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Review
. 2017:2017:8023935.
doi: 10.1155/2017/8023935. Epub 2017 Sep 25.

Treatment of the Fluoroquinolone-Associated Disability: The Pathobiochemical Implications

Krzysztof Michalak  1   2 , Aleksandra Sobolewska-Włodarczyk  3 , Marcin Włodarczyk  3 , Justyna Sobolewska  4 , Piotr Woźniak  4 , Bogusław Sobolewski  4
Affiliations
Review

Treatment of the Fluoroquinolone-Associated Disability: The Pathobiochemical Implications

Krzysztof Michalak et al. Oxid Med Cell Longev. 2017.

Abstract

Long-term fluoroquinolone-associated disability (FQAD) after fluoroquinolone (FQ) antibiotic therapy appears in recent years as a significant medical and social problem, because patients suffer for many years after prescribed antimicrobial FQ treatment from tiredness, concentration problems, neuropathies, tendinopathies, and other symptoms. The knowledge about the molecular activity of FQs in the cells remains unclear in many details. The effective treatment of this chronic state remains difficult and not effective. The current paper reviews the pathobiochemical properties of FQs, hints the directions for further research, and reviews the research concerning the proposed treatment of patients. Based on the analysis of literature, the main directions of possible effective treatment of FQAD are proposed: (a) reduction of the oxidative stress, (b) restoring reduced mitochondrion potential ΔΨm,

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Figures

Figure 1
Figure 1
The schematic presentation of the ATP production system. The acetyl-CoA supports Krebs cycle to produce NADH2. Hydrogen from NADH2 (and FADH2) enters the cytochrome chain. Some electrons leak before they reach oxygen generating O2− and next H2O2. H2O2 comes away from mitochondria and works as a redox signaling molecule. The amount of leaking electrons depends mainly on NADH2/NAD ratio (hydrogen pressure). The degree of PTP opening must be precisely regulated and depends on many factors, for example, O2−/H2O2, Ca2+, and ΔΨm.
Figure 2
Figure 2
The main ways of FQ toxicity. The positive regulatory loops magnifying the toxicity of FQs are marked with “+.” The “?” signs denote the possible but not confirmed effects of FQ toxicity.
Figure 3
Figure 3
The exemplary FQ—norfloxacin and its zwitterion structure.
See this image and copyright information in PMC

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