Treat Ankylosing Spondylitis with Methazolamide

Abstract

Background: Increased bone resorption and new bone information are two characteristics of ankylosing spondylitis (AS). Much evidence has shown that carbonic anhydrase inhibitors can restrain bone resorption. We had detected increased expression of carbonic anhydrase I (CA1) in synovium of patients with AS. This study aimed to evaluate the effectiveness and safety of methazolamide, an anti-carbonic anhydrase drug, for treating patients with AS.Methods: Two patients, called as S and L, were diagnosed with active AS based on BASDAI and BASFI assessments, radiographic data and other clinical indices. They took methazolamide tablets at a dose of 25 mg twice every day.Results: Patient S's BASDAI score fell from 5.4 to 4.4, while patient L's BASDAI fell from 2.4 to 2. Patient S's BASFI score change from 2.7 to 2.9, while patient L's BASFI score fell from 1.2 to 0.2. The ESR values of patient S were considerably reduced, while the ESR value of patient L remained unchanged and in the normal range. The calcium concentration of patient S decreased from 3.05 mmol/L to 2.39 mmol/L. The CT evidence indicates that the articular surfaces of the erosive sacroiliac joints became clearer and the area of the calcium deposits began decreased. No significant systemic side effects were observed in either patient.Conclusions: The above results indicate that methazolamide was effective for active AS. Methazolamide may improve AS symptoms by inhibiting carbonic anhydrase activity during the processes of bone reporption and new bone formation.

Methazolamide improves neurological behavior by inhibition of neuron apoptosis in subarachnoid hemorrhage mice

“…Methazolamide is a carbonic anhydrase inhibitor, which can penetrate the BBB due to its small molecule. It has been confirmed the effect of neuroprotection in recent years by us and other investigators 24 25 . However, there is no literature reported whether methazolamide has a protective effect on brain injury after SAH.…”

Transgenic mice over-expressing carbonic anhydrase I showed aggravated joint inflammation and tissue destruction

“…Immunohistochemistry and western blotting analyses confirmed the above findings [5]. Furthermore, we also reported that methazolamide, an anti-CA drug, may improve AS symptoms by a case report [6]. CA1 is a member of the carbonic anhydrase (CA) family, and it catalyzes the reversible hydration and dehydration reactions of CO 2 /H 2 CO 3 [7].…”

Carbonic anhydrase I (CA1) is involved in the process of bone formation and is susceptible to ankylosing spondylitis

“…They suggested that the carbonic anhydrase inhibitors played an antiarthritic role by inhibiting bone resorption. In a case report, we have also reported that methazolamide, an anti-CA drug, may improve AS symptoms [32]. CA1 carries out the catalysis of the following reactions: CO 2 + H 2 O = H + + HCO 3 - .…”