Evaluation of biobank constitution and use: multicentre analysis in France and propositions for formalising the activities of research ethics committees

Thoughts on donation of a tooth to science, in the course of dental care

INTRODUCTION

Research on biological samples, including dental pulp stem cells (DPSC), has expanded considerably in recent years and is now seen as a way forward toward the possibilities of new therapies, such as craniofacial bone and tooth repair. The extraction of healthy teeth and their donation for scientific research is now well accepted by both patients and researchers alike. The present situation, as described above, presents a timely opportunity to reflect on the ethical and moral obligations of all of the stakeholders involved in this methodology.

METHOD

Twenty-two patients who received dental treatment between November 2013 and February 2014 in the dental department of Louis Mourier Hospital in Colombes, France, completed a questionnaire. The questionnaire was designed to gather data in respect of giving patients optimal information necessary to acquire informed consent for extraction of teeth to be used for odontological biomedical research.

RESULTS

When patients agree to donate their teeth for purposes of scientific research it is vital that they are properly informed and enabled so that they are able to give consent freely.

CONCLUSIONS

The risks to patients during dental extractions are minimal. However despite the growing need for a supply of extracted teeth for dental pulp stem cell research it is imperative that any ethical questions that may be raised by potential donors guarantee the security, integrity, and respect of the intentions and aspirations of the donor. To enable the acquisition of true informed consent, this article explores how the dissemination of information relating to biomedical research in the field of dental care must remain as a duty of care and professional ethics.

Ethical aspects of human biobanks: a systematic review

Aim

To systematically assess the existing literature on ethical aspects of human biobanks.

Method

We searched the Web of Science and PubMed databases to find studies addressing ethical problems in biobanks with no limits set (study design, study population, time period, or language of publication). All identified articles published until November 2010 were included. We analyzed the type of published articles, journals publishing them, involvement of countries/institutions, year of publication, and citations received, and qualitatively assessed every article in order to identify ethical issues addressed by the majority of published research on human biobanking.

Results

Hundred and fifty four studies satisfied our review criteria. The studies mainly came from highly developed countries and were all published in the last two decades, with over half of them published in 2009 or 2010. They most commonly discussed the informed consent, privacy and identifiability, return of results to participants, importance of public trust, involvement of children, commercialization, the role of ethics boards, international data exchange, ownership of samples, and benefit sharing.

Conclusions

The focus on ethical aspects is strongly present through the whole biobanking research field. Although there is a consensus on the old and most typical ethical issues, with further development of the field and increasingly complex structure of human biobanks, these issues will likely continue to arise and accumulate, hence requiring constant re-appraisal and continuing discussion.

Pediatric HIV BioBank: a new role of the Spanish HIV BioBank in pediatric HIV research

The vulnerability of children has long raised ethical concerns resulting in the lack of inclusion of children in research studies. This has impeded the development of relevant medical therapies specific for children. In response to these circumstances, international policies have begun to recognize the need to carry out research focused on children. Translational HIV infection research is highly dependent on many factors including the availability, quality, and traceability of samples and their associated data under a strict system of quality management. The primary objective of the Pediatric HIV BioBank is to contribute to the furthering of scientific knowledge about vertical HIV infection. To achieve this aim, the BioBank processes, stores, and provides distinct samples from HIV/AIDS children to research projects free of charge. Strict compliance to ethical norms is always guaranteed. At present the Pediatric HIV BioBank has 429 vials containing different sample types from 243 vertically HIV-infected children. The Pediatric HIV BioBank represents a novel approach to HIV research that might be of general interest not only for basic and clinical research teams working with HIV, but also for those groups trying to establish large networks focused on researching specific clinical problems. It also represents a model to stimulate cooperative research on specific clinical problems. The main objective of this article is to show the structure and function of the Pediatric HIV BioBank that allow it to efficiently provide samples to different research projects in Spain and in other countries.

The Spanish HIV BioBank: a model of cooperative HIV research

Background

The collection of samples from HIV-infected patients is the beginning of the chain of translational research. To carry out quality research that could eventually end in a personalized treatment for HIV, it is essential to guarantee the availability, quality and traceability of samples, under a strict system of quality management.

Methods

The Spanish HIV BioBank was created with the objectives of processing, storing and providing distinct samples from HIV/AIDS patients, categorized according to strictly defined characteristics, free of charge to research projects. Strict compliance to ethical norms is always guaranteed.

