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In a 2017 study published in Scientific Reports, researchers exposed rats to human-relevant levels of E171 to examine the effects of intestinal inflammation and carcinogenesis. They saw that “a 100-day E171 treatment promoted colon microinflammation and initiated preneoplastic lesions while also fostering the growth of aberrant crypt foci in a chemically induced carcinogenesis model.” They continued: “Stimulation of immune cells isolated from Peyer’s Patches [which are clusters of lymphoid follicles found in the intestine] showed a decrease in Thelper (Th)-1 IFN-γ secretion, while splenic Th1/Th17 inflammatory responses sharply increased,” researchers wrote. “A 100-day titanium dioxide treatment promoted colon microinflammation and initiated preneoplastic lesions.” The scientists concluded: “These data should be considered for risk assessments of the susceptibility to Th17-driven autoimmune diseases and to colorectal cancer in humans exposed to TiO2 from dietary sources.”

Recently, Yanagisawa et al. reported that the transdermal exposure (mimicking skin-barrier dysfunction or defect) of NC/Nga mice to TiO₂ NPs (15, 50, or 100 nm), in combination with allergen, aggravated atopic dermatitis-like lesions through a T-helper type 2 (Th2) dominant immune response. The study also indicated that TiO₂ NPs can play a role in the initiation and/or progression of skin diseases, since histamine was released, even in the absence of allergen.

When manufacturers add titanium dioxide to foods and other ingestible products, it’s typically referred to as E171, which relates to food-grade purity.