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Batatinha H, Diak DM, Niemiro GM, Baker FL, Smith KA, Zúñiga TM, Mylabathula PL, Seckeler MD, Lau B, LaVoy EC, Gustafson MP, Katsanis E, Simpson RJ. Human lymphocytes mobilized with exercise have an anti-tumor transcriptomic profile and exert enhanced graft-versus-leukemia effects in xenogeneic mice. Front Immunol 2023; 14:1067369. [PMID: 37077913 PMCID: PMC10109447 DOI: 10.3389/fimmu.2023.1067369] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/09/2023] [Indexed: 04/05/2023] Open
Abstract
BackgroundEvery bout of exercise mobilizes and redistributes large numbers of effector lymphocytes with a cytotoxic and tissue migration phenotype. The frequent redistribution of these cells is purported to increase immune surveillance and play a mechanistic role in reducing cancer risk and slowing tumor progression in physically active cancer survivors. Our aim was to provide the first detailed single cell transcriptomic analysis of exercise-mobilized lymphocytes and test their effectiveness as a donor lymphocyte infusion (DLI) in xenogeneic mice engrafted with human leukemia.MethodsPeripheral blood mononuclear cells (PBMCs) were collected from healthy volunteers at rest and at the end of an acute bout of cycling exercise. Flow cytometry and single-cell RNA sequencing was performed to identify phenotypic and transcriptomic differences between resting and exercise-mobilized cells using a targeted gene expression panel curated for human immunology. PBMCs were injected into the tail vein of xenogeneic NSG-IL-15 mice and subsequently challenged with a luciferase tagged chronic myelogenous leukemia cell line (K562). Tumor growth (bioluminescence) and xenogeneic graft-versus-host disease (GvHD) were monitored bi-weekly for 40-days.ResultsExercise preferentially mobilized NK-cell, CD8+ T-cell and monocyte subtypes with a differentiated and effector phenotype, without significantly mobilizing CD4+ regulatory T-cells. Mobilized effector lymphocytes, particularly effector-memory CD8+ T-cells and NK-cells, displayed differentially expressed genes and enriched gene sets associated with anti-tumor activity, including cytotoxicity, migration/chemotaxis, antigen binding, cytokine responsiveness and alloreactivity (e.g. graft-versus-host/leukemia). Mice receiving exercise-mobilized PBMCs had lower tumor burden and higher overall survival (4.14E+08 photons/s and 47%, respectively) at day 40 compared to mice receiving resting PBMCs (12.1E+08 photons/s and 22%, respectively) from the same donors (p<0.05). Human immune cell engraftment was similar for resting and exercise-mobilized DLI. However, when compared to non-tumor bearing mice, K562 increased the expansion of NK-cell and CD3+/CD4-/CD8- T-cells in mice receiving exercise-mobilized but not resting lymphocytes, 1-2 weeks after DLI. No differences in GvHD or GvHD-free survival was observed between groups either with or without K562 challenge.ConclusionExercise in humans mobilizes effector lymphocytes with an anti-tumor transcriptomic profile and their use as DLI extends survival and enhances the graft-versus-leukemia (GvL) effect without exacerbating GvHD in human leukemia bearing xenogeneic mice. Exercise may serve as an effective and economical adjuvant to increase the GvL effects of allogeneic cell therapies without intensifying GvHD.
