Micro-Nanoplastic Exposure and Lung Cancer Biomarkers: The Role of Extracellular Vesicle-Mediated Intercellular Communication.

Micro- and nanoplastics (MNPs) are widespread environmental pollutants, with increasing evidence of human exposure through multiple routes. Their detection in human tissues, including the lungs, raises concerns about their potential impact on respiratory health, including lung cancer (LC). This review synthesizes current evidence on the biological effects of MNP exposure, with a focus on mechanisms potentially relevant to LC. In particular, extracellular vesicles (EVs) are discussed as mediators potentially linking environmental exposure to cellular responses. Experimental studies suggest that MNPs may induce oxidative stress, inflammation, and genotoxicity, and may alter EV biogenesis and cargo, thereby influencing pathways involved in epithelial-mesenchymal transition, angiogenesis, and immune modulation. We also explore the potential contribution of the gut-lung axis, where MNP-induced dysbiosis and intestinal barrier disruption may promote systemic inflammatory responses, with bacterial EVs acting as additional mediators. However, evidence directly linking MNP exposure, EV-mediated signaling, and LC is limited and largely derived from experimental models. Key challenges include the lack of standardized detection methods, insufficient dose-response data, and scarce epidemiological evidence. Integrating exposomic and multi-omic approaches, including EV-omics, lipidomics, and metabolomics, is needed to clarify the relevance of these mechanisms and support the identification of potential biomarkers in human disease.