By Sandra Basu
WASHINGTON — The Spanish flu epidemic occurred 94 years ago, yet researchers were able to reconstruct the 1918 influenza virus for study. That is just one benefit of the military’s premier pathology reference center, which recently held an open house to showcase its capabilities.
The Joint Pathology Center (JPC) officially opened last year and is billed as the federal government’s pathology reference center supporting the Military Health Service, DoD and other federal agencies. The National Defense Authorization Act of 2008 established JPC and mandated that it would take over many of the responsibilities of the Armed Forced Institute of Pathology (AFIP) after it was slated for closure during the 2005 Base Realignment and Closure (BRAC) process.
“The JPC is, if you will, the son of the AFIP, or daughter if you like,” Vice Adm. John Mateczun, medical commander of the Joint Task Force National Capital Region, explained at the open house event for JPC last month. “It is the successor to the AFIP, because Congress saw the need for this kind of specialty and subspecialty consultation in the federal government.”
JPC pathologists provide expert secondary pathology consultation for challenging pathology diagnoses faced by treatment facilities. JPC also provides education for residents, fellows and staff through formal pathology rotations and is home to DoD’s only veterinary pathology residency program.
Mateczun said that other agencies, such as the VA, also utilize JPC services.
“The VHA relies on the JPC, formerly the AFIP, for the secondary pathology consultations and for the tremendous work that goes on in the VA,” he said, adding that, with very difficult cases, it is necessary to have a resource like the JPC,” he said.
The JPC’s mission differs from the former AFIP, which would provide consultation on civilian cases. The JPC focuses solely on military pathology cases and is a leaner organization, handling the same number of military cases with fewer pathologists than did the AFIP, said Col. Thomas Baker, MD, the interim director of JPC.
The jewel of the JPC is its renowned tissue repository containing 32 million tissue samples and 55 million pathology glass slides. The repository previously was managed by the AFIP and includes cases submitted for pathology consultation since 1917.
Officials said it is the largest tissue repository of its kind in the world and provides unique research opportunities. In recent years, researchers used this repository to study lung tissues of troops dating as far back as1918, when more than 50 million people died of the Spanish flu, in order to fully reconstruct the 1918 influenza virus.
“If you have a disease where you have 5,000 specimens, you can actually determine something that will ultimately affect treatment or patient care with it, so that is the real beauty of what we have here,” Baker said during a tour of the facility.
Tissue samples are stored in a library-like warehouse on shelves. The samples are organized by patient number.
Pulmonary pathologist, Dr. Teri Franks, demonstrates how the Joint Pathology Center uses cutting-edge technology to provide secondary consults to support various government health care providers during the JPC’s Open House on March 6. (Photo courtesy of JTF CapMed Public Affairs)
“It is all linked to patient information in the computer systems, so we can actually look up a patient and look up a diagnosis all the way back to 1917 and be able to find a case or a series of cases,” he pointed out.
Baker said there is no other tissue repository in the world that even comes close to the amount of material held in the one at the JPC.
“The fact that these do represent challenging and difficult consultation pieces from the past means that these are truly difficult diagnoses and very rare diagnoses,” he said. “With that in mind, the potential of research is not only on common diseases but on very rare diseases.”
The material is open to only JPC researchers, but officials are trying to determine how best to open up the repository to other medical investigators.
DoD contracted with the IoM in September 2010 for an 18-month study on how best to utilize the repository. The report is due in June and will help officials determine how best to use the tissue repository and who should have access to it.
“Our goal is to really open this up very widely for medical research,” said Baker. “It is not our asset. It should be opened widely for medical research, because it should advance medical care.”
While implantable devices have shown promise in reducing rehospitalization for heart failure (HF), VA researchers sought to determine if options that are less expensive and non-invasive would have comparable results.
Legislation to prevent VA from outsourcing creation of its drug formulary and to require more input from medical professions is being considered in Congress.