Effects of inhibition of angiotensin converting enzyme and carbonic anhydrase on fluid production by ciliary process, choroid plexus, and pancreas.

Inhibitors of angiotensin converting enzyme (ACE) (1) and of carbonic anhydrase (CA) (2,3) decrease intraocular pressure (IOP) in conscious rabbits. We asked whether ACE inhibition decreases IOP through effects on CA-dependent flow of aqueous humor (AH) and whether ACE inhibitors decrease other CA-dependent secretions. We show in anesthetized rabbits (a) that topical inhibitors of ACE decrease both IOP and AH flow as much as systemic inhibitors of CA; (b) that the maximal effects of ACE and CA inhibition are not additive, therefore these treatments may affect one or more components of a single system for fluid production; and that (c) ACE inhibitors do not work through inhibition of CA. Looking at other fluid production systems, we find (d) that cerebrospinal fluid (CSF) production is increased after ventriculocisternal perfusion with a potent ACE inhibitor and (e) that flow of pancreatic juice (PJ) is increased after systemic ACE inhibition.