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.

Even though significant development has transformed the space food system over the last 5 decades to attain more appealing dietary fare for low-orbit space crews, the advances do not meet the need for crews that might travel to Mars and beyond. It is estimated that a food system for a long-duration mission must maintain organoleptic acceptability, nutritional efficacy, and safety for a 3-to 5-y period to be viable. In addition, the current mass and subsequent waste of the food system must decrease significantly to accord with the allowable volume and payload limits of the proposed future space vehicles. Failure to provide the appropriate food or to optimize resource utilization introduces the risk that an inadequate food system will hamper mission success and/or threaten crew performance. Investigators for the National Aeronautics and Space Administration (NASA) Advanced Food Technology (AFT) consider identified concerns and work to mitigate the risks to ensure that any new food system is adequate for the mission. Yet, even with carefully planned research, some technological gaps remain. NASA needs research advances to develop food that is nutrient-dense and long-lasting at ambient conditions, partial gravity cooking processes, methods to deliver prescribed nutrients over time, and food packaging that meets the mass, barrier, and processing requirements of NASA. This article provides a brief review of research in each area, details the past AFT research efforts, and describes the remaining gaps that present barriers to achieving a food system for long exploration missions.

Strains of lactic acid bacteria, yeasts, and molds have been selected over thousands of years based on the unique sensory attributes they provide to food fermentations. Over the centuries they have evolved to their domesticated roles, leading to genome decay, loss of pathways, acquisition of genomic elements, and beneficial mutations that provide an advantage in their nutrient-rich food environments. This review highlights the evolutionary traits influenced by the domestication process as these microbes adapted to nutrient-rich foods developed by humans.

Processed and prepackaged space food is the main source of nutrition for crew aboard the International Space Station, and likely will continue to be the main source of nutrition for future exploration missions. However, very little information is available on the nutritional stability of space foods. To better understand their nutritional stability, 24 micronutrients were measured in 109 space foods stored over 3 years at room temperature. Our analysis indicated that potassium, calcium, vitamin D, and vitamin K concentrations in the food may not be adequate to meet the recommended daily intake requirements even before storage. Decreases in vitamins A, C, B1, and B6 were observed during storage. Notably, vitamins B1 and C may degrade to inadequate levels after 1 year and 3 years, respectively. This assessment suggests that different technological approaches will be required to stabilize processed foods to enable spaceflight missions over 1 year.

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