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Collagen
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=== Fluoroquinolone antibiotics === “Fluoroquinolones upregulate cell matrix metalloproteinases, resulting in a reduction of collagen fibrils of types I and III collagen.”<ref>{{Cite web | url = https://www.jwatch.org/na48248/2019/02/13/adverse-effects-fluoroquinolones-where-do-we-stand | title = NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals | website = jwatch.org|access-date=2019-06-18}}</ref> A longitudinal study found Fluoroquinolones increased the risk of collagen-related adverse events like tendon ruptured and detached retinas.<ref>{{Cite journal | last = Redelmeier | first = Donald A. | last2 = Lu | first2 = Hong | last3 = Daneman | first3 = Nick | date = 2015-11-01 | title = Fluoroquinolones and collagen associated severe adverse events: a longitudinal cohort study | url = https://bmjopen.bmj.com/content/5/11/e010077 | journal = BMJ Open|language=en|volume=5 | issue = 11| pages = e010077|doi=10.1136/bmjopen-2015-010077|issn=2044-6055|pmid=26582407}}</ref> In December 2018, the FDA recommended against its use in patients with connective tissue disorders like [[Ehlers-Danlos Syndrome]] and Marfan Syndrome.<ref>{{Cite journal | last = Research|first = Center for Drug Evaluation and | date = 2019-04-15 | title = FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients |url =http://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-increased-risk-ruptures-or-tears-aorta-blood-vessel-fluoroquinolone-antibiotics | journal = FDA|language=en}}</ref> [[Doxycycline]], by contrast, inhibits MMP production.<ref name=":02">{{Cite journal | last = De Paiva | first = Cintia S. | last2 = Corrales | first2 = Rosa M. | last3 = Villarreal | first3 = Arturo L. | last4 = Farley | first4 = William J. | last5 = Li | first5 = De-Quan | last6 = Stern | first6 = Michael E. | last7 = Pflugfelder | first7 = Stephen C. | date = 2006-09-01 | title = Corticosteroid and doxycycline suppress MMP-9 and inflammatory cytokine expression, MAPK activation in the corneal epithelium in experimental dry eye | url =http://www.sciencedirect.com/science/article/pii/S0014483506001709 | journal = Experimental Eye Research|volume=83 | issue = 3 | pages = 526–535|doi=10.1016/j.exer.2006.02.004|issn=0014-4835}}</ref><ref>{{Cite journal | last = Roach|first = D. M | last2 = Fitridge | first2 = R. A | last3 = Laws | first3 = P. E | last4 = Millard | first4 = S. H | last5 = Varelias | first5 = A | last6 = Cowled | first6 = P. A | date = 2002-03-01 | title = Up-regulation of MMP-2 and MMP-9 Leads to Degradation of Type IV Collagen During Skeletal Muscle Reperfusion Injury; Protection by the MMP Inhibitor, Doxycycline | url =http://www.sciencedirect.com/science/article/pii/S1078588402915984 | journal = European Journal of Vascular and Endovascular Surgery|volume=23 | issue = 3 | pages = 260–269|doi=10.1053/ejvs.2002.1598|issn=1078-5884}}</ref><ref>{{Cite journal | last = Niedzwiecki|first = A. | last2 = Rath | first2 = M. | last3 = Kalinovsky | first3 = T. | last4 = Monterrey | first4 = J.C. | last5 = Roomi | first5 = M.W. | date = 2010-03-01 | title = In vitro modulation of MMP-2 and MMP-9 in human cervical and ovarian cancer cell lines by cytokines, inducers and inhibitors |url =http://www.spandidos-publications.com/or/23/3/605/abstract | journal = Oncology Reports|volume=23 | issue = 3 | pages = 605–614|doi=10.3892/or_00000675|issn=1021-335X}}</ref><ref>{{Cite journal | last = Choi|first = Dong-Hoon | last2 = Moon | first2 = Ik-Sang | last3 = Choi | first3 = Bong-Kyu | last4 = Paik | first4 = Jeong-Won | last5 = Kim | first5 = Yoon-Sik | last6 = Choi | first6 = Seong-Ho | last7 = Kim | first7 = Chong-Kwan | date = 2004 | title = Effects of sub-antimicrobial dose doxycycline therapy on crevicular fluid MMP-8, and gingival tissue MMP-9, TIMP-1 and IL-6 levels in chronic periodontitis |url =https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0765.2004.00696.x | journal = Journal of Periodontal Research|language=en|volume=39 | issue = 1 | pages = 20–26|doi=10.1111/j.1600-0765.2004.00696.x|issn=1600-0765}}</ref><ref>{{Cite journal | last = Li|first = De-Quan | last2 = Lokeshwar | first2 = Balakrishna L | last3 = Solomon | first3 = Abraham | last4 = Monroy | first4 = Dagoberto | last5 = Ji | first5 = Zhonghua | last6 = Pflugfelder | first6 = Stephen C | date = 2001-10-01 | title = Regulation of MMP-9 Production by Human Corneal Epithelial Cells |url =http://www.sciencedirect.com/science/article/pii/S0014483501910541 | journal = Experimental Eye Research|volume=73 | issue = 4 | pages = 449–459|doi=10.1006/exer.2001.1054|issn=0014-4835}}</ref><ref>{{Cite journal | last = Brown David L. | last2 = Desai Kavita K. | last3 = Vakili Babak A. | last4 = Nouneh Chadi | last5 = Lee Hsi-Ming | last6 = Golub Lorne M. | date = 2004-04-01 | title = Clinical and Biochemical Results of the Metalloproteinase Inhibition with Subantimicrobial Doses of Doxycycline to Prevent Acute Coronary Syndromes (MIDAS) Pilot Trial | url = https://www.ahajournals.org/doi/full/10.1161/01.ATV.0000121571.78696.dc | journal = Arteriosclerosis, Thrombosis, and Vascular Biology|volume=24 | issue = 4 | pages = 733–738|doi=10.1161/01.ATV.0000121571.78696.dc}}</ref>
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