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Research methods for investigating infectious disease in manned space flight without human exposure
Infectious diseases represent an urgent risk for spaceflight with consequences ranging from loss in crew performance to crew incapacitation or loss of life should an outbreak occur. The resident environmental microbiome on the International Space Station has been monitored through routine surveillance over almost twenty years, beginning with culture-based microbial detection which has advanced to molecular methods in recent years. This has created a wealth of data that we have begun mining to define the microbial ecology of the ISS. Summarized here is our analysis of data from the historical microbial population defined by culture-based monitoring from the past two decades, organized by their likelihood to cause disease into clinical categories. As expected, many residents of the normal microflora in environments where people work and live were detected. However, some known pathogens were also detected. As the spaceflight environment can predispose humans to infection, crew health records were used to source additional data for the set to uncover clinical relevance. Data mining was performed on crew health records to capture adverse health events that may be related to infectious disease. Machine learning, specifically Random Forest analysis, was used to analyze the microbial and crew health datasets. The symptom categories were not explained by the ranked bacteria, due to lack of sufficient data for some categories and due to poor ranking of the pathogens for others. Poor ranking of the bacteria could be due to the clinical symptoms being linked to other disease-causing factors, such as allergy or viral infection. These findings suggest a lack of relationship between bacteria detected on surfaces in the ISS and historical health events experienced by astronauts.
Background: The transmission of vectorborne infectious diseases is often influenced by environmental, meteorological and climatic parameters, because the vector life cycle depends on these factors. For example, the geophysical parameters relevant to malaria transmission include precipitation, surface temperature, humidity, elevation, and vegetation type. Because these parameters are routinely measured by satellites, remote sensing is an important technological tool for predicting, preventing, and containing a number of vectorborne infectious diseases, such as malaria, dengue, West Nile virus, etc. Methods: A variety of NASA remote sensing data can be used for modeling vectorborne infectious disease transmission. We will discuss both the well known and less known remote sensing data, including Landsat, AVHRR (Advanced Very High Resolution Radiometer), MODIS (Moderate Resolution Imaging Spectroradiometer), TRMM (Tropical Rainfall Measuring Mission), ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer), EO-1 (Earth Observing One) ALI (Advanced Land Imager), and SIESIP (Seasonal to Interannual Earth Science Information Partner) dataset. Giovanni is a Web-based application developed by the NASA Goddard Earth Sciences Data and Information Services Center. It provides a simple and intuitive way to visualize, analyze, and access vast amounts of Earth science remote sensing data. After remote sensing data is obtained, a variety of techniques, including generalized linear models and artificial intelligence oriented methods, t 3 can be used to model the dependency of disease transmission on these parameters. Results: The processes of accessing, visualizing and utilizing precipitation data using Giovanni, and acquiring other data at additional websites are illustrated. Malaria incidence time series for some parts of Thailand and Indonesia are used to demonstrate that malaria incidences are reasonably well modeled with generalized linear models and artificial intelligence based techniques. Conclusions: Remote sensing data relevant to the transmission of vectorborne infectious diseases can be conveniently accessed at NASA and some other websites. These data are useful for vectorborne infectious disease surveillance and modeling.
Animal movement patterns are important for ecological processes such as population dynamics and infectious disease transmission. Because animals move in response to environmental cues like temperature and precipitation, changes to the environment – whether they are seasonal, interannual, or long-term – can change these processes, leading to changes in population sizes or infectious disease prevalence across space and time. My work uses a combination of simulation modeling and data analysis at multiple spatial and temporal scales to understand the environment-movement-disease connection in diverse animal taxa and environments. In this seminar, I will highlight the diverse ways that the environment can influence infectious disease dynamics via changes to animal movement patterns, including through a global study of migration in ungulate populations, a study of American White Ibis adapting to urban environments in South Florida, and examples of avian influenza prevalence in wild waterfowl. Together, these examples highlight that understanding environment-movement interactions can help predict how infectious disease dynamics might change in the future, as changes to climate, land use, and habitats alter animal movement patterns.
This is a collection of viewgraphs on the Johnson Space Center's work on infectious disease. It addresses their major concern over outbreaks of infectious disease that could jeopardize the health, safety and/or performance of crew members engaged in long duration space missions. The Antarctic environment is seen as an analogous location on Earth and a good place to carry out such infectious disease studies and methods for proposed studies as suggested.
This slide presentation opens with views of the shuttle in various stages of preparation for launch, a few moments after launch prior to external fuel tank separation, a few pictures of the earth,and several pictures of astronomical interest. The presentation reviews the factors effecting the risks of infectious disease during space flight, such as the crew, water, food, air, surfaces and payloads and the factors that increase disease risk, the factors affecting the risk of infectious disease during spaceflight, and the environmental factors affecting immunity, such as stress. One factor in space infectious disease is latent viral reactivation, such as herpes. There are comparisons of the incidence of viral reactivation in space, and in other analogous situations (such as bed rest, or isolation). There is discussion of shingles, and the pain and results of treatment. There is a further discussion of the changes in microbial pathogen characteristics, using salmonella as an example of the increased virulence of microbes during spaceflight. A factor involved in the risk of infectious disease is stress.
