JULIAN WILLETT'S COLUMN

Gene Expression Changes in Heart Cells: A New Threat to Astronaut Health?

Genetic expression can change in blood vessels under low gravity. Should astronauts be worried?

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The last thing one wants to hear about is someone we care about having a heart attack. In my clinical care, I have seen a family’s immense hardship as their loved one recovers from a heart attack or another vascular event. I have sat with the tragedy of patients we could not bring back when it happened in the hospital, family members powerless outside the room, the news ultimately shattering their hearts alongside ours.

As we move closer to space travel becoming more feasible for the average person (hopefully in the coming decades), physicians will have to face the reality of astronauts experiencing health problems beyond the borders of a hospital, where there is less help available. While astronauts are selected to be in good health and unlikely to develop severe health complications while traveling, one will eventually suffer an adverse event. Previously healthy athletes’ hearts have been known to stop during exercise on rare occasions, possibly due to undiagnosed heart defects, such as hypertrophic cardiomyopathy. Fortunately, it is a possibility that NASA considers.

We also need to understand more ways to prevent such an event from occurring so we do not have to rely on such contingencies. A group of Japanese researchers sought to find answers for this problem. Will it make space travel safer? Remember to give my article claps and read it all the way through to support me as a writer!

Photo by Kelly Sikkema on Unsplash

Heart attacks and strokes are ultimately caused by fat deposits in your blood vessels breaking apart, driving a series of reactions that eventually obstruct the vessel, starving your heart or brain of essential oxygen. A way to better understand this process, so we can keep you (and astronauts) safe using the wonders of modern medicine, is to know how the genes in your blood vessels are affected by external triggers, such as a fat plaque deciding it had enough or microgravity. This is where it gets interesting when considering space travel!

A group of scientists created a device called a clinostat that can mimic a low-gravity environment by rotating the cells in blood vessels at a particular rate (so less need to conduct expensive space station experiments). They found that we have gravity-sensitive genes in our blood vessels that produce more or less of their downstream products (think of DNA like a conveyor belt where DNA is used to make other things) when gravity changes! But how is this evidence convincing and exciting?

The group found that the gene SLCO2A1 appeared to be the gravity-dependent gene (stay tuned because there will likely turn out to be other gravity-dependent genes). This gene is notable because others have found its expression linked with cardiovascular disease (like heart attacks) and high blood pressure. While more research, perhaps using mathematical approaches as I use in my genetics research, will be required to clarify the intersection between this gene, heart disease, and gravity changes, it is a good step toward understanding how being in space changes our bodies! So what needs to happen now?

Due to the nature of being among the first to explore this piece of science, the group focused on genes that are more commonly expressed. Future studies could study the expression of all roughly 20,000 genes to see if there is anything else interesting that changes. This study used only cells, which can behave differently in mammals like us or mice. Finding a way to non-invasively measure blood vessel gene expression in these more complex models could further clarify the role of this gene or other genes that could be contributing. There is still a lot that we can do. That is what makes science so exciting!

Photo by Bill Jelen on Unsplash

Aerospace medicine and our understanding of how being in space changes the body has made progress. Unanswered questions could also help us navigate the stars while ensuring travelers are well cared for. Studies such as this help understand how being in an unfamiliar place can change our bodies, thus offering targets to monitor as they could influence astronaut health or risk of developing diseases down the road. Give it time, and we’ll have a better sense of it all, making your orbital flight that much safer.

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JULIAN WILLETT, MD

Medika Columnist

M.D. trained in the US, now researching SARS-CoV-2 and COVID-19 in Canada for his Ph.D. After earning my Ph.D., I will be pursuing an Anatomic Pathology residency embracing my path towards being a physician-scientist. My academic interests are directed towards topics that provide the greatest net benefit for the greatest number of people. I love complicated, messy, and poorly understood topics.

I enjoy writing in my spare time, along with 3D printing and staying connected with my family. I have been a longstanding proponent for global health with projects ranging from supporting Doctors without Borders (MSF) to Syrian refugees (Syrian American Medical Society).

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