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Pharmacogenomics in Lebanon: current status, challenges and opportunities

The Pharmacogenomics Journal volume 24, Article number: 16 (2024) Cite this article

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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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Fig. 1: Description of the pharmacogenomic research landscape in Lebanon.
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Data are available in Supplementary Table 1.

References

  1. Kabbani D, Akika R, Wahid A, Daly AK, Cascorbi I, Zgheib NK. Pharmacogenomics in practice: a review and implementation guide. Front Pharm. 2023;14:1189976.

    Article  CAS  Google Scholar 

  2. Bartlett G, Antoun J, Zgheib NK. Theranostics in primary care: pharmacogenomics tests and beyond. Expert Rev Mol Diagn. 2012;12:841–55.

    Article  CAS  PubMed  Google Scholar 

  3. Zgheib NK, Patrinos GP, Akika R, Mahfouz R. Precision Medicine in Low- and Middle-Income Countries. Clin Pharm Ther. 2020;107:29–32.

    Article  Google Scholar 

  4. El Shamieh S, Zgheib NK. Pharmacogenetics in developing countries and low resource environments. Hum Genet. 2022;141:1159–64.

    Article  PubMed  Google Scholar 

  5. Abou Diwan E, Zeitoun RI, Abou Haidar L, Cascorbi I. and N. Khoueiry Zgheib, Implementation and obstacles of pharmacogenetics in clinical practice: An international survey. Br J Clin Pharmacol. 2019;85:2076–88.

  6. Ghaddar F, Cascorbi I, Zgheib NK. Clinical implementation of pharmacogenetics: a nonrepresentative explorative survey to participants of WorldPharma 2010. Pharmacogenomics. 2011;12:1051–9.

    Article  PubMed  Google Scholar 

  7. Ghaddar F, Saba K, Zgheib NK. Teaching Pharmacogenetics in Low and Middle Income Countries (LMICs): An Empirical Study of the Lessons Learned. Curr Pharmacogenomics Personalized Med. 2012;10:217–25.

    Article  CAS  Google Scholar 

  8. Khattab M, Baguneid M, Ali BR, Sadek B, Beiram R, Atallah B, et al. A review of pharmacogenomics studies assessing the knowledge and attitudes of physicians and pharmacists across the Arab and Middle Eastern Region. Pharm Pract. 2023;21:01–12.

    Google Scholar 

  9. Britannica, T.E.o.E. Lebanon summary. 2021. https://www.britannica.com/summary/Lebanon.

  10. Bank, T.W. Lebanon Overview: Development news, research, data. 2022. https://www.worldbank.org/en/country/lebanon/overview.

  11. Bou Sanayeh E, El Chamieh C. The fragile healthcare system in Lebanon: sounding the alarm about its possible collapse. Health Econ Rev. 2023;13:21.

    Article  PubMed  PubMed Central  Google Scholar 

  12. El Achi N, Honein-Abouhaidar G, Rizk A, Kobeissi E, Papamichail A, Meagher K, et al. Assessing the capacity for conflict and health research in Lebanon: a qualitative study. Confl Health. 2020;14:59.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tadmouri GO, Mandil A, Rashidian A. Biomedical and health research geography in the Eastern Mediterranean Region. East Mediterr Health J. 2019;25:728–43.

    Article  PubMed  Google Scholar 

  14. Dagher M, Bilani N, Zgheib N. Precision Genetic and Genomic Research in Lebanon: How Can We Move Forward? Le Journal médical libanais. Leban Med J. 2018;66:35–40.

    Article  Google Scholar 

  15. Kattan J, Karak FE, Farhat F, Gerges DA, Mokaddem W, Chahine G, et al. Prevalence of Her2-neu status and its clinicopathological association in newly diagnosed gastric cancer patients. BMC Cancer. 2022;22:1114.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Khansa S, Hoteit R, Shammaa D, Khalek RA, El Halas H, Greige L, et al. HLA Class I allele frequencies in the Lebanese population. Gene. 2013;512:560–5.

    Article  CAS  PubMed  Google Scholar 

  17. Awada Z, Haider S, Tfayli A, Bazarbachi A, El-Saghir NS, Salem Z, et al. Pharmacogenomics variation in drug metabolizing enzymes and transporters in relation to docetaxel toxicity in Lebanese breast cancer patients: paving the way for OMICs in low and middle income countries. Omics. 2013;17:353–67.

