Countermeasures-based Improvements in Stress, Immune System Dysregulation and Latent Herpesvirus Reactivation onboard the International Space Station – Relevance for Deep Space Missions and Terrestrial Medicine

Brian E. Crucian, George Makedonas, Clarence F. Sams, Duane L. Pierson, Richard Simpson, Raymond P. Stowe, Scott M. Smith, Sara R. Zwart, Stephanie S. Krieger, Bridgette Rooney, Grace Douglas, Meghan Downs, Mayra Nelman-Gonzalez, Thomas J. Williams, Satish Mehta

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations


The International Space Station (ISS) has continued to evolve from an operational perspective and multiple studies have monitored both stress and the immune system of ISS astronauts. Alterations were ascribed to a potentially synergistic array of factors, including microgravity, radiation, psychological stress, and circadian misalignment. Comparing similar data across 12 years of ISS construction and operations, we report that immunity, stress, and the reactivation of latent herpesviruses have all improved in ISS astronauts. Major physiological improvements seem to have initiated approximately 2012, a period coinciding with improvements onboard ISS including cargo delivery and resupply frequency, personal communication, exercise equipment and protocols, food quality and variety, nutritional supplementation, and schedule management. We conclude that spaceflight associated immune dysregulation has been positively influenced by operational improvements and biomedical countermeasures onboard ISS. Although an operational challenge, agencies should therefore incorporate, within vehicle design limitations, these dietary, operational, and stress-relieving countermeasures into deep space mission planning. Specific countermeasures that have benefited astronauts could serve as a therapy augment for terrestrial acquired immunodeficiency patients.

Original languageEnglish (US)
Pages (from-to)68-76
Number of pages9
JournalNeuroscience and Biobehavioral Reviews
StatePublished - Aug 2020
Externally publishedYes


  • Stress
  • confinement
  • exercise
  • gravity
  • immunity
  • spaceflight
  • viral reactivation

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience

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