Fluoroquinolone antibiotics have been known to cause severe, multisystem adverse side effects, termed fluoroquinolone toxicity (FQT). This toxicity syndrome can present with adverse effects that vary from individual to individual, including effects on the musculoskeletal and nervous systems, among others. The mechanism behind FQT in mammals is not known, although various possibilities have been investigated. Among the hypothesized FQT mechanisms, those that could potentially explain multisystem toxicity include off-target mammalian topoisomerase interactions, increased production of reactive oxygen species, oxidative stress, and oxidative damage, as well as metal chelating properties of FQs. This review presents relevant information on fluoroquinolone antibiotics and FQT and explores the mechanisms that have been proposed. A fluoroquinolone-induced increase in reactive oxygen species and subsequent oxidative stress and damage presents the strongest evidence to explain this multisystem toxicity syndrome. Understanding the mechanism of FQT in mammals is important to aid in the prevention and treatment of this condition.
Futher research has shown that transgenics overexpressing type I H+-PPases develop more root and shoot biomass, and have enhanced rhizosphere acidification capacity than wild types. The increased root biomass suggests that previous reports describing the response of these plants to water scarcity as drought tolerance are incomplete. Larger root systems indicate that an important component of the response is drought resistance. The enhanced rhizosphere acidification capacity has also been associated with an increase in nutrient use efficiency, conferring a growth advantage under nitrogen and phosphorous deficient conditions.
While a vacuolar localized H+-PPase easily explains the salt tolerant phenotypes, it does little to provide a mechanism for an increase in root and shoot biomass and/or an augmented rhizosphere acidification capacity. Several groups have argued that higher levels and transport of the growth hormone auxin could be responsible for the above phenotypes. An alternative model focusing on the function of a plasma membrane bound H+-PPase in sieve elements and companion cells links these phenotypes with enhanced phloem sucrose loading and transport.
The following paper reviews publications in which the H+-PPase overexpression technology has been used since 2006 in an attempt to identify cues that could help us test the compatibility of the the proposed models with the actual data.