Tissue banking may not exactly be a household phrase in Arizona, but it could soon become one.
As the research industry continues to grow rapidly both in-state and nationwide, the demand for tissue samples to use in clinical studies has kept pace. Thus, the relatively unknown concept of creating tissue repositories has quietly made its way onto the local bioscience landscape.
The trend is in keeping with the recommendations of Arizona’s Bioscience Roadmap, the result of a comprehensive study conducted by Battelle in 2002. According to the Roadmap, building the state’s clinical infrastructure should be one of Arizona’s main strategies for developing a healthy bioscience industry.
The establishment of tissue repositories in Arizona not only helps to build that infrastructure, but also serves to strengthen the state’s growing reputation as a center for bioscience research.
“Tissue banking is really critical to Arizona’s research efforts,” says Mitch Horowitz of Battelle. “Tissue banks give the state a leg-up in the field of molecular diagnostics and therapeutics, positioning Arizona for great advancement in personalized medicine.”
Three significant tissue banking efforts lead the effort in Arizona: repositories developed at the International Genomics Consortium (IGC); Sun Health Research Institute; and Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center.
Each institution, though varying in size, methodology, and focus, represents an important contribution to Arizona’s biosciences.
Setting a national example
Thanks to its quiet but significant work in tissue banking, IGC has attracted national attention and a five-year, $6.6 million grant.
IGC in collaboration with the Translational Genomic Research Institute (TGen), was selected out of more than 370 applicants nationwide to create a national tissue bank of cancer tumor specimens for The Cancer Genome Atlas Project (TCGA).
Funded by the National Institutes of Health, TCGA is considered the next phase of the Human Genome Project, a 13-year effort to map the human genome.
TCGA will initially attempt to map the genomes of three different kinds of cancer—lung, brain, and ovarian—in order to better understand the diseases and develop new treatments and therapies.
One of the project’s four central components is the tissue bank, called the Human Cancer Biospecimen Core Resource (BCR), which will gather and analyze tissue specimens.
IGC’s selection to run the BCR “is a return on the vision to the city, county, state, and the other entities involved that have invested to bring us here,” says Dr. Robert J. Penny, IGC’s chief operating and medical officer and principal investigator for the BCR.
According to Penny, the program will build on IGC’s original Expression Project for Oncology (expO), an innovative program that succeeded in creating a database of tumor tissues for public access. In order to do this, IGC had to de-identify the profiles — removing details that could identify tissue donors.
In order to collect a wide range of standardized specimens, expO formed working partnerships with AmeriPath and US Oncology, two of the nation’s leading institutions in pathology research. Each institution boasts an extensive network of hospitals, physicians, and pathologists nationwide.
“We estimate that, between the two, we have access to 30-35 percent of oncology patients in the United States,” says Penny, who plans to utilize these partnerships for the national repository as well.
ExpO, explains Penny, was a trial run for a more comprehensive database like the BCR. In achieving success with expO, he says, IGC gained “core competencies” needed to tackle TCGA.
These core competencies include being able to collect tissue specimens nationwide, get patients’ consent in an “ethically appropriate manner,” de-identify patients’ tissue, and create an extensive public database featuring project findings, says Penny.
According to Penny, IGC’s expertise in these areas made them strong candidates for running the national repository.
IGC’s lead role in one of the nation’s centerpiece scientific efforts signals a major victory for both the institute itself and the state’s bioscience industry.
In order for Arizona’s bioscience community to thrive, explains Penny, “It’s important that there is collaboration on research efforts with Sun Health, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Scottsdale Health, Banner Health, and Mayo Clinic. Collaboration will be of great value for the state to go forward and be successful in the bioscience industry.”
“It’s a tremendous honor to be able to do this,” says Penny. “It’s really about how you affect patient care, both in discovery and in the big picture.”
Serving a unique community
To understand Sun Health Research Institute’s tissue banking program, one must first understand the unique history of the institution itself.
Established in the retirement community of Sun City in 1986, the institute started without buildings or funding.
Its founder, Dr. Joseph Rogers, left his posts at the University of Massachusetts and Harvard’s National Alzheimer’s Disease Research Center to come to Arizona and take on a program that did not yet exist.
Sun City, Rogers realized, offered an unparalleled opportunity for aging and disease studies. With more than 75,000 residents over the age of 65 in the greater Sun City area, the community represented a wealth of resources for a researcher interested in aging.
