Dr. Ali Chaari

“The webinar series will aim to assess and address current gaps in knowledge regarding neurodegenerative diseases in Qatar, the Middle East and North Africa (MENA) region, and beyond.”

Dr. Ali Chaari is a Biochemist who obtained his degree in engineering biology from the National Engineering School in Tunisia and his PhD in Biochemistry and Cellular Biology from the University of Versailles, France. He is currently an Assistant Professor of Biology at Weill Cornell Medicine-Qatar (WCM-Q), where he teaches Biochemistry in the pre-medical division. Dr. Chaari has been a Pl and co-Pl on internally and externally funded projects and has also participated in a host of other projects. This has led to several publications involving pre-medical and medical students. His two active research areas are 1) the study of amyloid proteins modulation in neurodegenerative diseases and type 2 diabetes (T2D) and 2) the role of Microbiome Therapy on health promotion and disease. Dr. Chaari is also the Director of a new online webinar series offered by the Division of Continuing Professional Development at WCM-Q, titled Protein Misfolding Diseases and Neurodegeneration: From Experimental Approach to Clinical Therapy. The series runs until October 25, 2023. The launch of the series has been timed to coincide with World Alzheimer’s Day to help raise awareness of this important disease. 

Who is the target audience for your new webinar course and what is the benefit of healthcare professionals undertaking this training?

The target audience for the new webinar series will be all healthcare professionals across multiple disciplines, including medical students, researchers, and educators. This is because the presentations are organized in a way that explain the basic pathogenesis, causes of onset and development, as well as the most recent advancements in diagnostic and therapeutic capabilities associated with neurodegenerative diseases. This will help the participants to promote a better understanding of the healthcare management options for neurodegenerative diseases, both now and into the future.

What are the most prevalent forms of neurodegenerative disease? 

Neurodegenerative diseases affect millions of people worldwide. Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the most common neurodegenerative diseases. As an example, the prevalence of AD is roughly 30% among people 85 years and older. With prominent strides in medical science and a gradual increase in overall life expectancy, the global prevalence of dementia, a primary pathology associated with many such disorders, is expected to increase from 57.4 million in 2019 to 152.8 million by 2050, while the prevalence across the US is to almost double in the same time period. 

What is protein misfolding and how does it lead to neurodegenerative disease? 

The misfolding of proteins and disruption of protein homeostasis are linked to the accumulation of amyloid fibrils or amorphous aggregates. When this happens in vulnerable neural cells, the resulting neurotoxicity and stress (with the help of the host’s immune cells and associated inflammatory mechanisms) lie behind the primary pathogenesis of the most prevalent age-associated neurodegenerative diseases, including Alzheimer’s disease, Huntington’s Disease (HD), Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS), and multiple prion diseases such as Creutzfeldt – Jakob disease (CJD). Despite the existence of some similarities between neurodegenerative diseases, the origin of the causes may differ. Protein aggregation and misfolding are also the subjects of discussion of the pathogenesis of non-neurological disorders such as systemic amyloidosis, dialysis-related amyloidosis, type 2 diabetes, and cataract. 

 Why are neurodegenerative diseases becoming more common? 

Neurodegenerative diseases represent a major threat to human health. These age-dependent disorders are becoming increasingly prevalent, in part because the elderly population has increased in recent years. In fact, one in ten individuals aged ≥65 years has AD, and its prevalence continues to increase with increasing age. Also, the change in lifestyle and losing good habits such as a balanced diet, a certain level of physical activity, as well as increased risk of certain diseases such as hypertension and T2D, lead to the increased prevalence of neurodegenerative diseases. 

What are the risk factors for neurodegenerative disease?

Aging is the main risk factor for most neurodegenerative diseases. Besides aging, the combination of a person’s genes and environment contributes to their risk of developing a neurodegenerative disease. In fact, the existence of certain genetic polymorphisms can increase the susceptibility of a person to have the associated neurodegenerative disease. For example, someone might have a gene that makes them more susceptible to AD or PD disease, but their environmental exposures can affect whether, when, and how severely they are affected. This is without neglecting the effect of other possible contributing factors, including gender, poor education, and health conditions. For instance, the susceptibility to have neurodegenerative diseases increases with people having one of these conditions: oxidative stress, inflammation, stroke, hypertension, diabetes, smoking, head trauma, depression, infection, tumors, vitamin deficiencies and immune and metabolic conditions. 

How do neurological diseases affect populations in the MENA region? 

Studies of Arab countries, including those of the MENA region, found neurodegenerative diseases to be prevalent regionally, ranging between 1.1-2.3% in the ≥ 50 years population and this percentage is increasing with age to reach 13.5-18.5% in the ≥ 80 years population. The importance of this number, which may increase in the coming years may be explained by the high prevalence of hypertension as well as T2D in the Arab countries. 

How do sleep and physical activity affect cognitive function in older adults? 

First, recognizing that a neurodegenerative disease is a condition that affects neurons in the brain, causing symptoms such as memory loss, moodiness, anxiety, depression, and agitation, helps explain how sleep and physical activity affect cognitive function in older adults, who are more susceptible than other groups to neurodegenerative disease. 

Getting a good sleep, which is defined by getting enough hours of high-quality sleep, increases attention-span and concentration. Sleep also supports numerous other aspects of thinking, including memory, problem-solving, creativity, emotional processing, and judgment. Related to this, many studies linked poor sleep with longer-term cognitive decline, including the development of dementia and Alzheimer’s disease. Research demonstrates that exercise can boost memory and thinking by reducing stress and anxiety as well as improving mood and sleep. In this regard, research demonstrated that increased levels of physical activity in elderly subjects was associated with an increase in their hippocampal volume, which can lead to improved memory performance. 

 What can individuals do to reduce their risk of developing neurodegenerative disease?

