Cytokines and mechanisms of action of glucocorticoids and aminosalicylates in the treatment of ulcerative colitis and Crohn's disease.

Medical therapy of ulcerative colitis and Crohn's disease involves the control of active inflammation to obtain clinical remission and then maintaining that remission. Corticosteroids and 5-aminosalicylic acid are the mainstay of such management. Both have a wide range of properties and are able to inhibit many effector mechanisms which are potentially involved in mucosal inflammation. In in vitro assays, both are able to inhibit the release of a wide variety of pro-inflammatory and immunoregulatory cytokines. In vivo, such effects would limit tissue damage, prevent further amplification of the immune response and restore epithelial function.