{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:27:31Z","timestamp":1790623651826,"version":"4.1.0"},"reference-count":106,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Xenobiot.","JoX"],"abstract":"<jats:p>The exponential rise in global plastic production has resulted in the widespread environmental dissemination of micro- and nanoplastics (MNPs) across air, water, and biological systems. Inhalation of airborne MNPs represents a biologically plausible pathway of pulmonary exposure, particularly within indoor and occupational environments. Experimental evidence indicates that inhaled MNPs deposit within distal lung compartments, where their small aerodynamic diameter and surface reactivity may favor cellular uptake, oxidative stress induction, inflammatory activation, and prolonged biopersistence. Experimental studies further indicate that MNP exposure may induce DNA damage, chromosomal instability, and the dysregulation of signaling pathways involved in genomic integrity, thereby providing additional mechanistic support for their potential role in carcinogenesis. Chronic redox imbalance, macrophage dysfunction, inflammasome activation, epithelial\u2013mesenchymal transition, and dysregulated cell adhesion collectively resemble mechanisms implicated in inflammation-associated carcinogenesis. Emerging in vitro and in vivo data further suggest that nanoplastics may function as tumor promoters or co-carcinogenic modifiers, particularly under chronic low-dose exposure or in combination with other airborne toxicants. However, human epidemiological evidence remains limited, and causality has not been established. This review synthesizes current mechanistic evidence regarding inhaled MNPs as potential modifiers of lung carcinogenesis, compares them with established inhaled carcinogens, and outlines critical research priorities necessary to clarify exposure\u2013response relationships and clinical relevance. Current evidence supports biological plausibility rather than confirmed carcinogenic classification.<\/jats:p>","DOI":"10.3390\/jox16040136","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:26:23Z","timestamp":1785115583000},"page":"136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inhaled Micro- and Nanoplastics as Environmental Modifiers of Lung Carcinogenesis: Mechanistic Insights and Evidence Synthesis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4672-6396","authenticated-orcid":false,"given":"Chrysa","family":"Andrikopoulou","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, General University Hospital of Patras, University of Patras, 26504 Patras, Greece"},{"name":"Department of General Surgery, General Hospital of Eastern Achaia\u2013Unit of Aigio, 25100 Aigio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9206-7053","authenticated-orcid":false,"given":"Nikolaos E.","family":"Koletsis","sequence":"additional","affiliation":[{"name":"Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zographou, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8692-0059","authenticated-orcid":false,"given":"Vasileios","family":"Leivaditis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, 67655 Kaiserslautern, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7198-2628","authenticated-orcid":false,"given":"Francesk","family":"Mulita","sequence":"additional","affiliation":[{"name":"Second Department of Surgery, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0606-7287","authenticated-orcid":false,"given":"Sofoklis","family":"Mitsos","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Periklis","family":"Tomos","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2779-5398","authenticated-orcid":false,"given":"Ioannis","family":"Panagiotopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2445-0879","authenticated-orcid":false,"given":"Vasiliki","family":"Androutsopoulou","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7775-4634","authenticated-orcid":false,"given":"Marios G.","family":"Kostakis","sequence":"additional","affiliation":[{"name":"Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zographou, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4624-4735","authenticated-orcid":false,"given":"Nikolaos S.","family":"Thomaidis","sequence":"additional","affiliation":[{"name":"Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zographou, 15772 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1660-4047","authenticated-orcid":false,"given":"Efstratios","family":"Koletsis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, General University Hospital of Patras, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.5334\/aogh.4056","article-title":"The Minderoo-Monaco Commission on Plastics and Human Health","volume":"89","author":"Landrigan","year":"2023","journal-title":"Ann. Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"230226","DOI":"10.1183\/16000617.0226-2023","article-title":"Microplastic and plastic pollution: Impact on respiratory disease and health","volume":"33","author":"Vasse","year":"2024","journal-title":"Eur. Respir. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3381","DOI":"10.1038\/s41467-020-17201-9","article-title":"Atmospheric transport is a major pathway of microplastics to remote regions","volume":"11","author":"Evangeliou","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1743-8977-2-8","article-title":"Principles for characterizing the potential human health effects from exposure to nanomaterials: Elements of a screening strategy","volume":"2","author":"Maynard","year":"2005","journal-title":"Part. Fibre Toxicol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lu, K., Zhan, D., Fang, Y., Li, L., Chen, G., Chen, S., and Wang, L. (2022). Microplastics, potential threat to patients with lung diseases. Front. Toxicol., 4, Erratum in Front. Toxicol. 2022, 4, 1119994. https:\/\/doi.org\/10.3389\/ftox.2022.1119994.","DOI":"10.3389\/ftox.2022.958414"},{"key":"ref_6","first-page":"521","article-title":"Comprehensive analysis of natural and man-made disasters: A narrative review of causes, impacts and management strategies in greece and the european union","volume":"30","author":"Leivaditis","year":"2025","journal-title":"Surg. Chron."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s12032-025-02765-7","article-title":"The role of the tumour microenvironment in lung cancer and its therapeutic implications","volume":"42","author":"Edirisinghe","year":"2025","journal-title":"Med. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1126\/science.1094559","article-title":"Lost at sea: Where is all the plastic?","volume":"304","author":"Thompson","year":"2004","journal-title":"Science"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"104901","DOI":"10.1016\/j.ebiom.2023.104901","article-title":"The potential impacts of micro-and-nano plastics on various organ systems in humans","volume":"99","author":"Ali","year":"2024","journal-title":"EBioMedicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"138359","DOI":"10.1016\/j.jhazmat.2025.138359","article-title":"The long-term in vitro co-exposure of polyethylene terephthalate (PET) nanoplastics and cigarette smoke condensate exacerbates the induction of carcinogenic traits","volume":"493","author":"Villacorta","year":"2025","journal-title":"J. Hazard. Mater."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Salvia, R., Ca\u00f1averas, M., Rico, L.G., Drozdowskyj, A., Ward, M.D., Jurado, R., G\u00f3mez-Mu\u00f1oz, L., Vives-Pi, M., Mart\u00ednez-C\u00e1ceres, E., and Petriz, J. (2024). Prospective investigation of nanoplastic accumulation in healthy subjects, autoimmune diseases, hematological malignancies, lung cancer, and murine models. Microplastics, 4.","DOI":"10.31219\/osf.io\/ey2sp"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12943-025-02230-z","article-title":"The micro(nano)plastics perspective: Exploring cancer development and therapy","volume":"24","author":"Deng","year":"2025","journal-title":"Mol. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Yee, M.S., Hii, L.W., Looi, C.K., Lim, W.M., Wong, S.F., Kok, Y.Y., Tan, B.K., Wong, C.Y., and Leong, C.O. (2021). Impact of Microplastics and Nanoplastics on Human Health. Nanomaterials, 11.","DOI":"10.3390\/nano11020496"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4226","DOI":"10.4081\/ejh.2025.4226","article-title":"Forever particles: Histochemistry in the plasticene age","volume":"69","author":"Camia","year":"2025","journal-title":"Eur. J. Histochem."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"166320","DOI":"10.1016\/j.scitotenv.2023.166320","article-title":"Unraveling the in vivo fate of inhaled micro- and nanoplastics with PET imaging","volume":"904","author":"Delaney","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ruggieri, L., Amato, O., Marrazzo, C., Nebuloni, M., Dalu, D., Cona, M.S., Gambaro, A., Rulli, E., and La Verde, N. (2024). Rising Concern About the Carcinogenetic Role of Micro-Nanoplastics. Int. J. Mol. Sci., 26.","DOI":"10.20944\/preprints202411.1921.v1"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1021\/acs.est.8b05143","article-title":"Transfer of PCBs from Microplastics under Simulated Gut Fluid Conditions Is Biphasic and Reversible","volume":"53","author":"Koelmans","year":"2019","journal-title":"Environ. Sci. Technol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"154907","DOI":"10.1016\/j.scitotenv.2022.154907","article-title":"Detection of microplastics in human lung tissue using \u03bcFTIR spectroscopy","volume":"831","author":"Jenner","year":"2022","journal-title":"Sci. Total Environ."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"139129","DOI":"10.1016\/j.jhazmat.2025.139129","article-title":"Small Particles, Big Problems: Polystyrene nanoparticles induce DNA damage, oxidative stress, migration, and mitogenic pathways predominantly in non-malignant lung cells","volume":"495","author":"Ernhofer","year":"2025","journal-title":"J. Hazard. Mater."