Trojan horse in the intestine: A review on the biotoxicity of microplastics combined environmental contaminants.

With the reported ability of microplastics (MPs) to act as "Trojan horses" carrying other environmental contaminants, the focus of researches has shifted from their ubiquitous occurrence to interactive toxicity. In this review, we provided the latest knowledge on the processes and mechanisms of interaction between MPs and co-contaminants (heavy metals, persistent organic pollutants, pathogens, nanomaterials and other contaminants) and discussed the influencing factors (environmental conditions and characteristics of polymer and contaminants) that affect the adsorption/desorption process. In addition, the bio-toxicological outcomes of mixtures are elaborated based on the damaging effects on the intestinal barrier. Our review showed that the interaction processes and toxicological outcomes of mixture are complex and variable, and the intestinal barrier should receive more attention as the first line of defensing against MPs and environmental contaminants invasion. Moreover, we pointed out several knowledge gaps in this new research area and suggested directions for future studies in order to understand the multiple factors involved, such as epidemiological assessment, nanoplastics, mechanisms for toxic alteration and the fate of mixtures after desorption.