Apheresis, a blood-cleansing treatment developed primarily for patients with severe, treatment-resistant cholesterol disorders, may also remove certain persistent environmental pollutants, according to a small exploratory study from Technische Universität Dresden. The research, published on 4 August 2026 in the peer-reviewed journal Brain Health, reports that therapeutic apheresis reduced circulating concentrations of several per- and polyfluoroalkyl substances, or PFAS, and produced preliminary evidence of changes in measurable plastic particles in blood. The findings suggest that lipoprotein-removal systems could be affecting more than cholesterol, but the researchers emphasize that the work does not yet demonstrate a reduction in total body pollution or any health benefit.
Apheresis draws blood from a patient, separates plasma from blood cells, and passes the plasma through a filtration membrane or an adsorption column before returning it to the circulation. In double filtration plasmapheresis, progressively finer filters remove selected plasma components according to their size, while adsorption systems use specialized materials that bind particular molecules or particles. The Dresden center performs as many as 10,000 treatments annually, making it one of the largest apheresis programs worldwide. Because many environmental chemicals associate with lipids or proteins, the researchers asked whether some might be removed incidentally during procedures designed to lower lipoproteins.
The study focused partly on PFAS, a large family of synthetic chemicals used in products such as water-resistant textiles, nonstick materials, industrial coatings, and some food-contact applications. More than 4,700 PFAS have been identified in commercial use or environmental circulation. Many are highly persistent, and several have biological half-lives measured in years. Biomonitoring studies have detected PFAS in more than 99 percent of people tested in the United States. Research has also linked higher income with higher serum concentrations of some PFAS, possibly because of dietary patterns, including fish and seafood consumption, and exposure to treated consumer products.
The researchers analyzed blood collected immediately before and after apheresis sessions. In 34 patients undergoing two double filtration plasmapheresis treatments, established markers of inflammation and coagulation changed substantially: C-reactive protein and fibrinogen both declined with very high statistical significance. LDL cholesterol and lipoprotein(a), the principal targets of the treatment, also decreased. These findings confirmed that the procedures were producing their expected physiological effects and provided a context for examining less familiar compounds in the same plasma samples.
PFAS measurements from 14 patients analyzed at Medizinisches Labor Bremen showed reductions of up to 25 percent in perfluorooctanoic acid, perfluorooctane sulfonic acid, perfluorononanoic acid, and perfluorohexane sulfonic acid. The reported statistical significance ranged from P≤0.05 to P≤0.001. A separate analysis by Creative Biostructure examined four patients after a single session and found average decreases of 48.9 percent for perfluorooctane sulfonic acid, 43.5 percent for perfluorooctanoic acid, 55.0 percent for perfluorononanoic acid, 75.8 percent for perfluorododecanoic acid, and 47.1 percent for perfluorodecanoic acid. The same compounds were detected in the eluate, the discarded material leaving the treatment system.
The findings are consistent with a proposed “passenger” mechanism, although they do not prove it. PFAS can associate with proteins and lipids, and laboratory studies indicate that some PFAS may partition onto low-density and very-low-density lipoproteins. Microplastics can also acquire a biological coating, known as a corona, made from plasma proteins and lipids. Such a coating may alter a particle’s size, stability, and interactions with cells. If pollutants circulate in these lipid-rich or protein-rich complexes, removing lipoproteins or other plasma components could carry some of the contaminants out of the bloodstream.
The evidence concerning plastics was considerably less consistent. Pyrolysis gas chromatography-mass spectrometry, a technique that heats material and identifies the resulting chemical fragments, found that polyethylene declined in all four patients tested and polyvinyl chloride declined in three. Polypropylene decreased in one patient, increased in two, and was undetectable in another. Polystyrene rose in one patient while polyamide 66 fell. In two patients treated with double filtration plasmapheresis combined with a selective nucleic acid adsorption device, several detectable plastic species disappeared from the samples after treatment. With only two patients, however, the result remains suggestive rather than conclusive.
A third analysis used Nile Red staining and flow cytometry to estimate hydrophobic nanoparticles in blood. The researchers observed an average reduction of about 70 percent in particle counts across four patients, but the change did not reach statistical significance. Nile Red binds hydrophobic substances broadly and cannot establish that every stained particle is plastic. Raman spectroscopy nevertheless detected and mapped polystyrene particles in human eyelid skin, demonstrating that plastic particles can be identified within ordinary human tissue rather than only in the bloodstream. In a separate cell experiment, 30-nanometer polystyrene beads produced a trend toward increased cell death in NCI-H295R human adrenal cells, while serum collected after apheresis showed a trend toward a weaker signal. The experiment included only three replicates.
The authors caution that the measurements represent short-term changes in circulating material, not proof of reduced total body burden. The study involved small and heterogeneous groups, used exploratory plastic assays, and faced the possibility of contamination during sampling. Patients were not consistently paired across all analyses, so a common clearance mechanism cannot be claimed. Pollutants may also be mobilized from tissues after treatment, potentially offsetting an initial decline in blood. Apheresis is generally considered safe in experienced centers, although temporary hypotension, dizziness, fatigue, nausea, and citrate-related symptoms can occur. The Dresden team plans animal studies using radiolabeled or iron-labeled micro- and nanoplastics, followed by PET and MRI imaging, to determine whether apheresis can influence tissue-associated deposits. For now, the researchers describe the treatment as a possible investigative tool—not an established detoxification therapy—and continue to identify exposure prevention as the most effective way to limit environmental pollutants.
Subject of Research: People
Article Title: Therapeutic apheresis: A possible effective strategy for a combined targeting of circulating lipids, inflammatory markers, PFAS, and microplastics in cardiometabolic and neurodegenerative disease?
News Publication Date: 4 August 2026
Web References: https://doi.org/10.61373/bh026a.0024
References: Bornstein SR, Kanczkowski W, Walther R, Kronstein-Wiedemann R, Fischer D, Oikonomakos I et al. “Therapeutic apheresis: A possible effective strategy for a combined targeting of circulating lipids, inflammatory markers, PFAS, and microplastics in cardiometabolic and neurodegenerative disease?” Brain Health. 2026. DOI: 10.61373/bh026a.0024. Buekers J, Colles A, Cornelis C, Morrens B, Govarts E, Schoeters G. “Socio-Economic Status and Health: Evaluation of Human Biomonitored Chemical Exposure to Per- and Polyfluorinated Substances across Status.” International Journal of Environmental Research and Public Health. 2018;15(12):2818. DOI: 10.3390/ijerph15122818.
Image Credits: Stefan Bornstein
Keywords
Apheresis, PFAS, microplastics, nanoplastics, lipoproteins, environmental pollutants, plasma filtration, adsorption, Raman spectroscopy, blood biomarkers, therapeutic apheresis, human health