    Article  CAS  PubMed  Google Scholar 

  18. Haroun F, Al-Shaar L, Habib RH, El-Saghir N, Tfayli A, Bazarbachi A, et al. Effects of CYP2B6 genetic polymorphisms in patients receiving cyclophosphamide combination chemotherapy for breast cancer. Cancer Chemother Pharm. 2015;75:207–14.

    Article  CAS  Google Scholar 

  19. Saladores P, Mürdter T, Eccles D, Chowbay B, Zgheib NK, Winter S, et al. Tamoxifen metabolism predicts drug concentrations and outcome in premenopausal patients with early breast cancer. Pharmacogenomics J. 2015;15:84–94.

    Article  CAS  PubMed  Google Scholar 

  20. Schroth W, Winter S, Mürdter T, Schaeffeler E, Eccles D, Eccles B, et al. Improved Prediction of Endoxifen Metabolism by CYP2D6 Genotype in Breast Cancer Patients Treated with Tamoxifen. Front Pharm. 2017;8:582.

    Article  Google Scholar 

  21. Khor CC, Winter S, Sutiman N, Mürdter TE, Chen S, Lim JSL, et al. Cross-Ancestry Genome-Wide Association Study Defines the Extended CYP2D6 Locus as the Principal Genetic Determinant of Endoxifen Plasma Concentrations. Clin Pharm Ther. 2023;113:712–23.

    Article  CAS  Google Scholar 

  22. Mueller-Schoell A, Klopp-Schulze L, Schroth W, Mürdter T, Michelet R, Brauch H, et al. Obesity Alters Endoxifen Plasma Levels in Young Breast Cancer Patients: A Pharmacometric Simulation Approach. Clin Pharm Ther. 2020;108:661–70.

    Article  CAS  Google Scholar 

  23. Zgheib NK, Akika R, Mahfouz R, Aridi CA, Ghanem KM, Saab R, et al. NUDT15 and TPMT genetic polymorphisms are related to 6-mercaptopurine intolerance in children treated for acute lymphoblastic leukemia at the Children’s Cancer Center of Lebanon. Pediatr Blood Cancer. 2017;64:146–50.

    Article  CAS  PubMed  Google Scholar 

  24. Moradveisi B, Muwakkit S, Zamani F, Ghaderi E, Mohammadi E, Zgheib NK. ITPA, TPMT, and NUDT15 Genetic Polymorphisms Predict 6-Mercaptopurine Toxicity in Middle Eastern Children With Acute Lymphoblastic Leukemia. Front Pharm. 2019;10:916.

    Article  CAS  Google Scholar 

  25. Zgheib NK, Akra-Ismail M, Aridi C, Mahfouz R, Abboud MR, Solh H, et al. Genetic polymorphisms in candidate genes predict increased toxicity with methotrexate therapy in Lebanese children with acute lymphoblastic leukemia. Pharmacogenet Genomics. 2014;24:387–96.

    Article  CAS  PubMed  Google Scholar 

  26. Zgheib NK, Ghanem KM, Tamim H, Aridi C, Shahine R, Tarek N, et al. Genetic polymorphisms in candidate genes are not associated with increased vincristine-related peripheral neuropathy in Arab children treated for acute childhood leukemia: a single institution study. Pharmacogenet Genomics. 2018;28:189–95.

    Article  CAS  PubMed  Google Scholar 

  27. Zgheib NK, El-Khoury H, Maamari D, Basbous M, Saab R, Muwakkit SA. A GRIN3A polymorphism may be associated with glucocorticoid-induced symptomatic osteonecrosis in children with acute lymphoblastic leukemia. Per Med. 2021;18:431–9.

    Article  CAS  PubMed  Google Scholar 

  28. Darwish MH, Farah RA, Farhat GN, Torbey PH, Ghandour FA, Bejjani-Doueihy NA, et al. Association of CYP3A4/5 genotypes and expression with the survival of patients with neuroblastoma. Mol Med Rep. 2015;11:1462–8.

