NxPCM

    What is the purpose of the Non-exercise Physiological Countermeasures (NxPCM) Project?



    Non-exercise Physiological Countermeasures (NxPCM) Project Non-exercise Physiological Countermeasures (NxPCM) Project
    If human space exploration missions to the Moon and then Mars are to be successful, space life scientists need a precise understanding of the effects of long-duration spaceflight on the human body and the way in which the body adapts to the microgravity and partial gravity environments. Failure to prevent or minimize harmful changes caused by spaceflight can lead to illness or even loss of life during long term missions. Physiology is the branch of biology that deals with the integrated functions of the human body (in this case, organs such as the brain, heart, muscle, skeletal system tissues, and cells that reside in the blood system) and with the physical and chemical events involved. Although many changes occur in the human body during spaceflight, this NASA project focuses mainly on 6 discipline groups or processes: cardiovascular, immunological, skeletal (bone), nutritional, pharmacological, and neurovestibular (sensorimotor) physiology. The Non-exercise Physiological Countermeasures (NxPCM) Project exists to deal with and integrate the physiological changes in body systems to make sure astronauts are healthy, safe, and able to perform the assigned transit and exploration tasks during space missions. Countermeasures are therapies, devices, or procedures that counteract harmful effects of spaceflight.

    Skeletal (Bone) Changes
    Exposure to long-term reduced gravity causes reduction in bone density and change in bone composition and strength. Currently, astronauts primarily use exercise during long-duration missions onboard the International Space Station (ISS) to mitigate these alterations, and upon return to Earth they enter a regimen of physical therapy that promotes recovery of lost bone density. Such support will not be readily available during long-duration missions on the Moon or to Mars, so astronauts may not be able to perform surface or emergency egress procedures necessary for mission success. Countermeasures other than exercise are being studied to provide additional protection against debilitating bone loss.

    Non-exercise Physiological Countermeasures (NxPCM) Project Cardiovascular Changes
    Cardiovascular Changes
    Cardiovascular changes seem to increase with the amount of time spent in space. Soon after launch, body fluid including blood moves from the legs to the head and upper body. Additional cardiovascular changes include a decrease in the total amount of blood in the body and total cardiac output. When an astronaut returns to One Earth Normal (OEN) gravity, the cardiovascular changes that occurred during spaceflight result in low blood pressure and reduced cardiac output. Astronauts that have been in prolonged spaceflight (> 30 days) are often unable to stand up soon after landing. This greatly increases the risk that they would be unable to rapidly get out of the vehicle upon return to Earth in an emergency, and also greatly increases the health risks of performing surface operations when crew members land on Mars. When astronauts return to Earth, landing and rehabilitation personnel are ready to assist them, but these trained personnel will not be available to crew members arriving on Mars. To compensate for these cardiovascular changes, countermeasures for use before landing and self-sustaining rehabilitation regimens will need to be developed.

    Non-exercise Physiological Countermeasures (NxPCM) Project Immunological Changes
    Immunological Changes
    Changes in the immune system also occur and place crew members at risk. To understand the mechanisms involved and to determine the specific risks to crew members, we need to fully characterize these changes for flight durations longer than our current experience on the International Space Station (ISS). Reducing these risks will require NASA to develop procedures to boost the immune system, countermeasures to prevent conditions favoring infection by opportunistic and constitutive microbes, and countermeasures to restore health to any crewmember that becomes ill.

    Nutritional Changes
    Nutrition is the study of food and nourishment. Nutrition efforts are required to make sure the nutritional status of astronauts remains adequate throughout long-duration missions. When tested after missions,astronauts have shown high systemic levels of some nutrients and low levels of others. It can be hypothesized that either the body absorbs and processes foods differently in microgravity than on Earth, or that the foods themselves change in useful nutrient content during missions - NxPCM needs to determine which of these options is true.

    Nutrition plays a critical role in all body systems and also may serve as a countermeasure itself. Optimal nutrition will enable other countermeasure systems such as exercise to be effective, while inadequate nutrition may cause planned countermeasures to fail. The potential for other countermeasures to have an adverse impact on nutrition also is significant. The possible consequences of having too much or too little of an important nutrient include performance losses, illness, and in many cases, if an imbalance is left uncorrected, even death.

    Pharmacological Changes
    Pharmacotherapeutics is the study of the therapeutic uses and effects of drugs. Specifically, pharmacotherapeutics efforts are necessary to provide safe and effective medical care for astronauts. Microgravity can lower the efficacy of drugs, requiring additional dosing before getting the needed effect. It is likely that these drugs are not metabolized the same in space as on Earth, and these changes need to be quantified.
    Non-exercise Physiological Countermeasures (NxPCM) Project Pharmacological Changes


    Some of the areas included in pharmacotherapeutics are pharmacokinetics and pharmacodynamics. Pharmacokinetics is the study of the process whereby a drug is absorbed, distributed, metabolized, and eliminated from the body. Pharmacodynamics is the study of the action or effects of drugs on living organisms. Current knowledge of the pharmacokinetics and pharmacodynamics of medications in space is lacking in detail. The number of effective, stable pharmaceuticals available for treatment in space is limited; this is an important part of the risk to astronaut health and limits the ability to treat illness or injury.

