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"Sulfasalazine is an immunomodulator used to treat Inflammatory bowel disease, rheumatoid arthritis, psoriatic arthritis and peripheral spondyloarthropathy. There are two main types of Inflammatory bowel disease: ulcerative colitis which involves superficial inflammation of rectosigmoid area and progresses proximally, and there is Crohn's disease which transmural inflammation involving the ileocaecal region and can affect anywhere along the gastrointestinal tract in patches. Sulfasalazine (SSZ) is a prodrug composed of 5-aminosalicylic acid (5-ASA) linked to sulfapyridine through an azo bond. Linkade minimizes absorption of the drug in the upper GIT. In the colon, however, bacteria break the azo bond and free both sulfapyridine and 5 aminosalicylic acid. In IBD and other rheumatological conditions arachidonic acid formed from cel membranes of cells is converted to prostaglandins and leukotrienes via enzymes cyclooxygenase and LOX. Prostaglandins and leukotrienes essentially promote inflammation. In damaged or inflamed cells the transcription factors NFkB also become active producing inflammatory procytoines such as TNFa and IL1."
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