Combined pollutants of per- and poly-fluoroalkyl substances (PFAS) and antibiotics are commonly found in aquatic environments. This study aimed to investigate the effects of PFAS (perfluorobutyric acid (PFBA) and perfluorooctanoic acid (PFOA)) and antibiotics (tetracycline (TC) and chloramphenicol (CAP)) on Vallisneria natans (V. natans) and their epiphytic biofilms. The changes in photosynthetic pigments and oxidative damage in V. natans were altered by these pollutants. For example, the total chlorophyll was increased from 4.64 to 8.10 mg/L due to the combined pollutant of PFOA and TC. When exposed to the combined pollutant of PFBA and TC, a concentration of malondialdehyde of 28.4 nmol/g was measured, which was significantly higher than that in the control group. For combined toxicity, the PFAS and antibiotics primarily exhibited antagonistic effects within V. natans. The glycine, serine, and threonine metabolism pathways were mainly affected by the combined stress of PFBA and TC. Single pollutants of TC and CAP were found to inhibit the uptake of nutrients by V. natans, while the coexisting antibiotics enhanced the inhibitory effects of PFBA and PFOA in combined pollutant treatments. The growth of microorganisms in the epiphytic biofilms was significantly promoted by PFBA and PFOA, whereas their growth was notably inhibited by CAP. The composition of biofilms could be altered by single and combined pollutants, with antibiotics being more likely than PFAS to change the microbial communities within the biofilms. When exposed to TC and CAP, the ACE indices decreased from 1171.5 to 466.4 and 703.8, respectively.
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