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Horeau M, Delalande M, Ropert M, Leroyer P, Martin B, Orfila L, Loréal O, Derbré F. Sex similarities and divergences in systemic and muscle iron metabolism adaptations to extreme physical inactivity in rats. J Cachexia Sarcopenia Muscle 2024. [PMID: 39049183 DOI: 10.1002/jcsm.13547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 05/15/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Previous data in humans suggest that extreme physical inactivity (EPI) affects iron metabolism differently between sexes. Our objective was to deepen the underlying mechanisms by studying rats of both sexes exposed to hindlimb unloading (HU), the reference experimental model mimicking EPI. METHODS Eight-week-old male and female Wistar rats were assigned to control (CTL) or hindlimb unloading (HU) conditions (n = 12/group). After 7 days of HU, serum, liver, spleen, and soleus muscle were removed. Iron parameters were measured in serum samples, and ICP-MS was used to quantify iron in tissues. Iron metabolism genes and proteins were analysed by RT-qPCR and Western blot. RESULTS Compared with control males, control females exhibited higher iron concentrations in serum (+43.3%, p < 0.001), liver (LIC; +198%, P < 0.001), spleen (SIC; +76.1%, P < 0.001), and transferrin saturation (TS) in serum (+53.3%, P < 0.001), contrasting with previous observations in humans. HU rat males, but not females, exhibited an increase of LIC (+54% P < 0.001) and SIC (+30.1%, P = 0.023), along with a rise of H-ferritin protein levels (+60.9% and +134%, respectively, in liver and spleen; P < 0.05) and a decrease of TFRC protein levels (-36%; -50%, respectively, P < 0.05). HU males also exhibited an increase of splenic HO-1 and NRF2 mRNA levels, (p < 0.001), as well as HU females (P < 0.001). Concomitantly to muscle atrophy observed in HU animals, the iron concentration increased in soleus in females (+26.7, P = 0.004) while only a trend is observed in males (+17.5%, P = 0.088). In addition, the H-ferritin and myoglobin protein levels in soleus were increased in males (+748%, P < 0.001, +22%, P = 0.011, respectively) and in females (+369%, P < 0.001, +21.9%, P = 0.007, respectively), whereas TFRC and ferroportin (FPN) protein levels were reduced in males (-68.9%, P < 0.001, -76.8%, P < 0.001, respectively) and females (-75.9%, P < 0.001, -62.9%, P < 0.001, respectively). Interestingly, in both sexes, heme exporter FLVCR1 mRNA increased in soleus, while protein levels decreased (-39.9% for males P = 0.010 and -49.1% for females P < 0.001). CONCLUSIONS Taken together, these data support that, in rats (1) extreme physical inactivity differently impacts the distribution of iron in both sexes, (2) splenic erythrophagocytosis could play a role in this iron misdistribution. The higher iron concentrations in atrophied soleus from both sexes are associated with a decoupling between the increase in iron storage proteins (i.e., ferritin and myoglobin) and the decrease in levels of iron export proteins (i.e., FPN and FLVCR1), thus supporting an iron sequestration in skeletal muscle under extreme physical inactivity.
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Affiliation(s)
- Mathieu Horeau
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS, Rennes, France
- INSERM, University of Rennes, INRAE, UMR 1317, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France
| | - Melissa Delalande
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS, Rennes, France
| | - Martine Ropert
- INSERM, University of Rennes, INRAE, UMR 1317, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France
- Elemental Analysis and Metabolism of Metals (AEM2) Platform, Univ Rennes CHU Pontchaillou, Rennes, France
| | - Patricia Leroyer
- INSERM, University of Rennes, INRAE, UMR 1317, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France
| | - Brice Martin
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS, Rennes, France
| | - Luz Orfila
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS, Rennes, France
| | - Olivier Loréal
- INSERM, University of Rennes, INRAE, UMR 1317, Nutrition Metabolisms and Cancer (NuMeCan) Institute, Rennes, France
- Elemental Analysis and Metabolism of Metals (AEM2) Platform, Univ Rennes CHU Pontchaillou, Rennes, France
| | - Frédéric Derbré
- Laboratory "Movement Sport and Health Sciences" EA7470, University of Rennes/ENS, Rennes, France
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2
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Rutter LA, MacKay MJ, Cope H, Szewczyk NJ, Kim J, Overbey E, Tierney BT, Muratani M, Lamm B, Bezdan D, Paul AM, Schmidt MA, Church GM, Giacomello S, Mason CE. Protective alleles and precision healthcare in crewed spaceflight. Nat Commun 2024; 15:6158. [PMID: 39039045 PMCID: PMC11263583 DOI: 10.1038/s41467-024-49423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/05/2024] [Indexed: 07/24/2024] Open
Abstract
Common and rare alleles are now being annotated across millions of human genomes, and omics technologies are increasingly being used to develop health and treatment recommendations. However, these alleles have not yet been systematically characterized relative to aerospace medicine. Here, we review published alleles naturally found in human cohorts that have a likely protective effect, which is linked to decreased cancer risk and improved bone, muscular, and cardiovascular health. Although some technical and ethical challenges remain, research into these protective mechanisms could translate into improved nutrition, exercise, and health recommendations for crew members during deep space missions.
