Duane L. Pierson, Ph.D.NASA Johnson Space Center

Houston, Texas

Duane L. Pierson, Ph.D.NASA Johnson Space Center

Houston, Texas

Muscle lossMuscle loss

Fluid shifts,hematological changes Fluid shifts,hematological changes

Neurosensory adaptationsNeurosensory adaptations

Gastrointestinal alterationsGastrointestinal alterations

Cardiovascular adaptationsCardiovascular adaptations

Taste and odor sensitivityTaste and odor sensitivity

Sleep and circadianrhythm disturbancesSleep and circadianrhythm disturbances

Psychological-Behavioral-Performance issues Psychological-Behavioral-Performance issues

Immune changesImmune changes

Bone lossBone loss

ADAPTATION TO SPACEFLIGHTADAPTATION TO SPACEFLIGHT

HUMAN IMMUNE RESPONSEHUMAN IMMUNE RESPONSE

• Blood Cell CountBlood Cell Count

• Lymphocyte Proliferative ResponsesLymphocyte Proliferative Responses

• Cell Mediated ImmunityCell Mediated Immunity

• Cytokine ProductionCytokine Production

• NK Cell CytotoxicityNK Cell Cytotoxicity

• Humoral FactorsHumoral Factors

• Specific Antibody ResponseSpecific Antibody Response

• Wound HealingWound Healing

• Neutrophil FunctionsNeutrophil Functions

HEALTHHEALTH

DISEASEDISEASE

•• Crowded Living Conditions•• Closed-Loop Environment (Water/Air)•• Reduced Capability for Personal Hygiene•• Limited Clean-up and Disinfection Capability•• Inability to Isolate Contagious Crewmember•• Limited Treatment Capability and Crew Return•• Altered Immune Response

FACTORS INCREASING DISEASE RISKFACTORS INCREASING DISEASE RISK

•• Skin InfectionsSkin Infections

•• Gastrointestinal DistressGastrointestinal Distress

•• Urinary Tract InfectionsUrinary Tract Infections

•• Upper RespiratoryUpper Respiratory

• Latent Viral Reactivation

INFECTIOUS DISEASE RISKSINFECTIOUS DISEASE RISKS

SPECIFIC APPLICATIONMay be used as an early predictor of impending medically significant changes in the immune response.

SPECIFIC APPLICATIONMay be used as an early predictor of impending medically significant changes in the immune response.

Herpesviruses are the most readily recognized latent viruses.

These viruses are ubiquitous and represent important infectious disease risks with oncogenic potential.

Herpesviruses are the most readily recognized latent viruses.

These viruses are ubiquitous and represent important infectious disease risks with oncogenic potential.

WHY HERPESVIRUSES?WHY HERPESVIRUSES?

They are not mitigated by preflight quarantine.

Space flight stress alters immune response.

Diminished immunity results in reactivation and dissemination (“shedding”) of latent viruses.

They are not mitigated by preflight quarantine.

Space flight stress alters immune response.

Diminished immunity results in reactivation and dissemination (“shedding”) of latent viruses.

SALIVA COLLECTION PROCEDURE

Antarctica: EBVAntarctica: EBV

Days in IsolationDays in Isolation

EB

V D

NA

O.D

. @

405

nm

EB

V D

NA

O.D

. @

405

nm

DT

H r

esp

on

seD

TH

res

po

nse

-100 -50 0 50 100 150 200 2500

1

2

3

4

5

Subject 1

Pre

Normal

Hypoergic

Anergic

PostIsolation

Space Shuttle: EBV copiesSpace Shuttle: EBV copies E

BV

Co

pie

s p

er m

l E

BV

Co

pie

s p

er m

l

0

200

400

600

800

1000

EBV Frequency: 29%EBV copies 40+ 2

Day before launch(L-)

Day before launch(L-)

200-140 139-60 59-1

EBV Frequency:16%EBV copies 417+ 31

Day offlight

Day offlight

2-4 5-7 8-14

Day after recovery(R+)

Day after recovery(R+)

1-30 31-45

EBV Frequency: 16%

EBV copies 44+ 5

n = 32Space Flights = 10

•Control•Mir

Space Shuttle: CMV FrequencySpace Shuttle: CMV Frequency

% P

osi

tive

CM

V U

rin

e S

amp

les

% P

osi

tive

CM

V U

rin

e S

amp

les

Astronauts Control0

5

10

15

20

25

30n = 71

n = 61

CMV IgG Antibody TitersCMV IgG Antibody TitersC

MV

Ig

G A

nti

bo

dy

Tit

ers

(Mea

n +

/- S

E l

og

2)

CM

V I

gG

An

tib

od

y T

iter

s (M

ean

+/-

SE

lo

g2)

55 Astronauts

40 non-shedders

* significant increase from BL (p<0.001)† significant increase from L-10 (p< 0.001)

BL L-10 R+0 R+32

3

4

5

6

7

8

15 CMV Shedders

*

*

†*

CONCLUSIONSCONCLUSIONS

1. Space flight is a unique stress model

2. Antarctic Science Stations model many aspects of space flight

3. Stress associated with space flight results in increased reactivation of EBV, CMV and VZV.

4. Viral reactivation in astronauts appears to be linked to duration in Space (Stress/ Microgravity ?).

5. Space flight associated stress manifested through the HPA-axis result in increased stress hormones, reduced CMI, and increased viral reactivation.

1. Space flight is a unique stress model

2. Antarctic Science Stations model many aspects of space flight

3. Stress associated with space flight results in increased reactivation of EBV, CMV and VZV.

4. Viral reactivation in astronauts appears to be linked to duration in Space (Stress/ Microgravity ?).

5. Space flight associated stress manifested through the HPA-axis result in increased stress hormones, reduced CMI, and increased viral reactivation.

• Satish K Mehta, Ph.D., NASA-JSC

• Desmond J. Lugg, M.D., Australian Antarctic Div, Hobart, Australia

• Janet S. Butel, Ph.D., NSBRI/Baylor College of Medicine, Houston,TX

• Randall J. Cohrs, Ph.D., Uni Colorado Health Sciences Center, Denver Co

• Bagher Forghani, Ph.D.,California Department of Health Services, Richmond, CA

• Stephen K. Tyring, M.D., Ph.D., UTMB, Galveston, TX

• Ronald Glaser, Ph.D., The Ohio State University, Columbus, OH

• Satish K Mehta, Ph.D., NASA-JSC

• Desmond J. Lugg, M.D., Australian Antarctic Div, Hobart, Australia

• Janet S. Butel, Ph.D., NSBRI/Baylor College of Medicine, Houston,TX

• Randall J. Cohrs, Ph.D., Uni Colorado Health Sciences Center, Denver Co

• Bagher Forghani, Ph.D.,California Department of Health Services, Richmond, CA

• Stephen K. Tyring, M.D., Ph.D., UTMB, Galveston, TX

• Ronald Glaser, Ph.D., The Ohio State University, Columbus, OH

ACKNOWLEDGEMENTSACKNOWLEDGEMENTS