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Published on: September 19, 2025
Transient immune impairment after a simulated long-haul flight
Annelies Wilder-Smith1, Fatima B Mustafa, Chung Mien Peng
1Department of Medicine, National University Singapore, Yong Loo Lin School of Medicine, Singapore. epvws@pacific.net.sg
Introduction:
Almost 2 billion people travel aboard commercial airlines every year, with about 20% developing symptoms of the common cold within 1 wk after air travel. We hypothesize that hypobaric hypoxic conditions associated with air travel may contribute to immune impairment.
Methods:
We studied the effects of hypobaric hypoxic conditions during a simulated flight at 8000 ft (2438 m) cruising altitude on immune and stress markers in 52 healthy volunteers (mean age 31) before and on days 1, 4, and 7 after the flight. We did a cohort study using a generalized estimating equation to examine the differences in the repeated measures.
Results:
Our findings show that the hypobaric hypoxic conditions of a 10-h overnight simulation flight are not associated with severe immune impairment or abnormal IgA or cortisol levels, but with transient impairment in some parameters: we observed a transient decrease in lymphocyte proliferative responses combined with an upregulation in CD69 and CD14 cells and a decrease in HLA-DR in the immediate days following the simulated flight that normalized by day 7 in most instances.
Discussion:
These transient immune changes may contribute to an increased susceptibility to respiratory infections commonly seen after long-haul flights.
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