose group (0.5 mg/kg/d), middle dose group (5 mg/kg/d) and high dose group (50 mg/kg/d), with 12 rats in each group. After 90 consecutive days of intragastric administration of PS-MPs, biochemical markers in myocardium, aorta and blood were detected, and HE staining was performed to observe the toxic effects of PS-mps on cardiovascular system. Furthermore, non-targeted metabolomics methods were used to analyze the effect of PS-MPs exposure on the metabolism of cardiovascular system in rats, and to explore its potential molecular mechanism.

Results

The results revealed no pathological changes in the heart and aorta following PS-MPs exposure. However, the myocardial enzyme levels in the high dose PS-MPs group of rats showed a significant increase. Moreover, exposure to polystyrene microplastics caused a disorder in lipid metabolism in rats, and led to an increase in indicators of inflammation and oxidative stress in myocardial and aortic tissues, but resulted in a decrease in the level of IL-6. Untargeted metabolomics results showed that metabolites with antioxidant and anti-inflammatory effects, including equol and 4-hydroxybenzoic acid, were significantly upregulated.

Conclusion

These results suggest that long-term exposure to high concentrations of PS-MPs may lead to abnormal lipid metabolism and cardiovascular system damage. The mechanism may be related to oxidative stress and inflammatory response. Exogenous antioxidants and changes in own metabolites may have a protective effect on the injury. Therefore, understanding the toxicological mechanism of PS-MPs not only helps to elucidate its pathogenesis, but also provides new ideas for the treatment of chronic diseases.

The biodistribution of polystyrene nanoparticles administered intravenously in the chicken embryo

Nanoplastics can cause severe malformations in chicken embryos. To improve our understanding of the toxicity of nanoplastics to embryos, we have studied their biodistribution in living chicken embryos. We injected the embryos in the vitelline vein at stages 18-19. We injected polystyrene nanoparticles (PS-NPs) tagged with europium- or fluorescence. Their biodistribution was tracked using inductively-coupled plasma mass spectrometry on tissue lysates, paraffin histology, and vibratome sections analysed by machine learning algorithms. PS-NPs were found at high levels in the heart, liver and kidneys. Furthermore, PS-NPs crossed the endocardium of the heart at sites of epithelial-mesenchymal transformation; they also crossed the liver endothelium. Finally, we detected PS-NPs in the allantoic fluid, consistent with their being excreted by the kidneys. Our study shows the power of the chicken embryo model for analysing the biodistribution of nanoplastics in embryos. Such experiments are difficult or impossible in mammalian embryos. These findings are a major advance in our understanding of the biodistribution and tissue-specific accumulation of PS-NPs in developing animals.

Exposure to Environmental Toxins: Potential Implications for Stroke Risk via the Gut- and Lung-Brain Axis

Recent evidence indicates that exposure to environmental toxins, both short-term and long-term, can increase the risk of developing neurological disorders, including neurodegenerative diseases (i.e., Alzheimer's disease and other dementias) and acute brain injury (i.e., stroke). For stroke, the latest systematic analysis revealed that exposure to ambient particulate matter is the second most frequent stroke risk after high blood pressure. However, preclinical and clinical stroke investigations on the deleterious consequences of environmental pollutants are scarce. This review examines recent evidence of how environmental toxins, absorbed along the digestive tract or inhaled through the lungs, affect the host cellular response. We particularly address the consequences of environmental toxins on the immune response and the microbiome at the gut and lung barrier sites. Additionally, this review highlights findings showing the potential contribution of environmental toxins to an increased risk of stroke. A better understanding of the biological mechanisms underlying exposure to environmental toxins has the potential to mitigate stroke risk and other neurological disorders.

Bioaccumulation of Microplastics in Decedent Human Brains Assessed by Pyrolysis Gas Chromatography-Mass Spectrometry

Rising global concentrations of environmental micro- and nanoplastics (MNPs) drive concerns for human exposure and health outcomes. Applying pyrolysis gas chromatography-mass spectrometry (Py-GC/MS) methods to isolate and quantify MNPs from human samples, we compared MNP accumulation in kidneys, livers, and brains. Autopsy samples from the Office of the Medical Investigator in Albuquerque, NM, collected in 2016 and in 2024, were digested for Py-GC/MS analysis of 12 polymers. Brains exhibited higher concentrations of MNPs than liver or kidney samples. All organs exhibited significant increases from 2016 to 2024. Polyethylene was the predominant polymer; the relative proportion of polyethylene MNPs was greater in brain samples than in liver or kidney. Transmission electron microscopy verified the nanoscale nature of isolated particles, which largely appeared to be aged, shard-like plastics remnants across a wide range of sizes. Results demonstrate that MNPs are selectively accumulated into the human brain and concentrations are rising over time.

