Existential dilemma for ‘irreplaceable asset’

It’s widely accepted that smoking is detrimental to health. Doctors advise postmenopausal women to maintain a healthy weight to lower their risk of breast cancer. Trans fats have largely vanished from our nutrition.

These pioneering public health initiatives are grounded in the Nurses’ Health Studies, which have monitored data concerning lives and lifestyles — and collected biological samples — from thousands of participating nurses over several decades. Currently, federal cuts in research funding are placing these initiatives at risk.

The biological samples from the studies are preserved in a network of state-of-the-art freezers, which must sustain temperatures as low as 170 degrees below zero Celsius. These freezers are filled with liquid nitrogen and supervised by a small team of research assistants and managers at the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital. Funding for the operation of the biorepository has been discontinued.

“These women have contributed immensely for us,” stated biobank manager Janine Neville-Golden about the volunteers whose blood and tissue are preserved in the repository and who have dedicated their time over the years to complete questionnaires and undergo observation during significant life events such as illness and pregnancy. “We need to safeguard these samples immediately. They are vital for future health.”

The Nurses’ Health Study, initiated in 1976 and extended through a second cohort named Nurses’ Health Study II in the late ’80s, has led to significant advancements in nutritional research, cancer studies, and the comprehension of hormones in women’s health. The Nurses’ Health Study 3, commenced in 2010, includes various types of health professionals and, for the first time, male nurses.

“This is a distinct, irreplaceable asset, in many ways. There are other biobanks, but this one stands out in scale and associated data.”

Jorge Chavarro

In 2010, Chan School researchers Jorge Chavarro, Walter Willett, Janet Rich-Edwards, and Stacey Missmer initiated the third study in cooperation with investigators at the Channing Division of Network Medicine at Brigham and Women’s Hospital and Harvard Medical School to build upon the findings achieved through the study of nurses’ health.

This initiative was launched alongside the Growing Up Today Study (GUTS), which recruits children of Nurses’ Health II participants and has aimed to expand on insights collected from the previous studies.

In light of the funding reductions, sample collection for both studies has been halted.

“This is a distinct, irreplaceable asset, in many regards,” remarked Chavarro, principal investigator for both Nurses Health III and GUTS. “There are alternative biobanks, but this one is unparalleled in scope and associated data.”

Chavarro explained that while collecting biological samples is comparatively straightforward, “What makes a biobank valuable is the ability to connect information from those samples to data about the health of individuals.”

Many participants from Nurses Health I and II — numbering in the hundreds of thousands — have provided multiple biological samples, including urine, cheek swabs, and blood. They have responded to numerous questionnaires and have been observed during major life transitions such as illness and pregnancy.

“These samples were initially gathered when individuals were young and healthy and contain decades of information about their lifestyles and follow-ups,” Chavarro noted.

He highlighted that the Chan School is actively seeking funding to replace the lost federal grants. Yet, without a long-term solution, the crucial liquid nitrogen cannot be acquired, leading to the degradation of millions of samples.

“If a sustainable method for funding the ongoing operations of the biorepositories is not established, we will lose samples,” he cautioned. “It may not happen this week, but it is not something that can be postponed indefinitely.”

Chavarro also expressed concern about the potential loss of the team essential to conducting specimen research like his.

“Running a biorepository involves more than just placing samples in a freezer. It requires considerable technical expertise,” he explained. “You must understand how to store samples under certain conditions, and you need personnel trained to respond if there’s a freezer malfunction.”

Neville-Golden, who has been with the biorepository for 16 years, supervises a minimal crew responsible for maintaining samples and preparing them for research. If a freezer malfunctions in the middle of the night, she is the one who gets called. For her, this initiative is deeply human-centric.

“I’ve learned so much,” she said, ranging from freezer upkeep to the ambitious goals of the researchers she collaborates with to test hypotheses using the samples. “It’s not merely about funding; it’s about service and the greater good.”

Neville-Golden mentioned that her team — a small group of research assistants and a committed project manager, Nicole Romero — receives approximately 200 external requests annually for data from the cohorts.

“There’s a long queue to gain access to these samples, primarily due to insufficient personnel to retrieve the samples that are requested,” she noted.

The team meticulously selects samples from tens of thousands stored in each freezer, thaws them, and prepares them for research. It’s demanding work, yet Neville-Golden remains mindful of the individuals who provided the samples and their hopes in doing so.

“Some have mentioned over the years that when we are at work and witness people suffering from illnesses, we feel compelled to do whatever we can to alleviate that suffering, to make improvements, and reduce pain,” she expressed. “So, it has genuinely been a labor of love.”