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Affiliation(s)
- Lindsay A Rutter
- Transborder Medical Research Center, University of Tsukuba, Ibaraki, 305-8575, Japan
- Department of Genome Biology, Institute of Medicine, University of Tsukuba, Ibaraki, 305-8575, Japan
- School of Chemistry, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Matthew J MacKay
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, 10065, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA
- The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Henry Cope
- School of Medicine, University of Nottingham, Nottingham, DE22 3DT, UK
| | - Nathaniel J Szewczyk
- School of Medicine, University of Nottingham, Nottingham, DE22 3DT, UK
- Ohio Musculoskeletal and Neurological Institute (OMNI), Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
| | - JangKeun Kim
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, 10065, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Eliah Overbey
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, 10065, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Braden T Tierney
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, 10065, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Masafumi Muratani
- Transborder Medical Research Center, University of Tsukuba, Ibaraki, 305-8575, Japan
- Department of Genome Biology, Institute of Medicine, University of Tsukuba, Ibaraki, 305-8575, Japan
| | - Ben Lamm
- Colossal Biosciences, 1401 Lavaca St, Unit #155 Austin, Austin, TX, 78701, USA
| | - Daniela Bezdan
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
- NGS Competence Center Tübingen (NCCT), University of Tübingen, Tübingen, Germany
- Yuri GmbH, Meckenbeuren, Germany
| | - Amber M Paul
- Embry-Riddle Aeronautical University, Department of Human Factors and Behavioral Neurobiology, Daytona Beach, FL, 32114, USA
| | - Michael A Schmidt
- Sovaris Aerospace, Boulder, CO, 80302, USA.
- Advanced Pattern Analysis & Human Performance Group, Boulder, CO, 80302, USA.
| | - George M Church
- GC Therapeutics Inc, Cambridge, MA, 02139, USA.
- Department of Genetics, Harvard Medical School, Boston, MA, 02115, USA.
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02115, USA.
| | | | - Christopher E Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, 10065, USA.
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA.
- The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, 10065, USA.
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02115, USA.
- The Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10065, USA.
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3
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Kikina AY, Matrosova MS, Gorbacheva EY, Gogichaeva KK, Toniyan KA, Boyarintsev VV, Kotov OV, Ogneva IV. Weightlessness leads to an increase granulosa cells in the growing follicle. NPJ Microgravity 2024; 10:70. [PMID: 38909072 PMCID: PMC11193763 DOI: 10.1038/s41526-024-00413-4] [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: 03/18/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
The participation of women in space programs of increasing flight duration requires research of their reproductive system from the perspective of subsequent childbearing and healthy aging. For the first time, we present hormonal and structural data on the dynamics of recovery after a 157-day space flight in a woman of reproductive age. There were no clinically significant changes in the reproductive system, but detailed analysis shows that weightlessness leads to an increase in the proportion of early antral follicles and granulosa cells in large antral follicles. Returning to Earth's gravity reduces the number and diameter of early antral follicles.
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Affiliation(s)
- Anna Yu Kikina
- Gagarin Research and Test Cosmonaut Training Center, 141160, Star City, Moscow Region, Russia
| | - Mariia S Matrosova
- Radiology Department, European Medical Center, 129090, Moscow, Russia
- Research Center of Neurology, 125367, Moscow, Russia
| | - Elena Yu Gorbacheva
- Cell Biophysics Lab, State Scientific Center of the Russian Federation Institute of Biomedical Problems of the Russian Academy of Sciences, 123007, Moscow, Russia
- Gynecology Department, FGBU KB1 (Volynskaya) UDP RF, 121352, Moscow, Russia
| | - Ksenia K Gogichaeva
- Cell Biophysics Lab, State Scientific Center of the Russian Federation Institute of Biomedical Problems of the Russian Academy of Sciences, 123007, Moscow, Russia
| | - Konstantin A Toniyan
- Cell Biophysics Lab, State Scientific Center of the Russian Federation Institute of Biomedical Problems of the Russian Academy of Sciences, 123007, Moscow, Russia
- Gynecology Department, FGBU KB1 (Volynskaya) UDP RF, 121352, Moscow, Russia
| | - Valery V Boyarintsev
- Emergency and Extreme Medicine Department, Central State Medical Academy UDP RF, 121359, Moscow, Russia
| | - Oleg V Kotov
- Cell Biophysics Lab, State Scientific Center of the Russian Federation Institute of Biomedical Problems of the Russian Academy of Sciences, 123007, Moscow, Russia
| | - Irina V Ogneva
- Cell Biophysics Lab, State Scientific Center of the Russian Federation Institute of Biomedical Problems of the Russian Academy of Sciences, 123007, Moscow, Russia.
- Medical and Biological Physics Department, I.M. Sechenov First Moscow State Medical University, 119991, Moscow, Russia.
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4
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Gimunová M, Paludo AC, Bernaciková M, Bienertova-Vasku J. The effect of space travel on human reproductive health: a systematic review. NPJ Microgravity 2024; 10:10. [PMID: 38238348 PMCID: PMC10796912 DOI: 10.1038/s41526-024-00351-1] [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: 08/24/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
With increasing possibilities of multi-year missions in deep space, colonizing other planets, and space tourism, it is important to investigate the effects of space travel on human reproduction. This study aimed to systematically review and summarize the results of available literature on space travel, microgravity, and space radiation, or Earth-based spaceflight analogues impact on female and male reproductive functions in humans. This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Space Biomedicine Systematic Review methods. The search was performed using three databases: PubMed, Web of Science, and Medline Complete. During the database search, 364 studies were identified. After the study selection process, 16 studies were included in the review. Five studies included female participants, and the findings show an increased risk of thromboembolism in combined oral contraceptive users, decreased decidualization, functional insufficiency of corpus luteum, and decreased progesterone and LH levels related to space travel or its simulation. Male participants were included in 13 studies. In males, reproductive health considerations focused on the decrease in testosterone and sex hormone-binding globulin levels, the ratio of male offspring, sperm motility, sperm vitality, and the increase in sperm DNA fragmentation related to space travel or its simulation. Results of this systematic review highlight the need to focus more on the astronaut's reproductive health in future research, as only 16 studies were found during the literature search, and many more research questions related to reproductive health in astronauts still need to be answered.