Results

At the moment, the HIV BioBank possesses nearly 50,000 vials containing different prospective longitudinal study sample types. More than 1,700 of these samples are now used in 19 national and international research projects.

Conclusion

The HIV BioBank represents a novel approach to HIV research that might be of general interest not only for basic and clinical research teams working on HIV, but also for those groups trying to establish large networks focused on research on specific clinical problems. It also represents a model to stimulate cooperative research among large numbers of research groups working as a network on specific clinical problems. The main objective of this article is to show the structure and function of the HIV BioBank that allow it to very efficiently release samples to different research project not only in Spain but also in other countries.

Rhode Islanders' attitudes towards the development of a statewide genetic biobank

AIMS

To explore the attitudes of a voluntary subset of Rhode Island residents towards the potential development of a large, prospective, population-based study of sudden cardiac arrest, which will include a biobank to store blood for future biochemical and molecular analyses.

METHODS

A mailed survey and focus groups.

RESULTS

Survey respondents and focus group participants indicated willingness to provide biospecimens, medical history and personal lifestyle information, and to undergo medical tests. Both datasets included multiple concerns regarding long-term storage of biospecimens and personal information, and the need of potential biobank participants for detailed information regarding study protocols and oversight.

CONCLUSION

A biobank has high potential for successful participant recruitment in Rhode Island if preceded by preparatory steps of public engagement and transparent mechanisms of addressing the population's concerns and questions.

The Genome Austria Tissue Bank (GATiB)

In the context of the Austrian Genome Program, a tissue bank is being established (Genome Austria Tissue Bank, GATiB) which is based on a collection of diseased and corresponding normal tissues representing a great variety of diseases at their natural frequency of occurrence from a non-selected Central European population of more than 700,000 patients. Major emphasis is put on annotation of archival tissue with comprehensive clinical data, including follow-up data. A specific IT infrastructure supports sample annotation, tracking of sample usage as well as sample and data storage. Innovative data protection tools were developed which prevent sample donor re-identification, particularly if detailed medical and genetic data are combined. For quality control of old archival tissues, new techniques were established to check RNA quality and antigen stability. Since 2003, GATiB has changed from a population-based tissue bank to a disease-focused biobank comprising major cancers such as colon, breast, liver, as well as metabolic liver diseases and organs affected by the metabolic syndrome. Prospectively collected tissues are associated with blood samples and detailed data on the sample donor's disease, lifestyle and environmental exposure, following standard operating procedures. Major emphasis is also placed on ethical, legal and social issues (ELSI) related to biobanks. A specific research project and an international advisory board ensure the proper embedding of GATiB in society and facilitate international networking.

[Analysis of the ethical issues raised by a ten-year epidemiology program in French Guiana: limitations of the current legal framework and solutions adopted]

BACKGROUND

This paper discusses the ethical aspects of a large research program in virology, conducted since 1994 and which has evolved in parallel with the elaboration of bioethics laws in France. This research, which involved the collection of a considerable amount of epidemiological data in the field, focused on epidemiological determinants (mother to child transmission, genetic susceptibility/resistance) of the human oncogenic retrovirus human T cell lymphotropic virus type 1 (HTLV-1). Data were collected from a specific population (Noirs Marrons) living in remote areas in French Guiana (South America). This ethnic group of African descent is highly endemic for HTLV-1 and associated adult T cell leukemia/lymphoma. The population has lived for two centuries on either side of the Maroni river, which constitutes the frontier between French Guiana and Surinam. The low socioeconomic and education levels of a large part of this population are mainly explained by a recent housing/residence fixation on the French side of the Maroni river. It is also linked to significant immigration from Surinam due to the civil war, which lasted for five years in the late 1990s, in this country. Conducting epidemiological surveys in this peculiar context illustrates the limitations of the available current legal framework in France for such studies. Indeed, several important ethical issues arose concerning not only individual and population benefits, but also specificities of the given information and of the informed consent. Another question concerns individual information feed-back in such a context of persistent viral infection, with a very low disease incidence, in a population with a relatively low education level. The goal of this work was mainly to report several of the ethical issues encountered and to discuss possible ways of achieving better information deliver and consent procedures in such a context. Indeed, these procedures should include new ideas and regulations promoting a real partnership, in order to conduct long-term epidemiological studies in populations with a low education level.