The impact of genetics on Crohn's disease

Reports focusing on the familiarity and "pedigree" of patients with Crohn's Disease (CD) are increasing. The study of the role of genetics as a predisposing factor in providing the ideal milieu upon which environmental agents and immuno-inflammatory responses may act, could be paramount in finding the pith of the etiopathogenesis of this disease.

In order to determine the impact of familiarity on CD, a series of 187 patients, managed between January 1965 and January 1997, was subdivided into two groups. In group I (145 pts.), the family history relied only on direct information from the patient, while in group II (42 pts.) a prospective study was carried out involving both close and distant relatives who were interviewed and, in some cases, clinically investigated.

In this study, relatives with suspected CD were 9 out of 122 in group I patients (7.4%), while in the more detailed assessment of group II, 18 out of 42 cases (43%) had an ascertained CD familiarity.

The importance of familiarity in the pathogenesis of CD may be higher than expected if properly sought for. Reports on the possibility that the onset of CD may be strongly influenced by genetics, favor our hypothesis that the true etiology may find its base in a hemolymphatic disorder of the mesentery followed by superimposed inflammatory responses.