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Affiliation(s)
- Helena Batatinha
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
| | - Douglass M. Diak
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
| | - Grace M. Niemiro
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
- Cancer Center, The University of Arizona, Tucson, AZ, United States
| | - Forrest L. Baker
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
- Cancer Center, The University of Arizona, Tucson, AZ, United States
| | - Kyle A. Smith
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
| | - Tiffany M. Zúñiga
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
| | - Preteesh L. Mylabathula
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
| | - Michael D. Seckeler
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
| | - Branden Lau
- University of Arizona Genetics Core, The University of Arizona, Tucson, AZ, United States
| | - Emily C. LaVoy
- Department of Health and Human Performance, University of Houston, Houston, TX, United States
| | - Michael P. Gustafson
- Department of Laboratory Medicine and Pathology, Mayo Clinic in Arizona, Phoenix, AZ, United States
| | - Emmanuel Katsanis
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
- Cancer Center, The University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, The University of Arizona, Tucson, AZ, United States
| | - Richard J. Simpson
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, United States
- Department of Pediatrics, The University of Arizona, Tucson, AZ, United States
- Cancer Center, The University of Arizona, Tucson, AZ, United States
- Department of Immunobiology, The University of Arizona, Tucson, AZ, United States
- *Correspondence: Richard J. Simpson,
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Mylabathula PL, Diak DM, Baker FL, Niemiro GM, Markofski MM, Crucian BE, Katsanis E, Simpson RJ. IL-2 and Zoledronic Acid Therapy Restores the In Vivo Anti-Leukemic Activity of Human Lymphocytes Pre-Exposed to Simulated Microgravity. Front Biosci (Landmark Ed) 2022; 27:215. [PMID: 35866402 DOI: 10.31083/j.fbl2707215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/29/2022] [Accepted: 06/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND We have previously shown that the anti-tumor activity of human lymphocytes is diminished in vitro after 12-hours pre-exposure to simulated microgravity (SMG). Here we used an immunocompromised mouse model to determine if this loss of function would extend in vivo, and to also test the efficacy of IL-2 and zoledronic acid (ZOL) therapy as a potential countermeasure against SMG-induced immune dysfunction. We adoptively transferred human lymphocytes that were exposed to either SMG or 1G-control into NSG-Tg (Hu-IL15) mice 1-week after they were injected with a luciferase-tagged human chronic myeloid leukemia (K562) cell line. Tumor growth was monitored 2x weekly with bioluminescence imaging (BLI) for up to 6-weeks. RESULTS Mice that received lymphocytes exposed to SMG showed greater tumor burden compared to those receiving lymphocytes exposed to 1G (week 6 BLI: 1.8e10 ± 8.07e9 versus 2.22e8 ± 1.39e8 photons/second; p < 0.0001). Peak BLI was also higher in the SMG group compared to 1G-control (2.34e10 ± 1.23e10 versus 3.75e8 ± 1.56e8 photons/second; p = 0.0062). Exposure to SMG did not affect the ability of human lymphocytes to engraft or evoke xeno-graft-versus-host disease in the mice. Additionally, we injected the mice with IL-2 and zoledronic acid (ZOL) to expand and activate the anti-tumor activity of NK cells and γ δ-T cells, respectively. This treatment was found to revive the loss of anti-leukemic function observed in vivo when lymphocytes were pre-exposed to SMG. CONCLUSIONS Microgravity plays a contributory role in loss of tumor control in vivo. Immuno-stimulating agents like ZOL+IL-2 may offer an important countermeasure for immune dysregulation during prolonged spaceflight.
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Affiliation(s)
- Preteesh L Mylabathula
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA.,Department of Pediatrics, The University of Arizona, Tucson, AZ 85721, USA
| | - Douglass M Diak
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA.,Department of Pediatrics, The University of Arizona, Tucson, AZ 85721, USA
| | - Forrest L Baker
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA.,Department of Pediatrics, The University of Arizona, Tucson, AZ 85721, USA
| | - Grace M Niemiro
- Department of Pediatrics, The University of Arizona, Tucson, AZ 85721, USA
| | - Melissa M Markofski
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX 77004, USA
| | | | - Emmanuel Katsanis
- Department of Pediatrics, The University of Arizona, Tucson, AZ 85721, USA.,Department of Immunobiology, The University of Arizona, Tucson, AZ 85721, USA.,The University of Arizona Cancer Center, Tucson, AZ, 85721, USA
| | - Richard J Simpson
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA.,Department of Pediatrics, The University of Arizona, Tucson, AZ 85721, USA.,Department of Immunobiology, The University of Arizona, Tucson, AZ 85721, USA.,The University of Arizona Cancer Center, Tucson, AZ, 85721, USA
