"Die postoperative Nachbehandlung gestaltete sich schwierig; 1/2 Jahr nach der Operation ist die Patientin noch nicht vollständig beschwerdefrei. Wir führen diesen schleppenden Heilungsverlauf auf die massive Gewebsschädigung zurück... Histologisch sahen wir fokale Nekrosen... Bei der Ciprofloxacin-induzierten Tendopathie ist die Gewebeschädigung möglicherweise auf eine direkte Wirkung des Medikaments auf die Zelle zurückzuführen."
(Quelle siehe pdf)
FA verursacht in der Skelettmuskulatur fokale Nekrosen (schwarzer Pfeil).
(https://www.researchgate.net/publicatio ... lard_ducks)
5-Fluortryptophan (a.k.a. 2-Amino-5-Fluorbenzoesäure) verursacht Nekrosen.
"All compounds of this type caused considerable irritation and, in some cases, tissue necrosis."
Fluorine Chemistry
Ciprofloxacin-induzierte Gewebeschädigung / Nekrosen möglicherweise durch direkte Wirkung auf die Zelle
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- Beiträge: 341
- Registriert: 07.11.2016, 17:40
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- Beiträge: 341
- Registriert: 07.11.2016, 17:40
Re: Ciprofloxacin-induzierte Gewebeschädigung / Nekrosen möglicherweise durch direkte Wirkung auf die Zelle
Fluorchinolone können gastrointestinale Perforationen verursachen. Diese Komplikation ist operationspflichtig und potentiell tödlich (Mortaliät 10-30%):
"We found that use of fluoroquinolones was associated with a non-negligible increased risk of gastrointestinal perforation, and physicians should be aware of this possible association...
Given the high mortality associated with gastrointestinal perforation, these findings may warn the clinicians to weigh the overall risk-benefit balance of fluoroquinolone treatment in patients at high risk for gastrointestinal perforation."
https://www.researchgate.net/publicatio ... ive_cohort
Und was wird bei der Operation gastrointestinaler Perforationen empfohlen?
"A number of different antibiotics may be used such as piperacillin/tazobactam or the combination of ciprofloxacin and metronidazole."
Gastrointestinal perforation
Offenbar sind Fluorchinolone auch mit einem erhöhten Risiko für Morbus Crohn assoziiert:
"Exposure to metronidazole (OR 5.01, 95% CI 1.65–15.25) or fluoroquinolones (OR 1.79, 95% CI 1.03–3.12) was most strongly associated with new-onset IBD."
http://www.nature.com/ajg/journal/v109/ ... 4246a.html
Und was wird im Rahmen akuter Morbus Crohn-Schübe empfohlen?
"Metronidazol und Ciprofloxacin können vor allem zur Behandlung von Fisteln eingesetzt werden."
Morbus Crohn
"We found that use of fluoroquinolones was associated with a non-negligible increased risk of gastrointestinal perforation, and physicians should be aware of this possible association...
Given the high mortality associated with gastrointestinal perforation, these findings may warn the clinicians to weigh the overall risk-benefit balance of fluoroquinolone treatment in patients at high risk for gastrointestinal perforation."
https://www.researchgate.net/publicatio ... ive_cohort
Und was wird bei der Operation gastrointestinaler Perforationen empfohlen?
"A number of different antibiotics may be used such as piperacillin/tazobactam or the combination of ciprofloxacin and metronidazole."
Gastrointestinal perforation
Offenbar sind Fluorchinolone auch mit einem erhöhten Risiko für Morbus Crohn assoziiert:
"Exposure to metronidazole (OR 5.01, 95% CI 1.65–15.25) or fluoroquinolones (OR 1.79, 95% CI 1.03–3.12) was most strongly associated with new-onset IBD."
http://www.nature.com/ajg/journal/v109/ ... 4246a.html
Und was wird im Rahmen akuter Morbus Crohn-Schübe empfohlen?
"Metronidazol und Ciprofloxacin können vor allem zur Behandlung von Fisteln eingesetzt werden."
Morbus Crohn
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- Registriert: 07.11.2016, 17:40
Re: Ciprofloxacin-induzierte Gewebeschädigung / Nekrosen möglicherweise durch direkte Wirkung auf die Zelle
MMP gelten nie als alleinige Ursache FC-induzierter Gewebeschäden.
