Multiple studies have characterized differences in gene expression, DNA methylation and cell subset in blood among individuals with and without mental (or other) illnesses1-4. These studies, however, have been obtained from clinical settings in which disease-associated differences may be magnified due to the generally more severe nature of the illnesses for which patients are seeking treatment. Due to advances in “omics” approaches, the past decade has seen an explosion of interest in obtaining biologic samples from community and/or epidemiologic settings5-7, in order to provide population-based estimates of disease prevalence and a broader picture of the environmental determinants of these mental and/or physical illnesses.
A key challenge in this regard is the requirement for rapid processing of the collected specimens. Degradation of mononuclear cells, key immune system components that are frequently used to assess the health of an individual, begins immediately upon blood draw with a significant decrease in recovery after 2 hr of collection8-10. To address this challenge, we present an optimized protocol in which multiple components of human whole blood are simultaneously isolated from samples obtained in homes of subjects living in a large metropolitan area. The protocol is based upon our compilation and modification of current techniques, including storage of all “extra” fractions in the event future techniques allow for further isolation/analyses. While alternative methods or kits may be employed in place of the individual methods described here, those outlined have proven to be a reliable and efficient means for processing samples in a high-throughput manner. High-quality fractions (PBMCs, DNA, serum, and RNA) of fresh blood can be produced within 2 hr of collection and all assay-ready specimens can be available within 2 days (Figure 1).
This protocol was developed to enable the efficient processing of samples collected from community-dwelling, adult residents of the city of Detroit for testing in the Detroit Neighborhood Health Study (DNHS; DA022720, RC1MH088283, DA022720-05-S1), a population-based study of the social and biological determinants of post-traumatic stress disorder (PTSD) and other mental illnesses. The prevalence of PTSD in Detroit is more than twice the national average11,12. Identifying biological determinants of PTSD in this population may help to develop appropriate pharmacologic and/or cognitive-behavioral interventions to aid those suffering from the disorder, both in this urban population, and in other high-risk populations (e.g., returning military veterans). Our laboratory, previously located at Wayne State University in Detroit, Michigan, was selected for processing based on our expertise in handling fresh tissue samples derived from a variety of sources, the necessity to begin processing the samples within 2 hr of collection, and our proximity to the collection sites. With this unique opportunity at hand, our goal was to optimize the processing for greatest yield of DNA, RNA, serum and peripheral blood mononuclear cells (PBMCs) from each specimen (a total of N=1,639 samples over 5 waves of specimen collection). The procedures outlined here can be performed simultaneously in a non-clinical setting, thus producing starting material (see Table 1 for average yields) for a multitude of downstream applications including microarray, epigenetic, real-time RT-PCR, and flow cytometry analyses.

Figure 1. Overall work flow. The overall process depicted here includes the logistics of obtaining the blood specimens from identifying consenting participants to the blood draw itself. High-quality, fractions (peripheral blood mononuclear cells; PBMCs, DNA, serum, and RNA) of fresh whole blood can be produced within 2 hr of collection and all assay-ready specimens can be available within 2 days. Moreover, the fractions prepared through this method are suitable for long-term storage if samples are not to be tested immediately. The entire timeline outlined here could be completed in a single day (~5 hr total). However, such a day would be extremely labor intensive especially for a single technician with substantial experience with the techniques. Thus, we recommend dividing the procedures on Day 1 between at least two technicians and completing the RNA processing on Day 2. Please click here to view a larger version of this figure.