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Journal Article
Systematic Review
Biological and chemical changes in fluoroquinolone-associated tendinopathies: a systematic review.
British Medical Bulletin 2019 June 20
INTRODUCTION: The present systematic review investigates the biological and chemical mechanisms that affect the health and structure of tendons following the use of fluoroquinolones (FQs).
SOURCES OF DATA: A total of 12 articles were included, organized, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
AREAS OF AGREEMENT: 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.
AREAS OF CONTROVERSY: There is no definite structure-damage relationship. The dose-effect relationship is unclear.
GROWING POINTS: 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.
AREAS TIMELY FOR DEVELOPING RESEARCH: Clinical and basic sciences studies for each FQs are necessary.
SOURCES OF DATA: A total of 12 articles were included, organized, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
AREAS OF AGREEMENT: 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.
AREAS OF CONTROVERSY: There is no definite structure-damage relationship. The dose-effect relationship is unclear.
GROWING POINTS: 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.
AREAS TIMELY FOR DEVELOPING RESEARCH: Clinical and basic sciences studies for each FQs are necessary.
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