How could the fluoroquinolones cause Parkinson’s Disease?
Fluoroquinolones Oxidative Stress Mitochondrial Dysfunction Parkinson’s Disease
An internal FDA pharmacovigilance review memo dated April 17, 2013, issued by the Food and Drug Administration’s Center for Drug Evaluation and Research, Office of Surveillance and Epidemiology shows that the FDA is fully aware of permanent disabling peripheral neuropathy in otherwise healthy individuals and that the likely method of action (or damage) for the peripheral neuropathy is mitochondrial toxicity. They go on to note that the method of damage, mitochondrial toxicity, is also the underlying mechanisms in neurodegenerative diseases such as Parkinson’s, Alzheimer’s, and ALS (1)
Mitochondria are highly dynamic organelles which fulfill a plethora of functions. In addition to their prominent role in energy metabolism, mitochondria are intimately involved in various key cellular processes, such as the regulation of calcium homeostasis, stress response and cell death pathways. Thus, it is not surprising that an impairment of mitochondrial function results in cellular damage and is linked to aging and neurodegeneration. Many lines of evidence suggest that mitochondrial dysfunction plays a central role in the pathogenesis of Parkinson’s disease (PD), starting in the early 1980s with the observation that an inhibitor of complex I of the electron transport chain can induce parkinsonism. Remarkably, recent research indicated that several PD-associated genes interface with pathways regulating mitochondrial function, morphology, and dynamics. In fact, sporadic and familial PD seem to converge at the level of mitochondrial integrity (2).
It is important to note that not everyone that takes or has an adverse event to the FQ’s will go on to develop Parkinson’s. However, there have been numerous anecdotal reports of Parkinson like symptoms additionally, documented FQ usage in Parkinson patients who were previously healthy. Even despite the fact that the FDA documents a neurodegenerative link, more tracking and research are needed to further elucidate the long term impact that the FQ’s are having in the causative factors of neurodegenerative disease and on society as a whole. Given these facts, it is both prudent and wise that the very powerful fluorquinolones are used in an extremely judicious manner by medical personnel.