Removing gravity allows researchers to do experiments they could never duplicate on the ground
6 min
Medical research in space is leading to advances that could help patients on Earth.
Several technologies developed for space exploration have afterward contributed to medical products. Infrared thermometers, for example, stem from infrared sensors created to remotely measure the temperature of distant stars and planets.
But increasingly, scientists aim to perform research in space specifically for human health. Interest in conducting medical research in space has grown as researchers recognise possibilities enabled by microgravity, in which objects appear to be weightless, aboard the International Space Station, or ISS, which orbits the Earth about 250 miles from its surface.
Removing gravity’s influence alters biological systems, enabling experiments that can’t be done on the ground. Researchers are sending materials into space to study treatments for cancer, heart disease, neurological disorders, blindness and other conditions.
Such investigations extend beyond civilian medicine. With preparations under way for long-term missions to the moon, and eventually to Mars, scientists are advancing technologies to help astronauts endure extended space travel and confront illnesses and medical emergencies.
Several factors complicate space-based research. The cost of transporting materials, for one, as well as preparations needed to convert experiments conducted on Earth into ones that can be run on the ISS, which is itself a complicated partnership of five space agencies from 15 countries. The station has been occupied continuously since November 2000.
Space studies’ potential to discover cures and create tools that make healthcare more accessible justify the expense and complexity, some scientists say.
“Everything we do onboard has potential applications for healthcare on Earth,” says Dr. Dave Williams, who conducted neuroscience research on space shuttle Columbia, and is now chief executive of Leap Biosystems, a developer of medical devices for virtual clinical care in space and on Earth.
Space travel itself, for example, is known to cause bone and muscle loss, immune suppression, central nervous system changes and other effects. Detrimental as these effects are, they are of particular interest to scientists.
For the most part, health concerns astronauts develop in space resolve when they return, says Dr. Christopher Austin, former director of the National Center for Advancing Translational Sciences and now CEO of biotechnology startup Vesalius Therapeutics. Studying how this reversal occurs could provide insight on turning back the clock on disorders of ageing on Earth, he adds.
Exposure to microgravity seems to replicate the effects of aging at the cellular level, says Michael Roberts, chief scientific officer of the U.S. National Laboratory on the ISS. As a result, investigators in months can glean insights from studies that might require years of research on Earth.
“What happens in space is akin to accelerated ageing,” says Arun Sharma, assistant professor at the Board of Governors Regenerative Medicine Institute at Cedars-Sinai Medical Center, who says his experience with space research includes sending stem-cell-derived heart cells to the ISS. “We can study these aging processes in a faster way in microgravity.”
Meantime, companies including drugmaker Merck and biotechnology concerns Axonis Therapeutics and LambdaVision aim to capitalise on microgravity to improve existing treatments or optimize experimental ones.
Merck has been conducting experiments aboard the ISS to determine whether it can come up with a crystalline form of an anticancer drug in its portfolio, Keytruda. The drug, which treats several cancers, generated $20.9 billion in sales in 2022. Patients receive it in 30-minute intravenous infusions. Its active ingredient, pembrolizumab, a large molecule known as a monoclonal antibody, isn’t highly soluble, so developing a high-concentration liquid formulation that can be given through a simple injection is difficult, says Paul Reichert, a Merck Research Laboratories scientist.
One solution is to produce it in crystallised form, a routine process for small-molecule drugs taken as pills. But making an optimal crystalline suspension is challenging for large-molecule, antibody drugs, Reichert says.
So Merck decided to attempt it in space. In 2017 it sent pembrolizumab to the ISS to see whether crystals would form better in space. Without gravity, molecules move more slowly and forces including convection currents are limited. Crystals produced on the ISS were smaller and more uniform than Earth counterparts, Reichert says.
On the ground, Merck identified techniques to mimic these effects and enable high-quality crystals. Now it is conducting long-term stability research to enable a Keytruda formulation that is injectable and, unlike today’s version, stable at room temperature. That would make it more accessible in areas with limited refrigeration.
Such studies will take years, but could lead to a lower-cost version of Keytruda that is easier to administer and cheaper to transport, Reichert says.
“That would be a game-changer for biologics drug delivery,” he adds.
Sometimes space research yields surprising results.
Biotech startup Angiex sought to better understand how an experimental cancer drug interacted with normal cells lining blood vessels, known as endothelial cells, says Paul Jaminet, co-founder, president and chief operating officer. The problem was these cells, when cultured on Earth, typically die quickly unless they are cultured with growth factors and changed to a proliferative state similar to that of endothelial cells in tumours. As a result, there is no good cell-culture model for the normal endothelial cells in which Angiex’s drugs are expected to have their toxicity, he says.
Angiex’s team hypothesised that culturing them in microgravity would be a solution, sending endothelial cells to the ISS in 2018. The cells did grow in space, but as they adapted to microgravity, they took on unusual characteristics that may not have a counterpart on Earth, Jaminet says.
