Salivary antimicrobial proteins and stress biomarkers are elevated during a 6-month mission to the International Space Station

Nadia H. Agha, Forrest L. Baker, Hawley E. Kunz, Guillaume Spielmann, Preteesh L. Mylabathula, Bridgette V. Rooney, Satish K. Mehta, Duane L. Pierson, Mitzi S. Laughlin, Melissa M. Markofski, Brian E. Crucian, Richard J. Simpson

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


As the international space community plans for manned missions to Mars, spaceflight-associated immune dysregulation has been identified as a potential risk to the health and safety of the flight crew. There is a need to determine whether salivary antimicrobial proteins, which act as a first line of innate immune defense against multiple pathogens, are altered in response to long-duration (>6 mo) missions. We collected 7 consecutive days of whole and sublingual saliva samples from eight International Space Station (ISS) crewmembers and seven ground-based control subjects at nine mission time points, ∼180 and ∼60 days before launch (L-180/L-60), on orbit at flight days ∼10 and ∼90 (FD10/FD90) and ∼1 day before return (R-1), and at R+0, R+18, R+33, and R+66 days after returning to Earth. We found that salivary secretory (s)IgA, lysozyme, LL-37, and the cortisol-to-dehydroepiandrosterone ratio were elevated in the ISS crew before (L-180) and during (FD10/FD90) the mission. "Rookie" crewmembers embarking on their first spaceflight mission had lower levels of salivary sIgA but increased levels of α-amylase, lysozyme, and LL-37 during and after the mission compared with the "veteran" crew who had previously flown. Latent herpesvirus reactivation was distinct to the ∼6-mo mission crewmembers who performed extravehicular activity ("spacewalks"). Crewmembers who shed at least one latent virus had higher cortisol levels than those who did not shed. We conclude that long-duration spaceflight alters the concentration and/or secretion of several antimicrobial proteins in saliva, some of which are related to crewmember flight experience, biomarkers of stress, and latent viral reactivation. NEW & NOTEWORTHY Spaceflight-associated immune dysregulation may jeopardize future exploration-class missions. Salivary antimicrobial proteins act as a first line of innate immune defense. We report here that several of these proteins are elevated in astronauts during an International Space Station mission, particularly in those embarking on their first space voyage. Astronauts who shed a latent herpesvirus also had higher concentrations of salivary cortisol compared with those who did not shed. Stress-relieving countermeasures are needed to preserve immunity and prevent viral reactivation during prolonged voyages into deep space.

Original languageEnglish (US)
Pages (from-to)264-275
Number of pages12
JournalJournal of Applied Physiology
Issue number2
StatePublished - 2020


  • Astronauts
  • Herpesvirus
  • Immunology
  • Latent viral reactivation
  • Spaceflight

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)


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