CDC/NIH Lipid Standardization Laboratory

We learn directly from Gerald Cooper, founder of the NIH/CDC Lipid Standardization Program, about the near-serendipitous events leading to his heading up those special laboratories at CDC. He tells us that the need was made clear to him at the early Chicago meetings of CVD epidemiologists, and that the administrative role of Jim Watt at NIH was critical to the CDC eventually providing laboratory standards for epidemiological studies and trials internationally (Cooper-Labarthe Interview 2005).

The historical interest for CVD epidemiology lies in Cooper and colleagues’ story about facing for the first time the broad need for laboratory standards and then developing the procedural and statistical models for quality control. Their innovations included certifying a coterie of national and international reference laboratories, for which the CDC would provide the “ultimate” reference, thus allowing it to extend service to virtually all international lipid research laboratories in a cost-efficient manner.

Gerry Cooper’s long-suffering, positive attitude, and his creative, “get-it-done” philosophy shines through in his interview with Darwin Labarthe, including the story of his finding ways to provide an international outreach within a limited budget and a rigid U.S. bureaucracy. Cooper found for himself an intellectual, operational, and career challenge in providing this function critical to the international success of CVD epidemiology and clinical prevention trials. Still, his career goes on; it has spanned 50 years of standardizing activity. The following comes from his 2005 interview:

I attended epidemiologic conferences to learn about the problems going on in cardiovascular disease. In Chicago, Oglesby Paul headed up an epidemiologic conference there one year in January [1961] when it was really cold. Presentations were made and problems were pointed out about lack of standardization and Henry Blackburn, particularly, spoke up and wanted to make sure that all measurements were standardized and at practically every meeting he stated that we should have a standardization program for the clinical trials.

But, we really didn’t get highly involved until Jim Watt at the National Institutes of Health in about 1963 or ’64 evaluated the grants and found out that the reason for failure to gain the objective was the cholesterol measurement. So he invited me up there to talk and in our discussions we decided to form a partnership between the National Heart and Lung Institute and CDC to start a standardization program for surveys and clinical trials. And in a very short time we had as many as 70 laboratories participating because they knew they had to be standardized for their grants. And that’s what really got us started to where we were working very closely with the different studies and clinical trials. Now we have over 100 laboratories that are either a research laboratory concerned with methods, or laboratories for a clinical trial, or are in a public health prevention program. We call that program now the CDC/NHLBI Lipid Standardization Program.

[For the international program it was] Jim Watt again, he was on a committee that met about cardiovascular disease at WHO and the number one subject they discussed was standardization of cholesterol and lipid measurements. Jim Watt told me later that he said, ‘Why don’t you get Gerald Cooper to work with you and develop an international program?’

Well, they followed up and I wrote back and said we were working on a national program. Please let us work up our problems and then we’ll be glad to do it.

Boy, right back came a letter to the Surgeon General saying that I didn’t want to work with them. I’m telling you, the next day after CDC got the letter, I was in Geneva!

I went over and wrote up an international program for them and it included two things: one that we get a WHO collaborating center for reference and research in blood lipids so that we have an excuse for working with the international labs. NHLBI, where we were getting our money, really is a national lab. And the second thing was I realized they just didn’t have any money and nothing was going to work internationally if we depended on money from anywhere. So what we decided to do was to superimpose the international program on top of our national NHBLI/CDC program and just go on and do it. And that’s what happened. So we have running now about, I’d say, 45 international laboratories that we have standardized under the WHO collaborating center. (Cooper 2005)(Henry Blackburn)(1)

Reference

(1)Cooper-Labarthe Interview 2005

The history of lipid measurement is treated in detail by Daniel Steinberg in the Journal of Lipid Research series during 2005-2006 (Steinberg 2005)