Pharmacoanthropology: outline, problems, and the nature of case histories

Prerequisites for the evaluation of interethnic differences in response to drugs and toxicants are, first, the understanding of population characteristics in social and genetic terms, and second, the development and use of methods suitable for the pharmacological investigation of fair numbers of subjects. The term pharmacoanthropology is proposed to indicate an appreciation of the difficulties in assessing the causes of quantitative differences between populations, and to emphasize the medical and biological (rather than social or economical) nature of the enquiry. A few case histories are sketched to illustrate the scope of the subject. The classical cases of balanced polymorphism include, for instance, acetylation polymorphism, glucose-6-phosphate dehydrogenase deficiency, and sickle cell anemia. Interethnic differences in alcohol response exemplify a consequence of gross but unexplained differences in gene frequencies for two enzymes, i.e., alcohol and aldehyde dehydrogenases. There may be incidental associations of drug response with blood groups, HLA types, or other traits that differ between populations. Interethnic differences in the predominant nature of essential hypertension appear to illustrate an interaction between diet and genetic constitution, and the resulting patterns of pathology may cause differences in drug response. Clarification of scope and nature of interethnic differences will require many future investigations.