The results of this study showed that mean liver enzyme SGOT was significantly greater in groups that received 10 ppm and 300 ppm TiO2 than the control group two days after the intervention. Seven and 14 days after the injection, the liver damage returned in both groups. Maybe, the other liver enzyme (such as metalothioneine) activated and neutralized the effects of TiO2 after 7 days. In addition, mean SGPT, two days after the intervention, in the group that received 300 ppm TiO2 was significantly greater than the groups that received 100 ppm TiO2 and 10 ppm TiO2. Higher concentrations of titanium dioxide (300 ppm TiO2) had a higher toxicity on hepatic enzymes than other concentrations. No difference was observed between the experimental and control groups in terms of mean SGPT. Furthermore, the histological results of liver in group 1 showed hepatocyte vasculature, hypertrophy approximate, in group 2: decreased effect of hepatocyte acidophilic, elimination of hepatic lobules, in group 3: significant shrinkage of central veins, immediate hyperemia showed and histological results in lung: destruction of alveolus and their overlapping (group 1) and vasculature hyperemia in all groups showed. The results indicated intense histopathological changes in lung and liver tissues by 10 - 15 nanometer spherical-shaped TiO2 nanoparticles in all three experimental groups.
Special features of nanoparticles, such as their small size, shape, high surface area, and their specific construction, are the reasons for the biomedical and industrial applications of these particles [
14,
15]. However, in recent years, evidence of the adverse impact of nanoparticles has been reported, such as increased mortality, cardio-respiratory diseases, and malignant asthma [
16].
Researchers showed that TiO
2 nanoparticles can damage DNA and cause cell death by induced oxidative stress. In addition, these nanoparticles can produce reactive oxygen species (ROS) and reduce cell antioxidants such as glutathione and vitamin E [
17]. ROS is the physiological products generated during aerobic metabolism in mammalian mitochondria. The intracellular ROS level is balanced through balancing the metabolism (by antioxidant enzymes and scavengers). A number of possible signaling pathways can describe the ROS association with apoptosis including death pathways involving cell-surface receptors (external) and mitochondrial pathways (internal) [
18].
Ma et al. reviewed the acute liver damage in mice caused by anatase TiO
2 nanoparticles. In this study, nano-anatase TiO
2 (5 nm) were injected into the abdominal cavity of ICR mice for 14 days and the inflammatory responses in the mice’s liver was examined. Results of this study demonstrated the concentration of titanium observable in the liver DNA, histopathological changes, apoptosis in liver hepatocytes, and liver dysfunction with higher doses of nano-anatase TiO
2 [
19].
Afaq et al. investigated the titanium dioxide nanoparticle toxicity in rats induced by intratracheal instillation. The peroxidation of lipid and hydrogen peroxide radicals did not change with an increase in the activity of glutathione peroxidase, glutathione reductase, 6-phosphate dehydrogenase, and glutathione S-transferase. This indicates the induction of antioxidant enzymes in animals by nano-TiO
2 (30 nm) [
20].
Ma et al. showed that high doses of nano-anatase TiO
2 (5 nm) can cause liver dysfunction, and induced invasion and oxidative stress in rat’s liver [
21].
Although it is clear that TiO
2 nanoparticles or other nanoparticles can induce serious toxicity in the liver, the molecular mechanisms and pathogenesis have not been identified yet. When TiO
2 nanoparticles stimulate hepatocyte, they are able to induce inhibitory proteins such as phosphorylated I
kBs (nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor) and analyze it, and then inhibit NF-kb (nuclear factor kappa-light-chain-enhancer of activated B cells) activity that ultimately leads to the transcription of proinflammatory and inflammatory cytokine genes in rat’s liver [
22].
Liu et al. investigated the biochemical toxicity of nano-anatase TiO
2 in mice. In order to evaluate the toxicity of these nanoparticles, they were injected into the abdominal cavity of ICR (imprinting control region) mice for 14 days and the coefficient of the organs and serum biochemical parameters were examined. The results showed that increased dose of these nanoparticles gradually increased the coefficients of liver, kidney, and spleen. Moreover, it gradually decreased the lung and brain coefficients, and the change in brain coefficients was not significant. The order of titanium concentration in organs included: heart < brain < lung < spleen < kidney. Reviewing serum biochemical parameters with a low dose of titanium dioxide nanoparticles, showed a small difference with the control group. However, a high dose of such nanoparticles significantly increased indicators of liver function, including alkaline phosphatase, alanine, leucine acid peptide, pseudocholinesterase, and total protein and albumin. Renal function indicators, including blood urea nitrogen and uric acid decreased. Indicators of heart function such as activity of aspartate aminotransferase, creatine kinase, dehydrogenase lactate, and alpha-hydroxy butyrate dehydrogenase increased [
23].
