Prof. Samia J. Khoury

Steps Toward a Better Tomorrow
Every person's life is a story of challenges, victories, and failures, each one offering a world of experience. Among them, Samia Khoury is one of the scientific figures who, through the twists and turns of her choices, followed a path that not only impacted her own future but also the lives of others. She skillfully translates the findings of her experiments into human realms and, through her hypotheses, provides promising results for the treatment of MS. Her life is an example of the impact of knowledge and commitment in solving medical and social issues.
A Life-Altering Crossroad
In 1975, when Khoury was just 15 years old, her homeland, Lebanon, was engulfed in the flames of civil war—a fire that drowned life in instability and the light of the future in darkness. School closures, bloodshed, and the severe injury of her father created circumstances where any teenager would walk the path of despair and hopelessness. However, Khoury did not abandon her childhood dream. She had dreamed of becoming a doctor since age three, imagining herself in a white coat. The events that unfolded did not hinder her growth; instead, amid bombings and the sight of wounded individuals, they nurtured in her the motivation to become a savior.
A Light in the Darkness
Although the year-long school closures had halted her pursuit of knowledge, Khoury, with the support of her parents, became a role model for her younger brother and two sisters, finding a way to blossom amid the chaos of war. She immersed herself in books and studying, seeking refuge in the world of science and knowledge. Khoury saw no limitations in her path to progress, and even in the absence of electricity, she studied by candlelight, preparing for the following year's lessons. Each page she turned brought her one step closer to her goal, eventually earning her the top rank in the Lebanese national entrance exam. She then attended the American University of Beirut to pursue her medical degree, using it as a springboard to Harvard University. In 1983, she became a member of the honorary medical society, Alpha Omega Alpha, and in 1984, after receiving her degree, she began specializing in MS at Harvard. She then completed her internship and residency in Cleveland, Ohio, until 1988, and then pursued a neurology fellowship at Harvard Medical School.
A Companion
In 1980, amid the competitive atmosphere of the American University of Beirut, she met Mohamed Sayegh. Both were medical students, and what drew them together was their shared love of science and learning that burned within them. They worked together on ideas and research projects, deepening both their personal and professional relationship. At the time, while Khoury was at Harvard, under Dr. Howard Weiner’s supervision, completing her neuroimmunology course, she began her research and clinical training on MS. There was no treatment for the disease then, which motivated Khoury to dedicate herself more seriously to this issue. In 2011, while both were at the height of their scientific and professional achievements, Khoury and her husband returned to Lebanon to apply the results of years of research at Harvard in their home country. From the very beginning, Khoury was determined to return to Beirut after her studies to serve her people. Her husband's support further fueled her determination. In 2021, Mohamed Sayegh was honored with the Mustafa(pbuh) Prize for his innovative treatments to improve the results of kidney and heart allografts in medical science. This recognition also introduced Khoury to the prize and integrated her into this esteemed scientific community.
Awards and Achievements
Khoury’s belief in the connection between physical and psychological harm led to the establishment of the multidisciplinary MS center in Lebanon. This center focuses on multidimensional treatments, where individuals are not only examined from a physical standpoint but also from a psychological and emotional one. Khoury’s innovative treatment methods and her efforts to identify the pathogens and mechanisms regulating and tolerating it the disease earned her the Mustafa(pbuh) Prize in 2023. She has also received the Kuwait Science Award in 2007 from the Kuwait Foundation for the Advancement of Sciences for her research in immunology and the King Salman Award for her research on disability and impairments in 2022.
She has served as a professor of Neurology and Immunology, director of the MS Nehme and Therese Tohme Center, and director of the Abu-Haidar Neuroscience Institute at the American University of Beirut. throughout her scientific career, she has held various roles, including the Associate Dean of the Faculty for Clinical and Applied Research and as the director of the MS Research Center in Boston. Furthermore, numerous articles authored by her have been published in scientific journals. From 2000 to 2004, she was a contributing writer for the Journal of Immunology, and from 2016 to 2021, she held a similar role at the Annals of Neurology.
The Meaning of Wealth
With a deep concern for helping her fellow countrymen, Khoury has significantly contributed to improving the lives of the Lebanese. Through her persistence and commitment to the health of financially disadvantaged patients, she has raised funds to cover treatment costs. Her goal is to ensure that all MS patients, regardless of their financial situation, can receive essential medical services at the MS center.
