The database of peptide medications for human deep space missions demonstrates potential for on-demand "Astropharmacy"

Rebecca C. Blum^1,2Dorra Omrani¹Alina Kunitskaya^3,4*Jessica E. Snyder^2,4Cynthia Bui¹Philip M. Williams⁵David J. Loftus⁶Lynn J. Rothschild^1,4,7

• ¹Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, United States
• ²Blue Marble Space Institute of Science, Seattle, United States
• ³NASA Postdoctoral Program / Oak Ridge Associated Universities, Oak Ridge, United States
• ⁴Planetary Systems Branch, NASA Ames Research Center, Moffett Field, United States
• ⁵University of Nottingham School of Pharmacy, Nottingham, United Kingdom
• ⁶Space Biosciences Research Branch, NASA Ames Research Center, Moffett Field, United States
• ⁷Space Science & Astrobiology Division, NASA Ames Research Center, Moffett Field, United States

With a new age of long-duration lunar and Martian space missions ahead, health risks will increase significantly as astronauts will be exposed to prolonged periods of reduced gravity, elevated levels of radiation, celestial dust, and isolated environments that may interfere with psychological health and sleep. Astronauts will rely increasingly on pharmaceutical intervention to mitigate these health risks, especially drugs that are targeted to treat spaceflight-induced medical conditions such as bone loss, cytopenias, and other degenerative conditions secondary to radiation exposure and immune system dysfunction. Many of these are biologic drugs, and peptide and protein pharmaceuticals are especially unstable with limited shelf life (~6 months) even with refrigeration, which is inadequate for a 2+ years round trip to Mars. In addition to the reduced drug stability in space, there are mass/volume constraints, the inability to predict how much - if any - of the drugs will be needed and all in the face of severely limited re-supply opportunities. NASA has identified the need to establish a drug formulary for long-duration space missions, as well as a process for ensuring medications stay efficacious during flight. To address these challenges, we are developing an "Astropharmacy", a compact platform that uses engineered microbes to produce small doses of biologics on demand, in transit or at space destinations that may be far from Earth. To assess the potential for this Astropharmacy, we have compiled a database of peptide and protein drugs that may be needed to mitigate the health risks during long-duration missions to the Moon and Mars that are well-suited for production by the Astropharmacy system. The compiled database acts as a guide for the drugs that could be produced in the Astropharmacy system. Importantly, the database can be a valuable resource for flight surgeons and the medical community on Earth, particularly those providing care in resource-limited environments, as well as researchers studying biological drug development.