Can We Survive in Space? It Might Depend on How Our Gut Microbiome Adapts

Researchers at Penn State University are developing a way to use microbes to turn human waste into food on long space voyages. Image: Yuri Gorby, Rensselaer Polytechnic Institute
Microbes play a critical role on Earth. Understanding how they react to space travel is crucial to ensuring astronaut health. Credit: Yuri Gorby, Rensselaer Polytechnic Institute

For over a century, people have dreamed of the day when humanity (as a species) would venture into space. In recent decades, that dream has moved much closer to realization, thanks to the rise of the commercial space industry (NewSpace), renewed interest in space exploration, and long-term plans to establish habitats in Low Earth Orbit (LEO), on the lunar surface, and Mars. Based on the progression, it is clear that going to space exploration will not be reserved for astronauts and government space agencies for much longer.

But before the “Great Migration” can begin, there are a lot of questions that need to be addressed. Namely, how will prolonged exposure to microgravity and space radiation affect human health? These include the well-studied aspects of muscle and bone density loss and how time in space can impact our organ function and cardiovascular and psychological health. In a recent study, an international team of scientists considered an often-overlooked aspect of human health: our microbiome. In short, how will time in space affect our gut bacteria, which is crucial to our well-being?

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Researchers Are Building a Simulated Moon/Mars Research Station Deep Underground

These images show the first laboratory in the Bio-SPHERE project. The medical lab is located 1 km under the surface, near one of the UK's deepest mine sites. Image Credit: Dr. Alexandra Iordachescu/University of Birmingham.

In the early days of spaceflight, just getting a satellite into Earth’s orbit was an accomplishment. In our era, landing rovers on other planets and bringing samples home from asteroids is the cutting edge. But the next frontier is rapidly approaching, when astronauts will stay for long periods of time on the Moon and hopefully Mars.

But before we can send people to those dangerous environments, the Artemis partner space agencies have to know how to keep them safe. An important part of that is simulating the conditions on the Moon and Mars.

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Space Flight Destroys Your Red Blood Cells

Flight Engineer Anne McClain in the cupola holding biomedical gear for MARROW. Credit: NASA

It’s really true: space wants to kill us. And this time, space is trying to kill us from the inside out.

A new study on astronauts living on board the International Space Station shows that while in space, the astronauts’ bodies destroyed 54 percent more red blood cells than they normally would on Earth. Even one year after their flight and back on Earth, the symptoms of “space anemia” persisted in the 14 astronauts tested.

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How Would We Do Surgery in Space?

Virtually rendered cutaway view of a postulated traumapod surgical module. Multiple layers of thermal and radiation shielding are visible. A four?armed surgical robot is situated within the module. The patient is tethered to the operating table, while the assistant, using a touchscreen console, is tethered to the module structure via a movable chair. Illustration by T. Trapp (https://www.planvis.co.uk) CC BY-SA 4.0

Any mission to Mars requires deeper planning than missions to the ISS or the Moon. Based purely on the length of the mission, contingencies branch outwards in complex logistical pathways. What if there’s an accident? What if someone’s appendix bursts?

And what if surgery is needed?

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Cancer Seems to Have Trouble Spreading in Microgravity

The International Space Station (ISS), seen here with Earth as a backdrop. Credit: NASA
The International Space Station (ISS), seen here with Earth as a backdrop. Credit: NASA

There are a number of health risks that come with going to space. Aside from the increased exposure to solar radiation and cosmic rays, there are the notable effects that microgravity can have on human physiology. As Scott Kelly can attest, these go beyond muscle and bone degeneration and include diminished organ function, eyesight, and even changes at the genetic level.

Interestingly enough, there are also a number of potential medical benefits to microgravity. Since 2014, Dr. Joshua Choi, a senior lecturer in biomedical engineering at the University of Technology Sydney, has been investigating how microgravity affects medicine and cells in the human body. Early next year, he and his research team will be traveling to the ISS to test a new method for treating cancer that relies on microgravity.

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New Ideas to Reduce Muscle Loss During Spaceflight

Canadian astronaut Robert Thirsk using the exercise bike on the ISS. Exercise is one way of combatting muscle atrophy in space. Image Credit: NASA

One of the obstacles to long space missions is the muscle loss that astronauts suffer from. It’s called atrophy, and NASA says that astronauts can lose up to 20% muscle mass during missions of only 5 to 11 days. This muscle loss affects what are called “anti-gravity muscles,” including calf muscles, the quadriceps and the muscles of the back and neck.

This muscle loss makes it hard for astronauts to complete their tasks, especially when missions to Mars happen. It can also be very dangerous to astronauts, because they’re weakened when they return to Earth. If there are problems during re-entry, and they need to perform any strenuous emergency procedures, that missing muscle could be the difference between life and death.

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Gender Generates Biological Challenges For Long Duration Spaceflight

Astronaut Bruce McCandless untethered above the Earth on Feb. 12, 1984. (NASA)
Astronaut Bruce McCandless untethered above the Earth on Feb. 12, 1984. (NASA)

Men and women look exactly the same when ensconced in a space suit. But female physiology is different from male physiology in significant ways. And those differences create challenges when those bodies have to endure long duration spaceflight, such as during proposed missions to Mars.

Some of the effects of spending a long time in space are well-known, and affect both genders. Exposure to microgravity creates most of these effects. With less gravity acting on the body, the spine lengthens, causing aches and pains. Lowered gravity also causes bone loss, as the skeletal system loses important minerals like nitrogen, calcium, and phosphorous. And the muscles atrophy, since they aren’t used as much.

