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On 13 August 2021, the PGH Biobank was represented at a press conference held by the College of Science UP Diliman to talk about their involvement in a recent publication entitled Elevated levels of perfluoroalkyl substances in breast cancer patients within the Greater Manila Area.

The recent study entitled Elevated levels of perfluoroalkyl substances in breast cancer patients within the Greater Manila Area, aimed to analyze the effect of 41 endocrine-disrupting chemicals (EDCs) on Filipino women by obtaining urine and blood samples of 150 participants with a mean age of
45.8 years old (50% were patients with breast cancer and the other 50% were patients with no breast cancer), to establish baseline data on EDC exposures in Filipino women. EDCs are known to disrupt the normal function of the endocrine system, causing a variety of health issues.

After analyzing EDC concentrations, the study highlighted high Per- and Polyfluoroalkyl substance (PFAS) exposure in participants with breast cancer. Participants with breast cancer who resided in Region IV-A were further noted to have high exposure to long-chain PFAS, suggesting that individuals living in this region may be at a higher risk of PFAS exposure compared to those in NCR. PFAS or Forever Chemicals, are man-made chemicals used in various industries such as food packaging, non-stick cookware, stain-and water-repellant fabrics, paints, cosmetics. They are considered a threat to public and environmental health due to its nature of being a persistent organic pollutant (POPs) and being positively associated with breast cancer occurrence. Significantly enough, participants with breast cancer who worked in factories showed higher PFOSA exposure, compared to those who did not work in such an environment.

With the Philippines having the highest prevalence of breast cancer in Asia and the apparent lack of data regarding EDC exposures in humans, in Southeast Asia, specifically the Philippines, the researchers provided baseline data on the levels of EDC exposures in Filipinas. This study hopes to inspire the need for a biomonitoring program in the country, to hopefully strictly regulate the use of long-chain PFAS.

This study, headed by UP Diliman Professor Dr. Michael Velarde, is a collaborative project between UP Diliman Institute of Biology (UPD-IB), UP Manila Philippine General Hospital (UP-PGH), and the University of California San Francisco (UCSF) through Commission on Higher Education (CHED)-Philippine-California
Advanced Research Institutes (PCARI). Additional information on the press conference may be obtained at the UP Diliman College of Science Website.

Dr. Rodney Dofitas, Prof. Michael Velarde, Dr. Ma. Antonia Habana, Dr. Apple Valparaiso and Dr. Shiela Macalindong, Ma. Easter Joy Sajo PhD, Joji Marie Teves MSc.

The Philippine General Hospital (PGH) Biobank, based at the University of the Philippines-Manila, was established In January 2018 as a unique, investigator-driven initiative to understand the genetic and molecular characteristics of cancer among Filipinos. The government-based biobank collects patient-derived tumor specimens, peripheral blood specimens, hair and urine for long-term storage and application into various biomedical or clinical research pursuits. PGH biobanks new facility envisions that the collected tumor specimens from Filipino cancer patients can extend beyond the institute and can support nationwide studies and even globally, as means for representation of the Filipino community. Moreover, the investigator-driven study supporting the newly established biobank further aims to explore the environmental exposure factors including endocrine-disrupting chemicals and ethnogeographical biodiversity in a groundbreaking attempt to find a cure for cancer. The project is seen to expand all over the country to obtain high quality biospecimens, specifically breast cancer, in the future. As of the moment. the biobank have established collaborations with the University of California in San Francisco and the University of the Philippines-Diliman, and continues to be open for potential collaborators.

WHAT

A biobank is a biorepository that logs, processes, stores, and then distributes biological specimens and samples for further in vitro research or for clinical care [1]. This study evaluated the PGH Biobank experience and assessed the various logistical aspects of establishing and maintaining a biobank. It was found that there is a general lack of equipment and dedicated biobank infrastructure in the Philippines; equipment that is difficult to procure and more often than not, double the price due to the need for a middleman. Moreover, data collection proved to be difficult as there is a lack of standard operating procedures for biobanks in the Philippines. Transport of fresh tissues was also found to be challenging due to long travel times caused by traffic and delayed flights. In the end, the study surmised that there is an overall lack of funding as the public is not well-informed on the advantages of biobanks to advancing clinical research.

