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Peer-reviewedCC BYResearch and practice in thrombosis and haemostasis

Microplastics, nanoplastics, and thrombogenesis.

  • Rhesha Balwan1
  • Yu Yue Hew1
  • Gerard Gurumurthy2,3
  • Xiao Wei Ang1
  • Ryan Ruiyang Ling4,5
  • Chuanhui Xu4,6,7,8
  • Ying Jie Chee4,6,8,9
  • Rinkoo Dalan4,6,8,9
  • Prahlad Ho10,11,12
  • Hui Yin Lim10,11
  • Barbara D Lam13
  • Jecko Thachil14
2 more authors
  • Emmanuel J Favaloro15,16,17,18
  • Bingwen Eugene Fan1,4,6,8,10,11
18 affiliations
  1. 1Department of Haematology, Tan Tock Seng Hospital, Singapore.
  2. 2The Queen Elizabeth Kings Lynn National Health Service Foundation Trust, Kings Lynn, United Kingdom.
  3. 3Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom.
  4. 4Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  5. 5Australia and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
  6. 6Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
  7. 7Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore.
  8. 8KLARIS Precision Health Research Clinic, Tan Tock Seng Hospital, Singapore.
  9. 9Department of Endocrinology, Tan Tock Seng Hospital, Singapore.
  10. 10Northern Clinical Diagnostics and Thrombovascular Research Centre, Northern Health, Epping, Victoria, Australia.
  11. 11Department of Medicine, Northern Health, University of Melbourne, Epping, Victoria, Australia.
  12. 12School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia.
  13. 13Division of Hematology & Oncology, Fred Hutch Cancer Center, University of Washington, Seattle, Washington, USA.
  14. 14Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.
  15. 15Haematology Department, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia.
  16. 16Sydney Centres for Thrombosis and Haemostasis, Research and Education Network, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia.
  17. 17School of Dentistry and Medical Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
  18. 18School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia.
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Abstract

Micro- and nanoplastics (MNPs) are produced through mechanical, chemical, and ultraviolet-mediated degradation of plastics and may enter the human bloodstream via ingestion, inhalation, dermal exposure, and iatrogenic sources. Their detection in human blood, atheromas, and thrombi has raised concerns that they may contribute to thrombogenesis. We conducted a structured narrative review of English-language studies indexed in PubMed, Embase, and Scopus over the preceding 15 years, up to March 31, 2026. The search identified 981 database records and 39 additional manually identified articles; after removing duplicates and screening, 72 articles were included. Evidence was synthesized according to Virchow's triad, focusing on endothelial injury, altered blood flow, hypercoagulability, cellular uptake, polymer type, surface charge, weathering, and protein corona formation. MNPs may contribute to all 3 components of Virchow's triad. Proposed mechanisms include oxidative endothelial injury, glycocalyx disruption, monocyte adhesion, foam-cell formation, plaque instability, immune cell-mediated microvascular obstruction, platelet activation, NETosis, von Willebrand factor interactions, factor XII activation, thrombin generation, and fibrin-rich clot stabilization. These effects appear to vary with particle size, polymer composition, surface charge, and environmental weathering. However, mechanistic evidence largely comes from polystyrene nanoparticle models, whereas human thrombus and atheroma studies more commonly detect polyethylene and polyvinyl chloride. MNPs are biologically plausible contributors to thrombogenesis, but their clinical relevance remains uncertain. Prospective human studies, standardized contamination-controlled detection methods, and dose-response experiments using clinically relevant particles and concentrations are required.

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Cite

BibTeXRIS
BibTeX
@article{balwan2026microplastics,
  title = {{Microplastics, nanoplastics, and thrombogenesis.}},
  author = {Rhesha Balwan and Yu Yue Hew and Gerard Gurumurthy and Xiao Wei Ang and Ryan Ruiyang Ling and Chuanhui Xu and Ying Jie Chee and Rinkoo Dalan and Prahlad Ho and Hui Yin Lim and Barbara D Lam and Jecko Thachil and Emmanuel J Favaloro and Bingwen Eugene Fan},
  journal = {Research and practice in thrombosis and haemostasis},
  year = {2026},
  month = aug,
  doi = {10.1016/j.rpth.2026.106931},
  url = {https://europepmc.org/article/MED/42894845},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Microplastics, nanoplastics, and thrombogenesis.
AU  - Rhesha Balwan
AU  - Yu Yue Hew
AU  - Gerard Gurumurthy
AU  - Xiao Wei Ang
AU  - Ryan Ruiyang Ling
AU  - Chuanhui Xu
AU  - Ying Jie Chee
AU  - Rinkoo Dalan
AU  - Prahlad Ho
AU  - Hui Yin Lim
AU  - Barbara D Lam
AU  - Jecko Thachil
AU  - Emmanuel J Favaloro
AU  - Bingwen Eugene Fan
PY  - 2026
DA  - 2026/08/28
JO  - Research and practice in thrombosis and haemostasis
DO  - 10.1016/j.rpth.2026.106931
UR  - https://europepmc.org/article/MED/42894845
AB  - Micro- and nanoplastics (MNPs) are produced through mechanical, chemical, and ultraviolet-mediated degradation of plastics and may enter the human bloodstream via ingestion, inhalation, dermal exposure, and iatrogenic sources. Their detection in human blood, atheromas, and thrombi has raised concerns that they may contribute to thrombogenesis. We conducted a structured narrative review of English-language studies indexed in PubMed, Embase, and Scopus over the preceding 15 years, up to March 31, 2026. The search identified 981 database records and 39 additional manually identified articles; after removing duplicates and screening, 72 articles were included. Evidence was synthesized according to Virchow's triad, focusing on endothelial injury, altered blood flow, hypercoagulability, cellular uptake, polymer type, surface charge, weathering, and protein corona formation. MNPs may contribute to all 3 components of Virchow's triad. Proposed mechanisms include oxidative endothelial injury, glycocalyx disruption, monocyte adhesion, foam-cell formation, plaque instability, immune cell-mediated microvascular obstruction, platelet activation, NETosis, von Willebrand factor interactions, factor XII activation, thrombin generation, and fibrin-rich clot stabilization. These effects appear to vary with particle size, polymer composition, surface charge, and environmental weathering. However, mechanistic evidence largely comes from polystyrene nanoparticle models, whereas human thrombus and atheroma studies more commonly detect polyethylene and polyvinyl chloride. MNPs are biologically plausible contributors to thrombogenesis, but their clinical relevance remains uncertain. Prospective human studies, standardized contamination-controlled detection methods, and dose-response experiments using clinically relevant particles and concentrations are required.
SN  - 2475-0379
ER  -