Fluoroquinolone-Induced Aortic Injury

According to clinical studies, the use of uoroquinolone antibacterial agents is associated with such rare, but serious adverse reactions as aortic injuries. The aim of the study was to analyse scientic literature data on the risk of aortic injury during uoroquinolone treatment. The analytical review showed that the risk factors for uoroquinolone-induced aortic injury are male gender, age over 45 years, underlying aortic disease, as well as smoking and associated atherosclerosis. Clinical and morphological forms of uoroquinolone-associated aortic injuries include dilatation (aneurysm development), dissection, and rupture. The analysis of data on the association between aortic injuries and the use of most common uoroquinolones (ciprooxacin, levooxacin, and moxioxacin) showed that development of aneurysm and dissection was most often observed for levooxacin, and least often for ciprooxacin. The mechanism of aortic injury is due to uoroquinolone-mediated activation of matrix metalloproteinases which damage elastic components of vascular walls, as well as reduction in lysyl oxidase expression and collagen synthesis. The ability of uoroquinolones to form complexes with magnesium ions reduces the availability of magnesium to the cell enzyme systems, which delays synthesis of extracellular matrix structural proteins, leads to metalloproteinase activation and calcication of the vascular walls. Prevention, early detection, and timely management of the above-mentioned issues depend on the awareness of dierent medical specialists about the risks of aortic injury associated with the use of uoroquinolone antibiotics.