Biobank literature update week 41 (2015)
[1] Maximizing the Capabilities of the DoD Serum Repository to Meet Current and Future Needs: Report of the Needs
Panel. Mancuso JD, Mallon TM, Gaydos JC. Military medicine 2015; 180:13-24. In June 2013, the Armed Forces Health
Surveillance Center, Silver Spring, MD, hosted two panels of civilian and military public health and laboratory
professionals to address medical surveillance and primary care needs of the Department of Defense (DoD) that might be
met by a biorepository that contained specimens that would be suitable for testing using emerging laboratory
technologies. The first panel, the "needs panel," was asked to identify capabilities that were needed by the Military
Medicine community to better perform their jobs but were either not presently available or not supported by specimens
archived in the current DoD Serum Repository (DoDSR). A second panel, the "technology panel," considered whether
current technology existed to support the needs identified by the first panel. This report summarizes the findings of the
needs panel, to include recommendations regarding both current capabilities using the DoDSR and possible future
capabilities.
[2] Overview of 'Omics Technologies for Military Occupational Health Surveillance and Medicine. Bradburne C,
Graham D, Kingston HM et al. Military medicine 2015; 180:34-48. Systems biology ('omics) technologies are emerging as
tools for the comprehensive analysis and monitoring of human health. In order for these tools to be used in military
medicine, clinical sampling and biobanking will need to be optimized to be compatible with downstream processing and
analysis for each class of molecule measured. This article provides an overview of 'omics technologies, including
instrumentation, tools, and methods, and their potential application for warfighter exposure monitoring. We discuss the
current state and the potential utility of personalized data from a variety of 'omics sources including genomics,
epigenomics, transcriptomics, metabolomics, proteomics, lipidomics, and efforts to combine their use. Issues in the
"sample-to-answer" workflow, including collection and biobanking are discussed, as well as national efforts for
standardization and clinical interpretation. Establishment of these emerging capabilities, along with accurate xenobiotic
monitoring, for the Department of Defense could provide new and effective tools for environmental health monitoring
at all duty stations, including deployed locations.
[3] An Overview of Biorepositories-Past, Present, and Future. Siwek M. Military medicine 2015; 180:57-66. The
collection, storage, and distribution of biological materials for research and improving health have been employed for
more than a century. Biorepositories have been used to maintain and reallocate these specimens. Historically, the
Department of Defense (DoD) has been maintaining biorepositories and using the materials stored to expand our
understanding of diseases and for developing medical countermeasures since the Civil War. Other U.S. Government and
nongovernmental organizations are also engaged in curating human and other samples for future studies, as are
organizations in other countries. The reasons for collection and the possible uses of specimens maintained within
repositories have changed with the advent of novel technologies and the genomics discipline. However, over the years,
many of the issues faced by repositories have remained largely the same, although of increased importance more
recently because of limited funding and enhanced ethical concerns. These issues include what samples to collect; how to
collect, transport, and store the samples; legal and ethical matters relating to sample collection and use; durability of
analytes of interest in stored specimens; assessing the quality of stored specimens and providing researchers with
statements of specimen quality; costs; maintenance and sustainability of the repository; and, implementing and
maintaining laboratory quality programs and possibly accreditation. National and international scientific groups are
working to identify and define best practices, but universal standards and practices remain challenges for the future. To
begin addressing the above issues, the DoD implemented several initiatives, which are described elsewhere in this
Military Medicine Supplement. Additionally, staff members working on the issues saw potential value in identifying
other biorepository groups and similar work being done by these groups with the expectation of developing lines of
communication and, eventually, even collaboration in establishing universal standards and practices. The repositories
identified are briefly discussed in this report.
[4] The Air Force Health Study Data and Specimens as a Resource for Researchers. Styka AN, Butler DA. Military
medicine 2015; 180:79-84. The Air Force Health Study (AFHS) is perhaps the most thorough longitudinal examination of
both the health of military personnel and the health effects of herbicide exposure ever conducted. Data were collected
through comprehensive physical examinations, questionnaires, and other records at six time points over a 20-year
Biobank literature update week 41 (2015)
period; 2,758 subjects participated in at least one examination cycle. Data collected during physical examinations
included indices of health status overall and specific endpoints for each organ system. Questionnaire data included
sociodemographic information, marital and fertility history, health habits, recreation activities, toxic substances
exposure, and military experience. Biospecimens were collected at each examination cycle; serum was collected at all six
examinations while other biospecimens, such as semen and whole blood, were collected at one time. More than 200
clinical laboratory tests and measures were performed, with more than 60 of these measured at all six cycles. The vast
amount of electronic data and the more than 91,000 unaliquoted biospecimens contained in the repository offer unique
opportunities for new research on understanding determinants of health. The Institute of Medicine is the custodian of
the AFHS materials and conducted a pilot research program to facilitate new research using the materials. An expert
committee issued requests for proposals, created a Web-based form for submissions, reviewed and evaluated potential
research studies, and made data and biospecimens available to qualified researchers. This article summarizes the
experience of this initiative.
