Figure 9.

Toxic effects induced by TiO₂ NPs in H9c2 cells. TiO₂ NPs are internalized into the cytoplasm (1), producing strong oxidative stress and changes in the cellular redox state, increasing ROS production and mitochondrial damage (2), decreasing mitochondrial membrane potential (ΔΨm) (3). High oxidative stress causes strong cell damage, associated with autophagy (4), involving the formation of autophagosomes in the endoplasmic reticulum (ER), these in turn fuse with lysosomes to produce degradation of cytoplasmic components formed during cell damage. Finally, TiO₂ NPs increase membrane permeability and induce necrosis (5).