Blood-Filtering Technique for Cholesterol Also Removes Forever Chemicals and Microplastics, Study Finds
核心洞察
Researchers at TU Dresden found that double-filtration plasmapheresis, long used to lower cholesterol, also removes PFAS (搜索) forever chemicals from blood by up to 75.8% in some measurements.
In 34 patients, LDL cholesterol (搜索), lipoprotein(a), and inflammatory markers fell sharply alongside reductions in four common PFAS (搜索) compounds, with the pollutants detected in discarded filter fluid.
Microplastic removal evidence was less conclusive, though flow cytometry suggested an average 70% drop in particles, and Raman spectroscopy confirmed plastic particles in human eyelid skin tissue.
A decades-old blood-filtering technique used to treat patients with inherited high cholesterol has yielded an unexpected finding: it also strips out toxic forever chemicals and, to a lesser extent, microplastics from circulating blood. The discovery, reported by researchers at the world's largest apheresis center at the Technical University of Dresden (搜索), opens a new frontier in addressing the near-universal human burden of per- and polyfluoroalkyl substances (PFAS (搜索)).
The study, published in the journal Brain Health, represents the first practical demonstration that these persistent environmental pollutants can be removed from a living person's bloodstream.
How the discovery unfolded
The Dresden program has treated patients with inherited high cholesterol for 25 years and now runs approximately 200 sessions per week. The double-filtration plasmapheresis technique draws blood from one arm, separates fat molecules from plasma, and returns the cleansed blood through the other arm—using no replacement fluid.
"We always assumed that in addition to lipids other factors may contribute to the surprising success of this treatment," said Stefan R. Bornstein of TU Dresden and University Hospital Carl Gustav Carus, the study's first author. His team began investigating after learning that PFAS (搜索) travel through the body attached to LDL and VLDL particles, the same carriers that transport cholesterol.
The established effects were confirmed: in 34 patients measured before and after two sessions, C-reactive protein, fibrinogen, LDL cholesterol (搜索), and lipoprotein(a) all fell sharply.
PFAS (搜索) reductions measured across independent laboratories
The novel finding emerged from mass spectrometry analysis. At a certified German laboratory in Bremen, plasma from 14 patients showed drops of up to 25% in four of the most common forever chemicals. A second laboratory measuring four additional patients after a single session found steeper declines: 48.9% for PFOS, 43.5% for PFOA, 55.0% for PFNA, and 75.8% for the longer-chain compound PFDoDA.
Critically, the same compounds were detected in the eluate—the fraction the machine discards—confirming that the pollutants exited the body with the filtered fluid. Bornstein characterized the findings as "a relevant and significant clearance of these toxins from human blood circulation."
Microplastic evidence remains preliminary
Data on microplastic removal was less definitive, and the authors acknowledge this candidly. Gas chromatography on blood from four patients showed polyethylene falling in all four and polyvinyl chloride in three of four. However, polypropylene fell in only one patient, rose in two, and was undetectable in the fourth.
Two patients also received a device that binds loose genetic material in blood. In one, all detectable polystyrene and polypropylene disappeared afterward; in the other, polyethylene and PET were eliminated. With a sample of two, the team describes this as suggestive only.
Flow cytometry performed at the Germans Trias i Pujol Research Institute in Spain stained particles in four patients and counted them, yielding an average drop of about 70%. The authors caution that this figure missed statistical significance at that cohort size and that the stain marks fats generally, not plastics specifically.
Tissue burden and cellular effects
Beyond circulating measurements, the team used Raman spectroscopy on human eyelid skin to locate and map polystyrene particles within tissue—a capability that may prove significant for future research by making the plastic burden in tissue identifiable and quantifiable.
In a separate experiment, human adrenal cells exposed to 30-nanometer polystyrene beads trended toward cell death. Serum drawn from patients before apheresis changed nothing, while serum drawn afterward pushed the cell-death signal downward. The experiment was run three times, and the authors describe the result as a trend rather than proof.
A shift in perspective
Charlotte Steenblock, the senior author in the same Dresden department, articulated the conceptual shift these results suggest: "For years we treated the lipoprotein as the disease. If it proves to be a vehicle as well, the question shifts from whether we can measure these pollutants in people to what happens when we take some of them out."
Safety profile and clinical context
Therapeutic apheresis carries a long safety record. Bornstein reports that 70% to 80% of patients treated at the Dresden center have had no further cardiovascular event—no stroke and no heart attack—attributing this to the deep removal of cholesterol and lipoprotein(a). He calls the therapy "far superior to all currently available medications" and notes that German insurers reimburse it as a "gold standard treatment."
Reported side effects are typically mild and brief: low blood pressure, dizziness, fatigue, nausea, and cramps from the anticoagulant. "Therapeutic apheresis is an invasive treatment but has very little side effects and in more than hundred thousand treatments in our center we have rarely ever seen a major problem," said Bornstein.
Important limitations
The authors present their limitations with unusual candor. Sample sizes are small, patient conditions and machine types varied, and plastic assays are exploratory in a field lacking validated methods. Contamination is a constant hazard when measuring plastics in a laboratory environment. No randomized controlled trial exists, and there are no long-term outcome data.
The most critical caveat concerns time: all measurements reflect acute changes in circulating levels immediately after the procedure, not reductions in total body burden. Tissue reservoirs may release stored pollutants back into circulation, partially offsetting initial drops. Several authors also declare financial ties to companies manufacturing apheresis equipment.
"We did not go looking for this," said Bornstein. "It means the machine caught them. It does not yet mean the body is rid of them."
Next steps and broader context
The Advanced Research Projects Agency for Health (ARPA-H (搜索)) has launched a $144 million program to measure and affordably remove plastic particles from the body. The Dresden group plans to expose large animals to labeled plastics and image them after treatment using PET and MRI.
"More long-term studies will have to be implemented to show if this approach will become a specific treatment for patients with progressive cardiometabolic and neurometabolic diseases," said Bornstein. He added: "None of this displaces the first priority, which remains preventing exposure. Cleaning up afterwards is the harder and more expensive way to solve the problem."
More than 4,700 PFAS (搜索) compounds are in use or loose in the environment, with biomonitoring detecting them in the blood of over 99% of Americans. Approximately 200 million Americans have been exposed through drinking water. The compounds have a half-life of 4.8 to 8.5 years in the body. Meanwhile, people swallow an estimated 39,000 to 52,000 plastic particles annually—rising to 74,000 to 121,000 when inhalation is included—and particles have been found in human blood, placenta, lung tissue, and the brain.