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Preflight and postflight microbiological results from 25 space shuttle crews

Clinical-microbiological investigations are an important aspect of the crew health stabilization program. To ensure that space crews have neither active nor latent infections, clinical specimens, including throat and nasal swabs and urine samples, are collected at 10 days (L-10) and 2days (L-2) before launch, and immediately after landing (L+0). All samples are examined for the presence of bacteria and fungi. In addition, fecal samples are collected at L-10 and examined for bacteria, fungi and parasites. This paper describes clinical-microbiological findings from 144 astronauts participating in 25 Space Shuttle missions spanning Space Transportation System (STS)-26 to STS-50. The spectrum of microbiological findings from the specimens included 25 bacterial and 11 fungal species. Among the bacteria isolated most frequently were Staphylococcus aureus, Enterobacter aerogenes, Enterococcus faecalis, Escherichia coli, Proteus mirabilis and Streptococcus agalactiae. Candida albicans was the most frequently isolated fungal pathogen.

Pierson, Duane L.↗

Evaluation and Treatment of Essential Hypertension During Short Duration Space Flight

During the last four decades of manned space flight, two individuals have successfully flown in space with the preflight diagnosis of essential hypertension (HTN). Treatment of this disease process in the astronaut population warrants special consideration particularly when selecting medication for a mission. A retrospective review of data offers two different clinical scenarios involving the treatment, or lack thereof, for essential hypertension during space flight. Case I; A Caucasian quinquagenerian diagnosed with HTN one year prior to the mission obtained flight certification after a negative diagnostic workup. The patient was placed on a diuretic. Preflight isolated blood pressure (BP) measurements averaged 138/102. Inflight, the patient electively declined medication. A 36-hour BP monitor revealed an average value of 124/87. Postflight, BP measurements returned to preflight BP values. Case II: A Caucasian quatrogenerian diagnosed with HTN 6 months prior to launch completed flight training after a negative diagnostic workup. The patient was placed on an ACE inhibiter. Preflight BP measurements averaged 130/80. Inflight, isolated BP measurements were considerably less. Normotensive values were obtained postflight. In both cases, BP values inflight were lower than pre or postflight values. Yelle et al has confirmed similar findings in the normotensive astronaut population. Spaceflight may result in fluid shifting, mild dehydration, electrolyte imbalance, orthostatic hypotension, and increased heart rates. Based on these factors, certain classes of antihypertensive agents such as vasodilators, beta-blockers, and diuretics are excluded from consideration as a primary therapeutic modality. To date, Ace Inhibitors are viewed as the more acceptable drug of choice during spaceflight. Newer classes of drugs may also provide additional choices. Presently, astronauts developing uncomplicated HTN may continue their careers when treated with the appropriate class of continue their careers when treated with the appropriate class of antihypertensive medication.

Rossum, Alfred C.↗

Space analogue studies in Antarctica

Medical research has been carried out on the Australian National Antarctic Research Expeditions (ANARE) for 50 years. As an extension of this program collaborative Australian/United States research on immunology, microbiology, psychology and remote medicine has produced important data and insight on how humans adapt to the stress of extreme isolation, confinement and the harsh environment of Antarctica. An outstanding analogue for the isolation and confinement of space missions (especially planetary outposts), ANARE has been used as an international research platform by Australia and the United States since 1993. Collaborative research has demonstrated a lowered responsiveness of the immune system under the isolation and confinement of Antarctic winter-over; a reduction of almost 50% in T cell proliferation to mitogen phytohaemogglutinin, as well as changes in latent herpesvirus states and the expansion of the polyclonal latent Epstein-Barr virus infected B cell populations. Although no clinically significant disease has been found to result from these immune changes, research is currently assessing the effects of psychological factors on the immune system. This and associated research performed to date and its relevance to both organisations is discussed, and comment made on possible extensions to the program in both medical and other fields.

