Minoretti Piercarlo, Fontana Jacopo M, Yilmaz Yusuf
Occupational Health, Studio Minoretti, Oggiono, ITA.
Biotechnology, Istituto Auxologico Italiano, Verbania, ITA.
Cureus. 2024 Oct 24;16(10):e72268. doi: 10.7759/cureus.72268. eCollection 2024 Oct.
The human microbiota plays a crucial role in maintaining health and preventing disease; however, the effects of occupational exposure on the microbiota of aircrew and astronauts are not fully understood. This narrative review aims to synthesize the current knowledge on microbiota alterations in aerospace medicine, assess the potential of probiotics as a countermeasure, and identify key gaps that warrant further research. The references were identified through searching PubMed for English articles published between 2010 and 2024, using keywords related to microbiota, probiotics, aviation, spaceflight, pilots, and astronauts. Additionally, the bibliographies of relevant papers were reviewed. Studies in aerospace medicine were selected based on their focus on the occupational impact on microbiota and the use of probiotics in this context. For aircrew, initial studies indicate a decrease in beneficial gut bacteria, suggesting that probiotics could enhance gastrointestinal health, immunity, and overall well-being. However, unsupervised use of probiotics carries potential risks. Conversely, spaceflight induces significant changes in the gut, skin, oral, and nasal microbiota of astronauts, characterized by altered diversity and abundance of specific microbial taxa. These changes include a relative decrease in the abundance of beneficial gut bacteria, an increase in opportunistic pathogens, and evidence of microbial transfer between astronauts and spacecraft surfaces. While simulated space studies suggest the potential for probiotics to mitigate dysbiosis, direct testing done during actual spaceflight is lacking. The observed microbiota changes during spaceflight are associated with various health implications, including alterations in metabolic pathways and interactions between the microbial metabolic capabilities and the host's metabolism. In conclusion, this review highlights the profound impact of spaceflight on astronaut microbiota and the promising role of probiotics as an intervention in both space and aviation medicine. However, significant research gaps remain. These include elucidating the functional implications of microbial shifts, developing personalized countermeasures, and validating the efficacy of probiotics during spaceflight. Future studies should leverage advanced tools such as metagenomic analysis and longitudinal tracking of astronaut health to inform targeted interventions that support the well-being of aerospace personnel. Integrating data across different sites of the body and missions, facilitated by resources like the Space Omics and Medical Atlas (SOMA), can help identify consistent microbial changes induced by the unique occupational conditions of spaceflight and aviation. This integrated approach will be crucial for developing effective microbiota-based countermeasures to mitigate the occupational health risks associated with space and aviation.
人类微生物群在维持健康和预防疾病方面起着至关重要的作用；然而，职业暴露对机组人员和宇航员微生物群的影响尚未完全了解。本叙述性综述旨在综合当前关于航空航天医学中微生物群改变的知识，评估益生菌作为一种应对措施的潜力，并确定需要进一步研究的关键差距。通过在PubMed上搜索2010年至2024年发表的英文文章来确定参考文献，使用与微生物群、益生菌、航空、太空飞行、飞行员和宇航员相关的关键词。此外，还查阅了相关论文的参考文献。航空航天医学研究的选择基于其对微生物群职业影响的关注以及在此背景下益生菌的使用。对于机组人员，初步研究表明有益肠道细菌减少，这表明益生菌可以增强胃肠道健康、免疫力和整体幸福感。然而，无监督使用益生菌存在潜在风险。相反，太空飞行会导致宇航员的肠道、皮肤、口腔和鼻腔微生物群发生显著变化，其特征是特定微生物类群的多样性和丰度改变。这些变化包括有益肠道细菌丰度相对降低、机会性病原体增加，以及宇航员与航天器表面之间微生物转移的证据。虽然模拟太空研究表明益生菌有可能减轻生态失调，但实际太空飞行期间缺乏直接测试。在太空飞行期间观察到的微生物群变化与各种健康影响相关，包括代谢途径的改变以及微生物代谢能力与宿主代谢之间的相互作用。总之，本综述强调了太空飞行对宇航员微生物群的深远影响以及益生菌作为太空和航空医学干预措施的潜在作用。然而，仍存在重大研究差距。这些差距包括阐明微生物变化的功能影响、制定个性化应对措施，以及验证太空飞行期间益生菌的功效。未来的研究应利用宏基因组分析和宇航员健康纵向跟踪等先进工具，为支持航空航天人员福祉的针对性干预措施提供信息。通过太空组学和医学图谱（SOMA）等资源促进跨身体不同部位和任务的数据整合，有助于识别由太空飞行和航空独特职业条件引起的一致微生物变化。这种综合方法对于开发有效的基于微生物群的应对措施以减轻与太空和航空相关的职业健康风险至关重要。
