i
International Space Station
Benefits for Humanity
2nd Edition
This book was developed collaboratively by the members of
...
ii
Acknowledgements
A Product of the ISS Program Science Forum
National Aeronautics and Space Administration:
Julie Robin...
iii
About the Cover Art
Several themes are integrated into the cover art for this 2nd
International Space Station
Benefits...
iv
Book Highlights
Robotic arms lend a healing touch
The world’s first robotic technology capable of performing surgery in...
v
Acknowledgments............................................................................................................
vi
Heart Health and Biorhythms...............................................................................................
vii
Global Education
Inspiring the next generation of students with the International Space Station .........................
viii
ix
Executive Summary
The International Space Station (ISS) is a unique scientific platform that enables researchers from a...
x
Introduction
Welcome as we share the successes of the International Space Station (ISS) in this second edition of the
In...
xi
on ISS and commercial service providers selling services directly to ISS users. This section provides examples
of the u...
xii
Medical team prepares for SYMBIS Surgical System use in the operating room.
Image credit: University of Calgary
1
Human
Health
The International Space Station is a unique laboratory for performing investigations that affect human
heal...
2
3
Robotic arms lend a healing touch
The delicate touch that successfully removed an
egg-shaped tumor from Paige Nickason’s...
4
Since Paige Nickason’s surgery in 2008, neuroArm has
been used in initial clinical experience with 35 patients
who were ...
5
Robots from space lead to one-stop
breast cancer diagnosis treatment
Technology derived from the highly capable robots
d...
6
can be challenging to many radiologists, optimizing
patient time to diagnose.
Dr. Nathalie Duchesne, co-investigator on ...
7
hold steady and see clearly even while this move-
ment is taking place. This involves the brain constantly
interpreting ...
8
The Thermolab experiment has been looking at
changes in thermal regulation and cardiovascular
adaptations in weightlessn...
9
smaller and even more sophisticated scanner dubbed
Ultrasound 2, currently in use aboard the orbiting
laboratory.
Now th...
10
Are you asthmatic? Your new helper
comes from space
Kalle, a 10-year-old boy, is already in favor of space
technology. ...
11
Because it is a charged gas, plasma can permeate
many materials, spreading evenly and quickly. It can
disinfect surface...
12
crystal structures. Basic experiments tested a wide
range of particle sizes and different gas types, and
researchers fo...
13
Preventing bone loss in spaceflight with
prophylactic use of bisphosphonate:
Health promotion of the elderly by
space m...
14
a decade, with a proven efficacy to increase bone
mass and decrease the occurrence of bone frac-
ture. Through 90-day b...
15
is also important for activation of vitamin D. Physical
exercise to increase bone load and muscle training
should also ...
16
“weigh” anything on the space station, but resistance
machines allow astronauts to get the same kind of
workout. The ne...
17
of lowering sodium intake. NASA food scientists have
reformulated more than 80 space foods to reduce the
sodium content...
18
textbooks said this was not possible. “Sodium reten-
tion in space” became an important subject to study.
Salt intake w...
19
Early detection of immune changes
prevents painful shingles in astronauts
and in Earth-bound patients1
The physiologica...
20
how the immune system will function over the long
stays in space that may be required for exploration
missions.
To dete...
21
infection either during or right after flight. Forty years
later, Leukin results show that immunosuppression
begins wit...
22
information for targeted treatments on Earth. This
could either be for the purpose of developing pharma-
ceuticals that...
23
Developing New Therapies
Studying the unique and complicated structures of proteins in the human body leads to the deve...
24
are kept for a period of one-and-a-half to four months
at a stable temperature, 68 degrees Fahrenheit (20
degrees Celsi...
25
The OBI research team has successfully determined
the 3-D structure of H-PGDS in a complex with a
prototype H PGDS-spec...
26
The MEPS-II system is now being brought to com-
mercial scale under U.S. Food and Drug Administra-
tion (FDA) Good Manu...
27
gravity are recreated. As a result, changes typical
of acute gravitational unloading are reproduced in
the body.
The po...
28
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NASA - International Space Station - Benefits for Humanity - 2nd Edition (154 p.) 7.36 MB

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Transcripts - NASA - International Space Station - Benefits for Humanity - 2nd Edition (154 p.) 7.36 MB

  • 1. i International Space Station Benefits for Humanity 2nd Edition This book was developed collaboratively by the members of the International Space Station Program Science Forum, which includes the National Aeronautics and Space Administration (NASA), Canadian Space Agency (CSA), European Space Agency (ESA), Japan Aerospace Exploration Agency (JAXA), Russian Federal Space Agency (Roscosmos), and the Italian Space Agency (ASI). NP-2015-01-001-JSC
  • 2. ii Acknowledgements A Product of the ISS Program Science Forum National Aeronautics and Space Administration: Julie Robinson, Pete Hasbrook, Amelia Rai, Tara Ruttley, Camille Alleyne, Cynthia Evans, William Stefanov, Michael Read, Kirt Costello, David Hornyak, Tracy Thumm, Susan Anderson, Joshua Byerly, Joshua Buck Canadian Space Agency: Nicole Buckley, Luchino Cohen, Ruth Ann Chicoine, Christine Giguère European Space Agency: Martin Zell, Eric Istasse, Jason Hatton, Jennifer Ngo-Anh, Nigel Savage, Jon Weems Japan Aerospace Exploration Agency: Shigeki Kamigaichi, Kazuyuki Tasaki, Sayaka Umemura, Koki Oikawa, Hideyuki Watanabe, Nobuyoshi Fujimoto, Masato Koyama, Yayoi Miyagawa, Tatsuya Aiba, Shiho Ogawa, Toshitami Ikeda Russian Federal Space Agency: Georgy Karabadzhak, Elena Lavrenko, Igor Sorokin, Natalya Zhukova, Nataliya Biryukova, Mark Belakovskiy, Anna Kussmaul Italian Space Agency: Salvatore Pignataro, Jean Sabbagh, Germana Galoforo Executive Editor: Julie Robinson, NASA Managing Editor: Amelia Rai, NASA Section Editors: Camille Alleyne, Kirt Costello, David Hornyak, Michael Read, Tara Ruttley, William Stefanov; NASA Technical Editor: Neesha Hosein, DB Consulting Group, Inc. Graphic Designer: Cynthia Bush, DB Consulting Group, Inc.
  • 3. iii About the Cover Art Several themes are integrated into the cover art for this 2nd International Space Station Benefits for Humanity. The most central theme is that of “bringing light to the darkness,” as indicated by the predominantly nighttime view of Earth, with both the station crew and the populace over which it soars on the verge of experiencing a new dawn. The Earth view chosen includes some of the most underdeveloped regions on the planet; home to people whose lives stand to gain the greatest enrichment from the groundbreaking research being conducted high overhead. The double-headed arrow, which can be interpreted to be a stylized representation of the space station’s orbital flight path, is also the visual centerpiece for two of the remaining themes. The double arrow points both behind the station—back toward Earth, and ahead of the station—forward past the Earth, to the moon, Mars, and to far more distant destinations. This highlights the dual charter of station research to improve life on Earth and to lay the technological groundwork for human expansion beyond low-Earth orbit. The arrow’s color shift from silver to gold represents the third theme: “Invest silver, get back gold.” This theme pays homage to the manifold benefits of knowledge realized through international investment in the space station. It also celebrates “gold” of another kind, the enrichment of life on Earth that is the subject of this volume. These benefits for humanity are represented by five gold medallions, each signifying a major area of emphasis: Human Health, Earth Observation and Disaster Response, Innovative Technology, Global Education, and Economic Development of Space. The final theme is also the most subtle. Although this is a publication coordinated by NASA, the NASA logo is absent from the front cover, in deference to the fact that the benefits chronicled herein are a result, not of any single nation’s efforts, nor those of one nation above others, but of unprecedented international partnership and cooperation. This is a benefit for humanity in and of itself, one which promises incalculable rewards not only in such tangibles as heightened international commerce, but perhaps most importantly, in greater cross-cultural understanding and tolerance, the very foundation for humanity’s future. Michael C. Jansen December 2014 Human Health Earth Observation and Disaster Response Economic Development of Space Global Education Innovative Technology
  • 4. iv Book Highlights Robotic arms lend a healing touch The world’s first robotic technology capable of performing surgery inside magnetic resonance machines makes difficult surgeries easier or impossible surgeries possible. Page 3 Bringing space station ultrasound to the ends of the Earth Small ultrasound units, tele-medicine and remote guidance techniques make medical care more accessible in remote regions. Page 8 Advanced ISS technology supports water purification efforts worldwide At-risk areas can gain access to advanced water filtration and purification systems affording them clean drinking water. Page 65 Tomatosphere™: Sowing the seeds of discovery through student science This award-winning educational project with an estimated 3 million students participating is helping researchers answer questions about growing food in space while teaching students about science, agriculture and nutrition. Page 94 Calling cosmonauts from home Currently aboard the Russian segment of the station are four space investigations that have educational components to inspire future generations of scientists, technologists, engineers and mathematicians. Page 104 Commercialization of low-Earth orbit (LEO) Forward-thinking, agile companies like NanoRacks and UrtheCast believe routine utilization of the unique environment of outer space has come of age, and that at long last ISS is open for business. Page 112 Space mice teach us about muscle and bone loss Biotech and pharmaceutical companies like Amgen use spaceflight to study their drugs and do preclinical work important for FDA approval. Page 129 Improved eye surgery with space hardware An eye-tracking device allows the tracking of eye position without interfering with a surgeon’s work during corrective laser eye surgery. Page 6 Earth remote sensing from the space station ISS contributes to humanity by collecting data on global climate, environmental change, and natural hazards using its unique complement of crew-operated and automated Earth observation payloads. Page 51 High-quality protein crystal growth experiment aboard Kibo Protein crystal growth experiments contribute to the development of medical treatments. JAXA is making positive advancements in research on obstinate diseases through experiments in space. Page 23
  • 5. v Acknowledgments...........................................................................................................ii About the Cover Art....................................................................................................... iii Book Highlights..............................................................................................................iv Executive Summary........................................................................................................ix Introduction..................................................................................................................... x Human Health Health Technology...................................................................................................................................... 3 Robotic arms lend a healing touch............................................................................................................. 3 Robots from space lead to one-stop breast cancer diagnosis treatment.................................................... 5 Improved eye surgery with space hardware................................................................................................ 6 Sensor technologies for high-pressure jobs and operations ....................................................................... 7 Bringing space station ultrasound to the ends of the Earth ........................................................................ 8 Are you asthmatic? Your new helper comes from space .......................................................................... 10 Cold plasmas assist in wound healing...................................................................................................... 10 Preventing Bone Loss.............................................................................................................................. 13 Preventing bone loss in spaceflight with prophylactic use of bisphosphonate: Health promotion of the elderly by space medicine technologies.............................................................. 13 Improved scanning technologies and insights into osteoporosis............................................................... 15 Good diet, proper exercise help protect astronauts’ bones ...................................................................... 15 Add salt? Astronauts’ bones say please don’t.......................................................................................... 17 Immune Defenses..................................................................................................................................... 19 Early detection of immune changes prevents painful shingles in astronauts and in Earth-bound patients............................................................................................................................ 19 Station immunology insights for Earth and space .................................................................................... 20 Targeted treatments to improve immune response................................................................................... 21 Developing New Therapies...................................................................................................................... 23 High-quality protein crystal growth experiment aboard Kibo..................................................................... 23 Cancer-targeted treatments from space station discoveries...................................................................... 25 Using weightlessness to treat multiple ailments........................................................................................ 26 Food and the Environment...................................................................................................................... 29 Microbiology applications from fungal research in space........................................................................... 29 Plant growth on ISS has global impacts on Earth..................................................................................... 30 Experiments with higher plants on the Russian Segment of the International Space Station..................... 32 Table of Contents 1