NASA Center HQS↗

Influence of trimetazidine on the synthesis of complex lipids in the heart and other target organs

Trimetazidine exerts antianginal properties at the cellular level, without haemodynamic effect in clinical and experimental conditions. This cytoprotection was attributed to a decreased utilization of fatty acids for energy production, balanced by an increased incorporation in structural lipids. This study evaluated the influence of Trimetazidine on complex lipid synthesis from [2-(3)H] glycerol, in ventricular myocytes, isolated rat hearts and in vivo in the myocardium and several other tissues. In cardiomyocytes, Trimetazidine increased the synthesis of phosphatidyl-choline (+ 80%), phosphatidyl-ethanolamine (+ 210%), phosphatidyl-inositol (+ 250%) and cardiolipid (+ 100%). The common precursor diacylglycerol was also increased (+ 40%) whereas triacylglycerol was decreased (-70%). Similar results were obtained in isolated hearts with 10 microm Trimetazidine (phosphatidyl-choline + 60%, phosphatidyl-ethanolamine + 60%, phosphatidyl-inositol + 100% and cardiolipid + 50%), the last two phospholipids containing 85% of the radioactivity. At 1 microm, Trimetazidine still stimulated the phospholipid synthesis although the difference was found significant only in phosphatidyl-inositol and cardiolipid. In vivo studies (10 mg/kg per day for 7 days and 5 mg/kg, i.p. before the experiment) revealed significant changes in the intracellular lipid biosynthesis, with increased labelling of phospholipids and reduced incorporation of glycerol in nonphosphorous lipids. Trimetazidine increased the glycerol uptake from plasma to the other tissues (liver, cochlea, retina), resulting in an altered lipid synthesis. The anti-anginal properties of Trimetazidine involve a reorganisation of the glycerol-based lipid synthesis balance in cardiomyocytes, associated with an increased uptake of plasma glycerol that may contribute to explain the pharmacological properties reported in other organs.

Trimetazidine/pharmacology↗

Validation of Multisystem Countermeasures Protocol for Spaceflight during Antarctica Winter-over at Palmer Station (Palmer Countermeasures)

Exploration-class missions beyond the Van Allen belt to the Moon and then Mars will begin soon. Low-Earth orbital spaceflight results in the persistent perturbation of the human immune system, characterized by reductions in T and NK cell function, altered cytokine profiles, and the reactivation of latent herpesviruses. While these alterations have not caused widespread clinical issues, some crewmembers experience immune-related adverse events, including manifestations of symptomatic herpes viral reactivation, allergy, and respiratory distress. Because future deep-space exploration missions will be of unprecedented duration, it is reasonable to hypothesize that the immune perturbations observed aboard International Space Station (ISS) will intensify during longer missions in deep space, thereby placing crewmembers at elevated clinical risk. Thus, it is imperative to preserve the immune vigilance of astronauts by developing a countermeasure strategy. Of all the Earth analogs studied to date, an Antarctica winter-over (AWO) mission most closely reproduces the spaceflight experience: prolonged deployment, extreme environment, circadian misalignment, isolation, station lifestyle, and personal risk. The US maintains three primary stations in Antarctica: South Pole Station, McMurdo, and Palmer. Previous studies suggest that stations located near the interior of Antarctica (South Pole, McMurdo) have confounding effects on the immune system due to persistent hypobaric hypoxia. Thus, it was hypothesized that winter-over at a coastal station (Palmer) would be more akin to spaceflight due to its normoxic but still extreme environment. Therefore, AWO at Palmer Station was chosen as the platform for testing and validating the effectiveness of a NASA multi-system countermeasures protocol designed for deep space missions. The array of countermeasure protocols and monitoring methods deployed for each AWO will consist of diet modifications, nutritional supplementation, prescribed aerobic and resistive exercise, and a protocol of stress relieving virtual reality exercises. A multitude of biological sample types, including blood, saliva, and hair will be collected in tandem with the countermeasures in order to examine the combined effectiveness of the countermeasures. Samples and logs from subjects will be transported from Palmer Station to Johnson Space Center for further processing and distribution to co-investigators at the end of each winter-over. Extracted samples will be analyzed by appropriate testing platforms (Multiplex, qPCR, ELISA, etc.) to monitor alterations in leukocyte distribution, T cell and NK function, cytokine profiles, reactivation of latent herpesviruses, and nutritional factors. The data collected will be compared to a control year in which no countermeasures were deployed to evaluate the overall effectiveness of the analog and to validate the candidate immune countermeasure strategy. With the completion of the Antarctica Winter-Over (WO) 2022 control year, samples for 13 subjects have been successfully returned from Antarctica to NASA/JSC for further processing and distribution to Co-Investigators. WO 2023, the first countermeasure year, has also commenced with 11 subject consenting and performing their base line data collections (BDC) held in Chile. Another 5 subjects, who were already stationed at Palmer Station, Antarctica, joined as participates in the investigation. These 5 subjects were consented, but no BDC was able to be collected due to their joining in-mission. Therefore, there will be a total of 16 subjects participating in Antarctica's 2023 Winter-Over.

