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This study examined the individual and joint toxicity of polyethylene nanoplastics (PE-NPs; 20 and 80\u00a0nm, 5\u00a0mg L\u207b\u00b9) and potassium clavulanate (CA; 100 ng L\u207b\u00b9) in African catfish (\n                    <jats:italic>Clarias gariepinus<\/jats:italic>\n                    ) during a 15-day exposure followed by a 15-day recovery phase. Exposure to PE-NPs (20\u00a0nm) alone significantly increased erythrocyte apoptosis (2.8-fold vs. control,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), while CA alone also caused significant DNA damage (1.9-fold vs. control,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). PE-NPs (80\u00a0nm) alone induced no notable alterations. Co-exposure to CA and PE-NPs, particularly the 20\u00a0nm particles, produced the strongest erythrocyte apoptosis, DNA damage, and declines in Hb, Hct, RBCs, and WBCs. These hematological and genotoxic effects persisted after recovery, indicating incomplete or delayed reversal of toxicity. Spleen histopathology showed vascular congestion, hemorrhage, fibrosis, and lymphoid depletion, especially in co-exposed fish. The results demonstrate a statistically significant, size-dependent synergistic interaction, suggesting that smaller PE-NPs amplify CA-induced cytotoxicity and genotoxicity through a \u201cTrojan horse\u201d mechanism. The persistence of these effects underscores the ecological risk of NP\u2013pharmaceutical mixtures and the need to include such interactions in aquatic risk assessments.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-27780-6","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T15:46:35Z","timestamp":1764776795000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Polyethylene nanoplastics intensify toxicity of potassium clavulanate in African catfish (Clarias gariepinus)"],"prefix":"10.1038","volume":"15","author":[{"given":"Walied A","family":"Kamel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa El-Din H.","family":"Sayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaimaa Kamal A.","family":"Idriss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba Allah M.","family":"Elbaghdady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"issue":"6510","key":"27780_CR1","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1126\/science.aba9475","volume":"369","author":"WW Lau","year":"2020","unstructured":"Lau, W. 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