  • 6. vi Heart Health and Biorhythms.................................................................................................................. 35 Space cardiology for the benefit of health care......................................................................................... 35 Biological rhythms in space and on Earth................................................................................................. 36 Innovative space-based device promotes restful sleep on Earth............................................................... 37 Improving Balance and Movement......................................................................................................... 39 New technology simulates microgravity and improves balance on Earth................................................... 39 New ways to assess neurovestibular system health in space also benefits those on Earth ....................... 40 Space research leads to non-pharmacological treatment and prevention of vertigo, dizziness and equilibrium disturbances.................................................................................................................... 42 Capturing the secrets of weightless movements for Earth applications..................................................... 44 Space technologies in the rehabilitation of movement disorders............................................................... 45 Earth Observation and Disaster Response Environmental Earth Observations......................................................................................................... 51 Earth remote sensing from the space station ........................................................................................... 51 Coastal ocean sensing extended mission ................................................................................................ 53 Visual and instrumental scientific observation of the ocean from space .................................................... 54 Disaster Response................................................................................................................................... 57 Space station camera captures Earthly disaster scenes .......................................................................... 57 Clear high-definition images aid disaster response .................................................................................. 59 Innovative Technology Fluids and Clean Water............................................................................................................................ 65 Advanced ISS technology supports water purification efforts worldwide .................................................. 65 Exploring the wonders of fluid motion: Improving life on Earth through understanding the nature of Marangoni convection ................................. 66 Space station-inspired mWater app identifies healthy water sources ....................................................... 68 Space-tested fluid flow concept advances infectious disease diagnoses ................................................. 69 Materials.................................................................................................................................................... 71 Improving semiconductors with nanofibers .............................................................................................. 71 InSPACE’s big news in the nano world .................................................................................................... 72 Satellites.................................................................................................................................................... 75 Deploying small satellites from ISS ........................................................................................................... 75 Pinpointing time and location ................................................................................................................... 77 Space station technology demonstration could boost a new era of satellite-servicing .............................. 78 Transportation Technology...................................................................................................................... 81 Cool flame research aboard space station may lead to a cleaner environment on Earth ........................... 81 Robotics.................................................................................................................................................... 83 Robonaut’s potential shines in multiple space, medical and industrial applications ................................... 83 63 49
  • 7. vii Global Education Inspiring the next generation of students with the International Space Station ......................................... 89 Inquiry-based Learning............................................................................................................................ 91 Student scientists receive unexpected results from research in space ..................................................... 91 Europe’s alliance with space droids ......................................................................................................... 92 NASA has a HUNCH about student success in engineering..................................................................... 93 Tomatosphere™: Sowing the seeds of discovery through student science .............................................. 94 Students photograph Earth from space via Sally Ride EarthKAM program ............................................... 96 Try zero G 2: Igniting the passion of the next generation in Asia ............................................................... 97 Inspiration................................................................................................................................................. 99 Asian students work with astronauts in space missions ........................................................................... 99 Educational benefits of the space experiment “Shadow-beacon” on ISS ............................................... 100 Students get fit the astronaut way ......................................................................................................... 102 Inspiring youth with a call to the International Space Station .................................................................. 103 Calling cosmonauts from home ............................................................................................................. 104 MAI-75 experiment, main results and prospects for development in education ...................................... 105 Economic Development of Space Commercial Service Providers.............................................................................................................. 111 Water production in space: Thirsting for a solution ................................................................................. 111 Commercialization of low-Earth orbit (LEO)............................................................................................. 112 Innovative public-private partnerships for ISS cargo services: Part 1 ...................................................... 113 Innovative public-private partnerships for ISS cargo services: Part 2 ...................................................... 115 Precision pointing platform for Earth observations from the ISS.............................................................. 116 The Groundbreaker: Earth observation................................................................................................... 118 A flock of CubeSats photographs our changing planet........................................................................... 119 Stretch your horizons, Stay CuriousTM ..................................................................................................... 120 Mission critical: Flatworm experiment races the clock after splashdown................................................. 122 Economic development of space in JAXA.............................................................................................. 123 Commercial Research........................................................................................................................... 127 Colloids in space: Where consumer products and science intersect ...................................................... 127 Space mice teach us about muscle and bone loss ................................................................................ 129 Protein crystals in microgravity .............................................................................................................. 130 Muscle atrophy: Mice on the ISS helping life on Earth ............................................................................ 131 Link to Archived Stories and Videos ................................................................................................................. 134 Authors and Principal Investigators by Section............................................................... 135 109 87
  • 8. viii
  • 9. ix Executive Summary The International Space Station (ISS) is a unique scientific platform that enables researchers from all over the world to put their talents to work on innovative experiments that could not be done anywhere else. Although each space station partner has distinct agency goals for station research, each partner shares a unified goal to extend the resulting knowledge for the betterment of humanity. We may not know yet what will be the most important discovery gained from the space station, but we already have some amazing breakthroughs. In the areas of human health, innovative technology, education and observations of Earth from space, there are already demonstrated benefits to people back on Earth. Lives have been saved, station-generated images assist with disaster relief, new materials improve products, and education programs inspire future scientists, engineers and space explorers. Some benefits in this updated second edition have expanded in scope. In other cases, new benefits have developed. Since the publication of the first edition, a new constituency has developed, one that is using the ISS in a totally different fashion—to develop a commercial market in low-Earth orbit. From pharmaceutical companies conducting commercially-funded research on ISS, to private firms offering unique research capabilities and other services, to commercial cargo and crew, the ISS is proving itself to be just as adaptable to new business relationships as it has been for a broad diversity in research disciplines. This book summarizes the scientific, technological and educational accomplishments of research on the space station that have had and will continue to have an impact to life on Earth. All serve as examples of the space station’s potential as a groundbreaking research facility. Through advancing the state of scientific knowledge of our planet, looking after our health, developing advanced technologies and providing a space platform that inspires and educates the science and technology leaders of tomorrow, these benefits will drive the legacy of the space station as its research strengthens economies and enhances the quality of life here on Earth for all people.
  • 10. x Introduction Welcome as we share the successes of the International Space Station (ISS) in this second edition of the International Space Station Benefits for Humanity. The ISS is a unique scientific platform that has existed since 1998 and has enabled over 2,400 researchers in 83 countries and areas to conduct more than 1,700 experiments in microgravity through just September 2014, and the research continues… Since November 2, 2000, the ISS has maintained a continuous human presence in space. Even before it was habitable, the research began on the only orbiting laboratory of its kind. In 2011, when ISS assembly was complete, the focus shifted to fully utilizing the lab for continued scientific research, technology development, space exploration, commerce, and education. The tremendous value of the ISS began through the engineering achievement evolving over a decade. Components were built in various countries around the world—all without the benefit of prior ground testing— allowing us to learn a vast amount about construction and about how humans and spacecraft systems function in orbit. This testament to the international achievement exemplifies cultural harmonization through cooperative teamwork leading to an international partnership that has continued to flourish and foster international cooperation. While each ISS partner has distinct agency goals for research conducted, a unified goal exists to extend the knowledge gleaned to benefit all humankind. In the first edition of the book released in 2012, the scientific, technological and educational accomplishments of ISS research that have an impact on life on Earth were summarized through a compilation of stories. The many benefits being realized were primarily in the areas of human health, Earth observations and disaster response, and global education. This second edition includes updated statistics on the impacts of those benefits as well as new benefits that have developed since the first publication. In addition, two new sections have been added to the book: Economic Development of Space and Innovative Technology. Economic Development of Space highlights case studies from public-private partnerships that are leading to a new economy in low-Earth orbit (LEO). Businesses provide both transportation to the ISS as well as some research facilities and services. These relationships promote a paradigm shift of government-funded, contractor- provided goods and services to commercially-provided goods purchased by government agencies. Other examples include commercial firms spending their research and development dollars to conduct investigations Value of the Platform
  • 11. xi on ISS and commercial service providers selling services directly to ISS users. This section provides examples of the use of ISS as a testbed for new business relationships and illustrates successful partnerships. The second new section, Innovative Technology, merges technology demonstration and physical science findings that promise to return Earth benefits through continued research. Examples include robotic refueling concepts for life extensions of costly satellites in geo-synchronous orbit that have applications to the robotics industry on Earth, flame behavior experiments that reveal insight into how fuel burns in microgravity leading to the possibility of improving engine efficiency on Earth, and nanostructures and smart fluids examples of materials improvements that are being developed using data from ISS. This publication also expands the benefits of research results in human health, environmental change and disaster response and in education activities developed to capture student imaginations in support of Science, Technology, Engineering and Mathematics, or STEM, education, internationally. Applications to human health of the knowledge gained on ISS continue to grow and improve healthcare technologies and our understanding of human physiology. The ISS is a stepping stone for future space exploration, as the only orbiting multi-disciplinary laboratory of its kind returning research results that develop LEO and improve life on our planet. The goal of this publication is to serve as a source of pride to those who read it and learn of the unique shared laboratory orbiting our planet that provides ground for critical technologies and ways to keep humans healthy in space. Benefits of Research and Technology Benefits for Humanity Themes
  • 12. xii Medical team prepares for SYMBIS Surgical System use in the operating room. Image credit: University of Calgary
  • 13. 1 Human Health The International Space Station is a unique laboratory for performing investigations that affect human health both in space and on Earth. During its time in orbit, the space station has enabled research that is providing a better understanding of many aspects of human health including aging, trauma, disease and environmental impacts. Driven by the need to support astronaut health, several biological and human physiological investigations have yielded important results that we on Earth can also benefit from. These results include new ways to mitigate bone loss, insights into bacterial behavior, and innovative wound- healing techniques. Advances in telemedicine, disease models, psychological stress response systems, nutrition and cell behavior are just a few more examples of the benefits that have been gained from applying studies in orbit to human health back on Earth.
