Editorial

Dear Colleagues,

In the Arab World, genetic diseases represent a major public health problem. Several factors contribute to the wide prevalence of genetic disorders in the region including the high rate of consanguinity, social trend to have more children until menopause, selective factors favoring inherited disease characters like thalassemia and glucose-6-phosphate dehydrogenase deficiency, and the lack of public awareness towards the early recognition and prevention of inherited disease. The vision of H.H. Sheikh Hamdan Bin Rashid Al Maktoum to alleviate human suffering from genetic diseases in the Arab World crystallized in the establishment of the Centre for Arab Genomic Studies (CAGS) to characterize and prevent genetic disorders and transfigure the future practice of health care in the region.

Recently, CAGS initiated the ambitious project to establish a comprehensive "Catalogue for Transmission Genetics in Arabs" (CTGA) with the aim to enlighten the scientific community and the public on the occurrence of inherited disorders in Arabs and to suggest future investigation strategies. The available resources, capable people, and the will to attain this objective have led to the realization of a successful model of the CTGA database in the United Arab Emirates. This achievement encouraged CAGS to call for an active cooperation among national and international expertise in the health domain to initiate multidisciplinary collaborative research lines aiming at the identification, elucidation, and prevention of genetic diseases in the Arab World.

The present issue of the CAGS Newsletter marks the beginning of a new service that CAGS will offer on a bi-monthly basis to the international scientific community. Similar to how data in the CTGA database is increasing as a result of a collective and concerted activity of many scientists in the Arab World, we also call colleagues working on health-related aspects to contribute to future issues of the CAGS Newsletter. We welcome your comments on the content of the present and future issues of the CAGS Newsletter as well as your contributions to any of the sections of the newsletter with information that might be beyond our reach or you feel is a priority to address to the scientific community in the Arab World. We also hope that you propagate our word by forwarding this newsletter to your colleagues and friends.

Genetic Disorders in the Arab World

Breast Cancer

Breast cancer (referring to mammary carcinoma, not mammary sarcoma) is an extremely common malignancy, affecting one in eight women during their lifetime. In fact, in women, 32% of all cancers arise in the breast, but they only account for 18% of cancer deaths. Designating an individual as high risk for breast cancer depends primarily on a positive family history and, probably, on ethnic origin.

Literature on the genetic predisposition of breast cancer is limited in Arab women. However, it is well known that Arab women tend to develop breast cancer at least a decade earlier than their counterparts in Western countries. Due to social customs, many Arab women do not present themselves for regular medical examination and this usually results in late presentations, scanty epidemiological data, and insufficient clinico-pathological studies.

Breast cancer is histopathologically and almost certainly etiologically and genetically heterogeneous. The histology of breast cancers in women predisposed by reason of carrying BRCA1 and BRCA2 mutations differs from that in sporadic cases. Inherited cases of breast cancer have been associated with a variety of genes such as: BRCA1, BRCA2, BRCATA, BRCA3, BWSCR1A, TP53, BRIP1, RB1CC1, PTEN, and STK11 genes. However, a high percentage of hereditary breast cancers usually contain mutations in the BRCA1 and BRCA2 genes. The "Catalogue for Transmission Genetics in Arabs" (CTGA) currently reports on the occurence of breast cancer in Jordan and the United Arab Emirates. As for mutations in the BRCA1 or BRCA2 genes, CTGA indicates the presence of studies on samples from a variety of Arab countries such as: Egypt, Iraq, Jordan, Morocco, Palestine, Saudi Arabia, Syria, Tunisia, the United Arab Emirates, and Yemen.

Interview Prof. Najib Al Khaja

Secretary General, Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences

President, Centre for Arab Genomic Studies

CAGS

Now that CAGS completed the collection of data on genetic disorders in the UAE, what is the next step?

There are many steps to achieve. First, data collection will start soon in those Arab countries that expressed their wishes to join their efforts with CAGS. Countries like Bahrain, Saudi Arabia, Lebanon, and Egypt are strong candidates, whereas the doors are always open to cooperate with researchers in other Arab countries too. Second, the data that we are collecting will be maintained by continuously updating the information as progress is achieved in genetic research in the Arab World.

How will you coordinate data collection from other Arab countries?

We can do that by collaborating with scientists and decision makers in the corresponding countries. These individuals will then form the core of a Regional Advisory Board for CAGS as a step to offer our services to the Arab World.

Besides data collection, what will be the contribution of CAGS to research on genetic disorders in the Arab World?

Although CAGS does not have its proper research laboratories, we already started a linkage analysis project to depict the genetic basis of a rare skeletal dysplasia in a family from the UAE with collaborating centers. The project is completely funded by Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences and we hope to see more projects running under the name of CAGS.

Is the support given by Sheikh Hamdan Award for Medical Sciences only limited to research in the UAE?

Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences is the only private body in the UAE that offers research grants to promote scientific research in the country. Research grants are, thus, offered to those projects solely conducted in the UAE. At present, the Award is supporting 36 medical research projects in the UAE and we hope to be able to support more groups in the future.

