Pictured: NASA astronaut Jasmin Moghbeli processes liver stem cell samples aboard the International Space Station/Flickr, NASA Johnson
Biomedical research, the bedrock of medical advancements on Earth, has always been a maze of challenges. From the complexities of human biology to the unpredictability of diseases, researchers are in a constant battle with variables that can alter the course of a study. But what if there was a way to sidestep some of these Earth-bound limitations? This is where space, the next frontier in clinical research, comes into play.
With its unique environment of microgravity, space offers a fresh perspective for research. In microgravity, where the gravitational pull is much weaker than on Earth, cells and molecules behave differently. This unique environment can provide insights into diseases and their treatments that are impossible to achieve here on Earth.
Cell Behavior in the Cosmic Lab
One of the most intriguing aspects of space-based research is cells’ behavior in microgravity. On Earth, when cells are grown in labs, they tend to flatten on the surface of culture dishes. However, in space, they take on more natural, three-dimensional shapes, allowing for more in-depth study of diseases and potential treatments. For instance, a study aboard the International Space Station (ISS) is currently exploring how a type of cancer called diffuse midline glioma (DMG) develops.
DMG is a brain tumor originating from the central nervous system’s glial cells, often located in the brainstem’s pons region. Predominantly affecting children aged 5-7, DMG constitutes 10–15% of pediatric brain tumors in the U.S., resulting in 150–300 new cases annually. Tragically, the two-year survival rate after diagnosis is below 10% for children with DMG. By studying these DMG cancer cells in space, researchers hope to gain insights into their structure and composition that could lead to more robust and effective treatments.
Heart Matters: Cardiac Discoveries in Orbit
Cancer takes a heavy toll on humanity, but the burden of cardiovascular disease is even greater, accounting for 20 million fatalities each year globally. Intriguingly, the vast expanse of space may hold the key to potential remedies for heart-related ailments.
In 2018, NASA launched a study to explore the development of heart cells, known as cardiomyocytes, in the unique environment of space. This research concluded that in the unique conditions of space, specific sets of stem cells are more likely to develop into heart muscle cells called cardiomyocytes. Building on this insight, another study, MVP Cell-03, concluded that these heart cells not only developed more frequently in space but could also be used to treat heart problems caused by long space flights or heart diseases on Earth.
Protein Crystallography in Space
While the heart is central to circulating blood, it's the myriad 20,000 proteins in our bodies that truly govern our physiological functions, driving nearly every chemical process within us. Understanding proteins’ structure can help in developing new medicines. In the unique environment of space, proteins form larger and more orderly crystals than on Earth. This allows scientists a clearer insight into their makeup. For instance, the NanoRacks-PCG Therapeutic Discovery project in space has provided valuable information on proteins associated with leukemia and breast and skin cancers. Similarly, research on the KRAS protein, which is linked to several cancers, has been enhanced by space studies, offering hope for more effective cancer treatments in the future.
International Collaborations in Space-Based Clinical Research
While individual studies and projects shed light on the potential of space-based research, it takes collaborative efforts on a global scale to truly amplify the impact and reach of these discoveries. In one initiative, Russia’s State Space Corporation, Roscosmos, introduced the “Kristallizator” program, which is centered around cultivating distinct protein crystals suitable for X-ray analysis. The knowledge gained from this initiative is paving the way for the development of novel tuberculosis treatments. Meanwhile, the Japan Aerospace Exploration Agency, JAXA, continues its pioneering space work, which has identified potential therapeutic agents for conditions such as Duchenne muscular dystrophy.
Challenges in Space-Based Clinical Research
The allure of space for clinical research is undeniable, but it comes with unique challenges. First, the logistics of transporting experiments to space are intricate. Launching payloads into space requires meticulous planning, ensuring that the sensitive equipment and samples can withstand the rigors of space travel. The high costs associated with these launches can also be prohibitive. Every kilogram sent to space comes with a hefty price tag, making budgeting a significant concern for researchers.
The International Space Station (ISS), one of the primary venues for space-based research, has limited availability. With numerous countries and private entities vying for a spot on the ISS research schedule, securing a slot for research can be competitive. Another concern is the long-term effects of microgravity on the health of the humans tasked with carrying out experiments in space. While we have gleaned some insights from astronauts who have spent extended periods in space, there is still much we don’t know about how prolonged exposure to microgravity might affect our cellular processes, immune system or even DNA. These unknown risks add layers of complexity to research in space. But every challenge presents an opportunity.
Innovative Solutions: Paving the Way Forward
The beauty of challenges is that they drive innovation. Imagine pop-up labs in space: compact, deployable research stations that can be launched affordably, making space research more accessible to smaller institutions. Telemedicine techniques, already transforming healthcare on Earth, could be adapted for space, allowing real-time consultations between astronauts and Earth-bound experts. And as we look to the future, partnerships between countries and even private companies could lead to shared research spaces in orbit, democratizing access and fostering collaboration. The concept of “space habitats”—self-sustaining environments beyond the ISS—is gaining traction, potentially extending research opportunities. Furthermore, the integration of AI and machine learning in space research can help in real-time data analysis, making research more efficient and actionable.
Steering the Ship: Governance in Space-Based Research
As we venture deeper into the cosmos, our guiding principles in space research must be firmly rooted in ethics, transparency and collaboration. Disease and drug research, with its inherent complexities, demands a robust and adaptive governance framework, especially when conducted in the unique environment of space. This framework should prioritize collaboration and the ethical use of shared resources in space, ensuring that every space-based laboratory research project adheres to rigorous global standards and responsible practices.
The concept of a space research consortium offers a promising solution. By bringing together nations and private stakeholders, this consortium would democratize research opportunities, ensuring that space becomes a shared laboratory for humanity. More than just a collaborative platform, it would set universal ethical standards for research in space. Open-source research, championed by this consortium, would ensure that discoveries made beyond our atmosphere themselves transcend geopolitical boundaries and are accessible and beneficial to all.
From Earth to the Stars: A New Chapter in Laboratory Research
Space, the final frontier, offers more than just stars and galaxies: It presents a unique canvas for clinical laboratory research. As we decode the mysteries of cells in microgravity and harness the potential of proteins crystallized in space, we’re writing a new chapter in medical science. But this journey, as exhilarating as it is, demands a compass guided by strong collaboration between public and private entities and a deep commitment to ethical usage of shared resources in space. As we set our sights on the cosmos, let’s ensure that our voyage is not just about reaching new heights but also about elevating the standards of research here on Earth for the betterment of all.
Deepika Khedekar is a clinical trial lead at IQVIA Inc, a global clinical research organization where she spearheads clinical trial monitoring programs for major pharmaceutical companies. In her 12+ years in the pharmaceutical industry, she led Phase I, II and III clinical trial programs in respiratory and gastrointestinal therapeutics and drugs for leading U.S.- and Australia-based pharmaceutical organizations such as Gilead Sciences, Macleods Pharma, Arrowhead Pharmaceuticals, NoNO Inc., EpimAb and Impact Pharma.