Microgravity makes the body sense that it is carrying too much fluid in the chest and head, and the body tries to eliminate it. Astronauts feel less thirst, and over time the body’s fluid level decreases. With less fluid, the heart doesn’t have to work as hard. The heart’s a muscle, so it atrophies much like other muscles. The fluid level causes other changes too. Fluid accumulates in the face, causing “Puffy Face Syndrome.”

But some problems are specific to gender, and Gregor Reid, PhD, and Camilla Urbaniak, PhD Candidate at the Shulich School of Medicine and Dentistry are focusing on one fascinating and important area: the human microbiome. Female and male microbiomes are different, and they are affected by microgravity, and other aspects of space travel, in different ways.

The human microbiome is the trillions of microorganisms living on the human body and in the gut. They are important for digestion and nutrition, and also for the immune system. A healthy human being requires a healthy microbiome. If you’ve ever travelled to another part of the world, and had stomach problems from the food there, those can be caused by changes in your microbiome.

Research on astronauts shows that spending time in space changes different aspects of the microbe population in a human being. Some of these changes cause health complications when the microbes responsible for digestion and immunity are affected. Reid says that the microbe has to be understood as its own organ, and we need a better understanding of how to keep that organ healthy. Keeping the microbiome healthy will keep the astronaut healthy, and reduce the risk of disease.

After conducting a literature review, the two researchers suggested that astronauts should incorporate probiotics and fermented foods into their diet to boost the health of their microbiome. They think that astronauts should have access to probiotic bacteria that they can prepare food with. Urbaniak acknowledges that female astronauts don’t want to be limited to shorter duration space flights, and using probiotics to manipulate the microbiome of female astronauts will allow them to withstand longer voyages.

Reid and Urbaniak also highlight some other problems facing women in long distance space voyages. If a female astronaut is diagnosed with breast cancer, ovarian cancer, or a urinary tract infection during an extended journey in space, any treatment involving antibiotics would be problematic. The antibiotics themselves may work less effectively due to changes in the microbiome.

Research on male astronauts has already shown a decrease in beneficial microorganism in the gut, and in the nasal and oral pathways. Those decreases were noted in both long and short duration stays in space. The research also shows an increase in harmful microorganisms such as E. coli. and staphylococcus. But so far, the same research hasn’t been done on female astronauts.

It’s well understood that women and men have different microbial profiles, and that their microbiomes are different. But there’s a lot we still don’t know about the specifics. This is an important area of research for NASA. According to Urbaniak, though, previous studies of the human microbiome and its response to space travel have focused on male astronauts, not female astronauts. Reid and Urbaniak are hopeful that their work will start a conversation that results in a greater understanding of the effects of space travel on women.

Doctor Who? Astronauts Need To Figure Out Medical Procedures Before Leaving Earth

ESA astronaut Alexander Gerst practicing his medical skills on a mannequin. Credit: European Space Agency

Should an astronaut get sick on the International Space Station, that could be a bad scene given the nearest hospital requires a spaceship ride. That’s why every crew has at least two medical officers on board that can deal with some routine procedures, getting to items as complex as filling teeth, for example.

How to get that training done?

Here’s an example: above is Alexander Gerst, an astronaut with the European Space Agency, recently working with a mannequin at the Uniklinik Köln, a hospital in Cologne, Germany. The mannequin is at least as realistic as some baby dolls you can buy in stores: “it blinks, breathes and responds to injections”, ESA stated.

That’s in addition to three days Gerst spent in operating theatres, emergency and the intensive care unit at the hospital. He has about another year to do medical training before going to station for Expedition 40/41 in May 2014.

Chris Cassidy, an Expedition 36 flight engineer, tests his eyesight aboard the International Space Station. Credit: NASA
Chris Cassidy, an Expedition 36 flight engineer, tests his eyesight aboard the International Space Station. Credit: NASA

Mind you, help is also a phone call away to a ground control station, who has doctors on site. Also, there are a lot of medical doctors or similarly trained personnel that fly in space.

On board the International Space Station right now is a trained Navy SEAL, for example: Chris Cassidy. He would have been trained to treat injuries during combat. In May, he told Universe Today that he expects “muscle memory” would kick in during an emergency, whether medical or station-related:

“I think just the training that I got in the field, training in the early part of my Navy career, and during my time being an astronaut will all combine together,” he said.

“What I know from combat in the Navy, there’s a sort of calmness that comes over people who are well-trained and know what to do. Muscle memory kicks in, and it’s not until after the thing is over that you realize what you went through.”

While those who fly in space train for medical emergencies, they also serve as medical guinea pigs for ongoing experiments. Turns out microgravity simulates aging processes on Earth, so the research could have benefits on the ground in future decades. Here’s a couple of experiments happening right now on station:

  • Space Headaches: “Current, pre, in-flight and post-flight data via questionnaires to evaluate the prevalence and characteristics of crewmembers’ headaches in microgravity.”
  • Reaction Self Test:  “A portable 5-minute reaction time task that will allow the crewmembers to monitor the daily effects of fatigue on performance while on board the International Space Station.”

Looking at the medical aspect alone, it’s abundantly clear why astronauts spend years in training before flying to the station. Remember, though, this is on top of other science experiments they do there, not to mention repairs, maintenance and the occasional spacewalk or catching a supply spacecraft.