Effect of long-term therapy with sulphasalazine, levamisole, corticosteroids and ascorbic acid and of disease activity on polymorphonuclear leukocyte function in patients with ulcerative colitis.

Adhesion, random migration and chemotactic migration, phagocytosis, and spontaneous nitroblue tetrazolium-dye reduction (NBT) capacity of polymorphonuclear leukocytes (PMNs) were analysed in 38 patients with ulcerative colitis before and during therapy with sulphasalazine (12 months), corticosteroids (6 months), levamisole (12 months), ascorbic acid (6 months) and sulphasalazine plus levamisole (12 months). Remission was achieved by levamisole in as many patients as by sulphasalazine and by sulphasalazine and levamisole used together. Nevertheless, the only function of PMNs affected by levamisole therapy was a depression of chemotaxis, whereas other functions as well as chemotaxis were altered by sulphasalazine, whether used alone or in combination with levamisole. Of patients treated with corticosteroids, all were in remission at 6 months and the most marked decrease in chemotaxis was seen. No clinical benefits were observed after 6 months of treatment with ascorbic acid and PMNs function was unaltered. The depression of chemotaxis occurred whether or not remission was achieved, suggesting a direct drug-induced effect. The apparent discrepancies of the "in vivo" drug effects in comparison with previously reported findings may reflect abnormal reactivity of PMNs in UC.