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Minoretti P, Fortuna G, Lavdas K, D'Acquino D. Potential Biomarkers of Resilience to Microgravity Hazards in Astronauts. Cureus 2024; 16:e57173. [PMID: 38681405 PMCID: PMC11056033 DOI: 10.7759/cureus.57173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Space exploration exposes astronauts to the unique environment of microgravity, which poses significant health challenges. Identifying biomarkers that can predict an individual's resilience to the stressors of microgravity holds great promise for optimizing astronaut selection and developing personalized countermeasures. This narrative review examines the principal health risks associated with microgravity and explores potential biomarkers indicative of resilience. The biomarkers being evaluated represent a broad spectrum of physiological domains, including musculoskeletal, neurological, immunological, gastrointestinal, cardiovascular, and cutaneous systems. Earth-based microgravity analogs, such as dry immersion and head-down tilt bed rest, may provide valuable platforms to validate candidate biomarkers. However, biomarker sensitivity and specificity must be further evaluated to ensure efficacy and reliability. Establishing a panel of biomarkers predictive of resilience to microgravity-induced health risks would significantly enhance astronaut health and mission success, especially for long-duration exploration missions. Insights gained may also translate to health conditions on Earth characterized by reduced physical activity and mechanical loading.
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Tomsia M, Cieśla J, Śmieszek J, Florek S, Macionga A, Michalczyk K, Stygar D. Long-term space missions' effects on the human organism: what we do know and what requires further research. Front Physiol 2024; 15:1284644. [PMID: 38415007 PMCID: PMC10896920 DOI: 10.3389/fphys.2024.1284644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/22/2024] [Indexed: 02/29/2024] Open
Abstract
Space has always fascinated people. Many years have passed since the first spaceflight, and in addition to the enormous technological progress, the level of understanding of human physiology in space is also increasing. The presented paper aims to summarize the recent research findings on the influence of the space environment (microgravity, pressure differences, cosmic radiation, etc.) on the human body systems during short-term and long-term space missions. The review also presents the biggest challenges and problems that must be solved in order to extend safely the time of human stay in space. In the era of increasing engineering capabilities, plans to colonize other planets, and the growing interest in commercial space flights, the most topical issues of modern medicine seems to be understanding the effects of long-term stay in space, and finding solutions to minimize the harmful effects of the space environment on the human body.
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Affiliation(s)
- Marcin Tomsia
- Department of Forensic Medicine and Forensic Toxicology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Julia Cieśla
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Śmieszek
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Szymon Florek
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agata Macionga
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Michalczyk
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Dominika Stygar
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- SLU University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
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3
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Hoenemann JN, Moestl S, Diedrich A, Mulder E, Frett T, Petrat G, Pustowalow W, Arz M, Schmitz MT, Heusser K, Lee SMC, Jordan J, Tank J, Hoffmann F. Impact of daily artificial gravity on autonomic cardiovascular control following 60-day head-down tilt bed rest. Front Cardiovasc Med 2023; 10:1250727. [PMID: 37953766 PMCID: PMC10634666 DOI: 10.3389/fcvm.2023.1250727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Impaired cardiovascular autonomic control following space flight or immobilization may limit the ability to cope with additional hemodynamic stimuli. Head-down tilt bedrest is an established terrestrial analog for space flight and offers the opportunity to test potential countermeasures for autonomic cardiovascular deconditioning. Previous studies revealed a possible benefit of daily artificial gravity on cardiovascular autonomic control following head-down tilt bedrest, but there is a need for efficiency in a long-term study before an artificial gravity facility would be brought to space. We hypothesized that artificial gravity through short-arm centrifugation attenuates functional adaptions of autonomic function during head-down tilt bed rest. 24 healthy persons (8 women, 33.4 ± 9.3 years, 24.3 ± 2.1 kg/m2) participated in the 60-day head-down tilt bed rest (AGBRESA) study. They were assigned to three groups, 30 min/day continuous, or 6(5 min intermittent short-arm centrifugation, or a control group. We assessed autonomic cardiovascular control in the supine position and in 5 minutes 80° head-up tilt position before and immediately after bed rest. We computed heart rate variability (HRV) in the time (rmssd) and frequency domain, blood pressure variability, and baroreflex sensitivity (BRS). RR interval corrected rmssd was reduced supine (p = 0.0358) and during HUT (p = 0.0161). Heart rate variability in the high-frequency band (hf-RRI; p = 0.0004) and BRS (p < 0.0001) decreased, whereas blood pressure variability in the low-frequency band (lf-SBP, p = 0.0008) increased following bedrest in all groups. We did not detect significant interactions between bedrest and interventions. We conclude that up to daily 30 min of artificial gravity on a short-arm centrifuge with 1Gz at the center of mass do not suffice to prevent changes in autonomic cardiovascular control following 60-day of 6° head-down tilt bed rest. Clinical Trial Registration: https://drks.de/search/en/trial/DRKS00015677, identifier, DRKS00015677.
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Affiliation(s)
- J.-N. Hoenemann
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Cologne, Germany
| | - S. Moestl
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - A. Diedrich
- Department of Medicine, Division of Clinical Pharmacology, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TN, United States
| | - E. Mulder
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - T. Frett
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - G. Petrat
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - W. Pustowalow
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - M. Arz
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - M.-T. Schmitz
- Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany
| | - K. Heusser
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - S. M. C. Lee
- Wyle Laboratories, Life Sciences and Systems Division, Houston, TX, United States
| | - J. Jordan
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Head of Aerospace Medicine, University of Cologne, Germany, Cologne
| | - J. Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - F. Hoffmann
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
- Department of Internal Medicine III, Division of Cardiology, Pneumology, Angiology, and Intensive Care, University of Cologne, Cologne, Germany
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4
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Alassafi MO, Khan IR, AlGhamdi R, Aziz W, Alshdadi AA, Dessouky MM, Bahaddad A, Altalbe A, Albishry N. Studying Dynamical Characteristics of Oxygen Saturation Variability Signals Using Haar Wavelet. Healthcare (Basel) 2023; 11:2280. [PMID: 37628478 PMCID: PMC10454822 DOI: 10.3390/healthcare11162280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
An aim of the analysis of biomedical signals such as heart rate variability signals, brain signals, oxygen saturation variability (OSV) signals, etc., is for the design and development of tools to extract information about the underlying complexity of physiological systems, to detect physiological states, monitor health conditions over time, or predict pathological conditions. Entropy-based complexity measures are commonly used to quantify the complexity of biomedical signals; however novel complexity measures need to be explored in the context of biomedical signal classification. In this work, we present a novel technique that used Haar wavelets to analyze the complexity of OSV signals of subjects during COVID-19 infection and after recovery. The data used to evaluate the performance of the proposed algorithms comprised recordings of OSV signals from 44 COVID-19 patients during illness and after recovery. The performance of the proposed technique was compared with four, scale-based entropy measures: multiscale entropy (MSE); multiscale permutation entropy (MPE); multiscale fuzzy entropy (MFE); multiscale amplitude-aware permutation entropy (MAMPE). Preliminary results of the pilot study revealed that the proposed algorithm outperformed MSE, MPE, MFE, and MMAPE in terms of better accuracy and time efficiency for separating during and after recovery the OSV signals of COVID-19 subjects. Further studies are needed to evaluate the potential of the proposed algorithm for large datasets and in the context of other biomedical signal classifications.
