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- Title
Meeting Reports: Notes and commentaries on Turkish Medical Genetics Association and Cyprus Turkish Genetic Union Meeting.
- Authors
Ergören, Mahmut Çerkez; Çobanoğulları, Havva; Tulay, Pınar; Fahrioglu, Umut; Tuncel, Gulten; Betmezoglu, Meryem; Kalkan, Rasime; Yeşil, Gözde; Gümüş, Evren; Aras, Beyhan Durak; Bahsi, Taha; Bakır, Abdullatif; Akın, Haluk; Mocan, Gamze; Ergün, Mehmet Ali; Dündar, Munis
- Abstract
Background A momentous first step was undertaken by the members of the Faculty of Medicine and DESAM Institute from Near East University and Executive Board Members of Turkish Medical Genetics Association (Tıbbi Genetik Derneği) on February, 22th 2020 at the V. Internationally Participated Erciyes Medicine Genetics Days Congress in Cappadocia, Turkey. The purpose of this article is to essentially pinpoint the common difficulties and problems that the medical geneticists have been facing in North Cyprus and to emphasize some possible solutions which were discussed during the meeting between the two communities. The first human genome sequence was established at the beginning of the third millennium. Since then advanced life sciences has been shaping economies, societies, bodies and minds. For many diagnostic and research laboratories in the developing world, a lack of funding and insufficient scientific knowledge of the governments, technical and logistical difficulties are just some of the major hurdles to establish molecular medicine laboratories and producing DNA sequence data. Here, we introduce our case for North Cyprus and illustrate the problems of adjusting to the ‘new molecular genetics era’, since it is an example of a developing country that is striving to progress from an agrarian to an industrial and research technology development society. Cyprus, which is the third largest island in the Mediterranean Sea, has been at the crossroads of multiple civilizations throughout human history. Today, the Turkish Cypriots and the Greek Cypriots constitute two major ethnic groups in Cyprus, along with minority groups including the Maronites, the Armenians, and the Latins. Given an account of the former inhabitants of this island, it should be no surprise that the genetic characteristics of the current Turkish Cypriot population have been determined by the interactive forces of migrations, admixture, genetic drift, etc. Turkish Cypriots are located at the Northern Cyprus which is de facto state that comprises the northeastern portion of the island of Cyprus. North Cyprus is recognized only by Turkey and considered by the international community to be part of the Republic of Cyprus. Due to its lack of recognition, ~350.000 population of Northern Cyprus is heavily dependent on Turkey for economic, political and military support. Past two decades, health tourism has been contributing to country’s economy. Despite hosting well equipped hospitals and IVF centers, lack of legal regulations in medical genetics and genetic counseling fields have urged the aforementioned meeting. Overall, two parties in the meeting have agreed that the establishment of Cyprus Turkish Genetic Association is necessary for rising awareness of the genetics field in the population, providing a common and strong voice to government for drawing attention to following developments in medical genetic diagnosis and enhancing the health-care system in North Cyprus. We hope to achieve our mission through a number of community building activities including organizing seminars, symposiums and meetings with the support of the Medical Genetics Association in the future. The Topics that were discussed at the V. Internationally Participated National Erciyes Medicine Genetics Days Congress The technological advancement in genomic analysis and sophisticated sequencing tools have revolutionized the diagnosis and interpretation of genetic diseases within the past ten years (Cho et al., 2017). One of the key features of analysis in genetics is the association of sequence variation with heritable phenotypes. Genetic variations in the human genome can be observed in different forms such as single nucleotide changes or substitutions, tandem repeats, insertion and deletions (indels). Single nucleotide polymorphisms (SNPs), the most common genetic variations, are structural variants and often categorized as ‘specific’ and ‘shared’ based on their distribution in a single population or a range of populations. An SNP might be specific to an individual or a family or to a population or to an ancestral group. Therefore, population-specific SNPs might be critical while analyzing characteristic phenotypes and disease susceptibility/protection to a population (Choudhury et al., 2014). In light of the evidence from previous studies, a number of polymorphisms on several genes and rare genetic disorders have been previously studied in the Turkish Cypriot population. Also, some of these studies shed light on learning more about the association of different polymorphisms and the susceptibility of the Turkish Cypriot population to diseases such as cardiovascular conditions, dyslipidemia and hypercholesterolemia and obesity as well as understanding the molecular mechanisms of rare genetic disorders. As a result, a substantial amount of genetic data has been generated which requires storage in a population specific database that strengthens the curation, clinical interpretation and sharing of genomic data, therefore, lowering destructive errors or delayed diagnosis (Thorogood, Touré, Ordish, Hall, & Knoppers, 2018). Turkish National Genetic Variants Database