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Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight

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Abstract

Summary

We report the results of alendronate ingestion plus exercise in preventing the declines in bone mass and strength and elevated levels of urinary calcium and bone resorption in astronauts during 5.5 months of spaceflight.

Introduction

This investigation was an international collaboration between NASA and the JAXA space agencies to investigate the potential value of antiresorptive agents to mitigate the well-established bone changes associated with long-duration spaceflight.

Methods

We report the results from seven International Space Station (ISS) astronauts who spent a mean of 5.5 months on the ISS and who took an oral dose of 70 mg of alendronate weekly starting 3 weeks before flight and continuing throughout the mission. All crewmembers had available for exercise a treadmill, cycle ergometer, and a resistance exercise device. Our assessment included densitometry of multiple bone regions using X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and assays of biomarkers of bone metabolism.

Results

In addition to pre- and post-flight measurements, we compared our results to 18 astronauts who flew ISS missions and who exercised using an early model resistance exercise device, called the interim resistance exercise device, and to 11 ISS astronauts who exercised using the newer advanced resistance exercise device (ARED). Our findings indicate that the ARED provided significant attenuation of bone loss compared with the older device although post-flight decreases in the femur neck and hip remained. The combination of the ARED and bisphosphonate attenuated the expected decline in essentially all indices of altered bone physiology during spaceflight including: DXA-determined losses in bone mineral density of the spine, hip, and pelvis, QCT-determined compartmental losses in trabecular and cortical bone mass in the hip, calculated measures of fall and stance computed bone strength of the hip, elevated levels of bone resorption markers, and urinary excretion of calcium.

Conclusions

The combination of exercise plus an antiresoptive drug may be useful for protecting bone health during long-duration spaceflight.

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Acknowledgments

This project was supported by the Human Research Program at the National Aeronautic Space Administration and the Japan Aerospace Exploration Agency. We wish to thank Curtis Kershner, Karen Lawrence, and Michelle Lawless of Lockheed Martin for their help in managing the experiment documentation, along with Lisa King and Scott A Smith of Wyle for their help in acquiring the DXA and pQCT data. The authors would especially like to thank the astronauts who participated in this research project.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Universities Space Research Association, 3600 Bay Area Blvd, Houston, TX, 77058, USA

    A. LeBlanc & R. Ploutz-Snyder

  2. Department of Medicine and Bioregulatory Sciences, Graduate School of Medical Sciences, University of Tokushima, Tokushima, Japan, 770-8503

    T. Matsumoto

  3. Center for Space Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    J. Jones

  4. Kennedy Krieger Institute, Baltimore, MD, 21205, USA

    J. Shapiro

  5. Department of Radiology, University of California, San Francisco, CA, 94143, USA

    T. Lang

  6. Human and Adaptation Countermeasure Division NASA Johnson Space Center, Houston, TX, USA

    L. Shackelford, S. M. Smith & J. Sibonga

  7. Wyle, 1290 Hercules Drive, Houston, TX, 77058, USA

    H. Evans & E. Spector

  8. Department of Radiological Sciences, University of California, Irvine, CA, 92697, USA

    J. Keyak

  9. Department of Orthopedic Surgery, University of Occupational and Environmental, Kitakyushu, Japan

    T. Nakamura

  10. Department of Nephrology, Nagoya City University, Nagoya, Japan

    K. Kohri

  11. Japan Aerospace Exploration Agency, Tsukuba, Japan

    H. Ohshima

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  1. A. LeBlanc
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Corresponding author

Correspondence to A. LeBlanc.

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LeBlanc, A., Matsumoto, T., Jones, J. et al. Bisphosphonates as a supplement to exercise to protect bone during long-duration spaceflight. Osteoporos Int 24, 2105–2114 (2013). https://doi.org/10.1007/s00198-012-2243-z

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  • DOI: https://doi.org/10.1007/s00198-012-2243-z

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