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Affiliation(s)
- Marta Gimunová
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic.
| | - Ana Carolina Paludo
- Department of Sport Performance and Exercise Testing, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Martina Bernaciková
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Julie Bienertova-Vasku
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
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5
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Elahi MM, Witt AN, Pryzdial ELG, McBeth PB. Thrombotic triad in microgravity. Thromb Res 2024; 233:82-87. [PMID: 38029549 DOI: 10.1016/j.thromres.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/11/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
Thrombotic disease may be an underdiagnosed condition of prolonged exposure to microgravity and yet the underlying factors remain poorly defined. Recently, an internal jugular vein thrombosis was diagnosed in a low-risk female astronaut after an approximately 7-week space mission. Six of the additional 10 crew members demonstrated jugular venous flow risk factors, such as suspicious stagnation or retroversion. Fortunately, all were asymptomatic. Observations in space as well as clinical and in vitro microgravity studies on Earth, where experiments are designed to recapitulate the conditions of space, suggest effects on blood flow stasis, coagulation, and vascular function. In this article, the related literature on thrombotic disease in space is reviewed, with consideration of these elements of Virchow's triad.
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Affiliation(s)
- Mohammad M Elahi
- Faculty of Medicine, University of British Columbia, Canada; Centre for Blood Research, Life Sciences Institute, University of British Columbia, Canada.
| | - Alexandra N Witt
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Canada; Canadian Blood Services, Medical Affairs and Innovation, Canada
| | - Edward L G Pryzdial
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Canada; Canadian Blood Services, Medical Affairs and Innovation, Canada
| | - Paul B McBeth
- Faculty of Medicine, Department of Surgery, University of Calgary, Canada; Faculty of Medicine, Department of Critical Care Medicine, University of Calgary, Canada
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6
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Scott JPR, Green DA, Weerts G, Cheuvront SN. Effects of body size and countermeasure exercise on estimates of life support resources during all-female crewed exploration missions. Sci Rep 2023; 13:5950. [PMID: 37045858 PMCID: PMC10097614 DOI: 10.1038/s41598-023-31713-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
Employing a methodology reported in a recent theoretical study on male astronauts, this study estimated the effects of body size and aerobic countermeasure (CM) exercise in a four-person, all-female crew composed of individuals drawn from a stature range (1.50- to 1.90-m) representative of current space agency requirements (which exist for stature, but not for body mass) upon total energy expenditure (TEE), oxygen (O2) consumption, carbon dioxide (CO2) and metabolic heat (Hprod) production, and water requirements for hydration, during space exploration missions. Assuming geometric similarity across the stature range, estimates were derived using available female astronaut data (mean age: 40-years; BMI: 22.7-kg·m-2; resting VO2 and VO2max: 3.3- and 40.5-mL·kg-1·min-1) on 30- and 1080-day missions, without and with, ISS-like countermeasure exercise (modelled as 2 × 30-min aerobic exercise at 75% VO2max, 6-day·week-1). Where spaceflight-specific data/equations were not available, terrestrial equivalents were used. Body size alone increased 24-h TEE (+ 30%), O2 consumption (+ 60%), CO2 (+ 60%) and Hprod (+ 60%) production, and water requirements (+ 17%). With CM exercise, the increases were + 25-31%, + 29%, + 32%, + 38% and + 17-25% across the stature range. Compared to the previous study of theoretical male astronauts, the effect of body size on TEE was markedly less in females, and, at equivalent statures, all parameter estimates were lower for females, with relative differences ranging from -5% to -29%. When compared at the 50th percentile for stature for US females and males, these differences increased to - 11% to - 41% and translated to larger reductions in TEE, O2 and water requirements, and less CO2 and Hprod during 1080-day missions using CM exercise. Differences between female and male theoretical astronauts result from lower resting and exercising O2 requirements (based on available astronaut data) of female astronauts, who are lighter than male astronauts at equivalent statures and have lower relative VO2max values. These data, combined with the current move towards smaller diameter space habitat modules, point to a number of potential advantages of all-female crews during future human space exploration missions.
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Affiliation(s)
- Jonathan P R Scott
- Institut Médecine Physiologie Spatiale (MEDES), Toulouse, France.
- Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany.
| | - David A Green
- Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany
- KBR GmbH, Cologne, Germany
- Centre of Human and Applied Physiological Sciences, King's College London, London, UK
| | - Guillaume Weerts
- Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany
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7
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Jain V, Chuva de Sousa Lopes SM, Benotmane MA, Verratti V, Mitchell RT, Stukenborg JB. Human development and reproduction in space-a European perspective. NPJ Microgravity 2023; 9:24. [PMID: 36973260 PMCID: PMC10042989 DOI: 10.1038/s41526-023-00272-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
This review summarises key aspects of the first reproductive and developmental systems Science Community White Paper, supported by the European Space Agency (ESA). Current knowledge regarding human development and reproduction in space is mapped to the roadmap. It acknowledges that sex and gender have implications on all physiological systems, however, gender identity falls outside the scope of the document included in the white paper collection supported by ESA. The ESA SciSpacE white papers on human developmental and reproductive functions in space aim to reflect on the implications of space travel on the male and female reproductive systems, including the hypothalamic-pituitary-gonadal (HPG) reproductive hormone axis, and considerations for conception, gestation and birth. Finally, parallels are drawn as to how this may impact society as a whole on Earth.
