Future crewed expeditions beyond Earth will span multiple years, requiring a transition away from Earth-dependent pharmaceutical supply chains. Medications degrade more rapidly in space due to radiation exposure and storage constraints, while transporting large quantities of temperature-controlled biologics is logistically impractical. These challenges necessitate the development of self-sufficient, in-situ medical capabilities for deep space missions. This study evaluates the operational and clinical relevance (OCR) and recombinant production feasibility (RPF) of peptide therapeutics for on-demand manufacturing during long-duration spaceflight. Building on established astropharmacy databases and literature, 26 peptide-based medications relevant to spaceflight were identified and ranked using ten predefined OCR and RPF criteria. OCR criteria included regulatory status, shelf stability, storage requirements, NASA Human Research Roadmap risk/impact score, and purification requirements. RPF criteria included amino acid chain length, prior recombinant production, functional assay availability, dosing requirements, and post-translational modification complexity. All criteria were scored from 0-2 points. Teriparatide achieved the highest overall score (17/20), followed by abaloparatide and amylin (16/20). Several therapeutics, including angiotensin II, daptomycin, GLP-1 agonists, G-CSF, GM-CSF, and salmon calcitonin, also demonstrated potential (14/20). This study identifies peptide therapeutics as promising candidates for in-situ production and provides a structured framework to guide future astropharmacy development.

Salmon calcitonin (sCT) is a peptide with poor enzymatic stability and permeability, limiting its oral delivery. This study investigated how hydrophobic ion pair (HIP) type and self-nanoemulsifying drug delivery systems (SNEDDS) composition influence the oral delivery of sCT, and whether in vitro findings correlate with in vivo outcomes. HIPs were prepared with sodium caprate (C10) or sodium docusate (DOC) and incorporated into two SNEDDS differing in a single excipient: F1 contained 10% lysophosphatidylcholine (LPC), a natural permeation enhancer, while F2 replaced LPC with propylene glycol. In vitro, sCT:C10 provided no protection against trypsin, whereas sCT:DOC did (p < 0.05 vs native sCT). Incorporating HIPs into SNEDDS enhanced sCT proteolytic stability against trypsin relative to native sCT, but the extent was formulation-dependent, with F1 showing lower protection than F2 for the same HIP. Permeability in Caco-2 cells was mainly driven by SNEDDS, with F1 consistently showing lower FD4 transport than F2, indicating no additional benefit from LPC. In vivo, sCT:C10 showed no significant difference in relative pharmacological activity (PArel) over native sCT, whereas sCT:DOC significantly increased activity. HIP-loaded SNEDDS enhanced sCT activity compared with native sCT, yet F1 did not improve activity beyond F2. Among all groups, sCT:DOC in F2 achieved the highest PArel (8.8 ± 0.8%), indicating more favourable conditions for sCT oral delivery. In addition, in vitro trends correlated well with in vivo outcomes. Overall, HIP type and SNEDDS composition significantly influenced oral sCT delivery, highlighting the need to co-optimize these parameters to achieve effective oral peptide delivery.

» Intranasal salmon calcitonin (IN-CAL) is a well-tolerated, noninvasive antiresorptive agent with reproducible pharmacodynamic activity, despite lower systemic bioavailability than parenteral formulations. » In preosteoporotic postmenopausal women, IN-CAL provides small, spine-limited preservation of bone mass, with minimal hip or forearm benefit; treatment response depends more on baseline bone turnover than on dose escalation. » In established postmenopausal osteoporosis, IN-CAL produces early biochemical suppression (1-3 months) and small but consistent lumbar spine bone mineral density (BMD) gains with sustained therapy (≥6-12 months). » IN-CAL is less effective than bisphosphonates and modern anabolic agents for increasing BMD and reducing fracture risk; accordingly, its use is best reserved for patients who cannot take first-line therapies due to contraindications, intolerance, or personal preference. » IN-CAL provides short-term pain relief for vertebral fractures in osteoporosis and offers a similarly time-limited analgesic benefit in acute orthopaedic settings, with pain reduction often within days and biochemical or skeletal effects evolving over subsequent weeks.

A 69-year-old female presented with hypercalcemia, recurrent fever, and lymphadenectasis following COVID-19 infection. Positron emission tomography/computed tomography (PET-CT) revealed no suspicious malignancy. Lymph node biopsy from bilateral inguinal areas suggested Langerhans cell histiocytosis, supporting a possible diagnosis of dermatopathic lymphadenitis or rare Langerhans cell histiocytosis. The immunohistology staining showed that the proliferated Langerhans cells in lymph nodes expressed CD68, CD1a, and S100, further supporting the diagnosis of dermatopathic lymphadenitis.

Wear particle-induced prosthesis aseptic loosening severely affects the longevity of total joint arthroplasty. This condition arises from periprosthetic osteolysis, which is driven by excessive inflammation and enhanced bone resorption under particle stimulation. Herein, we develop an injectable hydrogel-based system co-encapsulating anti-inflammatory emodin (Emo) and anti-osteoporotic salmon calcitonin (sCT) to synergistically inhibit wear particle-induced aseptic loosening. This hydrogel is formulated from thermosensitive poly(lactic acid-co-glycolic acid)-b-poly(ethylene glycol)-b-poly(lactic acid-co-glycolic acid) triblock copolymers and water. The aqueous system undergoes a sol-to-gel phase transition upon heating with the transition temperature between room temperature and body temperature. Highly hydrophobic Emo is efficiently solubilized into micelles formed by the amphiphilic carrier polymers, while hydrophilic sCT is encapsulated within bovine serum albumin (BSA)-derived nanoparticles to suppress its initial burst release and prolong its release duration from the hydrogel matrix. This dual-delivery platform achieves simultaneous and continuous liberation of both therapeutic agents with distinct properties. In a mouse bone-implanted air pouch model, a single administration of the hydrogel formulation plus the sustained release of active Emo and sCT efficiently suppresses titanium particle-induced aseptic inflammation and osteolysis. Therefore, this local and long-acting co-delivery system holds great promise for preventing wear particle-induced aseptic loosening.