Cody L Gutierrez↗

Providing Housing, Food and Medical Support for 25,000 Katrina Evacuees with 12 Hours Notice: The Harris County Medical Support of the Superdome Evacuees

Hurricane Katrina was responsible for trapping 25,000 people in the New Orleans Superdome and isolating many others throughout Louisiana and Mississippi. The transport of these evacuees to the Reliant Park (Houston, Texas) used 500 buses each containing about 55 people. Processing the arriving evacuees included addressing their health status and medical needs as follows: an initial triage at disembarkation, a secondary triage in the Reliant Astrodome and Center, and definitive clinical care in the Reliant Arena "Katrina" Clinic. Baylor College of Medicine (BCM) physicians boarded buses and identified the sickest for emergency transport to Harris County Hospital District (HCHD) hospitals. BCM departments represented included pediatrics, family and community medicine, internal medicine, radiology, obstetrics and gynecology, orthopedics, surgery, and psychiatry. Astrodome and Center triage was managed by BCM physicians and staffed by HCHD Nurses and volunteers from Texas and beyond. The Reliant Astrodome, Center and Arena reached peak headcounts of 15,000,4500, and 2500, respectively Most evacuees visiting the triage sites in the Astrodome and Center were treated using "over-the-counter" medications with the remaining being transported to the "Katrina" clinic. The clinic was equipped with a lab, pharmacy, digital X-ray, and ultrasound machines in addition to electronic patient records created using 80 computer terminals. The Katrina clinic saw more than 15,000 patients during 15 days of operations (2,000 on the first full day), administered 10,000 tetanus shots, and filled thousands of prescriptions. At the peak of operations, the clinic saw 150 patients/hour with 25 physicians scheduled for each 12-hour shift. Approximately 900 people were transported to hospital emergency rooms. Within 3 weeks of arriving at the Reliant Park facilities, more than 90% of the families found permanent housing, enrolled children in schools, and found work. Using data obtained from manual and electronic medical records, this presentation will document the major milestones and lessons learned from this extraordinary project to help the Katrina evacuees.

Hamilton, Douglas↗

Real-Time Teleguidance of a Non-Surgeon Crew Medical Officer Performing Orthopedic Surgery at the Amundsen-Scott South Pole Station During Winter-Over

The Amundsen-Scott South Pole Research station located at the geographic South Pole, is the most isolated, permanently inhabited human outpost on Earth. Medical care is provided to station personnel by a non-surgeon crew medical officer (CMO). During the winter-over period from February to October, the station is isolated, with no incoming or outgoing flights due to severe weather conditions. In late June, four months after the station had closed for the austral winter, a 31 year old meteorologist suffered a complete rupture of his patellar tendon while sliding done an embankment. An evacuation was deemed to be too risky to aircrews due to the extreme cold and darkness. A panel of physicians from Massachusetts General Hospital, Johns Hopkins University and the University of Texas Medical Branch were able to assess the patient remotely via telemedicine and agreed that surgery was the only means to restore mobility and prevent long term disability. The lack of a surgical facility and a trained surgical team were overcome by conversion of the clinic treatment area, and intensive preparation of medical laypersons as surgical assistants. The non-surgeon CMO and CMO assistant at South Pole, were guided through the administration of spinal anesthetic, and the two-hour operative repair by medical consultants at Massachusetts General Hospital. Real-time video of the operative field, directions from the remote consultants and audio communication were provided by videoconferencing equipment, operative cameras, and high bandwidth satellite communications. In real-time, opening incision/exposure, tendon relocation, hemostatsis, and operative closure by the CMO was closely monitored and guided and by the remote consultants. The patient s subsequent physical rehabilitation over the ensuing months of isolation was also monitored remotely via telemedicine. This was the first time in South Pole s history that remote teleguidance had been used for surgery and represents a model for real-time guidance of CMO s working at remote duty stations.

