3 Things Microbes in Space Can Teach Us About Our Health on Earth
We all know the typical astronaut accessories—the EVA suit, the oxygen tanks, the radio assembly. But there's an invisible part of each space mission that's often overlooked: the trillions of microorganisms that hitch a ride.
Observing responses of pathogens in space could help scientists figure out how to outsmart them when they cause trouble on Earth.
Dr. Sarah Wallace is a NASA microbiologist who aims to keep microbes from causing problems for U.S. astronauts aboard the International Space Station. According to Wallace, research on microorganisms in space has more than cosmic importance. It can also reveal things about our health here on Earth:
1) Avoiding disease isn't all about maintaining a sterile environment.
NASA has a great track record of keeping the crew healthy on space missions. But surprisingly, it's not from having kept the space flight environment as sterile as possible.
Wallace says, "We [monitor] the environment but unless we find something that's medically significant, or [in] super high numbers, we're not going to do anything."
Not only is it impossible for astronauts to live in completely sterile quarters—crew members, after all, are microbe-shedding machines—but it may not even be desirable, given what we now know about the human microbiome. Scientists have found that the entire community of microorganisms (bacteria, archaea, fungi, and viruses) living in and on us likely have an active role in keeping us healthy. This means that down on the ground we need to let go of the germophobe idea that eradicating all microbes is always better for our health.
2) Disease-causing microbes change their behavior under different conditions.
Remember the recent E. coli O157:H7 outbreak linked to romaine lettuce? We're still grappling with a lot of pathogen problems here on Earth. One reason is that scientists are still learning which strategies these disease-causing microorganisms are capable of employing under different conditions.
Space missions are associated with a major shift in gut microbiome composition—as shown in NASA's twin study.
Wallace says experiments with Salmonella Typhimurium showed that the pathogen became more virulent in space. Yet curiously, the opposite seemed to happen to Staphylococcus aureus under space-flight-like conditions—it became more benign.
"The way these organisms have evolved, certain triggers [in the space flight environment] might be dictating how they're responding," Wallace says.
Observing these responses could help scientists figure out how to outsmart the pathogen when it causes trouble on Earth. "It's giving us some great insights into how we could target them differently in the future," she explains.
3) Major shifts in the gut microbiome could affect health in specific ways.
Scientists still have a lot to learn about which changes in an adult's gut microbiome actually cause a change in health status. In fact, microbiome-focused therapeutics companies are in hot pursuit of these connections.
Space missions are associated with a major shift in gut microbiome composition—as shown in NASA's twin study, which followed astronaut Scott Kelly during a year aboard the ISS while his identical twin brother Mark (a retired astronaut) stayed on the ground. Scott experienced simultaneous changes in telomere length and bone formation; were these related to the gut microbial differences?
Wallace says a soon-to-be-published study of nine additional astronauts could help answer this question. The research may reveal how closely gut microbiome shifts track health outcomes, and the reversibility of the changes.
She emphasizes the science from her lab isn't meant to help only the small minority of humans who will ever go to space: "That's always our goal—that our research is helping people on Earth."
When a patient is diagnosed with early-stage breast cancer, having surgery to remove the tumor is considered the standard of care. But what happens when a patient can’t have surgery?
Whether it’s due to high blood pressure, advanced age, heart issues, or other reasons, some breast cancer patients don’t qualify for a lumpectomy—one of the most common treatment options for early-stage breast cancer. A lumpectomy surgically removes the tumor while keeping the patient’s breast intact, while a mastectomy removes the entire breast and nearby lymph nodes.
Fortunately, a new technique called cryoablation is now available for breast cancer patients who either aren’t candidates for surgery or don’t feel comfortable undergoing a surgical procedure. With cryoablation, doctors use an ultrasound or CT scan to locate any tumors inside the patient’s breast. They then insert small, needle-like probes into the patient's breast which create an “ice ball” that surrounds the tumor and kills the cancer cells.
Cryoablation has been used for decades to treat cancers of the kidneys and liver—but only in the past few years have doctors been able to use the procedure to treat breast cancer patients. And while clinical trials have shown that cryoablation works for tumors smaller than 1.5 centimeters, a recent clinical trial at Memorial Sloan Kettering Cancer Center in New York has shown that it can work for larger tumors, too.
In this study, doctors performed cryoablation on patients whose tumors were, on average, 2.5 centimeters. The cryoablation procedure lasted for about 30 minutes, and patients were able to go home on the same day following treatment. Doctors then followed up with the patients after 16 months. In the follow-up, doctors found the recurrence rate for tumors after using cryoablation was only 10 percent.
For patients who don’t qualify for surgery, radiation and hormonal therapy is typically used to treat tumors. However, said Yolanda Brice, M.D., an interventional radiologist at Memorial Sloan Kettering Cancer Center, “when treated with only radiation and hormonal therapy, the tumors will eventually return.” Cryotherapy, Brice said, could be a more effective way to treat cancer for patients who can’t have surgery.
“The fact that we only saw a 10 percent recurrence rate in our study is incredibly promising,” she said.
Few things are more painful than a urinary tract infection (UTI). Common in men and women, these infections account for more than 8 million trips to the doctor each year and can cause an array of uncomfortable symptoms, from a burning feeling during urination to fever, vomiting, and chills. For an unlucky few, UTIs can be chronic—meaning that, despite treatment, they just keep coming back.
But new research, presented at the European Association of Urology (EAU) Congress in Paris this week, brings some hope to people who suffer from UTIs.
Clinicians from the Royal Berkshire Hospital presented the results of a long-term, nine-year clinical trial where 89 men and women who suffered from recurrent UTIs were given an oral vaccine called MV140, designed to prevent the infections. Every day for three months, the participants were given two sprays of the vaccine (flavored to taste like pineapple) and then followed over the course of nine years. Clinicians analyzed medical records and asked the study participants about symptoms to check whether any experienced UTIs or had any adverse reactions from taking the vaccine.
The results showed that across nine years, 48 of the participants (about 54%) remained completely infection-free. On average, the study participants remained infection free for 54.7 months—four and a half years.
“While we need to be pragmatic, this vaccine is a potential breakthrough in preventing UTIs and could offer a safe and effective alternative to conventional treatments,” said Gernot Bonita, Professor of Urology at the Alta Bro Medical Centre for Urology in Switzerland, who is also the EAU Chairman of Guidelines on Urological Infections.
The news comes as a relief not only for people who suffer chronic UTIs, but also to doctors who have seen an uptick in antibiotic-resistant UTIs in the past several years. Because UTIs usually require antibiotics, patients run the risk of developing a resistance to the antibiotics, making infections more difficult to treat. A preventative vaccine could mean less infections, less antibiotics, and less drug resistance overall.
“Many of our participants told us that having the vaccine restored their quality of life,” said Dr. Bob Yang, Consultant Urologist at the Royal Berkshire NHS Foundation Trust, who helped lead the research. “While we’re yet to look at the effect of this vaccine in different patient groups, this follow-up data suggests it could be a game-changer for UTI prevention if it’s offered widely, reducing the need for antibiotic treatments.”