    Article  CAS  PubMed  Google Scholar 

  29. Mukherji D, Massih SA, Tfayli A, Kanso M, Faraj W. Three different polymorphisms of the DPYD gene associated with severe toxicity following administration of 5-FU: a case report. J Med Case Rep. 2019;13:76.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Zgheib NK, Alameddine R, Massoud R, Nasr R, Zahreddine A, El Cheikh J, et al. The role of candidate genetic polymorphisms in the interaction between voriconazole and cyclosporine in patients undergoing allogeneic hematopoietic cell transplantation: An explorative study. Curr Res Transl Med. 2020;68:51–58.

    Article  PubMed  Google Scholar 

  31. Hajj A, Halepian L, Osta NE, Chahine G, Kattan J, Rabbaa Khabbaz L. OPRM1 c.118 A > G Polymorphism and Duration of Morphine Treatment Associated with Morphine Doses and Quality-of-Life in Palliative Cancer Pain Settings. Int J Mol Sci. 2017;18:669.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Zgheib NK, Aouad MT, Taha SK, Nassar AH, Masri RF, Khoury MY, et al. μ-opioid receptor genetic polymorphisms and duration of epidural fentanyl analgesia during early labor. Minerva Anestesiol. 2018;84:946–54.

    Article  PubMed  Google Scholar 

  33. Saab Y, Nakad Z. A software tool to adjust codeine dose based on CYP2D6 gene-pair polymorphisms and drug-drug interactions. Pharmacogenomics J. 2023;23:217–24.

    Article  CAS  PubMed  Google Scholar 

  34. Hajj A, Peoc’h K, Laplanche JL, Jabbour H, Naccache N, Abou Zeid H, et al. Genotyping test with clinical factors: better management of acute postoperative pain? Int J Mol Sci. 2015;16:6298–311.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hajj A, Obeid S, Sahyoun S, Haddad C, Azar J, Rabbaa Khabbaz L, et al. Clinical and Genetic Factors Associated with Resistance to Treatment in Patients with Schizophrenia: A Case-Control Study. Int J Mol Sci. 2019;20:4753.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Hajj A, Hallit S, Chamoun K, Sacre H, Obeid S, Haddad C, et al. Negative symptoms in schizophrenia: correlation with clinical and genetic factors. Pharmacogenomics. 2021;22:389–99.

    Article  CAS  PubMed  Google Scholar 

  37. Hajj A, Hachem R, Khoury R, Hallit S, El JB, Nasr F, et al. Clinical and genetic factors associated with anxiety and depression in breast cancer patients: a cross-sectional study. BMC Cancer. 2021;21:872.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Hajj A, Hachem R, Khoury R, Nehme T, Hallit S, Nasr F, et al. Clinical and Genetic Factors Associated With the Breast Cancer-Related Sleep Disorders: The “CAGE-Sleep” Study-A Cross-Sectional Study. J Pain Symptom Manag. 2021;62:e46–e55.

    Article  Google Scholar 

  39. Hajj A, Chamoun R, Salameh P, Khoury R, Hachem R, Sacre H, et al. Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors. BMC Cancer. 2022;22:16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Esmerian MO, Mitri Z, Habbal MZ, Geryess E, Zaatari G, Alam S, et al. Influence of CYP2C9 and VKORC1 polymorphisms on warfarin and acenocoumarol in a sample of Lebanese people. J Clin Pharm. 2011;51:1418–28.

    Article  CAS  Google Scholar 

  41. Isma’eel HA, Sakr GE, Habib RH, Almedawar MM, Zgheib NK, Elhajj IH. Improved accuracy of anticoagulant dose prediction using a pharmacogenetic and artificial neural network-based method. Eur J Clin Pharm. 2014;70:265–73.

    Article  Google Scholar 

  42. El-Halabi MM, Zgheib N, Mansour NM, Malli A, Ghaith OA, Mahfouz R, et al. CYP2C19 genetic polymorphism, rabeprazole and esomeprazole have no effect on the antiplatelet action of clopidogrel. J Cardiovasc Pharm. 2013;62:41–9.

    Article  CAS  Google Scholar 

  43. Saab YB, Zeenny R, Ramadan WH. Optimizing clopidogrel dose response: a new clinical algorithm comprising CYP2C19 pharmacogenetics and drug interactions. Ther Clin Risk Manag. 2015;11:1421–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Platt DE, Ghassibe-Sabbagh M, Salameh P, Salloum AK, Haber M, Mouzaya F, et al. Caffeine Impact on Metabolic Syndrome Components Is Modulated by a CYP1A2 Variant. Ann Nutr Metab. 2016;68:1–11.

