#28: Space Medicine
How research aboard the International Space Station could help us live to infinity and beyond.
Space Invaders
Space travel—an incredibly noble profession and every kid’s dream—pushes the human body to its limits. In space, astronauts suffer from loss of bone density, muscle atrophy, immune suppression, and sustained vision problems, all while trying to function in a 310 lb spacesuit. So it’s no wonder aspiring astronauts must complete a rigorous, military-like training program well before they ever leave our atmosphere.
Once aboard the International Space Station (ISS), the space environment demands astronauts continue to be extremely diligent about their health, exercising daily and following a strict diet. But even with the utmost care of their bodies in space, hurtling around Earth at 17,500 miles per hour takes a toll. NASA dedicates millions of dollars to its Human Research Program in search of solutions that will protect astronauts from the health challenges occurring 60+ miles from Earth.
NASA Twin Study
There’s still so much we don’t know about how long-term space travel affects humans. After all, astronauts typically spend only about six months in space at a time.
In 2019, though, NASA conducted the landmark Twin Study, bringing together 10 scientific research teams to complete the first study assessing how well humans can endure—mind, body, and spirit—long-term space flight. Twins Scott and Mark Kelly—one an astronaut and the other an Arizona Congressman—served as perfect study subjects, providing identical genetic makeups.
Scott spent 340 days in low orbit aboard the ISS while his brother Mark—a retired astronaut in his own right—remained on Earth. During the journey, scientists collected health data on Scott’s sleep, blood, physiology, urine, and even DNA.
Most of the results were as expected. Scott Kelly suffered damages to his central nervous system, early signs of osteoporosis, and shifts in microbiome composition—the latter likely owing to diet and environmental factors unique to space. Scott Kelly even received a vaccine in the ISS, to which his immune system responded accordingly.
Some results were surprising. Scott grew two inches taller than his brother Mark. He also suffered thickening of his carotid artery wall and experienced significant epigenetic changes due to abnormal DNA methylation while in space. Perhaps most surprising, Scott’s telomeres—the protective ends of chromosomes that shorten due to stress and aging—lengthened in space.
The Twin Study largely demonstrates the resilience and adaptability of the human body and has since catalyzed ongoing research into space-induced illnesses, medical emergencies, and how we can combat the effects of space travel on human health.
Today, the ISS doubles as both a hub for space exploration and a research center dedicated to exploring how the effects of space can provide insight into improving human health back on Earth.
Extraterrestrial Laboratory
If there’s one thing we all know about space, it’s not that 1 teaspoon of neutron star weighs the same as the entire human population, or that the Milky Way galaxy smells of booze (don’t worry, commercial space travel may be closer than we think).
The first thing we learn about outer space is that there is no gravity. Zero-G, also called microgravity, replicates the human aging process at a cellular level, making space the perfect environment for conducting medical research that would normally take years to complete on Earth.
Drug Discovery
Merck: In conjunction with the ISS, Merck developed a crystalline form of their blockbuster cancer drug Keytruda in space. Proteins aren’t easily ordered into crystals on Earth, but microgravity creates optimal conditions for molecules to pack together tightly. Keytruda’s current formulation is administered in the doctor’s office through an IV, but a crystal form—one that is stable at room temperature—will likely lead to an injectable at-home version, significantly increasing access to the life-saving drug.
LambdaVision: Startup LambdaVision is leveraging space’s microgravity to develop the world’s first protein-based artificial retina for people suffering from retinal disease. The artificial retina is expected to enter clinical trials within three years.
Cancer Research
Dr. Catriona Jamieson, Director of the Sanford Stem Cell Institute at UC San Diego, is trying to figure out why stem cells develop cancerous mutations as they age by sending them into space. So far, her research has uncovered two main findings:
The ADAR1 gene becomes hyper-expressed in space, making astronauts more susceptible to cancer.
In space, tumors take just 10 days to triple in growth (as opposed to 10 years on Earth).
Dr. Jamieson’s work has led to the creation of a small molecule inhibitor called rebecsinib, which reverses the over-activation of ADAR1 proteins.
Med Tech
Ultrasound: The Butterfly IQ single probe ultrasound was developed through The Advanced Diagnostic Ultrasound in Microgravity (ADUM) experiment, allowing astronauts on the ISS to diagnose crewmates with the guidance of Earth-based doctors. The technology has been adapted for use in large hospital systems and remote areas on Earth, with over 45,000 medical professionals globally trained in diagnostic care for underserved regions.
Wireless arthroscope: Engineers from NASA were consulted on the creation of the first wireless arthroscope to receive FDA clearance. Scientists identified similarities between arthroscopes and CubeSats—the nano-satellites orbiting Earth. Both technologies need to be lightweight and powered for long periods of time.
Beyond Health
NASA has long served as an incubator for technologies benefiting society beyond just clinical medicine. Each year, NASA releases a “Spinoff” report, highlighting commercialized products and services incorporating NASA technology/expertise that benefit the public. Some of this year’s spinoffs are particularly interesting:
Materials from spacesuits—which swing between -250°F to 250°F—are being used to create temperature-regulating mattresses and sleeping products.
Sunscreen and anti-aging products incorporate Bacillus Lysate into their formulation—a microbe first identified by NASA for surviving cosmic radiation and extreme temperatures of 18 months in space.
Scouting robots, originally developed for deployment onto the Moon and Mars to collect information, are helping first responders plan approaches to dangerous situations.
Small-scale farming techniques, designed for extended missions to Mars, are making indoor farming a major source of food on Earth.
A leader in understanding climate change and Earth science, NASA is creating AI maps from satellite information to reveal sustainable options for farming, reforestation, and land management.
NASA technology for identifying pathogens inside a spacecraft is improving wastewater surveillance of COVID-19.
Empatica, makers of clinical-grade health wearables (and a Black Opal Ventures portfolio company), was originally designed to track the physiology of astronauts in space.
Hydroxyapatite toothpaste products, which use similar crystalline technology to semiconductors, are finally entering the US market.
Giant Leaps for Humankind
We owe space for many of the life-saving medical instruments we use today—cochlear implants, heart-assist devices, infrared thermometers, medical light, and cancer screening tests to name a few. Astronauts are heroes in their own right, risking their lives traveling to space in an attempt to advance humanity here on Earth.
Writing this piece reminded me of one such hero, Dr. Jonny Kim.
Dr. Kim is an Astronaut, Surgeon, and Navy SEAL. But more importantly, he’s the subject of one of my favorite all-time memes.
Same here @wes_chu. Same here.
What I’m reading this week:
Special Report on Social Media and Mental Health, nyc.gov
The Promise of Weight-Loss Drugs, NYT
Transforming Consumer Health: How Digital Health is Catalyzing Change in Weight Management, 7wireVentures
The Opaque Industry Secretly Inflating Prices for Prescription Drugs, NYT
It shouldn’t be so hard to live near your friends, Vox