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            "note": "<p>Acknowledgement of fluorquinolone cytotoxicity and recommendations for concomitant supplementation to minimize risk.</p>",
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                    "firstName": "Mederic M",
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            "abstractNote": "Fluoroquinolone antibiotics are associated with a wide spectrum of musculoskeletal complications that involve not only tendon but also cartilage, bone, and muscle. Insights into the pathoetiology of fluoroquinolone toxicity on musculoskeletal tissues have been evolving over recent years. Although the pathoetiology is certainly multifactorial, alterations in cell signaling proteins and direct toxic effects on musculoskeletal tissues have been strongly implicated. Increasing age and concomitant systemic corticosteroid use appear to significantly increase the risk of adverse events. The purpose of this article is to review the musculoskeletal complications associated with use of fluoroquinolone antibiotics by adults; identify risk factors associated with fluoroquinolone toxicity; explore the possible pathoetiology of fluoroquinolone toxicity on tendon, cartilage, bone, and muscle; and offer recommendations regarding evaluation and treatment of fluoroquinolone-associated musculoskeletal complications. In addition, this review will provide recommendations regarding fluoroquinolone use in athletes and return to play after fluoroquinolone exposure.",
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            "shortTitle": "Musculoskeletal complications of fluoroquinolones",
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            "note": "<p>Correlation between SOD2 mutation and fluoroquinolone sensitivity</p>",
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            "title": "Trovafloxacin, a fluoroquinolone antibiotic with hepatotoxic potential, causes mitochondrial peroxynitrite stress in a mouse model of underlying mitochondrial dysfunction",
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                    "firstName": "Chin-Ju J.",
                    "lastName": "Hsiao"
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                    "firstName": "Husam",
                    "lastName": "Younis"
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                {
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                    "firstName": "Urs A.",
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            "abstractNote": "Trovafloxacin (TVX) is a fluoroquinolone antibiotic whose therapeutic use was severely restricted due to an unacceptable risk of idiosyncratic liver injury. Oxidative stress and mitochondrial injury have been implicated in fluoroquinolone toxicity, but the mechanisms underlying liver injury are poorly understood. Because TVX-induced hepatotoxicity cannot be modeled in normal healthy rodents, we asked whether an underlying genetic defect (heterozygous deficiency in mitochondrial superoxide dismutase, Sod2) might aggravate TVX-induced mitochondrial adverse effects. Wild-type and Sod2+/− mice were treated with vehicle or alatrofloxacin (the prodrug of TVX, 33 mg/kg/day, ip) for 28 days. We found that hepatic protein carbonyls were increased by 2.5-fold and hepatic mitochondrial aconitase activity was decreased by 20% in mutant, but not wild-type mice. Because aconitase is a major target of peroxynitrite, we determined the extent of nitrotyrosine residues in hepatic mitochondrial proteins. Trovafloxacin significantly increased nitrotyrosine in Sod2+/− mice only. Using the NO-selective probe DAF-2, we found that TVX increased the production of mitochondrial NO in immortalized human hepatocytes. Similarly, mitochondrial Ca2+ was increased by TVX, suggesting Ca2+-dependent activation of mitochondrial NOS activity. Furthermore, the transcript levels of the mtDNA-encoded gene Cox2/mtCo2 were decreased in Sod2+/− mice only, while the expression of nDNA-encoded mitochondrial genes was not significantly altered in both genotypes, suggesting selective effects on mtDNA expression. The amount of mtDNA (copy number) was, however, unchanged. These data indicate that TVX enhances hepatic mitochondrial peroxynitrite stress in mice with underlying increased basal levels of superoxide, leading to the disruption of critical mitochondrial enzymes and gene regulation.",
            "publicationTitle": "Chemico-Biological Interactions",
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            "date": "October 6, 2010",
            "volume": "188",
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            "pages": "204-213",
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            "journalAbbreviation": "Chemico-Biological Interactions",
            "DOI": "10.1016/j.cbi.2010.07.017",
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            "url": "http://www.sciencedirect.com/science/article/pii/S0009279710004746",
            "accessDate": "2013-09-05T18:34:44Z",
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            "tags": [
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                    "tag": "Drug-induced liver injury (DILI)",
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                },
                {
                    "tag": "Mitochondria",
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                },
                {
                    "tag": "Mitochondrial NOS",
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                {
                    "tag": "Peroxynitrite",
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                {
                    "tag": "Sod2 (Mn-SOD)",
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