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Affiliation(s)
- Varsha Jain
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | | | | | - Vittore Verratti
- Department of Psychological, Health and Territorial Sciences, "G. d'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Royal Hospital for Children and Young People, Edinburgh, UK
| | - Jan-Bernd Stukenborg
- NORDFERTIL Research Lab Stockholm, Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, and Karolinska University Hospital, Solna, Sweden.
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8
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Theotokis P, Manthou ME, Deftereou TE, Miliaras D, Meditskou S. Addressing Spaceflight Biology through the Lens of a Histologist-Embryologist. Life (Basel) 2023; 13:life13020588. [PMID: 36836946 PMCID: PMC9965490 DOI: 10.3390/life13020588] [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: 11/28/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 02/23/2023] Open
Abstract
Embryogenesis and fetal development are highly delicate and error-prone processes in their core physiology, let alone if stress-associated factors and conditions are involved. Space radiation and altered gravity are factors that could radically affect fertility and pregnancy and compromise a physiological organogenesis. Unfortunately, there is a dearth of information examining the effects of cosmic exposures on reproductive and proliferating outcomes with regard to mammalian embryonic development. However, explicit attention has been given to investigations exploring discrete structures and neural networks such as the vestibular system, an entity that is viewed as the sixth sense and organically controls gravity beginning with the prenatal period. The role of the gut microbiome, a newly acknowledged field of research in the space community, is also being challenged to be added in forthcoming experimental protocols. This review discusses the data that have surfaced from simulations or actual space expeditions and addresses developmental adaptations at the histological level induced by an extraterrestrial milieu.
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Affiliation(s)
- Paschalis Theotokis
- Laboratory of Histology and Embryology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Maria Eleni Manthou
- Laboratory of Histology and Embryology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Dimosthenis Miliaras
- Laboratory of Histology and Embryology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Soultana Meditskou
- Laboratory of Histology and Embryology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence:
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9
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The State of the Organs of the Female Reproductive System after a 5-Day "Dry" Immersion. Int J Mol Sci 2023; 24:ijms24044160. [PMID: 36835572 PMCID: PMC9966354 DOI: 10.3390/ijms24044160] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
The impact of weightlessness on the female reproductive system remains poorly understood, although deep space exploration is impossible without the development of effective measures to protect women's health. The purpose of this work was to study the effect of a 5-day "dry" immersion on the state of the reproductive system of female subjects. On the fourth day of the menstrual cycle after immersion, we observed an increase in inhibin B of 35% (p < 0.05) and a decrease in luteinizing hormone of 12% (p < 0.05) and progesterone of 52% (p < 0.05) compared with the same day before immersion. The size of the uterus and the thickness of the endometrium did not change. On the ninth day of the menstrual cycle after immersion, the average diameters of the antral follicles and the dominant follicle were, respectively, 14% and 22% (p < 0.05) higher than before. The duration of the menstrual cycle did not change. The obtained results may indicate that the stay in the 5-day "dry" immersion, on the one hand, can stimulate the growth of the dominant follicle, but, on the other hand, can cause functional insufficiency of the corpus lutea.
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10
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Harris KM, Arya R, Elias A, Weber T, Green DA, Greaves DK, Petersen LG, Roberts L, Kamine TH, Mazzolai L, Bergauer A, Kim DS, Olde Engberink RH, zu Eulenberg P, Grassi B, Zuccarelli L, Baldassarre G, Tabury K, Baatout S, Jordan J, Blaber AP, Choukér A, Russomano T, Goswami N. Pathophysiology, risk, diagnosis, and management of venous thrombosis in space: where are we now? NPJ Microgravity 2023; 9:17. [PMID: 36797288 PMCID: PMC9935502 DOI: 10.1038/s41526-023-00260-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/20/2023] [Indexed: 02/18/2023] Open
Abstract
The recent incidental discovery of an asymptomatic venous thrombosis (VT) in the internal jugular vein of an astronaut on the International Space Station prompted a necessary, immediate response from the space medicine community. The European Space Agency formed a topical team to review the pathophysiology, risk and clinical presentation of venous thrombosis and the evaluation of its prevention, diagnosis, mitigation, and management strategies in spaceflight. In this article, we discuss the findings of the ESA VT Topical Team over its 2-year term, report the key gaps as we see them in the above areas which are hindering understanding VT in space. We provide research recommendations in a stepwise manner that build upon existing resources, and highlight the initial steps required to enable further evaluation of this newly identified pertinent medical risk.
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Affiliation(s)
- Katie M. Harris
- grid.25055.370000 0000 9130 6822Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada
| | - Roopen Arya
- grid.429705.d0000 0004 0489 4320Kings College Hospital, NHS Foundation Trust, London, UK
| | - Antoine Elias
- Vascular Medicine, Toulon Hospital Centre, Toulon, France
| | - Tobias Weber
- Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany. .,KBR, Cologne, Germany.