  • 14. 2
  • 15. 3 Robotic arms lend a healing touch The delicate touch that successfully removed an egg-shaped tumor from Paige Nickason’s brain got a helping hand from a world-renowned arm—a robotic arm, that is. The technology that went into developing neuroArm, the world’s first robot capable of perform- ing surgery inside magnetic resonance machines, was born of the Canadarm (developed in collaboration with engineers a MacDonald, Dettwiler, and Associates, Ltd. [MDA] for the U.S. Space Shuttle Program) as well as Canadarm2 and Dextre, the Canadian Space Agency’s family of space robots performing the heavy lifting and maintenance aboard the International Space Station. neuroArm began with the search for a solution to a surgical dilemma: how to make difficult surgeries easier or impossible surgeries possible. MDA worked with a team led by Dr. Garnette Sutherland at the University of Calgary to develop a highly precise robotic arm that works in conjunction with the advanced imaging capa- bilities of magnetic resonance imaging (MRI) systems. Surgeons wanted to be able to perform surgeries while a patient was inside an MRI machine, which meant designing a robot that was as dexterous as the human hand but even more precise and tremor-free. Operat- ing inside the MRI also meant it had to be made en- tirely from safe, MRI compatible materials (for instance, ceramic motors) so that it would not be affected by the MRI’s magnetic field or, conversely, disrupt the MRI’s images. The project team developed novel ways to control the robot’s movements and give the robot’s operator a sense of touch via an intuitive, haptic hand- controller located at a remote work station—essential so that the surgeon can precisely control the robot and can feel the tool-tissue interface during the surgery. Health Technology Research on ISS has allowed for innovations in surgical performance through the world’s first robotic technology capable of performing surgery inside MRI machines. This technology is making difficult brain tumor surgeries easier and impossible surgeries possible. Soon, medical technology stemming from space station robotics will enter clinical trials for use in the early diagnosis and treatment of breast cancer by providing increased access, precision and dexterity resulting in highly accurate and minimally invasive procedures. Development of an advanced technology solution for pediatric surgery is also in the design stages. In common laser surgeries to correct eyesight, a new technology developed on ISS is now used on Earth to track the patient’s eye and precisely direct a laser scalpel. Thermal regulation research on ISS has also led to the use of sensor technology for monitoring during surgery. When medical facilities are not readily available such as in remote and underdeveloped regions of the world, ultrasound units are used in conjunction with protocols for performing complex procedures rapidly with remote expert guidance and training. These telemedicine and remote guidance techniques empower local healthcare providers, provide patients with access to more timely and diagnostic care, and the healthcare system is made more efficient. A lightweight, easy-to-use device to measure nitric oxide in air exhaled by astronauts on ISS is used to study possible airway inflammation before health problems are encountered. This device is now used at some health centers to monitor levels of asthma control leading to more accurate medication dosing, reduced attacks, and improved quality of life. The study of plasmas (charged gases that can permeate many materials and spread evenly and quickly) reveals that they support the disinfecting of chronic wounds, the neutralization of bacteria, the boosting of tumor inactivation, and even the jumpstarting plant growth. Robotic specialists and surgeons sought to make difficult surgeries easier or impossible surgeries possible.
  • 16. 4 Since Paige Nickason’s surgery in 2008, neuroArm has been used in initial clinical experience with 35 patients who were otherwise inoperable. In 2010, the neuroArm technology was licensed to IMRIS Inc., a private, publicly traded medical device manufacturer based in Winnipeg, Manitoba, Canada, for development of the next-generation platform and for wide distribution under the name “SYMBIS Surgical System.” IMRIS is advancing the design to commercialize mini- mally invasive brain tumor resection procedures, which allow surgeons to see detailed, 3-D images of the brain as well as use surgical tools and hand controllers that allow the surgeon to feel tissue and apply pressure when he or she operates. SYMBIS has been undergo- ing calibration, testing and validation at Dr. Sutherland’s research facility since March 2015. SYMBIS is expect- ed to be able to perform microsurgery and stereotactic biopsy within the bore of the magnet while real-time MR images are being acquired. The system is more compact, with improved haptics, safety no-go zones, motion scaling and tremor filters. SYMBIS is currently being reviewed by the FDA, and once approved, the system will be made available commercially for other centers worldwide to establish its clinical efficacy through clinical trials. MDA is also continuing to apply its space technologies and know-how to medical solutions for life on Earth. The company has partnered with the Hospital for Sick Children (SickKids) in Toronto, Ontario, to collaborate on the design and development of an advanced tech- nology solution for pediatric surgery. Dubbed KidsArm, the sophisticated, teleoperated surgical system is being designed specifically to operate on small children and babies. KidsArm is intended for use by surgeons in conjunction with a high-precision, real-time imag- ing technology to reconnect delicate vessels such as veins, arteries or intestines. In collaboration with the Centre for Surgical Invention and Innovation (CSII) in Hamilton, Ontario, MDA is also developing an advanced platform to provide a more accurate and less invasive identification and treatment of breast tumors in the MRI. The image-guided au- tonomous robot (IGAR) will provide increased access, precision and dexterity, resulting in more accurate and less invasive procedures. IGAR is currently in the second phase of clinical trials in Hamilton, Ontario, Canada, and Quebec City, Quebec, Canada. Watch these videos to learn more: neuroArm: http://tinyurl.com/neuroArm KidsArm: http://tinyurl.com/KidsArm IGAR: http://tinyurl.com/CSA-IGAR Medical team prepares for SYMBIS Surgical System use in the operating room. Image credit: University of Calgary “Where the robot entered my head,” says 21-year-old Paige Nickason, the first patient to have brain surgery performed by a robot, as she points to an area on her forehead. “Now that neuroArm has removed the tumor from my brain, it will go on to help many other people like me around the world.” Image credit: University of Calgary
  • 17. 5 Robots from space lead to one-stop breast cancer diagnosis treatment Technology derived from the highly capable robots designed for the International Space Station may soon increase access to life-saving surgical techniques to fight breast cancer. A team of collaborative researchers with the Centre for Surgical Invention and Innovation (CSII) in Canada is working to enhance the quality and access to healthcare through the development and commercialization of innovative medical robotic technologies. In particular, an advanced platform is about to enter clinical trials for use in the early diagnosis and treatment of breast cancer. The main player besides the medical staff is a robot. But not just any robot. This robot’s technology was designed for use aboard the International Space Station by MacDonald, Dettwiler and Associates Ltd. (MDA) for the Canadian Space Agency (CSA). Researchers created the Image-Guided Autonomous Robot (IGAR) from a long line of Canadian heavy lifters and maintenance performers for the space shuttle and space station Canadarm, Canadarm2 and Dextre. In dealing with breast cancer, IGAR is expected to provide increased access, precision and dexterity, resulting in highly accurate and minimally invasive procedures. Dr. Mehran Anvari, chief executive officer and scientific director at CSII, said the IGAR platform moves the use of robotics in surgery to a new dimension, allowing the robot to act in an automated fashion after programming by a physician. IGAR is designed to work in combination with an MRI scanner, which is highly sensitive to early detection of suspicious breast lesions before they possibly turn into a much larger problem. The radiologist uses specially designed software to tag the potential target and tell IGAR what path to take. The software then helps the radiologist to make sure he or she is accurately hitting the right area. IGAR has a special tool interface that can be used to define adaptors for any needle-based biopsy device or a wide range of instruments that remove tissue, known in the medical world as needle- based ablation devices. Anvari explained that the automated robot is capable of placing the biopsy and ablation tools within 1 mm of the lesion in question with a high degree of targeting accuracy, improving sampling, reducing the pain of the procedure, reducing time in the MRI suite and reducing cost as a consequence. He also said that using the robot will allow all radiologists to perform this procedure equally well, regardless of the number of cases per year and move the site of treatment from operation room to radiology suite for a significant number of patients. The radiologist can operate in the challenging magnetic environment of the MRI, providing access to leading tumor-targeting technology. The robot fits on the patient bed, so it can travel in and out of the MRI opening easily. This in turn simplifies the flow of patients in the department, which Dr. Mehran Anvari, chief executive officer and scientific director at the Centre for Surgical Invention and Innovation, with the Image-Guided Autonomous Robot (IGAR) manipulator. Image credit: The Hamilton Spectator ISS technologies enable a robot to provide increased access, precision and dexterity, resulting in highly accurate and minimally invasive surgical procedures.