The institute, which focuses primarily on Alzheimer’s research, began soliciting community support in the form of financial donations, volunteers, patients for clinical studies, and tissue donations.
The community, in turn, recognized the importance of a local research institution dedicated to curing diseases of aging and responded enthusiastically.
Today, Sun Health’s tissue bank is a testament to the institute’s foundation of community support.
The bank started in 1987 as a brain repository. Since then, more than 2,000 people have enrolled as donors and many more have served as volunteers.
The repository utilizes a network of trained scientists and volunteers who wait on-call to retrieve a donor’s body as soon as possible after death. The system has become so efficient that the time between death and autopsy averages 2.5 hours—the shortest post-mortem delay in the world.
Tissue donation is a necessary component in aging disease research, as researchers must have high quality diseased and normal tissues to use in their studies.
Using donated brain tissues, says Dr. Tom Beach, senior scientist and head of the Dr. W. Harold Civin Laboratory of Neuropathology at Sun Health, the institute has been able to pioneer a number of Alzheimer’s treatments, from anti-inflammatory treatments to cholesterol-lowering agents, all of which are still in experimental stages of clinical trials.
The success of the brain banking program positioned Sun Health to expand into collecting other body tissues as well.
Beach says the expansion “has more than doubled — in fact, tripled — our workload.”
Nevertheless, the repository’s broadened program sets the stage for Sun Health to enlarge its research focus.
“Our expansion into the Brain and Body Donation Program will provide the scientific raw material we need to begin studying other major diseases of aging,” explains Beach. “So far we’ve only studied Alzheimer’s and Parkinson’s, as well as arthritis, and now we would like to expand into heart disease and cancer.”
According to Beach, the expansion to brain and body tissues is also intended to help ease the national shortage of tissue specimens for cancer research.
“The National Cancer Institute has said that the biggest single obstacle to cancer research is availability of tissue,” Beach explains. “So within four or five years, we hope to have a very good cancer bank for the most common cancers.”
Sun Health also hopes to contribute more to the statewide research effort underway in Arizona. “We’ve always had our brain bank available to other institutions in Arizona,” says Beach. “But soon we will have body tissues from all organs available.”
In the meantime, Beach is looking forward to getting the program running on its own so that he can return to the lab full-time.
“Right now with the expansion of the program, I’m spending most of my time administering it, but I need to be getting back to research,” Beach says.
“Because that’s what we’re here for, not just to run a program, but to do research and contribute to the scientific body of knowledge.”
Working toward the future
Barrow Neurological Institute (BNI) already boasts a long list of impressive programs. Now it can add the introduction of a specialized tissue bank to its list of accomplishments.
The Human Specimen Procurement Service (HSPS) was established in 2004 to enable researchers at BNI to utilize the institute’s vast network of patients who undergo treatment for neurological disorders.
Compared to IGC and Sun Health, BNI’s program is a fledgling endeavor. Like Sun Health, however, BNI benefits from a unique patient population — in this case, one that covers a wide range of neurological diseases. As a result, the tissue bank is quickly carving its own niche within Arizona and beyond.
“Barrow Neurological Institute has a phenomenal set of surgeons and facilities, and patients from all over the world come here because of the surgical procedures that are performed, the research, and the state-of-the-art facilities,” explains Sheri English, HSPS program coordinator.
“We have a very rare subset of neurovascular tissues that are invaluable to research because they don’t exist in very many places across the nation.”
According to English, the bank was created to bridge the gap between physicians with access to tissue samples and researchers in desperate need of specimens for their studies.
Patients usually agree to donate, says English, because they want to help find a cure for future generations.
“When we meet with patients to get their consent, one of the things that we stress with them is that often they will not benefit immediately from the research because of the number of years it takes to go from a drug concept to FDA approval,” explains English.
“What we do tell them is that the next generation—whether that’s their grandchildren or their own children—will benefit.”
About 850 patients have given their consent to become donors. Each patient typically gives one to five solid tissue samples.
HSPS currently only provides tissue samples to BNI researchers. As the program continues to develop, however, it aims to make its resources available nationwide.
“Currently we’re providing a lot of internal resources,” says English. “But I think as we strengthen our own processing techniques and refine the specimens that we have into more researchable components, we can help to facilitate research throughout the community.”
The overall goal, says English, “is to provide tissue to any researcher across the nation that could benefit patients as a whole.”
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