In 1992 María Ángeles Muñoz was in the middle of the perfect storm. A little known virus was raging in Madrid and other Spanish cities. Deaths increased every year without doctors being able to do much to avoid it. In 1995 almost 6,000 people died throughout the country. This doctor and biologist from Madrid remembers watching the death of children of a few years who had been infected by their mothers during pregnancy. They were the worst years of the global AIDS epidemic.
“In the hospital we had a specific unit for infected children. There were always 20 or 30 and in Reyes we organized a party. It was bleak. Now at most two or three cases occur every year throughout Spain, ”Muñoz explains in a basement at the Gregorio Marañón Hospital in Madrid.
Behind it are huge metal vats and refrigerators that retain blood samples from more than 9,000 people at 120 degrees below zero. Muñoz has been collecting these tissues since 1992, when he saw clearly that it was necessary to create a kind of library that accumulated the more cases of human immunodeficiency syndrome (HIV) better, because it was the only way to understand the virus and seek treatments against it.
Today the Marañón biobank – one of the first created in Spain – is the only one in Europe specialized in patients with HIV. Religiously, every six months blood samples have been collected from patients to follow their evolution and that of the virus. On the shelves of this library there are whole lives. Among them are those of some babies who were born infected in 1994 and today, thanks to the use of antiretroviral therapy, are in their twenties with an undetectable viral load. “You can say that this bank saves lives because it helps to have quality samples so that there are quality results,” explains the Madrid scientist.
One of Muñoz’s dreams is to have to eliminate the samples he retains because the AIDS epidemic has been eradicated and it is no longer necessary to conserve them. He knows that it is an impossible dream, because despite the advances in Spain people are still dying of this disease and there are new infections. “The profile of the infected person is now that of young people, mostly homosexual, who become infected at night after having sex with two or three people.”
Muñoz has seen the AIDS virus evolve before his eyes. “It has changed a lot and for good, it is now less aggressive,” he says. The biobank run by this researcher since its official creation in 2004 has 12 patient cohorts: adults and children, including the so-called “elite responders” that have no viral load and in which there are hardly any copies of the virus crouched in the cells of the Body.
At present, the biobank treasures blood of all types of patients and of any pathology. Samples from hospitals throughout Spain are received every day, almost 1,000 a year. The hospital itself is responsible for sending a special courier service to the source that guarantees that the blood is properly preserved and fulfills its main objective: to investigate.
This library serves research groups from all over Spain and also to Europe. Normally, a fee is charged for sending the samples, but in this the bank is also atypical: “We always service, we only ask that they pay if they can afford it,” says Muñoz, who in addition to directing the repository has been researching with the samples you collect and custody. Among his current projects is to develop a gel based on nanoparticles that block the door through which the AIDS virus enters the cells and that can be applied before sexual intercourse to prevent infection. The researcher also projects the creation of organoids, microscopic replicas of any organ in the body obtained from stem cells. She wants to focus on creating a mini-bank in which you could try “any type of drug.”
“The biobank of Gregorio Marañón is the jewel in the crown, it allows very serious studies that would otherwise be impossible for the benefit of clinical research and, therefore, of the health of patients,” says Santiago Moreno, doctor and researcher from the Ramón y Cajal hospital in Madrid.
The Marañón is one of the 39 that form the Spanish network of biobanks, which together add up samples of almost 200,000 patients and that allow to investigate any pathology. These collections unite the patients – whose personal data are confidential – the hospitals where the samples are collected and the research laboratories where they try to understand the diseases and seek new treatments.
“The work we do has a direct impact on patients and is fundamental to the new era of precision medicine,” he summarizes the biologist Cristina Villena, network coordinator. “It is essential that the samples are of quality, that they are taken systematically. A sample that is collected in the operating room less than 30 minutes after surgery is not the same as another one brought to you by the guard at five hours. And this heterogeneity is very bad for science, because in part it causes that around 50% of the research done with these samples is not reproducible. That means, for example, that a certain biomarker or treatment does not reach patients or take longer to do so. Right now we are in a moment of professional specialization to guarantee that all the samples that are collected are of the highest quality ”, highlights Villena.
Some of the sample banks continue to face real penalties to obtain samples of patients and donations from deceased people, in part because many people such banks “sound like Chinese,” Villena points out. “Hopefully at some point you can normalize the donation to the biobank, which is as simple as who goes to the doctor. People have to think that their donation is for the benefit of the one who comes behind, whether they are healthy or sick, ”he adds.