Ciprofloxacin enhances the stimulation of matrix metalloproteinase 3 expression by interleukin‐1β in human tendon‐derived cells

Objective To determine whether the fluoroquinolone antibiotic ciprofloxacin, which can cause tendon pain and rupture in a proportion of treated patients, affects the expression of matrix metalloproteinases (MMPs) in human tendon‐derived cells in culture. Methods Cell cultures were derived from 6 separate tendon explants, and were incubated in 6‐well culture plates for 2 periods of 48 hours each, with ciprofloxacin (or DMSO in controls) and interleukin‐1β (IL‐1β), alone and in combination. Samples of supernatant medium from the second 48‐hour incubation were assayed for MMPs 1, 2, and 3 by Western blotting. RNA was extracted from the cells and assayed for MMP messenger RNA (mRNA) by semiquantitative reverse transcription–polymerase chain reaction, with normalization for GAPDH mRNA. Results Unstimulated tendon cells expressed low or undetectable levels of MMP‐1 and MMP‐3, and substantial levels of MMP‐2. IL‐1β induced a substantial output of both MMP‐1 and MMP‐3 into cell supernatants, reflecting increases (typically 100‐fold) in MMP mRNA, but had only minor effects on MMP‐2 expression. Ciprofloxacin had no detectable effect on MMP output in unstimulated cells. Preincubation with ciprofloxacin potentiated IL‐1β–stimulated MMP‐3 output, reflecting a similar effect on MMP‐3 mRNA expression. Ciprofloxacin also potentiated IL‐1β–stimulated MMP‐1 mRNA expression, but did not potentiate the output of MMP‐1, and had no significant effects on MMP‐2 mRNA expression or output. Conclusion Ciprofloxacin can selectively enhance MMP expression in tendon‐derived cells. Such effects might compromise tendon microstructure and integrity.