Tucked away in freezers chilled to minus-80 degrees centigrade are thousands of blood and tissue samples. Protected by alarms and backup power generators, they are among Cedars-Sinai Medical Center's most precious materials.
Now the infrastructure supporting this collection is being updated and expanded to make this resource more useful to researchers and clinical investigators alike.
Back in 2007, Mahul Amin, MD, chair of Pathology and Laboratory Medicine, envisioned updating and integrating existing Cedars-Sinai efforts under the Cedars-Sinai Biobank and Translational Research Core. The aim was to create an enterprise-wide, state-of-the-art biorepository that would generate new avenues for research to develop personalized treatments. Until then, there had been several large preexisting tissue collections - disease-specific legacy biobanks - established by individual investigators.
The biobank initiative was accelerated by a large federal grant received by Cedars-Sinai Academic Affairs and by the recruitment of Beatrice Knudsen, MD, PhD, in May 2011. Knudsen is the medical director of the biobank and director of Translational Pathology in the Departments of Pathology and Laboratory Medicine and Biomedical Sciences.
"We are just at a point where we have put together the basic structure of the biobank, and we are ready to mount an educational campaign about it," Knudsen said. "We cannot do this in isolation. Everyone is a stakeholder. We really want opinions and input from the community before moving forward."
Under strict procedures, Cedars-Sinai patients are fully informed about the biobank and sign a voluntary consent form before donating tissue or blood samples. Currently, the biospecimens are stored in the Pathology Department in the South Tower and in the Davis Research building. After the Advanced Health Sciences Pavilion opens next year, the biobank will be housed in the Spielberg Building.
"What we've done is to integrate the tissue collections for all those biorepositories," Knudsen said. "We have centralized the collection. The benefit of this is there is a systematic and consistent approach to collecting tissue samples, and there is associated quality control for the tissues."
Consistency in handling biospecimens is important to guarantee the accuracy of research. "You can change the constituents of the tissue if you don't stabilize it quickly enough," she said. Getting a high enough concentration of diseased cells is critical, as is ensuring the integrity of DNA, RNA, proteins and metabolic constituents, such as sugar and fat content.
"We don't want to introduce any changes in the abundance of these constituents after the tissue is removed from the patient," Knudsen said. "We want to have an accurate representation of the disease." In addition, quality control must be customized to the end user, based on the technologies employed for analysis of tissues.
Among many uses, biospecimens can help determine how the same disease can take a different course among individuals. Starting with a focus on cancer, the biobank will help elucidate differences between indolent and lethal cancers - knowledge that can guide treatment and help determine the likelihood of response and resistance to novel drugs.
To meet its goals, the biobank is overseen by a network of internal and external boards, including a steering committee, a biospecimen distribution committee and the Institutional Review Board.
It's a complicated process. In fact, managing tissue samples is sufficiently complex to warrant its own discipline: biospecimen science. With the institution of the biobank, Cedars-Sinai is taking a giant step toward advancing this science.