Discovery, against all odds

Published online 17 November 2020

Nathalie Khoueiry-Zgheib from Lebanon is recognized for her research studying the links between genetics and drug reactions.

Ola Al-Ghazawy

While the whole world has been contending with the COVID-19 pandemic, Lebanon has also faced mass protests, an economic crisis, and an explosion that killed hundreds and destroyed Beirut's port. Still, many Lebanese scientists are pushing through these huge challenges to produce high-quality research. 

The Abdulhameed Shoman Foundation has recognized pharmacogeneticist Nathalie Khoueiry-Zgheib of the American University in Beirut (AUB) with their 2020 Arab Researchers Award in the medical and health sciences category. The award's scientific committee described her work as original and aligned with international research trends in pharmacogenetics, adding value to the cumulative scientific knowledge in this field.

The path to research

Following her graduation from the AUB in 1998, Khoueiry-Zgheib spent a few years as a family physician. But her hunger for discovery meant it was not long before she accepted a grant to spend three years conducting research at the University of Pittsburgh in the US. 

"That was when I fell in love with pharmacogenetics," she says. "I decided that this was the career I wanted when I returned to the AUB."

Back home, Khoueiry-Zgheib founded a pharmacogenetics laboratory at the AUB in 2007. Working closely with her handpicked team, Khoueiry-Zgheib tries to determine whether genetic differences explain why people respond differently to various drugs; whether in efficacy or toxicity. 

Anwar El-Halh, the director of Abdulhameed Shoman Foundation’s scientific research department, says that Khoueiry-Zgheib was largely recognized for the award because of her establishment of that lab, along with her ability to build partnerships with researchers around the world. 

Impactful work

With a growing team, Khoueiry-Zgheib’s lab has been pursuing several avenues of research. 

Her work currently focuses on understanding genetic and epigenetic influences on breast cancer development, especially on exposure to environmental factors, such as air pollution, or behavioural factors, such as waterpipe smoking. She is also looking at variability in breast cancer response to anti-cancer drugs like tamoxifen. 

"My team’s most recent research aims to find a more personalized therapy for children with acute lymphocytic leukaemia," she says. This is the most common cancer in children and today’s advanced therapies have led to high remission rates. But Khoueiry-Zgheib says some children can suffer or even die from severe drug toxicity. Preemptive genotyping for candidate genes that make children more susceptible to drug toxicity could help clinicians prescribe a more appropriate and personalized drug dose. 

Khoueiry-Zgheib has also launched a cardiovascular biorepository at the AUB, where researchers investigate stored tissues to find biomarkers that can pinpoint potential links between cardiovascular disease and air pollution. 

Additionally, her research has shown that a gene found more commonly in Lebanese people compared to other populations is associated with intolerance to 6-mercaptopurine, a drug used to treat acute lymphoblastic leukaemia.

Current challenges and the future

Securing funding for scientific research is difficult anywhere in the world, but that is especially the case in Lebanon. “By persevering, collaborating, and focusing on unexplored research niches, one can proudly make a difference in this area of the world,” says Khoueiry Zgheib. 

Khoueiry-Zgheib remains hopeful. She finds validation for her hard work and efforts in the recognition given by the likes of the Abdulhameed Shoman Arab Researchers Award. "I genuinely feel blessed to be a faculty member at the AUB. Being affiliated with this outstanding institution has facilitated my ability to collaborate and secure research funds from the AUB and other national and international funding agencies."

When things get particularly difficult, Khoueiry-Zgheib finds solace in training graduate students and building up capacity in Lebanon and the Arab world. Her advice to students is always simple and straightforward: "Follow your dream and stay focused on your mission and career." 

"My goal is to put Lebanon and the Arabic-speaking Middle East on the pharmacogenetics map, and to make personalized medicine a reality by replacing the one-drug-fits-all approach in this area of the world."