Abstract
Carbonic anhydrases (CAs) are widespread enzymes in bacteria, archaea and eukaryotes, and catalyze a crucially important physiological reaction: the hydration of carbon dioxide to bicarbonate and protons. These enzymes are inhibited by several classes of compounds, such as sulphonamides, sulphamates and sulphamides, among others. The inhibitors bind to the catalytic zinc ion within the enzyme cavity. Several such derivatives are clinically used inhibitors, such as acetazolamide, methazolamide, ethoxzolamide, dichlorophenamide, dorzolamide, brinzolamide, topiramate, zonisamide, sulpiride, sukthiame, celecoxib and valdecoxib among others. Several compounds are in clinical development, such as indisulam and COUMATE-667. CA inhibitors (CAIs) are used in therapy as diuretic and antiglaucoma agents but also show anti-obesity and antitumour effects. Some compounds are in clinical development for such applications (obesity and cancer). Most CAIs that are currently available show undesired side effects due to indiscriminate inhibition of CA isoforms other than the target one. Many new CAIs are developed in the search of isozyme-selective compounds as potential drugs with fewer side effects. Bacterial, fungal and protozoan CAs present in many pathogens have recently been considered as potential targets for the development of inhibitors with therapeutic applications. CA activators (CAAs) participate in the enzyme catalytic cycle by facilitating the rate-determining step: a release of a proton from the zinc-coordinated water molecule to the reaction medium. CAAs from various classes of compounds were developed in the past and characterized by means of X-ray crystallography and kinetic measurements. Such derivatives may lead to the development of anti-Alzheimer's disease agents and therapies to enhance memory.

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