  • 18. 6 can be challenging to many radiologists, optimizing patient time to diagnose. Dr. Nathalie Duchesne, co-investigator on the clinical study and breast radiologist at the Saint-Sacrament Hospital in Quebec City, Quebec, Canada, has been teaching MRI-guided breast biopsy for years and will be performing the first of three clinical trials. She said there are many steps in the procedure that are operator-dependent, and these steps may prevent good sampling of the lesions if not done properly. Duchesne believes IGAR will decrease the time of the exam, ensure good sampling and increase patient’s comfort during the exam. Duchesne and her team think that IGAR will improve sample collection because it will be less operator-dependent, and it will be constant from one doctor to another, from one patient to the other, and from one lesion to the other. IGAR removes most of the “manual” aspects of the procedure and reduces user-dependence and the level of training required. This allows for a standard process regardless of experience. An expert will program remotely once the patient is in the MRI suite. A physician will then supervise to make sure the patient is comfortable and there are no complications. Anvari said this technology lays the foundation for a family of telerobotic systems, and it has the potential to change the way people think about performing these interventions and ensures that specialized, highly-trained doctors are focusing on the activities to which their training is best suited. Anvari believes this technology will improve efficiency in the health care system by streamlining clinical workflow and allowing highly skilled radiologists to extend their care to a wider population through teleoperation. This robotic technology is not limited only to biopsies. Duchesne explained that IGAR is paving the way for the minimally invasive excision and treatment of small tumors that are often found incidentally during pre-op MRI. The trend toward breast preservation has brought on the importance of lumpectomies. For tumors that may require this procedure because they are invisible to ultrasound and X-ray mammography, researchers are currently developing the ability for IGAR to deploy a radioactive seed—smaller than a grain of rice—near the area of interest. During surgery, the seed can be located with a detector, allowing the doctor to identify the lesion and remove it with increased accuracy and patient comfort. It is expected that follow-up surgeries also will be greatly reduced. Whether it be capturing a visiting spacecraft or helping save lives, Canadian-designed robots are lending a hand. Bringing beneficial technologies from the space station to the ground will hopefully one day allow us to make historic strides in cancer treatment. Watch this video to learn more about IGAR: http://tinyurl.com/CSA-IGAR Improved eye surgery with space hardware Laser surgery to correct eyesight is common practice, and technology developed for use in space is now commonly used on Earth to track the patient’s eye and precisely direct the laser scalpel. When looking at a fixed point while tilting or shaking one’s head, a reflex allows the eyes to automatically IGAR manipulator and full breast intervention platform mounted on the patient support structure with a biopsy tool attached. Image credit: CSii and MDA Artist rendering of IGAR performing a biopsy. Image credit: CSii and MDA
  • 19. 7 hold steady and see clearly even while this move- ment is taking place. This involves the brain constantly interpreting information from the inner ear to maintain balance and stable vision. An essential feature of this sensory system is the use of gravity as a reference. The Eye Tracking Device experiment researched mechanisms involved in this process and how humans’ frames of reference are altered in space. The experi- ment used a specially designed headset fitted with high-performance, image-processing chips able to track the eyes without interfering with an astronaut’s normal work. The results showed that our balance and the overall control of eye movements are indeed affected by weightlessness. These two systems work closely together under normal gravity conditions but become somewhat dissociated in weightlessness. After a flight, it takes several days to weeks for the astronauts to return to normal. The findings point to the entire sensory-motor complex and spatial percep- tion relying on gravity as a reference for orientation. In parallel with its use on the space station, the engi- neers realized the device had potential for applications on Earth. Tracking the eye’s position without interfering with the surgeon’s work is essential in laser surgery. The space technology proved ideal, and the Eye Track- ing Device equipment is now being used in a large proportion of corrective laser surgeries throughout the world. A commercially available version has been delivered to a large number of research laboratories in Europe and North America for ground-based studies. Sensor technologies for high-pressure jobs and operations Novel sensor technologies used within the joint Thermolab experiment (2009-2012) of ESA/DLR have been used for improving our understanding of thermal regulation of astronauts in space. These sensor technologies also hold great potential and benefits for use within many different critical areas from fire-fighting to recognizing exhaustion or early overheating. In fact, the sensor is currently used in hospitals for monitoring during surgeries and on intensive care units. Thermal regulation in the body is vital for our well- being. Our vital organs are kept at a constant temperature of 37° C (98.6 F) whether it is the middle of a freezing winter or on a hot sunny beach. Any disturbance to this stasis can cause symptoms such as physical and mental fatigue or, in the extreme, fatal effects on how the body functions under conditions such as heat stroke and hypothermia. In weightlessness, the adaptation of the cardiovascular system, the lack of convection in space and the shifting of fluids to the upper half of the body could have a negative influence on thermal regulation. Former ESA astronaut Thomas Reiter undertakes the Eye Tracking Device experiment on the ISS in 2006. Image credit: ESA The device developed for ISS allows the tracking of eye position without interfering with a surgeon’s work during corrective laser eye surgery. Sensor technology developed on ISS is now used to monitor thermal regulation during surgeries and in intensive care units.
  • 20. 8 The Thermolab experiment has been looking at changes in thermal regulation and cardiovascular adaptations in weightlessness by investigating how the body heats up and cools down during exercise. The testing of this new type of sensor to record the core body temperature in orbit could have novel applications in space and on Earth. This new sensor was developed for DLR by Charité (Berlin) and Draegerwerk (Lübeck) since standard ground measurement in clinics and surgeries use an internal body probe for taking measurements, which is not practical in orbit. The sensors measure the skin temperature and the heat flow in the skin, which are used to calculate core body temperature using sophisticated algorithms. Compared to on Earth, core body temperature rises faster during exercise on the International Space Station. This is likely caused by fluid shifts and modified heat flow away from the body. It is also noticeable that the body temperature takes longer to cool down to core temperature after exercise. The measurement of the core body temperature together with cardiovascular measurements taken during NASA’s VO2 Max protocol can be used to evaluate the subject’s state of fatigue, which is very important during a space mission for optimising mission success. This makes this non-invasive double sensor a very useful diagnostic tool for recognising early warning signs of fatigue during spacewalks in orbit. On Earth, firefighters, jet pilots, miners, steel workers, soldiers in combat, divers, mountaineers, polar explorers, marine fishermen, and all who work in extreme conditions could benefit from the new measurement technology. Bringing space station ultrasound to the ends of the Earth Fast, efficient and readily available medical attention is key to survival in a health emergency. When a per- son is stricken with injury or illness, getting a quick and accurate diagnosis through medical imaging technol- ogy can be crucial for ensuring proper treatment. For people who live in major cities and towns where fully equipped hospitals are only a quick ambulance ride away, that’s not usually a problem. But for those without medical facilities within easy reach, it can mean the difference between life and death. For astronauts in orbit about 240 miles above Earth aboard the International Space Station, that problem was addressed through the Advanced Diagnostic Ultrasound in Microgravity (ADUM) investigation. Space station astronauts are trained to use a small ultrasound unit aboard the station to examine fellow crewmates. In the event of a health concern, astronauts could use this facility to diagnose many injuries and illnesses with the help of doctors on Earth. Launched in 2011, the ultrasound unit used for ADUM was replaced with a NASA astronaut Sunita Williams uses the Portable Pulmonary Function System whilst on the CEVIS cycle exercise device during a session of the joint Thermolab/EKE/VO2Max experiments in August 2012. Image credit: NASA Medical care becomes more accessible in remote regions by use of small ultrasound units and tele-medicine, and remote guidance techniques, just like those on ISS.