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Coletta AM, Agha NH, Baker FL, Niemiro GM, Mylabathula PL, Brewster AM, Bevers TB, Fuentes-Mattei E, Basen-Engquist K, Gilchrist SC, Simpson RJ. The impact of high-intensity interval exercise training on NK-cell function and circulating myokines for breast cancer prevention among women at high risk for breast cancer. Breast Cancer Res Treat 2021; 187:407-416. [PMID: 33555464 PMCID: PMC8189992 DOI: 10.1007/s10549-021-06111-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/21/2021] [Indexed: 12/31/2022]
Abstract
Purpose Preclinical evidence suggests that natural killer cell (NK-cell) function and myokines facilitate the protective effects of exercise for breast cancer prevention. Since higher-intensity exercise acutely promotes greater mobilization and larger changes in NK-cell cytotoxicity than lower-intensity, high-intensity interval training (HIIT) might offer increased immune protection compared to moderate-intensity continuous-training (MICT). This study compared a 12-week HIIT program to a 12-week MICT program and usual care on changes in resting NK-cell function and circulating myokines among women at high risk for breast cancer. Methods Thirty-three women were randomized to HIIT, MICT, or usual care, for a supervised exercise intervention. Blood was collected at baseline and end-of-study. The cytotoxic activity of CD3−/CD56+ NK-cells against the K562 target cell line in vitro was determined by flow cytometry. Circulating myokines (IL-15, IL-6, irisin, OSM, osteonectin, IL-7) were assessed with luminex multiplex assays and ELISA. One-way ANOVA and paired sample t-tests assessed between- and within-group differences, respectively. Pearson correlation coefficients determined relationships between baseline fitness and change variables. Results Significant differences were not observed between groups for change in NK-cell function or circulating myokines (p > 0.05). Significant correlations were only observed for baseline peak aerobic capacity (ml/kg/min) and change in NK-cell-specific lysis (r = − 0.43, p = 0.02) and hemacytotoxicity for the total sample (r = − 0.46, p = 0.01). Conclusion Our findings suggest that exercise intensity may not significantly impact change in resting NK-cell function and circulating myokines among women at high risk for breast cancer. Structured exercise training may have a larger impact on NK-cell function in those with lower levels of cardiorespiratory fitness. Clinical trial registration: NCT02923401; Registered on October 4, 2016
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Affiliation(s)
- Adriana M Coletta
- Department of Health and Kinesiology, The University of Utah, Salt Lake City, UT, USA. .,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA. .,Huntsman Cancer Institute at the University of Utah, 2000 Circle of Hope Drive, Research South Building Room 4747, Salt Lake City, UT, 84112, USA.
| | - Nadia H Agha
- Department of Health and Human Performance, The University of Houston, Houston, TX, USA
| | - Forrest L Baker
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA
| | - Grace M Niemiro
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA
| | - Preteesh L Mylabathula
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA
| | - Abenaa M Brewster
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Therese B Bevers
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Enrique Fuentes-Mattei
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard J Simpson
- Department of Pediatrics, The University of Arizona, Tucson, AZ, USA.,Department of Nutritional Sciences, The University of Arizona, Tucson, AZ, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Immunobiology, The University of Arizona, Tucson, AZ, USA.,The University of Arizona Cancer Center, Tucson, AZ, USA
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Agha NH, Baker FL, Kunz HE, Spielmann G, Mylabathula PL, Rooney BV, Mehta SK, Pierson DL, Laughlin MS, Markofski MM, Crucian BE, Simpson RJ. Salivary antimicrobial proteins and stress biomarkers are elevated during a 6-month mission to the International Space Station. J Appl Physiol (1985) 2019; 128:264-275. [PMID: 31751178 DOI: 10.1152/japplphysiol.00560.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Nadia H Agha
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Forrest L Baker
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona.,Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Hawley E Kunz
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
| | - Guillaume Spielmann
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,School of Kinesiology, Louisiana State University, Baton Rouge, Louisiana
| | - Preteesh L Mylabathula
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona.,Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Bridgette V Rooney
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,GeoControl Systems, Incorporated, National Aeronautics and Space Administration Johnson Space Center, Houston, Texas
| | - Satish K Mehta