Otto, Christian↗

Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

Chough, Natacha G.↗

Challenges to Health During Deep Space Exploration Missions

Long duration missions outside of low Earth orbit will present unique challenges to the maintenance of human health. Stressors with physiologic and psychological impacts are inherent in exploration missions, including reduced gravity, increased radiation, isolation, limited habitable volume, circadian disruptions, and cabin atmospheric changes. Operational stressors such as mission timeline and extravehicular activities must also be considered, and these varied stressors may act in additive or synergistic fashions. Should changes to physiology or behavior manifest as a health condition, the rendering of care in an exploration environment must also be considered. Factors such as the clinical background of the crew, inability to evacuate to Earth in a timely manner, communication delay, and limitations in available medical resources will have an impact on the assessment and treatment of these conditions. The presentations associated with this panel will address these unique challenges from the perspective of several elements of the NASA Human Research Program, including Behavioral Health and Performance, Human Health Countermeasures, Space Radiation, and Exploration Medical Capability.

Watkins, S.↗

Pilot Assessment of Immune Dysregulation, Stress and Latent Herpesvirus Reactivation at Palmer, Antarctica - Platform for validation of Immune Countermeasures?

Recent studieshave characterized adverse health events potentially relatedto immune system dysregulation, latent herpesvirus reactivation, and clinical incidence for crewmembers onboard ISS. Both areview article describing potential spaceflight countermeasures related to immunityand a specific countermeasures protocol for deep space missions were recently published. An appropriate ground analogto enable spaceflight countermeasures has yet to be validated, although winterover in Antarctica (AWO) seems a highly relevant mission parallel to spaceflight. AWO consists of prolonged deployment, extreme environment, circadian misalignment, personal isolation, station lifestyle (varies by base), and personal risk. Through several studies, AWO at several European bases has beencharacterized, and to date the data has revealed that (immunologically) deployment to interior bases at elevation and with persistent hypobaric hypoxia possesses certaindissimilarities to spaceflight. This proposal seeks to collect low cost pilot data assessing stress, immunity and viral reactivation during AWOat thecoastalU.S. Palmer Station. Even among coastal bases, lifestyle, available crew time/workload and logistical access can vary considerably. Considering all factors, if validated, Palmer may be the most feasible location to evaluate NASA countermeasures. The goal of this pilot study is to ascertain if Palmer may serve as a spaceflight analog option for ground validation of immune countermeasures.The study initiatedwith the crew deployed for winterover at Palmer in 2020.A second crew participated in the recently concluded WO2021 season.All participatingcrew havecollectedand preservedsaliva, plasma and hair samples. On location, the crewmembers alsoperformeda fingerstick blood collection for immediate analysis of basic peripheral leukocyte subsets. Preserved biosamples have beenreturned for analysis, with the WO2020 samples received, and the WO2021 samples currently en-route to Houston. It should be noted that COVID-19 had significant impacts on operations, including training and the collection of pre-mission baseline samples. Preliminary data from the 2020 crewmembers indicate that a relatively mild but detectable immune dysregulation persists at Palmer Station, including alterations in concentration of some plasma cytokines and consistent increases in the incidence of EBV reactivation. Final study data will be tabulated upon receipt of the 2021 crew samples.

Stephanie Krieger↗

Subclinical Reactivation and Shed of Infectious Varicella Zoster Virus in Saliva of Astronauts