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Affiliation(s)
- Madini O. Alassafi
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.O.A.); (A.B.); (A.A.); (N.A.)
| | - Ishtiaq Rasool Khan
- College of Computer Science and Engineering, University of Jeddah, Jeddah 21725, Saudi Arabia; (I.R.K.); (A.A.A.); (M.M.D.)
| | - Rayed AlGhamdi
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.O.A.); (A.B.); (A.A.); (N.A.)
| | - Wajid Aziz
- Department of Computer Science and Information Technology, King Abdullah Campus, University of Azad Jammu and Kashmir Muzaffarabad (AK), Azad Jammu and Kashmir 13100, Pakistan;
| | - Abdulrahman A. Alshdadi
- College of Computer Science and Engineering, University of Jeddah, Jeddah 21725, Saudi Arabia; (I.R.K.); (A.A.A.); (M.M.D.)
| | - Mohamed M. Dessouky
- College of Computer Science and Engineering, University of Jeddah, Jeddah 21725, Saudi Arabia; (I.R.K.); (A.A.A.); (M.M.D.)
- Department of Computer Science & Engineering, Faculty of Electronic Engineering, Menoufia University, Menouf 12548, Egypt
| | - Adel Bahaddad
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.O.A.); (A.B.); (A.A.); (N.A.)
| | - Ali Altalbe
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.O.A.); (A.B.); (A.A.); (N.A.)
| | - Nabeel Albishry
- Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.O.A.); (A.B.); (A.A.); (N.A.)
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Hélissen O, Kermorgant M, Déjean S, Mercadie A, Le Gonidec S, Zahreddine R, Calise D, Nasr N, Galès C, Arvanitis DN, Pavy-Le Traon A. Autonomic Nervous System Adaptation and Circadian Rhythm Disturbances of the Cardiovascular System in a Ground-Based Murine Model of Spaceflight. Life (Basel) 2023; 13:life13030844. [PMID: 36983999 PMCID: PMC10057816 DOI: 10.3390/life13030844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Whether in real or simulated microgravity, Humans or animals, the kinetics of cardiovascular adaptation and its regulation by the autonomic nervous system (ANS) remain controversial. In this study, we used hindlimb unloading (HU) in 10 conscious mice. Blood pressure (BP), heart rate (HR), temperature, and locomotor activity were continuously monitored with radio-telemetry, during 3 days of control, 5 days of HU, and 2 days of recovery. Six additional mice were used to assess core temperature. ANS activity was indirectly determined by analyzing both heart rate variability (HRV) and baroreflex sensitivity (BRS). Our study showed that HU induced an initial bradycardia, accompanied by an increase in vagal activity markers of HRV and BRS, together with a decrease in water intake, indicating the early adaptation to fluid redistribution. During HU, BRS was reduced; temperature and BP circadian rhythms were altered, showing a loss in day/night differences, a decrease in cycle amplitude, a drop in core body temperature, and an increase in day BP suggestive of a rise in sympathetic activity. Reloading induced resting tachycardia and a decrease in BP, vagal activity, and BRS. In addition to cardiovascular deconditioning, HU induces disruption in day/night rhythmicity of locomotor activity, temperature, and BP.
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Affiliation(s)
- Ophélie Hélissen
- Institute of Cardiovascular and Metabolic Diseases, UMR1297, INSERM, University Hospital of Toulouse, 31400 Toulouse, France
| | - Marc Kermorgant
- Institute of Cardiovascular and Metabolic Diseases, UMR1297, INSERM, University Hospital of Toulouse, 31400 Toulouse, France
- Neurology Department, University Hospital of Toulouse, 31400 Toulouse, France
| | - Sébastien Déjean
- Institut de Mathématiques de Toulouse, UMR5219, CNRS, Université de Toulouse, UT3, 31062 Toulouse, France
| | - Aurélie Mercadie
- Institut de Mathématiques de Toulouse, UMR5219, CNRS, Université de Toulouse, UT3, 31062 Toulouse, France
| | - Sophie Le Gonidec
- CREFRE-Anexplo, Services Phénotypage et Microchirurgie, UMS006, INSERM, Université de Toulouse, UT3, ENVT, 31062 Toulouse, France
| | - Rana Zahreddine
- CREFRE-Anexplo, Services Phénotypage et Microchirurgie, UMS006, INSERM, Université de Toulouse, UT3, ENVT, 31062 Toulouse, France
| | - Denis Calise
- CREFRE-Anexplo, Services Phénotypage et Microchirurgie, UMS006, INSERM, Université de Toulouse, UT3, ENVT, 31062 Toulouse, France
| | - Nathalie Nasr
- Institute of Cardiovascular and Metabolic Diseases, UMR1297, INSERM, University Hospital of Toulouse, 31400 Toulouse, France
| | - Céline Galès
- Institute of Cardiovascular and Metabolic Diseases, UMR1297, INSERM, University Hospital of Toulouse, 31400 Toulouse, France
| | - Dina N Arvanitis
- Institute of Cardiovascular and Metabolic Diseases, UMR1297, INSERM, University Hospital of Toulouse, 31400 Toulouse, France
| | - Anne Pavy-Le Traon
- Institute of Cardiovascular and Metabolic Diseases, UMR1297, INSERM, University Hospital of Toulouse, 31400 Toulouse, France
- Neurology Department, University Hospital of Toulouse, 31400 Toulouse, France
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Hedge ET, Patterson CA, Mastrandrea CJ, Sonjak V, Hajj-Boutros G, Faust A, Morais JA, Hughson RL. Implementation of exercise countermeasures during spaceflight and microgravity analogue studies: Developing countermeasure protocols for bedrest in older adults (BROA). Front Physiol 2022; 13:928313. [PMID: 36017336 PMCID: PMC9395735 DOI: 10.3389/fphys.2022.928313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/27/2022] [Indexed: 12/18/2022] Open
Abstract
Significant progress has been made in the development of countermeasures to attenuate the negative consequences of prolonged exposure to microgravity on astronauts’ bodies. Deconditioning of several organ systems during flight includes losses to cardiorespiratory fitness, muscle mass, bone density and strength. Similar deconditioning also occurs during prolonged bedrest; any protracted time immobile or inactive, especially for unwell older adults (e.g., confined to hospital beds), can lead to similar detrimental health consequences. Due to limitations in physiological research in space, the six-degree head-down tilt bedrest protocol was developed as ground-based analogue to spaceflight. A variety of exercise countermeasures have been tested as interventions to limit detrimental changes and physiological deconditioning of the musculoskeletal and cardiovascular systems. The Canadian Institutes of Health Research and the Canadian Space Agency recently provided funding for research focused on Understanding the Health Impact of Inactivity to study the efficacy of exercise countermeasures in a 14-day randomized clinical trial of six-degree head-down tilt bedrest study in older adults aged 55–65 years old (BROA). Here we will describe the development of a multi-modality countermeasure protocol for the BROA campaign that includes upper- and lower-body resistance exercise and head-down tilt cycle ergometry (high-intensity interval and continuous aerobic exercise training). We provide reasoning for the choice of these modalities following review of the latest available information on exercise as a countermeasure for inactivity and spaceflight-related deconditioning. In summary, this paper sets out to review up-to-date exercise countermeasure research from spaceflight and head-down bedrest studies, whilst providing support for the proposed research countermeasure protocols developed for the bedrest study in older adults.