| | - David A. Green
- grid.461733.40000 0001 2375 6474Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany ,KBR, Cologne, Germany ,grid.13097.3c0000 0001 2322 6764Centre for Human and Applied Physiological Sciences, King’s College London, London, UK
| | - Danielle K. Greaves
- grid.46078.3d0000 0000 8644 1405Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Lonnie G. Petersen
- grid.5254.60000 0001 0674 042XDepartment of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.116068.80000 0001 2341 2786Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, USA
| | - Lara Roberts
- grid.429705.d0000 0004 0489 4320Kings College Hospital, NHS Foundation Trust, London, UK
| | - Tovy Haber Kamine
- grid.281162.e0000 0004 0433 813XDivision of Trauma, Acute Care Surgery, and Surgical Critical Care, Baystate Medical Center, Springfield, MA USA
| | - Lucia Mazzolai
- grid.9851.50000 0001 2165 4204Department of Angiology, Lausanne University, Lausanne, Switzerland
| | | | - David S. Kim
- grid.461733.40000 0001 2375 6474Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany ,grid.17091.3e0000 0001 2288 9830Department Emergency Medicine, University British Columbia, Vancouver, Canada
| | - Rik H. Olde Engberink
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Department of Internal Medicine, Section of Nephrology, Amsterdam, The Netherlands ,Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | - Peter zu Eulenberg
- grid.5252.00000 0004 1936 973XInstitute for Neuroradiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Bruno Grassi
- grid.5390.f0000 0001 2113 062XDepartment of Medicine, University of Udine, Udine, Italy
| | - Lucrezia Zuccarelli
- grid.5390.f0000 0001 2113 062XDepartment of Medicine, University of Udine, Udine, Italy
| | - Giovanni Baldassarre
- grid.5390.f0000 0001 2113 062XDepartment of Medicine, University of Udine, Udine, Italy
| | - Kevin Tabury
- grid.8953.70000 0000 9332 3503Radiobiology Unit, Belgian Nuclear Research Centre, SCK CEN, Mol, Belgium
| | - Sarah Baatout
- grid.8953.70000 0000 9332 3503Radiobiology Unit, Belgian Nuclear Research Centre, SCK CEN, Mol, Belgium
| | - Jens Jordan
- grid.7551.60000 0000 8983 7915Institute of Aerospace Medicine, German Aerospace Center and University of Cologne, Köln, Germany
| | - Andrew P. Blaber
- grid.61971.380000 0004 1936 7494Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC Canada
| | - Alexander Choukér
- grid.411095.80000 0004 0477 2585Translational Research Stress & Immunity, Klinik für Anästhesiologie/Forschungslabors, LMU Klinikum, München, Germany
| | - Thais Russomano
- grid.411095.80000 0004 0477 2585Translational Research Stress & Immunity, Klinik für Anästhesiologie/Forschungslabors, LMU Klinikum, München, Germany ,InnovaSpace UK, London, UK
| | - Nandu Goswami
- grid.11598.340000 0000 8988 2476Division of Physiology, Otto Löwi Research Center for Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria ,Mohammed Bin Rashid University of Medicine and Applied Health Sciences, Dubai, United Arab Emirates
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11
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Harrison ME, Tyson N. Menstruation: Environmental impact and need for global health equity. Int J Gynaecol Obstet 2023; 160:378-382. [PMID: 35781656 DOI: 10.1002/ijgo.14311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/03/2022] [Accepted: 06/17/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Megan E Harrison
- Division of Adolescent Health, CHEO, University of Ottawa, Faculty of Medicine, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Nichole Tyson
- Pediatric Adolescent Gynecology, Stanford Children's Health, Stanford University School of Medicine, Palo Alto, California, USA
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12
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Extraterrestrial Gynecology: Could Spaceflight Increase the Risk of Developing Cancer in Female Astronauts? An Updated Review. Int J Mol Sci 2022; 23:ijms23137465. [PMID: 35806469 PMCID: PMC9267413 DOI: 10.3390/ijms23137465] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023] Open
Abstract
Outer space is an extremely hostile environment for human life, with ionizing radiation from galactic cosmic rays and microgravity posing the most significant hazards to the health of astronauts. Spaceflight has also been shown to have an impact on established cancer hallmarks, possibly increasing carcinogenic risk. Terrestrially, women have a higher incidence of radiation-induced cancers, largely driven by lung, thyroid, breast, and ovarian cancers, and therefore, historically, they have been permitted to spend significantly less time in space than men. In the present review, we focus on the effects of microgravity and radiation on the female reproductive system, particularly gynecological cancer. The aim is to provide a summary of the research that has been carried out related to the risk of gynecological cancer, highlighting what further studies are needed to pave the way for safer exploration class missions, as well as postflight screening and management of women astronauts following long-duration spaceflight.
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13
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Reyes DP, Masterova KS, Walton M, Kerstman EL, Antonsen EL. Assessment of Sex-Dependent Medical Outcomes During Spaceflight. J Womens Health (Larchmt) 2022; 31:1145-1155. [PMID: 35549913 DOI: 10.1089/jwh.2021.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introduction: In this study sex-differences in medical outcomes during spaceflight are reviewed and probabilistic risk assessment (PRA) is used to assess the impact on spaceflight missions of varying lengths. Materials and Methods: We use PRA to simulate missions of 42 days, 6 months, and 2.5 years. We model medical outcomes using three crews: two men and two women, four women, or four men. Total medical events (TME), crew health index (CHI), probability (0-1) of medical evacuation (pEVAC), probability of loss of crew life (pLOCL), and influential medical conditions were determined. Results: No differences were seen in any metric for the 42-day mission. There were no differences seen for any mission length, in any crew, for TME, CHI, pLOCL, or environmental causes of pEVAC. Sex-dependent differences are seen for rates of nonemergent pEVAC during the 6 month and 2.5-year missions, where women have a higher pEVAC in the 182-day (0.0388 vs. 0.0354) and 2.5-year missions (0.350 vs. 0.228). These differences were driven by higher incidence of partially treated urinary tract infection (UTI). In the 2.5 year mission, with resupply of medical resources, the influence of UTI in women on pEVAC decreases (0.35-0.11). Discussion: Although resupply is unlikely for deep space missions, modeled results suggest that sex-specific medical needs can be readily managed through preventive measures and inclusion of appropriate medical capabilities. Within its many limitations, PRA is a useful tool to estimate medical risks in unique environments where only expert opinion was previously available.
