The Future of Personalized Medicine in Space: From Observations to Countermeasures

Frontiers in Bioengineering and Biotechnology, vol. 9, pp. 739747

Abstract

The aim of personalized medicine is to detach from a “one-size fits all approach” and improve patient health by individualization to achieve the best outcomes in disease prevention, diagnosis and treatment. Technological advances in sequencing, improved knowledge of omics, integration with bioinformatics and new in vitro testing formats, have enabled personalized medicine to become a reality. Individual variation in response to environmental factors can affect susceptibility to disease and response to treatments. Space travel exposes humans to environmental stressors that lead to physiological adaptations, from altered cell behavior to abnormal tissue responses, including immune system impairment. In the context of human space flight research, human health studies have shown a significant inter-individual variability in response to space analogue conditions. A substantial degree of variability has been noticed in response to medications (from both an efficacy and toxicity perspective) as well as in susceptibility to damage from radiation exposure and in physiological changes such as loss of bone mineral density and muscle mass in response to deconditioning. At present, personalized medicine for astronauts is limited. With the advent of longer duration missions beyond low Earth orbit, it is imperative that space agencies adopt a personalized strategy for each astronaut, starting from pre-emptive personalized pre-clinical approaches through to individualized countermeasures to minimize harmful physiological changes and find targeted treatment for disease. Advances in space medicine can also be translated to terrestrial applications, and vice versa. This review places the astronaut at the center of personalized medicine, will appraise existing evidence and future preclinical tools as well as clinical, ethical and legal considerations for future space travel.

Authors 13

1. Elizabeth Pavez Loriè corresponding

   Leibniz Institute of Environmental Medicine

   Affiliation as printed

   Leibniz Institute for Environmental Medicine, IUF, Düsseldorf, Germany

2. Sarah Baatout

   Ghent University · Belgian Nuclear Research Centre

   Affiliation as printed

   Department of Biotechnology, Ghent University, Ghent, Belgium

   Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium

3. Alexander Choukèr

   Ludwig-Maximilians-Universität München · LMU Klinikum

   Affiliation as printed

   Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany

4. Judith‐Irina Buchheim

   Ludwig-Maximilians-Universität München · LMU Klinikum

   Affiliation as printed

   Laboratory of Translational Research "Stress and Immunity", Department of Anesthesiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany

5. Bjorn Baselet

   Belgian Nuclear Research Centre

   Affiliation as printed

   Radiobiology Unit, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium

6. Cinzia Dello Russo

   University of Liverpool · Agostino Gemelli University Polyclinic · Istituti di Ricovero e Cura a Carattere Scientifico · Università Cattolica del Sacro Cuore

   Affiliation as printed

   Department of Healthcare Surveillance and Bioethics, Section of Pharmacology, Università Cattolica Del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

   MRC Centre for Drug Safety Science and Wolfson Centre for Personalized Medicine, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, United Kingdom

7. Virginia E. Wotring

   International Space University

   Affiliation as printed

   International Space University, Illkirch-Graffenstaden, France

8. Monica Monici

   University of Florence

   Affiliation as printed

   ASA Campus Joint Laboratory, ASA Research Division, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy

9. Lucia Morbidelli

   University of Siena

   Affiliation as printed

   Department Life Sciences, University of Siena, Siena, Italy

10. Dimitri Gagliardi

    University of Manchester

    Affiliation as printed

    Manchester Institute of Innovation Research, Alliance Manchester Business School, The University of Manchester, Manchester, United Kingdom

11. Julia Stingl Aachen Institute of Clinical Pharmacology

    RWTH Aachen University · Universitätsklinikum Aachen

    Affiliation as printed

    Institute of Clinical Pharmacology, University Hospital of the RWTH Aachen, Aachen, Germany

12. Leonardo Surdo

    European Space Agency · European Space Research and Technology Centre

    Affiliation as printed

    Space Applications Services NV/SA for the European Space Agency, Noordwijk, Netherlands

13. Vincent Lai Ming Yip

    University of Liverpool

    Affiliation as printed

    MRC Centre for Drug Safety Science and Wolfson Centre for Personalized Medicine, Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, United Kingdom