Abstract
Fluoroquinolones (FQs) are a broad class of antibiotics typically prescribed for bacterial infections, including infections for which their use is discouraged. The FDA has proposed the existence of a permanent disability (Fluoroquinolone Associated Disability; FQAD), which is yet to be formally recognized. Previous studies suggest that FQs act as selective GABAA receptor inhibitors, preventing the binding of GABA in the central nervous system. GABA is a key regulator of the vagus nerve, involved in the control of gastrointestinal (GI) function. Indeed, GABA is released from the Nucleus of the Tractus Solitarius (NTS) to the Dorsal Motor Nucleus of the vagus (DMV) to tonically regulate vagal activity. The purpose of this review is to summarize the current knowledge on FQs in the context of the vagus nerve and examine how these drugs could lead to dysregulated signaling to the GI tract. Since there is sufficient evidence to suggest that GABA transmission is hindered by FQs, it is reasonable to postulate that the vagal circuit could be compromised at the NTS-DMV synapse after FQ use, possibly leading to the development of permanent GI disorders in FQAD.
Highlights
NeuroSci 2021, 2, 235–253. https://Fluoroquinolones (FQs) are one of the most commonly prescribed antibiotics within the United States
We explored some compelling clinical and experimental evidence of
The literature presented in this review highlights two main key points for the understanding of how this cranial nerve might be affected in Fluoroquinolones associated disability” (FQAD): (1) FQs are selective inhibitors of GABAA receptors, and (2) FQs can chelate Mg2+ ions, contributing to the disinhibition of NMDA receptors
Summary
NeuroSci 2021, 2, 235–253. https://Fluoroquinolones (FQs) are one of the most commonly prescribed antibiotics within the United States. Fluoroquinolones (FQs) are one of the most commonly prescribed antibiotics within the United States. FQs are typically included in the treatment protocols of several illnesses such as urinary tract infections, bacterial bronchitis, bacterial gastroenteritis and other infectious diseases [1]. In 2014, FQs were prescribed to 31.5 million people across the country [2]. The most common demographic to receive a prescription for FQs usually consists of individuals who are 45 years of age or older [3]. FQs are extremely efficacious in treating bacterial infections through inhibition of bacterial type II DNA topoisomerases, DNA gyrase and topoisomerase IV.
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