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"10445","DOI":"10.1021\/acs.est.3c06840","article-title":"The Known and Unknown: Investigating the Carcinogenic Potential of Plastic Additives","volume":"58","author":"Vincoff","year":"2024","journal-title":"Environ. Sci. Technol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Dzier\u017cy\u0144ski, E., Gawlik, P.J., Pu\u017aniak, D., Flieger, W., J\u00f3\u017awik, K., Teresi\u0144ski, G., Forma, A., Wdowiak, P., Baj, J., and Flieger, J. (2024). Microplastics in the Human Body: Exposure, Detection, and Risk of Carcinogenesis: A State-of-the-Art Review. Cancers, 16.","DOI":"10.3390\/cancers16213703"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1038\/s41565-021-00888-2","article-title":"Placing nanoplastics in the context of global plastic pollution","volume":"16","author":"Mitrano","year":"2021","journal-title":"Nat. Nanotechnol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Sychowski, G., Romanowicz, H., Cie\u015blik-Wolski, B., Wojciechowska-Durczy\u0144ska, K., and Smolarz, B. (2025). Microplastics Exposure Impact on Lung Cancer\u2014Literature Review. Cancers, 17.","DOI":"10.3390\/cancers17223616"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1146\/annurev-pharmtox-030424-112828","article-title":"Advancements in Assays for Micro- and Nanoplastic Detection: Paving the Way for Biomonitoring and Exposomics Studies","volume":"65","author":"Shao","year":"2025","journal-title":"Annu. Rev. Pharmacol. Toxicol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"107177","DOI":"10.1016\/j.envint.2022.107177","article-title":"Pulmonary toxicology assessment of polyethylene terephthalate nanoplastic particles in vitro","volume":"162","author":"Zhang","year":"2022","journal-title":"Environ. Int."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"108350","DOI":"10.1016\/j.envint.2023.108350","article-title":"Foodborne and airborne polyethersulfone nanoplastics respectively induce liver and lung injury in mice: Comparison with microplastics","volume":"183","author":"Zha","year":"2024","journal-title":"Environ. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1038\/s41370-023-00634-x","article-title":"Systematic review of microplastics and nanoplastics in indoor and outdoor air: Identifying a framework and data needs for quantifying human inhalation exposures","volume":"34","author":"Eberhard","year":"2024","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3934\/environsci.2019.5.367","article-title":"Toxicological considerations of nano-sized plastics","volume":"6","author":"Stapleton","year":"2019","journal-title":"AIMS Environ. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1021\/acs.est.8b05512","article-title":"Emergence of Nanoplastic in the Environment and Possible Impact on Human Health","volume":"53","author":"Lehner","year":"2019","journal-title":"Environ. Sci. Technol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"tfae138","DOI":"10.1093\/toxres\/tfae138","article-title":"Sterile inflammation induced by respirable micro and nano polystyrene particles in the pathogenesis of pulmonary diseases","volume":"13","author":"Antonio","year":"2024","journal-title":"Toxicol. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"116818","DOI":"10.1016\/j.ecoenv.2024.116818","article-title":"Detection and quantification of microplastics in various types of human tumor tissues","volume":"283","author":"Zhao","year":"2024","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"107200","DOI":"10.1016\/j.envint.2022.107200","article-title":"Human airway organoids and microplastic fibers: A new exposure model for emerging contaminants","volume":"163","author":"Winkler","year":"2022","journal-title":"Environ. Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.eehl.2023.08.002","article-title":"A systematic review of the impacts of exposure to micro- and nano-plastics on human tissue accumulation and health","volume":"2","author":"Feng","year":"2023","journal-title":"Eco-Environ. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1186\/s12951-025-03419-6","article-title":"Pulmonary hazards of nanoplastic particles: A study using polystyrene in in vitro models of the alveolar and bronchial epithelium","volume":"23","author":"Michelini","year":"2025","journal-title":"J. Nanobiotechnology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"176017","DOI":"10.1016\/j.scitotenv.2024.176017","article-title":"Integrin A5B1-mediated endocytosis of polystyrene nanoplastics: Implications for human lung disease and therapeutic targets","volume":"953","author":"Han","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e24355","DOI":"10.1016\/j.heliyon.2024.e24355","article-title":"Effect of microplastics deposition on human lung airways: A review with computational benefits and