The findings may advance understanding of how microgravity affects astronauts, he says. “In science, unexpected results are very precious,” he adds.
But since it appears the cells cultured in microgravity don’t resemble normal endothelial cells, and acquired a novel pathological state not previously seen, it isn’t yet clear if these cells are useful for drug-development purposes. Further work, he says, will be needed to understand this novel state and see if it is useful for understanding diseases on Earth.
“When you put cells into a completely new system, you’re going to get intended results and unintended results,” says Dr. Serena Auñón-Chancellor, an astronaut who worked on the Angiex research on the ISS, and a clinical associate professor of medicine for the LSU Health Sciences Center in Baton Rouge.
Axonis in August had good luck with a project to coax two kinds of human brain cells, neurons and astrocytes, to unite into a three-dimensional model of the brain in microgravity. It used the model to test a gene therapy designed to restore neural connections damaged by neurodegenerative diseases or spinal-cord injury.
The experiment provided evidence that Axonis’s gene therapy travels to its intended target, neurons, and avoids astrocytes, says co-founder and Chief Scientific Officer Shane Hegarty. In labs on Earth, neurons and astrocytes would form a carpet-like, two-dimensional layer. This doesn’t fully represent the brain’s complexity and is less useful for advancing the gene therapy, Hegarty adds.
The implications of this research are that scientists could use patients’ own cells to create models of their disease in space to speed their search for treatments, he says.
“For any drug-development effort, you need a good model first,” Hegarty says.
One long-term research program on the ISS is LambdaVision’s effort to restore vision to people blinded by diseases of the retina, the light-sensitive tissue at the back of the eye.
LambdaVision has flown eight payloads to the ISS since 2016, says Chief Scientific Officer Jordan Greco, adding that the company has found that its artificial retina seems to come together better in microgravity.
Microgravity enables more ordered and even packing of protein molecules onto the scaffold, CEO Nicole Wagner says. If its artificial retina, expected to enter clinical trials in about three years, earns regulatory approval, LambdaVision will manufacture it on the ISS or a commercial space station, she says.
Considering the demand for vision-restoration therapy, reimbursement from insurers should be sufficient to justify this expense, Wagner says. “With artificial retinas, there’s a clear unmet need,” she says.
To convert its lab process into one viable for the ISS, LambdaVision teamed with space-biotech company Space Tango to condense the process into a device that looks like a metal shoebox. The automated system contains proteins, polymers and solutions to assemble the artificial retina layers, and cameras that let researchers monitor and control the process from the ground, Wagner says.
Also using Space Tango is Encapsulate, a biotech with grant funding to launch into space biochips containing micro tumours made from patient cancer cells. The chips could predict an individual’s response to drugs, helping oncologists tailor treatment, Encapsulate co-founder and CEO Armin Rad says.
When adapting scientists’ projects for space “we have to take the human out of it and stuff it all into a box,” Space Tango Chief Strategy Officer Alain Berinstain says. Biotechs also express interest in the automated system for ground use, which was unexpected, he says. “It’s turned into a new business opportunity for us,” he adds.
The National Aeronautics and Space Administration plans a crewed mission to the lunar surface in 2025 and eventually a mission to Mars. Astronauts will require medications for the trip, and they can’t pack every drug they might need, says Phil Williams, a professor of biophysics in the School of Pharmacy at the University of Nottingham.
Medications degrade faster in space because of high radiation levels, says Williams, who is working with NASA researcher Lynn Rothschild on an astropharmacy, a briefcase-like system enabling astronauts to produce medications on demand.
In one version under study, cellular machinery that certain microbes use to make proteins would be combined with genetic sequences that code for specific biological medicines, Williams says. This could be paired with a production system to express the therapeutic protein and DNA-synthesis technology, he adds.
The notion of an astropharmacy extends to other extreme environments. If the technology proves effective in space it could also be used in hard-to-reach locations on Earth, he says.
“If we can make the drug for the astronaut, then we can make it for anybody,” Williams says.
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What a quarter-million dollars gets you in the western capital.
Alexandre de Betak and his wife are focusing on their most personal project yet.
Multinationals like Starbucks and Marriott are taking a hard look at their Chinese operations—and tempering their outlooks.
4 min
For years, global companies showcased their Chinese operations as a source of robust growth. A burgeoning middle class, a stream of people moving to cities, and the creation of new services to cater to them—along with the promise of the further opening of the world’s second-largest economy—drew companies eager to tap into the action.
Then Covid hit, isolating China from much of the world. Chinese leader Xi Jinping tightened control of the economy, and U.S.-China relations hit a nadir. After decades of rapid growth, China’s economy is stuck in a rut, with increasing concerns about what will drive the next phase of its growth.
Though Chinese officials have acknowledged the sputtering economy, they have been reluctant to take more than incremental steps to reverse the trend. Making matters worse, government crackdowns on internet companies and measures to burst the country’s property bubble left households and businesses scarred.
