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Meertens R, Knapp KM, Strain WD, Casanova F, Ball S, Fulford J, Thorn C. In vivo Measurement of Intraosseous Vascular Haemodynamic Markers in Human Bone Tissue Utilising Near Infrared Spectroscopy. Front Physiol 2021; 12:738239. [PMID: 34630158 PMCID: PMC8497693 DOI: 10.3389/fphys.2021.738239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Poor vascular health is associated with reduced bone strength and increased risk of fragility fracture. However, direct measurement of intraosseous vascular health is difficult due to the density and mineral content of bone. We investigated the feasibility of using a commercially available continuous wave near infrared spectroscopy (NIRS) system for the investigation of vascular haemodynamics in human bone in vivo. Approach: An arterial occlusion (AO) protocol was developed for obtaining haemodynamic measurements of the proximal tibia and lateral calf, including assessment of the protocol’s intra operator reproducibility. For 36 participants, intraosseous haemodynamics derived by NIRS were compared to alternative tests of bone health based on dual x-ray absorptiometry (DXA) testing and MRI. Main Results: Near infrared spectroscopy markers of haemodynamics of the proximal tibia demonstrated acceptable reproducibility, comparable with reproducibility assessments of alternative modalities measuring intraosseous haemodynamics, and the use of NIRS for measuring muscle. Novel associations have been demonstrated between haemodynamic markers of bone measured with NIRS and body composition and bone mineral density (BMD) measurements obtained with both DXA and MRI. Significance: Near infrared spectroscopy provides inexpensive, non-invasive, safe, and real time data on changes in oxygenated and deoxygenated haemoglobin concentration in bone at the proximal tibia. This study has demonstrated the potential for NIRS to contribute to research investigating the pathophysiological role of vascular dysfunction within bone tissue, but also the limitations and need for further development of NIRS technology.
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Affiliation(s)
- Robert Meertens
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Karen M Knapp
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | | | - Francesco Casanova
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Susan Ball
- NIHR Applied Research Collaboration South West Peninsula (PenARC), College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Jon Fulford
- NIHR Exeter Clinical Research Facility, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Clare Thorn
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
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Abstract
Bone is a highly vascularized tissue. However, despite the importance of appropriate circulation for bone health, regulation of bone blood flow remains poorly understood. Invasive animal studies suggest that sympathetic activity plays an important role in bone flow control. However, it remains unknown if bone vasculature evidences robust vasoconstriction in response to sympathoexcitatory stimuli. Here, we characterized bone blood flow in young healthy individuals [n = 13, (four females)] in response to isometric handgrip exercise (IHE) and cold pressor test (CPT). These provide a strong stimulus for active vasoconstriction in the inactive muscle, and perhaps also in the bone. During sustained IHE to fatigue and CPT, we measured blood pressure, whole leg blood flow, and tibial perfusion using near-infrared spectroscopy. Tibia perfusion was determined as oxy- and deoxyhemoglobin. For both stimuli, tibial metabolism remained constant (i.e., no change in deoxyhemoglobin) and thus tibial arterial perfusion was represented by oxyhemoglobin. During IHE, oxyhemoglobin declined (beginning -0.20 ± 1.04 μM; end -1.13 ± 3.71 μM, both P < 0.01) slower than whole leg blood flow (beginning -0.85 ± 1.02 cm/s; end -2.72 ± 1.64 cm/s, both P < 0.01). However, during CPT, both oxyhemoglobin (beginning -0.46 ± 1.43 μM; end -0.60 ± 1.59 μM, both P < 0.01) and whole leg blood flow (beginning -1.52 ± 1.63 cm/s; end -0.69 ± 1.51 cm/s, both P < 0.01) declined with a similar timecourse, even though the magnitudes of decline were smaller than during IHE. These responses are likely due to the different timecourses of sympathetically mediated vasoconstriction in bone and muscle. These results indicate that sympathetic innervation of the bone vasculature serves a functional role in the control of flow in young healthy individuals.NEW & NOTEWORTHY The current study is the first one to noninvasively investigate control of bone blood perfusion in vivo in humans, on a moment-by-moment basis. Our results indicate that tibial bone vasculature demonstrates active vasoconstriction in response to sympathoexcitatory stimuli in young healthy individuals. Compared with whole leg vasculature, bone vasoconstrictor response seems to be smaller, delayed, and more variable.
