Shaping the Future: The Transformative Path of the Arab Board of Rheumatology.

Rheumatology fellowship programs represent a pivotal juncture for aspiring specialists, embarking on a transformative journey of expertise and care. The League of Arab States, comprising 22 nations and a collective population of 464.68 million as of 2022, established the Arab Board of Health Specialization in February 1978. This visionary initiative aimed to curb the emigration of Arab physicians and address the scarcity of specialized medical practitioners in the Arab world. Since the establishment of the Internal Medicine specialty in 1979, the curriculum and examinations have undergone sustained refinement and enhancement. In a significant stride, the Arab Board established the Scientific Committee of the Rheumatology Fellowship Program on November 28, 2022. Its main goal is to ensure that graduating fellows will be of high caliber and can contribute to the care of patients with rheumatic disease in the Arab world. This editorial illustrates the historical trajectory of the Arab Board's evolution and chronicles the dynamic expedition of shaping the rheumatology fellowship program.

Familial Mediterranean fever in the Syrian population: gene mutation frequencies, carrier rates and phenotype-genotype correlation.

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease mainly affecting particularly Arabs, Non-Ashkenazi Jews, Armenians, and Turks. It is an autoinflammatory periodic disorder characterized by febrile and painful attacks due to inflammation involving the serosal membranes in the abdomen, chest or joints. Over 50 mutations have been identified in the MEFV gene responsible for FMF. OBJECTIVE: To identify the distribution and the frequency of the MEFV gene mutations in Syrian FMF patients and population and perform a genotype/phenotype correlation in the patients' cohort. PATIENTS AND METHODS: The study was carried out on 83 clinically diagnosed Syrian FMF patients and 242 healthy subjects. The tested individuals were screened for the most common five MEFV mutations (M694V, M694I, M680I, V726A and E148Q) by restriction fragment length polymorphism. Sequencing of exon 10 was performed only for the patients' DNA where just one or no mutation was detected. RESULTS AND DISCUSSION: Of the 83 patients studied, 74 (89%) were positive either for one, two or three mutations and nine (11%) had no mutations detected. Of those positive for mutations, 25 were homozygous, 30 were compound heterozygotes, three had complex alleles, and 16 patients had only one mutation. The M694V, V726A, M694I, M680I and E148Q mutations accounted for 45.8%, 26%, 13.9%, 4.8% and 6% of the alleles, respectively. The carrier rate in the Syrian population for the tested mutations was 17.5%, E148Q being the most common mutation, followed by V726A and M694V. The severity of the disease and development of amyloidosis seem to have an association with M694V, the most common mutation in Syrian FMF patients.

HLA-B27 and its subtypes in Syrian patients with ankylosing spondylitis.

OBJECTIVE: To assess HLA-B*27 and its subtypes associated with ankylosing spondylitis (AS) in Syrian patients. METHODS: A polymerase chain reaction with specific sequence primer method were used to study the HLA-B* locus polymorphism in 50 Syrian patients fulfilling the modified New York criteria for classification of ankylosing spondylitis and 217 unrelated healthy Syrian controls. Patients were recruited from the Outpatients Department, Alassad University Hospital, Damascus, Syria between December 2006 and December 2007. The study took place at the Laboratory for Research and Genetic Consultations, Faculty of Medicine, Damascus University, Damascus Syria. RESULTS: HLA-B*27 allele was found in 1.4% healthy Syrians and 60% in patients with AS (OR=107, p=0.0001, corrected p=0.003). The most common HLA-B*27 variants in patients were B*2705, which was found in 67% of patients, followed by B*2702 found in 20% of patients. HLA-B*27 was identified in all cases with uveitis, peripheral arthritis, and positive family history. CONCLUSION: Although HLA-B*27 allele frequency in this group of Syrian patients with AS is lower compared to the noted AS patients in many populations, its association with the disease risk in our population seems to be the strongest one. If confirmed by larger study, this finding may be of great interest, particularly for diagnosis at disease onset where some clinical features as uveitis and peripheral arthritis may precede the fulfilling of all standard criteria for AS diagnosis.