Fluoroquinolone-Induced Achilles Tendon Damage: Structural and Biochemical Insights into Collagen Type I Alterations

Area of Science:

• Pharmacology
• Biochemistry
• Orthopedics

Background:

• Fluoroquinolones are widely used antibiotics with known serious adverse effects, including tendinopathies.
• Achilles tendon injuries, particularly involving collagen and extracellular matrix (ECM), are frequently linked to fluoroquinolone use.

Purpose of the Study:

• To review the impact of fluoroquinolones on Achilles tendon structure, focusing on collagen type I.
• To identify risk factors for fluoroquinolone-associated Achilles tendon damage.
• To explore potential preventive strategies, including antioxidant use.

Main Methods:

• Literature review summarizing existing research on fluoroquinolone mechanisms and tendon pathology.
• Analysis of biochemical pathways affected by fluoroquinolones, such as collagen and proteoglycan synthesis.
• Examination of the role of metalloproteinases in tendon regeneration and fluoroquinolone interference.

Main Results:

• Fluoroquinolones decrease collagen and proteoglycan synthesis, impairing tendon structure and healing.
• Downregulation of metalloproteinase activity by fluoroquinolones hinders essential collagen remodeling after injury.
• The electronegativity and metal-chelating properties of fluorine are proposed mechanisms for fluoroquinolone-induced tendon damage.

Conclusions:

• Fluoroquinolones adversely affect Achilles tendon integrity, primarily impacting collagen type I synthesis and repair processes.
• Understanding risk factors and exploring preventive strategies like antioxidant use are crucial for mitigating fluoroquinolone-associated tendinopathies.