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Affiliation(s)
- Adina E Draghici
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.,Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, Massachusetts
| | - J Andrew Taylor
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.,Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, Massachusetts
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Abstract
Diseases and associated fragility of bone is an important medical issue. There is increasing evidence that bone health is related to blood flow and oxygen delivery. The development of non-invasive methods to evaluate bone blood flow and oxygen delivery promise to improve the detection and treatment of bone health in human. Near-infrared spectroscopy (NIRS) has been used to evaluate oxygen levels, blood flow, and metabolism in skeletal muscle and brain. While the limited penetration depth of NIRS restricts its application, NIRS studies have been performed on the medial aspect of the tibia and some other prominent bone sites. Two approaches using NIRS to evaluate bone health are discussed: (1) the rate of re-oxygenation of bone after a short bout of ischemia, and (2) the dynamics of oxygen levels during an intervention such as resistance exercise. Early studies have shown these approaches to have the potential to evaluate bone vascular health as well as the predicted efficacy of an intervention before changes in bone composition are detectable. Future studies are needed to fully develop and exploit the use of NIRS technology for the study of bone health.
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Affiliation(s)
- Chuan Zhang
- Department of Kinesiology, University of Georgia, Athens, GA, United States
| | - Kevin K McCully
- Department of Kinesiology, University of Georgia, Athens, GA, United States
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Kim MS, Park J. Immediate Effects of an Inverted Body Position on Energy Expenditure and Blood Lactate Removal after Intense Running. Applied Sciences 2020; 10:6645. [DOI: 10.3390/app10196645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We compared the immediate effects of a cool-down strategy including an inverted body position (IBP: continuous 30-s alternations of supine and IBP) after a short period of an intense treadmill run with active (walking) and passive (seated) methods. Fifteen healthy subjects (22 years, 172 cm, 67 kg) completed three cool-down conditions (in a counterbalanced order) followed by a 5-min static stretch on three separate days. Heart rate, energy expenditure, blood lactate concentration, fatigue perception, and circumference of thighs and calves were recorded at pre- and post-run at 0, 5, 10, 20, and 30 min. At 5 min post-run, subjects performing the IBP condition showed (1) a 22% slower heart rate (p < 0.0001, ES = 2.52) and 14% lower energy expenditure (p = 0.01, ES = 0.48) than in the active condition, and (2) a 23% lower blood lactate than in the passive condition (p = 0.001, ES = 0.82). Fatigue perception and circumferences of thighs and calves did not differ between the conditions at any time point (F10,238 < 0.96, p < 0.99 for all tests). IBP appears to produce an effect similar to that of an active cool-down in blood lactate removal with less energy expenditure. This cool-down strategy is recommended for tournament sporting events with short breaks between matches, such as Taekwondo, Judo, and wrestling.
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Goswami N, Blaber AP, Hinghofer-Szalkay H, Convertino VA. Lower Body Negative Pressure: Physiological Effects, Applications, and Implementation. Physiol Rev 2019; 99:807-851. [PMID: 30540225 DOI: 10.1152/physrev.00006.2018] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
This review presents lower body negative pressure (LBNP) as a unique tool to investigate the physiology of integrated systemic compensatory responses to altered hemodynamic patterns during conditions of central hypovolemia in humans. An early review published in Physiological Reviews over 40 yr ago (Wolthuis et al. Physiol Rev 54: 566-595, 1974) focused on the use of LBNP as a tool to study effects of central hypovolemia, while more than a decade ago a review appeared that focused on LBNP as a model of hemorrhagic shock (Cooke et al. J Appl Physiol (1985) 96: 1249-1261, 2004). Since then there has been a great deal of new research that has applied LBNP to investigate complex physiological responses to a variety of challenges including orthostasis, hemorrhage, and other important stressors seen in humans such as microgravity encountered during spaceflight. The LBNP stimulus has provided novel insights into the physiology underlying areas such as intolerance to reduced central blood volume, sex differences concerning blood pressure regulation, autonomic dysfunctions, adaptations to exercise training, and effects of space flight. Furthermore, approaching cardiovascular assessment using prediction models for orthostatic capacity in healthy populations, derived from LBNP tolerance protocols, has provided important insights into the mechanisms of orthostatic hypotension and central hypovolemia, especially in some patient populations as well as in healthy subjects. This review also presents a concise discussion of mathematical modeling regarding compensatory responses induced by LBNP. Given the diverse applications of LBNP, it is to be expected that new and innovative applications of LBNP will be developed to explore the complex physiological mechanisms that underline health and disease.
