Toxins

The introduction of botulinum neurotoxin (BoNT) to our therapeutic strategies has been an incredible success story [...]

Microplastics (MPs) and microcystins (MCs) frequently occur together in eutrophic environments. However, their interaction in aquatic systems is poorly understood. This study aimed to examine how MP particle size and salinity influence the adsorption behaviour of the cyanotoxin MC-LR onto polystyrene MPs (PS-MPs). Two particle size groups (180–500 µm and 700–1000 µm diameter) were mixed with a microcystin-LR (MC-LR) producing Microcystis aeruginosa lysate in either freshwater (salinity ≤ 0.05 g L⁻¹) or brackish water (salinity 16.00 g L⁻¹) and incubated at 25 °C in an orbital shaker for 48 h. MC-LR bound to PS-MPs was extracted and measured using triple quadrupole LC-MS/MS. The MC-LR adsorption rate exhibited a degree of oscillation throughout time, with peak adsorption observed for the smaller-sized PS-MPs at 1.60% in freshwater after 4 h and 4.60% in brackish water after 6 h. For the larger particle size of PS-MPs, peak adsorption occurred after 4 h, reaching 0.1% in freshwater and 1.3% in brackish water. This study provides evidence that PS-MPs have limited potential as vectors of MC-LR in eutrophic freshwater and brackish environments.

Hemodiafiltration (HDF) is increasingly used because of its enhanced theoretical clearance of diverse uremic toxins, particularly middle molecules and inflammatory cytokines, relative to conventional hemodialysis (HD), yet evidence on its biochemical benefits remains conflicting. Therefore, this meta-analysis was performed to evaluate the effects of HDF versus HD on uremic toxins, inflammation, anemia, and nutritional parameters. A systematic literature search was conducted using PubMed, Scopus, and the Cochrane Central Register of Controlled Trials to identify relevant studies. Only randomized controlled trials (RCTs) were included. Random-effects meta-analyses were performed to evaluate changes in the prespecified outcomes. Twenty-four RCTs involving 6072 dialysis patients were included. Compared with conventional HD, HDF was associated with significant reductions in serum phosphorus (weighted mean difference [WMD] −0.28 mg/dL; 95% CI −0.44 to −0.12) and β2-microglobulin (WMD −4.84 mg/dL; 95% CI −6.13 to −3.54). HDF also significantly reduced serum urea and C-reactive protein (CRP) levels, along with weekly erythropoietin requirements. Serum albumin levels were slightly but significantly lower in the HDF group than in the conventional HD group (WMD –0.06 g/dL; 95% CI −0.10 to −0.01); however, the clinical significance of such a difference remains uncertain. Higher convective volumes were identified as a key determinant of greater reductions in β2-microglobulin and CRP. Compared with conventional HD, HDF demonstrated superior reductions in several surrogate endpoints, including serum phosphorus, urea, β2-microglobulin, CRP, and weekly erythropoietin requirements. Reduced need for phosphate binders and anemia management may lower treatment-related costs.