GENE THERAPY Spaceflight 52: 114, 2010.

Regarding the report of the recent review of the space program by the Augustine panel several points of contention should be addressed.

Many involved in the space program as well as the lay public, are not aware that pharmaceuticals cannot be used for those engaged in space flight because of deterioration of some – no longer meeting U.S.P. standards and invariable malabsorption, so that whatever pharmaceuticals are used, would have to be given subcutaneously with at this time no satisfactory, replenishable subcutaneous silicon device available, to administer pharmaceuticals.

In addition, since there is potential liver and kidney dysfunction as a result of the vascular complications of space flight, there is no way to ensure that these substances will be adequately metabolized or excreted.

Therefore, there is no solution other than the use of gene therapy, which may require several decades of research. At this time the major problems with gene therapy involve finding a suitable vector to deliver the genes to various tissues which are targeted, without triggering severe immune reactions, complicating the use of virus vectors.

Gene therapy has not proven to be nearly as successful as had been predicted with a major stumbling block related to the fact that the effects of delivering the genes to various tissues have been shown to be only temporary. Thousands of patients have been treated with gene transfer therapies but reproducibility of positive results has yet to be demonstrated conclusively.

Therefore, before considering a Mars or asteroid mission, years of research will be required in space as well as on earth, necessitating the use of the international space station for a much longer period and a lunar mission to conduct research involved in measures to eliminate inhalation of ultrafine dust – brought into the lunar habitats on the space suits.

William J. Rowe M.D. FBIS