Current flight studies onboard the International Space Station (ISS) are addressing the knowledge gap regarding the status of the immune system during space flight. These studies are identifying consistent parameters which are the basis of in-flight immune dysfunction. They are also defining an appropriate monitoring strategy for in-flight immune changes. However, a knowledge gap remains regarding the clinical relevance of space flight-associated immune dysregulation. Transient immune changes may occur without clinical risk, or persistent changes may result in specific risks for adverse clinical events. A collaborative invitation was extended for NASA to participate in European clinical studies. NASA participation consisted of several high-priority immune and viral assays (based on current flight data), allowed immune monitoring similar to flight studies. Although the new ESA clinical study is focused on specific adverse clinical outcomes (intensive care unit, sepsis), participation does afford an economical opportunity to, for the first time, begin correlating immune changes with specific adverse clinical outcomes.
This study had the following specific aims:
- Assessment and understanding of immune system changes associated with specific adverse clinical events.
- Assessment and understanding of latent virus reactivation associated with specific adverse clinical events.
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A paired t-test was used to assess the effect of medical stress on immune function. Multiple patient samples were collected from initial presentation through recovery. Data during peak adverse health was compared to both recovery and healthy control data from NASA’s Johnson Space Center’s Immunology Laboratory database. In total, 76 patients with severe sepsis or septic shock were included. An age- and sex matched healthy volunteer control group participated. At the time of enrollment, 96.0% of patients received antimicrobial therapy. In 53% of patients, pneumonia was identified as the primary focus, followed by intra-abdominal foci (19%). Pathogen detection was achieved in 51% of the cases. Therein 54% were shown to be gram-negative sepsis, 38% gram-positive and 8% viral.
Approximately 95% of patients were treated with inotropic or vasopressor medications for an average of 14.2 ± 8.3 h at study enrolment. The majority of patients on multiple catecholamines received hydrocortisone within the first 24 hours. The 90-day mortality was 18.7% with a mean survival of 30.6 ± 33.4 days. Immediately after patient enrollment, blood was drawn for the study. In mean average this was 14.5 hours after the first symptoms occurred.
For more detailed results, please see the publication cited in this record.
Feuerecker M, Sudhoff L, Crucian B, Pagel JI, Sams C, Strewe C, Guol A, Schelling G,. Briegel J, I. Kaufmann I, and Choukèr A. Early immune anergy towards recall
antigens and mitogens in patients
at onset of septic shock. 2018. Scientific Reports v8, 1754. [DOI]
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The Human Research Program (HRP) investigates and mitigates the highest risks to human health
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