As NASA prepares to send astronauts to Mars sometime in the 2030s, scientists are using the concepts behind precision medicine to develop a way to predict and prevent medical conditions during space missions.
Precision medicine takes into account an individual’s environment, genetics and lifestyle. But what happens when that person lives aboard a spaceship millions of miles from direct access to health care on Earth?
This is the question George Mias, PhD, Chief of the Systems Biology Division at the Institute for Quantitative Health Science and Engineering and Assistant Professor in the Department of Biochemistry and Molecular Biology at Michigan State University, seeks to answer.
Mias is creating an algorithm that will read longitudinally measured signals — including digital input as well as molecular measurements, such as proteomes and transcriptomes — to monitor each individual’s “wellness baseline” and detect deviations from this baseline for astronauts on deep space missions.
“This idea is a little bit of a new paradigm because your typical doctor’s exam will only look at a handful of measurements,” Mias says. “We’re trying to integrate thousands of molecular measurements together with physiological signals over multiple time points.”
Mias will monitor molecular and physiological signals taken from a multitude of samples, ranging from saliva to RNA to protein, while the astronauts are in flight and compare them to changes in their baseline since departing Earth. He will then use longitudinal surveillance of astronaut health and algorithms that will detect deviations from each individual’s normal health fluctuations. Mias’ algorithm aims to prevent disease and injury at the earliest stages.
“It’s important to assess these individuals and give them timely alerts [about health deviations],” Mias says, “especially since they’re remote from physicians.”
The study will focus on molecules that change over time to distinguish normal changes from adverse events, he says.
“Everything we’re doing is to try to develop methods to put all that information together in a way that can be interpreted by doctors,” adds Carlo Piermarocchi, PhD, Professor of Physics in the Department of Physics and Astronomy at Michigan State University. “The idea is to be able to extract ... [which] genes are changing over time.”
“The main goal of this project is to maintain astronaut health. As they push the boundaries of exploration, we’re trying to help by pushing the boundaries of what we can do with monitoring human health.”
— George Mias, PhD, Chief of the Systems Biology Division at the Institute for Quantitative Health Science and Engineering and Assistant Professor in the Department of Biochemistry and Molecular Biology at Michigan State University
Managing Astronaut Health
The goal of the project caught the eye of the Translational Research Institute for Space Health (TRISH) at Baylor College of Medicine, which, in partnership with NASA, offered Mias a two-year grant.
This research could prove beneficial in addressing numerous medical challenges of space travel.
Space radiation, for example, “may place astronauts at significant risk for radiation sickness and increased lifetime risk for cancer, central nervous system effects and degenerative diseases,” NASA notes on its website. Further, a lack of gravity means bone loss happens much faster than on Earth; astronauts may lose 1 percent of bone mass per month spent in space. And some research suggests that the space environment could accelerate the stiffening of blood vessels.
Dorit Donoviel, PhD, Director of the Translational Research Institute for Space Health and Associate Professor at the Center for Space Medicine at Baylor College of Medicine, points to issues such as urinary tract infections (UTIs), which are particularly common among female astronauts.
“When you’re on a mission to Mars, and your antibiotic is not taking care of your UTI, you can have a serious problem,” she says. “Kidney stones are also more likely to happen in astronauts because their bones are breaking down and remodeling in space, and minerals get into the body. ... There’s also a potential that bacteria or viruses may mutate in space and no longer become responsive to treatments.”
By providing astronauts a “dashboard” for their health, Donoviel explains, astronauts will gain knowledge about what is normal for their bodies — even in the abnormal environment of space — as well as when preventive measures should be taken.
“When they become susceptible to an infection, maybe some of their immune cells go off a bit,” she says. “They can get an immune booster to prevent getting the actual condition.”
“Our investments in science, medicine and tech are ... about all of humanity staying healthy in response to a changing environment, whether it be in outer space or here on Earth.”
— Dorit Donoviel, PhD, Director of the Translational Research Institute for Space Health and Associate Professor at the Center for Space Medicine at Baylor College of Medicine
Health Monitoring in Space and Beyond
The precision medicine algorithm may advance medicine on Earth, as well.
“I think our approach can be applied to pretty much every individual,” Mias says. “It’s a general paradigm for how to deal with monitoring people over time and make informed decisions about their health.”
Piermarocchi believes the technology could find its way into standard medical practice.
“Precision medicine ... can help [physicians] make the best decision for the patient,” he says. “I hope this project will help physicians look at precision medicine as something they maybe could use very easily in the future.”
Donoviel has similar hopes.
“We’re not just developing for people on the way to Mars,” she says. “We’re developing for humans. Not having access [to advanced medicine] holds true for a lot of people on Earth.”