Now, multinational companies are taking a hard look at their Chinese operations and tempering their outlooks. Marriott International narrowed its global revenue per available room growth rate to 3% to 4%, citing continued weakness in China and expectations that demand could weaken further in the third quarter. Paris-based Kering , home to brands Gucci and Saint Laurent, posted a 22% decline in sales in the Asia-Pacific region, excluding Japan, in the first half amid weaker demand in Greater China, which includes Hong Kong and Macau.
Pricing pressure and deflation were common themes in quarterly results. Starbucks , which helped build a coffee culture in China over the past 25 years, described it as one of its most notable international challenges as it posted a 14% decline in sales from that business. As Chinese consumers reconsidered whether to spend money on Starbucks lattes, competitors such as Luckin Coffee increased pressure on the Seattle company. Starbucks executives said in their quarterly earnings call that “unprecedented store expansion” by rivals and a price war hurt profits and caused “significant disruptions” to the operating environment.
Executive anxiety extends beyond consumer companies. Elevator maker Otis Worldwide saw new-equipment orders in China fall by double digits in the second quarter, forcing it to cut its outlook for growth out of Asia. CEO Judy Marks told analysts on a quarterly earnings call that prices in China were down roughly 10% year over year, and she doesn’t see the pricing pressure abating. The company is turning to productivity improvements and cost cutting to blunt the hit.
Add in the uncertainty created by deteriorating U.S.-China relations, and many investors are steering clear. The iShares MSCI China exchange-traded fund has lost half its value since March 2021. Recovery attempts have been short-lived. undefined undefined And now some of those concerns are creeping into the U.S. market. “A decade ago China exposure [for a global company] was a way to add revenue growth to our portfolio,” says Margaret Vitrano, co-manager of large-cap growth strategies at ClearBridge Investments in New York. Today, she notes, “we now want to manage the risk of the China exposure.”
Vitrano expects improvement in 2025, but cautions it will be slow. Uncertainty over who will win the U.S. presidential election and the prospect of higher tariffs pose additional risks for global companies.
For now, China is inching along at roughly 5% economic growth—down from a peak of 14% in 2007 and an average of about 8% in the 10 years before the pandemic. Chinese consumers hit by job losses and continued declines in property values are rethinking spending habits. Businesses worried about policy uncertainty are reluctant to invest and hire.
The trouble goes beyond frugal consumers. Xi is changing the economy’s growth model, relying less on the infrastructure and real estate market that fueled earlier growth. That means investing aggressively in manufacturing and exports as China looks to become more self-reliant and guard against geopolitical tensions.
The shift is hurting western multinationals, with deflationary forces amid burgeoning production capacity. “We have seen the investment community mark down expectations for these companies because they will have to change tack with lower-cost products and services,” says Joseph Quinlan, head of market strategy for the chief investment office at Merrill and Bank of America Private Bank.
Another challenge for multinationals outside of China is stiffened competition as Chinese companies innovate and expand—often with the backing of the government. Local rivals are upping the ante across sectors by building on their knowledge of local consumer preferences and the ability to produce higher-quality products.
Some global multinationals are having a hard time keeping up with homegrown innovation. Auto makers including General Motors have seen sales tumble and struggled to turn profitable as Chinese car shoppers increasingly opt for electric vehicles from BYD or NIO that are similar in price to internal-combustion-engine cars from foreign auto makers.
“China’s electric-vehicle makers have by leaps and bounds surpassed the capabilities of foreign brands who have a tie to the profit pool of internal combustible engines that they don’t want to disrupt,” says Christine Phillpotts, a fund manager for Ariel Investments’ emerging markets strategies.
Chinese companies are often faster than global rivals to market with new products or tweaks. “The cycle can be half of what it is for a global multinational with subsidiaries that need to check with headquarters, do an analysis, and then refresh,” Phillpotts says.
For many companies and investors, next year remains a question mark. Ashland CEO Guillermo Novo said in an August call with analysts that the chemical company was seeing a “big change” in China, with activity slowing and competition on pricing becoming more aggressive. The company, he said, was still trying to grasp the repercussions as it has created uncertainty in its 2025 outlook.
Few companies are giving up. Executives at big global consumer and retail companies show no signs of reducing investment, with most still describing China as a long-term growth market, says Dana Telsey, CEO of Telsey Advisory Group.
Starbucks executives described the long-term opportunity as “significant,” with higher growth and margin opportunities in the future as China’s population continues to move from rural to suburban areas. But they also noted that their approach is evolving and they are in the early stages of exploring strategic partnerships.
Walmart sold its stake in August in Chinese e-commerce giant JD.com for $3.6 billion after an eight-year noncompete agreement expired. Analysts expect it to pump the money into its own Sam’s Club and Walmart China operation, which have benefited from the trend toward trading down in China.
“The story isn’t over for the global companies,” Phillpotts says. “It just means the effort and investment will be greater to compete.”
Corrections & Amplifications
Joseph Quinlan is head of market strategy for the chief investment office at Merrill and Bank of America Private Bank. An earlier version of this article incorrectly used his old title.
