Carbonic anhydrase inhibitors for the treatment of neuropathic pain and arthritis

Carbonic anhydrase inhibitors have long been used as diuretics, topically acting antiglaucoma agents, systemic anticonvulsants, or for the treatment of altitude sickness. More recently, CAIs have shown promising results as antiobesity, antimicrobial, and mainly antitumor agents/diagnostic tools with a sulfonamide CAI currently in phase II clinical trials for the treatment of solid tumors overexpressing human CA IX. Recent studies have reported positive effects with the use of CAIs in the treatment of inflammatory processes such as arthritis or neuropathic pain. Moreover, an unexpected polypharmacology has been demonstrated with sulfonamide cyclooxygenase 2 (COX-2) inhibitors such as celecoxib, valdecoxib, and polmacoxib, also able to efficiently inhibit CAs. This cross-reactivity has opened a new scenario in the field of antiglaucoma and anticancer therapies.