The impact of genetics on Crohn's Disease

BACKGROUND/AIMS: Reports focusing on the familiarity and "pedigree" of pati ents with Crohn's Disease (CD) are increasing. The study of the role of gen etics asa predisposing factor in providing the ideal milieu upon which envi ronmental agents and immune-inflammatory responses may act, could be paramo unt in finding the pith of the etiopathogenesis of this disease. METHODOLOGY: In order to determine the impact of familiarity on CD, a serie s of 187 patients, managed between January 1965 and January 1997, was subdi vided into two groups. In group I (145 pts.), the family history relied onl y on direct information from the patient, while in group II (42 pts.) a pro spective study was carried out involving both close and distant relatives w ho were interviewed and, in some cases, clinically investigated. RESULTS: In this study, relatives with suspected CD were 9 out of 122 in gr oup I patients (7.4%), while in the more detailed assessment of group II, 1 8 out of 42 cases (43%) had an ascertained CD familiarity. CONCLUSIONS: The importance of familiarity in the pathogenesis of CD may be higher than expected if properly sought for. Reports on the possibility th at; the onset of CD may be strongly influenced by genetics, favor our hypot hesis that the true etiology may find its base in a hemolymphatic disorder of the mesentery followed by superimposed inflammatory responses.