Extracorporeal therapeutic apheresis demonstrated the ability to remove microplastic-like particles from human blood in patients with myalgic encephalomyelitis/chronic fatigue syndrome, according to a recent study published.
The research marks the first evidence that therapeutic apheresis—an established extracorporeal technique used to selectively remove specific blood components—may offer a potential method for removing microplastics and nanoplastics from the human body.
Growing Health Concern
Microplastics (1 μm to 5mm) and nanoplastics (less than 1 μm) are small plastic particles that originate from commercial production, including cosmetics and medical drugs, as well as from the degradation of large plastic waste. These particles, collectively referred to as microplastics and nanoplastics (MNPs), are virtually omnipresent in the environment.
Recent studies have reported the presence of microplastics in numerous tissues, including the lung, heart, gut, liver, brain, and metabolically active tissues.
"Growing evidence suggest that MNPs may contribute to the development and progression of various conditions, including cardiovascular and metabolic diseases, infertility, cancer, and even neurodegenerative disorders such as dementia," wrote lead study researcher Stefan R. Bornstein, MD, of the University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany, and colleagues.
Apheresis Treatment and Analysis
The researchers analyzed 21 patients with a confirmed diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) related to a postinfectious syndrome. Each patient received at least two cycles of therapeutic apheresis with double filtration. .
After each apheresis session, the concentrated eluate collected from the blood circulation was analyzed for MNP-like particles via attenuated total reflection Fourier transform infrared (ATR-FT-IR) spectroscopy.An analysis showed
14 different substances or mixtures of substances could be detected only in the eluates from these patients. Examples included substances with resemblance to polyamide 6 and a polyurethane . Polyamide 6, commonly referred to as nylon 6, is a synthetic polymer that is predominantly manufactured in fiber form rather than as particles.
For specialized uses, electrospun fibers are produced with diameters under 100 nm, which may account for why the researchers detected particles in eluates that had been double-filtered through pores of 200 nm or smaller.
Study Limitations and Future Directions
The researchers noted that the analysis does not quantitatively measure MNPs; it only determines whether MNP-like particles are present. Moreover, since ATR-FT-IR spectroscopy identifies polyamide bonds, some of these signals could also partially arise from proteins.
MNP-like particles observed in eluates from patient samples were not found in any filter prerinse samples, suggesting they were exclusively derived from the patient eluates.
Previously, the researchers and others demonstrated that up to 70% of patients with ME/CFS, including some with long COVID, reported statistically significant improvement in their symptoms following extracorporeal apheresis.
Clinical Implications
Because MNPs are widespread in the environment, it is not feasible to entirely avoid exposure noted researchers. Although some initiatives advocate for a global strategy to curb MNP intake, the researchers highlighted the pressing need for an effective approach to eliminate these particles from the human body.
The researchers advocate for an extensive investigation into the elimination of MNPs using diverse filter systems with varying pore sizes, aiming to establish approaches that both prevent uptake and support the clearance of accumulated particles.
"However, larger patient cohorts and quantitative analyses, such as pyrolysis gas chromatography mass spectrometry, are required to confirm the effective removal of MNPs through therapeutic apheresis," the researchers wrote.
Future studies should include measuring MNP levels in plasma samples before and after apheresis, as well as in eluates, across multiple cycles. These investigations aim to determine the extent of particle elimination from blood and tissues and assess whether this correlates with symptom improvements in disorders like ME/CFS.
Full disclosures can be found in the study.
Source: Brain Medicine