challenges","volume":"10","author":"Saha","year":"2024","journal-title":"Heliyon"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"15702","DOI":"10.1038\/s41598-021-95073-9","article-title":"Noxic effects of polystyrene microparticles on murine macrophages and epithelial cells","volume":"11","author":"Rudolph","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Giordano, M.E., Lionetto, F., and Lionetto, M.G. (2025). Impact of polyethylene terephthalate nanoplastics (PET) on fibroblasts: A study on NIH-3T3 cells. Front. Physiol., 16.","DOI":"10.3389\/fphys.2025.1580682"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1016\/S0142-9612(98)00140-9","article-title":"Polyethylene particles of a \u2018critical size\u2019 are necessary for the induction of cytokines by macrophages in vitro","volume":"19","author":"Green","year":"1998","journal-title":"Biomaterials"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1743-8977-7-2","article-title":"Deposition and biokinetics of inhaled nanoparticles","volume":"7","author":"Geiser","year":"2010","journal-title":"Part. Fibre Toxicol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"100531","DOI":"10.1016\/j.impact.2024.100531","article-title":"Gut-lung microbiota dynamics in mice exposed to Nanoplastics","volume":"36","author":"Bertorello","year":"2024","journal-title":"NanoImpact"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1186\/s12967-024-05731-5","article-title":"Microplastics: An often-overlooked issue in the transition from chronic inflammation to cancer","volume":"22","author":"Cheng","year":"2024","journal-title":"J. Transl. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.freeradbiomed.2010.09.006","article-title":"Oxidative stress, inflammation, and cancer: How are they linked?","volume":"49","author":"Reuter","year":"2010","journal-title":"Free Radic. Biol. Med."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Zeng, S., Zhang, Y., Li, S., Li, Z., Li, P., Xie, J., Zhang, J., Xie, L., and Yang, Y. (2025). From metabolic alterations to chronic inflammation: Mechanisms and immunoregulation of metabolic reprogramming in COPD. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1698832"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"117803","DOI":"10.1016\/j.envres.2023.117803","article-title":"Interactions between inhalable aged microplastics and lung surfactant: Potential pulmonary health risks","volume":"245","author":"Cao","year":"2024","journal-title":"Environ. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"128109","DOI":"10.1016\/j.jhazmat.2021.128109","article-title":"Potential health risks of the interaction of microplastics and lung surfactant","volume":"429","author":"Shi","year":"2022","journal-title":"J. Hazard. Mater."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"127149","DOI":"10.1016\/j.envpol.2025.127149","article-title":"Lung hazards of microplastics and their toxicological mechanisms","volume":"385","author":"Huang","year":"2025","journal-title":"Environ. Pollut."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"140839","DOI":"10.1016\/j.jhazmat.2025.140839","article-title":"Impact of nanoplastics emitted from incineration of polyethylene plastic on THP-1 macrophage viability and immune function","volume":"501","author":"Bazina","year":"2026","journal-title":"J. Hazard. Mater."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"113612","DOI":"10.1016\/j.ecoenv.2022.113612","article-title":"Exposure to polystyrene nanoplastics impairs lipid metabolism in human and murine macrophages in vitro","volume":"238","author":"Florance","year":"2022","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"115018","DOI":"10.1016\/j.ecoenv.2023.115018","article-title":"Atmospheric microplastic and nanoplastic: The toxicological paradigm on the cellular system","volume":"259","author":"Choudhury","year":"2023","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"118643","DOI":"10.1016\/j.ecoenv.2025.118643","article-title":"Co-exposure of polystyrene nanoplastics and ozone synergistically induced airway inflammation: Evidence and biomarkers screening","volume":"302","author":"Jian","year":"2025","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Milillo, C., Aruffo, E., Di Carlo, P., Patruno, A., Gatta, M., Bruno, A., Dovizio, M., Marinelli, L., Dimmito, M.P., and Di Giacomo, V. (2024). Polystyrene nanoplastics mediate oxidative stress, senescence, and apoptosis in a human alveolar epithelial cell line. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1385387"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"169260","DOI":"10.1016\/j.scitotenv.2023.169260","article-title":"Polystyrene nanoplastics-induced lung apoptosis and ferroptosis via ROS-dependent endoplasmic reticulum stress","volume":"912","author":"Wu","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"143702","DOI":"10.1016\/j.chemosphere.2024.143702","article-title":"Assessing toxicity of amorphous nanoplastics in airway- and lung epithelial cells using air-liquid interface models","volume":"368","author":"Gosselink","year":"2024","journal-title":"Chemosphere"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"117618","DOI":"10.1016\/j.taap.2025.117618","article-title":"Polystyrene nanoplastics and lung cancer: Insights from network toxicology and mechanistic in vitro studies","volume":"506","author":"Le","year":"2026","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_56","first-page":"1","article-title":"Mitochondrial stress response in lung cells triggered by the inhaled nanoplastics","volume":"100","author":"Szczepanowska","year":"2026","journal-title":"Arch. Toxicol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1186\/s12943-025-02409-4","article-title":"Microplastics as emerging carcinogens: From environmental pollutants to oncogenic drivers","volume":"24","author":"Mishra","year":"2025","journal-title":"Mol. Cancer"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"121575","DOI":"10.1016\/j.jhazmat.2019.121575","article-title":"Polystyrene microplastic particles: In vitro pulmonary toxicity assessment","volume":"385","author":"Dong","year":"2020","journal-title":"J. Hazard. Mater."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"133794","DOI":"10.1016\/j.scitotenv.2019.133794","article-title":"Internalization and toxicity: A preliminary study of effects of nanoplastic particles on human lung epithelial cell","volume":"694","author":"Xu","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"4509","DOI":"10.2147\/IJN.S381776","article-title":"Cytotoxicity and Genotoxicity of Polystyrene Micro- and Nanoplastics with Different Size and Surface Modification in A549 Cells","volume":"17","author":"Shi","year":"2022","journal-title":"Int. J. Nanomed."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"133412","DOI":"10.1016\/j.jhazmat.2023.133412","article-title":"Micro- and nano-plastics in the atmosphere: A review of occurrence, properties and human health risks","volume":"465","author":"Luo","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12967-025-07553-5","article-title":"From exposure to oncogenesis: A review on the multifaceted roles of microplastics in tumor initiation and progression","volume":"24","author":"He","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"154328","DOI":"10.1016\/j.tox.2025.154328","article-title":"Polystyrene nanoplastics increase migration in normal lung cells while inducing differential cytotoxicity in lung cancer cells","volume":"519","author":"Kim","year":"2026","journal-title":"Toxicology"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"102043","DOI":"10.1016\/j.toxrep.2025.102043","article-title":"Micro- and nanoplastic toxicity in humans: Exposure pathways, cellular effects, and mitigation strategies","volume":"14","author":"Jahedi","year":"2025","journal-title":"Toxicol. Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"108468","DOI":"10.1016\/j.mrrev.2023.108468","article-title":"Exposure to nanoplastic particles and DNA damage in mammalian cells","volume":"792","author":"Roursgaard","year":"2023","journal-title":"Mutat. Res. Rev. Mutat. Res."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"P\u0142uciennik, K., Sici\u0144ska, P., Misztal, W., and Bukowska, B. (2024). Important Factors Affecting Induction of Cell Death, Oxidative Stress and DNA Damage by Nano- and Microplastic Particles In Vitro. Cells, 13.","DOI":"10.3390\/cells13090768"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"106061","DOI":"10.1016\/j.isci.2023.106061","article-title":"Recent insights into uptake, toxicity, and molecular targets of microplastics and nanoplastics relevant to human health impacts","volume":"26","author":"Khan","year":"2023","journal-title":"iScience"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"100481","DOI":"10.1016\/j.impact.2023.100481","article-title":"Micro- and nanoplastics (MNPs) and their potential toxicological outcomes: State of science, knowledge gaps and research needs","volume":"32","author":"Yang","year":"2023","journal-title":"NanoImpact"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"108453","DOI":"10.1016\/j.mrrev.2023.108453","article-title":"Insights into the potential carcinogenicity of micro- and nano-plastics","volume":"791","author":"Domenech","year":"2023","journal-title":"Mutat. Res. Rev. Mutat. Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"16790","DOI":"10.1021\/acsnano.4c02335","article-title":"Realistic Nanoplastics Induced Pulmonary Damage via the Crosstalk of Ferritinophagy and Mitochondrial Dysfunction","volume":"18","author":"Ji","year":"2024","journal-title":"ACS Nano"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"175881","DOI":"10.1016\/j.scitotenv.2024.175881","article-title":"Recent advances on transport and transformation mechanism of nanoplastics in lung cells","volume":"952","author":"Zhang","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1002\/jat.4598","article-title":"Genotoxic and neurotoxic potential of intracellular nanoplastics: A review","volume":"44","author":"Casella","year":"2024","journal-title":"J. Appl. Toxicol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3892\/ol.2025.14939","article-title":"Role of microplastics in the tumor microenvironment (Review)","volume":"29","author":"Chen","year":"2025","journal-title":"Oncol. Lett."