The Children in White Coats
In science, the role of professors and their impact on future generations is incredibly significant. From 2009 to 2013, Khoury served as a faculty member in Neurology at Harvard Medical School under Jack, Sadie, and David Breakstone. Through her guidance, she encouraged many individuals to join the complex and beautiful world of neuroscience, leaving a profound impact on the future of medicine. Additionally, her two children, influenced by the academic environment at home, became diligent and successful doctors. Through her participation in prestigious scientific associations and presenting her findings on MS, she has expanded the boundaries of science in her own way, guiding many researchers toward this field and inspiring new generations of scholars to enter it. Not only does her research promise positive developments in medicine, but by nurturing future researchers, she is watering the scientific tree whose fruits will bear results in the future.
The story of Samia Khoury serves as a reminder that individual efforts can have a profound impact on both personal and social paths. By focusing on medical issues, Khoury worked tirelessly to find solutions to improve patient conditions. Her efforts to enhance the quality of life for patients not only influenced scientific research but also kept the light of hope alive for patients and their families, drawing a brighter future for humanity.
 

The Battle Against Demyelination
A Look at Samia Khoury's Efforts in Treating MS Patients
Multiple Sclerosis (MS) is a disease that challenges all our assumptions about the body's system functions and tells the story of an internal war. Chaos engulfs the central nervous system, and all the cells, from activated T cells to B cells and even the innate immune system, join forces to bring the body down. The myelin is mistakenly perceived as the enemy and is eliminated one by one. In the meantime, inflammation affects the function of neural stem cells, preventing neurons and brain cells from regenerating and healing. Gradually, the problems manifest: MS leads to visual impairments, tingling and numbness in the body, loss of balance or dizziness, and, in the worst case, premature death. However, amidst this battle, a ray of hope shines from researchers like Samia Khoury.
Since MS was first recognized, treatments have taken various paths, ranging from older drugs like Rituximab to Glatiramer acetate, Fingolimod, and Ocrelizumab. However, none have managed to target the Achilles' heel of the disease or provide a definitive cure. Today, Khoury, in pursuit of innovations in this field, has established the Multidisciplinary MS Center in Lebanon. The professionals at this institution, from nurses and pharmacists to social workers, are all specialists, and the focus is on providing comprehensive care for patients. In addition to studying the progress of MS in the 2,000 patients at the center, treatments for depression, physiotherapy sessions, and any necessary measures for recovery are carried out, considering all aspects. Khoury’s innovative approach to treating the disease, along with her efforts in identifying pathogenic factors and mechanisms of regulation and tolerance, led to her receiving the Mustafa(pbuh) Prize in 2023.
Despite the different ways MS manifests in different individuals, the disease is generally classified into three categories: relapsing-remitting, primary progressive, and secondary progressive. However, there is no specific test that can definitively diagnose the disease. In general, a combination of clinical symptoms and examinations, such as cerebrospinal fluid analysis and MRI, can suggest the presence of the disease. In this regard, extensive research is being conducted to improve prediction and diagnosis. Khoury’s research on the relapsing-remitting category offers hope for a brighter future in this field. Patients in this category experience periods of symptoms that improve, but after some time, some patients transition to the secondary progressive form, with symptoms gradually worsening. This study shows that thinning of the retinal layer can indicate the progression of the disease in relapsing-remitting MS. This layer is examined using a type of imaging called Optical Coherence Tomography (OCT), and interestingly, these changes can be predicted up to two years before the appearance of clinical symptoms.
Just as solving a puzzle requires finding clues, understanding MS requires identifying key clues which the Experimental Autoimmune Encephalomyelitis (EAE) model helps uncover. This model is a simulated form of MS that creates conditions similar to the disease in animals. With this approach, scientists can study inflammatory and immune activities in the body, leading to a better understanding of the causes and treatments of the disease. Khoury, by utilizing this method, was able to achieve a more precise analysis of the factors influencing the development of the disease, particularly the environmental factors involved. Through this approach, she simulated various events and predicted the potential consequences of environmental changes, making a significant contribution to our understanding of the relationship between the environment and health.
