A critical review on the bioaccumulation, transportation, and elimination of per- and polyfluoroalkyl substances in human beings

Per- and polyfluoroalkyl substances (PFAS) have been manufactured for over seven decades. Owing to the unique characteristics of C-F bond, it has been widely used in the industrial and commercial products, which leading to its wide presence in the environmental and biological matrix. In this critical review, we systematically summarized the existing literature on the behaviors and mechanisms of bioaccumulation, transportation, and elimination of PFAS in humans and pointed out the deficiencies and gaps of the existing research. Additionally, we calculated the binding affinities between a total of 56 PFAS and four important renal PFAS transporters (organic anion transporter 1, 3, and 4, together with urate transporter 4) to elucidate the renal elimination behaviors of PFAS in human body by molecular docking method for the first time. Furthermore, we put forwarded perspectives for future research to call on researchers to fill in the gaps of the existing studies and increase the investigations on the research topic. The understanding of the behaviors and mechanisms of PFAS in human beings are significant for the health risks assessment of human exposed to PFAS. Nevertheless, the research on the topic is still very limited. This review provides a comprehensive view of PFAS in human body, explores the potential human renal elimination mechanisms of PFAS, and presents insightful perspectives for further research on the relationship between PFAS exposure and its potential health effects on human beings.