Current consensus holds that the pathogenesis of Crohn's disease involves the interacting elements of multigenic host susceptibility factors and environmental priming from the enteric microflora.1 2 Tissue damage is mediated by the immune system, although the contributory mechanisms are still unclear, and may be multiple or varied in different individuals. In addition, many immunological alterations in patients with Crohn's disease seem to have no direct role in mediating tissue injury and are frequently dismissed as epiphenomena. The history of medical discovery is replete with examples of overlooked clues hitherto dismissed as unimportant. Could some of the antibody markers in Crohn's disease yet provide useful clues to disease aetiology and pathogenesis? Could some of these phenomena be manifestations of the linkage across genetic, immunological and environmental contributions to aetiopathogenesis?

Marker antibodies have attracted considerable attention as putative manifestations of the disease related immune response in inflammatory bowel disease.3 The relative specificity of some of these antibodies for either Crohn's disease …