WHY

Biobanking systems have progressed globally, but remain underrepresented in developing ASEAN countries. The establishment of a public biobank addresses the high cancer incidence and mortality in the Philippines and provides researchers access to biological samples from a wide array of patients. This includes low-income individuals, a demographic seldom seen in the small biobanks of private hospitals. The Philippine General Hospital (PGH) Biobank and the UPD Institute of Biology (IB) Cell Repository experience demonstrate the feasibility of establishing government-supported cancer biobanks in developing countries. Biospecimen collection from a broader demographic of Filipino patients would provide higher quality data for cancer-related research, biomonitoring studies on the genetic identity and possible risk factors of Filipinos, and the acceleration of medical innovations. The importance of biobank networking has been exemplified by developed institutions around the world, the PGH Biobank allows Filipino researchers to collaborate with other countries in biomonitoring studies, such as those concerning cancer-related health disparities in the ASEAN population.

HOW

The implementation of the PGH biobank included patient recruitment, data collection, sample acquisition, and cell culture as facilitated by the UPD IB Cell Repository. The study assessed the challenges encountered in these aspects, taking into consideration the funding, infrastructure, and technology provided. The researchers presented an outline of the PGH Biobank system, including its workflow and organizational framework. A total of 75 breast, 25 endometrial, and 25 ovarian cancer patients, in addition to 25 healthy people, were subjected to specimen collection: all of Filipino descent. The samples collected comprised of urine, blood, and tissue. Urine and blood were processed and stored until their transferal to USCF for biomonitoring analysis. Tissue samples were immediately shipped to the Institute of Biology (at an ideal temperature of ~4°C), where cancer and cancer-associated cells were then isolated, cultured, and propagated in vitro.

What the Authors Say

“So when I heard about this project, I saw its great potential to support the research and development sector in the Philippines that I decided to come back to the Philippines and work on this project with Prof. Michael C. Velarde, PhD. A biobank is not just simply a collection of biospecimens, it has contributed to a number of translational researches, health innovations, and even policies in other countries. While biobank has progressed globally, the biobank in the Philippines remains to be underrepresented. Thus, I saw a dire need to pursue this field. As evidenced in developed countries, biobanks have accelerated drug, vaccine, and diagnostic tool discovery; biobanks can also be a research collaboration hub for scientists, medical doctors, and researchers to attain more relevant discoveries and innovations in the future.” – 𝐃𝐫. 𝐌𝐚. 𝐄𝐚𝐬𝐭𝐞𝐫 𝐉𝐨𝐲 𝐕. 𝐒𝐚𝐣𝐨

“I want my research to have an impact on society. But in order to push our basic research to be more applicable to the clinic, we have to get clinical samples. This is very difficult given that I do not see patients, as I am not a medical doctor. Vice versa, it is very difficult for clinicians to do research as they are focused on taking care of patients and they have limited time to do research. Hence, a biobank is critical to bridge the gap between basic and translational research by allowing access to human samples for research purposes. Our research explored the possibility of establishing a biobank at a public hospital (PGH) in the Philippines. I can always use cell lines obtained abroad to discover new compounds to target cancer, but these cells are not of Filipino origin and do not have the same genetic identity as our peoples’. Hence, having access to cells and tissues obtained from Filipinos will help us move closer to discovering medications relevant to Filipinos”. – 𝐃𝐫. 𝐌𝐢𝐜𝐡𝐚𝐞𝐥 𝐕𝐞𝐥𝐚𝐫𝐝𝐞

CREDITS

Caption and Summary by: Arianne Yaneza, Mauro Dualan, Mika Nabong, Teo Eugenio, Macky Villaneuva, and Sean Chua
Template by: Greg Besande
Nat the Nautilus by: Rachelle Ang
Pub by: Sky Diaz, Gillian Uy

REFERENCES

[1] Souza, Y. G., & Greenspan, J. S. (2013). Biobanking past, present and future. Aids, 27(3), 303-312. doi:10.1097/qad.0b013e32835c1244
[2] Sajo, M., Teves, J., Corachea, A., Diaz, L. A., Chan, A., Valparaiso, A. P., Dy Echo, A., Macalindong, S. S., Uy, G., Dofitas, R. B., Habana, M., Gerona, R. R., Irwin, J. C., Giudice, L. C., & Velarde, M. C. (2020). A Pilot Cancer-Phenome Biobanking System in a Low-Resource Southeast Asian Setting: The Philippine General Hospital Biobank Experience. Biopreservation and biobanking, 18(3), 180–188. https://doi.org/10.1089/bio.2019.0114
[3] Website. (n.d.). Retrieved from https://www.biobank.ph/

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