Astronauts live and work in relatively crowded, confined environments on the Space Shuttle and the International Space Station. They experience a unique set of stressors that contribute to a diminishment of many immune responses. This study investigated the ability of the shuttle crew members' monocytes to respond to gram-negative endotoxin that they could encounter during infections. Blood specimens were collected from 20 crew members and 15 control subjects 10 days before launch, 3 to 4 h after landing, and 15 days after landing and from crew members during their annual medical examination at 6 to 12 months after landing. When challenged with gram-negative endotoxin, the crew member's monocytes collected at all three time points produced lower levels of interleukin-6 (IL-6) and IL-1 and higher levels of IL-1ra and IL-8 compared to those of control subjects. Cytokines were assessed by measuring the number of cells positive for intracellular cytokines. These values returned to normal 6 to 12 months after landing, except for IL-1ra, which was still higher (five-to sixfold) than in controls. This phenomenon was accompanied by an increased expression of Toll-like receptor 4 and decreased expression of CD14 on the crew members' monocytes at all time points. There were also increased levels of the lipopolysaccharide binding protein in the plasma of the crew members 3 to 4 h and 15 days after landing. This study shows that spaceflight-associated factors (in-flight and preflight) modulate the response of monocytes to gram-negative endotoxins.During spaceflight, astronauts are affected by many unusual factors, such as microgravity, radiation, physical and mental stresses, and isolation. Not only is spaceflight associated with in-flight factors influencing the astronauts, but even before launch, in preparation for the mission, the astronauts experience changes in circadian rhythms, rigorous training, and stresses of anticipation factors. Additionally, confinement of the crew during flight can and has resulted in the transfer of microorganisms between crew members (13,26,27). All of these factors are known to affect many physiological parameters of the astronauts, including the immune system (12,17,20,31,32,41). Their effects include decreased functions of cells of the innate immune system, including neutrophils (14, 36), monocytes (15), and NK cells (17,21). The innate immune system initiates the host defense against invading microbes by specific recognition mechanisms. The family of Toll-like receptors (TLRs) on monocytes have been shown to be involved in innate immune recognition in response to microbial antigens (1, 6, 38), such as lipopolysaccharide (LPS), or endotoxin, a major virulence factor of gram-negative bacteria (29). Tapping et al. (39) have shown that TLR4 is the predominant signaling receptor for LPS in human blood. In blood, LPS binds to LPS binding protein (LBP), which facilitates the transfer of LPS to CD14 molecules in the CD14-TLR4-MD2 complex on the cell membrane of monocytes (11). CD14 plays a ke...