 Several studies indicate that a person can try to reduce the risk of developing neurodegenerative diseases by exercising regularly, getting plenty of high-quality sleep, eating a healthy and balanced diet, staying mentally and socially active, reducing stress, taking control of their health, and managing chronic conditions.

How is neurodegenerative disease diagnosed and treated? 

Previously, some structural neuroimaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) were used for diagnosis, but due to very low specificity, they have been replaced by new neuroimaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT). Despite significant attempts to find drugs that can treat the symptoms of many neurodegenerative diseases, still there are no effective therapeutics to treat neurodegenerative diseases. The treatments available only manage the symptoms or halt the progression of the disease.

What does the future hold for the diagnosis and treatment of neurodegenerative disease in the light of new research? 

 Firstly, we should emphasize the impact of neurodegenerative diseases on the economy since this may justify any high research cost. Taking into consideration Alzheimer’s diseases as an example of neurodegenerative disease, we should note that the average duration of AD is between two and 10 years and this is predicted to cost about $1 trillion per annum in the US alone by 2050. With this in mind, even a therapy that could delay the symptoms of this kind of disease would have a significant positive influence on individuals, families, societies, and economies. 

Besides this, we should emphasize that the the etiology of neurodegenerative diseases is still not completely understood, and that most of the medication only treats symptoms. With life expectancy increasing, it is important to enhance our understanding of these diseases, their diagnosis, and their mechanisms in order to develop novel therapies. Currently, biological assays, including aggregation, cell viability and cytotoxicity to better understand the modification of neuronal death, signaling assays and neuron function, and the study of new biomarkers that might allow early diagnosis, are vital in helping scientists in better understanding of the underlying mechanisms of these conditions, in addition to discovering promising therapies. Further to this, advances in the technologies that allow for the imaging of pathological protein assemblies are one of the important areas of research to focus on.

How is the increasing sophistication of AI changing the research paradigm for neurodegenerative diseases and protein misfolding? 

 To combat the increased prevalence of protein misfolding, amyloid formation and neurodegenerative diseases, many studies focus on artificial intelligence (AI). In fact, AI can be used to predict cognitive impairment and to anticipate how severe some symptoms will be over time, such as the decline of motor skills. This can help accelerate patient diagnosis so the process of managing the progression of symptoms can begin earlier. Also, researchers can use AI to discover potential drugs and new biomarkers or biological targets that could lead to better treatments. 

What action can policymakers and healthcare and research leaders in the MENA region take to address the increasing prevalence of neurological diseases? 

 In my opinion, the first thing that should be done is to increase awareness of neurodegenerative diseases, the causes that may increase the prevalence of these diseases, and what we as individuals can do to reduce our risk of developing neurodegenerative disease. 

In this regard, and as a part of the National Health Strategy (2018-2022), the Ministry of Public Health in Qatar (MoPH) and its connected networks acknowledge the challenge of dementia, a common complication of Alzheimer’s Disease (AD), through the adoption of the extensive Qatar National Dementia Plan (2018-2022). This plan identifies various gaps, such as a lack of region-specific epidemiological statistics regarding incidence and prevalence, the lack of universal treatment guidelines and legislation, and a lack of adequately trained staff to address demand in the region (Ministry of Public Health, 2018). The MoPH also emphasizes the importance of “healthy ageing” through improving coordination of healthcare to the ever-increasing elderly population in the country (Ministry of Public Health, 2018). To empower this aging population with regards to the management and improvement of their own health and independence, their healthcare personnel should have a basic understanding of the pathogenies and treatment modalities for neurodegenerative diseases that disproportionately affect this group.

How does working with WCM-Q’s Division of Continuing Professional Development help drive progress in the research, diagnosis and treatment of neurodegenerative diseases?

Working with WCM-Q’s Division of Continuing Professional Development to develop the webinar series can help contribute to the goals set out in the National Health Strategy (2018-2022) to increase awareness of neurodegenerative diseases. The webinar series will aim to assess and address current gaps in knowledge regarding neurodegenerative diseases in Qatar, the Middle East and North Africa (MENA) region, and beyond. 

Working with the division of CPD on this series allows us to highlight various knowledge gaps related to neurodegenerative diseases and associated disorders. To address some of these gaps, the series will enable the audience to understand the mechanism of protein misfolding and amyloid formation behind the most common neurodegenerative diseases and learn about the most recent advancements in their potential treatment modalities to promote a better understanding of the healthcare management options now and in the future. 

A survey was conducted to recognize the needed assessment before we proposed this CPD series. The results showed very significant demand for a webinar series that complements the knowledge and competence of healthcare practitioners with regards to managing and caring for patients with neurodegenerative disease and its disorders. This survey will lead to a paper, which is currently in preparation, titled Knowledge and Attitude Towards Neurodegenerative Diseases and Associated Disorders: A Cross-Sectional Survey of Healthcare Professionals Across Qatar”. 

Another, more research-oriented survey, with a focus on 1) the level of knowledge of Alzheimer’s disease and dementia, 2) attitudes towards dementia patients, as well as 3) confidence and self-efficacy about dementia patients, is also in preparation. 

How do you envision the future development of this activity?

We are confident of the potential success of this series of webinars because it is based on an identified need. The next step will be to expand the series into an annual conference and a series of workshops to further meet the needs of the local and global healthcare community. This will allow us to attract well-recognized healthcare practitioners as well as researchers in the field of neurodegenerative diseases, which will benefit not only the healthcare professionals and researchers in Qatar but also the students. Altogether,  this will accord with the goals of National Health Strategy (2018-2022) and Qatar National Vision 2030.  We hope this webinar series will provide a great opportunity for WCM-Q to participate as an institution to raising awareness of the disease, as well as dementia, common symptoms, and risk factors attached to it.