TY - JOUR
T1 - Immune system dysregulation during spaceflight
T2 - Potential countermeasures for deep space exploration missions
AU - Crucian, Brian E.
AU - Choukèr, Alexander
AU - Simpson, Richard J.
AU - Mehta, Satish
AU - Marshall, Gailen
AU - Smith, Scott M.
AU - Zwart, Sara R.
AU - Heer, Martina
AU - Ponomarev, Sergey
AU - Whitmire, Alexandra
AU - Frippiat, Jean P.
AU - Douglas, G.
AU - Lorenzi, H.
AU - Buchheim, Judith Irina
AU - Makedonas, George
AU - Ginsburg, Geoffrey S.
AU - Mark Ott, C.
AU - Pierson, Duane L.
AU - Krieger, Stephanie S.
AU - Baecker, Natalie
AU - Sams, Clarence
N1 - Publisher Copyright:
© 2018 Crucian, Choukèr, Simpson, Mehta, Marshall, Smith, Zwart, Heer, Ponomarev, Whitmire, Frippiat, Douglas, Lorenzi, Buchheim, Makedonas, Ginsburg, Ott, Pierson, Krieger, Baecker and Sams.
PY - 2018/6/28
Y1 - 2018/6/28
N2 - Recent studies have established that dysregulation of the human immune system and the reactivation of latent herpesviruses persists for the duration of a 6-month orbital spaceflight. It appears certain aspects of adaptive immunity are dysregulated during flight, yet some aspects of innate immunity are heightened. Interaction between adaptive and innate immunity also seems to be altered. Some crews experience persistent hypersensitivity reactions during flight. This phenomenon may, in synergy with extended duration and galactic radiation exposure, increase specific crew clinical risks during deep space exploration missions. The clinical challenge is based upon both the frequency of these phenomena in multiple crewmembers during low earth orbit missions and the inability to predict which specific individual crewmembers will experience these changes. Thus, a general countermeasure approach that offers the broadest possible coverage is needed. The vehicles, architecture, and mission profiles to enable such voyages are now under development. These include deployment and use of a cis-Lunar station (mid 2020s) with possible Moon surface operations, to be followed by multiple Mars flyby missions, and eventual human Mars surface exploration. Current ISS studies will continue to characterize physiological dysregulation associated with prolonged orbital spaceflight. However, sufficient information exists to begin consideration of both the need for, and nature of, specific immune countermeasures to ensure astronaut health. This article will review relevant in-place operational countermeasures onboard ISS and discuss a myriad of potential immune countermeasures for exploration missions. Discussion points include nutritional supplementation and functional foods, exercise and immunity, pharmacological options, the relationship between bone and immune countermeasures, and vaccination to mitigate herpes (and possibly other) virus risks. As the immune system has sentinel connectivity within every other physiological system, translational effects must be considered for all potential immune countermeasures. Finally, we shall discuss immune countermeasures in the context of their individualized implementation or precision medicine, based on crewmember specific immunological biases.
AB - Recent studies have established that dysregulation of the human immune system and the reactivation of latent herpesviruses persists for the duration of a 6-month orbital spaceflight. It appears certain aspects of adaptive immunity are dysregulated during flight, yet some aspects of innate immunity are heightened. Interaction between adaptive and innate immunity also seems to be altered. Some crews experience persistent hypersensitivity reactions during flight. This phenomenon may, in synergy with extended duration and galactic radiation exposure, increase specific crew clinical risks during deep space exploration missions. The clinical challenge is based upon both the frequency of these phenomena in multiple crewmembers during low earth orbit missions and the inability to predict which specific individual crewmembers will experience these changes. Thus, a general countermeasure approach that offers the broadest possible coverage is needed. The vehicles, architecture, and mission profiles to enable such voyages are now under development. These include deployment and use of a cis-Lunar station (mid 2020s) with possible Moon surface operations, to be followed by multiple Mars flyby missions, and eventual human Mars surface exploration. Current ISS studies will continue to characterize physiological dysregulation associated with prolonged orbital spaceflight. However, sufficient information exists to begin consideration of both the need for, and nature of, specific immune countermeasures to ensure astronaut health. This article will review relevant in-place operational countermeasures onboard ISS and discuss a myriad of potential immune countermeasures for exploration missions. Discussion points include nutritional supplementation and functional foods, exercise and immunity, pharmacological options, the relationship between bone and immune countermeasures, and vaccination to mitigate herpes (and possibly other) virus risks. As the immune system has sentinel connectivity within every other physiological system, translational effects must be considered for all potential immune countermeasures. Finally, we shall discuss immune countermeasures in the context of their individualized implementation or precision medicine, based on crewmember specific immunological biases.
KW - Countermeasures
KW - Gravity
KW - Immunity
KW - Spaceflight
KW - Viral reactivation
UR - http://www.scopus.com/inward/record.url?scp=85049255533&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049255533&partnerID=8YFLogxK
U2 - 10.3389/fimmu.2018.01437
DO - 10.3389/fimmu.2018.01437
M3 - Review article
AN - SCOPUS:85049255533
SN - 1664-3224
VL - 9
JO - Frontiers in immunology
JF - Frontiers in immunology
IS - JUN
M1 - 1437
ER -