We have previously detected VZV in healthy astronauts both during spaceflight and shortly after landing. Herein, we show that VZV shed in seropositive astronauts is infectious. A total of 40 saliva samples were obtained from each of the 3 astronauts. From each astronaut, 14 samples were taken 109 to 133 days before liftoff, 1 sample was taken every day during 12 days in space, and one sample was taken for 14 consecutive days beginning the second day after landing. Quantitative PCR was used to detect VZV DNA in saliva. None of 42 preflight saliva samples contained VZV DNA. VZV DNA was detected in saliva from 2 of 3 astronauts. In 1 astronaut, 6 of 12 samples obtained during space flight contained 120 to 2,500 copies of VZV DNA per ml; after landing, 1250 copies of VZV DNA were present on day 2, 45 copies on day 3, and 110 copies on day 5. All samples taken 6 to 15 days after touchdown were negative for VZV DNA. In the second astronaut, 5 of 12 samples obtained during space flight contained 18 to 650 copies of VZV DNA per ml; after landing, 560 copies of VZV DNA were present in saliva on day 2, 340 copies on day 4, 45 copies on day 5, and 23 copes on day 6. All samples taken 7 to 15 days after touchdown were negative for VZV DNA. Saliva taken 2 to 6 days after landing from all 3 astronauts was cultured on human fetal lung cells. After one subcultivation, a cytopathic effect developed in cultures inoculated with saliva from the two astronauts whose saliva contained VZV DNA. Both PCR and immunostaining identified the isolates to be VZV and not HSV-1. Importantly, the astronaut in whom no VZV was detected had a history of zoster 9 years earlier. It is possible that a boost in cell-mediated immunity to VZV which is known to develop after zoster protected him from subclinical reactivation. The genotype of the two VZV isolates was determined by VZV ORF22-based PCR/sequencing along with FRET-based PCR assays that target specific nucleotide polymorphisms. Both VZV isolates were found to be the European genotype which also contained a rare MspI restriction enodnuclease site in VZV ORF62 at position 107,252. These findings extend our previous demonstration of VZV DNA in saliva of astronauts by showing that infectious VZV is also present. Thus, like HSV-1 and HSV-2, VZV can reactivate and shed infectious virus in the absence of clinical disease.

Cohrs, Randall J.↗

Tissue Photolithography

Tissue lithography will enable physicians and researchers to obtain macromolecules with high purity (greater than 90 percent) from desired cells in conventionally processed, clinical tissues by simply annotating the desired cells on a computer screen. After identifying the desired cells, a suitable lithography mask will be generated to protect the contents of the desired cells while allowing destruction of all undesired cells by irradiation with ultraviolet light. The DNA from the protected cells can be used in a number of downstream applications including DNA sequencing. The purity (i.e., macromolecules isolated form specific cell types) of such specimens will greatly enhance the value and information of downstream applications. In this method, the specific cells are isolated on a microscope slide using photolithography, which will be faster, more specific, and less expensive than current methods. It relies on the fact that many biological molecules such as DNA are photosensitive and can be destroyed by ultraviolet irradiation. Therefore, it is possible to protect the contents of desired cells, yet destroy undesired cells. This approach leverages the technologies of the microelectronics industry, which can make features smaller than 1 micrometer with photolithography. A variety of ways has been created to achieve identification of the desired cell, and also to designate the other cells for destruction. This can be accomplished through chrome masks, direct laser writing, and also active masking using dynamic arrays. Image recognition is envisioned as one method for identifying cell nuclei and cell membranes. The pathologist can identify the cells of interest using a microscopic computerized image of the slide, and appropriate custom software. In one of the approaches described in this work, the software converts the selection into a digital mask that can be fed into a direct laser writer, e.g. the Heidelberg DWL66. Such a machine uses a metalized glass plate (with chrome metallization) on which there is a thin layer of photoresist. The laser transfers the digital mask onto the photoresist by direct writing, with typical best resolution of 2 micrometers. The plate is then developed to remove the exposed photoresist, which leaves the exposed areas susceptible to chemical chrome etch. The etch removes the unprotected chrome. The rest of the photoresist is then removed, by either ultraviolet organic solvent or over-development. The remaining chrome pattern is quickly oxidized by atmospheric exposure (typically within 30 seconds). The ready chrome mask is now applied to the tissue slide and aligned manually, or using automatic software and pre-designed alignment marks. The slide plate sandwich is then exposed to UV to destroy the DNA of the unwanted cells. The slide and plate are separated and the slide is processed in a standard way to prepare for polymerase chain reaction (PCR) and potential identification of cancer sequences.

