Micro- and nanoplastics-mediated immunometabolic reprogramming: a systemic nexus for chronic inflammation and multi-organ disease risk.

Micro- and nanoplastics (MNP) are ubiquitous environmental stressors increasingly detected in human tissues and directly linked to clinical cardiovascular events. This review proposes immunometabolic reprogramming as the central nexus through which MNP drive systemic immune dysregulation and chronic inflammation. Upon entering via multiple routes, MNP selectively sequester in immune organs, disrupting mitochondrial quality control via Drp1-mediated fission and activating the cGAS-STING pathway. Furthermore, MNP induce a pseudohypoxic state that stabilizes HIF-1a, driving a glycolytic "Warburg-like" shift that promotes pro-inflammatory macrophage polarization. These intracellular perturbations are further amplified by "lipid corona" formation and gut microbiota dysbiosis, which depletes anti-inflammatory short-chain fatty acids. Collectively, this systemic immunometabolic remodeling provides a mechanistic framework for understanding MNP-related risks for cardiovascular, metabolic, and neurodegenerative disorders.  This review emphasizes the necessity of integrating immunometabolic parameters into future environmental health risk assessment frameworks.