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Wen, J., and Lin, Y. (2025). Invisible invaders: Unveiling the carcinogenic threat of microplastics and nanoplastics in colorectal cancer-a systematic review. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1653245"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1615\/JEnvironPatholToxicolOncol.2025054888","article-title":"Microplastics and Cancer: A Comprehensive Review of Their Impact on Tumor Progression and Mechanisms of Carcinogenesis","volume":"44","author":"Nivedita","year":"2025","journal-title":"J. Environ. Pathol. Toxicol. Oncol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12943-026-02657-y","article-title":"Emerging evidence on micro- and nanoplastics carcinogenicity: Mechanisms, models, and signaling networks","volume":"25","author":"Alaraby","year":"2026","journal-title":"Mol. Cancer"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Kurhaluk, N., Ko\u0142odziejska, R., Rymuszka, A., Bilski, R., Kaczorowska-Bilska, K., Tomin, V., Kami\u0144ski, P., and Tkaczenko, H. (2026). Microplastics as Vectors Influencing Oxidative Stress, Inflammation, and Endocrine Function During Early Development. Int. J. Mol. Sci., 27.","DOI":"10.3390\/ijms27125452"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Winiarska, E., Chaszczewska-Markowska, M., Ghete, D., Jutel, M., and Zemelka-Wiacek, M. (2024). Nanoplastics Penetrate Human Bronchial Smooth Muscle and Small Airway Epithelial Cells and Affect Mitochondrial Metabolism. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25094724"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"112041","DOI":"10.1016\/j.ecoenv.2021.112041","article-title":"Combined cytotoxicity of polystyrene nanoplastics and phthalate esters on human lung epithelial A549 cells and its mechanism","volume":"213","author":"Shi","year":"2021","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"10891","DOI":"10.1021\/acs.est.5c01628","article-title":"Long-Term Exposure to Real-Life Polyethylene Terephthalate Nanoplastics Induces Carcinogenesis In Vitro","volume":"59","author":"Egea","year":"2025","journal-title":"Environ. Sci. Technol."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Busch, M., Brouwer, H., Aalderink, G., Bredeck, G., K\u00e4mpfer, A.A.M., Schins, R.P.F., and Bouwmeester, H. (2023). Investigating nanoplastics toxicity using advanced stem cell-based intestinal and lung in vitro models. Front. Toxicol., 5.","DOI":"10.3389\/ftox.2023.1112212"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"112837","DOI":"10.1016\/j.ecoenv.2021.112837","article-title":"In vitro evaluation of nanoplastics using human lung epithelial cells, microarray analysis and co-culture model","volume":"226","author":"Yang","year":"2021","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"116580","DOI":"10.1016\/j.ecoenv.2024.116580","article-title":"Acute exposure to polystyrene nanoplastics induces unfolded protein response and global protein ubiquitination in lungs of mice","volume":"280","author":"Chen","year":"2024","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e2412286","DOI":"10.1002\/smll.202412286","article-title":"Nanoplastics Chronic Toxicity in Mice: Disturbing the Homeostasis of Tryptophan Metabolism in Gut-Lung-Microbiota Axis","volume":"21","author":"Wu","year":"2025","journal-title":"Small"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"118946","DOI":"10.1016\/j.ecoenv.2025.118946","article-title":"Dysregulation of SUSD2-CLDN18.2-mediated cell adhesion contributes to lung adenocarcinoma progression associated with chronic low-dose nanoplastics exposure","volume":"303","author":"Wang","year":"2025","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"126124","DOI":"10.1016\/j.jhazmat.2021.126124","article-title":"Presence of airborne microplastics in human lung tissue","volume":"416","author":"Ando","year":"2021","journal-title":"J. Hazard. Mater."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"4051","DOI":"10.1007\/s00204-025-04092-2","article-title":"Post-mortem evidence of microplastic bioaccumulation in human organs: Insights from advanced imaging and spectroscopic analysis","volume":"99","author":"Komaniecka","year":"2025","journal-title":"Arch. Toxicol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"119498","DOI":"10.1016\/j.envres.2024.119498","article-title":"Detection and analysis of microplastics in tissues and blood of human cervical cancer patients","volume":"259","author":"Xu","year":"2024","journal-title":"Environ. Res."