International Journal of Clinical Case Reports 2024, Vol.14, No.1, 55-62 http://medscipublisher.com/index.php/ijccr 58 and excretion of toxic substances in the body. GST gene polymorphisms are associated with the exposure and metabolism of certain environmental toxins and drugs. In addition to the aforementioned families, there are other metabolic enzymes and related genes such as acyl-CoA oxidase, alcohol dehydrogenase, renal transport proteins, etc. These also exhibit genetic polymorphisms that can influence drug metabolism and an individual's response to medications. 2 Genetic Polymorphism and Its Association with Drug Metabolism 2.1 Relationship between genotype and drug metabolism capacity There is a close association between genotype and drug metabolism capacity, as an individual's genetic makeup can influence the activity and efficacy of their drug-metabolizing enzymes. This relationship is crucial for understanding individual responses to medications, formulating personalized treatment plans, and predicting the rate of drug metabolism. Each individual's genome contains genes encoding drug-metabolizing enzymes. Variations in genotype among different individuals result in distinct alleles. These diverse alleles can influence the expression and activity of drug-metabolizing enzymes. Variations in alleles may lead to differences in the activity of drug-metabolizing enzymes (Figure 2). Some alleles may result in high enzyme activity, leading to faster drug metabolism, while others may lead to low enzyme activity, resulting in slower drug metabolism. Figure 2 Drug decomposition Individuals can be stratified into rapid metabolizers and slow metabolizers based on their genotypes. Rapid metabolizers typically carry highly active alleles, resulting in faster drug metabolism and clearance. In contrast, slow metabolizers usually possess low-activity alleles, leading to slower drug metabolism and higher drug concentrations in the body. Genotype directly influences an individual's metabolism rate for a specific drug. Rapid metabolizers may require higher drug doses to achieve therapeutic effects, while slow metabolizers may need lower doses. This stratification is crucial for developing personalized treatment plans. Variations in drug metabolism capacity may result in diverse responses to the same drug among individuals, affecting both therapeutic efficacy and toxicity reactions. Rapid metabolizers may achieve therapeutic effects more easily but are also more susceptible to drug toxicity. Conversely, slow metabolizers exhibit the opposite pattern. Genotype can also influence an individual's susceptibility to drug interactions. Certain drugs may alter the activity of metabolic enzymes, subsequently modifying the metabolism rates of other drugs, leading to potential drug interactions (Cagin et al., 2022). 2.2 Relationship between phenotypic polymorphism and drug response There is a close relationship between phenotypic polymorphism and drug response, as individual polymorphism variability can directly influence their responses to drugs. Phenotypic polymorphism refers to the differences among individuals in a population concerning specific traits or characteristics. These differences may encompass physiological features, metabolic capabilities, biochemical parameters, as well as susceptibility to diseases.
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