  • 21. 9 smaller and even more sophisticated scanner dubbed Ultrasound 2, currently in use aboard the orbiting laboratory. Now those same techniques are being adapted and used for people living in remote, underdeveloped areas where CT scans, MRIs and even simple X-ray exams are impossible. In partnership with the World Interac- tive Network Focused on Critical Ultrasound (WINFO- CUS), ADUM principal investigator Scott Dulchavsky, M.D., is taking techniques originally developed for space station astronauts and adapting them for use in Earth’s farthest corners by developing protocols for performing complex procedures rapidly with remote expert guidance and training. WINFOCUS is a global network organization whose main goal is to use ultrasound as an enabling point- of-care device in an effort to make medical care more accessible in remote regions. Using the ADUM methods, WINFOCUS has trained over 20,000 physicians and physician extenders in 68 countries. This includes two important holistic healthcare proj- ects: in remote areas of Nicaragua (from 2011) and in Brazil in a statewide healthcare project in partnership with the Secretary of Health of the State of Minas Gerais (since 2012). WINFOCUS has also benefited from the tele-medicine and remote guidance techniques developed for use on the space station, and has adapted and further developed them in order to allow large-scale integra- tion in healthcare systems on Earth through low-cost applications. Local healthcare providers are empow- ered, more patients can access quality and timely diagnostic care, and the healthcare system is made more accessible and efficient. ADUM’s impact is also felt in modern emergency rooms, proving the effectiveness of ultrasound in di- agnosing conditions previously considered beyond its technical capabilities, such as a collapsed lung, which has now become integrated as a standard of care in medical treatments. In addition, the ADUM protocols have proven so effective that they’re now part of the standard medical school curriculum. The American College of Surgeons, which requires ultrasound train- ing for all surgical interns and residents, is using the ADUM program. The ADUM investigation and the WINFOCUS part- nership have brought the promise of space station research back down to Earth in perhaps the most direct and immediate way possible—keeping people healthy and alive, even in remote regions where care was previously a limited option. World Interactive Network Focused on Critical Ultrasound (WINFOCUS) and Henry Ford Innovation Institute members, Dr. Luca Neri and Alberta Spreafico work with Kathleen Garcia from Wyle Engineering to help train Dr. Chamorro from the rural community of Las Salinas, Nicaragua, using the Advanced Diagnostic Ultrasound in Microgravity and tele-ultrasound applications. Image credit: WINFOCUS/Missions of Grace NASA astronaut Tom Marshburn assists Canadian Space Agency astronaut Chris Hadfield with an Ultrasound 2 scan in the Columbus Module of the International Space Station. Image credit: NASA
  • 22. 10 Are you asthmatic? Your new helper comes from space Kalle, a 10-year-old boy, is already in favor of space technology. In the future, he could control his asthma with a small device also used by crew members aboard the International Space Station. Because of it, he knows almost everything about nitric oxide— an important gas we all breathe out. Nitric oxide, or nitrogen monoxide, as it is properly called, is both a good and bad molecule, found almost everywhere as an air pollutant that is produced by vehicle exhaust and industrial processes burning fuel. Nitric oxide is a contributor to the damage of the ozone layer and easily converts into nitric acid—which may fall as acid rain. Intriguingly, tiny amounts of nitric oxide are released locally in inflamed tissue of humans and other mam- mals. Tracing it back to its source can reveal different diseases. In people with asthma, inflammation in the lung adds nitric oxide to exhaled air. Measuring the gas can help to diagnose the disease and may prevent attacks if the levels of nitric oxide indicate that medication should be adjusted. Nitric oxide is also an interesting molecule on the space station. Dust and small particles floating around in weightlessness can be inhaled by the astronauts, possibly triggering inflammation of the airways. It also plays a role in decompression sickness that may arise from spacewalks. The European Space Agency (ESA) uses a lightweight, easy-to-use, accurate device for measuring nitric oxide in exhaled air. The aim is to investigate possible airway inflammation in astronauts and act before it becomes a health problem. Following its development by the Swedish company Aerocrine AB and ESA, the device has been found beneficial in space exploration and everyday use on Earth. NIOX MINO® is now used by patients like Kalle at health centers. They can monitor levels of asthma control and the efficiency of medication—leading to more accurate dosing, reduced attacks and improved quality of life. Cold plasmas assist in wound healing A unique form of matter could help disinfect wounds, neutralize bacteria, help people heal faster, and even fight cancer—and its potential for human health is now well understood, thanks to research on the International Space Station. The microgravity environment provides a powerful method for studying plasmas, one of the four states of matter along with liquid, solid and gas. The Plasma Kristall Experiment (PK-3 Plus) lab, a Rus- sian-German collaboration, provided new insight into an unusual type of matter known as plasma crystals. A lightweight, easy-to-use device monitors levels of asthma control leading to more accurate medication dosing, reduced attacks, and improved quality of life. Former European Space Agency (ESA) astronaut Thomas Reiter undertakes science activities for the Nitric Oxide Analyzer experiment in 2006. Image credit: ESA
  • 23. 11 Because it is a charged gas, plasma can permeate many materials, spreading evenly and quickly. It can disinfect surfaces, and has been proven to neutral- ize drug-resistant bacteria like methicillin-resistant Staphylococcus aureus within seconds. In more than 3,500 examples in several clinical trials, physicians found plasmas can disinfect chronic wounds and help wounds heal faster. Other research has shown that along with chemotherapy, plasma treatment efficiently fights cancer; it can boost tumor inactivation by 500 percent, compared with just chemotherapy. Plasmas can even jumpstart plant growth. For the researchers involved in PK-3, the technical challenges of space-based research provided the knowledge base for the medical spin-offs, accord- ing to Professor Gregor E. Morfill, director at the Max Planck Institute for Extraterrestrial Physics in Garching, Germany. Without space station research, some team members would never have been involved in plasma medicine. The PK-3 lab was designed to study complex or “dusty” plasmas, which get their name from the pres- ence of small, solid particles mixed into the plasma’s charged gases. These particles can dramatically change the behavior of a plasma, and sometimes the particles even form crystalline structures. Dusty plas- mas are found near artificial satellites, occur in Earth’s upper atmosphere, and can be produced in lab set- tings. Physicists favor them because they are relatively easy to control and provide a unique view of physics at the single-particle level. But they can be difficult to study on Earth, because the planet’s gravity affects the way dust particles settle and how they crystallize. This isn’t the case on the space station, however. Investigations with PK-3 Plus created dusty plasmas containing argon or neon gas as well as micron-size particles. The gas molecules received an electric charge so they would ionize and form a plasma, and then particles were injected into it. A laser lit up the sample while a camera recorded the particles moving through the plasma and organizing themselves in Side view of a plasma crystal in the laboratory. Dust particles are suspended in an argon plasma above a high-frequency electrode (bottom). The horizontal field of view is 2 cm. Image credit: Max Planck Institute for Extraterrestrial Physics Plasma studies reveal applications to disinfect chronic wounds, neutralize bacteria, boost tumor inactivation, and jumpstart plant growth. Russian cosmonaut Oleg Kotov, Expedition 30 flight engineer, inspects the Plasma Kristall Experiment laboratory, enclosed in black housing, in its new home in the Poisk Mini-Research Module 2 of the International Space Station. Image credit: RKK-Energia
  • 24. 12 crystal structures. Basic experiments tested a wide range of particle sizes and different gas types, and researchers found a plethora of interesting new phenomena. In one example, researchers used the PK-3 Plus high-resolution camera to examine the exact point at which matter changes its phase from liquid to solid. Other experiments tested how radio waves cause particles in a dusty plasma to move. Beyond basic science, dusty plasmas have several practical applications in space and on Earth. For instance, some computer chips are manufactured us- ing a processing plasma, and removal of microscopic particles is crucial for preventing chip contamination. Understanding how gases and dusty plasmas interact is critical for improving this technology. A better grasp of this interaction could also help scientists create powders containing specific ingredients, for applica- tions like agriculture, hygiene and medicine. And plasmas hold great promise for treating sick and injured people on Earth. Astronauts and cosmonauts operated the PK-3 Plus equipment during 20 separate missions across a six-year period, each lasting about five days. All told, collaborators on the PK-3 Plus investigation and its predecessor, PKE-Nefedov, have published more than 70 scientific papers and given at least 100 presenta- tions at scientific conferences. The past PK investigations may be concluded in space, but plasma medicine research in particular continues to produce new applications—which will further increase with the PK-4 investigation for which new hardware was commissioned on ISS in November 2014.
  • 25. 13 Preventing bone loss in spaceflight with prophylactic use of bisphosphonate: Health promotion of the elderly by space medicine technologies Bone loss and kidney stones are well-known as es- sential problems for astronauts to overcome during extended stays in space. Crew members engage in physical exercise for two-and-a-half hours a day, six times a week (15 hours a week) while in orbit to avoid these issues. Nevertheless, the risks of these problems occurring cannot be completely eliminated through physical exercise alone. Bone plays an important role as a structure that sup- ports the body and stores calcium. It retains fracture resistance by remodeling through a balance of bone resorption and formation. In a microgravity environ- ment, because of reduced loading stimuli, there is increased bone resorption and no change in or pos- sibly decreased bone formation, leading to bone mass loss at a rate of about 10 times that of osteoporosis. The proximal femoral bone loses 1.0 to 1.5 percent of its mass per month, or roughly 6 to 10 percent over a six-month stay in space, with the recovery after returning to Earth taking at least three or four years. The calcium balance (the difference between intake and excretion), which is about zero on Earth, decreas- es to about -250 mg/day during flight, a value that increases the risk of kidney stones. Bisphosphonate is a therapeutic agent that has been used to treat osteoporosis patients for more than Preventing Bone Loss The common problem of bone loss in the elderly is also observed in astronauts when they are in space. Ongoing studies on ISS indicate a reduction in bone loss and renal stone risk through use of a bisphosphonate and exercise to increase bone load and muscle training, and in a well-balanced, low-sodium diet. In promoting the health of the elderly at risk of osteoporosis, improved scanning technologies are under development to provide a reference technique to enable the early detection of osteoporosis and in the development of more effective countermeasures to its effects. Ongoing studies indicate a reduction in bone loss and renal stone risk through use of a bisphosphonate and exercise. JAXA astronaut Soichi Noguchi performs exercise aboard the International Space Station. Image credit: JAXA/NASA
