Greenfield S M, Punchard N A, Teare J P, Thompson R P
Gastrointestinal Laboratory, Rayne Institute, St Thomas' Hospital, London, UK.
Aliment Pharmacol Ther. 1993 Aug;7(4):369-83. doi: 10.1111/j.1365-2036.1993.tb00110.x.
Sulphasalazine and other 5-aminosalicylic acid (5-ASA)-containing drugs are used in the treatment of acute inflammatory bowel disease and in the maintenance of clinical remission. Despite their use for over 50 years, the mechanism of action of this class of drugs remains uncertain, although a number of possibilities are discussed in this review. It seems likely that the aminosalicylates are important free radical scavengers, can reduce leukotriene production and can inhibit the cellular release of interleukin-1, all of which are likely to be important in reducing the acute inflammatory response in inflammatory bowel disease. The effects of these drugs on prostaglandin production are more contentious, but it appears that 10(-5) to 10(-4) M concentrations stimulate production of prostaglandins which may be cytoprotective, while higher doses of these drugs inhibit prostaglandin production. The aminosalicylates may maintain remission in inflammatory bowel disease by preventing leucocyte recruitment into the bowel wall. The drugs inhibit the chemotactic response to leukotriene B4, reduce the synthesis of platelet activating factor and also inhibit leucocyte adhesion molecule upregulation.
柳氮磺胺吡啶及其他含5-氨基水杨酸（5-ASA）的药物用于治疗急性炎症性肠病及维持临床缓解。尽管这类药物已使用了50多年，但其作用机制仍不明确，不过本综述讨论了多种可能性。氨基水杨酸类药物似乎是重要的自由基清除剂，可减少白三烯生成，并能抑制白细胞介素-1的细胞释放，所有这些在减轻炎症性肠病的急性炎症反应中可能都很重要。这些药物对前列腺素生成的影响更具争议性，但似乎10⁻⁵至10⁻⁴M的浓度会刺激可能具有细胞保护作用的前列腺素生成，而更高剂量的这些药物则会抑制前列腺素生成。氨基水杨酸类药物可能通过阻止白细胞募集到肠壁中来维持炎症性肠病的缓解。这些药物抑制对白三烯B4的趋化反应，减少血小板活化因子的合成，还抑制白细胞黏附分子上调。