Assessment of Ingested Micro- and Nanoplastic (MNP)-Mediated Genotoxicity in an In Vitro Model of the Small Intestinal Epithelium (SIE)

Micro- and nanoplastics (MNPs) have become ubiquitous contaminants of water and foods, resulting in high levels of human ingestion exposure. MNPs have been found in human blood and multiple tissues, suggesting that they are readily absorbed by the gastrointestinal tract (GIT) and widely distributed. Growing toxicological evidence suggests that ingested MNPs may pose a serious health threat. The potential genotoxicity of MNPs, however, remains largely unknown. In this study, genotoxicity of primary and environmentally relevant secondary MNPs was assessed in a triculture small intestinal epithelium (SIE) model using the CometChip assay. Aqueous suspensions of 25 and 1000 nm carboxylated polystyrene spheres (PS25C and PS1KC), and incinerated polyethylene (PEI PM0.1) were subjected to simulated GIT digestion to create physiologically relevant exposures (digestas), which were applied to the SIE model at final MNP concentrations of 1, 5, and 20 μg/mL for 24 or 48 h. PS25C and PS1KC induced DNA damage in a time- and concentration-dependent manner. To our knowledge, this is one of the first assessment of MNP genotoxicity in an integrated in vitro ingestion platform including simulated GIT digestion and a triculture SIE model. These findings suggest that ingestion of high concentrations of carboxylated PS MNPs could have serious genotoxic consequences in the SIE.

Quantitative assessment and monitoring of microplastics and nanoplastics distributions and lipid metabolism in live zebrafish using hyperspectral stimulated Raman scattering microscopy

Microplastics (MP) and nanoplastics (NP) pollutions pose a rising environmental threat to humans and other living species, given their escalating presence in essential resources that living subjects ingest and/or inhale. Herein, to elucidate the potential health implications of MP/NP, we report for the first time by using label-free hyperspectral stimulated Raman scattering (SRS) imaging technique developed to quantitatively monitor the bioaccumulation and metabolic toxicity of MP/NP within live zebrafish larvae during their early developmental stages. Zebrafish embryos are exposed to environmentally related concentrations (3-60 μg/ml) of polystyrene (PS) beads with two typical sizes (2 μm and 50 nm). Zebrafish are administered isotope-tagged fatty acids through microinjection and dietary intake for in vivo tracking of lipid metabolism dynamics. In vivo 3D quantitative vibrational imaging of PS beads and intrinsic biomolecules across key zebrafish organs reveals that gut and liver are the primary target organs of MP/NP, while only 50 nm PS beads readily aggregate and adhere to the brain and blood vessels. The 50 nm PS beads are also found to induce more pronounced hepatic inflammatory response compared to 2 μm counterparts, characterized by increased biogenesis of lipid droplets and upregulation of arachidonic acid detected in zebrafish liver. Furthermore, Raman-tagged SRS imaging of fatty acids uncovers that MP/NP exposure significantly reduces yolk lipid utilization and promotes dietary lipid storage in zebrafish, possibly associated with developmental delays and more pronounced food dilution effects in zebrafish larvae exposed to 2 μm PS beads. The hyperspectral SRS imaging in this work shows that MP/NP exposure perturbs the development and lipid metabolism in zebrafish larvae, furthering the understanding of MP/NP ingestions and consequent toxicity in different organs in living species.

What is driving the global decline of human fertility? Need for a multidisciplinary approach to the underlying mechanisms

An intense period of human population expansion over the past 250 years is about to cease. Total fertility rates are falling dramatically all over the world such that highly industrialized nations, including China and the tiger economies of SE Asia, will see their populations decline significantly in the coming decades. The socioeconomic, geopolitical and environmental ramifications of this change are considerable and invite a multidisciplinary consideration of the underlying mechanisms. In the short-term, socioeconomic factors, particularly urbanization and delayed childbearing are powerful drivers of reduced fertility. In parallel, lifestyle factors such as obesity and the presence of numerous reproductive toxicants in the environment, including air-borne pollutants, nanoplastics and electromagnetic radiation, are seriously compromising reproductive health. In the longer term, it is hypothesized that the reduction in family size that accompanies the demographic transition will decrease selection pressure on high fertility genes leading to a progressive loss of human fecundity. Paradoxically, the uptake of assisted reproductive technologies at scale, may also contribute to such fecundity loss by encouraging the retention of poor fertility genotypes within the population. Since the decline in fertility rate that accompanies the demographic transition appears to be ubiquitous, the public health implications for our species are potentially devastating.

The Impact of the Aryl Hydrocarbon Receptor on Antenatal Chemical Exposure-Induced Cardiovascular-Kidney-Metabolic Programming

Early life exposure lays the groundwork for the risk of developing cardiovascular-kidney-metabolic (CKM) syndrome in adulthood. Various environmental chemicals to which pregnant mothers are commonly exposed can disrupt fetal programming, leading to a wide range of CKM phenotypes. The aryl hydrocarbon receptor (AHR) has a key role as a ligand-activated transcription factor in sensing these environmental chemicals. Activating AHR through exposure to environmental chemicals has been documented for its adverse impacts on cardiovascular diseases, hypertension, diabetes, obesity, kidney disease, and non-alcoholic fatty liver disease, as evidenced by both epidemiological and animal studies. In this review, we compile current human evidence and findings from animal models that support the connection between antenatal chemical exposures and CKM programming, focusing particularly on AHR signaling. Additionally, we explore potential AHR modulators aimed at preventing CKM syndrome. As the pioneering review to present evidence advocating for the avoidance of toxic chemical exposure during pregnancy and deepening our understanding of AHR signaling, this has the potential to mitigate the global burden of CKM syndrome in the future.

