Shakibaei M, Pfister K, Schwabe R, Vormann J, Stahlmann R
Institute of Anatomy, Benjamin Franklin Medical Center, Freie Universit]at Berlin, 14195 Berlin, Germany.
Antimicrob Agents Chemother. 2000 Feb;44(2):261-6. doi: 10.1128/AAC.44.2.261-266.2000.
Fluoroquinolones can cause tendinitis and tendon rupture. However, toxicological as well as clinical information on quinolone-induced tendopathy is scarce. We performed extensive electron microscopic studies with Achilles tendon specimens from ofloxacin-treated rats. The drug was given at a dose of 1,200 mg/kg (body weight) orally. Juvenile Wistar rats received one or three oral doses each of 1,200 mg of ofloxacin/kg (body weight)/day. Three days after treatment, the tenocytes of their Achilles tendons showed degenerative alterations, such as multiple vacuoles and vesicles in the cytoplasm that had developed due to swellings and dilatations of cell organelles. Other indications of cell degradation were the occurrence of cell debris and cell detachment from the extracellular matrix accompanied by a loss of cell-matrix interaction. The tenocytes of juvenile Wistar rats that had been treated at day 36 with a single oral dose of 1,200 mg of ofloxacin/kg (body weight) and sacrificed either 3 or 6 months later exhibited similar degenerative alterations. The number of degenerative alterations of tenocytes after ofloxacin treatment was considerably higher in rats that had received a magnesium-deficient diet than in rats with normal magnesium status. Of the adult rats that had been treated once, 5 times, and 10 times with ofloxacin and killed 1 day later, only those with the 10-times treatment showed a significantly increased number of degeneratively altered tenocytes. In summary, effects observed in tendons show similar pathological features as described earlier in cartilage, indicating that quinolone-induced arthropathy and quinolone-induced tendopathy probably are different clinical manifestations of the same toxic effect on cellular components of connective tissue structures.
氟喹诺酮类药物可导致肌腱炎和肌腱断裂。然而,关于喹诺酮类药物引起的肌腱病的毒理学及临床信息却很匮乏。我们对经氧氟沙星处理的大鼠的跟腱标本进行了广泛的电子显微镜研究。药物以1200毫克/千克(体重)的剂量口服给药。幼年Wistar大鼠每天口服1200毫克氧氟沙星/千克(体重),给药一次或三次。治疗三天后,其跟腱的腱细胞出现退行性改变,如由于细胞器肿胀和扩张而在细胞质中形成多个空泡和小泡。细胞降解的其他迹象包括细胞碎片的出现以及细胞与细胞外基质分离,同时伴有细胞与基质相互作用的丧失。在第36天接受单次口服1200毫克氧氟沙星/千克(体重)治疗并在3个月或6个月后处死的幼年Wistar大鼠的腱细胞也表现出类似的退行性改变。与镁状态正常的大鼠相比,接受缺镁饮食的大鼠在氧氟沙星治疗后腱细胞的退行性改变数量明显更多。在成年大鼠中,分别接受氧氟沙星治疗1次、5次和10次并在1天后处死,只有接受10次治疗的大鼠显示退行性改变的腱细胞数量显著增加。总之,在肌腱中观察到的效应显示出与先前在软骨中描述的相似病理特征,这表明喹诺酮类药物引起的关节炎和喹诺酮类药物引起的肌腱病可能是对结缔组织结构细胞成分相同毒性作用的不同临床表现。