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echo: grand_rounds
to: ALL
from: KURT ULLMAN
date: 1996-09-25 08:04:00
subject: Alcoholic Liver Disease

(c) copyright 1996, Kurt Ullman
Q: I have a relative who is an alcoholic. Is there a hereditary link and can 
I be tested to see if I am at greater risk for alcoholism?
A:. By studying the incidence of alcoholism in families,  doctors have firmly 
established a genetic link to the risk of having drinking problems. However, 
currently there is no way to tell if a specific person in a family  is at 
risk.
	"Children of alcoholics are intensely concerned about their own risk 
for alcoholism and the possibility they will pass this along to their 
children," says David Crabb.M.D., a specialist in alcoholism at the Indiana 
University Medical Center. "We can't yet test someone and say they  have a 
higher or lower than average risk. Moreover, only about half of the risk  of 
alcoholism is genetically linked. Environmental factors are still important 
and effect everyone."
	Further complicating the issue is the feeling among researchers that 
several genes, although probably less than ten, are involved. This means that 
identification of all the genes, what they do in the body  and how they 
interact may be needed before the genetic link of alcoholism can be fully 
explained.
	According to Dr. Crabb there are three main thrusts to research into 
the genetic component of the disease. First is identifying those at genetic 
risk so counseling can begin early and possibly avoid problem drinking 
entirely. The second track will be to find drugs or other methods to 
interfere with the actions of the bad genes. Finally, and a long way down the 
road, is to find ways to actually change the gene so it functions 
differently.
	"We are a major participant in a long-term study in this area," notes 
Dr. Crabb. "Large numbers of families with many alcoholics have been 
identified.  Now we are trying to find gene markers that are inherited along 
with the tendency toward alcoholism."
 
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