Alterations in calcium homeostasis and bone during actual and simulated space flight

Abstract
The weightlessness experienced in space produces alterations in calcium homeostasis. Gemini, Apollo, and Skylab astronauts exhibited a negative calcium balance due primarily to hypercalciuria. In addition, the bone mineral density of the calcaneus declined by approximately 4% in Skylab crew members after 84 d of orbital flight. The negative calcium balance and loss of calcaneal bone mineral in normal adults subjected to prolonged bed rest was comparable to that observed in space. The pathogenesis of bone loss during space flight and bed rest is not well understood due to the lack of histomorphometric data. It is also uncertain whether osteoporotic changes in astronauts are corrected postflight. The observed bone loss would be reversible and of no long-term consequence if the only abnormality was an increased remodeling rate. However, altered bone cell activity would probably result in irreversible bone loss with the premature development of senile osteoporosis many years after space flight. The main skeletal defect in growing rats placed in orbit aboard Soviet Cosmos biosatellites appears to be diminished bone formation. Bone resorption was not elevated during weightlessness. Although cortical bone returned to normal postflight, the decline in trabecular bone mass was somewhat persistent. These studies established that the modeling of a growing skeleton was altered in a weightless environment, but do not necessarily imply that a remodeling imbalance occurs in adults during space flight. However, various forms of simulated space flight inhibited bone formation during both skeletal modeling and the remodeling of adult bone. The etiology of the bone changes associated with actual and simulated space flight has not been elucidated but may involve mechanical unloading and/or hypersecretion of corticostcroids. Future space experimentation should utilize adult animals with mature skeletons. Unfortunately, the skeletal response of adult humans to space flight may not be determined with certainty until histologic evaluations are performed on bone biopsies provided by future astronauts or, possibly, normal adults subjected to prolonged bed rest. If invasive procedures are not feasible in humans, kinetic analyses of stable calcium isotopes and bone mineral measurements at multiple skeletal sites should be encouraged.