Why Personalized Medicine Is the Frontier of Medicine and Performance for Humans in Space

Abstract

To date, more than 565 professional astronauts have flown in space, of whom only 11% have been women. Of these, ∼565 have been NASA astronauts, of whom 86% have been men and 14% have been women. This cohort of professional astronauts has been uniquely fit and exceptionally well trained. The advent of commercial spaceflight will see a wider range of individuals enter space, who lie on a variegated continuum of physical fitness, metabolic fitness, disease complexity, drug therapeutics, and genetics. Yet, there are currently little data on individuals of lesser fitness entering space. In addition, the initial planetary missions to Mars will embark without any data associated with such a mission (e.g., 3 years). Even as we begin to gather such data from the initial Mars missions, the cohorts will be small with uncertain generalizability. While spaceflight medicine has grown in sophistication, we are still faced with clear knowledge gaps. This occurs just as the community of space travelers is about to expand and the complexity of planetary missions is at its most ambitious. Fortunately, the advent of comprehensive molecular profiling, including some in mission, allows us to address some of these unknowns by applying complex molecular analytics to individuals and developing personalized countermeasures derived from those analytics.