MXenes are a family of two-dimensional (2D) composite materials based on transition metal carbides, nitrides and carbonitrides that have been attracting attention since 2011. Combination of electrical and mechanical properties with hydrophilicity makes them promising materials for biomedical applications. This review briefly discusses methods for the synthesis of MXenes, their potential applications in medicine, ranging from sensors and antibacterial agents to targeted drug delivery, cancer photo/chemotherapy, tissue engineering, bioimaging, and environmental applications such as sensors and adsorbents. We focus on in vitro and in vivo toxicity and possible mechanisms. We discuss the toxicity analogies of MXenes and other 2D materials such as graphene, mentioning the greater biocompatibility of MXenes. We identify existing barriers that hinder the formation of objective knowledge about the toxicity of MXenes. The most important of these barriers are the differences in the methods of synthesis of MXenes, their composition and structure, including the level of oxidation, the number of layers and flake size; functionalization, test concentrations, duration of exposure, and individual characteristics of biological test objects Finally, we discuss key areas for further research that need to involve new methods of nanotoxicology, including predictive computational methods. Such studies will bring closer the prospect of widespread industrial production and safe use of MXene-based products.
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