Biological and chemical changes in fluoroquinolone-associated tendinopathies: a systematic review

British Medical Bulletin
Domenico Rocco BisacciaNicola Maffulli

Abstract

The present systematic review investigates the biological and chemical mechanisms that affect the health and structure of tendons following the use of fluoroquinolones (FQs). A total of 12 articles were included, organized, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five mechanisms were identified: arrest of proliferation through a decreased activity of cyclin B, CDK-1, CHK-1, and increased PK-1; decrease tenocytes migration through decreased phosphorylation of FAK; decrease type I collagen metabolism through increased MMP-2; chelate effect on ions that influence epigenetics and several enzymes; fluoroquinolones-induced ROS (radical oxygen species) production in mitochondria. There is no definite structure-damage relationship. The dose-effect relationship is unclear. Knowing and defining the damage exerted by FQs plays a role in clinical practice, replacing FQs with other antibacterial drugs or using antioxidants to attenuate their pathological effects. Clinical and basic sciences studies for each FQs are necessary.

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Citations

Jun 9, 2020·Expert Opinion on Pharmacotherapy·Rocco AicaleNicola Maffulli
Oct 1, 2020·Journal of Foot and Ankle Research·Rocco AicaleNicola Maffulli
Jun 18, 2020·International Journal of Molecular Sciences·Erman PopowskiGundula Schulze-Tanzil
Aug 29, 2020·Polymers·Daniel-Cristian IoanMihaela Violeta Ghica
Jan 21, 2021·Journal of Functional Morphology and Kinesiology·Domiziano TarantinoBruno Corrado
May 29, 2021·Internal Medicine Journal·Chih Ying KoTara Mackenzie

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