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Affiliation(s)
- Eric T. Hedge
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | | | - Vita Sonjak
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Guy Hajj-Boutros
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Andréa Faust
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - José A. Morais
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
- Division of Geriatric Medicine, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Richard L. Hughson
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
- *Correspondence: Richard L. Hughson,
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Computational modeling of orthostatic intolerance for travel to Mars. NPJ Microgravity 2022; 8:34. [PMID: 35945233 PMCID: PMC9363491 DOI: 10.1038/s41526-022-00219-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/15/2022] [Indexed: 11/12/2022] Open
Abstract
Astronauts in a microgravity environment will experience significant changes in their cardiopulmonary system. Up until now, there has always been the reassurance that they have real-time contact with experts on Earth. Mars crew however will have gaps in their communication of 20 min or more. In silico experiments are therefore needed to assess fitness to fly for those on future space flights to Mars. In this study, we present an open-source controlled lumped mathematical model of the cardiopulmonary system that is able simulate the short-term adaptations of key hemodynamic parameters to an active stand test after being exposed to microgravity. The presented model is capable of adequately simulating key cardiovascular hemodynamic changes—over a short time frame—during a stand test after prolonged spaceflight under different gravitational conditions and fluid loading conditions. This model can form the basis for further exploration of the ability of the human cardiovascular system to withstand long-duration space flight and life on Mars.
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Pantalone D, Chiara O, Henry S, Cimbanassi S, Gupta S, Scalea T. Facing Trauma and Surgical Emergency in Space: Hemorrhagic Shock. Front Bioeng Biotechnol 2022; 10:780553. [PMID: 35845414 PMCID: PMC9283715 DOI: 10.3389/fbioe.2022.780553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/22/2022] [Indexed: 11/16/2022] Open
Abstract
Although the risk of trauma in space is low, unpredictable events can occur that may require surgical treatment. Hemorrhage can be a life-threatening condition while traveling to another planet and after landing on it. These exploration missions call for a different approach than rapid return to Earth, which is the policy currently adopted on the International Space Station (ISS) in low Earth orbit (LEO). Consequences are difficult to predict, given the still scarce knowledge of human physiology in such environments. Blood loss in space can deplete the affected astronaut’s physiological reserves and all stored crew supplies. In this review, we will describe different aspects of hemorrhage in space, and by comparison with terrestrial conditions, the possible solutions to be adopted, and the current state of the art.
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Affiliation(s)
- D. Pantalone
- Department of Experimental and Clinical Medicine, Fellow of the American College of Surgeons, Core Board and Head for Studies on Traumatic Events and Surgery in the European Space Agency-Topical Team on “Tissue Healing in Space Techniques for Promoting and Monitoring Tissue Repair and Regeneration” for Life Science Activities Agency, Assistant Professor in General Surgery, Specialist in Vascular Surgery, Emergency Surgery Unit–Trauma Team, Emergency Department–Careggi University Hospital, University of Florence, Florence, Italy
- *Correspondence: D. Pantalone,
| | - O. Chiara
- Fellow of the American College of Surgeons, Director of General Surgery–Trauma Team, ASST GOM Grande Ospedale Metropolitano Niguarda, Professor of Surgery, University of Milan, Milan, Italy
| | - S. Henry
- Fellow of the American College of Surgeons, Director Division of Wound Healing and Metabolism, R Adams Cowley Shock Trauma Center University of Maryland, Baltimore, MD, United States
| | - S. Cimbanassi
- Fellow of the American College of Surgeons, EMDM, Vice Director of General Surgery-Trauma Team, ASST GOM Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - S. Gupta
- Fellow of the American College of Surgeons, R Adams Cowl y Shock Trauma Center, University of Maryland, Baltimore, MD, United States
| | - T. Scalea
- Fellow of the American College of Surgeons, The Honorable Francis X. Kelly Distinguished Professor of Trauma Surgery.Physician-in-Chief, R Adams Cowley Shock Trauma Center, System Chief for Critical Care Services, University of Maryland Medical System, University of Maryland, Baltimore, MD, United States
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Du J, Cui J, Yang J, Wang P, Zhang L, Luo B, Han B. Alterations in Cerebral Hemodynamics During Microgravity: A Literature Review. Med Sci Monit 2021; 27:e928108. [PMID: 33446627 PMCID: PMC7814510 DOI: 10.12659/msm.928108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Most reported neurological symptoms that happen after exposure to microgravity could be originated from alterations in cerebral hemodynamics. The complicated mechanisms involved in the process of hemodynamics and the disparate experimental protocols designed to study the process may have contributed to the discrepancies in results between studies and the lack of consensus among researchers. This literature review examines spaceflight and ground-based studies of cerebral hemodynamics and aims to summarize the underlying physiological mechanisms that are altered in cerebral hemodynamics during microgravity. We reviewed studies that were published before July 2020 and sought to provide a comprehensive summary of the physiological or pathological theories of hemodynamics and to arrive at firm conclusions from incongruous results that were reported in those related articles. We give plausible explanations of inconsistent results on factors including intracranial pressure, cerebral blood flow, and cerebrovascular autoregulation. Although there are no definitive data to confirm how cerebral hemodynamics changes during microgravity, every discrepancy in results was interpreted by existing theories, which were derived from physiological and pathological processes. We conclude that microgravity-induced alterations of hemodynamics at the brain level are multifaceted. Factors including duration, partial pressures of carbon dioxide, and individual adaptability contribute to this process and are unpredictable. With a growing understanding of this hemodynamics model, additional factors will likely be considered. Aiming for a full understanding of the physiological and/or pathological changes of hemodynamics will enable researchers to investigate its cellular and molecular mechanisms in future studies, which are desperately needed.
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Affiliation(s)
- Jichen Du
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Jiangbo Cui
- Aerospace Clinic Academy, Peking University Health Science Center, Beijing, China (mainland)
| | - Jing Yang
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Peifu Wang
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Lvming Zhang
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Bin Luo
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
| | - Bailin Han
- Department of Neurology, Aerospace Center Hospital, Beijing, China (mainland)
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10
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Koutnik AP, Favre ME, Noboa K, Sanchez-Gonzalez MA, Moss SE, Goubran B, Ari C, Poff AM, Rogers CQ, DeBlasi JM, Samy B, Moussa M, Serrador JM, D'Agostino DP. Human Adaptations to Multiday Saturation on NASA NEEMO. Front Physiol 2021; 11:610000. [PMID: 33510647 PMCID: PMC7835980 DOI: 10.3389/fphys.2020.610000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/16/2020] [Indexed: 12/12/2022] Open
Abstract
Human adaptation to extreme environments has been explored for over a century to understand human psychology, integrated physiology, comparative pathologies, and exploratory potential. It has been demonstrated that these environments can provide multiple external stimuli and stressors, which are sufficient to disrupt internal homeostasis and induce adaptation processes. Multiday hyperbaric and/or saturated (HBS) environments represent the most understudied of environmental extremes due to inherent experimental, analytical, technical, temporal, and safety limitations. National Aeronautic Space Agency (NASA) Extreme Environment Mission Operation (NEEMO) is a space-flight analog mission conducted within Florida International University’s Aquarius Undersea Research Laboratory (AURL), the only existing operational and habitable undersea saturated environment. To investigate human objective and subjective adaptations to multiday HBS, we evaluated aquanauts living at saturation for 9–10 days via NASA NEEMO 22 and 23, across psychologic, cardiac, respiratory, autonomic, thermic, hemodynamic, sleep, and body composition parameters. We found that aquanauts exposed to saturation over 9–10 days experienced intrapersonal physical and mental burden, sustained good mood and work satisfaction, decreased heart and respiratory rates, increased parasympathetic and reduced sympathetic modulation, lower cerebral blood flow velocity, intact cerebral autoregulation and maintenance of baroreflex functionality, as well as losses in systemic bodyweight and adipose tissue. Together, these findings illustrate novel insights into human adaptation across multiple body systems in response to multiday hyperbaric saturation.
