News: 3 Questions: Space as scientific, medical and technology accelerator

Advancing medical capabilities in space and for planetary exploration can also lead to translating these innovations for human health on earth.

Mindy Blodgett | IMES

Testing human physiology—monitoring, predicting, counteracting and treating human reactions to being in space conditions—this is a key part of the research conducted by Lonnie G. Petersen, Samuel A Globlith Career Development Professor of Applied Biology, associate professor of Aeronautics and Astronautics, and a core faculty member at IMES. 

But Petersen, who has PhD in gravitational physiology and space medicine, and an MD, both from the University of Copenhagen, describes her research as following two parallel tracks: a "spin-up" track which is focused on space and aviation physiology including investigating effects of spaceflight on the human body; and a "spin-down" track focused on medical device and technology development.

The goal of the research is to not only to make spaceflight safer, but to apply knowledge gained in space for human health on earth. Petersen leads the Aerospace Physiology Lab at MIT, and has a background in anesthesiology, serving in intensive and pre-hospital care and remote area medicine including service as regional physician in Greenland. 

You have described your research as following two parallel tracks: one that is focused on space and aviation physiology, and another that is focused on medical device and technology development. How do these two approaches align, and what are some goals you have for innovations that will result from this research?

One way to classify the work of my lab is according to the applications. We have several “spin-up” lines of research which are focused on improving health and performance of astronauts both during space flight and for future Moon/Mars missions. We are focused on developing countermeasures that keep our crew healthy, but also advancing medical capabilities when disease or trauma inevitably will occur during a space mission. Also included in the “spin-up” applications is aviation—I am very interested in how aviation impacts human health. In my clinical work, I have flown many aerial patient transportations and medical evacuations—a significant part of my research is motivated by my clinical experience and dedicated to making Medical and Casualty Evacuation more efficient and safer. 

To achieve these goals, we test human physiology, push it to the limit, and we develop technology to either monitor, predict, counteract or treat to maintain optimal helath and performance—so that is the other component of the work. I sometimes call this the “spin-down” angle because although much of our medical technology development initially is intended for space and aviation, it often finds much more broad application in terrestrial medicine. 

Some specific examples to illustrate how the areas align are countermeasure development. When astronauts spend weeks to months in space, the lack of gravitational stress leads to a cascade of adaptations, these include weakening of bones and muscles, but importantly also a headward blood and fluid re-distribution which eventually causes a fluid accumulation in the brain and impaired vision. My lab use Lower Body Negative Pressure to simulate effects of gravity—the negative pressure displaces blood and fluid towards the feet – just like gravity does when we stand up on Earth. I usually call LBNP “poor-man’s gravity” and it will protect vison and keep the brain normal and healthy. We have created a wearable version of the LBNP-suit which the astronauts can wear just like pants and experience impact of 1G while they are floating around in space going about everyday talks. When we return humans to the Moon, they will impacted by 16%G—we do not expect this to be enough to fully prevent the negative impact of low gravity, so the crew can wear the LBNP-suit and it will augment the partial gravity back up to 1G. But astronauts are nor the only ones with too high pressure in the brain or too much fluid – we have a broad category of patients here on earth with the same challenges and we have shown that LBNP can immediately reduce pressure and alleviate symptoms in these patients. We are therefore now translating this astronaut-countermeasure into a medical device for patients on Earth. 

In general, there is much overlap between the spin-up and the spin-down: maintaining human health and performance in a resource limited and austere environment precents the same challenges whether we are talking about the surface of the Moon, in orbit, aeromedical evacuation, rural Kansas, the arctics, or an active battlefield. I am passionate about advancing medical capabilities also beyond the normal hospital setting

Last year, you were a co-investigator on the SpaceXray project, one of 22 science experiments that astronauts conducted during the Fram2 mission, the first human spaceflight mission to travel in a polar orbit. You helped to define and design the protocol around the project. Can you share what some of the findings have been from this project, and how taking the first in-orbit X-ray images can help make longer-term space travel safer?

This is one of those tangible examples of how we can advance medical capabilities in space and for planetary exploration. The spaceXrays were taken by the crew on the FRAM2 mission inside the SpaceX Dragon capsule. I was very excited to see if the increased background radiation in space would interfere with diagnostic quality of the images. This mission was the first ever human mission in a polar orbit, which has even more background radiation compared to other orbits in low earth orbit – as such it was actually the perfect mission to test the Xray system. The main finding was that the quality of the images was maintained! The crew was able to take radiographs of both hands, forearms and chest Xrays. There is much more work left to do, and we are currently working on expanding the capability and creating procedural guidelines for this diagnostic tool in space medicine. 

If I take off my MD-hat and put on my engineering hat, the data is equally significant, because in addition to imaging humans, the crew also took Xrays of hardware and small devices – we asked them for this to evaluate the potential of Xrays for non-destructive testing of hardware in space. This is a useful tool routinely used in in aviation and other areas, and now we have shown it works equally well in space and can be used to e.g. evaluate spacesuits before an EVA or for future lunar-surface mission to further investigate lunar rocks and regolith. This project therefore increased the diagnostic capability not only for humans but also for hardware and other items. 

You were quoted in a recent Boston Globe article on developments in space medicine as saying that “Space is like New York. If you can make it there, you can make it anywhere.” Can you elaborate on what you mean by this? How can studying space physiology and the effects of spaceflight on the human body have an impact on human health, here on earth? 

Space is a challenging environment – the requirements for any technology, including medical technology, is greatly elevated. If we can make something work in space and ensure that our crew is thriving, we can translate that to any corner of Earth from the most rural areas, to the arctic, or even an active battlefield. 

In a way it's a re-write of my usual saying which is: Space is the best technology accelerator we have – and this is especially for medical technology. To be useful during a space mission, devices, procedures etc must have large degree of autonomy and automation. For medical devices and medical procedures - it has to be safe, non-invasive, easy to use for non-specialized technicians, the data has to be understandable and actionable for non-specialists, devices must be portable, robust and so on. This pushes us to further develop our medical technology. The Xray is good example of this – we had to take a normal terrestrial medical procedure which usually occurs in a specialized radiology-department, acquired by specialized technicians, and analyzed by specialized radiologists and make it work in the hands of a private astronaut team with minimal training. Now if we can do this successfully in space, we can translate those advances to benefit all our patients here on Earth. I have served as regional physician in a remote and isolated part of Greenland, and every time we make a new advancement in space medicine, I find myself thinking “now, this I could have used in the arctics” there are many parallels between space and terrestrial austere medicine, pre-hospital medicine etc. Our work in space medicine therefore benefits not only the select few that get to travel in space, but all of us and all our patients here on Earth.