Bisphosphonate Use May Reduce the Risk of Urolithiasis in Astronauts on Long‐Term Spaceflights

JBMR Plus

Adrian LeBlanc¹  Jeffrey Jones¹  Kenjiro Kohri²  Takahiro Yasui²  Atsushi Okada²  Tadashi Koga³  Toshio Matsumoto⁴  Tatsuya Isomura⁵  Hiroshi Ohshima⁶  Elisabeth Spector⁷  Linda Shackelford⁸  Jean Sibonga⁸ 

[1] Baylor College of Medicine‐ Center for Space Medicine Houston TX USA;Department of Nephro‐urology Nagoya City University Graduate School of Medical Sciences Nagoya Japan;Department of Pharmacology St. Marianna University School of Medicine Kawasaki Japan;Fujii Memorial Institute of Medical Sciences Tokushima University Tokushima Japan;Institute of Medical Science Tokyo Medical University Tokyo Japan;Japan Aerospace Exploration Agency Tsukuba Japan;KBR Wyle Houston TX USA;NASA Johnson Space Center Houston TX USA;

关键词: BONE MODELING AND REMODELING;    BIOCHEMICAL MARKERS OF BONE TURNOVER;    DISEASES AND DISORDERS OF/RELATED TO BONE;    OSTEOPOROSIS;    THERAPEUTICS;    ANTIRESORPTIVES;   

DOI  :  10.1002/jbm4.10550

来源: DOAJ

【 摘 要 】

ABSTRACT Long‐duration spaceflight is associated with an increased risk of urolithiasis, and the pain caused by urinary calculi could result in loss of human performance and mission objectives. The present study investigated the risk of urolithiasis in astronauts during 6 months on the International Space Station, and evaluated whether the suppression of bone resorption by the bisphosphonate, alendronate (ALN), can reduce the risk. A total of 17 astronauts were included into the analysis: exercise using the advanced resistive exercise device (ARED) plus weekly oral 70 mg alendronate (ARED+ALN group, n = 7) was compared to resistive exercise alone (ARED group, n = 10). Urine volume decreased in both groups during spaceflight but recovered after return. The ARED group showed increased urinary calcium excretion from the 15th to 30th day of spaceflight, whereas urinary calcium was slightly decreased in the ARED+ALN group. Urinary N‐terminal telopeptide (NTX) and helical peptide (HP) of type I collagen, as bone resorption markers, were elevated in the ARED group during and until 0 days after spaceflight, while there was no elevation in these parameters in the ARED+ALN group. Urinary oxalate and uric acid excretion tended to be higher in the ARED group than in the ARED+ALN group during spaceflight. These results demonstrate that astronauts on long‐duration spaceflights may be at high risk for the formation of urinary calcium oxalate and calcium phosphate stones through increased urinary excretion of oxalate and uric acid, from degraded type I collagen, as well as of calcium from enhanced bone resorption. Our findings suggest that increased bone resorption during spaceflight, as a risk factor for urinary calculus formation, could be effectively prevented by an inhibitor of bone resorption. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

【 授权许可】

Unknown