  • 26. 14 a decade, with a proven efficacy to increase bone mass and decrease the occurrence of bone frac- ture. Through 90-day bed rest research on Earth, we confirmed that this agent has a preventive effect on the loss of bone mass. Based on these results as well as studies conducted by others, Japan Aerospace Exploration Agency (JAXA) and NASA decided to col- laborate on a space biomedical experiment to prevent bone loss during spaceflight. Dr. Adrain Leblanc, United Space Research Association, and Dr. Toshio Matsumoto, Tokushima University, are the two principal investigators of this study. JAXA and NASA crew members are participating in this study by taking this agent once a week while in space. The study is still ongoing; however, early results suggest that astronauts can significantly reduce the risk of bone loss and renal stones with the combination of resistive exercise and an antiresorptive such as a bisphosphonate. Bone loss is also observed in bedridden older people. Elderly people lose 1 or 2 percent per year of their bone mass because of aging and a decline in the amount of female hormone. Osteoporosis is declared when a person has a bone mass 30 percent lower than the average for young adults, which is a condition affecting 13 million Japanese and one in two women aged 70 years and older. Every year, 160 thousand patients undergo operations for femoral neck frac- tures in Japan, followed by intense rehabilitation for three months. Such operations cost 1.5 million yen per person, and the total annual expense for medical treatments and care of these bone fractures amounts to 66.57 billion yen in total national cost. The three key elements for promoting the health of el- derly people to prevent fractures are nutrition, exercise and medicine. Meals should be nutritionally balanced with calcium-rich foods (milk, small fish, etc.) and vitamin D (fish, mushrooms, etc.). Limited sunbathing Astronauts enjoy meals aboard the International Space Station. Image credit: JAXA/NASA
  • 27. 15 is also important for activation of vitamin D. Physical exercise to increase bone load and muscle training should also be integrated into each person’s daily life. Those at high risk for fractures should take effective medicines to reduce the risk of fractures. Accordingly, the secrets of the promotion of astro- nauts’ health obtained from space medicine are expected to be utilized to promote the health of elderly people and the education of children. Improved scanning technologies and insights into osteoporosis ESA’s Early Detection of Osteoporosis in Space (EDOS) experiment has been testing skeletal adaptation to long-term space exposure by using 3-D peripheral quantitative computed tomography (3DpQCT) as a technique for detection of bone structure. It has been providing a detailed evaluation of the bone loss and of kinetics of recovery after flight. ESA supported the development of the enhanced 3-D scanner by the Institute for Biomedical Engineering in Zürich and Scanco Medical as part of ESA’s Microgravity Applica- tions Programme (MAP). The scanner is providing high-quality, 3-D images of living bone structures as part of this ground experiment. This is backed up by analysis of bone biochemical markers in blood samples. One important element that has derived from this research into bone loss in space is the successful commercialisation of the 3DpQCT scanner, of which ESA supported the development, for a non-invasive/in vivo technique for observation of bone structure. The EDOS project has been assessing the efficiency of such a technique and will contribute to the devel- opment of a reference technique to perform an early detection of osteoporosis on Earth in a unique way. These improved diagnostics in the early stages of such a medical condition may prove extremely important in development of more effective countermeasures to the effects of osteoporosis. In 2006, according to the Inter- national Osteoporosis Foundation, 8.9 million fractures were estimated worldwide. The project will continue within the EDOS-2 project, which will commence in collaboration with Russia in spring 2015 in conjunction with the first one-year mission. Good diet, proper exercise help protect astronauts’ bones Eating right and exercising hard in space helps protect International Space Station astronauts’ bones, a find- ing that may help solve one of the key problems facing future explorers heading beyond low-Earth orbit. A study published in the September 2012 issue of the Journal of Bone and Mineral Research looked at the mineral density of specific bones as well as the entire skeleton of astronauts who used a new, stronger “weight lifting” machine. Of course, weights don’t really Early detection of osteoporosis, and the development of more effective treatments, link astro- nauts to patients on Earth. After 51 years of human spaceflight, we have made significant progress in protecting bone health through diet and exercise. Xtreme CT distal radius. Image credit: SCANCO Medical
  • 28. 16 “weigh” anything on the space station, but resistance machines allow astronauts to get the same kind of workout. The new Advanced Resistive Exercise Device (ARED), installed in 2008, doubles the maximum simu- lated weight to as much as 600 pounds. Researchers compared measurements from 2006 until 2008 when astronauts used a less capable workout machine. They found that astronauts using the ad- vanced system came home with more lean muscle and less fat and kept more of their whole body and regional bone mineral density. Those same astronauts also consumed sufficient calories and vitamin D, among other nutrients. These factors are known to support bone health and likely played a contributing role. After 51 years of human spaceflight, these data mark the first significant progress in protecting bone through diet and exercise. Since the 1990s, resistance exercise has been thought to be a key method of protecting astronauts’ bones. Normal, healthy bone constantly breaks down and renews itself, a process called re- modeling. As long as these processes are in balance, bone mass and density stay the same. Earlier studies of Russian Mir space station residents found an in- creased rate of breakdown but little change in the rate of regrowth, resulting in an overall loss in bone density. In the new study, astronauts who used the ARED device still had increased bone breakdown, but their bone renewal tended to increase, likely resulting in a better balance in whole bone-mineral density. Bone density loss in astronauts on long-duration mis- sions has been a major medical concern. In the past, astronauts have lost an average of 1 to 2 percent per month. By comparison, an elderly person loses about 1 to 2 percent per year. This study shows that, through proper exercise and nutrition, crew members on long journeys in space can return to Earth with much less loss of bone mineral density. But a key question remains as to whether the bones are as strong as when the astronaut launched into space. For these and other reasons, additional studies to evaluate bone strength before and after flight are currently under way. Beyond bone strength, further study is needed to figure out the best possible combination of exercise and diet for long-duration crews. One experiment on the space station right now is looking at how differ- ent ratios of animal protein and potassium in the diet affect bone health. Another is looking at the benefits NASA Astronaut Dan Burbank, Expedition 30 commander, exercises using the Advanced Resistive Exercise Device aboard the International Space Station. Image credit: JAXA/NASA NASA astronaut Jeffrey Williams, Expedition 22 commander, exercises using the Advanced Resistive Exercise Device in the Tranquility node of the International Space Station. Image credit: NASA
  • 29. 17 of lowering sodium intake. NASA food scientists have reformulated more than 80 space foods to reduce the sodium content. Information gained through space station studies like these will be critical in enabling humans to explore destinations beyond low-Earth orbit. Add salt? Astronauts’ bones say please don’t Osteoporosis is a harsh disease that reduces the quality of life for millions and costs Europe around €25 billion ($31 billion) each year. It typically affects the elderly, so the rise in life expectancy in developed countries means the problems inflicted by osteoporo- sis are increasing. Fortunately, research done in space may change the game. Astronauts on the International Space Station experience accelerated osteoporosis because of weightlessness, but it is carefully controlled, and they can regain their lost bone mass in time once they are back on Earth. Studying what happens during long spaceflights offers a good insight into the process of osteoporosis—losing calcium and changing bone structure—and helps to develop methods to combat it. It has been known since the 1990s that the human body holds on to sodium, without the corresponding water retention, during long stays in space. But the ISS research provides insight into the benefits of reduced sodium and increased bicarbonate consumption for those prone to osteoporosis. European Space Agence (ESA) astronaut André Kuipers (left) and Russian cosmonaut Oleg Kononenko (right) with food items on the International Space Station in December 2011. In the SOdium LOad in microgravity experiment, astronaut subjects undergo two different diet regimes to determine the physiological effects of sodium on the body. Image credit: ESA
  • 30. 18 textbooks said this was not possible. “Sodium reten- tion in space” became an important subject to study. Salt intake was investigated in a series of studies, in ground-based simulations and in space, and it was found that not only is sodium retained (probably in the skin), but it also affects the acid balance of the body and bone metabolism. So, high salt intake increases acidity in the body, which can accelerate bone loss. The European Space Agency’s (ESA’s) recent SOdium LOad in microgravity (SOLO) study zoomed in on this question. Nine crew members, including ESA’s Frank De Winne and Paolo Nespoli during their long-duration flights in 2010 and 2011, followed low- and high-salt diets. The expected results may show that additional negative effects can be avoided either by reducing sodium intake or by using a simple alkalizing agent like bicarbonate to counter the acid imbalance. This space research directly benefits everybody on Earth who is prone to osteoporosis. 3-D pQCT image of osteoporotic bone. Image credit: Scanco Medical AG The SOdium LOad in microgravity experiment carries out research into salt retention and its effect on bone metabolism in astronauts, which can help provide insights into medical conditions on Earth, such as osteoporosis. Image credit: Istockphoto/S.Kaulitzki European Space Agence (ESA) astronaut Frank De Winne undertakes a body mass measurement, an essential element of the SOdium LOad in microgravity experiment, on the space station. Image credit: ESA
  • 31. 19 Early detection of immune changes prevents painful shingles in astronauts and in Earth-bound patients1 The physiological, emotional and psychological stress associated with spaceflight can result in decreased im- munity that reactivates the virus that causes shingles, a disease punctuated by painful skin lesions. NASA has developed a technology that can detect immune changes early enough to begin treatment before pain- ful lesions appear in astronauts and people here on Earth. This early detection and treatment will reduce the duration of the disease and the incidence of long-term consequences. Spaceflight alters some elements of the human im- mune system: innate immunity, an early line of defense against infectious agents, and specific components of cellular immunity are decreased in astronauts. Astronauts do not experience increased incidence or severity of infectious disease during short-duration spaceflight, but NASA scientists are concerned about Immune Defenses Virtually the entire population is infected with one of eight herpes viruses, four of which reactivate and appear in body fluids in response to the stress of spaceflight. A patent-pending device designed for use in either a doctor’s office or on a spacecraft allow for the rapid detection of one of these viruses (VZV), which can lead to earlier treatment and prevent the onset of painful shingles. Microgravity studies on ISS help researchers pinpoint genetic triggers for immune responses in T-cells leading to future medical treatments on Earth for immunosuppression. Determining the changes that occur to the immune system in space is providing the means to develop targeted countermeasures to adverse effects in space, as well as providing additional information for targeted treatments on Earth for the development of pharmaceuti- cals that can suppress immune response to help manage autoimmune diseases or organ transplants. Space research has led to the rapid detection of Varicella (chickenpox virus), which improves treatment of shingles. 1Adapted from an original article that appeared in NASA Technology Innovation, Vol 15; 3, 2010; NP-2010-06-658-HQ. Varicella zoster-infected MeWo cells showing typical herpes virus-induced, multinucleated giant cells. Cultures are stained with acrydine orange to identify RNA (red) in the cytoplasm. Image credit: NASA