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Affiliation(s)
- Nandu Goswami
- Physiology Section, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz , Graz , Austria ; Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia , Canada ; Battlefield Health & Trauma Center for Human Integrative Physiology, Combat Casualty Care Research Program, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
| | - Andrew Philip Blaber
- Physiology Section, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz , Graz , Austria ; Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia , Canada ; Battlefield Health & Trauma Center for Human Integrative Physiology, Combat Casualty Care Research Program, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
| | - Helmut Hinghofer-Szalkay
- Physiology Section, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz , Graz , Austria ; Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia , Canada ; Battlefield Health & Trauma Center for Human Integrative Physiology, Combat Casualty Care Research Program, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
| | - Victor A Convertino
- Physiology Section, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz , Graz , Austria ; Department of Biomedical Physiology and Kinesiology, Simon Fraser University , Burnaby, British Columbia , Canada ; Battlefield Health & Trauma Center for Human Integrative Physiology, Combat Casualty Care Research Program, US Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas
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Meertens R, Casanova F, Knapp KM, Thorn C, Strain WD. Use of near-infrared systems for investigations of hemodynamics in human in vivo bone tissue: A systematic review. J Orthop Res 2018; 36:2595-2603. [PMID: 29727022 DOI: 10.1002/jor.24035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/27/2018] [Indexed: 02/04/2023]
Abstract
A range of technologies using near infrared (NIR) light have shown promise at providing real time measurements of hemodynamic markers in bone tissue in vivo, an exciting prospect given existing difficulties in measuring hemodynamics in bone tissue. This systematic review aimed to evaluate the evidence for this potential use of NIR systems, establishing their potential as a research tool in this field. Major electronic databases including MEDLINE and EMBASE were searched using pre-planned search strategies with broad scope for any in vivo use of NIR technologies in human bone tissue. Following identification of studies by title and abstract screening, full text inclusion was determined by double blind assessment using predefined criteria. Full text studies for inclusion were data extracted using a predesigned proforma and quality assessed. Narrative synthesis was appropriate given the wide heterogeneity of included studies. Eighty-eight full text studies fulfilled the inclusion criteria, 57 addressing laser Doppler flowmetry (56 intra-operatively), 21 near infrared spectroscopy, and 10 photoplethysmography. The heterogeneity of the methodologies included differing hemodynamic markers, measurement protocols, anatomical locations, and research applications, making meaningful direct comparisons impossible. Further, studies were often limited by small sample sizes with potential selection biases, detection biases, and wide variability in results between participants. Despite promising potential in the use of NIR light to interrogate bone circulation, the application of NIR systems in bone requires rigorous assessment of the reproducibility of potential hemodynamic markers and further validation of these markers against alternative physiologically relevant reference standards. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2595-2603, 2018.
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Affiliation(s)
- Robert Meertens
- Medical Imaging, University of Exeter Medical School, South Cloisters, St Luke's Campus, Heavitree Road, Exeter EX2 1LU, United Kingdom
| | - Francesco Casanova
- Diabetes and Vascular Research Centre, University of Exeter Medical School and National Institute of Health Research Exeter Clinical Research Facility, Barrack Rd, Exeter EX2 5DW, United Kingdom
| | - Karen M Knapp
- Medical Imaging, University of Exeter Medical School, South Cloisters, St Luke's Campus, Heavitree Road, Exeter EX2 1LU, United Kingdom
| | - Clare Thorn
- Diabetes and Vascular Research Centre, University of Exeter Medical School and National Institute of Health Research Exeter Clinical Research Facility, Barrack Rd, Exeter EX2 5DW, United Kingdom
| | - William David Strain
- Diabetes and Vascular Research Centre, University of Exeter Medical School and National Institute of Health Research Exeter Clinical Research Facility, Barrack Rd, Exeter EX2 5DW, United Kingdom
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Dziuda Ł, Krej M, Śmietanowski M, Sobotnicki A, Sobiech M, Kwaśny P, Brzozowska A, Baran P, Kowalczuk K, Skibniewski FW. Development and evaluation of a novel system for inducing orthostatic challenge by tilt tests and lower body negative pressure. Sci Rep 2018; 8:7793. [PMID: 29773912 PMCID: PMC5958117 DOI: 10.1038/s41598-018-26173-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 05/08/2018] [Indexed: 01/28/2023] Open
Abstract
Lower body negative pressure (LBNP) is a method derived from space medicine, which in recent years has been increasingly used by clinicians to assess the efficiency of the cardiovascular regulatory mechanisms. LBNP with combined tilt testing is considered as an effective form of training to prevent orthostatic intolerance. We have developed a prototype system comprising a tilt table and LBNP chamber, and tested it in the context of the feasibility of the device for assessing the pilots' efficiency. The table allows for controlled tilting in the range from -45 to +80° at the maximum change rate of 45°/s. The LBNP value can smoothly be adjusted down to -100 mmHg at up to 20 mmHg/s. 17 subjects took part in the pilot study. A 24-minute scenario included -100 mmHg supine LBNP, head up tilt (HUT) and -60 mmHg LBNP associated with HUT, separated by resting phases. The most noticeable changes were observed in stroke volume (SV). During supine LBNP, HUT and the combined stimulus, a decrease of the SV value by 20%, 40% and below 50%, respectively, were detected. The proposed system can map any pre-programed tilt and LBNP profiles, and the pilot study confirmed the efficiency of performing experimental procedures.