    NASA's planned exploration missions, which feature long periods of travel to the Moon or Mars, will require unprecedented periods of being far away from Earth and from easy restocking of food stores and medicines. Astronauts will require a complete stock of everything they will need on their journey, and their cargo must be stable enough to perform as needed throughout the entire duration of the journey.

    Non-exercise Physiological Countermeasures (NxPCM) Project Neurovestibular Changes
    Neurovestibular Changes
    Neurovestibular ChangesNeurovestibular (sensorimotor) changes occur immediately in response to spaceflight conditions, persist throughout the flight, and sometimes continue after landing. Examples of neuro-vestibular changes are dizziness and disorientation. Many of us as children had fun spinning ourselves (or our friends) until a sudden stop caused everything around us to spin. Crewmembers often experience this dizziness and disorientation while trying to perform important tasks or conducting activities that require accurate and tedious hand-eye coordination. This presents serious risk to the health and safety of the crew. Knowledge of neurovestibular changes is limited to changes that happen to Shuttle and ISS crew members, and is currently unknown whether any of the changes are permanent or what the recovery timeline is for temporary changes. Countermeasures are required to reduce neurovestibular changes and pre-adapt crew members for transitions between different amounts of gravity.

    What are the big challenges that the NxPCM Project must meet?
    Extended missions to the Moon and Mars require unprecedented durations of flights to planetary bodies far from Earth. Current knowledge of physiological changes caused by spaceflight is limited to data from crew members on shorter flights of the Shuttle and ISS. We must be sure the crew on exploration missions has with them everything they will need to maintain their health and safety, and that they are able to perform mission operations once they reach their destination, and then return home safe and healthy. Countermeasures (such as exercise regimens) will play a critical role in the functioning of the body in space and after landing on the Moon, Mars, or Earth. The NxPCM Project works with other NASA projects responsible for other areas of study to be sure different countermeasures are compatible with each other and have a positive synergistic effect.
    Non-exercise Physiological Countermeasures (NxPCM) Project What are the big challenges that the NxPCM Project must meet?


    Who is involved in the NxPCM Project, and where are they?
    The NxPCM Project was created by NASA Headquarters in 2005 under the Human Research Program within the Human System Research and Technology Theme. The NxPCM Project Office operates under the Biomedical Research and Environmental Services Division at the Johnson Space Center in Houston, Texas. Personnel involved in NxPCM-related investigations are located at NASA facilities (Johnson Space Center and Ames Research Center) as well as at universities and research institutions across the U.S. University investigators may work individually or through association with the National Space Biomedical Research Institute, a consortium of 12 universities formed to focus research on critical needs of space exploration. Specific laboratories involved in NxPCM research at the Johnson Space Center include the Bone, Cardiovascular, Immunology, Microbiology, Neurosciences, Nutritional Biochemistry, Pharmacotherapeutics, and Disease Modeling and Tissue Analogues Laboratories.

    What will the NxPCM Project do?
    The NxPCM Project develops, evaluates, validates, and implements technologies for risk assessment and mitigation, and countermeasures for health and safety risks relevant to planned space exploration. The project goal is to help ensure crewmember health and safety, by gaining knowledge and developing technologies to advance NASA's practice of evidence-based medicine, and by providing methods and technologies that enable NASA to safely and effectively use products, procedures, and strategies to prevent or minimize systemic physiological changes caused by spaceflight. Knowledge and further development of technologies and required countermeasures will be extended to missions to Mars.

    Research into physiological adaptation in general is being done in many different places by a large number of researchers. The NxPCM Project is concerned specifically with aspects of long-term spaceflight, including:
    • Establishing medical standards and safe operational limits for astronaut health
    • Determining effects of long-term space flight on astronaut physiology
    • Identifying "gaps" between needed astronaut performance capabilities and space flight affected performance capabilities
    • Developing safe and effective countermeasure systems which mitigate adverse space flight effects on astronauts in space
    • Minimizing risk of incompatibility between countermeasure systems
    • Demonstrating countermeasure system efficacy under conditions similar to planned operational flight use
    • Ensuring that stable and effective physiological countermeasures are available for long-term missions to the Moon and Mars
    The NxPCM Project will coordinate existing research and focus new proposals to gain and apply knowledge to resolve these concerns.Timeline

    Non-exercise Physiological Countermeasures (NxPCM) Project When will the NxPCM Project do all this?
    When will the NxPCM Project do all this?
    Efforts are currently underway. Any requirements the NxPCM Project proposes that will affect the initial design of the next-generation exploration spacecraft and space suits must be submitted in the next 2 to 4 years. Requirements that may affect mission planning or astronaut training must be submitted at least 2 years before the mission. At this time, NxPCM Project efforts are focused on the long-term lunar and Mars missions scheduled for the timeframe of 2020 or later.

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