},{"key":"ref_89","unstructured":"(2012). IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Arsenic, metals, fibres, and dusts. IARC Monogr. Eval. Carcinog. Risks Hum., 100, 11\u2013465."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1164\/ajrccm.157.5.9707141","article-title":"Mechanisms in the pathogenesis of asbestosis and silicosis","volume":"157","author":"Mossman","year":"1998","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/S1470-2045(12)70280-2","article-title":"Carcinogenicity of diesel-engine and gasoline-engine exhausts and some nitroarenes","volume":"13","author":"Baan","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1289\/ehp\/1408092","article-title":"Outdoor particulate matter exposure and lung cancer: A systematic review and meta-analysis","volume":"122","author":"Hamra","year":"2014","journal-title":"Environ. Health Perspect."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1289\/ehp.7339","article-title":"Nanotoxicology: An emerging discipline evolving from studies of ultrafine particles","volume":"113","year":"2005","journal-title":"Environ. Health Perspect."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Casella, C., Cornelli, U., Ballaz, S., Zanoni, G., Merlo, G., and Ramos-Guerrero, L. (2025). Plastic Smell: A Review of the Hidden Threat of Airborne Micro and Nanoplastics to Human Health and the Environment. Toxics, 13.","DOI":"10.3390\/toxics13050387"},{"key":"ref_95","first-page":"1","article-title":"Could e-cigarette devices generate inhalable micro- and nanoplastics? Exposure plausibility and reproductive relevance","volume":"36","author":"Sailis","year":"2026","journal-title":"Toxicol. Mech. Methods"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Du, Z., Yu, X., Li, X., Zhang, L., Lin, Y., He, Y., and Wu, Y. (2025). Mechanism of microplastics in respiratory disease from 2020 to 2024: Visualization and bibliometric analysis. Front. Med., 12.","DOI":"10.3389\/fmed.2025.1586772"},{"key":"ref_97","first-page":"31","article-title":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States","volume":"68","author":"Islami","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1158\/1055-9965.EPI-05-0456","article-title":"Complementing the genome with an \u201cexposome\u201d: The outstanding challenge of environmental exposure measurement in molecular epidemiology","volume":"14","author":"Wild","year":"2005","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1183\/09031936.00184308","article-title":"European Respiratory Society and European Society of Thoracic Surgeons joint task force on fitness for radical therapy. ERS\/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)","volume":"34","author":"Brunelli","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1067\/mtc.2002.120350","article-title":"Preoperative prediction of the risk of pulmonary complications after esophagectomy for cancer","volume":"123","author":"Ferguson","year":"2002","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1038\/nm.3394","article-title":"Microenvironmental regulation of tumor progression and metastasis","volume":"19","author":"Quail","year":"2013","journal-title":"Nat. Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1038\/s41591-018-0014-x","article-title":"Understanding the tumor immune microenvironment (TIME) for effective therapy","volume":"24","author":"Binnewies","year":"2018","journal-title":"Nat. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/S0140-6736(16)30958-8","article-title":"Lung cancer: Current therapies and new targeted treatments","volume":"389","author":"Hirsch","year":"2017","journal-title":"Lancet"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1038\/nature01322","article-title":"Inflammation and cancer","volume":"420","author":"Coussens","year":"2002","journal-title":"Nature"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.canlet.2019.12.027","article-title":"Proprotein convertases: Key players in inflammation-related malignancies and metastasis","volume":"473","author":"Siegfried","year":"2020","journal-title":"Cancer Lett."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"3217","DOI":"10.1038\/onc.2013.272","article-title":"Inflammatory chemokines and metastasis\u2014Tracing the accessory","volume":"33","author":"Borsig","year":"2014","journal-title":"Oncogene"}],"container-title":["Journal of Xenobiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4713\/16\/4\/136\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:51:19Z","timestamp":1785117079000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4713\/16\/4\/136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":106,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jox16040136"],"URL":"https:\/\/doi.org\/10.3390\/jox16040136","relation":{},"ISSN":["2039-4713"],"issn-type":[{"value":"2039-4713","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]}}}