The Genetics of Lithium Metabolism in Major Affective Disorders
Various kinetic processes are involved in the fate of a drug from its absorption to its binding to plasma proteins or to various tissues, its biotransformation and interaction with receptor sites, and finally to its excretion. These five major processes take place simultaneously, and genetically transmitted variations can occur through DNA mutations inducing structural alterations in the specific proteins directly involved in these five processes. In a given person, more than one pharmacologically significant mutation can arise and such mutations may not be so rare, as illustrated by phenomena responsible for genetic polymorphisms such as the ABO or the HLA, the pseudocholinesterase and the INH-acetyltransferase polymorphisms. The unimodal gaussian curve indicates genetic homogeneity or polygenic control, while the bimodal (mendelian autosomal dominant trait) or polymodal curve (autosomal recessive) are suggestive of a mechanism controlled by genes at a single locus.
KeywordsTwin Pair Twin Study Bipolar Patient Bipolar Illness Affective Illness
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