Spaceflight has measurable impacts on astronaut immune profiles as well as the virulence patterns of bacterial pathogens. Data with respect to human immunity indicate diminished T and NK cell function, altered cytokine profiles, persistent inflammation, and latent herpesvirus reactivation. Furthermore, evaluation of International Space Station (ISS) crewmembers gives evidence of compromised immunity, including atypical allergy, infectious disease, and dermatitis. Data with respect to certain human bacterial pathogens suggest modified virulence that may be enhanced. It is therefore critical to examine this interaction of immune dysregulation and increased microbial virulence and whether it might synergistically increase the risk of infectious disease to crew members. The goal of this study is to use modeled microgravity to study the impact of medically significant ISS bacteria that may have altered virulence on the immune response of the host. This study consists of two primary aims to assess this relationship. First, immune cells will be collected from healthy test subjects and cultured in static or in modeled microgravity conditions together with either control pathogens or with microgravity conditioned pathogens that were grown in bioreactors. Second, immune cells will be collected from astronauts before, during, and after flight and co-cultured with the control or the microgravity conditioned bacteria. Three pathogens were selected for this investigation: Pseudomonas aeruginosa , Salmonella enterica serovar Enteritidis and Burkholderia cepacia . Previously, the optimal cell to bacteria ratios that produce the greatest immune cell responses have been derived for these three bacteria. Cellular activation, as determined by the induction of cell surface activation markers and cytokine profiles, will be measured. Interactions between cells and bacteria will be assessed using fluorescent and electron microscopy techniques. This study will provide critical information to help understand how microgravity alters microbial virulence and the associated infectious disease risk to crewmembers during spaceflight missions. Over the past year, the Immunology and Microbiology laboratories at NASA Johnson Space Center have collaborated to process the astronaut subject samples to complete the last year of the flight portion of this study. This included the completion of four astronaut subjects full mission sampling sets. Sample processing included innate and adaptive cell flow cytometry as well as analysis of cytokine concentrations in the supernatant. The ground control segment of the study will take place during FY25 which involves parallel infections run under static and clinostat conditions. The acquired data sets over this 3-year study are now being analyzed to provide a comprehensive set of results and conclusions that will contribute to a more effective risk assessment for astronauts during spaceflight regarding this host-pathogen context.
Three-dimensional (3-D) cell cultures hold enormous potential to advance our understanding of infectious disease and to effectively translate basic cellular research into clinical applications. Using novel NASA bioreactor technology, the rotating wall vessel (RWV), we have engineered physiologically relevant 3-D human tissue culture models for infectious disease studies. The design of the RWV is based on the understanding that organs and tissues function in a 3-D environment, and that this 3-D architecture is critical for the differentiated form and function of tissues in vivo. The RWV provides large numbers of cells which are amenable to a wide variety of experimental manipulations and provides an easy, reproducible, and cost-effective approach to enhance differentiated features of cell culture models.
The International Space Station (ISS) is a semi-closed habitat in low Earth orbit with environmental conditions provided by an advanced life support system that controls temperature and recycles air and most of the potable water. The crew's activities, such as eating, sleeping, hygiene, and laboratory research, are performed in relatively close proximity. Research in the laboratory includes a myriad of experiments, including those with rodents, plants, and pathogenic microorganisms. Despite these conditions, in-flight monitoring of ISS indicates that the microbial diversity is similar to homes on earth. Accordingly, the crew is generally very healthy, however infectious disease does occur and potential routes of infection by obligate and opportunistic pathogens cannot be completely prevented. Determining the extent of this risk is further complicated, as microorganisms can alter their characteristics in response to spaceflight culture, as exemplified by the increase in virulence of the enteric pathogen Salmonella enterica Typhimurium during spaceflight compared to otherwise identical cultures grown on Earth. Taken together, these factors suggest a need for continued microbiological monitoring and research to understand and mitigate the risk of infectious disease during long duration missions.
The characterization of a clinical sample by a simple, fast, accurate, automatable analytical measurement is important in the management of infectious disease. Luminescence assays offer methods rich with options for these measurements. The instrumentation is common to each assay, and the investment is reasonable. Three general procedures were developed to varying degrees of completeness which measure bacterial levels by measuring their ATP, FMN and iron porphyrins. Bacteriuria detection and antibiograms can be determined within half a day. The characterization of the sample for its soluble ATP, FMN or prophyrins was also performed.
