Twenty years ago this morning, I had to defend a body of work that contained this paragraph on page 24:
HeLa cells are a human cervical carcinoma cell line having a doubling time of 24 hr and were obtained from Dr. Bert Flanegan, Dept. of Immunology and Microbiology, University of Florida. HeLa cells were maintained as subconfluent monolayer cultures in minimal essential media (alpha modification; GIBCO) with 10% fetal bovine serum (GIBCO) at 37° under a humidified atmosphere containing 5% CO2. Cells were maintained in logarithmic growth by subculturing every other day using 0.05% trypsin/0.02% EDTA and reseeded at a density of 5 X 105 in a 75cm2 tissue culture flask.
And with that, nothing more was said about the cellular system that led to the awarding of my PhD.
I am embarrassed by the omission of any reference to the 31-year-old Black woman from rural Virginia, Ms. Henrietta Lacks, whose aggressive cervical cancer allowed Dr. George Gey at Johns Hopkins to isolate and propagate the first, immortalized human cancer cell line.
I also find it telling that my advisor and my committee made no requests of me to better document the cells I used - no citation of the original paper by Gey's group or even the American Type Culture Collection source of the cells for Dr. Flanegan's lab downstairs.
Each Spring, we now hold memorial services on medical school campuses around the world to honor cadavers and their families who make first-year medical school anatomy dissection laboratories possible.
While cell culture gifts are much more detached, and usually anonymized, I've often thought that we basic scientists should take similar steps to honor those who have made our work possible.
This is one of the reasons that I am such an enthusiastic supporter of the upcoming book, The Immortal Life of Henrietta Lacks by Rebecca Skloot and why her 2006 New York Times Magazine cover story on human cells and tissues led me to seek her out to learn more about the origins of HeLa.
When I first started telling Rebecca how HeLa cells had spawned my doctoral work, I went through my CV and re-read some of the older papers where I had used the cell line. Much of my dissertation work on DNA topoisomerase IIα appeared in a 1991 paper in the Journal of Biological Chemistry. But I forgot that I also used HeLa cells as a source of human genomic DNA for the first paper from my first independent laboratory (in Molecular Pharmacology in 1995), co-authored with my first PhD student and first technician.
I note the journal names specifically because JBC was co-founded in 1905 by my 'nymsake, John Jacob Abel, and Mol Pharm is a journal of the American Society of Pharmacology and Experimental Therapeutics (ASPET), the organization established in late 1908 by a group led by Abel.
So while I have already acknowledged with "Abel" the history of my discipline, I find it only appropriate today to reflect on the life and legacy of the woman whose suffering gave rise to an unknowing gift, one that has touched the lives of thousands of scientists like me.
Really? Seems a bit extreme to me. Even if IRBs allowed for naming of donors, it would have been completely infeasible to describe each of the CABG patients whose leftover saphenous vein, IMA and radial arteries were used for my primary cell cultures.
HeLa cells have an interesting story, but what about all the other immortalized cell lines that we use in the lab? How about all those primary cell cultures? It seems odd selecting one person to put on a pedestal.
Not just an interesting story. A fable, with a moral.
Jonathan: "extreme" or just you can't be bothered with acknowledging your work is made possible by others. "infeasible" or unwilling?
Over the course of three years, I think I used between 40 and 50 different primary cultures. Ignoring for a second the *enormous* ethical issue with naming the anonymized patients who donated these bits of tissue (the sort of thing an IRB would shut down a lab for in the UK) it would have doubled the size of my thesis. All sentimentality aside, I was doing pharmacology, not social science.
I also find it a double standard. Why should HeLa cells receive this distinction but not whoever was behind the A549 cell line? Or the BEAS-2B? Or any of the hESCs? You try doing the same with one of the hESC donors and see where that gets you? Given the way the NIH ethics rules have been written, you'd probably be blacklisted from receiving grant funding in the future.
Who were those rules (and the other IRB rules anonymizing patients) written by? Heartless men in white coats or the bioethics community? Have you ever met people who work in bioethics/ELSI? I have, they're not the heartless white coat types.
Hi, Jonathan - my call for acknowledgment of cell donors was primarily intended for tumor lines but you raise a good point about the far more common, and numerous, donations of normal tissue from people who don't die. I would never, never, ever suggest that we violate ethics regarding the identity of tissue donors and I'm sorry if my writing was unclear in that regard.
Perhaps what I'm proposing is not clear: I'm not asking that an author devote 10 years of her life to expertly crafting a 300+ page book on each and every person whose cancer cells gave rise to an immortalized cell line. I'm just asking, as I do of my students, that one take a moment to acknowledge in dissertations and papers, the original source of the cells. My larger call, for some sort of memorial service as is done for cadavers, might be considered maudlin by some, but I think is very important for basic scientists to understand that much human suffering was associated with the tools they now use. Places like M.D. Anderson and the NCI are, for example, places where dozens if not more human cell lines were established. Would it kill anyone there to have an annual, 30-60 min memorial service to honor donors of biological tissues, many of whom are no longer with us?
I have to disagree strongly with Jonathan that a double standard exists for HeLa cells vs A549s. I thought I knew the HeLa story too but realized, upon serving as a scientific reviewer for Rebecca's manuscript, that my knowledge barely scratched the surface of just how special these cells and this story were. It was the first immortalized human cell line and led to an amazing series of studies that fueled two Nobel Prizes, contributed to the development of the polio vaccine, and illustrates the chasm in racial attitudes in medicine that continues today. The cells are a connection to an embarrassing time in our history when tissues were taken from disadvantaged groups without consent, when blacks could not get care in white hospitals and, even at Hopkins, there were separate clinics, bathrooms, and water fountains for the "colored." This was not the 1890s but rather the 1950s, when my Mom and Dad were in high school.
Moreover, the cells have been used in about 60,000 publications and have taught us innumerable lessons about the need for cell culture hygiene due to their ability to contaminate other cultures and completely outgrow original lines. I could go on but when the book becomes available in February, I'd like to buy a copy for Jonathan so that we may continue this discussion.
(btw, A549s have been pretty important, too, especially in the field of epidermal growth factor biology - they were isolated at NCI in 1971 from a 58-year-old white man with adenocarcinoma of the lung - one member of the team was the internationally-recognized cancer biologist and current head of oncological sciences at Mt. Sinai, Stuart Aaronson.)
Medical sociologists are now pointing out that our past cavalier (and unethical) attitude toward clinical trials subjects continues to impact a great deal on recruitment strategies, particularly among African Americans patients. There remains a tremendous degree of misunderstanding and mistrust of the establishment that makes it challenging for the study of health disparities. The CISCRP Everyday Medical Heroes program is just one public awareness campaign ongoing to recognize the importance of clinical trials participants (which include the donors of primary tissue for your work).