  • 32. 20 how the immune system will function over the long stays in space that may be required for exploration missions. To determine specific causes of decreased immunity in healthy individuals is difficult, but the herpes viruses have become valuable tools in early detection of changes in the immune system, based largely on the astronaut studies. Eight herpes viruses may reside in the human body, and virtually all of us are infected by one or more of these viruses. Herpes viruses cause diseases including common “fever blisters” (herpes simplex virus or HSV), infectious mononucleosis (Epstein-Barr virus or EBV), chickenpox and shingles (varicella zoster virus or VZV). In immune-suppressed individuals, herpes viruses may cause several types of cancer, such as carcinoma, lymphoproliferative disease and others. According to the Centers for Disease Control and Prevention, one million cases of shingles occur yearly in the U.S., and 100,000 to 200,000 of these cases develop into a particularly painful and sometimes debilitating condition known as post-herpetic neural- gia, which can last for months or years. The other seven herpes viruses also exist in an inactive state in different body tissues much like VZV, and similarly they may also reactivate and cause disease during periods of decreased immunity. The most common cause of decreasing immunity is age, but chronic stress also results in decreased im- munity and increases risk of the secondary disease, such as VZV-driven shingles. Chemotherapy, organ transplants and infectious diseases, such as human immunodeficiency virus (HIV), also result in decreased immunity. Thus, viral reactivation has been identified as an important indicator of clinically relevant immune changes. Studies of immune-compromised individuals indicate that these patients shed EBV in saliva at rates 90-fold higher than found in healthy individuals. The herpes viruses are already present in astronauts, as they are in at least 95 percent of the general adult population worldwide. So measuring the appearance of herpes viruses in astronaut body fluids is critical. It is widely believed that various stressors associated with spaceflight are responsible for the observed decreased immunity. Researchers at NASA’s Johnson Space Center found that four human herpes viruses reactivate and appear in body fluids in response to spaceflight. Due to the reduced cellular immunity, the viruses can emerge from their latent state into active infectious agents. The multiplying viruses are released into saliva, urine or blood and can be detected and quantified by a method called polymerase chain reaction (PCR) for each specific virus. The finding of VZV in saliva of astronauts was the first report of VZV being reactivated and shed in asymptomatic individuals, therefore posing a risk of disease in uninfected individuals. However, the PCR assay requires large, complex equipment, which is not practical for spaceflight. To overcome this obstacle, NASA developed a rapid method of detection of VZV in body fluids, and a patent application is currently pending for it. The new technology requires a small sample of saliva, which is mixed with specialized reagents that produce a red color only when VZV is present. This technology makes possible early detection, before the appearance of skin lesions. Early detection allows for early administration of antiviral therapy and thus limits nerve damage and prevents overt disease. The device is designed for use in doctors’ offices or spacecraft and can be modified easily for use with other viruses in saliva, urine, blood and spinal fluid. The sensitivity and specificity ema- nates from an antibody-antigen reaction. In another collaborative study, NASA and University of Colorado Health Science Center (Denver) researchers developed a tool to assess stress hormones during space shuttle missions. Saliva samples are collected on individual filter paper strips and tested once back on Earth. The test measures cortisol and dehydro- epiandrosterone (DHEA), two important stress and immune regulatory hormones. The filter paper also can be used for proteins and other molecules of interest in saliva. Booklets of these filter papers now are being used in university and government laboratories for remote saliva collection. These studies demonstrate the potential value of bringing to the general public a technology that could prevent a painful and debilitating condition in up to one million people each year in the U.S. alone. Station immunology insights for Earth and space When people get sick, their immune systems kick into gear to tell their bodies how to heal. T-cells—white blood cells that act like tiny generals—order an army of immune cells to organize and attack the enemy. Microgravity studies aboard the International Space Station are helping researchers pinpoint what drives these responses, leading to future medical treatments on Earth. Scientists have known since the early days of human spaceflight that living in microgravity suppresses the immune system. During the Apollo Program, for instance, 15 of the 29 astronauts developed an
  • 33. 21 infection either during or right after flight. Forty years later, Leukin results show that immunosuppression begins within the first 60 hours of flight. Findings from this investigation, led by Millie Hughes- Fulford, Ph.D., a former NASA astronaut and director of the Laboratory of Cell Growth at the University of California, San Francisco, enabled researchers to pinpoint some specific genetic triggers for the go/no go of the immune system responses in the T-cells. It was the first time scientists have been able to prove that gravity is making a difference in activation of the T-cell. A healthy body depends on these T-cells giving orders for the immune system to function properly as it marches into battle. There are factors that can hinder victory, however, such as signal interruption, delayed responses or even outright cell death. A suppressed immune system is like an army with an ineffective leader, significantly reducing the chances of a successful fight. Results revealed that specific genes within T-cells showed down regulation—a decrease in cell re- sponse—when exposed to microgravity. This com- bined down regulation in the genetics of T-cells leads to a reduction in the body’s defense against infections during spaceflight in various ways. For instance, there is a reduced proinflammatory response, the cell’s pro- tective reaction to initiate healing. Cells also produce fewer cytokines, the proteins responsible for signaling communications between cells. There is even a nega- tive impact to a cell’s ability to multiply, known as mi- togenesis, the chromosomal splitting in a cell nucleus necessary for cell reproduction. Examples of immunosuppression on Earth include the AIDS-related HIV infection, rheumatoid arthritis and even age-related impacts to the immune system, which is why the elderly have a difficult time fighting off infections like pneumonia. Identifying how the immune system works at the cellular level provides a powerful tool to develop treatments at the root of the defense response. This is like a negotiation for peace talks before conflict breaks out, instead of trying to raise a white flag in the midst of an already raging battle. If doctors can isolate and control specific immune responses, they increase the chance for recovery. With the removal of gravity as its own variable, the data gathered from immune studies in space can be used to help understand some of the immune chal- lenges seen in these populations on Earth. Hughes-Fulford launched a follow-on immunology study aboard the space station, funded by a grant from the National Institutes of Health and spon- sored by the Center for Advancement of Science in Space (http://www.iss-casis.org/). Launching on the SpaceX-3 commercial resupply mission, the investiga- tion, called T-Cell Activation in Aging, investigates at another class of control points in T-cells that trigger immune response. Finding the genes that tell the cells to turn on and off is key to advancing medical options to improve immune system functions. Data analysis is underway, with the potential to pinpoint new candidate pharmaceutical targets to treat immunosuppression. Targeted treatments to improve immune response Cell biology experiments have been uncovering different aspects of altered immune system response in weightlessness. Determining the changes that occur to the immune system in space is providing the means to develop targeted countermeasures to ad- verse effects in space, as well as providing additional Microgravity studies on ISS help researchers pinpoint genetic triggers for immune responses in T-cells leading to future medical treatments. Expedition 30 Flight Engineer Andre Kuipers, European Space Agency, works with the Kubik facility in the Columbus Module of the International Space Station. Image credit: NASA
  • 34. 22 information for targeted treatments on Earth. This could either be for the purpose of developing pharma- ceuticals that can improve treatment and recovery from certain medical conditions or alternatively targeted treatments that can suppress immune response, for example to help deal with autoimmune diseases or organ transplants. Research undertaken in the Kubik incubators has uncovered many altered mechanisms that occur in the immune system in space using biological samples processed at body temperature at 0 g and 1 g (centrifuge) in orbit. This has included discovering reduced function in monocyte white blood cells that is due to a disrupted cytoskeleton. This is an apparent in- hibition of the Protein Kinase C family of enzymes and a specific immune cell transmitter, called the Rel/NF-κB pathway, which stops working in weightlessness. All of these are important mechanisms in immune response. One of the most recent ESA experiments in this domain was the ROle of Apoptosis in Lymphocyte Depression (ROALD) experiment series, which was undertaken in 2008 with a follow-up experiment in 2011. In the first part of the experiment, researchers discovered that a particular enzyme called 5-LOX, which in part regulates the life expectancy of human cells, became more active in weightlessness and could play a real role in causing weakened immune systems. The 5-LOX enzyme can be blocked with existing drugs, so using these findings to improve human health could be a close reality. Additional efforts to understand this treatment pathway, targeting patient treatment on Earth, is ongoing. ESA astronaut Thomas Reiter undertakes in-orbit activities for one of ESA’s immunology experiments in 2006. Image credit: ESA ISS research provides the means to develop pharmaceuticals and targeted treatments that can suppress immune response to help deal with autoimmune diseases or organ transplants.
  • 35. 23 Developing New Therapies Studying the unique and complicated structures of proteins in the human body leads to the development of medical treatments. Microgravity allows unique conditions for growth of protein crystals where there is no gravity or convection to disrupt their growth. The protein expressed in certain muscle fibers of patients with Duchenne Muscular Dystrophy, which affects 1 in 3,500 boys, has been successfully crystallized in space revealing a new inhibitor several hundred times stronger than the prototype inhibitor. Microencapsulation is the process by which tiny, liquid-filled, biodegradable micro-balloons are created containing specific combinations of concentrated anti-tumor drugs. The goal is to deliver this medication using specialized needles to specific treatment sites within a cancer patient. The microgravity environment, where density differences do not cause layering of the medication, has allowed for the development of devices on Earth to create these microcapsules and devices that will aid in the drug delivery using this technology. Progress continues towards clinical studies in cancer patients one day in the future. Ongoing research of gravitational unloading supported by dry immersion technology allows for a broad spectrum of possible clinical applications such as the early diagnosis of slow-developing neurological disorders, the combating of edema that responds poorly to medication, post-operative rehabilitation, sports medicine and rehabilitation for premature babies. High-quality protein crystal growth experiment aboard Kibo There are more than 100,000 proteins in the human body and as many as 10 billion in nature. Every structure is different, and each one of them holds important information related to our health and to the global environment. Each protein has a unique and complicated structure, which is closely related to its function. Therefore, revealing protein structure leads to an understanding of its function. However, it is difficult to analyze protein structures here on Earth, where gravity interferes with optimal growth. The perfect environment in which to study these structures is space; microgravity means there is no convection to disrupt the liquid solution, nor is there precipitation to cause heavier molecules to sink. Therefore, protein molecules form orderly, high-quality crystals that provide optimal structures for study. Many crystals of various proteins have been created in the unique environment of space. The Japan Aerospace Exploration Agency (JAXA) has conducted nine sessions of protein crystallization experiments since 2003 in the Zvezda service module and has developed techniques to produce high-quality protein crystals in space. Based on these techniques, JAXA executed six sessions of experiments for the first series for the High-quality Protein Crystal Growth experiment (JAXA PCG) in the Japanese Kibo module on the space station from July 2009 to May 2013. JAXA is conducting another six sessions in total as the second series by periodic flight opportunities of six- month intervals. The first session of the second-series experiments started in March 2014. Through collaboration with the Russian Federal Space Agency (Roscosmos), protein samples are launched to the space station aboard the Russian Progress or Soyuz spacecraft. Soon after the docking, the samples are brought into Kibo to be placed inside the Protein Crystallization Research Facility (PCRF) where they Microgravity allows for optimal growth of the unique and complicated crystal structures of proteins leading to the development of medical treatments.
