Hughes-Fulford Millie, Carroll Danielle J, Allaway Heather C M, Dunbar Bonnie J, Sawyer Aenor J
UC Space Health, University of California San Francisco (UCSF), San Francisco, California, USA.
Department of Medicine, UCSF, San Francisco, California, USA.
Exp Physiol. 2024 Nov 2. doi: 10.1113/EP091527.
Exposure to the spaceflight environment causes adaptations in most human physiological systems, many of which are thought to affect women differently from men. Since only 11.5% of astronauts worldwide have been female, these issues are largely understudied. The physiological nuances affecting the female body in the spaceflight environment remain inadequately defined since the last thorough published review on the subject. A PubMed literature search yielded over 2200 publications. Using NASA's 2014 review series 'The effects of sex and gender on adaptation to space' as a benchmark, we identified substantive advancements and persistent knowledge gaps in need of further study from the nearly 600 related articles that have been published since the initial review. This review highlights the most critical issues to mitigate medical risk and promote the success of missions to the Moon and Mars. Salient sex-linked differences observed terrestrially should be studied during upcoming missions, including increased levels of inflammatory markers, coagulation factors and leptin levels following sleep deprivation; correlation between body mass and the severity of spaceflight-associated neuro-ocular syndrome; increased incidence of orthostatic intolerance; increased severity of muscle atrophy and bone loss; differences in the incidence of urinary tract infections; and susceptibility to specific cancers after exposure to ionizing radiation. To optimize health and well-being among all astronauts, it is imperative to prioritize research that considers the physiological nuances of the female body. A more robust understanding of female physiology in the spaceflight environment will support crew readiness for Artemis missions and beyond.
暴露于太空飞行环境会使大多数人体生理系统产生适应性变化，其中许多变化对女性的影响被认为与男性不同。由于全球宇航员中只有11.5%是女性，这些问题在很大程度上尚未得到充分研究。自上次关于该主题的全面发表综述以来，影响太空飞行环境中女性身体的生理细微差别仍未得到充分界定。一项PubMed文献检索产生了超过2200篇出版物。以美国国家航空航天局2014年的综述系列《性别对太空适应的影响》为基准，我们从自初步综述以来发表的近600篇相关文章中确定了实质性进展和仍需进一步研究的持续知识空白。本综述强调了减轻医疗风险和促进月球及火星任务成功的最关键问题。在即将进行的任务中，应研究在地球上观察到的显著性别差异，包括睡眠剥夺后炎症标志物、凝血因子和瘦素水平升高；体重与太空飞行相关神经眼部综合征严重程度之间的相关性；直立不耐受发生率增加；肌肉萎缩和骨质流失的严重程度增加；尿路感染发生率的差异；以及暴露于电离辐射后对特定癌症的易感性。为了优化所有宇航员的健康和福祉，必须优先考虑考虑女性身体生理细微差别的研究。对太空飞行环境中女性生理学有更深入的了解将有助于机组人员为阿尔忒弥斯任务及后续任务做好准备。
