A new era of research in the U.S. Department of War Serum Repository: a review of published studies, 2013-2024.

The Department of War Serum Repository (DOWSR, formerly DODSR1) was established in 1989 after the initiation in 1985 of the U.S. Department of War's universal mandatory human immunodeficiency virus (HIV) screening program. DOWSR, which is currently maintained by the Armed Forces Health Surveillance Division (AFHSD), preserves over 78 million serum specimens. Similar to a study that investigated research conducted from 1985 through 2012 utilizing the serum repository, this study evaluated DOWSR specimen availability, stratified by demographic variables, and conducted an analysis to determine total number and types of research studies performed using the DOWSR from 2013 through 2024. Two methods were employed: a structured PubMed search and an exhaustive online search based on records of requests for serum samples from AFHSD. Results show that the focus of DOWSR's research within the past decade has increased, especially in regulatory molecules, autoimmune indicators, and microRNA expression patterns, with increases in both the number of sponsored studies and variety of analytes investigated. Changes in the types of studies pursued by DOWSR research may reflect changing trends in funded research regarding health concerns for service members and veterans. This review identified 112 published and 21 non-published studies that used DOWSR sera during the study period. Of the published 112 studies, 30 investigated infectious diseases, 25 investigated autoimmune disorders, 13 investigated neoplasms, and 11 investigated chronic metabolic outcomes. More studies using DOWSR specimens were published on environmental exposures and autoimmune disorders compared to prior years.