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Affiliation(s)
- David P Reyes
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Kseniya S Masterova
- School of Medicine and The Graduate School of Biomedical Sciences, University of Texas Medical Branch, Galveston, Texas, USA
| | | | - Eric L Kerstman
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
| | - Erik L Antonsen
- Exploration Medical Capability, Johnson Space Center, National Aeronautics and Space Administration, Houston, Texas, USA.,Department of Emergency Medicine and Center for Space Medicine, Baylor College of Medicine, Houston, Texas, USA
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14
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Jain V, Chodankar RR, Maybin JA, Critchley HOD. Uterine bleeding: how understanding endometrial physiology underpins menstrual health. Nat Rev Endocrinol 2022; 18:290-308. [PMID: 35136207 PMCID: PMC9098793 DOI: 10.1038/s41574-021-00629-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 12/16/2022]
Abstract
Menstruation is a physiological process that is typically uncomplicated. However, up to one third of women globally will be affected by abnormal uterine bleeding (AUB) at some point in their reproductive years. Menstruation (that is, endometrial shedding) is a fine balance between proliferation, decidualization, inflammation, hypoxia, apoptosis, haemostasis, vasoconstriction and, finally, repair and regeneration. An imbalance in any one of these processes can lead to the abnormal endometrial phenotype of AUB. Poor menstrual health has a negative impact on a person's physical, mental, social, emotional and financial well-being. On a global scale, iron deficiency and iron deficiency anaemia are closely linked with AUB, and are often under-reported and under-recognized. The International Federation of Gynecology and Obstetrics have produced standardized terminology and a classification system for the causes of AUB. This standardization will facilitate future research endeavours, diagnosis and clinical management. In a field where no new medications have been developed for over 20 years, emerging technologies are paving the way for a deeper understanding of the biology of the endometrium in health and disease, as well as opening up novel diagnostic and management avenues.
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Affiliation(s)
- Varsha Jain
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Rohan R Chodankar
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
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15
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Zwart SR, Auñón-Chancellor SM, Heer M, Melin MM, Smith SM. Albumin, Oral Contraceptives, and Venous Thromboembolism Risk in Astronauts. J Appl Physiol (1985) 2022; 132:1232-1239. [PMID: 35389755 PMCID: PMC9126217 DOI: 10.1152/japplphysiol.00024.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND A venous thromboembolism (VTE) event occurred in a female astronaut during long-duration spaceflight. Multiple factors may have contributed to this risk, including the use of combined (progestin + estrogen) oral contraceptives (cOC). METHODS Biochemistry data from 65 astronauts were evaluated for associations with cOC use and with sex. RESULTS The female astronauts who used cOCs had lower concentrations of serum albumin and higher concentrations of transferrin, a protein involved in the clotting cascade, than the male astronauts and the female astronauts who were not taking cOCs (P<0.001). The women who used cOCs had higher serum concentrations of the acute phase reactant ceruloplasmin during flight and cortisol (P<0.001) than the men and the women who were not taking cOCs; they also had higher calculated whole blood viscosity than women not taking cOCs (P<0.001). CONCLUSIONS Lower circulating concentrations of albumin, higher concentrations of transferrin, and elevated markers of inflammation all could contribute to an increased risk of VTE during spaceflight. These changes, in association with a higher blood viscosity can directly affect endothelial glycocalyx integrity and hypercoagulability status, both of which contribute to VTE risk in terrestrial populations.
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Affiliation(s)
- Sara R Zwart
- University of Texas Medical Branch, Galveston, TX, United States
| | - Serena M Auñón-Chancellor
- LSU Health New Orleans School of Medicine, Baton Rouge, LA, United States.,NASA Johnson Space Center, Houston, TX, United States
| | - Martina Heer
- IU International University of Applied Sciences and University of Bonn, Bonn, Germany
| | - M Mark Melin
- M Health Fairview (University of Minnesota Physicians), Edina, MN, United States
| | - Scott M Smith
- NASA Johnson Space Center, Houston, TX, United States
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16
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Nolan D, Elliott-Sale KJ, Egan B. Prevalence of hormonal contraceptive use and reported side effects of the menstrual cycle and hormonal contraceptive use in powerlifting and rugby. PHYSICIAN SPORTSMED 2022; 51:217-222. [PMID: 34991413 DOI: 10.1080/00913847.2021.2024774] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The prevalence of hormonal contraceptive (HC) use and the associated symptomology of use or nonuse are under-studied in athletic populations, and in particular, in strength and collision sports. This study aimed to investigate the prevalence of hormonal contraceptive use and reported side effects of the menstrual cycle and hormonal contraceptive use in powerlifters and rugby players. METHODS Competitive female powerlifters and rugby players (aged ≥18 y), representing a strength and a collision sport respectively, completed an anonymous online questionnaire for the purpose of assessing self-reported prevalence of HC use, and symptoms of the menstrual cycle and HC use. Athletes were categorized by sport (powerlifters, n = 149; rugby players, n = 135) in order to conduct a stratified analysis. For open-ended questions, a content analysis was conducted to categorize responses, and frequency analyses were performed. RESULTS Current HC use was reported by 51.1% of athletes, with similar prevalence for the two sports (powerlifting, 48.3% vs. rugby, 54.1%, P = 0.34). Side effects of the menstrual cycle were reported in 83.5% of non-HC users, with the most common being unspecified cramping (42.4%), headache/migraine (24.5%), and fatigue (24.5%). Side effects were reported in 40.0% of HC users, with the most common being mood changes (17.9%), stomach pain (8.3%) and headaches/migraines (6.9%). CONCLUSION A large proportion of HC users and nonusers in this study experience negative side effects of HC use and the menstrual cycle, respectively. The symptoms experienced by both groups are wide-ranging, with a high degree of variation between individuals. The negative side-effects experienced by HC users and nonusers may have an influence on athletic performance, and this requires future investigation.