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Affiliation(s)
- Andrew P Koutnik
- Human Health, Resilience, & Performance, Institute for Human and Machine Cognition, Pensacola, FL, United States.,Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Michelle E Favre
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences, Newark, NJ, United States
| | - Karina Noboa
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | | | - Sara E Moss
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Bishoy Goubran
- Department of Psychiatry, Larkin Health System, Miami, FL, United States
| | - Csilla Ari
- Department of Psychology, Hyperbaric Neuroscience Research Laboratory, University of South Florida, Tampa, FL, United States.,Ketone Technologies LLC, Tampa, FL, United States
| | - Angela M Poff
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Chris Q Rogers
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Janine M DeBlasi
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Bishoy Samy
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences, Newark, NJ, United States
| | - Mark Moussa
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Jorge M Serrador
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences, Newark, NJ, United States.,Department of Cardiovascular Electronics, National University of Ireland Galway, Galway, Ireland
| | - Dominic P D'Agostino
- Human Health, Resilience, & Performance, Institute for Human and Machine Cognition, Pensacola, FL, United States.,Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.,Ketone Technologies LLC, Tampa, FL, United States
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11
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Michel JB. Phylogenic Determinants of Cardiovascular Frailty, Focus on Hemodynamics and Arterial Smooth Muscle Cells. Physiol Rev 2020; 100:1779-1837. [DOI: 10.1152/physrev.00022.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The evolution of the circulatory system from invertebrates to mammals has involved the passage from an open system to a closed in-parallel system via a closed in-series system, accompanying the increasing complexity and efficiency of life’s biological functions. The archaic heart enables pulsatile motion waves of hemolymph in invertebrates, and the in-series circulation in fish occurs with only an endothelium, whereas mural smooth muscle cells appear later. The present review focuses on evolution of the circulatory system. In particular, we address how and why this evolution took place from a closed, flowing, longitudinal conductance at low pressure to a flowing, highly pressurized and bifurcating arterial compartment. However, although arterial pressure was the latest acquired hemodynamic variable, the general teleonomy of the evolution of species is the differentiation of individual organ function, supported by specific fueling allowing and favoring partial metabolic autonomy. This was achieved via the establishment of an active contractile tone in resistance arteries, which permitted the regulation of blood supply to specific organ activities via its localized function-dependent inhibition (active vasodilation). The global resistance to viscous blood flow is the peripheral increase in frictional forces caused by the tonic change in arterial and arteriolar radius, which backscatter as systemic arterial blood pressure. Consequently, the arterial pressure gradient from circulating blood to the adventitial interstitium generates the unidirectional outward radial advective conductance of plasma solutes across the wall of conductance arteries. This hemodynamic evolution was accompanied by important changes in arterial wall structure, supported by smooth muscle cell functional plasticity, including contractility, matrix synthesis and proliferation, endocytosis and phagocytosis, etc. These adaptive phenotypic shifts are due to epigenetic regulation, mainly related to mechanotransduction. These paradigms actively participate in cardio-arterial pathologies such as atheroma, valve disease, heart failure, aneurysms, hypertension, and physiological aging.
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12
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Boada M, Perez-Poch A, Ballester M, García-Monclús S, González DV, García S, Barri PN, Veiga A. Microgravity effects on frozen human sperm samples. J Assist Reprod Genet 2020; 37:2249-2257. [PMID: 32683528 PMCID: PMC7492354 DOI: 10.1007/s10815-020-01877-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Microgravity has severe effects on cellular and molecular structures as well as on metabolic interactions. The aim of this study is to investigate the effects of microgravity (μg) exposure on human frozen sperm samples. METHODS Sibling samples from 15 normozoospermic healthy donors were frozen using glycerol as cryoprotectant and analyzed under microgravity and ground conditions. Microgravity was obtained by parabolic flights using a CAP10B plane. The plane executed 20 parabolic maneuvers with a mean of 8.5 s of microgravity for each parabola. RESULTS Frozen sperm samples preserved in cryostraws and stored in a secure and specific nitrogen vapor cryoshipper do not suffer significant alterations after μg exposure. Comparing the study group (μg) and the control group (1 g), similar results were obtained in the main parameters studied: sperm motility (M/ml) 13.72 ± 12.57 vs 13.03 ± 12.13 (- 0.69 95% CI [- 2.9; 1.52]), progressive a + b sperm motility (%) 21.83 ± 11.69 vs 22.54 ± 12.83 (0.03 95% CI [- 0.08; 0.15]), sperm vitality (%) 46.42 ± 10.81 vs 44.62 ± 9.34 (- 0.04 95% CI [- 0.13; 0.05]), morphologically normal spermatozoa (%) 7.03 ± 2.61 vs 8.09 ± 3.61 (0.12 95% CI [0.01; 0.24]), DNA sperm fragmentation by SCD (%) 13.33 ± 5.12 vs 13.88 ± 6.14 (0.03 95% CI [- 0.09; 0.16]), and apoptotic spermatozoa by MACS (%) 15.47 ± 15.04 vs 23.80 ± 23.63 (- 0.20 95% CI [- 0.66; 1.05]). CONCLUSION The lack of differences obtained between frozen samples exposed to μg and those maintained in ground conditions provides the possibility of considering the safe transport of human male gametes to space. Nevertheless, further research is needed to validate the results and to consider the possibility of creating a human sperm bank outside the Earth. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT03760783.
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Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain.
| | - A Perez-Poch
- Universitat Politècnica de Catalunya, UPC BarcelonaTech, EEBE Campus Diagonal-Besòs, C. E. Maristany 16, 08019, Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - S García-Monclús
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - D V González
- Aeroclub Barcelona-Sabadell, Sabadell Airport, Carretera de Bellaterra s/n, 08205 Sabadell, Barcelona, Spain
| | - S García
- Women's Health Dexeus, Unit of Biostatistics, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - P N Barri
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - A Veiga
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
- Barcelona Stem Cell Bank, Centre of Regenerative Medicine in Barcelona, Hospital Duran i Reynals, Gran Via de l'Hospitalet 199, 08908 Hospitalet de Llobregat, Barcelona, Spain
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13
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Patel S. The effects of microgravity and space radiation on cardiovascular health: From low-Earth orbit and beyond. IJC HEART & VASCULATURE 2020; 30:100595. [PMID: 32775602 PMCID: PMC7399104 DOI: 10.1016/j.ijcha.2020.100595] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 10/26/2022]
Abstract
The unique conditions of space harbor considerable challenges for astronauts to overcome. Namely, the ionizing content of space radiation and the effects of microgravity have been implicated in the pathogenesis of cardiovascular disease. Post-flight carotid arterial stiffness was demonstrated in astronaut studies while early arteriosclerosis has been linked with microgravity-induced oxidative stress in cellular studies. Similarly, radiation has been shown to disrupt molecular pathways, enhance reactive oxygen species and increase risk of cardiovascular disease in exposed populations. These results may bear even more significance in space owing to the propensity for microgravity and space radiation to yield synergistic and/or additive interactions. Potential countermeasures such as α-tocopherol and captopril target these oxidative pathways and may help to protect against the effects of microgravity and radiation-induced cardiac damage. However, more research needs to be conducted in this area to facilitate a safe passage for humans to the Moon, Mars and beyond.