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Affiliation(s)
- Łukasz Dziuda
- Department of Flight Simulator Innovations, Military Institute of Aviation Medicine, ul. Krasińskiego 54/56, 01-755, Warszawa, Poland.
| | - Mariusz Krej
- Department of Flight Simulator Innovations, Military Institute of Aviation Medicine, ul. Krasińskiego 54/56, 01-755, Warszawa, Poland
| | - Maciej Śmietanowski
- Department of Experimental and Clinical Physiology, Medical University of Warsaw, ul. Banacha 1B, 02-097, Warszawa, Poland
| | - Aleksander Sobotnicki
- Department of Research and Development, Institute of Medical Technology and Equipment, ul. Roosevelta 118, 41-800, Zabrze, 41-800, Poland
| | - Mariusz Sobiech
- Department of Research and Development, Institute of Medical Technology and Equipment, ul. Roosevelta 118, 41-800, Zabrze, 41-800, Poland
| | - Piotr Kwaśny
- ETC-PZL Aerospace Industries Sp. z o.o., Aleja Krakowska 110/114, 02-256, Warszawa, Poland
| | - Anna Brzozowska
- ETC-PZL Aerospace Industries Sp. z o.o., Aleja Krakowska 110/114, 02-256, Warszawa, Poland
| | - Paulina Baran
- Department of Flight Simulator Innovations, Military Institute of Aviation Medicine, ul. Krasińskiego 54/56, 01-755, Warszawa, Poland
| | - Krzysztof Kowalczuk
- Department of Simulator Studies and Aeromedical Training, Military Institute of Aviation Medicine, ul. Krasińskiego 54/56, 01-755, Warszawa, Poland
| | - Franciszek W Skibniewski
- Department of Flight Simulator Innovations, Military Institute of Aviation Medicine, ul. Krasińskiego 54/56, 01-755, Warszawa, Poland
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Howden M, Siamwala JH, Hargens AR. Bone microvascular flow differs from skin microvascular flow in response to head-down tilt. J Appl Physiol (1985) 2017; 123:860-866. [PMID: 28663380 DOI: 10.1152/japplphysiol.00881.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 06/01/2017] [Accepted: 06/22/2017] [Indexed: 11/22/2022] Open
Abstract
Loss of hydrostatic pressures in microgravity may alter skin and bone microvascular flows in the lower extremities and potentially reduce wound healing and bone fracture repair. The purpose of this study was to determine the rate at which skin and bone microvascular flows respond to head-down tilt (HDT). We hypothesized that microvascular flows in tibial bone and overlying skin would increase at different rates during HDT. Tibial bone and skin microvascular flows were measured simultaneously using photoplethysmography (PPG) in a total of 17 subjects during sitting (control posture), supine, 6° HDT, 15° HDT, and 30° HDT postures in random order. With greater angles of HDT, bone microvascular flow increased significantly, but skin microvascular flow did not change. Tibial bone microvascular flow increased from the sitting control posture (0.77 ± 0.41 V) to supine (1.95 ± 1.01 V, P = 0.001) and from supine posture to 15° HDT (3.74 ± 2.43 V, P = 0.004) and 30° HDT (3.91 ± 2.68 V, P = 0.006). Skin microvascular flow increased from sitting (0.703 ± 0.75 V) to supine (2.19 ± 1.72 V, P = 0.02) but did not change from supine posture to HDT (P = 1.0). We show for the first time that microcirculatory flows in skin and bone of the leg respond to simulated microgravity at different rates. These altered levels of blood perfusion may affect rates of wound and bone fracture healing in spaceflight.NEW & NOTEWORTHY Our data show that bone microvascular flow increases more than cutaneous blood flow with greater degrees of head-down tilt. A higher level of perfusion in bone may give insight into the bone mineral density loss in lower extremities of astronauts and why similar tissue degradation is not observed in the skin of the same areas.
