Natural compounds as potential countermeasures for spaceflight-associated neuro-ocular syndrome.
- 1Department of Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States.
- 2Department of Biochemistry, Molecular Biology and Pharmacology, Indiana University School of Medicine, Indianapolis, IN, United States.
Abstract
Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a complex and multifactorial condition most commonly observed following long-duration spaceflight. Clinical findings of SANS include optic disc edema, retinal nerve fiber layer swelling, globe flattening, chorioretinal folds, and hyperopic refractive shifts. As human space exploration extends toward prolonged missions such as Artemis and Mars expeditions, SANS represents a significant risk to astronaut health and mission success. Although headward fluid shifts, elevated intracranial pressure, venous outflow congestion, and lymphatic dysfunction have been implicated in SANS pathophysiology, no single unifying mechanism or universally effective countermeasure has been identified. Emerging evidence suggests that oxidative stress from galactic cosmic radiation, endothelial dysfunction, inflammation, mitochondrial injury, altered angiogenesis, and disruptions in one-carbon metabolism contribute meaningfully to SANS development. This review summarizes the clinical manifestations and proposed mechanisms underlying SANS and examines naturally occurring compounds with high therapeutic indices that target these pathways. Specifically, we review bilberry anthocyanins with French maritime pine bark extract, Ginkgo biloba extract, saffron/crocin, curcumin, coenzyme Q10, resveratrol, vitamin E, and B vitamins as potential supplemental approaches, highlighting their mechanisms of action and therapeutic efficacy when targeting terrestrial ocular diseases. While direct studies in spaceflight environments remain limited, these compounds demonstrate antioxidant, anti-inflammatory, neuroprotective, vasoregulatory, and metabolic effects relevant to SANS. Collectively, they represent promising adjunctive candidates within a multimodal preventative strategy aimed at mitigating SANS risk during long-duration spaceflight.
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BibTeX
@article{lange2026natural,
title = {{Natural compounds as potential countermeasures for spaceflight-associated neuro-ocular syndrome.}},
author = {R Mikal Lange and Tasneem P Sharma},
journal = {Frontiers in ophthalmology},
year = {2026},
month = oct,
doi = {10.3389/fopht.2026.1801651},
url = {https://europepmc.org/article/MED/42921159},
note = {CC BY},
}
RIS
TY - JOUR
TI - Natural compounds as potential countermeasures for spaceflight-associated neuro-ocular syndrome.
AU - R Mikal Lange
AU - Tasneem P Sharma
PY - 2026
DA - 2026/10/09
JO - Frontiers in ophthalmology
DO - 10.3389/fopht.2026.1801651
UR - https://europepmc.org/article/MED/42921159
AB - Spaceflight-Associated Neuro-Ocular Syndrome (SANS) is a complex and multifactorial condition most commonly observed following long-duration spaceflight. Clinical findings of SANS include optic disc edema, retinal nerve fiber layer swelling, globe flattening, chorioretinal folds, and hyperopic refractive shifts. As human space exploration extends toward prolonged missions such as Artemis and Mars expeditions, SANS represents a significant risk to astronaut health and mission success. Although headward fluid shifts, elevated intracranial pressure, venous outflow congestion, and lymphatic dysfunction have been implicated in SANS pathophysiology, no single unifying mechanism or universally effective countermeasure has been identified. Emerging evidence suggests that oxidative stress from galactic cosmic radiation, endothelial dysfunction, inflammation, mitochondrial injury, altered angiogenesis, and disruptions in one-carbon metabolism contribute meaningfully to SANS development. This review summarizes the clinical manifestations and proposed mechanisms underlying SANS and examines naturally occurring compounds with high therapeutic indices that target these pathways. Specifically, we review bilberry anthocyanins with French maritime pine bark extract, Ginkgo biloba extract, saffron/crocin, curcumin, coenzyme Q10, resveratrol, vitamin E, and B vitamins as potential supplemental approaches, highlighting their mechanisms of action and therapeutic efficacy when targeting terrestrial ocular diseases. While direct studies in spaceflight environments remain limited, these compounds demonstrate antioxidant, anti-inflammatory, neuroprotective, vasoregulatory, and metabolic effects relevant to SANS. Collectively, they represent promising adjunctive candidates within a multimodal preventative strategy aimed at mitigating SANS risk during long-duration spaceflight.
SN - 2674-0826
ER -