CIP-associated intestinal alterations and elevated circulating LPS levels may contribute to AD progression through a potential gut-vascular axis, providing new insights into fluoroquinolone-associated vascular injury and potential gut-targeted interventions.
Ciprofloxacin aggravated aortic injury in an aortic dissection mouse model.
Ciprofloxacin disrupted gut microbial composition in AD mice.
Ciprofloxacin impaired intestinal barrier integrity and increased circulating lipopolysaccharide (LPS) levels.
Combined ciprofloxacin and LPS stimulation enhanced human aortic smooth muscle cell (HASMC) apoptosis and phenotypic switching in vitro.
The study proposes a gut-vascular axis as a potential mechanism by which ciprofloxacin may aggravate aortic dissection.
This research suggests that ciprofloxacin (CIP), a commonly used antibiotic in the fluoroquinolone class, may worsen aortic dissection (a dangerous tearing of the main blood vessel from the heart) through an indirect pathway involving the gut. Using a mouse model of aortic dissection and laboratory experiments with human blood vessel cells, the researchers found that CIP disrupted the balance of bacteria in the gut, weakened the intestinal barrier, and allowed a bacterial toxin called lipopolysaccharide (LPS) to leak into the bloodstream at higher levels. This sequence of events appeared to harm the smooth muscle cells of the aorta, potentially worsening the dissection. In laboratory cell experiments, exposing human aortic smooth muscle cells to both CIP and LPS together caused more cell death and unhealthy changes in cell behavior than either substance alone. This suggests that the gut disruption caused by CIP may amplify the drug's harmful effects on blood vessels by delivering damaging signals via the bloodstream — a pathway the researchers call the 'gut-vascular axis.' This research matters because fluoroquinolone antibiotics like ciprofloxacin are widely prescribed, and there has been growing concern about their association with aortic diseases. These findings offer a possible biological explanation for that risk and suggest that protecting the gut microbiome and intestinal barrier could be a potential strategy to reduce vascular harm in patients who require these antibiotics.
Lv H, Wang Q, Abudesimu A, Yesitayi G, Aizitiaili A, Siti D, et al.. (2026). The Potential Role of the Gut-Vascular Axis in Ciprofloxacin-Associated Aggravation of Aortic Dissection.. Cardiovascular toxicology. https://doi.org/10.1007/s12012-026-10196-7