    Article  CAS  PubMed  Google Scholar 

  45. Naja K, Salami A, El Shamieh S, Fakhoury R. rs622342 in SLC22A1, CYP2C9*2 and CYP2C9*3 and Glycemic Response in Individuals with Type 2 Diabetes Mellitus Receiving Metformin/Sulfonylurea Combination Therapy: 6-Month Follow-Up Study. J Pers Med. 2020;10:53.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Naja K, El Shamieh S, Fakhoury R. rs622342A > C in SLC22A1 is associated with metformin pharmacokinetics and glycemic response. Drug Metab Pharmacokinet. 2020;35:160–4.

    Article  CAS  PubMed  Google Scholar 

  47. Hendi NN, Chakhtoura M, Al-Sarraj Y, Basha DS, Albagha O, Fuleihan GE, et al. The Genetic Architecture of Vitamin D Deficiency among an Elderly Lebanese Middle Eastern Population: An Exome-Wide Association Study. Nutrients. 2023;15:3216.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Milane A, Khazen G, Olaywan L, Zarzour F, Mohty R, Sarkis A, et al. Frequency of ABCB1 C3435T and CYP3A5*3 Genetic Polymorphisms in the Lebanese Population. Exp Clin Transpl. 2021;19:434–8.

    Article  Google Scholar 

  49. Zgheib NK, Mitri Z, Geryess E, Noutsi P. Cytochrome P4502E1 (CYP2E1) genetic polymorphisms in a Lebanese population: frequency distribution and association with morbid diseases. Genet Test Mol Biomark. 2010;14:393–7.

    Article  CAS  Google Scholar 

  50. Djaffar-Jureidini I, Chamseddine N, Keleshian S, Naoufal R, Zahed L, Hakime N. Pharmacogenetics of coumarin dosing: prevalence of CYP2C9 and VKORC1 polymorphisms in the Lebanese population. Genet Test Mol Biomark. 2011;15:827–30.

    Article  CAS  Google Scholar 

  51. Djaffar Jureidini I, Chamseddine N, Keleshian S, Naoufal R, Zahed L, Hakime N. Prevalence of CYP2C19 polymorphisms in the Lebanese population. Mol Biol Rep. 2011;38:5449–52.

    Article  CAS  PubMed  Google Scholar 

  52. Saade S, Mroueh M, Saab Y. Cytochrome P450 2D6 polymorphism in white Lebanese population. J Appl Res. 2006;6:89–97.

    CAS  Google Scholar 

  53. Auton A, Abecasis GR, Altshuler DM, Durbin RM, Abecasis GR, Bentley DR, et al. A global reference for human genetic variation. Nature. 2015;526:68–74.

    Article  PubMed  Google Scholar 

  54. Hajir S, Al Aaraj L, Zgheib N, Badr K, Ismaeel H, Abchee A, et al. The association of urinary metabolites of polycyclic aromatic hydrocarbons with obstructive coronary artery disease: A red alert for action. Environ Pollut. 2021;272:115967.

    Article  CAS  PubMed  Google Scholar 

  55. Awada Z, Cahais V, Cuenin C, Akika R, Silva Almeida Vicente AL, Makki M, et al. Waterpipe and cigarette epigenome analysis reveals markers implicated in addiction and smoking type inference. Environ Int. 2023;182:108260.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209–49.

    Article  PubMed  Google Scholar 

  57. Darazy M, Balbaa M, Mugharbil A, Saeed H, Sidani H, Abdel-Razzak Z. CYP1A1, CYP2E1, and GSTM1 gene polymorphisms and susceptibility to colorectal and gastric cancer among Lebanese. Genet Test Mol Biomark. 2011;15:423–9.

    Article  CAS  Google Scholar 

  58. Zgheib NK, Shamseddine AA, Geryess E, Tfayli A, Bazarbachi A, Salem Z, et al. Genetic polymorphisms of CYP2E1, GST, and NAT2 enzymes are not associated with risk of breast cancer in a sample of Lebanese women. Mutat Res. 2013;747-748:40–7.

