The continued evolution of space medicine through directly
examining the impact of the space environment on the human body in space
At the ISS, basic research and technological development for humans to live safely and healthily in space are taking place. The results of this research can also be applied to medical technologies on earth. For example, the research that JAXA is currently undertaking on loss of bone mass and deterioration of muscle function among astronauts can be used to clarify how particular conditions—such as osteoporosis and muscular dystrophy—develop in people on earth, as well as to develop the necessary treatment techniques.
right after it departed from the orbital outpost (Flight day 13). ©JAXA/NASA
Space medicine research on the ISS
Due to microgravity, cosmic radiation, and the enclosed nature of living conditions, the working environments for astronauts in space are extreme, and impact their bodies in various ways. It is therefore necessary to understand the physical changes that take place in space, examine their causes, and develop measures that allow astronauts to remain both physically and mentally healthy and perform to the best of their abilities. JAXA is thus using the environment on the ISS to undertake research on space medicine and develop related technologies.
It is thought that the changes the human body undergoes in space are similar to those caused by aging. Therefore, expectations are high for the results of space medicine research to be applied to medical treatment on earth and to help achieve healthy longevity.
List of main medical research themes on the ISS
A list of the main past and ongoing space medicine research themes (with astronauts as the subjects of research) conducted on the ISS can be found below.
Unique features of space medicine research
Constraints on research in space
While the number of researchers interested in studying space medicine is high, the number who have actually participated in space experiments is comparatively low. Two main large barriers are the scarce opportunities and the long wait until the actual experiments from submitting the experiment applications. Further, when astronauts are the subjects of the research, experiments face the mission schedule constraints.
Planning for on-orbit medical research
Space medicine research requires the tasks including launch of equipment, on-orbit experiments, and the collection of samples. Further, plans must also be made considering technologies of onboard equipment, changes and responses during experiments, the processing of samples, and the implementation of control experiments.
In preparation, preliminary experiments and simulations (for example, short-duration microgravity experiments and bed rest experiments), as well as controlled experiments, are undertaken on earth prior to research in space.
However, with short-duration microgravity experiments, for example, parabolic flights can only maintain microgravity conditions for approximately 25 seconds, and accurate comparisons cannot be made with conditions on the ISS. Meanwhile, with bed rest experiments, the installation of special equipment, attendance of research assistants, and other considerations will apply. Space medicine research plans are developed exercising ingenuity and based on knowledge from past researches.
Preparing space medicine research equipment
The equipment used for on-orbit medical research must meet safety standards for on-orbit use, and development therefore requires a certain amount of funding and time. Further, it often requires the hands-on operations of the astronauts and time constraints for astronauts' training must be considered as astronauts onboard ISS will be consecutively replaced by the next flight crew.
There are also limitations on transportation methods to and from earth, as well as the storage capacities of on-orbit refrigerators and freezers. This means that research activities including analysis of experimental samples must take into account the operational status of the ISS.
Sharing data pertaining to medicine and medical research on the ISS
Medical research on astronauts on the ISS accumulates a variety of data. While this data is mainly collected before, during, and after astronauts’ time in space. The same data is sometimes required for different research projects.
For example, if a single astronaut participates in two medical experiments during his/her time on the ISS, and both experiments require MRI data, sharing MRI data from one of the experiments with the other not only make the astronaut to avoid taking data twice but can significantly reduce the astronaut time for experiments and workload.
As such, medical research on the ISS is based on the ISS Medical Project Data Sharing Plan, a scheme that allows researchers to share data with one another.
Overview of medical research on the ISS
Planning for experiments on astronauts
Elaborate planning is necessary when conducting experiments on astronauts on the ISS. The plans must consider the number of astronauts subject to the experiments, the time allocated to each experiment, the equipment and power necessary, the freezing and storage of test samples, and other limitations. The ordinary equipment and techniques used at universities and research institutes may not easily be applied to experiments in space.
Plans for experiments in space must also include plans for controlled experiments on earth, so that comparisons can be made with the data collected during the space mission. By comparing the data collected in space with that from before and after the mission (baseline data), researchers can analyze what changes occur in space, and see how long it takes for the changes to return to the baseline.
Further, as these experiments are conducted on humans, thorough ethical considerations must also be made, including the safety and health of the astronauts, their human rights, and more. Plans must therefore conform with domestic and international rules and are reviewed by JAXA and responsible institutions.
Selection and ethical considerations of researches on astronauts
Selection of researches on astronauts
At JAXA, scientific researches on astronauts on the ISS are selected by inviting proposals for feasibility studies that use the Japanese Experiment Module "Kibo". Based on the Kibo Utilization Strategy, these researches must aim to generate results that can only be achieved on Kibo and that have high potential to impact society. The list of experiment equipment available for the researches on astronauts on the ISS can be found in the Kibo Utilization Handbook.
In addition to the above feasibility studies, researches on astronauts are also selected through life science proposals submitted to the International Space Life Sciences Working Group—a group comprising of the representatives of space agencies involved in the ISS. Researches that help to solve key JAXA issues, as well as those that demonstrate medical and testing equipment, are also selected. Further, as astronauts participate in multiple researches during their stay on the ISS, space agencies have to work together in advance to ensure any one research doesn’t interfere with another.
Ethical reviews of researches on astronauts
Prior to experiments on astronauts, reviews are conducted to ensure ethical considerations have been made pertaining to their safety and health, their human rights, and more.
The Human Research Multilateral Review Board (HRMRB), comprising of the representatives of space agencies involved in the ISS, is an organization tasked with investigating and reviewing ethical matters on the ISS. For every research conducted on an astronaut, the HRMRB looks at whether the safety and health of the astronaut is assured and whether the appropriate ethical considerations have been made. As and when necessary, the HRMRB issues recommendations or modification requests.
Further, prior to review by the HRMRB, the plans for these researches on astronauts are carefully examined by the ethics committee of the researcher’s university or research institute, the space agency proposing the research, and the space agency of the astronaut to be a subject of the research.
Ethical reviews at JAXA
JAXA’s Ethics Committee for Research and Development on Humans meets roughly eight times a year.
Researchers begin by creating and submitting their research plan (draft) to the ethics committee. These plans must be written in specific formats, and contain the research description, objectives, details of procedures, equipment to be used, and expected outcomes. Further, the plans must also describe why it is necessary to conduct the said research on humans, the safety management systems, the potential impacts on the research subjects, the measures to limit these impacts, the emergency medical systems in place, the research subjects’ consent, the number of research subjects, the management methods and systems pertaining to the research subjects’ personal information, the methods of publishing results, the measures to protect the research subjects’ personal information when results are published, and more.
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