Ciprofloxacin accelerates aortic enlargement and promotes dissection and rupture in Marfan mice - PubMed (original) (raw)
. 2022 Mar;163(3):e215-e226.
doi: 10.1016/j.jtcvs.2020.09.069. Epub 2020 Sep 22.
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- PMID: 34586071
- DOI: 10.1016/j.jtcvs.2020.09.069
Free article
Ciprofloxacin accelerates aortic enlargement and promotes dissection and rupture in Marfan mice
Scott A LeMaire et al. J Thorac Cardiovasc Surg. 2022 Mar.
Free article
Abstract
Objective: Aortic aneurysm and dissection are major life-threatening complications of Marfan syndrome. Avoiding factors that promote aortic damage is critical in managing the care of these patients. Findings from clinical and animal studies raise concerns regarding fluoroquinolone use in patients at risk for aortic aneurysm and dissection. Therefore, we examined the effects of ciprofloxacin on aortic aneurysm and dissection development in Marfan mice.
Methods: Eight-week-old Marfan mice (Fbn1C1041G/+) were given ciprofloxacin (100 mg/kg/d; n = 51) or vehicle (n = 59) for 4 weeks. Mice were monitored for 16 weeks. Aortic diameters were measured by using ultrasonography, and aortic structure was examined by using histopathologic and immunostaining analyses.
Results: Vehicle-treated Fbn1C1041G/+ mice showed progressive aortic enlargement, with aortic rupture occurring in 5% of these mice. Compared with vehicle-treated Fbn1C1041G/+ mice, ciprofloxacin-treated Fbn1C1041G/+ mice showed accelerated aortic enlargement (P = .01) and increased incidences of aortic dissection (25% vs 47%, P = .03) and rupture (5% vs 25%, P = .005). Furthermore, ciprofloxacin-treated Fbn1C1041G/+ mice had higher levels of elastic fiber fragmentation, matrix metalloproteinase expression, and apoptosis than did vehicle-treated Fbn1C1041G/+ mice.
Conclusions: Ciprofloxacin accelerates aortic root enlargement and increases the incidence of aortic dissection and rupture in Marfan mice, partially by suppressing lysyl oxidase expression and further compromising the inherited defect in aortic elastic fibers. Our findings substantiate that ciprofloxacin should be avoided in patients with Marfan syndrome.
Keywords: Marfan syndrome; aortic disease; ciprofloxacin.
Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
Comment in
- Commentary: Danger of fluoroquinolones in Marfan syndrome.
Si MS. Si MS. J Thorac Cardiovasc Surg. 2022 Mar;163(3):e228-e229. doi: 10.1016/j.jtcvs.2020.10.057. Epub 2020 Oct 22. J Thorac Cardiovasc Surg. 2022. PMID: 33189346 No abstract available. - Commentary: Fluoroquinolone guilt: The evidence mounts.
Elefteriades JA, Ziganshin BA. Elefteriades JA, et al. J Thorac Cardiovasc Surg. 2022 Mar;163(3):e235-e236. doi: 10.1016/j.jtcvs.2020.10.090. Epub 2020 Oct 29. J Thorac Cardiovasc Surg. 2022. PMID: 33234251 No abstract available. - Commentary: The unacceptable aortic risk with fluoroquinolone exposure in Marfan syndrome.
Balsam LB, Hoffman WD. Balsam LB, et al. J Thorac Cardiovasc Surg. 2022 Mar;163(3):e227-e228. doi: 10.1016/j.jtcvs.2020.09.115. Epub 2020 Oct 5. J Thorac Cardiovasc Surg. 2022. PMID: 33268123 No abstract available. - Commentary: Fluoroquinolone antibiotics are antiaortic.
Guzzardi DG, Dundas J, Fedak PWM. Guzzardi DG, et al. J Thorac Cardiovasc Surg. 2022 Mar;163(3):e231-e232. doi: 10.1016/j.jtcvs.2020.11.036. Epub 2020 Nov 20. J Thorac Cardiovasc Surg. 2022. PMID: 33293062 No abstract available. - Commentary: Fluoroquinolones and aortopathy-a basic (science) question?
Ibrahim M, Szeto W. Ibrahim M, et al. J Thorac Cardiovasc Surg. 2022 Mar;163(3):e232-e233. doi: 10.1016/j.jtcvs.2020.12.076. Epub 2020 Dec 25. J Thorac Cardiovasc Surg. 2022. PMID: 33546849 No abstract available.
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