    Article  CAS  PubMed  Google Scholar 

  59. Kobeissi LH, Yassine IA, Jabbour ME, Moussa MA, Dhaini HR. Urinary bladder cancer risk factors: a Lebanese case- control study. Asian Pac J Cancer Prev. 2013;14:3205–11.

    Article  PubMed  Google Scholar 

  60. Basma HA, Kobeissi LH, Jabbour ME, Moussa MA, Dhaini HR. CYP2E1 and NQO1 genotypes and bladder cancer risk in a Lebanese population. Int J Mol Epidemiol Genet. 2013;4:207–17.

    PubMed  PubMed Central  Google Scholar 

  61. Nasr R, Temraz S, Mukherji D, Shamseddine A, Akika R, Abbasi S, et al. Distribution and Role of N-acetyltransferase 2 Genetic Polymorphisms in Bladder Cancer Risk in a Lebanese Population. Asian Pac J Cancer Prev. 2017;18:2561–8.

    PubMed  PubMed Central  Google Scholar 

  62. El Kawak M, Dhaini HR, Jabbour ME, Moussa MA, El Asmar K, Aoun M. Slow N-acetylation as a possible contributor to bladder carcinogenesis. Mol Carcinog. 2020;59:1017–27.

    Article  CAS  PubMed  Google Scholar 

  63. Malhab SB, Hajj A, Lteif FHM, Salameh P, Khabbaz LR. Influence of genetic polymorphisms on waterpipe smoking phenotypes. Gene Rep. 2020;21:100899.

    Article  CAS  Google Scholar 

  64. Saad RK, Akiki VC, Rahme M, Ajjour S, Assaad M, Fuleihan GAEl-Hajj. Time trends and predictors of hypovitaminosis D across the life course: 2009-2016. Metabolism. 2020;105:154138.

    Article  CAS  PubMed  Google Scholar 

  65. Arabi A, Khoueiry-Zgheib N, Awada Z, Mahfouz R, Al-Shaar L, Hoteit M, et al. CYP2R1 polymorphisms are important modulators of circulating 25-hydroxyvitamin D levels in elderly females with vitamin insufficiency, but not of the response to vitamin D supplementation. Osteoporos Int. 2017;28:279–90.

    Article  CAS  PubMed  Google Scholar 

  66. Medlej-Hashim M, Jounblat R, Hamade A, Ibrahim JN, Rizk F, Azzi G, et al. Hypovitaminosis D in a Young Lebanese Population: Effect of GC Gene Polymorphisms on Vitamin D and Vitamin D Binding Protein Levels. Ann Hum Genet. 2015;79:394–401.

    Article  CAS  PubMed  Google Scholar 

  67. Arabi A, Zahed L, Mahfoud Z, El-Onsi L, Nabulsi M, Maalouf J, et al. Vitamin D receptor gene polymorphisms modulate the skeletal response to vitamin D supplementation in healthy girls. Bone. 2009;45:1091–7.

    Article  CAS  PubMed  Google Scholar 

  68. Nasreddine L, Naja F, Chamieh MC, Adra N, Sibai AM, Hwalla N. Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health. 2012;12:798.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Aoun C, Hajj A, Hajj F, Papazian T, Rabbaa Khabbaz L. The interaction between genetic polymorphisms in FTO, MC4R and MTHFR genes and adherence to the Mediterranean Diet in relation to obesity. Gene. 2022;809:146037.

    Article  CAS  PubMed  Google Scholar 

  70. Nasreddine L, Akika R, Mailhac A, Tamim H, Zgheib NK. The Interaction between Genetic Polymorphisms in FTO and TCF7L2 Genes and Dietary Intake with Regard to Body Mass and Composition: An Exploratory Study. J Pers Med. 2019;9:11.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Roco A, Nieto E, Suárez M, Rojo M, Bertoglia MP, Verón G, et al. A Pharmacogenetically Guided Acenocoumarol Dosing Algorithm for Chilean Patients: A Discovery Cohort Study. Front Pharm. 2020;11:325.

    Article  CAS  Google Scholar 

  72. Acenocoumarol Dosage Calculator Using Artificial Neural Networks. 2013. https://www.aub.edu.lb/fm/vmp/calc4/acenocoumarol_dosage_calculator.htm.

