Clinical liver assessment of risk, injury and toxicity from micro- and nanoplastics (CLARITY)

How plastics affect liver disease in patients

Clinical liver assessment of risk, injury and toxicity from micro- and nanoplastics (CLARITY)

How plastics affect liver disease in patients

Title: Clinical Liver Assessment of Risk, Injury and ToxicitY from Micro- and Nanoplastics (CLARITY)

Funded by: NIHR Integrated Academic Training scheme, University of Plymouth; British Association of the Study of the Liver (BASL) Neil Blenkinsop pump priming grant

Funding amount: 100% Academic Clinical Fellow salary for 3 years (NIHR); £3,000 (BASL)

Dates: October 2025–2028

University of Plymouth Co-Is: Professor Ashwin Dhanda , Professor Shilpa Chokshi

University of Plymouth staff: Professor Matthew Cramp , Dr Kieran Smith , Dr Dhanushan Gnanendran

Objectives

To determine how exposure to micro- and nanoplastics contributes to liver disease progression, treatment response and cancer risk, and to identify modifiable pathways that reduce exposure-induced injury:

Human biomonitoring of plastics exposure
Quantify micro- and nanoplastic burden in blood, urine, stool, bile and liver tissue from patients across the spectrum of liver disease, including cirrhosis and liver cancer, and relate particle signatures to disease stage, inflammation, fibrosis and clinical outcomes.
Exposure challenge studies using real-world plastic sources
Conduct controlled exposure studies in patients with liver disease, particularly those with increased intestinal permeability or 'leaky gut' to assess whether consumption of microwavable, plastic-packaged food leads to measurable increases in circulating and excreted plastics. Serial blood and urine sampling will be used to assess absorption, clearance and temporal kinetics.
Liver cancer association studies
Profile and compare plastic burden and polymer signatures in liver cancer tissue and adjacent non-tumour tissue to determine whether plastic accumulation or transformation within the hepatic microenvironment associates with carcinogenesis or tumour biology.
Mitigation and risk modification pathways
Identify biological, dietary, microbial and pharmacological factors that influence plastic uptake, trafficking or clearance – including gut barrier integrity, bile excretion pathways and macrophage-mediated sequestration – and evaluate whether modulating these pathways reduces particle burden or plastic-associated liver injury.

This project draws together experts in translational research to use the latest technology to investigate the impact of micro- and nanoplastics on liver health.

It is a critical first step in understanding the interaction between environmental and biopsychosocial factors in human liver disease.

Professor Ashwin Dhanda
Professor of Liver Medicine

Context of the issue

This project represents the first clinical investigation linking plastic exposure with liver disease progression. It establishes the clinical foundation for plastic-induced liver injury by answering fundamental questions:

Are patients with liver disease more exposed or less able to clear plastics?
Do plastics contribute to infections, inflammation, fibrosis or organ failure?
Can lifestyle, diet or microbiome interventions mitigate these risks?

Findings will inform public health policy, clinical management, and future guidelines for environmental liver risk.

Plate scratched with a fork revealing microplastics

Centre of Environmental Hepatology

The Centre of Environmental Hepatology (CEH) brings together scientists, clinicians and environmental researchers to generate mechanistic, clinically grounded evidence that can inform prevention, improve patient outcomes, and support policies that reduce harmful exposures.

Our mission is to transform understanding of liver health in a changing world and to ensure that research translates into meaningful impact for patients, communities, and future generations.

Discover more research from the Centre of Environmental Hepatology