Olmedo et al. reported that six months after intraperitoneal injection of TiO
2 nanoparticles, the deposition of the nanoparticles in organs such as liver, spleen, and lungs was observed [
24]. Results of the study by Huggins and Froehlich showed that after the intravenous injection of 250 mg/kg TiO2 (size 0.2 - 0.4 nm) in rats, almost 69% of the injected nanoparticles of titanium dioxide at 5 minutes and 80% of injected TiO
2 nanoparticles at 15 minutes were accumulate in the liver. The results indicated that liver deposition was the highest amount among the other tissues [
25].
Wang et al. fed TiO
2 nanoparticles to mature rats and evaluated them after two weeks. They observed that 25 and 80 nm nanoparticles in 5 g/kg dose had caused a toxic effect on them and influence biochemical parameters such as ALT, AST, ALP, and Liver pathology. They also did this through intravenous and intraperitoneal injection. Due to the agglomeration of the nanoparticles in liver and kidney cells, liver damage, renal pathological changes and renal inflammation were observed as glomeruli and nephron-like toxic damage to the liver hepatocytes around the central vein lobules. Accumulation of these substances caused abnormal pathological changes in the tissues of the heart, lung, testis, ovary, and spleen [
26].
Alkaline phosphatase exists (is distributed) in the liver, bone, bile duct, and ALT and AST in the liver, heart, and other organs. When organs are damaged, the activity of ALP, ALT, and AST increases. It has been indicated that LDH is an important isozyme in glycolysis and glycogen which are present in many tissues and the heart and liver. When tissues are damaged, LDH is released into the blood serum from the organs or cells, leading to an increase in LDH activity and isozymes in similar organs. Pseudocholinesterase (PChE, acylcholine acyl hydrolase), which is found in many animal tissues, acts with low-density in the metabolism of lipids and lipoprotein. When the liver is damaged, PChE activity is dramatically increased which causes impaired lipid metabolism and low-density lipoprotein [
27].
In order to find out that apoptotic hepatocyte is induced through the use of intragastric TiO
2 NPs (nanoparticles) for 60 consecutive days, apoptosis of hepatocytes, oxidative stress parameters, and the amount of expression of genes associated with stress in the liver of mice were examined by Cui et al. Results showed that hepatocyte apoptosis, oxidative stress, and altered expression of genes are associated with regulated metabolism/detoxification of titanium dioxide nanoparticles and radical scavenging activities [
27].
In this study, the toxic effect of spherical-shaped TiO2 nanoparticles with a diameter of 10 - 15 nm was evaluated on the function of liver and lung and SGPT and SGOT liver enzymes levels. We faced with increased concentration of such enzymes in high doses of nanoparticles. Due to damaged liver cells, such enzymes (which are inside the hepatocyte cell) are released into the blood. Therefore, a high amount of such enzymes indicates destruction of liver cells.
Various reports indicated that significant amounts of nanoparticles injected to the body are absorbed by the liver. The reticuloendothelial system in liver can gradually remove the accumulated nanoparticles from the body [
28].
Understanding the specific mechanisms of nanoparticles and their reaction requires very extensive research in this area. When nanoparticles are accumulated in a tissue, they may either be absorbed into the cell or no absorption may occur. If these nanoparticles are absorbed, the final cellular replacement in the lysosomal and cytoplasm of the cell will depend on the characteristics of the nanoparticle. If nanoparticles are located in the cytoplasm, some large size material can cause direct damage or cell death by such interactions [
29].
It seems that the main mechanism of toxicity is through oxidative stress causes damage to the lipids, carbohydrates, protein, and DNA. Probably the pathological changes in liver tissue are caused by accumulation and deposition of nanoparticles in this tissue [
30].
On the other hand, the entry of TiO
2 nanoparticles in this study shows their passing through blood and air barrier and damaging the lung tissue. Among the applications of nanoparticles that help in biological and medical fields is the influence and accumulation of effective nanoparticles in cells and various body organs after its injection [
31]. Given the current findings, it can be concluded that application of 10 - 15 nanometer spherical-shaped TiO
2 nanoparticles in vivo, even in small amounts for medical purposes, causes cell toxicity. Further researches are needed to study its effects on organs and blood factors.