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Affiliation(s)
- Smit Patel
- Vascular Biology, Cardiovascular Science, National Heart & Lung Institute (NHLI), Faculty of Medicine, Imperial College London, Dovehouse Street, London SW3 6LY, UK
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14
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Pandiarajan M, Hargens AR. Ground-Based Analogs for Human Spaceflight. Front Physiol 2020; 11:716. [PMID: 32655420 PMCID: PMC7324748 DOI: 10.3389/fphys.2020.00716] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
This mini-review provides an updated summary of various analogs for adaptations of humans to the microgravity of space. Microgravity analogs discussed in this paper include dry immersion, wet immersion, unilateral lower-extremity limb suspension, head down tilt (HDT), and supine bed rest. All Earth-based analogs are imperfect simulations of microgravity with their own advantages and disadvantages. This paper compares these five frequently used microgravity analogs to offer insights into their usefulness for various physiological systems. New developments for each human microgravity analog are explored and advantages of one analog are evaluated against other analogs. Furthermore, the newly observed risk of Spaceflight Associated Neuro-Ocular Syndrome (SANS) is included in this mini review with a discussion of the advantages and disadvantages of each method of simulation for the relatively new risk of SANS. Overall, the best and most integrated analog for Earth-based studies of the microgravity of space flight appears to be head-down tilt bed rest.
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Affiliation(s)
- Meenakshi Pandiarajan
- Department of Orthopaedic Surgery, Altman Clinical and Translational Research Institute, University of California, San Diego, San Diego, CA, United States
| | - Alan R Hargens
- Department of Orthopaedic Surgery, Altman Clinical and Translational Research Institute, University of California, San Diego, San Diego, CA, United States
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15
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Matić Z, Platiša MM, Kalauzi A, Bojić T. Slow 0.1 Hz Breathing and Body Posture Induced Perturbations of RRI and Respiratory Signal Complexity and Cardiorespiratory Coupling. Front Physiol 2020; 11:24. [PMID: 32132926 PMCID: PMC7040454 DOI: 10.3389/fphys.2020.00024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/14/2020] [Indexed: 12/21/2022] Open
Abstract
Objective: We explored the physiological background of the non-linear operating mode of cardiorespiratory oscillators as the fundamental question of cardiorespiratory homeodynamics and as a prerequisite for the understanding of neurocardiovascular diseases. We investigated 20 healthy human subjects for changes using electrocardiac RR interval (RRI) and respiratory signal (Resp) Detrended Fluctuation Analysis (DFA, α1RRI, α2RRI, α1Resp, α2Resp), Multiple Scaling Entropy (MSERRI1-4, MSERRI5-10, MSEResp1-4, MSEResp5-10), spectral coherence (CohRRI-Resp), cross DFA (ρ1 and ρ2) and cross MSE (XMSE1-4 and XMSE5-10) indices in four physiological conditions: supine with spontaneous breathing, standing with spontaneous breathing, supine with 0.1 Hz breathing and standing with 0.1 Hz breathing. Main results: Standing is primarily characterized by the change of RRI parameters, insensitivity to change with respiratory parameters, decrease of CohRRI-Resp and insensitivity to change of in ρ1, ρ2, XMSE1-4, and XMSE5-10. Slow breathing in supine position was characterized by the change of the linear and non-linear parameters of both signals, reflecting the dominant vagal RRI modulation and the impact of slow 0.1 Hz breathing on Resp parameters. CohRRI-Resp did not change with respect to supine position, while ρ1 increased. Slow breathing in standing reflected the qualitatively specific state of autonomic regulation with striking impact on both cardiac and respiratory parameters, with specific patterns of cardiorespiratory coupling. Significance: Our results show that cardiac and respiratory short term and long term complexity parameters have different, state dependent patterns. Sympathovagal non-linear interactions are dependent on the pattern of their activation, having different scaling properties when individually activated with respect to the state of their joint activation. All investigated states induced a change of α1 vs. α2 relationship, which can be accurately expressed by the proposed measure-inter-fractal angle θ. Short scale (α1 vs. MSE1-4) and long scale (α2 vs. MSE5-10) complexity measures had reciprocal interrelation in standing with 0.1 Hz breathing, with specific cardiorespiratory coupling pattern (ρ1 vs. XMSE1-4). These results support the hypothesis of hierarchical organization of cardiorespiratory complexity mechanisms and their recruitment in ascendant manner with respect to the increase of behavioral challenge complexity. Specific and comprehensive cardiorespiratory regulation in standing with 0.1 Hz breathing suggests this state as the potentially most beneficial maneuver for cardiorespiratory conditioning.
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Affiliation(s)
- Zoran Matić
- Biomedical Engineering and Technology, University of Belgrade, Belgrade, Serbia
| | - Mirjana M. Platiša
- Faculty of Medicine, Institute of Biophysics, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Kalauzi
- Department for Life Sciences, Institute for Multidisciplinary Research, University of Belgrade, Belgrade, Serbia
| | - Tijana Bojić
- Laboratory for Radiobiology and Molecular Genetics-080, Institute for Nuclear Sciences Vinča, University of Belgrade, Belgrade, Serbia
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16
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Cho HJ, Baek MO, Khaliq SA, Chon SJ, Son KH, Lee SH, Yoon MS. Microgravity inhibits decidualization via decreasing Akt activity and FOXO3a expression in human endometrial stromal cells. Sci Rep 2019; 9:12094. [PMID: 31431660 PMCID: PMC6702225 DOI: 10.1038/s41598-019-48580-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/08/2019] [Indexed: 12/28/2022] Open
Abstract
Decidualization is characterized by the differentiation of endometrial stromal cells (eSCs), which is critical for embryo implantation and maintenance of pregnancy. In the present study, we investigated the possible effect of simulated microgravity (SM) on the process of proliferation and in vitro decidualization using primary human eSCs. Exposure to SM for 36 h decreased the proliferation and migration of eSCs significantly, without inducing cell death and changes in cell cycle progression. The phosphorylation of Akt decreased under SM conditions in human eSCs, accompanied by a simultaneous decrease in the level of matrix metalloproteinase (MMP)-2 and FOXO3a. Treatment with Akti, an Akt inhibitor, decreased MMP-2 expression, but not FOXO3a expression. The decreased level of FOXO3a under SM conditions impeded autophagic flux by reducing the levels of autophagy-related genes. In addition, pre-exposure of eSCs to SM significantly inhibited 8-Br-cAMP induced decidualization, whereas restoration of the growth status under SM conditions by removing 8-Br-cAMP remained unchanged. Treatment of human eSCs with SC-79, an Akt activator, restored the reduced migration of eSCs and decidualization under SM conditions. In conclusion, exposure to SM inhibited decidualization in eSCs by decreasing proliferation and migration through Akt/MMP and FOXO3a/autophagic flux.
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Affiliation(s)
- Hye-Jeong Cho
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon, 21999, Republic of Korea.,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea.,Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, 21999, Republic of Korea
| | - Mi-Ock Baek
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon, 21999, Republic of Korea.,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea.,Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, 21999, Republic of Korea
| | - Sana Abdul Khaliq
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon, 21999, Republic of Korea.,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea.,Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, 21999, Republic of Korea
| | - Seung Joo Chon
- Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, 21565, Republic of Korea
| | - Kuk Hui Son
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, College of Medicine, Gachon University, Incheon, 21565, Republic of Korea
| | - Sung Ho Lee
- Department of Thoracic and Cardiovascular Surgery, Korea University, Seoul, 02841, Republic of Korea
| | - Mee-Sup Yoon
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon, 21999, Republic of Korea. .,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea. .,Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, 21999, Republic of Korea.