  73. Baba O, Bidikian A, Mukherji D, Shamseddin A, Temraz S, Fakhruddin N, et al. Tumor profiling of KRAS, BRAF, and NRAS gene mutations in patients with colorectal cancer: A Lebanese major center cohort study. Gene. 2022;834:146646.

    Article  CAS  PubMed  Google Scholar 

  74. Hamadeh LN, Farhat L, Hilal L, Assi H, Nasr F, Chahine G, et al. Frequency and mutational spectrum of PIK3CA gene mutations in breast cancer patients: Largest and first report from Lebanon. Gene. 2023;871:147433.

    Article  CAS  PubMed  Google Scholar 

  75. Khuri FR. The American University of Beirut Medical Center (AUBMC) officially receives its sixth reaccreditation from the Joint Commission International https://aubmc.org.lb/Pages/AUBMC-has-officially-received-its-6th-reaccreditation-from-JCI.aspx 2024.

  76. Administration, U.S.F.a.D. Table of Pharmacogenetic Associations. 2022. https://www.fda.gov/medical-devices/precision-medicine/table-pharmacogenetic-associations.

  77. Jelwan YA, Asbeutah AAA, Welty FK. Comprehensive Review of Cardiovascular Diseases, Diabetes, and Hypercholesterolemia in Lebanon. Cardiol Rev. 2020;28:73–83.

    Article  PubMed  Google Scholar 

  78. Organization, W.H. Global cancer burden growing, amidst mounting need for services. 2024. https://www.who.int/news/item/01-02-2024-global-cancer-burden-growing--amidst-mounting-need-for-services.

  79. Muwakkit S, Al-Aridi C, Samra A, Saab R, Mahfouz RA, Farra C, et al. Implementation of an intensive risk-stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon. Am J Hematol. 2012;87:678–83.

    Article  PubMed  Google Scholar 

  80. GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9:137–50.

    Article  PubMed Central  Google Scholar 

  81. Burns, C Antidepressant prescribing increases by 35% in six years. 2022. https://pharmaceutical-journal.com/article/news/antidepressant-prescribing-increases-by-35-in-six-years.

  82. Pirmohamed M. Pharmacogenomics: current status and future perspectives. Nat Rev Genet. 2023;24:350–62.

    Article  CAS  PubMed  Google Scholar 

  83. Ossaily S, Zgheib NK. The pharmacogenetics of drug metabolizing enzymes in the Lebanese population. Drug Metab Drug Interact. 2014;29:81–90.

    Article  CAS  Google Scholar 

  84. Bilani N, Dagher M, Zgheib NK. Precision Genetic and Genomic Medicine in the Middle East and North Africa Region: Are We There Yet? Public Health Genomics. 2017;20:149–57.

    Article  PubMed  Google Scholar 

  85. Chapman R, Likhanov M, Selita F, Zakharov I, Smith-Woolley E, Kovas Y. New literacy challenge for the twenty-first century: genetic knowledge is poor even among well educated. J Community Genet. 2019;10:73–84.

    Article  PubMed  Google Scholar 

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Acknowledgements

Funding from the American University of Beirut Faculty of Medicine Medical Practice Plan (MPP) and the ERASMUS + Programme of the European Union: 617303-EPP-1-2020-1-EG-EPPKA2-CBHE-JP. The European Union’s support for the production of this publication does not constitute an endorsement of the contents, which reflect the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained herein.

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Authors and Affiliations

  1. Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Lorenzo Chidiac & Hady Yazbeck

  2. Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Rami Mahfouz

  3. Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Nathalie K. Zgheib

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  1. Lorenzo Chidiac
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  2. Hady Yazbeck
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LC and HY did the literature search, and LC wrote the first draft of the manuscript. RM wrote the section on the clinical implementation landscape. NZ conceived the idea and contributed to writing. All authors approved the final version of the manuscript.

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Correspondence to Nathalie K. Zgheib.

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Chidiac, L., Yazbeck, H., Mahfouz, R. et al. Pharmacogenomics in Lebanon: current status, challenges and opportunities. Pharmacogenomics J 24, 16 (2024). https://doi.org/10.1038/s41397-024-00336-z

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