Investigation of tumor-associated carbonic anhydrase VII, IX, and XII enzyme levels during the treatment process of Hydrocephalus

Hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal fluid (CSF) in the cerebral ventricles and subarachnoid space, which can lead to serious neurological complications if left untreated. It can develop due to both congenital (primary) and acquired (secondary) causes, often associated with pathologies such as tumors, infections, prematurity, or trauma. This diversity complicates the determination of the disease's incidence, prevalence, and complication rates. CSF circulates within the central nervous system, providing protective effects, regulating ion balance, and maintaining the brain's internal environment. CSF production and circulation are controlled by various molecular mechanisms, particularly the carbonic anhydrase (CA) enzyme family. Hydrocephalus associated with brain tumors typically arises due to mechanical blockage of CSF circulation by the tumor or an increase in CSF production. In this process, the transfer of CO₂ from the central nervous system to CSF and its buffering is critically important for pH homeostasis. However, the exact effects of CO₂ and the carbonic anhydrase system on hydrocephalus and tumor formation have not yet been fully elucidated. Carbonic anhydrases catalyze the hydration of CO₂ to produce HCO₃⁻ and H⁺ ions, playing key roles in pH regulation, metabolic processes, CSF production, and tumor development. The distribution and activity of cancer-associated isoforms, such as CA-VII, CA-IX, and CA-XII, are of particular importance for understanding the molecular pathophysiology of the disease. The aim of this study is to evaluate the activity levels and protein expressions of tumor-associated CA-VII, CA-IX, and CA-XII enzymes in children and adults diagnosed with hydrocephalus. The data obtained will be used to analyze the contribution of these enzymes to the hydrocephalus process, their role in CSF pH regulation, and their impact on pathogenesis. According to the findings of this study, significant differences were found in the levels of CA-VII (p=0.023) and CA-XII (p=0.047) in CSF between the child and adult groups, with higher enzyme levels observed in children. In serum levels, only CA-IX showed a significant difference (p=0.000), being markedly higher in adults compared to children. Additionally, a strong and significant positive correlation was found between CSF and serum CA-XII levels in the child group (r=0.794, p=0.001). No statistically significant differences were found in comparisons based on gender and the relationship between CSF and serum levels in adults. This study aims to contribute to a better understanding of the mechanisms underlying hydrocephalus and to evaluate these enzymes as potential diagnostic and therapeutic targets.