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17
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Voorhies AA, Mark Ott C, Mehta S, Pierson DL, Crucian BE, Feiveson A, Oubre CM, Torralba M, Moncera K, Zhang Y, Zurek E, Lorenzi HA. Study of the impact of long-duration space missions at the International Space Station on the astronaut microbiome. Sci Rep 2019; 9:9911. [PMID: 31289321 PMCID: PMC6616552 DOI: 10.1038/s41598-019-46303-8] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/17/2019] [Indexed: 12/16/2022] Open
Abstract
Over the course of a mission to the International Space Station (ISS) crew members are exposed to a number of stressors that can potentially alter the composition of their microbiomes and may have a negative impact on astronauts’ health. Here we investigated the impact of long-term space exploration on the microbiome of nine astronauts that spent six to twelve months in the ISS. We present evidence showing that the microbial communities of the gastrointestinal tract, skin, nose and tongue change during the space mission. The composition of the intestinal microbiota became more similar across astronauts in space, mostly due to a drop in the abundance of a few bacterial taxa, some of which were also correlated with changes in the cytokine profile of crewmembers. Alterations in the skin microbiome that might contribute to the high frequency of skin rashes/hypersensitivity episodes experienced by astronauts in space were also observed. The results from this study demonstrate that the composition of the astronauts’ microbiome is altered during space travel. The impact of those changes on crew health warrants further investigation before humans embark on long-duration voyages into outer space.
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Affiliation(s)
- Alexander A Voorhies
- Department of Infectious Diseases, J. Craig Venter Institute, Rockville, MD, USA
| | - C Mark Ott
- NASA-Johnson Space Center, Houston, TX, USA
| | | | | | | | | | | | - Manolito Torralba
- Department of Infectious Diseases, J. Craig Venter Institute, Rockville, MD, USA
| | - Kelvin Moncera
- Department of Infectious Diseases, J. Craig Venter Institute, Rockville, MD, USA
| | - Yun Zhang
- Department of Infectious Diseases, J. Craig Venter Institute, Rockville, MD, USA
| | | | - Hernan A Lorenzi
- Department of Infectious Diseases, J. Craig Venter Institute, Rockville, MD, USA.
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18
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Diaz-Artiles A, Heldt T, Young LR. Short-Term Cardiovascular Response to Short-Radius Centrifugation With and Without Ergometer Exercise. Front Physiol 2018; 9:1492. [PMID: 30483141 PMCID: PMC6242912 DOI: 10.3389/fphys.2018.01492] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 10/03/2018] [Indexed: 12/26/2022] Open
Abstract
Artificial gravity (AG) has often been proposed as an integrated multi-system countermeasure to physiological deconditioning associated with extended exposure to reduced gravity levels, particularly if combined with exercise. Twelve subjects underwent short-radius centrifugation along with bicycle ergometry to quantify the short-term cardiovascular response to AG and exercise across three AG levels (0 G or no rotation, 1 G, and 1.4 G; referenced to the subject's feet and measured in the centripetal direction) and three exercise intensities (25, 50, and 100 W). Continuous cardiovascular measurements were collected during the centrifugation sessions using a non-invasive monitoring system. The cardiovascular responses were more prominent at higher levels of AG and exercise intensity. In particular, cardiac output, stroke volume, pulse pressure, and heart rate significantly increased with both AG level (in most of exercise group combinations, showing averaged increments across exercise conditions of 1.4 L/min/g, 7.6 mL/g, 5.22 mmHg/g, and 2.0 bpm/g, respectively), and workload intensity (averaged increments across AG conditions of 0.09 L/min/W, 0.17 mL/W, 0.22 mmHg/W, and 0.74 bpm/W respectively). These results suggest that the addition of AG to exercise can provide a greater cardiovascular benefit than exercise alone. Hierarchical regression models were fitted to the experimental data to determine dose-response curves of all cardiovascular variables as a function of AG-level and exercise intensity during short-radius centrifugation. These results can inform future studies, decisions, and trade-offs toward potential implementation of AG as a space countermeasure.
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Affiliation(s)
- Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, TX, United States
| | - Thomas Heldt
- Institute for Medical Engineering and Science and Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Laurence R. Young
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, United States
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19
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Crucian BE, Choukèr A, Simpson RJ, Mehta S, Marshall G, Smith SM, Zwart SR, Heer M, Ponomarev S, Whitmire A, Frippiat JP, Douglas GL, Lorenzi H, Buchheim JI, Makedonas G, Ginsburg GS, Ott CM, Pierson DL, Krieger SS, Baecker N, Sams C. Immune System Dysregulation During Spaceflight: Potential Countermeasures for Deep Space Exploration Missions. Front Immunol 2018; 9:1437. [PMID: 30018614 PMCID: PMC6038331 DOI: 10.3389/fimmu.2018.01437] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/11/2018] [Indexed: 12/11/2022] Open
Abstract
Recent studies have established that dysregulation of the human immune system and the reactivation of latent herpesviruses persists for the duration of a 6-month orbital spaceflight. It appears certain aspects of adaptive immunity are dysregulated during flight, yet some aspects of innate immunity are heightened. Interaction between adaptive and innate immunity also seems to be altered. Some crews experience persistent hypersensitivity reactions during flight. This phenomenon may, in synergy with extended duration and galactic radiation exposure, increase specific crew clinical risks during deep space exploration missions. The clinical challenge is based upon both the frequency of these phenomena in multiple crewmembers during low earth orbit missions and the inability to predict which specific individual crewmembers will experience these changes. Thus, a general countermeasure approach that offers the broadest possible coverage is needed. The vehicles, architecture, and mission profiles to enable such voyages are now under development. These include deployment and use of a cis-Lunar station (mid 2020s) with possible Moon surface operations, to be followed by multiple Mars flyby missions, and eventual human Mars surface exploration. Current ISS studies will continue to characterize physiological dysregulation associated with prolonged orbital spaceflight. However, sufficient information exists to begin consideration of both the need for, and nature of, specific immune countermeasures to ensure astronaut health. This article will review relevant in-place operational countermeasures onboard ISS and discuss a myriad of potential immune countermeasures for exploration missions. Discussion points include nutritional supplementation and functional foods, exercise and immunity, pharmacological options, the relationship between bone and immune countermeasures, and vaccination to mitigate herpes (and possibly other) virus risks. As the immune system has sentinel connectivity within every other physiological system, translational effects must be considered for all potential immune countermeasures. Finally, we shall discuss immune countermeasures in the context of their individualized implementation or precision medicine, based on crewmember specific immunological biases.
