An-Najah Staff

Introduction Complementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East.
Methods and results A multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author’s affiliation with an academic or clinical institution in the Middle East.
Results We identified 143 articles on CAM and cancer care that had been published in12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor–patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind–body medicine, shiatsu, therapeutic touch, and yoga.
Conclusions CAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.

The tripeptide glutathione (GSH) plays an important role in the maintenance of the intracellular thiol redox state and in detoxification processes. The intracellular GSH level depends on glutathione reductase as well as on GSH synthesis. The first and rate limiting step in the synthetic pathway is catalysed by γ-glutamylcysteine synthetase (γ-GCS). The γ-GCS was partially purified from the filarial parasite Onchocerca volvulus and preliminary steady state kinetics were performed. The Ki-value for Image -buthionine-S,R-sulphoximine (BSO), a specific inhibitor of γ-GCS, was determined to be 0.13 μM, which is 54-fold lower than the Ki-value for the mammalian enzyme. Filarial γ-GCS was also inhibited by cystamine with a Ki-value of 3.9 μM compared with 22.2 μM determined for the rat enzyme. Further, the cDNA and the gene of the O. volvulus γ-GCS were cloned and sequenced. The gene of 5762 bp is composed of 14 exons and 13 introns. Southern blot analysis indicates that the γ-GCS gene is present as a single-copy gene. In accordance with Northern blot analysis, the entire cDNA sequence encompasses 2377 bp. At its 5′ end a nematode-specific spliced leader 130 bp upstream of the first in frame methionine was identified. The cDNA encodes a polypeptide of 652 amino acids with 50 and 69% sequence identity to the human and the Caenorhabditis elegans counterparts, respectively. The filarial γ-GCS is proposed as a potential drug target.