Wade, Lawrence A.↗

An Objective Classification of Saturn Cloud Features from Cassini ISS Images

A k -means clustering algorithm is applied to Cassini Imaging Science Subsystem continuum and methane band images of Saturn's northern hemisphere to objectively classify regional albedo features and aid in their dynamical interpretation. The procedure is based on a technique applied previously to visible- infrared images of Earth. It provides a new perspective on giant planet cloud morphology and its relationship to the dynamics and a meteorological context for the analysis of other types of simultaneous Saturn observations. The method identifies 6 clusters that exhibit distinct morphology, vertical structure, and preferred latitudes of occurrence. These correspond to areas dominated by deep convective cells; low contrast areas, some including thinner and thicker clouds possibly associated with baroclinic instability; regions with possible isolated thin cirrus clouds; darker areas due to thinner low level clouds or clearer skies due to downwelling, or due to absorbing particles; and fields of relatively shallow cumulus clouds. The spatial associations among these cloud types suggest that dynamically, there are three distinct types of latitude bands on Saturn: deep convectively disturbed latitudes in cyclonic shear regions poleward of the eastward jets; convectively suppressed regions near and surrounding the westward jets; and baro-clinically unstable latitudes near eastward jet cores and in the anti-cyclonic regions equatorward of them. These are roughly analogous to some of the features of Earth's tropics, subtropics, and midlatitudes, respectively. This classification may be more useful for dynamics purposes than the traditional belt-zone partitioning. Temporal variations of feature contrast and cluster occurrence suggest that the upper tropospheric haze in the northern hemisphere may have thickened by 2014. The results suggest that routine use of clustering may be a worthwhile complement to many different types of planetary atmospheric data analysis.

atmosphere dynamics↗

Benchtop Antigen Detection Technique using Nanofiltration and Fluorescent Dyes

The designed benchtop technique is primed to detect bacteria and viruses from antigenic surface marker proteins in solutions, initially water. This inclusive bio-immunoassay uniquely combines nanofiltration and near infrared (NIR) dyes conjugated to antibodies to isolate and distinguish microbial antigens, using laser excitation and spectrometric analysis. The project goals include detecting microorganisms aboard the International Space Station, space shuttle, Crew Exploration Vehicle (CEV), and human habitats on future Moon and Mars missions, ensuring astronaut safety. The technique is intended to improve and advance water contamination testing both commercially and environmentally as well. Lastly, this streamlined technique poses to greatly simplify and expedite testing of pathogens in complex matrices, such as blood, in hospital and laboratory clinics.

Scardelletti, Maximilian C.↗

A non-invasive measure of minerals and electrolytes in tissue

A system for collecting epithelial cells from the oral mucosa for the determination of ion concentration is discussed with application to the study of man's adaptation to microgravity. A number of characteristics of these cells influenced the choice for clinical testing. They are non-cornified epithelial cells located on the inferior aspect of the tongue; therefore, they are well protected from trauma. They have the capability of reflecting relatively recent physiologic changes since they are renewed every three days and have aerobic metabolism. Most importantly, they are easily accessible and can be removed by a wooden applicator stick with minimum discomfort. Smears of cells removed in this manner show predominantly individual cells rather than sheets of contiuous cells. This facilitates the visual isolation of single cells with the electron microscope for analysis. NASA's principle effort in the development of a test to measure the ion concentration in sublingual cells has been research by the biomedical program carried out by scientists with expertise in skeletal metabolism. These efforts were directed toward determining the biological meaning and deviations in interacellular ions in nonhuman primates and in male volunteers for experiments in a model for weightlessness. A brief one page summary of the experiments and results are presented.

Arnaud, Sara B.↗

Immune Response in Microgravity: Genetic Basis and Countermeasure Development Implications

Impairment of the immunity in astronauts and cosmonauts even in shortterm flights is a recognized risk. Longterm orbital space missions and anticipated interplanetary flights increase the concern for more pronounced effects on the immune system with potential clinical consequences. Studies in true and modeled microgravity (MG) have demonstrated that MG directly affects numerous lymphocyte functions. The purpose of this study was to screen for genes involved in lymphocytes response to modeled microgravity (MMG) that could explain the functional and structural changes observed earlier. The microgravity-induced changes in gene expression were analyzed by microarray DNA chip technology. CD3and IL2activated Tcells were cultured in 1g (static) and modeled microgravity (NASA Rotating Wall Vessel bioreactor) conditions for 24 hours. Total RNA was extracted using the RNeasy isolation kit (Qiagen, Valencia, CA). Microarray experiments were performed utilizing Affymetrix Gene Chips (U133A), allowing testing for 18,400 human genes. To decrease the biological variation and aid in detecting microgravity-associated changes, experiments were performed in triplicate using cells obtained from three different donors. Exposure to modeled microgravity resulted in alteration of 89 genes, 10 of which were upregulated and 79 down-regulated. Altered genes were categorized by their function, structural role and by association with metabolic and regulatory pathways. A large proportion was found to be involved in fundamental cellular processes: signal transduction, DNA repair, apoptosis, and multiple metabolic pathways. There was a group of genes directly related to immune and inflammatory responses (IL7R, granulysin, proteasome activator subunit 2, peroxiredoxin 4, HLADRA, lymphocyte antigen 75, IL18R and DOCK2 genes). Among these genes only one (IL7R) was upregulated, the rest were downregulated. The upregulation of the IL7 receptor gene was confirmed by RT PCR. Three genes with altered expression were identified in the apoptosis related group (Granzyme B, APO2 ligand and Beta3endonexin). All of them were downregulated. Gene expression changes in MG might appear pivotal in identifying potential molecular targets for countermeasure development. (Supported by NRA OLMSA02 and NSCORT NAG54072 grants).

