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El-Gowilly SM, Metwaly HA, Makhlouf D, Elmansoury N, Abuiessa SA, Sorour AA, Abdelgalil MH, Fawaz M, Abushady AM, Gamaleldin M, Abdelghany TM, Fakhoury R, Abdelhady R, Ghanim AMH, Shehata S, Kamal M, Bahy R, Haroon SA, Manolopoulos VG, Cascorbi I, Daly A, Abdelkader NF, El Shamieh S, Nagy M, Wahid A. Analysis of the current situation of pharmacogenomics in terms of educational and healthcare needs in Egypt and Lebanon. Pharmacogenomics 2024; 25:429-440. [PMID: 39382016 PMCID: PMC11492645 DOI: 10.1080/14622416.2024.2403967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 09/10/2024] [Indexed: 10/10/2024] Open
Abstract
Pharmacogenomics (PGx) is a practice that investigates the link between genetic differences and drug response in patients. This can improve treatment effectiveness and reduce harmful side effects. However, has yet to be adequately realized in developing nations. Three surveys were conducted between November 2022 to March 2023 in Egypt and Lebanon. The first survey assessed availability of PGx testing in different healthcare facilities; the second one assessed knowledge, interest and attitude toward learning about PGx among pharmacists and physicians; and the third one assessed interest in providing PGx education at academic levels. In Egypt, a few of the surveyed healthcare facilities are conducting some form of pharmacogenetic testing. In Lebanon, very few germline pharmacogenomic tests are offered in Greater Beirut's leading hospitals, and no other testing was recorded. PGx education attracts considerable interest, with 34.3% of pharmacists very interested and 48.8% interested. Similarly, 24.8% of total physicians were very interested while 44.8% were interested. Academic professionals in the surveyed institutions in both countries agreed on the need for educational programs in PGx and 78.2% agreed that there were good opportunities for implementing PGx testing. These findings clearly indicate the need to develop and implement educational programs in PGx in the Middle-East.
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Affiliation(s)
- Sahar M El-Gowilly
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
| | - Heba A Metwaly
- Department of Biochemistry, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
| | - Dalia Makhlouf
- Department of Pharmaceutical Services, Children's Cancer Hospital Egypt57357, Cairo, Egypt
- Personalized Medication Management Unit, Children's Cancer Hospital Egypt57357, Cairo, Egypt
| | - Nehal Elmansoury
- Department of Biochemistry, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
| | - Salwa A Abuiessa
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
| | - Amani A Sorour
- Department of Biochemistry, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
| | | | - Mirna Fawaz
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut11-5020, Lebanon
| | - Asmaa M Abushady
- School of Biotechnology, Nile University, Giza, Egypt
- Genetic Department, Faculty of Agriculture, Ain Shams University, Cairo, Egypt
| | | | - Tarek M Abdelghany
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo, 11562, Egypt
- School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, Scotland, U.K
- School of Biomedical, Nutritional & Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon TyneNE24HH, United Kingdom
| | - Rajaa Fakhoury
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut11-5020, Lebanon
| | - Rasha Abdelhady
- Pharmacology & Toxicology Department, Faculty of Pharmacy, Fayoum University, Fayoum, 63514, Egypt
| | - Amal MH Ghanim
- Biochemistry department, Faculty of Pharmacy, Fayoum University, Fayoum, 63514, Egypt
| | - Samah Shehata
- Biochemistry department, Faculty of Pharmacy, Fayoum University, Fayoum, 63514, Egypt
| | - Marwa Kamal
- Clinical pharmacy department, Faculty of Pharmacy, Fayoum University, Fayoum, 63514, Egypt
| | - Rehab Bahy
- Microbiology & Immunology Department, Faculty of Pharmacy, Fayoum University, Fayoum, 63514, Egypt
| | - Sanaa A Haroon
- Plant protection department, Faculty of Agriculture, Fayoum University, Fayoum, 63514, Egypt
| | - Vangelis G Manolopoulos
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Dragana Campus, 68100, Alexandroupolis, Greece
| | - Ingolf Cascorbi
- Institute of Experimental & Clinical Pharmacology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Ann Daly
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Noha F Abdelkader
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo, 11562, Egypt
| | - Said El Shamieh
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut11-5020, Lebanon
| | - Mohamed Nagy
- Department of Pharmaceutical Services, Children's Cancer Hospital Egypt57357, Cairo, Egypt
