Specific Immunologic Countermeasure Protocol for Deep-Space Exploration Missions

Historically, serious illness of astronauts on orbit is rare, however clinical episodes requiring therapeutic intervention have occurred during International Space Station (ISS) missions at a noteworthy rate (1, 2). Persistent exposure to the space environment exacerbates perturbations to the immune system (3). In support, the NASA “twins” study—an evaluation of a crewmember during a 1-year ISS mission—revealed significant changes between in-flight and non-flight time points in the gene expression patterns of several immune response pathways, DNA methylation patterns of genes that regulate T cell responses, and the signatures of plasma cytokines, to promote during spaceflight decreased cellular responsiveness and increased inflammation (4). Because future deep-space exploration missions will endure for an unprecedented amount of time, with increased magnitude of mission-associated stressors, it is reasonable to expect a higher incidence of morbidities. Previously, we published a comprehensive review of potential countermeasures to obviate the immune “problem” associated with spaceflight. Now, we present a specific and personalized immune countermeasure prescription for prospective astronauts embarking on deep-space voyage