The gastrointestinal tract is a complex barrier/exchange system, and is the most important route by which macromolecules can enter the body. The main absorption takes place through villi and microvilli of the epithelium of the small and large intestines, which have an overall surface of about 200 m2. Already in 1922, it was recognized by Kumagai, that particles can translocate from the lumen of the intestinal tract via aggregation of intestinal lymphatic tissue (Peyer’s patch, containing M-cells (phagocytic enterocytes)). Uptake can also occur via the normal intestinal enterocytes. Solid particles, once in the sub-mucosal tissue, are able to enter both the lymphatic and blood circulation.
CSPI says it might reconsider its rating if specifications for food-grade titanium dioxide in the U.S. are updated to ensure nanoparticles are minimized, and new studies are conducted to assess its capacity to cause cancer or other health problems.
The European Commission banned titanium dioxide as a food additive in the EU in 2022 after the European Food Safety Authority (EFSA) conducted an updated safety assessment of E171 and concluded the panel could not eliminate concerns about its genotoxicity.