Human Mission to Mars: Implications for Biotechnology Jeffrey P. Sutton, M.D., Ph.D. CEO, National Space Biomedical Research Institute May 16, 2016
Human Mission to Mars:
Implications for Biotechnology
Jeffrey P. Sutton, M.D., Ph.D.
CEO, National Space Biomedical Research Institute May 16, 2016
• First mission – Oct 1960 – Soviet Union – flyby – launch failure
• 4 subsequent missions - 1960-1962 – Soviet Union – 3 flyby and 1
lander – 3 launch failures (failed to orbit, disintegration in LEO,
never left LEO), 1 spacecraft failure (comm loss)
• Nov 1964 - U.S. Mariner 3 – flyby - launch failure
Mariner 4 – flyby – success
- Soviet Union flyby – spacecraft failure
Robotic Missions to Mars
Landing on Mars
Viking 1 Lander
• 1969-1973 U.S. Mariners 7, 8 – flyby – successes
Mariner 8 – orbiter – launch failure
Mariner 9 – orbiter – success
Soviet Union 2 orbiters – mostly successful
(dust storms)
4 orbiters – launch failures
May 1971 – Mars 3 lander - partialsuccess
contact lost at 14.5 sec
4 other landers - spacecraft failures
1 rover – spacecraft failure
• 1975 U.S. Viking 1 – orbiter – success – 1385 orbits
Viking 1 – lander – success – 2245 sols
Viking 2 – orbiter – success – 700 orbits
Viking 2 – lander – success – 1281 sols
• 1988-1992 Soviet Union Fobos 1, 2 – spacecraft failures
U.S. Mars Observer – spacecraft failure
• 1996-1999 U.S. Mars Global Surveyor – orbiter – success
Mars Pathfinder – lander – success
Sojourner – rover – success
3 spacecraft failures
Russia, Japan – launch
and spacecraft failures
• 2003-2007 U.S., Europe – successful flybys and orbiters
U.S. – successful landers, rovers (Spirit, Opportunity)
Europe – Lander failure (Beagle 2)
Exploring Mars
• 2011- U.S. successful orbiter and rover (Curiosity)
India successful orbiter
Russia
– orbiter, Phobos sample – spacecraft failure, loss of
Chinese orbiter as part of mission
• En route Europe, Russia ExoMars Trace Gas Orbiter
lander
Future Missions to Mars
• Successful and failed attempts
• Prior exploration attempts inform subsequent missions
• Failures continue to occur
• Human missions add enormous challenges
• We are destined to explore
Space Exploration is Difficult
Example Human Missions to Mars
Long-Stay Mission
Example Human Missions to Mars
Short-Stay Mission
• Total spaceflight time: 132 crew-years
• Number of people who have flown in orbit: 544
• Cumulative spaceflight record:
Gennadi Padalka 878.5 days
• Single mission spaceflight record:
Valeri Polyakov 437.7 days
Human Space Experience as of May 2016
• Space environment
Reduced gravity
Radiation
Vacuum
Debris
• Space craft environment
Vehicle integrity
Life support
Isolation and confinement
Noise
• Space mission environment
Circadian rhythm, crew schedule, workload
Mission, payload and science hazards
Hazards of Human Spaceflight
Space Radiation
• #1 risk to astronaut health beyond low Earth orbit
Chancellor, Scott,
Sutton. Life 2014
ISS post-flight complex
chromosomal aberrations
Cucinotta et al. Radiation
Research 2008
Health Effects Due to Space Radiation Exposure
Physiological Adaptation
to Space Travel and
Biomedical Risks
Bone Mineral Density
Regional heterogeneity and differential susceptibility among astronauts
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TrochanterLoss0=7.8%Recovery Half-life=255 d
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PelvisLoss0=7.7% Recovery Half-life=97 d
Femoral NeckLoss0=6.8%Recovery Half-life=211 d
Bone Mineral Density Recovery
Risk for Renal Stones
• Astronauts are at an increased risk for developing calcium
oxalate, calcium phosphate and uric acid stones
associated with space missions
• Active U.S. astronauts have developed renal stones
• Crew’s urine typically becomes supersaturated with stone-
forming salts as a result of decreased urine output and pH,
and increased calcium excretion
• Stones can lead to urine obstruction, and if not treated,
acute renal failure, infection and sepsis
• Potassium citrate supplementation can lower risk for
certain stones (Ca oxal and uric acid stones, but not Ca
phosph stones)
Whitson PA, et al. Journal of Urology. 2009;182:2490-2496
• 2 Concerns and 31 Risks based on current evidence
• Path to Risk Reduction
Human Research Roadmap
Path to Risk Reduction
Human Research Roadmap
Planetary Design Reference Mission
Concerns (2) Unpredict med effects Intervertebral disc damage
Risks (31) CNS radiation Acute radiation syndrome
Psychiatric probs Dust exposure Host-microorg interactions
Altered immunity Med conditions Incompatible vehicle design
Bone changes Cardiac arrythmias Degen effects of radiation
Decompression probs Early osteoporosis Impaired flight control
Reduced muscle Human/robotic interact Human/computer interaction
Inadeq mission design Inadequate nutrition Ineffective meds
Injury from EVA Injury from loads Orthostatic intolerance
Inadequate teaming Inadequate food sys Sleep loss, circadian desyn
Training deficiencies Rad carcinogenesis Reduced physical perform
Renal stone formation Intracranial HT/vis
Human Research Roadmap
Planetary Design Reference Mission
Concerns (2) Unpredict med effects Intervertebral disc damage
Risks (31) CNS radiation Acute radiation syndrome
Psychiatric probs Dust exposure Host-microorg interactions
Altered immunity Med conditions Incompatible vehicle design
Bone changes Cardiac arrythmias Degen effects of radiation
Decompression probs Early osteoporosis Impaired flight control
Reduced muscle Human/robotic interact Human/computer interaction
Inadeq mission design Inadequate nutrition Ineffective meds
Injury from EVA Injury from loads Orthostatic intolerance
Inadequate teaming Inadequate food sys Sleep loss, circadian desyn
Training deficiencies Rad carcinogenesis Reduced physical perform
Renal stone formation Intracranial HT/vis
Concern of Clinically Relevant Unpredicted
Effects of Medication
Gaps
• We do not know the extent to which spaceflight alters
pharmacokinetics
Animal studies show spaceflight-associated changes (e.g., decreased
cytochrome P450) could alter pharmacokinetics but paucity and variability of
data preclude definitive conclusion
• We do not know the extent to which spaceflight alters
pharmacodynamics
• We do not know the extent to which current antimicrobial therapies
are effective against microbes that have been altered by spaceflight
Medication Use by U.S.
