Fig. 1
From: Current progress of fluoroquinolones-increased risk of aortic aneurysm and dissection
Mechanisms of FQ-induced AAD. FQ induces ECM remodeling via promoting MMP activation and inhibiting TIMP-1/2, P4H, Lysyl hydroxylase and LOX. FQ decreases cell proliferation and increases cell apoptosis through promoting mitochondrial dysfunction, ROS production, activation of STING. Patients with A1AT deficiency may associated with FQ-induced AAD. FQ fluoroquinolones, MMP martix metalloprotein, TIMP tissue inhibitors of matrix metalloproteinase, P4H prolyl 4-hydroxylase, LOX lysyl oxidase, ROS reactive oxygen species, STING stimulator of interferon genes, A1AT alpha-1 antitrypsin, ECM extracellular matrix, AAD aortic aneurysm and dissection