  • 36. 24 are kept for a period of one-and-a-half to four months at a stable temperature, 68 degrees Fahrenheit (20 degrees Celsius). A counter-diffusion method called “Gel-Tube method” is used for crystallization whereby polyethylene glycol or salt solution is diffused into the protein solution separated by a porous membrane inside a tube. In this method, concentration of polyethylene glycol in the protein solution gradually increases and finally satisfies the condition for protein crystallization. One of the major purposes of the protein crystal growth experiments is the contribution to the develop- ment of medical treatments. The relationship between a certain protein that causes disease and its medicine that suppresses the disease can be compared to the relationship between a “keyhole” and its “key.” If the shape of the keyhole becomes apparent by examining the structure of the protein, treatment-oriented medicine with few side effects—the key to fit the keyhole—can be designed. JAXA is making positive advancements in research on obstinate diseases through experiments in space with the hope of supporting medical care more effectively. An example of a protein that was successfully crys- tallized in space is hematopoietic prostaglandin D synthase (H-PGDS). This protein may hold the key to treating disease. A research team at the Osaka Biosci- ence Institute (OBI) reported that H-PGDS is expressed in certain muscle fibers of patients with Duchenne muscular dystrophy (DMD). An inherited muscle disorder, DMD is the most common form of muscular dystrophy, affecting approximately 1 in 3,500 boys. DMD causes muscular wasting and accelerates the progression of muscular deterioration. It is an obstinate disease for which a fundamental mode of treatment has not yet been found. Therefore, H-PGDS-specific inhibitors are considered to be useful drugs for muscu- lar dystrophy. High-quality crystals of H-PGDS-Inhibitor complexes. The detailed structure of muscular dystrophy related-protein became clear through a space experiment. Image credit: Osaka Bioscience Institute/ Tsukuba University/Maruwa Foods and Biosciences, Inc./JAXA Advantage of the Space Experiment. Because the structure of the disease-causing protein, or the keyhole, is vague when it is obtained on the ground, the shape of the key, or a medicine candidate compound for treatment cannot be determined. However, it is possible to find the structure of the disease-causing protein through the space experiments and medicine that fits the treatment (the key that fits the keyhole) can be developed. Image credit: JAXA
  • 37. 25 The OBI research team has successfully determined the 3-D structure of H-PGDS in a complex with a prototype H PGDS-specific inhibitor. H-PGDS has been crystallized several times in microgravity as part of JAXA’s space experiments. Using X-ray crystal- lographic analysis—using X-rays to determine the structure—researchers determined the structure of the high-quality crystals of H-PGDS-inhibitor complexes grown in space, and as a result, discovered a new in- hibitor with several hundred times stronger activity than the prototype inhibitor. This particular experiment is an example of how understanding a protein’s structure can lead to better drug designs. Further research is ongoing. Cancer-targeted treatments from space station discoveries Invasive and systemic cancer treatment is a necessary evil for many people with the devastating diagnosis. These patients endure therapies with ravaging side effects, including nausea, immune suppression, hair loss and even organ failure, in hopes of eradicating cancerous tissues in the body. If treatments targeted a patient’s cancerous tissues, it could provide clinicians with an alternative to lessen the delivery of toxic levels of chemotherapy or radiation. Remarkably, research that began in space may soon result in such options here on Earth. Using the distinctive, microgravity environment aboard the International Space Station, a particular series of research investigations is making further advance- ments in cancer therapy. A process investigated aboard the space station known as microencapsula- tion is able to produce tiny, liquid-filled, biodegrad- able micro-balloons containing specific combinations of concentrated anti-tumor drugs. Using specialized needles, doctors could deliver these micro-balloons, or microcapsules, directly to specific treatment sites within a cancer patient, effectively revolutionizing cancer treatment. Dr. Dennis Morrison of NASA’s Johnson Space Center used the microgravity environment aboard the space station for microencapsulation experiments as a tool to develop the Earth-based technology, called the Microencapsulation Electrostatic Processing System-II (MEPS-II), to make the most effective microcapsules. The technique for making these microcapsules could not be done on Earth, because the different densities of the liquids would layer. But in space, microgravity brought together two liquids incapable of mixing on Earth (80 percent water and 20 percent oil) in such a way that spontaneously caused liquid-filled microcap- sules to form as spherical, tiny, liquid-filled bubbles sur- rounded by a thin, semipermeable, outer membrane. In space, surface tension shapes liquids into spheres. Each molecule on a liquid’s surface is pulled with equal tension by its neighbors. The closely integrated molecules form into the smallest possible area, which is a sphere. In effect, the MEPS-II system allowed a combination of liquids in a bubble shape because surface tension forces took over and allowed the fluids to interface rather than sit atop one another. Studying the samples upon return to Earth allowed scientists to understand how to make a device that could create the same microcapsules on Earth. The microgravity environment has allowed for the develop- ment of devices on Earth to create microcapsules that could aid in drug delivery. The oil contains a visualization marker that is traceable by ultrasound and CT scans to allow doctors to follow the microcapsules as they are site-specifically delivered to the tumor. The semipermeable outer skin releases the drug slowly, through its physical ability to be timed released. Image credit: NuVue Therapeutics, Inc.
  • 38. 26 The MEPS-II system is now being brought to com- mercial scale under U.S. Food and Drug Administra- tion (FDA) Good Manufacturing Practice requirements, and commercialization of the MEPS technology and methods to develop new applications for these unique microcapsules has already begun. The space station research led to 13 licensed microcapsule-related patents and two that are pending. In laboratory testing, MEPS-II microcapsules contain- ing anticancer drugs were injected directly into a hu- man prostate and lung tumors in animal models. These models were then, in follow-on tests, also injected following the delivery of specific cryo-surgical effects, similar to a freeze and thaw effect on the tumorous tissues. Injecting the microcapsules directly into the tumor demonstrated improved site-specific therapeutic results and the inhibition of tumor growth. Following cryo-surgery, the microcapsules demonstrat- ed improved destruction of the tumor better than freezing or local chemotherapy alone. Though Morrison’s previous laboratory studies of microcapsules were primarily focused on prostate and lung cancer, his studies now target breast cancer for the FDA approval process through development with NuVue Therapeutics, Inc. Though it will take a few years to get approval to use the microcapsules as a treatment option filled with anti-tumor drug therapies, several devices that will aid in drug delivery using this technology are planned for pre-clinical study as early as 2015. After achieving full FDA approval, planned clinical trials will involve injecting the microcapsules with the anti- tumor drugs directly into tumor sites in humans at both MD Anderson Cancer Center in Houston and the Mayo Cancer Center in Scottsdale, Ariz. Given the success in animal models in laboratory studies with human prostate and lung tumor treatment, Morrison has high hopes in the near future of being able to begin use of the microcapsule treatment in breast cancer. These kinds of technologies are enabled by the avail- ability of the microgravity environment aboard the space station. Just as microgravity can aid in the discovery of new technologies for cancer treatment, these microcapsules may one day aid in the recovery of breast and other specific deep-tissue cancers. Using weightlessness to treat multiple ailments The technology of dry immersion was developed as an Earth-based model to study the effect of micrograv- ity factors on the human body. Using this model, the effectiveness of measures developed to prevent the negative impact of spaceflight factors on people has been and continues to be evaluated. The countermea- sures currently used on the International Space Station were tested in experiments involving dry immersion. Experts at the Institute of Biomedical Problems (IBMP) developed the automated immersion system to create water hypodynamia (utility model patent #44505 “Immersion bath” and invention patent #2441713 “Polymer covering and device for dry immersion”). The concept of the technology involves submerging a person in an immersion bath filled with water. The immersion system is an ergonomically designed tub with a built-in elevation mechanism, filtration, and tem- perature control systems. The subject is kept separate from the water by a thin water-proof cloth with an area significantly exceeding the area of the water’s surface. In this way, conditions closely simulating the lack of Dr. Dennis Morrison poses with the Microencap- sulation Electrostatic Processing System flight hardware that was used on the International Space Station to produce microcapsules for cancer treatment delivery. Image credit: NASA Ongoing research on dry immersion technology allows for a broad spectrum of possible clinical applications.
  • 39. 27 gravity are recreated. As a result, changes typical of acute gravitational unloading are reproduced in the body. The potential use of the system for health purposes relates to the specific physiological changes in the body caused by gravitational unloading. In particular, acute disruptions occur in the mechanisms of sensory interaction. These disruptions counteract compensa- tory processes in the central nervous system resulting in discovery of latent neurological disruptions. Treat- ment with dry immersion is also accompanied by a number of physiological shifts such as the redistribu- tion of fluids in the body, which have positive effects in certain cardiovascular conditions such as edema. The drug-free method of dry immersion offers the user: relaxation of muscles; increase in immunity; elimination of edema; and, normalization of blood pressure, thus making it possible to use the immer- sion system for the early diagnosis of slow-developing neurological disorders and to combat massive edema that responds poorly to pharmacological remedies. Its use may also be an effective mechanism in reha- bilitative treatment in areas such as psychoneurology, traumatology, orthopedics (post-operative rehabilita- tion), sports medicine, clinical neurophysiology, and applied psycho-physiology. The use of the immersion system is also a particularly valuable rehabilitation measure for premature babies who are exposed to the effects of gravity following the intrauterine environment. Perinatal damage to the central nervous system (hyperexcitability; depressive, muscle hypertonia, and cephalohematoma syndromes) is an opportunity for the use of the dry immersion method. Additional uses for dry immersion include treatment of immune disorders, hormone imbalances, muscle disease, wound healing, and cardiovascular health. The spectrum of possible applications of this system that simulates spaceflight conditions, such as those experienced by the International Space Station, is fairly broad and will expand with further study. Dry Immersion Complex (prototype). Image credit: Institute of Biomedical Problems, Russia New prototype of the automated immersion system used in clinics. Image credit: Aerospace Medical Center and Technology
  • 40. 28

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