Representative, reproducible and high-throughput models of human cells and tissues are critical for a meaningful evaluation of host-pathogen interactions and are an essential component of the research developmental pipeline. The most informative infection models - animals, organ explants and human trials - are not suited for extensive evaluation of pathogenesis mechanisms and screening of candidate drugs. At the other extreme, more cost effective and accessible infection models such as conventional cell culture and static co-culture may not capture physiological and three-dimensional aspects of tissue biology that are important in assessing pathogenesis, and effectiveness and cytotoxicity of therapeutics. Our lab has used innovative bioengineering technology to establish biologically meaningful 3-D models of human tissues that recapitulate many aspects of the differentiated structure and function of the parental tissue in vivo, and we have applied these models to study infectious disease. We have established a variety of different 3-D models that are currently being used in infection studies - including small intestine, colon, lung, placenta, bladder, periodontal ligament, and neuronal models. Published work from our lab has shown that our 3-D models respond to infection with bacterial and viral pathogens in ways that reflect the infection process in vivo. By virtue of their physiological relevance, 3-D cell cultures may also hold significant potential as models to provide insight into the neuropathogenesis of HIV infection. Furthermore, the experimental flexibility, reproducibility, cost-efficiency, and high throughput platform afforded by these 3-D models may have important implications for the design and development of drugs with which to effectively treat neurological complications of HIV infection.
Multiple environmental factors asociated with space flight can increase the risk of infectious illness among crewmembers thereby adversely affecting crew health and mission success. Host defences can be impaired by multiple physiological and psychological stressors including: sleep deprivation, disrupted circadian rhythms, separation from family, perceived danger, radiation exposure, and possibly also by the direct and indirect effects of microgravity. Relevant human immunological data from isolated or stressful environments including spaceflight will be reviewed. Long-duration missions should include reliable hardware which supports sophisticated immunodiagnostic capabilities. Future advances in immunology and molecular biology will continue to provide therapeutic agents and biologic response modifiers which should effectively and selectively restore immune function which has been depressed by exposure to environmental stressors.
In contemplating space travel beyond earth orbits, we humans face significant barriers and major challenges. Although researchers involved in several scientific subdisciplines, including space medicine and space life sciences, may provide insights to help overcome those barriers, their efforts are at an early stage of development, leaving open many questions of potentially major consequence.
It has long been known that cholera outbreaks can be initiated when Vibrio cholerae, the bacterium that causes cholera, is present in drinking water in sufficient numbers to constitute an infective dose, if ingested by humans. Outbreaks associated with drinking or bathing in unpurified river or brackish water may directly or indirectly depend on such conditions as water temperature, nutrient concentration, and plankton production that may be favorable for growth and reproduction of the bacterium. Although these environmental parameters have routinely been measured by using water samples collected aboard research ships, the available data sets are sparse and infrequent. Furthermore, shipboard data acquisition is both expensive and time-consuming. Interpolation to regional scales can also be problematic. Although the bacterium, V. cholerae, cannot be sensed directly, remotely sensed data can be used to infer its presence. In the study reported here, satellite data were used to monitor the timing and spread of cholera. Public domain remote sensing data for the Bay of Bengal were compared directly with cholera case data collected in Bangladesh from 1992-1995. The remote sensing data included sea surface temperature and sea surface height. It was discovered that sea surface temperature shows an annual cycle similar to the cholera case data. Sea surface height may be an indicator of incursion of plankton-laden water inland, e.g., tidal rivers, because it was also found to be correlated with cholera outbreaks. The extensive studies accomplished during the past 25 years, confirming the hypothesis that V. cholerae is autochthonous to the aquatic environment and is a commensal of zooplankton, i.e., copepods, when combined with the findings of the satellite data analyses, provide strong evidence that cholera epidemics are climate-linked.
West Nile Virus is a mosquito-borne virus of the family Flaviviridae. It infects birds and various mammals, including humans, and can cause encephalitis that may prove fatal, notably among vulnerable populations. Since its identification in New York City in 1999, WNV has become established in a broad range of ecological settings throughout North America, infecting more than 25,300 people and killing 1133 as of 2008 (CDC,2009). WNV is transmitted by mosquitoes that feed on infected birds. As a result, the degree of human infection depends on local ecology and human exposure. This study hypothesizes that remote sensing and GIS can be used to analyze environmental determinants of WNV transmission, such as climate, elevation, land cover, and vegetation densities, to map areas of WNV risk for surveillance and intervention.
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This presentation discusses the processes from data collection and processing to analysis involved in unraveling patterns between disease outbreaks and the surrounding environment and meteorological conditions. We used these patterns to estimate when and where disease outbreaks will occur. As a case study, we will present our work on assessing the relationship between meteorological conditions and influenza in Central America. Our work represents the discovery, prescriptive and predictive aspects of data analytics.