Biomarkers in asthma and allergic rhinitis.

A biological marker (biomarker) is a physical sign or laboratory measurement that can serve as an indicator of biological or pathophysiological processes or as a response to a therapeutic intervention. An applicable biomarker possesses the characteristics of clinical relevance (sensitivity and specificity for the disease) and is responsive to treatment effects, in combination with simplicity, reliability and repeatability of the sampling technique. Presently, there are several biomarkers for asthma and allergic rhinitis that can be obtained by non-invasive or semi-invasive airway sampling methods meeting at least some of these criteria. In clinical practice, such biomarkers can provide complementary information to conventional disease markers, including clinical signs, spirometry and PC(20)methacholine or histamine. Consequently, biomarkers can aid to establish the diagnosis, in staging and monitoring of the disease activity/progression or in predicting or monitoring of a treatment response. Especially in (young) children, reliable, non-invasive biomarkers would be valuable. Apart from diagnostic purposes, biomarkers can also be used as (surrogate) markers to predict a (novel) drug's efficacy in target populations. Therefore, biomarkers are increasingly applied in early drug development. When implementing biomarkers in clinical practice or trials of asthma and allergic rhinitis, it is important to consider the heterogeneous nature of the inflammatory response which should direct the selection of adequate biomarkers. Some biomarker sampling techniques await further development and/or validation, and should therefore be applied as a "back up" of established biomarkers or methods. In addition, some biomarkers or sampling techniques are less suitable for (very young) children. Hence, on a case by case basis, a decision needs to be made what biomarker is adequate for the target population or purpose pursued. Future development of more sophisticated sampling methods and quantification techniques, such as--omics and biomedical imaging, will enable detection of adequate biomarkers for both clinical and research applications.

Fish- and shellfish--borne trematode infections in Canada.

Food-borne trematode infections are endemic in various parts of the world, particularly Southeast Asia. Despite the high prevalence, morbidity and total costs of these infections, they remain poorly recognized by public health authorities and consumers. Factors such as poor sanitation and traditional methods of food preparation hasten the spread of food-borne trematode infections in endemic regions and must be carefully examined in order to develop effective control strategies. There is also a growing risk to consumers in non-endemic countries as a result of international trade. A considerable quantity of freshwater fish and shellfish is imported into Canada from endemic countries in Southeast Asia. Some of these products are imported fresh or processed in such a way that the infective metacercariae may not be destroyed. Further, current inspection procedures in Canada may not detect the presence of all parasites in imported fish products. Therefore, there may be a risk of infection if the fish or shellfish is consumed raw or lightly cooked. Many of the cases of infection in Canada involve recent immigrants from endemic regions who have become infected either before arriving or through the consumption of traditional or ethnic dishes prepared from imported products. International travel and the increasing availability and interest in ethnic foods also contribute to the risk of infection in all Canadians. In addition to these imported trematodes, a number of species are found in freshwater fishes and shellfish in North America and have also caused illness in humans. Although the prevalence of infection remains relatively low in Canada, the need for an increased general awareness of food-borne trematode infections and their causes is indicated.