Perspective on the consequences of short- and long-duration space flight on human physiology.

During the past three decades, humans have made significant progress in accomplishing their aspirations for exploring the Moon and the planets. It is now appreciated that humans undergo a remarkable number of physiologic adaptations in microgravity that affect most physiologic systems. Space motion sickness was one of the first adaptations that humans experienced in microgravity. However, it is self-limiting and, most of the time, is effectively treated pharmacologically. Of particular concern is that, in microgravity, there is marked wasting of the skeletal musculature and skeleton that appears to be unrelenting and could impact on the health and welfare of space travelers during prolonged space flights and on return to earth. Microgravity also has a significant impact on the cardiovascular system that could have potentially serious consequences in terms of cardiovascular health during long-duration space flights. Other adaptations such as decreased T-cell responsiveness and changes in circadian rhythms is only now being explored. We need to understand the role that microgravity has on human physiologic systems in order to develop strategies for permitting humans to experience prolonged microgravity without having significant impact on their health and welfare. Engineering some gravitational force as a component of long-duration space vehicles should be given a high priority.