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In this study, we conducted acute TIL exposure experiment using zebrafish model to explore the toxicological effects. In the concentration range of 20\u201380\u2009mg\/L, TIL did not affect zebrafish body length development but induced idiopathic scoliosis (IS)\u2010like symptoms accompanied by impaired mobility. IS predominantly occurs in adolescents, while the etiology remains unclear. Further studies showed that the combination of quercetin and luteolin effectively alleviated TIL\u2010induced spinal curvature and motor suppression. To explore the underlying mechanism, we performed network pharmacology analysis and enriched the PI3K\u2010Akt pathway. We validated that the expression of key target genes in the PI3K\u2010Akt pathway were significantly activated after TIL exposure, while quercetin and luteolin treatment effectively inhibited the PI3K\u2010Akt pathway activation. Further experiments revealed that TIL exposure decreased brain neural cell apoptosis, thereby causing an increase in neurocytes, interfering with motor ability, and promoting IS\u2010like vertebral malformations, which were especially noticeable during movement. This study expands our understanding that TIL exposure may be a predisposing factor for IS occurrence and progression, while the combination of quercetin and luteolin combination could protect against IS\u2010like symptom by regulating PI3K\u2010Akt pathway.<\/jats:p>","DOI":"10.1096\/fj.202403204rr","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T07:06:31Z","timestamp":1752217591000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute Exposure of Veterinary Antibiotic Tilmicosin Leads to Idiopathic Scoliosis\u2010Like Vertebral Malformation Development Through Regulating\n                    <scp>PI3K<\/scp>\n                    \u2010Akt Pathway in Zebrafish"],"prefix":"10.1096","volume":"39","author":[{"given":"Xianbin","family":"Zeng","sequence":"first","affiliation":[{"name":"Jiangxi Provincial Key Laboratory of Synthetic Pharmaceutical Chemistry, School of Geography and Environmental Engineering Gannan Normal University  Ganzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxiao","family":"Cong","sequence":"additional","affiliation":[{"name":"Jiangxi Provincial Key Laboratory of Synthetic Pharmaceutical Chemistry, School of Geography and Environmental Engineering Gannan Normal University  Ganzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Xu","sequence":"additional","affiliation":[{"name":"Jiangxi Provincial Key Laboratory of Synthetic Pharmaceutical Chemistry, School of Geography and Environmental Engineering Gannan Normal University  Ganzhou People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Ju","sequence":"additional","affiliation":[{"name":"Jiangxi Provincial Key Laboratory of Synthetic Pharmaceutical Chemistry, School of Geography and Environmental Engineering Gannan 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