Klar ist bislang vor allem, dass Gewebeschäden durch FC auf Nekrosen beruhen:
"In one patient who had a rupture, the histopathology showed necrosis... Histopathology in a second case of ruptured Achilles tendon showed necrosis..."
https://www.fqresearch.org/pdf_files/103.pdf
"extensive hepatocellular necrosis"
https://www.ncbi.nlm.nih.gov/pubmed/14994731
"acute tubular necrosis"
https://www.ncbi.nlm.nih.gov/pubmed/18614979
http://ekjm.org/journal/view.php?number=24917
"hepatocyte necrosis, acute tubular necrosis"
https://jamanetwork.com/journals/jamade ... act/480883
"full-thickness epidermal necrosis"
https://pdfs.semanticscholar.org/3293/a ... ecdee7.pdf
"Chondrocyte toxicity and necrosis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164164/
"single-cell necrosis, coagulative necrosis"
https://pharmacologia.com/fulltext/?doi ... 12.477.480
"phototoxic reaction that included necrosis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910230/
Die Nekrose beruht auf direkten Zellschäden:
"Necrosis results from direct damage to the cells primarily leading to cell membrane leakage and subsequent cell death..."
(http://onlinelibrary.wiley.com/doi/10.1 ... 425045/pdf)
Das korreliert mit der Einschätzung einiger Autoren, dass es sich bei FC-Schäden um direkte toxische Wirkungen handeln könnte (steht bereits im Forum):
"The sudden onset of some tendinopathies, occasionally after a single dose of a fluoroquinolone, suggests a direct toxic effect on collagen fibers."
(http://databankws.lareb.nl/Downloads/ACR2001_920.pdf)
"There may be a direct toxic effect on the collagen. The sudden onset of some tenopathies, sometimes after a single dose of a quinolone, suggests the possibility of direct toxicity."
(http://www.boneandjoint.org.uk/content/ ... 3.full.pdf)
"Although the pathoetiology is certainly multifactorial, alterations in cell signaling proteins and direct toxic effects on musculoskeletal tissues have been strongly implicated."
(https://www.ncbi.nlm.nih.gov/pubmed/21333952)
"However, it is possible that FQs have a direct cytotoxic effect on enzymes found in mammalian musculoskeletal tissue... FQs have chelating properties against several metal ions (e.g., calcium, magnesium, aluminum), and have been known to cause direct toxicity to type 1 collagen synthesis and promote collagen degradation... Chondrocyte depletion and fissures on adjacent nonruptured tendons are also suggestive of direct toxicity related to FQ exposure."
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921747/)
Klar ist bislang vor allem, dass Gewebeschäden durch FC auf Nekrosen beruhen:
"In one patient who had a rupture, the histopathology showed necrosis... Histopathology in a second case of ruptured Achilles tendon showed necrosis..."
https://www.fqresearch.org/pdf_files/103.pdf
"extensive hepatocellular necrosis"
https://www.ncbi.nlm.nih.gov/pubmed/14994731
"acute tubular necrosis"
https://www.ncbi.nlm.nih.gov/pubmed/18614979
http://ekjm.org/journal/view.php?number=24917
"hepatocyte necrosis, acute tubular necrosis"
https://jamanetwork.com/journals/jamade ... act/480883
"full-thickness epidermal necrosis"
https://pdfs.semanticscholar.org/3293/a ... ecdee7.pdf
"Chondrocyte toxicity and necrosis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164164/
"single-cell necrosis, coagulative necrosis"
https://pharmacologia.com/fulltext/?doi ... 12.477.480
"phototoxic reaction that included necrosis"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910230/
Die Nekrose beruht auf direkten Zellschäden:
"Necrosis results from direct damage to the cells primarily leading to cell membrane leakage and subsequent cell death..."
(http://onlinelibrary.wiley.com/doi/10.1 ... 425045/pdf)
Das korreliert mit der Einschätzung einiger Autoren, dass es sich bei FC-Schäden um direkte toxische Wirkungen handeln könnte (steht bereits im Forum):
"The sudden onset of some tendinopathies, occasionally after a single dose of a fluoroquinolone, suggests a direct toxic effect on collagen fibers."
(http://databankws.lareb.nl/Downloads/ACR2001_920.pdf)
"There may be a direct toxic effect on the collagen. The sudden onset of some tenopathies, sometimes after a single dose of a quinolone, suggests the possibility of direct toxicity."
(http://www.boneandjoint.org.uk/content/ ... 3.full.pdf)
"Although the pathoetiology is certainly multifactorial, alterations in cell signaling proteins and direct toxic effects on musculoskeletal tissues have been strongly implicated."
(https://www.ncbi.nlm.nih.gov/pubmed/21333952)
"However, it is possible that FQs have a direct cytotoxic effect on enzymes found in mammalian musculoskeletal tissue... FQs have chelating properties against several metal ions (e.g., calcium, magnesium, aluminum), and have been known to cause direct toxicity to type 1 collagen synthesis and promote collagen degradation... Chondrocyte depletion and fissures on adjacent nonruptured tendons are also suggestive of direct toxicity related to FQ exposure."
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921747/)
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