Exploring cardiovascular health and alternative biological fluid sampling methods in extreme environments: Lessons from a 12-day Mars analog mission

• Published in: Acta astronautica Vol. 234; pp. 194 - 206
• Main Authors: Derobertmasure, A., Toh, L.S., Kafi, L., Obeid, H., Burk, J., Decadi, A., Renaud, C., Villa-Massone, J., Davidson, K., kennedy, E., Bruno, R.M., Chhun, S., Boutouyrie, P.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.09.2025
• Subjects: Arterial health; Dried blood spot; Dried urine spot; Mars analog mission; Pulse wave velocity; Space pharmacology; Dried blood spot; PAX; UMphe; BP; AUC; LC-MS/MS; ESA; DBS; t1/2; Arterial health; Dried urine spot; MBP; PMphe; TDM; BMI; IMphe; SBP; Mars analog mission; DUS; MR; NASA; ISS; CAF; BLEO; DMS; SIC; SOL; CV; Kel; PD; ft-PWV; CYP1A2; Dtf; LEO; Pulse wave velocity; PCM; PK; MDRS; Space pharmacology
• ISSN: 0094-5765
• DOI: 10.1016/j.actaastro.2025.03.003

Long-term spaceflights (>6 months) induces early vascular aging in astronauts, compromising space missions, particularly as new individuals with unique profiles are expected to fly. The lack of vascular data in astronauts necessitates to test non-invasive and portable techniques to assess arterial health in conditions analog to spaceflight. Currently, therapeutic drug monitoring for astronauts faces limitations in conventional blood and urine sampling and sample management onboard the international space station. We evaluated arterial stiffness and body composition during a 12-day Mars analog mission at Mars Desert Research Station, Utah. We also explore the feasibility of dried blood spot (DBS) and dried urine spot (DUS) collection. Arterial stiffness was measured using finger-to-toe pulse wave velocity (ft-PWV) by photo-plethysmography (pOpmètre®) and connected scale (Withings®). Blood pressure was measured by a connected blood pressure monitor (Withings ®). Measurements were obtained daily, including after extravehicular activities. Body composition was assessed using a connected scale. DBS/DUS sampling validation was carried out via a pharmacokinetic study on caffeine and its metabolite, paraxanthine (as proof of concept). After >24h caffeine washout, coffee (115 mg) or tea (30 mg), or 3 dark chocolate squares (11 mg) were ingested. DBS/DUS samples were collected at before-, during- and post-mission. DBS were collected before the caffeine intake, at 2h, 3h, 6h post-consumption, while urine samples were collected over a 24-h period. Caffeine and paraxanthine were analyzed using liquid chromatography-tandem mass spectrometry 6 months later. The metabolic ratio (areas under the curves for caffeine and paraxanthine (AUCPAX/AUCCAF) defined the cytochrome P450-1A2 (CYP1A2) phenotype. User experience survey was also conducted. Six crew members participated in the study. Following the 12-day mission, subjects experienced a progressive weight loss (−2.0 kg, p < 0.05), primarily in fat and water mass. Blood pressure and ftPWV did not change. Extravehicular activities induced tachycardia (p < 0.03), but did not change ftPWV or blood pressure. Measurements of ftPWV was marginally limited by Raynaud phenomenon. Full DBS/DUS pharmacokinetic was feasible in the 6 crew members with 2 failures for DUS before the mission due to insufficient timing for collection. Expected differences in kinetic profiles were observed, consistent with consumption habits, ingested doses and drug-drug interactions. The metabolic ratio did not significantly differ during the mission compared to normal conditions. Overall, crew members were satisfied with the usability of the cardiovascular and microsampling devices and methods. Estimating PWV with the pOpmètre® device is feasible in extreme environment and isolated conditions, with minimally trained crew. Further studies are needed to observe long-term trends in ftPWV and weight changes. DBS/DUS collection were safe, stable, feasible and well accepted. These medical devices could help monitoring space-induced early vascular aging, and assessing human metabolism adaptation and drug exposure for deep space missions. •Astronauts exhibit space induced early vascular ageing during spaceflight.•Mars desert research station is a valid ground analog to validate devices for deep space missions.•Monitoring pulse wave velocity is feasible in isolation with a user-friendly medical device.•Pharmacokinetic of caffeine (proof of concept) with the Dried matrix spot sampling method is feasible in isolation.