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Affiliation(s)
- David Nolan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | | | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.,Florida Institute for Human and Machine Cognition, Pensacola, FL, USA
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17
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Limper U, Tank J, Ahnert T, Maegele M, Grottke O, Hein M, Jordan J. The thrombotic risk of spaceflight: has a serious problem been overlooked for more than half of a century? Eur Heart J 2021; 42:97-100. [PMID: 32428936 DOI: 10.1093/eurheartj/ehaa359] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/12/2020] [Accepted: 04/20/2020] [Indexed: 12/17/2022] Open
Abstract
The first ever venous thrombotic condition associated with spaceflight, an internal jugular vein thrombus requiring anticoagulation, has recently been reported. Systematic investigation of space travel-associated thrombotic risk has not been conducted. Cellular, animal, and human studies performed in ground-based models and in actual weightlessness revealed influences of weightlessness and gravity on the blood coagulation system. However, human study populations were small and limited to highly selected participants. Evidence in individuals with medical conditions and older persons is lacking. Evidence for thrombotic risk in spaceflight is unsatisfactory. This issue deserves further study in heterogeneous, high risk populations to find prevention strategies and to enable safe governmental and touristic human spaceflight.
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Affiliation(s)
- Ulrich Limper
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.,Department of Anaesthesiology and Intensive Care Medicine, Merheim Medical Center, Hospitals of Cologne, University of Witten/Herdecke, Ostmerheimer Strasse 200, D-51109, Cologne, Germany
| | - Jens Tank
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
| | - Tobias Ahnert
- Department of Orthopedic Surgery Traumatology and Sports Medicine, Merheim Medical Center, Hospitals of Cologne, University of Witten/Herdecke, Cologne, Germany
| | - Marc Maegele
- Department of Orthopedic Surgery Traumatology and Sports Medicine, Merheim Medical Center, Hospitals of Cologne, University of Witten/Herdecke, Cologne, Germany
| | - Oliver Grottke
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Marc Hein
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Jens Jordan
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.,Chair of Aerospace Medicine, Medical Faculty, University of Cologne, Cologne, Germany
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18
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Kim DS, Vaquer S, Mazzolai L, Roberts LN, Pavela J, Watanabe M, Weerts G, Green DA. The effect of microgravity on the human venous system and blood coagulation: a systematic review. Exp Physiol 2021; 106:1149-1158. [PMID: 33704837 DOI: 10.1113/ep089409] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
NEW FINDINGS What is the central question of this study? Recently, an internal jugular venous thrombus was identified during spaceflight: does microgravity induce venous and/or coagulation pathophysiology, and thus an increased risk of venous thromboembolism (VTE)? What is the main finding and its importance? Whilst data are limited, this systematic review suggests that microgravity and its analogues may induce an enhanced coagulation state due to venous changes most prominent in the cephalad venous system, as a consequence of changes in venous flow, distension, pressures, endothelial damage and possibly hypercoagulability in microgravity and its analogues. However, whether such changes precipitate an increased VTE risk in spaceflight remains to be determined. ABSTRACT Recently, an internal jugular venous thrombus was identified during spaceflight, but whether microgravity induces venous and/or coagulation pathophysiology, and thus, an increased risk of venous thromboembolism (VTE) is unclear. Therefore, a systematic (Cochrane compliant) review was performed of venous system or coagulation parameters in actual spaceflight (microgravity) or ground-based analogues in PubMed, MEDLINE, Ovid EMBASE, Cochrane Library, European Space Agency, National Aeronautics and Space Administration, and Deutsches Zentrum für Luft-und Raumfahrt databases. Seven-hundred and eight articles were retrieved, of which 26 were included for evaluation with 21 evaluating venous, and five coagulation parameters. Nine articles contained spaceflight data, whereas the rest reported ground-based analogue data. There is substantial variability in study design, objectives and outcomes. Yet, data suggested cephalad venous system dilatation, increased venous pressures and decreased/reversed flow in microgravity. Increased fibrinogen levels, presence of thrombin generation markers and endothelial damage were also reported. Limited human venous and coagulation system data exist in spaceflight, or its analogues. Nevertheless, data suggest spaceflight may induce an enhanced coagulation state in the cephalad venous system, as a consequence of changes in venous flow, distension, pressures, endothelial damage and possibly hypercoagulability. Whether such changes precipitate an increased VTE risk in spaceflight remains to be determined.
