Exposomal research in the context of birth cohorts

Baluch, Narges; Gallant, Mallory J.; Ellis, Anne K.

doi:10.1016/j.anai.2020.09.006

Cited by 8 publications

(4 citation statements)

References 61 publications

(67 reference statements)

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“…Moreover, certain life stages are recognized to be more susceptible to environmental exposures with regard to specific health outcomes such as asthma (15). In this context, the use of prospective birth cohort studies has been advocated (11,27). However, it should be pointed out that biomarkers of exposure might not be continuously recorded for a long time.…”

Section: The Exposome: An Innovative Approach For Assessing Environme...mentioning

confidence: 99%

Exposome and pharmacogenomics: towards precision medicine in childhood asthma

Ferrante,

Piacentini,

La Grutta

2024

Pediatr Respir J

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Asthma is a complex and heterogeneous disease that requires individualized management. In childhood, poor asthma control can irreversibly compromise the children's lung function. Beyond asthma phenotypes, considering disease endotypes has been assumed a crucial issue in developing tailored therapies. The interaction between genome and exposome determines the emergence of several cellular and molecular mechanisms that contribute to different asthma endotypes and clinical phenotypes. The exposome concept was introduced as an innovative approach for simultaneously assessing environmental risk factors and their impact on human health, thus encompassing the totality of the environmental exposures occurring over a lifetime. Given that different types of environmental exposures occurring throughout life have a major impact on asthma, an exposome-based approach appears to be particularly suggested, as it provides a risk profile rather than individual predictors. Pharmacogenomics refers to the genome-wide study of variants in the deoxyribonucleic acid, which evaluates the effect of genetic variants on the individual's response to treatment. Though many genetic variants have been shown to influence response to asthma treatment, results are still inconsistent and/or effect sizes are small. Furthermore, it should be considered that epigenetic changes, gene-gene and gene-environment interactions could affect pharmacogenomic associations. Sustainability and large-scale population-based studies are needed in order to improve research in exposome and pharmacogenomics. This review aims to discuss the latest developments related to childhood asthma in the fields of exposome and pharmacogenomics as well as challenges in integrating these innovative approaches into clinical practice and opportunities for future research.

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Section: The Exposome: An Innovative Approach For Assessing Environme...mentioning

confidence: 99%

Exposome and pharmacogenomics: towards precision medicine in childhood asthma

Ferrante,

Piacentini,

La Grutta

2024

Pediatr Respir J

View full text Add to dashboard Cite

show abstract

“…Moreover, certain life stages (for example, periods of organ development) have been identified as being more susceptible to environmental exposures with regard to asthma and allergic outcomes ( 3 , 16 ). In this regard, the use of prospective birth cohort studies has been advocated ( 16 , 33 ).…”

Section: Challenges Related To Measurement and Data Analysis To Suppo...mentioning

confidence: 99%

Addressing Exposome: An Innovative Approach to Environmental Determinants in Pediatric Respiratory Health

Ferrante

Fasola

Cilluffo

et al. 2022

Front. Public Health

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Developmental age is particularly vulnerable to impacts of environmental exposures. Until recent years, the field of environment and child health has predominantly relied on the study of single exposure–health effect relationships. The exposome is an emerging concept in epidemiology, encompassing the totality of the exposures experienced by an individual throughout life and their changes over time. This innovative approach provides a risk profile instead of individual predictors. Exposome research may contribute to better understand the complex relationships between environmental exposures and childhood respiratory health, in order to implement prevention strategies and mitigate adverse health outcomes across the life span. Indeed, an accurate assessment of the exposome needs several measurements as well as different technologies. High-throughput “omics” technologies may be promising tools to integrate a wide range of exposures. However, analyzing large and complex datasets requires the development of advanced statistical tools. This narrative review summarizes the current knowledge on exposome-based approaches in pediatric respiratory health. Further, it explores practical implementation, associated evidence gaps, research limitations and future research perspectives.

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“…Since exposures are central to allergic disease, framing our understanding of allergic diseases in terms of the individual level exposome is likely to yield new insights. Indeed, many recent reviews have superbly outlined our understanding of the leading factors of the exposome in allergic disease (74)(75)(76)(77)(78). It seems that almost everywhere we look, we can see the impact of specific factors of the exposome on allergic disease.…”

Section: Challenges In Sampling -The Exposomementioning

confidence: 99%

Achieving Precision Medicine in Allergic Disease: Progress and Challenges

2021

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Allergic diseases (atopic dermatitis, food allergy, eosinophilic esophagitis, asthma and allergic rhinitis), perhaps more than many other traditionally grouped disorders, share several overlapping inflammatory pathways and risk factors, though we are still beginning to understand how the relevant patient and environmental factors uniquely shape each disease. Precision medicine is the concept of applying multiple levels of patient-specific data to tailor diagnoses and available treatments to the individual; ideally, a patient receives the right intervention at the right time, in order to maximize effectiveness but minimize morbidity, mortality and cost. While precision medicine in allergy is in its infancy, the recent success of biologics, development of tools focused on large data set integration and improved sampling methods are encouraging and demonstrates the utility of refining our understanding of allergic endotypes to improve therapies. Some of the biggest challenges to achieving precision medicine in allergy are characterizing allergic endotypes, understanding allergic multimorbidity relationships, contextualizing the impact of environmental exposures (the “exposome”) and ancestry/genetic risks, achieving actionable multi-omics integration, and using this information to develop adequately powered patient cohorts and refined clinical trials. In this paper, we highlight several recently developed tools and methods showing promise to realize the aspirational potential of precision medicine in allergic disease. We also outline current challenges, including exposome sampling and building the “knowledge network” with multi-omics integration.

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Exposomal research in the context of birth cohorts

Cited by 8 publications

References 61 publications

Exposome and pharmacogenomics: towards precision medicine in childhood asthma

Exposome and pharmacogenomics: towards precision medicine in childhood asthma

Addressing Exposome: An Innovative Approach to Environmental Determinants in Pediatric Respiratory Health

Achieving Precision Medicine in Allergic Disease: Progress and Challenges

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