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Affiliation(s)
- Brian E. Crucian
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, United States
| | - Alexander Choukèr
- Laboratory of Translational Research “Stress and Immunity”, Department of Anesthesiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Richard J. Simpson
- Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, United States
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, The University of Arizona, Tucson, AZ, United States
| | | | - Gailen Marshall
- University of Mississippi Medical Center, Jackson, MS, United States
| | - Scott M. Smith
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, United States
| | - Sara R. Zwart
- University of Texas Medical Branch, Galveston, TX, United States
| | - Martina Heer
- Institute of Nutritional and Food Sciences, University of Bonn, Bonn, Germany
| | | | | | - Jean P. Frippiat
- Stress Immunity Pathogens Laboratory, EA7300, Lorraine University, Nancy, France
| | - Grace L. Douglas
- Human Systems Engineering and Development Division, NASA Johnson Space Center, Houston, TX, United States
| | | | - Judith-Irina Buchheim
- Laboratory of Translational Research “Stress and Immunity”, Department of Anesthesiology, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | | | - Geoffrey S. Ginsburg
- Duke Center for Applied Genomics and Precision Medicine, Durham, NC, United States
| | - C. Mark Ott
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, United States
| | - Duane L. Pierson
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, United States
| | | | - Natalie Baecker
- Institute of Nutritional and Food Sciences, University of Bonn, Bonn, Germany
| | - Clarence Sams
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, United States
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20
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21
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Hatzistergos KE, Jiang Z, Valasaki K, Takeuchi LM, Balkan W, Atluri P, Saur D, Seidler B, Tsinoremas N, DiFede DL, Hare JM. Simulated Microgravity Impairs Cardiac Autonomic Neurogenesis from Neural Crest Cells. Stem Cells Dev 2018; 27:819-830. [PMID: 29336212 DOI: 10.1089/scd.2017.0265] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Microgravity-induced alterations in the autonomic nervous system (ANS) contribute to derangements in both the mechanical and electrophysiological function of the cardiovascular system, leading to severe symptoms in humans following space travel. Because the ANS forms embryonically from neural crest (NC) progenitors, we hypothesized that microgravity can impair NC-derived cardiac structures. Accordingly, we conducted in vitro simulated microgravity experiments employing NC genetic lineage tracing in mice with cKitCreERT2/+, Isl1nLacZ, and Wnt1-Cre reporter alleles. Inducible fate mapping in adult mouse hearts and pluripotent stem cells (iPSCs) demonstrated reduced cKitCreERT2/+-mediated labeling of both NC-derived cardiomyocytes and autonomic neurons (P < 0.0005 vs. controls). Whole transcriptome analysis, suggested that this effect was associated with repressed cardiac NC- and upregulated mesoderm-related gene expression profiles, coupled with abnormal bone morphogenetic protein (BMP)/transforming growth factor beta (TGF-β) and Wnt/β-catenin signaling. To separate the manifestations of simulated microgravity on NC versus mesodermal-cardiac derivatives, we conducted Isl1nLacZ lineage analyses, which indicated an approximately 3-fold expansion (P < 0.05) in mesoderm-derived Isl-1+ pacemaker sinoatrial nodal cells; and an approximately 3-fold reduction (P < 0.05) in cardiac NC-derived ANS cells, including sympathetic nerves and Isl-1+ cardiac ganglia. Finally, NC-specific fate mapping with a Wnt1-Cre reporter iPSC model of murine NC development confirmed that simulated microgravity directly impacted the in vitro development of cardiac NC progenitors and their contribution to the sympathetic and parasympathetic innervation of the iPSC-derived myocardium. Altogether, these findings reveal an important role for gravity in the development of NCs and their postnatal derivatives, and have important therapeutic implications for human space exploration, providing insights into cellular and molecular mechanisms of microgravity-induced cardiomyopathies/channelopathies.
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Affiliation(s)
| | - Zhijie Jiang
- 2 Center for Computational Sciences, University of Miami , Miller School of Medicine, Miami, Florida
| | | | - Lauro M Takeuchi
- 1 Interdisciplinary Stem Cell Institute, University of Miami , Miami, Florida
| | - Wayne Balkan
- 1 Interdisciplinary Stem Cell Institute, University of Miami , Miami, Florida
| | - Preethi Atluri
- 1 Interdisciplinary Stem Cell Institute, University of Miami , Miami, Florida
| | - Dieter Saur
- 3 Department of Medicine II, Klinikum rechts der Isar, Technische Universität München , München, Germany .,4 German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg, Germany
| | - Barbara Seidler
- 3 Department of Medicine II, Klinikum rechts der Isar, Technische Universität München , München, Germany .,4 German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK) , Heidelberg, Germany
| | - Nicholas Tsinoremas
- 2 Center for Computational Sciences, University of Miami , Miller School of Medicine, Miami, Florida
| | - Darcy L DiFede
- 1 Interdisciplinary Stem Cell Institute, University of Miami , Miami, Florida
| | - Joshua M Hare
- 1 Interdisciplinary Stem Cell Institute, University of Miami , Miami, Florida
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Diaz-Artiles A, Heldt T, Young LR. Short-Term Cardiovascular Response to Short-Radius Centrifugation With and Without Ergometer Exercise. Front Physiol 2018. [PMID: 30483141 DOI: 10.3389/fphys.2018.00830/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Artificial gravity (AG) has often been proposed as an integrated multi-system countermeasure to physiological deconditioning associated with extended exposure to reduced gravity levels, particularly if combined with exercise. Twelve subjects underwent short-radius centrifugation along with bicycle ergometry to quantify the short-term cardiovascular response to AG and exercise across three AG levels (0 G or no rotation, 1 G, and 1.4 G; referenced to the subject's feet and measured in the centripetal direction) and three exercise intensities (25, 50, and 100 W). Continuous cardiovascular measurements were collected during the centrifugation sessions using a non-invasive monitoring system. The cardiovascular responses were more prominent at higher levels of AG and exercise intensity. In particular, cardiac output, stroke volume, pulse pressure, and heart rate significantly increased with both AG level (in most of exercise group combinations, showing averaged increments across exercise conditions of 1.4 L/min/g, 7.6 mL/g, 5.22 mmHg/g, and 2.0 bpm/g, respectively), and workload intensity (averaged increments across AG conditions of 0.09 L/min/W, 0.17 mL/W, 0.22 mmHg/W, and 0.74 bpm/W respectively). These results suggest that the addition of AG to exercise can provide a greater cardiovascular benefit than exercise alone. Hierarchical regression models were fitted to the experimental data to determine dose-response curves of all cardiovascular variables as a function of AG-level and exercise intensity during short-radius centrifugation. These results can inform future studies, decisions, and trade-offs toward potential implementation of AG as a space countermeasure.
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Affiliation(s)
- Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, TX, United States
| | - Thomas Heldt
- Institute for Medical Engineering and Science and Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Laurence R Young
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, United States
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23
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Morabito C, Guarnieri S, Catizone A, Schiraldi C, Ricci G, Mariggiò MA. Transient increases in intracellular calcium and reactive oxygen species levels in TCam-2 cells exposed to microgravity. Sci Rep 2017; 7:15648. [PMID: 29142208 PMCID: PMC5688167 DOI: 10.1038/s41598-017-15935-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/02/2017] [Indexed: 11/14/2022] Open
Abstract
The effects of microgravity on functions of the human body are well described, including alterations in the male and female reproductive systems. In the present study, TCam-2 cells, which are considered a good model of mitotically active male germ cells, were used to investigate intracellular signalling and cell metabolism during exposure to simulated microgravity, a condition that affects cell shape and cytoskeletal architecture. After a 24 hour exposure to simulated microgravity, TCam-2 cells showed 1) a decreased proliferation rate and a delay in cell cycle progression, 2) increased anaerobic metabolism accompanied by increased levels of intracellular Ca2+, reactive oxygen species and superoxide anion and modifications in mitochondrial morphology. Interestingly, all these events were transient and were no longer evident after 48 hours of exposure. The presence of antioxidants prevented not only the effects described above but also the modifications in cytoskeletal architecture and the activation of the autophagy process induced by simulated microgravity. In conclusion, in the TCam-2 cell model, simulated microgravity activated the oxidative machinery, triggering transient macroscopic cell events, such as a reduction in the proliferation rate, changes in cytoskeleton-driven shape and autophagy activation.