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Affiliation(s)
- David S Kim
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany.,Department of Emergency Medicine, University of British Columbia, British Columbia, Vancouver, Canada
| | - Sergi Vaquer
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany.,KBR, WyleLabs GmbH, Cologne, Germany
| | - Lucia Mazzolai
- Angiology division, Heart and Vessel Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Lara N Roberts
- Department of Haematological Medicine, King's Thrombosis Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - James Pavela
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Guillaume Weerts
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany
| | - David A Green
- Space Medicine Team, European Astronaut Centre, European Space Agency (ESA), Cologne, Germany.,KBR, WyleLabs GmbH, Cologne, Germany.,Centre of Human and Applied Physiological Sciences, King's College London, London, UK
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19
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Limper U, Ahnert T, Maegele M, Froehlich M, Grau M, Gauger P, Bauerfeind U, Görlinger K, Pötzsch B, Jordan J. Simulated Hypergravity Activates Hemostasis in Healthy Volunteers. J Am Heart Assoc 2020; 9:e016479. [PMID: 33283577 PMCID: PMC7955367 DOI: 10.1161/jaha.120.016479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Hypergravity may promote human hemostasis thereby increasing thrombotic risk. Future touristic suborbital spaceflight will expose older individuals with chronic medical conditions, who are at much higher thromboembolic risk compared with professional astronauts, to hypergravity. Therefore, we tested the impact of hypergravity on hemostasis in healthy volunteers undergoing centrifugation. Methods and Results We studied 20 healthy seated men before and after 15 minutes under 3 Gz hypergravity on a long‐arm centrifuge. We obtained blood samples for hemostasis testing before, immediately after, and 30 minutes after centrifugation. Tests included viscoelastic thromboelastometry, platelet impedance aggregometry, endothelial activation markers, blood rheology testing, microparticle analyses, and clotting factor analysis. Exposure to hypergravity reduced plasma volume by 12.5% (P=0.002) and increased the red blood cell aggregation index (P<0.05). With hypergravity, thrombelastographic clotting time of native blood shortened from 719±117 seconds to 628±89 seconds (P=0.038) and platetet reactivity increased (P=0.045). Hypergravity shortened partial thromboplastin time from 28 (26–29) seconds to 25 (24–28) seconds (P<0.001) and increased the activity of coagulation factors (eg, factor VIII 117 [93–134] versus 151 [133–175] %, P<0.001). Tissue factor concentration was 188±95 pg/mL before and 298±136 pg/mL after hypergravity exposure (P=0.023). Antithrombin (P=0.005), thrombin‐antithrombin complex (P<0.001), plasmin‐alpha2‐antiplasmin complex (0.002), tissue‐plasminogen activatior (P<0.001), and plasminogen activator inhibitor‐1 (P=0.002) increased with centrifugation. Statistical adjustment for plasma volume attenuated changes in coagulation. Conclusions Hypergravity triggers low‐level hemostasis activation through endothelial cell activation, increased viscoelasticity, and augmented platelet reactivity, albeit partly counteracted through endogenous coagulation inhibitors release. Hemoconcentration may contribute to the response.
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Affiliation(s)
- Ulrich Limper
- Department of Anesthesiology and Intensive Care Medicine Merheim Medical Center Hospitals of Cologne University of Witten/Herdecke Cologne Germany.,German Aerospace Center (DLR)Institute of Aerospace Medicine Cologne Germany
| | - Tobias Ahnert
- Department of Orthopedic Surgery Traumatology and Sports Medicine Merheim Medical Center Hospitals of Cologne University of Witten/Herdecke Cologne Germany
| | - Marc Maegele
- Department of Orthopedic Surgery Traumatology and Sports Medicine Merheim Medical Center Hospitals of Cologne University of Witten/Herdecke Cologne Germany
| | - Matthias Froehlich
- Department of Orthopedic Surgery Traumatology and Sports Medicine Merheim Medical Center Hospitals of Cologne University of Witten/Herdecke Cologne Germany
| | - Marijke Grau
- Department of Molecular and Cellular Sports Medicine German Sport University Cologne Cologne Germany
| | - Peter Gauger
- German Aerospace Center (DLR)Institute of Aerospace Medicine Cologne Germany
| | - Ursula Bauerfeind
- Department of Haematology and Transfusion Medicine (DTM) Merheim Medical Center Hospitals of Cologne Germany
| | - Klaus Görlinger
- Department of Anesthesiology and Intensive Care Medicine University Hospital Essen Essen Germany.,Medical Director Tem Innovations Munich Germany
| | - Bernhard Pötzsch
- Institute of Experimental Haematology and Transfusion Medicine University Hospital Bonn Bonn Germany
| | - Jens Jordan
- German Aerospace Center (DLR)Institute of Aerospace Medicine Cologne Germany.,Chair of Aerospace Medicine Medical Faculty University of Cologne Germany
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20
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Abstract
Extended travel in deep space poses potential hazards to the reproductive function of female and male astronauts, including exposure to cosmic radiation, microgravity, increased gravity (hypergravity), psychological stress, physical stress and circadian rhythm disruptions. This Review focuses on the effects of microgravity, hypergravity and cosmic radiation. Cosmic radiation contains protons, helium nuclei and high charge and energy (HZE) particles. Studies performed on Earth in which rodents were exposed to experimentally generated HZE particles have demonstrated a high sensitivity of ovarian follicles and spermatogenic cells to HZE particles. Exposure to microgravity during space flight and to simulated microgravity on Earth disrupts spermatogenesis and testicular testosterone synthesis in rodents, whereas the male reproductive system seems to adapt to exposure to moderate hypergravity. A few studies have investigated the effects of microgravity on female reproduction, with findings of disrupted oestrous cycling and in vitro follicle development being cause for concern. Many remaining data gaps need to be addressed, including the effects of microgravity, hypergravity and space radiation on the male and female reproductive tracts, hypothalamic-pituitary regulation of reproduction and prenatal development of the reproductive system as well as the combined effects of the multiple reproductive hazards encountered in space.
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Affiliation(s)
- Birendra Mishra
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Ulrike Luderer
- Center for Occupational and Environmental Health, Department of Medicine, Department of Developmental and Cell Biology, Program in Public Health, University of California Irvine, Irvine, CA, USA.
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