OBJECTIVES:In recent years, great progress has been made in the development of diagnostic tools, therapeutic approaches, and validated outcome measures in the understanding of the pathogenesis of ankylosing spondylitis (AS). The purpose of this review was to summarize these developments. METHODS:We performed a PubMed search for the period 1978 to 2005, using the keyword, "ankylosing spondylitis," resulting in a total of 4878 publications, including 778 reviews. Articles were then selected based on their discussion of recent diagnostic tools and new treatment approaches in the pathogenesis of AS, leading to a final total of 104 articles. RESULTS:In recent years, there have been 2 major developments in the management of AS that make earlier diagnosis possible and offer the hope of alleviating pain and preventing structural changes that result in loss of function. These developments include the use of magnetic resonance imaging to visualize the inflammatory changes in the sacroiliac joint and the axial spine, and the demonstration that tumor necrosis factor blocking agents are highly efficacious in reducing spinal inflammation and possibly in slowing radiographic progression. CONCLUSIONS:There have been major advances in both the diagnostic tools and the therapeutic regimens available for patients with AS.

Although the Codex Alimentarius Commission has functioned as part of the United Nations' Food and Agriculture Organization since 1962, its activities have been of little more than occasional interest until recent years. However, with the advent of the World Trade Organization (WTO) and the establishment of the North American Free Trade Agreement (NAFTA) and other trading blocs, the deliberations of Codex have become significantly more important to the international trade interests of government and industry groups alike. Increased interest in the elaboration of Codex standards, guidelines, and recommendations may be attributed to increased international awareness of 2 very practical functions of the Commission and its numerous committees. First, some countries have become aware that the guidance and information needed to fill in their own regulatory gaps are often made available in the Codex. Second, multinational corporations and trade associations have become aware of the role that Codex has been given in the WTO agreements as the means by which disputes over trade in food products may be resolved. Increased awareness of the practical functions of Codex activities in shaping national legislation and establishing international trade standards appears to have strengthened Codex's role as the focal point of efforts to achieve internationally harmonized food standards. However, marry international regulatory gaps show signs of being filled by legislation that imposes burdens on industry without demonstrable benefits to public welfare. In their most troublesome manifestations, some of these measures, especially recent regulations concerning biotech food labeling, could be viewed as technical barriers to trade.

ABSTRACT: Although the Codex Alimentarius Commission has functioned as part of the United Nations' Food and Agriculture Organization since 1962, its activities have been of little more than occasional interest until recent years. However, with the advent of the World Trade Organization (WTO) and the establishment of the North American Free Trade Agreement (NAFTA) and other trading blocs, the deliberations of Codex have become significantly more important to the international trade interests of government and industry groups alike. Increased interest in the elaboration of Codex standards, guidelines, and recommendations may be attributed to increased international awareness of 2 very practical functions of the Commission and its numerous committees. First, some countries have become aware that the guidance and information needed to fill in their own regulatory gaps are often made available in the Codex. Second, multinational corporations and trade associations have become aware of the role that Codex has been given in the WTO agreements as the means by which disputes over trade in food products may be resolved. Increased awareness of the practical functions of Codex activities in shaping national legislation and establishing international trade standards appears to have strengthened Codex's role as the focal point of efforts to achieve internationally harmonized food standards. However, many international regulatory gaps show signs of being filled by legislation that imposes burdens on industry without demonstrable benefits to public welfare. In their most troublesome manifestations, some of these measures, especially recent regulations concerning biotech food labeling, could be viewed as technical barriers to trade.

Biotechnology has the potential to meet the ever-increasing demand for enhanced food production. However, several factors besides scientific and agricultural advances can disrupt the progress of this field. This article reviews the interactions between political, regulatory, international, activist, consumer, and scientific entities. A discussion of the precautionary principle is included.