DRUG MISUSE AND SELF-MEDICATION AMONG PHARMACY STUDENTS IN JORDAN.

OBJECTIVE: Aim: To estimate risks and prevalence of self-medication and potential abuse risk among pharmacy students in Jordanian Universities. PATIENTS AND METHODS: Materials and Methods: A cross-sectional study design was conducted with 450 students, selected using multistage sampling methods, from seven different universities. Data was collected by self-administrated questionnaires covering demographic and academic information, health-related information, use of self-medication, and pattern of self-medication among pharmacy students. RESULTS: Results: Out of 394 students who answer the questions, 76.9% reported that they had usually treated themselves in case of simple cases without physician or pharmacist consultation. Most commonly used drugs among the surveyed students were Paracetamol 60%, multivitamins supplement 74.25%, and herbal products 37.2%, combination of NSAIDs and Paracetamol 20.6%, and laxatives 19.4%. Cold and flu 25.5%, headache 22.3%, abdominal pain 7.9%, gastric pain 7.9%, cold and flu, headache, abdominal pain, and gastric pain 14.9% were the main conditions which contribute to self-medication practice. It was also found that Pharmacy students were over-confident with the type of cases they could treat without referral to a specialist physician, despite knowing that some of the symptoms may be due to serious health problems. Misuse of analgesics and laxatives was clear, and there was a weakness in knowledge of the indications for the use of the most common drug. CONCLUSION: Conclusions: The prevalence of self-medication among pharmacy students in Jordan is high, and medical teaching institutions need to educate students about the proper use of medicines. Strict legislation and more education on self-medication are necessary for effective use of medicines.

Extracellular vesicles are conduits for E. coli heat-labile enterotoxin (LT) and the B-subunits of LT and cholera toxin in immune cell-to-cell communication.

Several pathogens excrete their toxins either directly into the host or through extracellular vesicles. Enterotoxigenic E. coli is capable of secreting heat-labile toxin LT in extracellular vesicles (EVs) which are delivered to mammalian cells. LT and its B-subunit, LTB, and their structurally and functionally related toxin from Vibrio cholerae, CT and CTB, are potent immunogens and adjuvants. However, despite their reported remarkable effects on immune cells, the mechanisms by which they mediate their immunological properties are still unclear. We show that B cells incubated with LT or LTB secreted EVs in the cell culture medium. However, compared to unstimulated cells, EVs and their internal protein content were significantly reduced in recipient B cells. Analysis of protein markers of the vesicles secreted by B cells were found to be enriched in exosomes of endosomal origin. B cells incubated with FITC-CTB secreted CTB in EVs which were taken up by recipient B and T cells. FITC-CTB transfected into exosomes from mouse dendritic cells were also taken up by recipient B cells. Moreover, B cells incubated with FITC-CTB secreted CTB in EVs which increased the number of recipient B cells expressing higher levels of CD25 and CD86. These results suggest that EVs from B cells are conduits for the enterotoxins, and play an important role in the enterotoxins immune cell-to-cell communication. This is the first report which looked at EVs as a mean to deliver these proteins from and to immune cells.

Uniqueness of RNA Coliphage Qß Display System in Directed Evolutionary Biotechnology.

Phage display technology involves the surface genetic engineering of phages to expose desirable proteins or peptides whose gene sequences are packaged within phage genomes, thereby rendering direct linkage between genotype with phenotype feasible. This has resulted in phage display systems becoming invaluable components of directed evolutionary biotechnology. The M13 is a DNA phage display system which dominates this technology and usually involves selected proteins or peptides being displayed through surface engineering of its minor coat proteins. The displayed protein or peptide's functionality is often highly reduced due to harsh treatment of M13 variants. Recently, we developed a novel phage display system using the coliphage Qß as a nano-biotechnology platform. The coliphage Qß is an RNA phage belonging to the family of Leviviridae, a long investigated virus. Qß phages exist as a quasispecies and possess features making them comparatively more suitable and unique for directed evolutionary biotechnology. As a quasispecies, Qß benefits from the promiscuity of its RNA dependent RNA polymerase replicase, which lacks proofreading activity, and thereby permits rapid variant generation, mutation, and adaptation. The minor coat protein of Qß is the readthrough protein, A1. It shares the same initiation codon with the major coat protein and is produced each time the ribosome translates the UGA stop codon of the major coat protein with the of misincorporation of tryptophan. This misincorporation occurs at a low level (1/15). Per convention and definition, A1 is the target for display technology, as this minor coat protein does not play a role in initiating the life cycle of Qß phage like the pIII of M13. The maturation protein A2 of Qß initiates the life cycle by binding to the pilus of the F+ host bacteria. The extension of the A1 protein with a foreign peptide probe recognizes and binds to the target freely, while the A2 initiates the infection. This avoids any disturbance of the complex and the necessity for acidic elution and neutralization prior to infection. The combined use of both the A1 and A2 proteins of Qß in this display system allows for novel bio-panning, in vitro maturation, and evolution. Additionally, methods for large library size construction have been improved with our directed evolutionary phage display system. This novel phage display technology allows 12 copies of a specific desired peptide to be displayed on the exterior surface of Qß in uniform distribution at the corners of the phage icosahedron. Through the recently optimized subtractive bio-panning strategy, fusion probes containing up to 80 amino acids altogether with linkers, can be displayed for target selection. Thus, combined uniqueness of its genome, structure, and proteins make the Qß phage a desirable suitable innovation applicable in affinity maturation and directed evolutionary biotechnology. The evolutionary adaptability of the Qß phage display strategy is still in its infancy. However, it has the potential to evolve functional domains of the desirable proteins, glycoproteins, and lipoproteins, rendering them superior to their natural counterparts.