Regenerative and Precision Medicine: Problems in Bioastronautics
By Ethan Sample '24
Left: SpaceX Falcon 9 Rocket Launch from NASA’s SpaceX Crew Dragon Demo-2 Mission to the International Space Station (ISS), the first ever human launch in a craft designed by a private firm (May 30, 2020). Bottom right: Astronaut Karen Nyberg utilizes a fundoscope to image the interior of her eye aboard the ISS (circa 2016). Top right: Diagram of SCHEMA recombination, a novel method of protein engineering developed in part by Princeton alumna and Nobel Laureate Frances Arnold (BSE ‘79).
The Next Space Age and Bioastronautics
A New Frontier
Wind batters the slender rocket body under a gray sky, preceding a crash of thunder. Unfortunately, the May 27th SpaceX rocket launch had to be scrubbed due to poor weather; the ensuing successful launch three days later was widely celebrated by engineers and space enthusiasts alike. It marked a novel achievement of private expansion into the aerospace industry, a field once monopolized by national agencies. This was the first ever successful human flight aboard a privately constructed spacecraft. Online viewership of over 10 million concurrent watchers, coupled with the 150,000 in-person onlookers, illustrated the recent reinvigoration of space exploration efforts among the populace. Professionals have felt a similar effect as well with the announcement of NASA’s Artemis Program, which aims to put humans back on the moon by 2024 in preparation for a mission to Mars. With the next phase of the space age upon the world, inexorable changes and challenges to human civilization are sure to appear.
One such challenge is the problem of bioastronautics. Bioastronautics refers to the use of engineering and technology to facilitate healthy human inhabitation of space. Humans evolved gravity-regulated physiological systems to live on Earth, many of which dysfunction as a result of microgravity. Diseases and disorders that arise from human spaceflight include disruption of circadian rhythms, muscular atrophy, osteopenia (bone density loss), balance problems, immune dysfunction, fluid distribution issues, anemia, etcetera. The list is immense, perhaps still lacking several undiscovered pathologies. Almost all phenomena that have been identified are poorly understood. One issue in particular that has been of recent concern is termed spaceflight associated neuro-ocular syndrome, a change in cerebrospinal fluid pressure that results in damage to the optic disk. This can be detrimental to longer term space missions, as sharp or at least correctable vision for astronauts is necessary for their work. As such, an efficacious solution needs to be developed in order to support travel to Mars and beyond.
Aerospace medicine is one answer, which will likely benefit from upcoming progress in synthetic biology and biochemical engineering. The ability to manipulate the function of organs through tissue engineering and regenerative medicine could facilitate constructing human physiology to be better suited to spaceflight. Furthermore, nanomedicine and molecular medicine are two budding fields that could fill in gaps of care where synthetic biology fails. Novel methods of protein engineering have promising targeted therapeutic applications that may be effective where conventional medication is not. Although in its infancy, as the 2018 Nobel Prize in Chemistry was only just awarded for the directed evolution of enzymes, it is projected knowledge and use of the discipline will grow significantly in the coming decades.
However, the lack of funding and support for success in scientific theory is disconcerting. There are only around 3 graduate degree programs in bioastronautics in the United States (HST, Texas A&M, Colorado Boulder), while there are upwards of 65 graduate degree programs in conventional aerospace engineering. Funding for research is sparse. The closest field to bioastronautics in NASA’s 2020 fiscal breakdown is their aeronautics human research program, under which falls the advanced technologies to support air revitalization initiative. Unfortunately, this subsection focuses more on basic life support as opposed to long term health maintenance. Even so, it comprises just 0.55 percent of NASA’s 22.689 billion dollars in funding, illustrating the near absence of bioastronautics in the space research community. Aforementioned spaceflight pathologies are both multitudinous and enigmatic, with little scientific description as of yet; considering it is imperative to develop effective treatments for space’s health detriments before embarking on a long term mission, NASA’s ambitious projections of humans setting foot on Mars during the 2030s appear pitifully optimistic. With an overall lack of scientific development and fundamental knowledge of spaceflight pathology, it is difficult to gauge whether these biological solutions to a physical problem will ever be successful.
Despite aerospace medicine’s salience, mission efforts continue with little regard for their indelible unsustainability. One explanation for the failure of the community to address this discrepancy is that of primacy. To fall ill in space, one must first be in space. It is already incredibly difficult to get there in the first place. NASA spends 50% of its budget on human spaceflight activities alone, not accounting for other robotic missions and satellites. Its resources are not unlimited, so it prioritizes the most immediate problems. Longer term space missions requiring bioastronautics solutions have not occurred yet, thus NASA would rather cross the bridge when it comes to it. Furthermore, the prospective success of aerospace biotechnologies is shaky; resultantly, many are reluctant to waste money on such research. This argument is complemented by the economics of bioastronautics; space is no longer purely a public endeavor. Private firms have little incentive to pump capital into aerospace medicine research. Rocketry and space stations are known science, therefore companies understand they will see returns if they can compete well enough to dominate the market. In contrast, regenerative and targeted therapeutics for aerospace diseases are not well understood. There exists high risk of investment, as firms do not know if they can produce successful therapeutics, let alone if there will be enough humans living in space to market them to. The present state of aerospace medicine is clearly one of neglect due to the nature of the world socioeconomic system.
Vision for the Future
In spite of all this, a light may exist at the end of the tunnel for aerospace medicine. Once physiological problems in astronauts become more relevant, NASA will boost spending correspondingly. Similarly, once there is clear market incentive for aerospace therapeutics, companies will enter the field to produce them. A substantial level of research is already being performed on protein engineering and regenerative medicine in the conventional pharmaceutical industry and academic landscape. Hence, aerospace medicine may just be a matter of applying what is already known to novel issues as the science is developed. Time seems to be the only benefactor for spaceflight bioengineering at the moment; eventually, if all goes well, the art of healing will be brought to the stars.
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