Consortium has been found under the presidency of Prof. Munis Dundar (Professor of Medical Genetics, Erciyes University, Kayseri, Turkey). The consortium is one of the commissions of the Medical Genetic Association, therefore, public and private medical genetic diagnosis laboratories have been providing genetic variation data to the consortium. As, the consortium have also been accepting the genetic variation data from Turkish Cypriot and Turkish populations living North Cyprus, Near East University has been an important part in this consortium. Noticeably, high-throughput DNA Sequencing technologies such as next generation sequencing (NGS) have been very quickly adopted in majority of clinical laboratories globally (Petersen, Fredrich, Hoeppner, Ellinghaus, & Franke, 2017). Moreover, NGS platforms helps to examine gene panels, exome genome sequencing for disease-causing variations for many diseases such as cancer and rare disorders. During the meeting, the participants have been agreed that NGS technology should be also established since it is a breakthrough technology which analyzes genetic information easier, faster, and less expensive compare to conventional methods. Particularly, lack of genetic laboratory regulations, some private medical biochemistry diagnostic laboratories offer many genetic tests genetic tests which are not performed in North Cyprus. Firstly, the genetic tests should be requested from genetic laboratories or clinical geneticists and even then, the interpretation of these test results still remain a big problem for patients and their families. Therefore, further strategies should be developed between the two associations to find solutions for these important health-care problems. Another relevant topic which was discussed at the meeting was the importance of a resident Clinical Geneticist in North Cyprus. Clinical geneticists work in hospitals and centers in cooperation with genetic counsellors and medical scientists to provide genetic services to the community (Kosztolányi & Cassiman, 2010; Paneque et al., 2017). Unfortunately, currently there is no clinical geneticist working in North Cyprus. Consequently, with the implicit approval of Republic of Turkish Ministry of Health, Medical Genetic Association Executive Board Members have been agreed to appoint a clinical geneticist to refer patients for diagnosis and management of genetic testing in North Cyprus if it will have requested by TRNC Ministry of Health. Discussion The main purpose of this meeting was to bring together the executive members of Turkish Medical Genetics Association and Near East University Faculty of Medicine and DESAM Institute Members to point out the challenges and difficulties in genetic field in North Cyprus. During the meeting, The Congress President Prof. Munis Dundar emphasized the importance of the Cyprus Turkish Genetic Association establishment in order to find a solution and achieve the aims that were mentioned above. Additionally, heterogeneity of members of the Cyprus Turkish Genetic Association is curial, therefore, all scientist or clinicians in the genetic field should be engaged in the process. Thus, it will become easier to convey the problems and challenges to the TRNC Ministry of Health as well as other institutions. Undoubtedly, the executive members of Medical Genetics Association stated that they are always ready to convey their experiences with Turkish Cypriot Genetic Community. In order to do this, due to financial problems, education programs which will be held in North Cyprus can be arranged as a first step by Medical Genetics Association. Notably, sponsorships can be a powerful way of preparing educational programs such as symposiums and conferences with a huge number of participants. Therefore, Turkish Medical Genetic Association Members were advised to expand the potential research areas in TRNC. Clearly, if the right judicial mechanisms are followed, it will not take long time to establish the Cyprus Turkish Genetic Association. However, until then, there is still the option of being an associate member of Medical Genetics Society of Turkey, which was also debated at the meeting. Moreover, Molecular Medicine Philosophy Doctorate (PhD) program can be more modified according the Medical Genetics curriculum. In addition, clinical genetic diagnosis laboratory regulation standards and guidelines should be prepared under considering European Union Medical Laboratory Regulations. Finally, it was pinpointed that the communication and the distribution of work between the members of the Cyprus Turkish Genetic Community is very crucial. Conclusion In order to achieve the aims written above, all of the attendees agreed that the necessary establishment the Cyprus Turkish Genetic Association. Furthermore, a direct communication between the executive board of Turkish Medical Genetic Association and Turkish Cypriot Genetic Community has been emphasized. Subsequently, one of the board members or society member from Turkish Medical Genetics Association ought to be responsible from the progression during the establishment of the Cyprus Turkish Genetic Community in North Cyprus. Overall, important topics related to human health have been discussed and negotiated during the meeting. The meeting that gathered together two parties was successfully concluded with mutually agreed upon decisions.
- Subjects
NORTHERN Cyprus; CYPRUS; MEDICAL genetics; MEDICAL societies; SCIENTIFIC knowledge; PHILOSOPHY of medicine; MEDICAL laws; DYSLIPIDEMIA; TURKISH Cypriots
- Publication
Gazi Medical Journal, 2020, Vol 31, Issue 3, p1
- ISSN
1300-056X
- Publication type
Article