Fluoroquinolones Oxidative Stress Mitochondrial Dysfunction Mitochondrial Disease

The common impression that most people have of mitochondrial disease, if they have heard of it at all, is a disorder that presents itself at birth and makes children very sick.   The truth is it can appear at any age.

Two of the world’s leading experts on Mitochondrial disease, Sumit Parikh, M.D. & Bruce H. Cohen, M.D. who both practice in the Cleveland, Ohio area and are associated with the Cleveland Clinic write the following (this information, unfortunately is not well known).

It is a myth that mitochondrial diseases are maternally inherited.

Fact The majority of mitochondrial diseases are due to mutations in nuclear DNA (the “regular” DNA contained in the nucleus of the cell). The current thinking is that the majority of persons with mitochondrial diseases have inherited the disorder as a consequence of autosomal recessive inheritance or one of more complex inheritance patterns. Only mitochondrial disorders caused by mutations in the mitochondrial DNA are maternally inherited. However, mitochondrial DNA contains the genetic code for only a small number of the proteins in the mitochondria. Secondary mitochondrial disorders may also account for a large percentage of affected individuals, where the mitochondria become poorly functional as a consequence of another disease process (including other chromosomal disorders), toxin or viral exposure. Finally there may be inherited genetic mutations that in and of themselves are not pathologic until there is another trigger (an epigenetic factor)(1).

The FQ’s can trigger mitochondrial disease by two avenues: 

First, as stated above, they act as a toxin to initiate a secondary mitochondrial disorder.

Second, they are an epigenetic trigger which triggers inherited mutation.

It is important to note that not everyone that takes or has an adverse event to the FQ’s will go on to develop full blown mitochondrial disease, but it does happen.  We have had documented cases where the Fluoroquinolones initiated true mitochondrial disease (acquired).  More than likely, those who become chronically affected by the FQ’s develop a secondary mitochondrial disorder.