“Explore the Exposome: The Next Frontier in Individualizing Medicine” was the title of a Mayo Clinic conference that brought together experts from around the world, including NIEHS leaders and grantees, November 2 and 3 in Rochester, Minnesota. Participants explored how the exposome – the totality of a person’s lifetime exposures and their corresponding biological effects – can advance human health on a personalized level.
Left to right: Cathy Wurzer, Konstantinos Lazaridis, MD, Gary Miller, Ph.D., and Rick Woychik, Ph.D. discuss the exposome at the Mayo Clinic’s 11th Annual Conference on Individualized Medicine . (Photo courtesy of Mayo Clinic Center for Individualized Medicine)Accelerate discoveries
“We have made significant progress in mapping the human genome and understanding the role of genes in disease, but genetics only accounts for about 10% to 15% of disease,” said Konstantinos Lazaridis, MD, executive director from the Mayo Clinic’s Center for Individualized Medicine, in a statement promoting the event. “The key to accelerating new discoveries in individualized medicine lies in putting the exposome under the microscope,” he added.
“To predict individualized health outcomes, you need to factor environmental exposures into the equation,” NIEHS Director Rick Woychik, Ph.D., told attendees. He was joined by NIEHS Deputy Director Trevor Archer, Ph.D., who participated in another panel discussion titled “Exposome Big Data and Translation.”
Woychik has sought to ensure that the environment is considered in projects such as From maps to the mechanisms of medicinean initiative of International Common Disease Alliance to study how genetic traits affect health.
He also highlighted the Human Health and Exposure Analysis Resource (HHEAR), funded in part by the NIEHS. Through HHEAR, researchers have access to the tools and infrastructure they need to conduct exposome studies. Woychik then drew attention to the National Institutes of Health All of us Research program, which will integrate the analysis of environmental exposures as part of a large-scale effort to promote precision medicine.
A bright future for exposomes
“Some people say, ‘It’s impossible to measure everything a person has been exposed to throughout their lifetime, so why bother?
Walker, a NIEHS grantee, discussed an open and fair framework for exposome analysis. (Photo courtesy of Douglas Walker)Several years ago, when he was teaching at Emory University, Miller and his colleague Dean Jones, Ph.D., an NIEHS fellow, who also spoke at the conference, sought to clarify the exposomal and to show what is possible through such research.
“We came up with a modified definition, which was to get systematic information about cumulative exposures — things we could actually measure — and corresponding biological responses,” he said. “It’s totally doable.”
Exposome epidemiology is now beginning to identify health risks based on biomarkers of environmental exposures, Jones noted.
“The key to successful use of precision medicine will be to detect responses to exposures and intervene to improve health outcomes,” he added.
Jones shared his excitement for the conference and his optimism about the future of the field.
“I came away with a very positive feeling that my dream of an international human exposition project could come true in my lifetime,” he said.
Other contributions from NIEHS grantees
Susan Sumner, Ph.D., director of the metabolomics and exposome laboratory at the University of North Carolina at Chapel Hill Nutrition Research Institute, discussed precision nutrition.
A hybrid roundtable featured (left to right) Wurzer, Archer, Arjun Athreya, Ph.D. of Mayo Clinic; Jones and Sumner on the big screen. (Photo courtesy of Mayo Clinic Center for Individualized Medicine)“In precision medicine, we often study how some people respond well to drug treatment while others don’t have a positive response,” she said. “In precision nutrition, we study the different nutritional needs of individuals, or their different responses to intake. How an individual responds to nutrients or a diet is related to their health status, hereditary genetics, and lifetime exposures. Our goal is to understand how exposures, or co-exposures, relate to individual responses, and use this information to uncover biological mechanisms as well as pharmacological and nutritional targets.
“Environmental exposures can influence genetic processes, often negatively,” Miller added. “But diet can sometimes help control genetic diseases.”
Barbara Cohn, Ph.D., of the Institute of Public Health, described her work from studies dating back to the 1960s, which showed that cumulative exposures during pregnancy can affect at least three generations. “Pregnancy is a vulnerable window of susceptibility for mothers and their offspring,” she said.
Douglas Walker, Ph.D., of the Rollins School of Public Health at Emory University, is working on an atlas of exposome-diseases that will allow large-scale profiling of the exposome.
“With millions of samples stored in biobanks and with corresponding geospatial information, we are on the verge of transforming our understanding of the impact of the environment on disease,” he said.
(John Yewell is contract writer for the NIEHS Office of Communications and Public Liaison.)
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