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Douglass Diak

Publications and source records attributed to Douglass Diak.

Herpesviruses in Saliva and Their Clinical Significance

Saliva has been used as a source of biological markers for a wide spectrum of normal and disease states for a long time. It is a non-invasive, easily accessible, and self-collected body fluid that contains a variety of measurable biological substances. While mostly water, saliva also contains ions, carbohydrates, proteins and peptides, exfoliated cells, nucleic acids, and microorganisms. Saliva can reflect tissue levels of some natural substances and a large variety of molecules introduced for therapeutic use, emotional status; hormonal status, immunological status, neurological effects, and nutritional and metabolic status. It can also be used to monitor a variety of drugs including marijuana, cocaine, and alcohol. It is the most cost-effective approach for screening large population in community mass screening programs and for longitudinal sampling of hospitalized individuals aimed at monitoring viral load dynamics and treatment response. During the COVID-19 pandemic, scientific evidence emerged indicating that molecular tests performed on saliva have diagnostic sensitivity and specificity comparable to those observed with nasopharyngeal swabs for SARS-CoV-2 RNA detection. The presence of IgA and IgG antibodies at the mucosal level has been demonstrated to influence the progression of viral infection and the severity of clinical manifestation. As saliva contains both respiratory secretions and immunological components, it has wide applications, ranging from clinical diagnostics to post-vaccine disease burden and immunity surveillance.

Douglass Diak

Pilot Assessment of Immune Dysregulation, Stress and Latent Herpesvirus Reactivation at Palmer, Antarctica - Platform for validation of Immune Countermeasures?

Recent studieshave characterized adverse health events potentially relatedto immune system dysregulation, latent herpesvirus reactivation, and clinical incidence for crewmembers onboard ISS. Both areview article describing potential spaceflight countermeasures related to immunityand a specific countermeasures protocol for deep space missions were recently published. An appropriate ground analogto enable spaceflight countermeasures has yet to be validated, although winterover in Antarctica (AWO) seems a highly relevant mission parallel to spaceflight. AWO consists of prolonged deployment, extreme environment, circadian misalignment, personal isolation, station lifestyle (varies by base), and personal risk. Through several studies, AWO at several European bases has beencharacterized, and to date the data has revealed that (immunologically) deployment to interior bases at elevation and with persistent hypobaric hypoxia possesses certaindissimilarities to spaceflight. This proposal seeks to collect low cost pilot data assessing stress, immunity and viral reactivation during AWOat thecoastalU.S. Palmer Station. Even among coastal bases, lifestyle, available crew time/workload and logistical access can vary considerably. Considering all factors, if validated, Palmer may be the most feasible location to evaluate NASA countermeasures. The goal of this pilot study is to ascertain if Palmer may serve as a spaceflight analog option for ground validation of immune countermeasures.The study initiatedwith the crew deployed for winterover at Palmer in 2020.A second crew participated in the recently concluded WO2021 season.All participatingcrew havecollectedand preservedsaliva, plasma and hair samples. On location, the crewmembers alsoperformeda fingerstick blood collection for immediate analysis of basic peripheral leukocyte subsets. Preserved biosamples have beenreturned for analysis, with the WO2020 samples received, and the WO2021 samples currently en-route to Houston. It should be noted that COVID-19 had significant impacts on operations, including training and the collection of pre-mission baseline samples. Preliminary data from the 2020 crewmembers indicate that a relatively mild but detectable immune dysregulation persists at Palmer Station, including alterations in concentration of some plasma cytokines and consistent increases in the incidence of EBV reactivation. Final study data will be tabulated upon receipt of the 2021 crew samples.

Stephanie Krieger

Dry Saliva Development-Artemis

Prior to the deployment of prolonged deep space missions which may carry increased crew health risks, it is essential to determine the effect that missions beyond the Van Allen Belt will have on physiology. Historically the National Aeronautics and Space Administration (NASA), Human Research Program (HRP) has developed, conducted, and delivered research findings and countermeasures that will maintain the health and safety of crews aboard the International Space Station (ISS) in anticipation of future exploration class missions. To support these objectives, research operations on ISS typically include the collection and storage of human physiological samples and their return to Earth for analysis. Transition to Gateway and Artemis lunar exploration will limit the available up mass and biosample return capability resulting in new challenges to monitor crew health during the mission. The Artemis lunar missions provide a perfect opportunity to assess new technology that could support crew biosample return that is compatible with the severe operational constraints of Artemis mission design. Dried biosample chemistry analysis is a potential technology that can enable the collection of samples and tracking of crew health during these exploration class missions. The development and implementation of dried biosample chemistry technology for tracking immune health, viral reactivation and hormone fluctuations provide a simple alternative strategy for sample collection and sample return (light weight non-conditioned stowage option) for the continuation of human research during Artemis missions. Saliva is established as an informative biosample that has both its own unique available analytes as well as others that are also present in blood. Saliva is already routinely collected from ISS astronauts for the detection of stress hormones and latent virus DNA. The ‘Dry Saliva’ book sample collection/storage protocol, already successfully deployed to ISS, represents a perfect method for collecting biosamples from Gateway and Artemis astronauts because it requires a simple, non-invasive sample collection protocol, minimum volume, and uses non-conditioned storage. We are currently conducting an expanded stability study of the dry saliva analyte platform to include additional stress hormones, cytokines, antimicrobial proteins, and latent virus DNA as well as other markers of immunity and inflammation. Validation testing on parabolic flight will establish collection methods for saliva and blood to dry sampling substrates to finalize the collection protocols for flight. For the new expanded analyte stability study, a short-term stability study with time points out to 14 days has been completed with analysis underway to determine whether additional analytes could be recovered, as well as assessing the best storage conditions for the samples collected. In parallel, a long-term stability study is being conducted out to 1 year to improve the stability of some unstable analytes. To this end, the NASA Johnson Space Center’s Immunology/Virology lab is currently finalizing the saliva dry chemistry platform, including assay compatibility and stability studies. This technology is approved to be implemented, as part of the ‘Biomarkers’ study, during Artemis II through Artemis IV lunar missions.

Mayra Nelman-Gonzalez