Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, Torre La Sabana, 7mo piso, Sabana Norte, San José, Costa Rica.
Cancer Epidemiol Biomarkers Prev. 2010 Apr;19(4):916-22. doi: 10.1158/1055-9965.EPI-10-0066. Epub 2010 Mar 23.
The Proyecto Epidemiológico Guanacaste (PEG) has conducted several large studies related to human papillomavirus (HPV) and cervical cancer in Guanacaste, Costa Rica in a long-standing collaboration with the U.S. National Cancer Institute. To improve molecular epidemiology efforts and save costs, we have gradually transferred technology to Costa Rica, culminating in state-of-the-art laboratories and a biorepository to support a phase III clinical trial investigating the efficacy of HPV 16/18 vaccine.
Here, we describe the rationale and lessons learned in transferring molecular epidemiologic and biorepository technology to a developing country.
At the outset of the PEG in the early 1990s, we shipped all specimens to repositories and laboratories in the United States, which created multiple problems. Since then, by intensive personal interactions between experts from the United States and Costa Rica, we have successfully transferred liquid-based cytology, HPV DNA testing and serology, chlamydia and gonorrhea testing, PCR-safe tissue processing, and viable cryopreservation. To accommodate the vaccine trial, a state-of-the-art repository opened in mid-2004. Approximately 15,000 to 50,000 samples are housed in the repository on any given day, and >500,000 specimens have been shipped, many using a custom-made dry shipper that permits exporting >20,000 specimens at a time. Quality control of shipments received by the NCI biorepository has revealed an error rate of <0.2%. Recently, the PEG repository has incorporated other activities; for example, large-scale aliquotting and long-term, cost-efficient storage of frozen specimens returned from the United States. Using Internet-based specimen tracking software has proven to be efficient even across borders.
For long-standing collaborations, it makes sense to transfer the molecular epidemiology expertise toward the source of specimens. The successes of the PEG molecular epidemiology laboratories and biorepository prove that the physical and informatics infrastructures of a modern biorepository can be transferred to a resource-limited and weather-challenged region. Technology transfer is an important and feasible goal of international collaborations.
Proyecto Epidemiológico Guanacaste(PEG)在与美国国家癌症研究所的长期合作下,在哥斯达黎加瓜纳卡斯特进行了几项与人类乳头瘤病毒(HPV)和宫颈癌相关的大型研究。为了提高分子流行病学研究的效率并节约成本,我们逐渐将技术转移到哥斯达黎加,最终建立了最先进的实验室和生物库,以支持一项评估 HPV 16/18 疫苗疗效的 III 期临床试验。
本文描述了将分子流行病学和生物库技术转移到发展中国家的基本原理和经验教训。
在 20 世纪 90 年代初 PEG 项目开始时,我们将所有标本都运送到美国的储存库和实验室,这造成了许多问题。此后,通过美国和哥斯达黎加专家之间的密集互动,我们成功地转移了液基细胞学、HPV DNA 检测和血清学、衣原体和淋病检测、PCR 安全组织处理以及可存活的冷冻保存技术。为了适应疫苗试验,一个最先进的储存库于 2004 年年中开放。目前每天有 15000 到 50000 个样本存放在储存库中,已经运送了超过 50 万份样本,其中许多使用定制的干运器,一次可运送超过 20000 份样本。美国国家癌症研究所生物库对收到的样本进行的质量控制显示,错误率低于 0.2%。最近,PEG 储存库还开展了其他活动,例如对从美国返回的冷冻标本进行大规模分装和长期、经济高效的储存。使用基于互联网的标本跟踪软件,即使跨越国界也非常高效。
对于长期合作,将标本来源的分子流行病学专业知识转移过来是有意义的。PEG 分子流行病学实验室和生物库的成功证明,现代生物库的物理和信息基础设施可以转移到资源有限和气候条件恶劣的地区。技术转让是国际合作的一个重要且可行的目标。