Can you please explain to our readers the relationship between Sh. Hamdan Award for Medical Sciences and CAGS?

Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences was established in 1999 with a view to honor researchers from every part of the world who tirelessly pursue distinctive medical research serving the larger concerns of humanity. While the interest of the award encompasses all branches of medicine, CAGS, established in year 2003, constitutes the division of the award that focuses on aspects of genetic research in the Arab World.

Arab Medical Institutions

Faculty of Medicine, American University of Beirut, Lebanon

The American University of Beirut (AUB) is a private, non-sectarian institution of higher learning founded in 1866 in Lebanon. The Faculty of Medicine at AUB aims at providing optimum, advanced, state of the art, comprehensive, timely, and cost effective medical education. The faculty also strives for improved student performance and career opportunities, as well as improved basic and clinical research, more effective patient management, and new and innovative medical approaches. Although the primary function of the faculty is to give students basic training in medicine, the faculty also offers a number of special undergraduate and postdoctoral programmes including an MS (Basic Science) - MD combined programme, and MS (Basic Science) - Ph.D. (Basic Science) - MD combined programe, internship, residency, and fellowship training programmes.

The Faculty of Medicine at AUB consists of 420 bed hospital, providing all medical, surgical, pediatrics, OBS/GYN and psychiatry specialties. The center offers comprehensive healthcare services, extensive tertiary resources, and medical, nursing and paramedical training. The center adheres to the standards of the joint commission on acreditation to hospitals in the United States. In 2002, the Faculty of Medicine at AUB received the Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences as the best medical institution in the Arab World.

www.aub.edu.lb

Arab Medical Journals

Saudi Medical Journal

The Saudi Medical Journal is a peer-reviewed publication that was launched in July 1979. In 1999, it became monthly with a steady growth in manuscripts submitted and number of pages published. Since then the journal size was increased and the rate of submission from out-of-the Kingdom of Saudi Arabia increased considerably reaching 49%. The rejection rate of original articles is approximately 35%, which gives an indication to the high quality requirements necessary for publishing in the Journal.

The Saudi Medical Journal has a wide spectrum of coverage reporting original work, epidemiology, public health, indigenous disease and standards of health care from all parts of the globe. There are also sections for Case Reports, Letters to the Editor, Correspondence and medical news items. Since its inauguration, the Saudi Medical Journal has evolved as one of the leading scientific educational journals in the region. The journal is indexed by Index Medicus, Excerpta Medica, Current Contents and the Science Citation Index. In 2000, Saudi Medical Journal was recognized by the National Library of Medicine and indexed in MEDLINE and PubMed.

After 25 years of excellence, the Journal has an international faculty, not only from the Kingdom of Saudi Arabia but also from all countries in our Region and beyond including Jordan, Lebanon, Iran, Pakistan, Qatar, Syria, Turkey, Europe and North America. The Saudi Medical Journal is not only a basin for publication of manuscripts on medical research, but also in society education by publishing Arabic issues.

www.smj.org.sa

Arab Paper Reviews

Localization of Friedreich ataxia phenotype with selective vitamin E deficiency to chromosome 8q by homozygosity mapping

Nature Genetics. 1993 Oct; 5(2):107-8.

Authors: Ben Hamida et al.

Address: Laboratoire de Neurobiologie, Moleculaire et de Neuropathologie, Institut National de Neurologie, La Rabta, Tunis, Tunisia.

Friedreich ataxia and ataxia with selective vitamin E deficiency (AVED) share very similar clinical phenotypes. Ben Hamida et al. mapped the AVED locus to proximal 8q with only three large consanguinous Tunisian families, representing to their knowledge the first use of homozygosity mapping for primary linkage analysis. Subsequently, three additional families showed linkage with the same markers. A maximum lod score of 17.9 was obtained at theta = 0 for the haplotype D8S260-D8S510, consisting of the two closest markers. With only 6 families, the AVED locus is therefore mapped precisely as illustrated by the lod-1 confidence interval of 2.4 cM on either side of D8S260-D8S510. Isolation of a yeast artificial chromosome contig > 800 kilobases (kb) showed that D8S260 and D8S510 are less than 400 kb apart.

Arab Health Websites

Palestinian Health Information Center

This is a public website service of the Ministry of Health of the State of Palestine. It is an extensive portal in English and Arabic on many health-related aspects in Palestine. The website offers information on the epidemiology of diseases in Palestine, status of HIV/AIDS, woman health, health education, mental health, school health, blood banks, pharmacies, health research, and health projects. The portal also offers a variety of statistics such as mortality statistics as well as an important cancer registry. In addition, the website offers a variety of publications including an extensive report on the "Health Status in Palestine", a "Palestinian Health Data Dictionary", and the "Palestinian Guideline for Diagnosis and Management of Non-Communicable Diseases" and others. The website has an elaborate search engine. The Arabic version of the website is as extensive as the English version and presents almost similar services and content.

www.moh.gov.ps