The Maleth program: Malta's first space mission discoveries on the microbiome of diabetic foot ulcers

Christine Gatt; Braden T Tierney; Pedro Madrigal; Christopher E Mason; Afshin Beheshti; Anja Telzerow; Vladimir Benes; Graziella Zahra; Jurgen Bonett; Kevin Cassar; Joseph Borg

doi:10.1016/j.heliyon.2022.e12075

The Maleth program: Malta's first space mission discoveries on the microbiome of diabetic foot ulcers

Heliyon. 2022 Dec 5;8(12):e12075. doi: 10.1016/j.heliyon.2022.e12075. eCollection 2022 Dec.

Authors

Christine Gatt¹, Braden T Tierney², Pedro Madrigal³, Christopher E Mason^{2

4

5

6}, Afshin Beheshti^{7

8}, Anja Telzerow⁹, Vladimir Benes⁹, Graziella Zahra¹⁰, Jurgen Bonett¹¹, Kevin Cassar¹², Joseph Borg¹

Affiliations

¹ Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida MSD, 2080, Malta.
² Department of Physiology and Biophysics, Weill Cornell Medical College, New York, NY, 10065, USA.
³ European Molecular Biology Laboratory, European Bioinformatics Institute, EMBL-EBI, Hinxton CB10 1SD, UK.
⁴ The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, NY, USA.
⁵ WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, NY, USA.
⁶ The Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, NY, USA.
⁷ KBR, Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, 94035, USA.
⁸ Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.
⁹ Genomics Core Facility, European Molecular Biology Laboratory, Heidelberg, Germany.
¹⁰ Molecular Diagnostics for Infectious Diseases, Department of Pathology, Mater Dei Hospital, Msida, Malta.
¹¹ Ministry for Health, Primary HealthCare, Floriana, Malta.
¹² Department of Surgery, Faculty of Medicine and Surgery, University of Malta, Valletta, Malta.

Abstract

The purpose of the Maleth Program, also known as Project Maleth, is Malta's first space program to evaluate human skin tissue microbiome changes in type 2 diabetes mellitus (T2DM) patients afflicted with diabetic foot ulcers (DFU). This was carried out in both ground-based models and spaceflight. The first mission (Maleth I) under this program was carried out to uncover the effects of spaceflight, microgravity and radiation on human skin tissue microbiome samples from six T2DM patients recruited into the study. Each patient human skin tissue sample was split in three, with one section processed immediately for genomic profiling by 16S typing and the rest were processed for longer term ground-control and spaceflight experiments. Ground-control and spaceflight human skin tissue samples were also processed for genomic profiling upon mission re-entry and completion. Maleth I's overall objective was achieved, as human skin tissue samples with their microbiomes travelled to space and back yielding positive results by both standard microbiology techniques and genetic typing using 16S rRNA amplicon sequencing. Preliminary findings of this mission are discussed in light of its innovative approach at DFU microbiome research, and the clinical implications that may emerge from this and other future similar studies.

Keywords: 16S typing; Bacteria; Diabetes; International space station; Malta; Microbiome; Microgravity; Space.