Aerospace Medicine: The Next Great Health Frontier?


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Since childhood, I have been interested in things and things related to space. The concept of humans traveling outside Earth’s orbit was mind-blowing, and inspired me to pursue a career in aerospace engineering. After my first semester of college, I realized that medicine was a more compelling career choice because I wanted to work directly with people and improve lives. But my desire for space was always in the back of my mind.

In the year In 2020, before I entered pharmacy school, a colleague sent me. Text in the New England Journal of Medicine A team of doctors called by NASA to order a medical procedure for an astronaut who suffered a thrombosis in her left internal coronary artery while aboard the International Space Station (ISS). This type of medical condition had never been documented before, and within days of the diagnosis, the astronaut was prescribed a regimen: subcutaneous injections of enoxaparin daily for 42 days, then oral apixaban twice daily for the remainder of the flight. The drug was classified in this way because initially there was a limited anticoagulant supply in the ISS and no anticoagulant-reversing agent; Apixaban was to be sent at a later date.

As a good health care professional, I understand that astronauts need medical attention before, during and after spaceflight and may need special precautions to protect against harmful stresses in this harsh environment. With increasing demand for commercial spaceflight tourism, coupled with NASA’s desire to travel to the Moon and Mars, it is important to gain a greater understanding of human health and biology after prolonged exposure to the space environment.

I began to wonder if there would be any career opportunities for me in this field — and to what extent does this field of study exist?

Current research on health in space

While scientists have been collecting data for decades, the implications of extended space travel are less well known.

In the year In 2019, NASA published a study, “The NASA Twins Study: A Multidimensional Analysis of One Year of Human Spaceflight.” This study is the only part of the literature documenting the biological and physiological changes that occur in humans over 6 months of spaceflight. In this study, two identical twin astronauts were subjected to over 300 different samples to generate pre-flight, flight and post-flight spatial data. One of the twins was sent to the ISS for 12 months, while the other twin stayed on Earth during this time; Both astronauts were 50 years old at the time.

Scientists have observed the following changes.

  • Cardiovascular fluids shift to the upper body and head during flight, increasing cardiac output, stroke volume, and carotid intima-media thickness, but decreasing mean blood pressure and blood volume.
  • Increased inflammation, indicated by increased cytokine and chemokine release as well as oxidative stress biomarkers in the vasculature, also modulated, innate and natural killer cell-mediated immune responses.
  • The total body weight is reduced by 7%, and the amount of urine is reduced
  • Symptoms of bone fracture and formation increased by 50-60% during the first 6 months of flights, but decreased immediately before landing during the last 6 months.
  • There was evidence of retinal edema, indicating increased choroidal thickness and weight of choroidal folds; This finding is consistent with previous studies that coined the term. Neuro-ocular syndrome associated with spaceflight; or SANS for short
  • Microbiome changes have occurred, but not to a significant or alarming level; Changes in DNA methylation and telomere length were also observed
  • Cognitive efficiency, measured by cognitive speed and a computerized cognitive test, was unchanged during the flight, but significantly decreased after the flight.

Although the exact causes of these physical and biological changes have not been established, there are several hypotheses. For example, weightlessness, cosmic rays, and isolation are thought to combine to cause some of these changes. Many other physiological changes or health-related conditions that may be affected by spaceflight were not included in this study—from intracranial pressure to the Mental health to the Emotional crisisAnd Countless others — but now it is being checked elsewhere. Several Organizations And Institutions They are collaborating around the world to learn more about the short- and long-term health effects in hopes of properly preparing our species for journeys beyond low Earth orbit.

Uncharted territory: Many questions remain

Researchers have only scratched the surface of health and healthcare in space, especially after long periods of space exploration. As a pharmacology student, one area that particularly intrigues me is the logistical and operational challenges of approaching safe drug use and storage in space. Because of this, the dosage may need to be adjusted Pharmacokinetics and drug changes Due to the vast majority of physiological changes that we have studied so far, they occur in humans. In addition, the stability and shelf life of the drug It has changed While in space, it may have been caused by accelerated degradation from radiation exposure from space.

When we think about future missions in space, there are countless ways to connect with health. While every aerospace medicine fellow and consultant I’ve met at conferences and organizations so far has been bright, welcoming, and encouraging, the need for more healthcare professionals and scientists researching this area is urgent. I urge you to consider exploring this field, especially for any medical students or first-year professionals with a passion for healthcare and space. Now’s the time to get involved: aerospace medicine could be the next big thing in healthcare.

Tom Diaz is a D of Pharmacy candidate at Chapel Hill, North Carolina, graduating in 2024.


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