Genetic Predisposition Only Explains a Fraction of the Increased Risk 
The exact causes of MS are still not fully understood, but research suggests it is the result of a complex interaction between genetic and environmental factors. While genetics plays a key role in many diseases, studies on MS have not yet been able to fully establish the inheritance patterns of the disease. Research on the DNA of MS patients shows that more than 200 genetic variants are associated with the disease and may increase the likelihood of developing it; however, these variants alone do not cause the disease. As a result, even if an individual carries these specific variants, they will have a lower chance of developing MS if they live in a healthy environment. Scientists continue to study the relationship between genetics and environment to better understand the disease and come up with preventive approaches.
Here, we examine a few environmental factors affecting MS, according to Khoury's research:
Vitamin D Deficiency
"vitamin D" is often associated with two words: calcium and bones. However, the role of this vitamin goes beyond just calcium absorption and bone strength. Khoury's research on the impact of vitamin D on MS represents a significant step in understanding the connection between nutrition and the health of the nervous system. Since this vitamin plays a crucial role in regulating immune responses, it can act as a protective agent against inflammation and neural damage in this disease. Additionally, vitamin D influences the proliferation and differentiation of neural stem cells, potentially increasing the production of oligodendrocytes, which are the primary cells responsible for creating myelin. The tests in this study showed that patients with insufficient vitamin D levels scored lower on the Symbol Digit Modalities Test (SDMT). In this test, participants must memorize symbols with numbers shown beforehand and then re-associate them. The mentioned research indicates that lower scores in individuals with insufficient vitamin D suggest that their brain processing speed was slower than normal. In another phase, MRI scans revealed that patients who received adequate vitamin D levels had significant changes in brain volume, especially in the cerebellum. Khoury noted that obtaining vitamin D through sunlight or supplements, especially in Middle Eastern countries like Lebanon, where individuals often show low levels of this vitamin, could help improve MS-related symptoms. However, it's important to note that awareness of vitamin D’s wide-ranging effects should not lead to self-prescription. As a fat-soluble vitamin, vitamin D should be taken under medical supervision, since high doses can cause serious side effects.
Smoking Fuels the Flame of MS
Smoking is a risk factor for MS. Smokers, compared to those who have never smoked, tend to have worse conditions, with the progression of the disease being faster. Additionally, smoking accelerates brain tissue loss, and gradually, smokers experience greater challenges with their neurological functions. In general, smoking not only impacts the severity of the disease but also causes faster progression and more severe complications for patients. As a result, quitting smoking can be a beneficial step toward improving the health of these individuals.
From the Equator to the Poles
Khoury's research on 50,000 patients shows that geographic factors such as climate, sunlight, and even cultural traditions can contribute to the development of secondary progressive MS. People living in northern and colder regions are at a higher risk of developing MS due to the possible effects of low sunlight and vitamin D deficiency, while those living near the equator are likely less prone to the disease. Understanding these geographic factors allows society to adopt more preventive measures in daily life.
A Microscopic Look
Khoury's research on the impact of Epstein-Barr Virus (EBV) showed that viruses can also influence MS. In one of these studies, 249 MS patients were compared to 230 healthy individuals. The results revealed that the patients had the highest levels of EBV-related antibodies compared to the healthy controls. This finding led to the hypothesis that B lymphocytes infected with this virus could negatively affect immune cell function through a molecule called an exosome. However, it’s important to note that this virus is not the primary cause of the disease; it merely increases the likelihood of developing MS.
From Research to Treatment
Cytokines are crucial proteins that help regulate immune responses, and any disruption in their function can lead to autoimmune diseases, including MS. Therefore, balancing these levels may be effective in preventing disease progression. Khoury is working on improving the condition of patients by researching cytokines like TGF-β. Additionally, her research has led to clinical studies using oral antigens. One of the interesting results of the research has been the success in inducing oral tolerance. When specific antigens are introduced orally into the body, they can reduce the immune reactions that cause autoimmune diseases. Essentially, using these antigens could help the immune system recognize them as part of the body and not attack them. By generating a favorable immune response, this process helps reduce symptoms of MS and EAE (Experimental Autoimmune Encephalomyelitis).
In conclusion, the research findings are significant for both the scientific community and the general public, helping to raise awareness and fight the disease. Samia Khoury, with her wealth of experience, has become a symbol of hope and motivation for those affected. Through her efforts, she has shown that hope can illuminate the way, even in the darkest moments.