The Association of Desert Dust with the Risk of Acute Coronary Syndrome in Subjects of a Younger Age

Objectives: Recently, desert dust in Europe has been recognized as a cardiovascular health problem. In Spain, desert dust inflows in recent years have been associated with worsening air quality. The present study examines whether desert dust events are related to the incidence of acute coronary syndrome (ACS) in patients under 55 years of age. Methods: Data from 2416 consecutive patients admitted to a tertiary hospital due to ACS were prospectively analyzed. A case-crossover time-stratified design using Poisson conditional regression models was applied to estimate the impact of desert dust events involving particulate matter concentrations of an aerodynamic diameter <10 μm (PM10) on the incidence of ACS in patients under 55 years of age. Results: Desert dust intrusion on days 0 to 5 before ACS onset showed no significant association with the incidence of ACS in patients under 55 years of age. The incidence rate ratios of PM10 concentrations 1, 2, 3, 3, 4, and 5 days before ACS onset (for changes of 10 µg/m3) were 1.02 (95% CI 0.97-1.1; p = 0.41), 1.01 (95% CI 0.96-1.07; p = 0.66), 0.99 (95% CI 0.94-1.05; p = 0.78), 0.96 (95% CI 0.9-1.02; p = 0.18), and 0.97 (95% CI 0.91-1.04; p = 0.41). Conclusions: Our findings suggest that desert dust is unlikely to be related to the incidence of ACS in patients under 55 years of age.

Fibrinaloid Microclots and Atrial Fibrillation

Atrial fibrillation (AF) is a comorbidity of a variety of other chronic, inflammatory diseases for which fibrinaloid microclots are a known accompaniment (and in some cases, a cause, with a mechanistic basis). Clots are, of course, a well-known consequence of atrial fibrillation. We here ask the question whether the fibrinaloid microclots seen in plasma or serum may in fact also be a cause of (or contributor to) the development of AF. We consider known 'risk factors' for AF, and in particular, exogenous stimuli such as infection and air pollution by particulates, both of which are known to cause AF. The external accompaniments of both bacterial (lipopolysaccharide and lipoteichoic acids) and viral (SARS-CoV-2 spike protein) infections are known to stimulate fibrinaloid microclots when added in vitro, and fibrinaloid microclots, as with other amyloid proteins, can be cytotoxic, both by inducing hypoxia/reperfusion and by other means. Strokes and thromboembolisms are also common consequences of AF. Consequently, taking a systems approach, we review the considerable evidence in detail, which leads us to suggest that it is likely that microclots may well have an aetiological role in the development of AF. This has significant mechanistic and therapeutic implications.

Increasing the complexity of lipoprotein characterization for cardiovascular risk in type 2 diabetes

The burden of cardiovascular disease is particularly high among individuals with diabetes, even when LDL cholesterol is normal or within the therapeutic target. Despite this, cholesterol accumulates in their arteries, in part, due to persistent atherogenic dyslipidaemia characterized by elevated triglycerides, remnant cholesterol, smaller LDL particles and reduced HDL cholesterol. The causal link between dyslipidaemia and atherosclerosis in T2DM is complex, and our contention is that a deeper understanding of lipoprotein composition and functionality, the vehicle that delivers cholesterol to the artery, will provide insight for improving our understanding of the hidden cardiovascular risk of diabetes. This narrative review covers three levels of complexity in lipoprotein characterization: 1-the information provided by routine clinical biochemistry, 2-advanced nuclear magnetic resonance (NMR)-based lipoprotein profiling and 3-the identification of minor components or physical properties of lipoproteins that can help explain arterial accumulation in individuals with normal LDLc levels, which is typically the case in individuals with T2DM. This document highlights the importance of incorporating these three layers of lipoprotein-related information into population-based studies on ASCVD in T2DM. Such an attempt should inevitably run in parallel with biotechnological solutions that allow large-scale determination of these sets of methodologically diverse parameters.

Atherosclerosis and the Bidirectional Relationship between Cancer and Cardiovascular Disease: From Bench to Bedside-Part 1

Atherosclerosis, a complex metabolic-immune disease characterized by chronic inflammation driven by the buildup of lipid-rich plaques within arterial walls, has emerged as a pivotal factor in the intricate interplay between cancer and cardiovascular disease. This bidirectional relationship, marked by shared risk factors and pathophysiological mechanisms, underscores the need for a comprehensive understanding of how these two formidable health challenges intersect and influence each other. Cancer and its treatments can contribute to the progression of atherosclerosis, while atherosclerosis, with its inflammatory microenvironment, can exert profound effects on cancer development and outcomes. Both cancer and cardiovascular disease involve intricate interactions between general and personal exposomes. In this review, we aim to summarize the state of the art of translational data and try to show how oncologic studies on cardiotoxicity can broaden our knowledge of crucial pathways in cardiovascular biology and exert a positive impact on precision cardiology and cardio-oncology.