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Affiliation(s)
- C Morabito
- Department of Neuroscience, Imaging and Clinical Sciences and Centro Scienze dell' Invecchiamento e Medicina Traslazionale (CeSI-MeT), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - S Guarnieri
- Department of Neuroscience, Imaging and Clinical Sciences and Centro Scienze dell' Invecchiamento e Medicina Traslazionale (CeSI-MeT), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - A Catizone
- Section of Histology and Medical Embryology, Department of Anatomy, Histology, Forensic and Orthopaedic Medicine, "Sapienza" University of Rome, Rome, Italy
| | - C Schiraldi
- Department of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - G Ricci
- Department of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - M A Mariggiò
- Department of Neuroscience, Imaging and Clinical Sciences and Centro Scienze dell' Invecchiamento e Medicina Traslazionale (CeSI-MeT), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
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24
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Fortrat JO, de Holanda A, Zuj K, Gauquelin-Koch G, Gharib C. Altered Venous Function during Long-Duration Spaceflights. Front Physiol 2017; 8:694. [PMID: 28955249 PMCID: PMC5600926 DOI: 10.3389/fphys.2017.00694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/29/2017] [Indexed: 11/16/2022] Open
Abstract
Aims: Venous adaptation to microgravity, associated with cardiovascular deconditioning, may contribute to orthostatic intolerance following spaceflight. The aim of this study was to analyze the main parameters of venous hemodynamics with long-duration spaceflight. Methods: Venous plethysmography was performed on 24 cosmonauts before, during, and after spaceflights aboard the International Space Station. Venous plethysmography assessed venous filling and emptying functions as well as microvascular filtration, in response to different levels of venous occlusion pressure. Calf volume was assessed using calf circumference measurements. Results: Calf volume decreased during spaceflight from 2.3 ± 0.3 to 1.7 ± 0.2 L (p < 0.001), and recovered after it (2.3 ± 0.3 L). Venous compliance, determined as the relationship between occlusion pressure and the change in venous volume, increased during spaceflight from 0.090 ± 0.005 to 0.120 ± 0.007 (p < 0.01) and recovered 8 days after landing (0.071 ± 0.005, arbitrary units). The index of venous emptying rate decreased during spaceflight from −0.004 ± 0.022 to −0.212 ± 0.033 (p < 0.001, arbitrary units). The index of vascular microfiltration increased during spaceflight from 6.1 ± 1.8 to 10.6 ± 7.9 (p < 0.05, arbitrary units). Conclusion: This study demonstrated that overall venous function is changed during spaceflight. In future, venous function should be considered when developing countermeasures to prevent cardiovascular deconditioning and orthostatic intolerance with long-duration spaceflight.
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Affiliation(s)
- Jacques-Olivier Fortrat
- UMR Centre National de la Recherche Scientifique, Faculté de Médecine d'Angers, 6214 Institut National de la Santé et de la Recherche Médicale, 1083 (Biologie Neurovasculaire et Mitochondriale Intégrée)Angers, France
| | - Ana de Holanda
- UMR Centre National de la Recherche Scientifique, Faculté de Médecine d'Angers, 6214 Institut National de la Santé et de la Recherche Médicale, 1083 (Biologie Neurovasculaire et Mitochondriale Intégrée)Angers, France
| | - Kathryn Zuj
- Faculty of Applied Health Sciences, University of WaterlooWaterloo, ON, Canada
| | | | - Claude Gharib
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1Lyon, France
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25
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Watenpaugh DE. Analogs of microgravity: head-down tilt and water immersion. J Appl Physiol (1985) 2016; 120:904-14. [DOI: 10.1152/japplphysiol.00986.2015] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/04/2016] [Indexed: 01/26/2023] Open
Abstract
This article briefly reviews the fidelity of ground-based methods used to simulate human existence in weightlessness (spaceflight). These methods include horizontal bed rest (BR), head-down tilt bed rest (HDT), head-out water immersion (WI), and head-out dry immersion (DI; immersion with an impermeable elastic cloth barrier between subject and water). Among these, HDT has become by far the most commonly used method, especially for longer studies. DI is less common but well accepted for long-duration studies. Very few studies exist that attempt to validate a specific simulation mode against actual microgravity. Many fundamental physical, and thus physiological, differences exist between microgravity and our methods to simulate it, and between the different methods. Also, although weightlessness is the salient feature of spaceflight, several ancillary factors of space travel complicate Earth-based simulation. In spite of these discrepancies and complications, the analogs duplicate many responses to 0 G reasonably well. As we learn more about responses to microgravity and spaceflight, investigators will continue to fine-tune simulation methods to optimize accuracy and applicability.
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Affiliation(s)
- Donald E. Watenpaugh
- Department of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, Texas
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26
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Hallgren E, Migeotte PF, Kornilova L, Delière Q, Fransen E, Glukhikh D, Moore ST, Clément G, Diedrich A, MacDougall H, Wuyts FL. Dysfunctional vestibular system causes a blood pressure drop in astronauts returning from space. Sci Rep 2015; 5:17627. [PMID: 26671177 PMCID: PMC4680856 DOI: 10.1038/srep17627] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 11/03/2015] [Indexed: 02/08/2023] Open
Abstract
It is a challenge for the human body to maintain stable blood pressure while standing. The body’s failure to do so can lead to dizziness or even fainting. For decades it has been postulated that the vestibular organ can prevent a drop in pressure during a position change – supposedly mediated by reflexes to the cardiovascular system. We show – for the first time – a significant correlation between decreased functionality of the vestibular otolith system and a decrease in the mean arterial pressure when a person stands up. Until now, no experiments on Earth could selectively suppress both otolith systems; astronauts returning from space are a unique group of subjects in this regard. Their otolith systems are being temporarily disturbed and at the same time they often suffer from blood pressure instability. In our study, we observed the functioning of both the otolith and the cardiovascular system of the astronauts before and after spaceflight. Our finding indicates that an intact otolith system plays an important role in preventing blood pressure instability during orthostatic challenges. Our finding not only has important implications for human space exploration; they may also improve the treatment of unstable blood pressure here on Earth.
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Affiliation(s)
- Emma Hallgren
- Antwerp University Research center for Equilibrium and Aerospace, Dept. of Biomedical Physics, University of Antwerp, Belgium
| | - Pierre-François Migeotte
- Université libre de Bruxelles &Erasmus Hospital, Department of Cardiology, Laboratory of Physics and Physiology, Brussels, Belgium
| | - Ludmila Kornilova
- Laboratory of Vestibular Physiology, Institute of Biomedical Problems of the Russian academy of sciences, Moscow, Russia
| | - Quentin Delière
- Université libre de Bruxelles &Erasmus Hospital, Department of Cardiology, Laboratory of Physics and Physiology, Brussels, Belgium
| | - Erik Fransen
- StatUa center for statistics, University of Antwerp, Antwerp, Belgium
| | - Dmitrii Glukhikh
- Laboratory of Vestibular Physiology, Institute of Biomedical Problems of the Russian academy of sciences, Moscow, Russia
| | - Steven T Moore
- Human Aerospace Laboratory, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Gilles Clément
- Lyon Neuroscience Research Center, IMPACT Team, University of Lyon, France
| | - André Diedrich
- Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Hamish MacDougall
- Sydney Human Factors Research, School of Psychology, University of Sydney, Australia
| | - Floris L Wuyts
- Antwerp University Research center for Equilibrium and Aerospace, Dept. of Biomedical Physics, University of Antwerp, Belgium
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