[5] The DoD Joint Pathology Center as a Resource for Researchers. Butler DA, Baker TP. Military medicine 2015; 180:8589. The Department of Defense's Joint Pathology Center (JPC) is the world's largest collection of human pathology
specimens, comprising some 7.4 million accessions. The biorepository, which began during the Civil War as a collection
of materials obtained from medical and surgical procedures performed by Army physicians, houses specimens and
associated data obtained for diagnostic purposes. It also holds several collections of specimens from military personnel
who shared a common, service-related exposure or medical condition. This article, which is excerpted and adapted from
the 2012 Institute of Medicine report "Future Uses of the Department of Defense JPC Biorepository,"1 summarizes
information on the repository, its past uses, and the future operational issues and challenges that the JPC faces as it
develops a concept of operations that will allow it to move forward as a resource for researchers.
[6] Building a DoD Biorepository for the Future: Potential Benefits and Way Forward. Lindler LE. Military medicine
2015; 180:90-94. Significant advances have been made in the molecular analyses of the human physiological state. In
general, these techniques have been termed "omics" because of their requirements for sophisticated analyses of large
datasets. Application of these new omics technologies has led to advances in medical practice related to public health as
well as a new field termed personalized medicine. The Department of Defense (DoD) consistently needs the ability to
identify people who have been exposed to environmental hazards during deployments and in their day-to-day jobs. The
department currently has a biorepository of sera collected from military service members and has used that repository
to study potential environmental exposures (toxins and infectious diseases) since 1987. The DoD Serum Repository is
also linked to service member health records, making it a very powerful tool for studies related to force health
protection and public health practice. However, this repository does not contain a reliable source of nucleic acid.
Accordingly, to take advantage of modern molecular omics technologies, the DoD should establish an enhanced
biospecimen repository that can support future questions related to force health protection. This article briefly discusses
the various omics techniques, and how they can be used for analyses to support medical practice and public health.
[7] Genetic Testing and Tissue Banking for Personalized Oncology: Analytical and Institutional Factors. Miles G, Rae J,
Ramalingam SS, Pfeifer J. Seminars in oncology 2015; 42:713-723. Personalized oncology, or more aptly precision
oncogenomics, refers to the identification and implementation of clinically actionable targets tailored to an individual
patient's cancer genomic information. Banking of human tissue and other biospecimens establishes a framework to
extract and collect the data essential to our understanding of disease pathogenesis and treatment. Cancer cooperative
groups in the United States have led the way in establishing robust biospecimen collection mechanisms to facilitate
translational research, and combined with technological advances in molecular testing, tissue banking has expanded
from its traditional base in academic research and is assuming an increasingly pivotal role in directing the clinical care of
cancer patients. Comprehensive screening of tumors by DNA sequencing and the ability to mine and interpret these
large data sets from well-organized tissue banks have defined molecular subtypes of cancer. Such stratification by
genomic criteria has revolutionized our perspectives on cancer diagnosis and treatment, offering insight into prognosis,
progression, and susceptibility or resistance to known therapeutic agents. In turn, this has enabled clinicians to offer
treatments tailored to patients that can greatly improve their chances of survival. Unique challenges and opportunities
Biobank literature update week 41 (2015)
accompany the rapidly evolving interplay between tissue banking and genomic sequencing, and are the driving forces
underlying the revolution in precision medicine. Molecular testing and precision medicine clinical trials are now
becoming the major thrust behind the cooperative groups' clinical research efforts.
[8] Ongoing Use of Data and Specimens From National Cancer Institute-Sponsored Cancer Prevention Clinical Trials in
the Community Clinical Oncology Program. Minasian LM, Tangen CM, Wickerham DL. Seminars in oncology 2015;
42:748-763. Large cancer prevention trials provide opportunities to collect a wide array of data and biospecimens at
study entry and longitudinally, for a healthy, aging population without cancer. This provides an opportunity to use prediagnostic data and specimens to evaluate hypotheses about the initial development of cancer. We report on strides
made by, and future possibilities for, the use of accessible biorepositories developed from precisely annotated samples
obtained through large-scale National Cancer Institute (NCI)-sponsored cancer prevention clinical trials conducted by the
NCI Cooperative Groups. These large cancer prevention studies, which have enrolled more than 80,000 volunteers,
continue to contribute to our understanding of cancer development more than 10 years after they were closed.