I've read some journals about cotrimoxazole and its immunomodulatory properties via the inhibition of folic acid formation, therefore cotrimoxazole may lower the level of inflammation indirectly.
But does cotrimoxazole actually have a direct effect on the production of inflammatory cytokines?
Cotrimoxazole used for treatment for rheumatoid arthritis one of the severe inflammatory disease. Several lines of evidence suggested that CTX has nonspecific anti-inflammatory and immunomodulatory properties. Although nausea and vomiting were common reasons for CTX withdrawal, they were noted in only some studies, and no major organ toxicity was observed.
From a clinical point of view TMS should have some anti-iniflammatory effects since it proved to be effective in localized forms of Wegener's granulomatosis (granulomatous polyangiitis). See attached paper. However it's anti-inflammatory effect is not pronounced.
I looked at the anti-inflammatory properties of cotrimoxazole in the past and although trimethoprim does have some activity, sulfamethoxazole had none. The effects I observed made the study not worth pursuing.
Actually my research is about cotrimoxazole's recent effectiveness in infectious disease. I found out that there's decline in proinflammatory cytokine's level in some groups treated with cotrimoxazole in vivo,
I find it difficult to distinguish whether the decline is because of cotrimoxazole's anti-inflammatory properties or because of its bacteriostatic effect (which indirectly lowers the proinflammatory cytokine's level).
According to your information I assume that cotrimoxazole indeed has antiinflammatory properties.
Very good question; it prevents relapse of gpa vasculitis probably by inhibiting growth of staph in nasal mucosa thus preventing superantigens from triggerring vasculitis relapse. All sulphas are immunomodulatory too in autoimmune rheumatic diseases, hence its not antibacterial action alone.
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