Ciprofloxacin interferes with collagen I/II and matrix metalloproteinase synthesis

Abstract

Abstract Background Fluoroquinolones are a wide-spectrum synthetic antibiotic that increases the risk of tendon rupture and has undesirable side-effects on collagen synthesis. Fibroblasts are the predominant cells that produce collagen. Objective This study therefore used human fibroblasts to investigate the effects of ciprofloxacin on their extracellular matrix and collagen metabolism. Result We found that low ciprofloxacin concentrations improved cell culture conditions. However, high ciprofloxacin concentrations, exerted a negative effect on cell proliferation and collagen type I/II formation. Conclusion Ciprofloxacin significantly decreased the collagen I to collagen II ratio through lowering collagen I concentration, which could be the mechanism underlying the drug’s effects on tendon injury. Ciprofloxacin also upregulates MMP9 expression, potentially leading to fibrosis. In conclusion, it demonstrated that high ciprofloxacin concentrations exerted cytotoxic effects on fibroblasts, specifically through inhibiting collagen I synthesis and upregulating MMP9 expression, which alter extracellular matrix homeostasis and likely play a key role in tendon injury.