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Affiliation(s)
- Michelle Howden
- Department of Orthopedic Surgery, University of California, San Diego, California
| | - Jamila H Siamwala
- Department of Orthopedic Surgery, University of California, San Diego, California
| | - Alan R Hargens
- Department of Orthopedic Surgery, University of California, San Diego, California
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Siamwala JH, Macias BR, Lee PC, Hargens AR. Gender differences in tibial microvascular flow responses to head down tilt and lower body negative pressure. Physiol Rep 2017; 5:5/4/e13143. [PMID: 28242824 PMCID: PMC5328775 DOI: 10.14814/phy2.13143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/05/2017] [Accepted: 01/08/2017] [Indexed: 11/24/2022] Open
Abstract
The purpose of the investigation was to study lower body negative pressure recovery in response to head down tilt position in men and women. The study examined the primary hypothesis that tibial bone microvascular flow responses to HDT and lower body negative pressure (LBNP) differ in women and men. Nine women and nine men between 20 to 30 years of age participated in the study. Tibial microvascular flow, head and tibial oxygenation and calf circumference were measured using photoplethysmography (PPG), near‐infrared spectroscopy (NIRS) and strain gauge plethysmography (SGP), respectively, during sitting (control baseline), supine, 15° HDT, and 15° HDT with 25 mmHg LBNP. Tibial microvascular flow with HDT increased by 57% from supine position (from 1.4V ± 0.7 to 2.2V ± 1.0 HDT; ANOVA P < 0.05) in men but there is no significant difference between supine and HDT in women. Ten minutes of LBNP during 15oHDT restored tibial bone microvascular flows to supine levels, (from 2.2V±1.0 HDT to 1.1V ± 0.7 supine; ANOVA P < 0.05) in men but not in women. These data support the concept that there are gender specific microvascular responses to a fluid‐shift countermeasure such as LBNP. Thus, gender differences should be considered while developing future countermeasure strategies to headward fluid shifts in microgravity.
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Affiliation(s)
- Jamila H Siamwala
- Department of Orthopedic Surgery, University of California, San Diego, California
| | - Brandon R Macias
- Department of Orthopedic Surgery, University of California, San Diego, California
| | - Paul C Lee
- Department of Orthopedic Surgery, University of California, San Diego, California
| | - Alan R Hargens
- Department of Orthopedic Surgery, University of California, San Diego, California
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Grimm D, Grosse J, Wehland M, Mann V, Reseland JE, Sundaresan A, Corydon TJ. The impact of microgravity on bone in humans. Bone 2016; 87:44-56. [PMID: 27032715 DOI: 10.1016/j.bone.2015.12.057] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/17/2015] [Accepted: 12/18/2015] [Indexed: 12/22/2022]
Abstract
Experiencing real weightlessness in space is a dream for many of us who are interested in space research. Although space traveling fascinates us, it can cause both short-term and long-term health problems. Microgravity is the most important influence on the human organism in space. The human body undergoes dramatic changes during a long-term spaceflight. In this review, we will mainly focus on changes in calcium, sodium and bone metabolism of space travelers. Moreover, we report on the current knowledge on the mechanisms of bone loss in space, available models to simulate the effects of microgravity on bone on Earth as well as the combined effects of microgravity and cosmic radiation on bone. The available countermeasures applied in space will also be evaluated.
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Affiliation(s)
- Daniela Grimm
- Department of Biomedicine, Aarhus University, DK-8000 Aarhus C, Denmark.
| | - Jirka Grosse
- Department of Nuclear Medicine Germany, University of Regensburg, D-93042 Regensburg, Germany
| | - Markus Wehland
- Clinic for Plastic, Aesthetic and Hand Surgery, Otto-von-Guericke University, D-39120 Magdeburg, Germany
| | - Vivek Mann
- Department of Biology, Texas Southern University, 3100 Cleburne, Houston, TX 77004, USA
| | - Janne Elin Reseland
- Department of Biomaterials, Faculty of Dentistry, University of Oslo, N-0317 Oslo, Norway
| | - Alamelu Sundaresan
- Department of Biology, Texas Southern University, 3100 Cleburne, Houston, TX 77004, USA
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