Self-Immolation in the Arab World: A Systematic Review

Introduction

Self-immolation is the centuries-old act of setting fire to oneself. Recent spikes in self-immolation events have been noticed in the Arab world, specifically in the aftermath of the Arab Spring in 2011.

Objectives

To examine the literature assessing the characteristics and patterns of suicide by self-immolation in the Arab world.

Methods

We registered our systematic review in Prospero [CRD42020207164]. We searched PubMed, Medline, PsycInfo, Embase, and Scopus databases from inception until 6 September 2021. We collected relevant articles via title and abstract screening followed by full-text screening. We then conducted a narrative synthesis of the results.

Results

We found 31 out of 314 articles that fit our inclusion criteria: 4 qualitative and 27 quantitative cross-sectional studies. The quantitative studies had a sample size ranging from 22 to 600 self-inflicted burn victims. The studies emanated from Iraq (n=16), Tunisia (n=6), Saudi Arabia (n=2), Libya (n=2), Jordan (n=2), and Egypt, Palestine and Bahrain collectively (n=3). Studies showed that self-immolators are commonly married females, age ranging between 13 and 66 years old, having no education or solely primary education, and of low socioeconomic status. Self-immolation was more likely to happen at home, usually following marital conflicts, with the primary motive being suicide. Studies highlighted an increase of self-immolation as a form of protest. Kerosene was the most commonly used accelerant. Depression was the most comorbid mental health diagnosis.

Conclusions

Self-immolation is not uncommon in the Arab world. Specific interventions directed at the population at risk are warranted.

Disclosure

No significant relationships.

Transcriptomic profiling of trophoblast fusion using BeWo and JEG-3 cell lines

In human placenta, alteration in trophoblast differentiation has a major impact on placental maintenance and integrity. However, little is known about the mechanisms that control cytotrophoblast fusion. The BeWo cell line is used to study placental function, since it forms syncytium and secretes hormones after treatment with cAMP or forskolin. In contrast, the JEG-3 cell line fails to undergo substantial fusion. Therefore, BeWo and JEG-3 cells were used to identify a set of genes responsible for trophoblast fusion. Cells were treated with forskolin for 48 h to induce fusion. RNA was extracted, hybridised to Affymetrix HuGene ST1.0 arrays and analysed using system biology. Trophoblast differentiation was evaluated by real-time PCR and immunocytochemistry analysis. Moreover, some of the identified genes were validated by real-time PCR and their functional capacity was demonstrated by western blot using phospho-specific antibodies and CRISPR/cas9 knockdown experiments. Our results identified a list of 32 altered genes in fused BeWo cells compared to JEG-3 cells after forskolin treatment. Among these genes, four were validated by RT-PCR, including salt-inducible kinase 1 (SIK1) gene which is specifically upregulated in BeWo cells upon fusion and activated after 2 min with forskolin. Moreover, silencing of SIK1 completely abolished the fusion. Finally, SIK1 was shown to be at the center of many biological and functional processes, suggesting that it might play a role in trophoblast differentiation. In conclusion, this study identified new target genes implicated in trophoblast fusion. More studies are required to investigate the role of these genes in some placental pathology.