Adjuvant pharmacological strategies for the musculoskeletal system during long-term space missions

Microgravity-induced changes in skeletal muscle and possible countermeasures: What we can learn from bed rest and human space studies

Despite exercise countermeasures to sustain health and performance in spaceflight, complete maintenance of muscle mass and functions in microgravity is still not possible for most astronauts. The principal cause of the limited effectiveness of existing exercise countermeasures is the difficulty in achieving full loading forces in space. The implementation of countermeasures which require small devices and simulate Earth-like loading forces to maintain muscle mass, strength and endurance is therefore highly desirable. At present, the cellular mechanisms that induce muscle atrophy in weightlessness are not yet fully known; a better understanding of how skeletal muscle cells adapt to microgravity will help in designing more effective countermeasures to sustain the health and operational capacity of the crew during long- and short-duration missions. The 6° head-down-tilt bed rest is a powerful ground-based analogue platform to simulate and study the physiological effects of spaceflight on the human body, and test the effectiveness of countermeasures before they are potentially applied in space. The aims of this narrative review are therefore to provide an overview of (i) the main mechanisms underlining muscle atrophy learnt from space and bed rest studies, (ii) the currently available countermeasures, and (iii) potential suitable countermeasures - such as neuromuscular electrical stimulation that is delivered with light and small portable units - to attenuate muscle wasting in astronauts during spaceflight.

Advancing insights into microgravity induced muscle changes using Caenorhabditis elegans as a model organism

Spaceflight presents significant challenges to the physiological state of living organisms. This can be due to the microgravity environment experienced during long-term space missions, resulting in alterations in muscle structure and function, such as atrophy. However, a comprehensive understanding of the adaptive mechanisms of biological systems is required to devise potential solutions and therapeutic approaches for adapting to spaceflight conditions. This review examines the current understanding of the challenges posed by spaceflight on physiological changes, alterations in metabolism, dysregulation of pathways and the suitability and advantages of using the model organism Caenorhabditis elegans nematodes to study the effects of spaceflight. Research has shown that changes in the gene and protein composition of nematodes significantly occur across various larval stages and rearing environments, including both microgravity and Earth gravity settings, often mirroring changes observed in astronauts. Additionally, the review explores significant insights into the fundamental metabolic changes associated with muscle atrophy and growth, which could lead to the development of diagnostic biomarkers and innovative techniques to prevent and counteract muscle atrophy. These insights not only advance our understanding of microgravity-induced muscle atrophy but also lay the groundwork for the development of targeted interventions to mitigate its effects in the future.

Human hypoxia models in aerospace medicine: Potential applications for human pharmacological research

Aerospace medicine required controlled terrestrial models to investigate influences of altered atmosphere conditions, such as hypoxia, on human health and performance. These models could potentially be expanded to encompass disease conditions or treatment targets regulated through hypoxia or hypercapnia. Hypoxia, a condition in which the body is deprived of adequate oxygen supply, profoundly affects human physiology at multiple levels and contributes to the pathogenesis of various diseases. Experimental exposure to hypoxic conditions has gained recognition as a model for studying diseases such as pulmonary hypertension, chronic obstructive pulmonary disease, obstructive sleep apnoea, migraine and kidney disease. This approach may be particularly useful in mechanism-oriented early-stage clinical studies. This review discusses the ability of hypoxia models from space medicine research to mimic or induce these conditions in a controlled laboratory setting as a tool for testing the efficacy and safety of new pharmaceutical interventions.