- Personalized Medication Management Unit, Children's Cancer Hospital Egypt57357, Cairo, Egypt
| | - Ahmed Wahid
- Department of Biochemistry, Faculty of Pharmacy, Alexandria University, Alexandria, 21500, Egypt
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Chidiac L, Yazbeck H, Mahfouz R, Zgheib NK. Pharmacogenomics in Lebanon: current status, challenges and opportunities. THE PHARMACOGENOMICS JOURNAL 2024; 24:16. [PMID: 38778046 DOI: 10.1038/s41397-024-00336-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
Pharmacogenomics (PGx) research and applications are of utmost relevance in Lebanon considering its population genetic diversity. Moreover, as a country with regional leadership in medicine and higher education, Lebanon holds a strong potential in contributing to PGx research and clinical implementation. In this manuscript, we first review and evaluate the available PGx research conducted in Lebanon, then describe the current status of PGx practice in Lebanon while reflecting on the local and regional challenges, and highlighting areas for action, and opportunities to move forward. We specifically expand on the status of PGx at the American University of Beirut Faculty of Medicine and Medical Center as a case study and guide for the further development of local and regional comprehensive PGx research, teaching, and clinical implementation programs. We also delve into the status of PGx knowledge and education, and prospects for further advancement such as with online courses and certificates.
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Affiliation(s)
- Lorenzo Chidiac
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hady Yazbeck
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rami Mahfouz
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nathalie K Zgheib
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
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Hao C, Ma X, Wang L, Zhang W, Hu J, Huang J, Yang W. Predicting the presence and mechanism of busulfan drug-drug interactions in hematopoietic stem cell transplantation using pharmacokinetic interaction network-based molecular structure similarity and network pharmacology. Eur J Clin Pharmacol 2020; 77:595-605. [PMID: 33179758 DOI: 10.1007/s00228-020-03034-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/30/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE This study aimed to predict the presence and mechanism of busulfan drug-drug interactions (DDIs) in hematopoietic stem cell transplantation (HSCT) using pharmacokinetic interaction (PKI) network-based molecular structure similarity and network pharmacology. METHODS Logistic function models were established to predict busulfan DDIs based on the assumption that an approved drug tends to interact with the drug used in HSCT (DH) if structurally similar to the drugs in the PKI network of the DH. The PKI network of the DH represented the association between drugs and the proteins related to the PK of the DH. The most appropriate model was applied to predict busulfan DDIs in HSCT. Candidate targets for busulfan DDIs and their interacting were identified by network pharmacology. RESULTS Six of the top ten predicted busulfan DDIs were clinically relevant and involved voriconazole, fludarabine, itraconazole, cyclophosphamide, metronidazole, and melphalan. Candidate targets for these DDIs were CYP450s (3A4, 2B6, 2C9, and 2C19), GSTs (GSTA1, GSTP1, GSTT1, and GSTM1), and ABC transporters (ABCB1, ABCC1, ABCC2, and ABCC3), in the targets of drug-induced liver injury (DILI). The networks of interacting proteins and candidate targets indicated the regulatory potential of pregnane X receptor (PXR), as a nuclear receptor. Enrichment analysis showed the metabolism of drugs and xenobiotics, glutathione metabolism, and bile secretion associated with busulfan DDIs and DILI. CONCLUSIONS This study has successfully predicted busulfan DDIs in HSCT through PKI-based molecular structure similarity. The mechanism of busulfan DDI and DILI was attributed mostly to CYP450s, GSTs, and ABC transporters, and PXR was identified as a potential target.
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Affiliation(s)
- Chenxia Hao
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoqin Ma
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lining Wang
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weixia Zhang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiong Hu
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Huang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanhua Yang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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