Crewmembers on the
International Space Station
Wotring VE. FASEB J. 2015
Nov;29(11):4417-23
Risk of Ineffective or Toxic Medications
Due to Long Term Storage
Gaps
• We do not know how
medications are used during
spaceflight
• We do not know how long
medications may be safe and
effective beyond their
expiration dates
Risk of Adverse Health Outcomes and Decrements in
Performance due to Inflight Medical Conditions
22 Gaps
Parabolic Flight for Analog Studies
• Unique, national translational research and development program
– Product-driven focus on countermeasures
– Hybrid NIH/DOD model
– Multidisciplinary distributed teams
– Aligned with NASA goals
– Virtual institute Enhanced by
core facility
– Cost effective
National Space Biomedical Research Institute
• Established in 1997
• Unparalleled intellectual and institutional resources, leveraging the
nation’s investment in biomedical research and development, are
brought to bear on solving problems for NASA
– High caliber and productivity of investigators from ~70 institutions
INTEGRATED RESEARCH TEAMS
Cardiovascular Alterations
Human Factors and Performance
Musculoskeletal Alterations
Neurobehavioral and Psychosocial Factors
Radiation Effects
Sensorimotor Adaptation
Smart Medical Systems and Technology
USER PANEL
INDUSTRY FORUM
EDUCATION PROGRAMS
NSBRI Components
• Advanced Diagnostic Ultrasound in Microgravity
Development of effective training procedures and new medical applications
Ultrasound atlas of human anatomy and physiology in space
First scientific paper ever from space [Radiology 2005;234(2):319-322]
• Earth-based applications
Human performance with real-time imaging
Global health care
NSBRI Achievements
Ensuring Health in Space, Benefiting Life on Earth
Introducing Astro-Omics as a First Step to
Deploying Precision Medicine in Space
Scott Kelly – ISS for one year
Mark Kelly – Earth control
Telomere Length
Bailey
DNA Mutations
Feinberg
DNA Hydroxy-methylation
Mason
Chromatin
Feinberg
large/small RNA
& RNA Methylation
Mason
Proteomics
Lee/Rana
Antibodies
Mignot/Snyder
Cytokines
Mignot
DNA Methylation
Feinberg & Mason
B-cells / T-cells
Mignot
Targeted and Global Metabolomics
Lee/Rana, Mignot/Snyder & Smith
Microbiome
TurekCognition
Basner
Vasculature
Lee
• MARS 500 Project – first high-fidelity
simulation of a 520-day crewed
mission to Mars
• NASA restricted in its participation
• Demonstration of differential vulnerability
in crew members, with the majority
experiencing sleep-wake disturbances
International Collaborations
• Newly recognized syndrome with 4 Gaps
• #1 risk to astronaut health in low Earth orbit
• 70% of International Space Station astronauts affected
• Many hypotheses
Prevailing hypothesis - elevated intracranial pressure during spaceflight
contributes to the visual alterations and ophthalmological findings
Normal Globe Flat Globe
Globe Flattening
Increased Optic Nerve Sheath Diameter
Optic Disc Edema
Hyperopic Shifts
Up to +1.75
diopters
Choroidal Folds
+ICP?
“Cotton wool” Spots
Scotoma
Risk of Spaceflight-induced Intracranial
Hypertension/Visual Alterations
Non-invasive Measurement of
Intracranial Pressure – Vittamed Device
Integrated Ultrasound Imaging and
Therapeutics for Non-invasive Surgery
Ultrasonic propulsion of renal stones
using acoustic radiation force
generated by a series of 50 ms, 2 MHz
ultrasound pulses
High intensity focused
ultrasound for non-invasive
hemostasis
• Established in 2008
• First time space medicine codified at the level of an academic
center or department in a university or medical school
• Academic home to all physician astronauts worldwide
• First four-year Space Medicine Track
inspiring and training the next generation
• Cutting-edge research and laboratories
BCM Center in Space Medicine
XMed3D printing for
exploration medicine
Autonomous care
capabilities
• Fuel for roundtrip – methane and oxygen can be produced using
Martian H20 (ice) and atmospheric CO2
• Other propulsion (e.g., ion, nuclear)
• Continuous source of food (e.g., plant farm)
• Water recovery
• Oxygen generation
• Habitat construction and sustainability
• Mars spacesuit
• Rover
• Energy – solar, radioisotope thermoelectric generator
• Cost
• Geopolitical factors
Beyond the Path for Risk Reduction
for a Human Mission to Mars
The Future is Happening Here and Now