The central idea of Astro-Omics is personalization. The personalization of diagnosis, assessment, treatment, and prevention are all key to this new field. Genomics, proteomics and metabolomics are all instruments in this individualized treatment plan.
Mapping one’s genome, observing their metabolism, and tracking the proteins of their body can give a lot of insight into what already affects a person – and what could in the future. For instance, the discovery of a mutation in the BRCA1 and BRCA2 genes is known to indicate heightened risk for cancer, which can influence future medical choices. In the same way, the discovery of a DNA repair mutation may rule out an astronaut candidate, as DNA reparation is essential in resisting the effects of radiation.
This new way of analyzing a person’s biological systems is a more precise version of following family trees. Whereas tracking family illnesses can be hit-and-miss, observing genes is much more accurate. These tests can reveal those who may react badly in the space environment (e.g., someone at risk for coronary disease), and also reveal conditions that may simply require a more personalized treatment plan (e.g., someone with an HFE mutation, and high levels of iron). This in-depth gene mapping analysis would require several tests – a total-body MRI, genetic screening, screening for psychiatric problems, etc. – but such efforts would be worth it. Having a full assessment of a crew member’s physiological and genetic makeup could be important at several points in the mission (e.g., during a medical emergency) and this database would provide information to help future crews.
Similarly, such an analysis can be used to decide which drugs may be the most effective, and produce the fewest negative side-effects. This can be done by creating an individual drug metabolism profile of each astronaut, and analyzing, through genotypic assessment, which drugs may be poorly tolerated by each individual. Such an analysis can be done by analyzing individual cytochrome P450 (CYP450) profiles (this is a major set of drug-metabolizing enzymes). A list can then be generated by identifying the CYP450 enzymes (with genetic variants) in a specific individual. This list can be cross-referenced with the mission drug list. When conflicts arise between the CYP SNP profile and the mission drug list, alternative drugs can be selected, so as to avoid adverse effects. Other such tests can be performed, so as to create a precise, individualized drug workup.
Recent advances in the speed of genetic mapping allow for an unprecedented level of genetic profiling of astronauts, and form the baseline of capability that will power Astro-Omics in this new Space Age.