- JesTech, National Aeronautics and Space Administration Johnson Space Center, Houston, Texas
| | - Duane L Pierson
- National Aeronautics and Space Administration, Johnson Space Center, Houston, Texas
| | - Mitzi S Laughlin
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,Fondren Orthopedic Research Institute, Houston, Texas
| | - Melissa M Markofski
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas
| | - Brian E Crucian
- National Aeronautics and Space Administration, Johnson Space Center, Houston, Texas
| | - Richard J Simpson
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, Texas.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona.,Department of Pediatrics, University of Arizona, Tucson, Arizona.,Department of Immunobiology, University of Arizona, Tucson, Arizona.,Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Bigley AB, Agha NH, Baker FL, Spielmann G, Kunz HE, Mylabathula PL, Rooney BV, Laughlin MS, Mehta SK, Pierson DL, Crucian BE, Simpson RJ. NK cell function is impaired during long-duration spaceflight. J Appl Physiol (1985) 2018; 126:842-853. [PMID: 30382809 DOI: 10.1152/japplphysiol.00761.2018] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Maintaining astronaut health during space travel is paramount for further human exploration of the solar system beyond Earth's orbit. Of concern are potential dysregulations in immunity, which could increase the likelihood of cancer and latent viral reactivation. Natural killer (NK) cells are critical effectors of the innate immune system, and their function and phenotype are important to immunosurveillance of nascent tumors and latent viral infections. We compared changes in NK cell phenotype and function in eight crew members who completed an ~6-mo mission to the International Space Station (ISS) with healthy controls who remained on Earth. Assessments were made before (180 and 60 days before launch), during [flight day + 90 days (FD+90) and 1 day before return (R-1)], and after the mission (at R+0, R+18, R+33, and R+66). These samples, plus an additional in-flight sample (FD+180), were collected from a crew member who spent 340 days (~1 yr) on the ISS. NK cell cytotoxic activity (NKCA) against K562 leukemia targets in vitro was reduced by ~50% at FD+90 in ISS crew but not controls. This decrease was more pronounced in "rookie" compared with "veteran" crew members. The ~1-yr mission crew member did not show declines in NKCA against K562 until late in the mission (R-1 and R+0). NK cell numbers, expression of activating and inhibitory receptors, target cell binding, and expression and degranulation of perforin and granzyme B were unaltered with spaceflight. Similarly, when we exposed an immortalized NK cell line (NK-92) to sera collected at different mission time points (before, during, and after flight), there was no effect on NKCA. This is the first study to report impaired NK cell function during long-duration space travel. Countermeasures may be needed to mitigate immune system impairment in exploration class mission crew during long-duration spaceflight missions. NEW & NOTEWORTHY Immune system impairment may inhibit future human space exploration missions to Mars. Natural killer (NK) cells are key components of immunity and vital for tumor surveillance and the prevention of latent virus reactivation. We report that NK cell function is impaired in astronauts during an ~6-mo orbital space mission compared with preflight levels and ground-based controls. Declines in NK cell function were more marked in first-time "rookie" fliers. Countermeasures are needed to preserve NK cell-mediated immunity during spaceflight.
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Affiliation(s)
- Austin B Bigley
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Nadia H Agha
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Forrest L Baker
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,Department of Pediatrics, The University of Arizona , Tucson, Arizona
| | - Guillaume Spielmann
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,School of Kinesiology, Louisiana State University , Baton Rouge, Louisiana
| | - Hawley E Kunz
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Preteesh L Mylabathula
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,Department of Pediatrics, The University of Arizona , Tucson, Arizona
| | - Bridgette V Rooney
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Mitzi S Laughlin
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Satish K Mehta
- National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Duane L Pierson
- National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Brian E Crucian
- National Aeronautics and Space Administration Johnson Space Center , Houston, Texas
| | - Richard J Simpson
- Department of Nutritional Sciences, The University of Arizona , Tucson, Arizona.,Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston , Houston, Texas.,Department of Pediatrics, The University of Arizona , Tucson, Arizona.,Department of Immunobiology, The University of Arizona , Tucson, Arizona
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