Risin, Diana↗

Conditions of the Toll-Like Receptors System of the Human Innate Immunity Cells During the Long-Term Isolation

During long duration missions onboard the International Space Station (ISS), alterations in T cell function and plasma cytokine profiles have been observed. Recent studies involving pattern recognition receptors (PRRs) have established that adaptation of innate immunity to long duration space flight occurs through changes in signal PRRs, Toll-like receptors (TLRs). Despite the fact that fundamental research of PRR molecular biology is far from complete, there are an increasing number of arguments confirming the important role of this system in regulating the initial stages of the adaptive immune response, as well as in the formation of autoimmune and allergic diseases. Long duration isolation is widely used by NASA as an analog for space flight with previous missions including several Antarctic bases, an undersea research station (NEEMO), and other isolation chambers. ‘SIRIUS’ is a multi-compartment pressurized facility at the IMBP in Moscow, Russia, in which subjects will spend 8 months executing tasks similar to those performed by astronauts in space. Prolonged isolation studies like SIRIUS replicate many of the influences expected to occur during long duration spaceflight missions including isolation, stress, confinement, and living in remote conditions. The immune study to be performed on the upcoming SIRIUS mission is being led by Dr. Sergey Ponomarev at the Institute of Biomedical Problems in Moscow, Russia. The NASA JSC Immunology lab will provide analysis of immune cell function, serum cytokines and stress hormones, and salivary cortisol, cytokines, and viruses. This study will be conducted with SIRIUS subjects under the auspices of the parent program. The goal of the study is to evaluate the effect of the 8-month isolation mission on components of human innate immunity at the molecular and cellular level. Successful implementation and completion of this project will provide a unique assortment of new data, significantly expanding the current understanding of the molecular and cellular changes in TLRs during long-term isolation. We hypothesize that mission-like isolation in the Russian NEK facility, consisting of circadian misalignment, isolation, stress, and ‘station lifestyle’, will result in a pattern of immune dysregulation similar to that observed in astronauts onboard ISS. This pattern of alterations can be summarized as phenotypic changes (altered distribution of peripheral cytotoxic, central memory, CD8+ T cell subsets), reductions in T cell function, alterations in plasma cytokine profiles (increased inflammatory and certain chemokines), and reductions in mitogen stimulated cytokine profiles (spans Th1, Th2, Th17). We further hypothesize that these immune changes will correlate with the reactivation of latent herpesviruses (which persists during orbital flight), to be used as measurable adverse clinical manifestation or with other observed symptomology. The SIRIUS-21 mission began in November of 2021 and successfully concluded with the crew emerging in July of 2022. Currently, the logistics of shipping the samples from Russia to the United States is being organized.

Cody L Gutierrez↗

Immune function during space flight

It is very likely that the human immune system will be altered in astronauts exposed to the conditions of long-term space flight: isolation, containment, microgravity, radiation, microbial contamination, sleep disruption, and insufficient nutrition. In human and animal subjects flown in space, there is evidence of immune compromise, reactivation of latent virus infection, and possible development of a premalignant or malignant condition. Moreover, in ground-based space flight model investigations, there is evidence of immune compromise and reactivation of latent virus infection. All of these observations in space flight itself or in ground-based models of space flight have a strong resonance in a wealth of human pathologic conditions involving the immune system where reactivated virus infections and cancer appear as natural consequences. The clinical conditions of Epstein-Barr-driven lymphomas in transplant patients and Kaposi's sarcoma in patients with autoimmune deficiency virus come easily to mind in trying to identify these conditions. With these thoughts in mind, it is highly appropriate, indeed imperative, that careful investigations of human immunity, infection, and cancer be made by space flight researchers.

manned↗