Doxy and TAA

Q: Doxycycline may have a ________________ effect on Thoracic Aortic Aneurysm (TAA)? (select one)

A) destructive

B) protective

Answer: B

Although not a part of regular clinical practice, doxycycline may have a protective effect on TAA. In animal models with fibrillin-1-deficient, doxycycline reduces matrix metalloproteinase (MMP) activity resulting in decreased elastin destruction and may prevent aortic root aneurysm. Similar benefit has been reported in Abdominal Aortic Aneurysm (AAA), though data is conflicting.

In contrast, fluoroquinolones should be avoided as they have confirmatory destructive effect on vessels.

#vascular-surgery

#pharmacology

References:

1. Chung AW, Yang HH, Radomski MW, van Breemen C. Long-term doxycycline is more effective than atenolol to prevent thoracic aortic aneurysm in marfan syndrome through the inhibition of matrix metalloproteinase-2 and -9. Circ Res 2008; 102:e73.

2. Pasternak B, Inghammar M, Svanström H. Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study. BMJ 2018; 360:k678.