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Yale School of Public Health Symposium on Lifetime Exposures and Human Health: the Exposome; Summary and Future Reflections Caroline H Yale school of public health symposium on lifetime exposures and human health: the exposome; summary and future reflections Caroline H. Johnson, Yale School of Public Health Toby J. Athersuch, Imperial College London Gwen W. Collman, National Institutes of Health Suraj Dhungana, Waters Corporation David F. Grant, University of Connecticut Dean Jones, Emory University Chirag J. Patel, Harvard Medical School Vasilis Vasiliou, Yale School of Public Health Publisher: Biomed Central LTD Publication Date: 2017-12-08 Type of Work: Report Publisher DOI: 10.1186/s40246-017-0128-0 Permanent URL: https://pid.emory.edu/ark:/25593/s6w0w Final published version: http://dx.doi.org/10.1186/s40246-017-0128-0 Copyright information: © 2017 The Author(s). This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/). Accessed October 1, 2021 10:15 AM EDT Johnson et al. Human Genomics (2017) 11:32 DOI 10.1186/s40246-017-0128-0 MEETING REPORT Open Access Yale school of public health symposium on lifetime exposures and human health: the exposome; summary and future reflections Caroline H. Johnson1*, Toby J. Athersuch2,3, Gwen W. Collman4, Suraj Dhungana5, David F. Grant6, Dean P. Jones7, Chirag J. Patel8 and Vasilis Vasiliou1* Abstract The exposome is defined as “the totality of environmental exposures encountered from birth to death” and was developed to address the need for comprehensive environmental exposure assessment to better understand disease etiology. Due to the complexity of the exposome, significant efforts have been made to develop technologies for longitudinal, internal and external exposure monitoring, and bioinformatics to integrate and analyze datasets generated. Our objectives were to bring together leaders in the field of exposomics, at a recent Symposium on “Lifetime Exposures and Human Health: The Exposome,” held at Yale School of Public Health. Our aim was to highlight the most recent technological advancements for measurement of the exposome, bioinformatics development, current limitations, and future needs in environmental health. In the discussions, an emphasis was placed on moving away from a one-chemical one-health outcome model toward a new paradigm of monitoring the totality of exposures that individuals may experience over their lifetime. This is critical to better understand the underlying biological impact on human health, particularly during windows of susceptibility. Recent advancements in metabolomics and bioinformatics are driving the field forward in biomonitoring and understanding the biological impact, and the technological and logistical challenges involved in the analyses were highlighted. In conclusion, further developments and support are needed for large-scale biomonitoring and management of big data, standardization for exposure and data analyses, bioinformatics tools for co-exposure or mixture analyses, and methods for data sharing. Background throughout the lifespan, including exposures from the Since the completion of the Human Genome Project in environment, behavior, diet, and endogenous processes” 2003, it has become apparent that most chronic diseases [5]. To begin the epic task of attempting to analyze all are attributable to both genetic and environmental influ- exposures that an individual may encounter over their ences; the environment is, however, the major contributor lifespan and connect those to biological impact, there to the global disease burden [1–3]. In 2005, Christopher have been significant technological advancements to Wild put forth the concept of the exposome, which enable the study of the exposome. Herein, the Department highlighted the need for comprehensive environmental of Environmental Health Sciences at Yale School of Public exposure assessment tools to better delineate causality and Health (YSPH) brought together leaders in exposome disease [4]. The exposome, originally defined as “the totality technology advancements to discuss recent developments, of environmental exposures encountered from birth to limitations, and future needs, also with the intention to death” [4], has moved from a concept to a reality and was bring increased awareness to this growing and important recently redefined as the “cumulative measure of envir- field. onmental influences and associated biological responses Findings * Correspondence: [email protected]; [email protected] The Symposium was initially opened by YSPH Dean 1Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA Dr. Sten Vermund and National Institute of Environmental Full list of author information is available at the end of the article Health Sciences (NIEHS) Director Dr. Linda Birnbaum (by © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Johnson et al. Human Genomics (2017) 11:32 Page 2 of 8 prerecorded video), who expressed the importance and Data science: Exposomic approaches generate value of the exposome in environmental health and extensive data to be stored, managed, analyzed, epidemiology. The exposome is a highly interdisciplinary integrated, and shared. Development of community- holistic approach that intersects environmental exposure based data standards and ontologies is critical [3]. monitoring with modern technologies such as genomics and metabolomics. It is a valuable science particularly While specific challenges exist in each domain, there are important for understanding how environmental factors cross-cutting themes and needs, central to implementing affect children’s health and later-life outcomes. the exposome into scientific research. Infrastructure sup- The Symposium discussed some current important port is needed for large-scale untargeted biomonitoring considerations, developments, and future perspectives and managing big data. Advancement and standardization for exposome research which are discussed below. of technologies and methods for exposomic analyses as well as data analyses, integration, and sharing are another area requiring considerable support. Training environ- Moving away from a single exposure-disease mental health scientists in big data and use of exposomic approach approaches in human health research is also critical. Environmental health research has traditionally focused on Promotion of the concept in research areas that can how a specific chemical, or class of chemicals, influences a benefit from the exposome approach, such as epidemi- specific health outcome. This single exposure-disease ology, can accelerate its implementation. approach does not, however, represent the complexity of The NIEHS Children’s Health Exposure Analysis Resource exposures encountered throughout life. Environmental (CHEAR) Program addresses many of these challenges. exposures are complex, widespread, and play a role in CHEAR laboratory services span the breadth of the human health and the development of disease. Researchers exposome and offer targeted and untargeted analyses. are now beginning to consider the totality of external and The CHEAR Data Center serves as a data repository, internal exposures across the life course, a concept called providing statistical analyses, data integration, and inter- the exposome. Since the concept was developed, most pretation services. This data center is also developing efforts have focused on defining the exposome and community-based data standards and ontologies. NIEHS challenges to its application into scientific research. supports a hybrid approach to investigating the exposome, Three studies in Europe—the Health and Environment- which depends upon interactive workshops, established wide Associations based on Large population Surveys resources (e.g., CHEAR), and new research initiatives. In (HEALS), Human Early-Life Exposome (HELIX), and these efforts, NIEHS interacts with other institutes within EXPoSOMICS projects—represent early coordinated efforts the National Institutes of Health, as well as with other to advance exposome research [6, 7]. To further advance federal agencies and international consortia as mentioned and promote implementation of the exposome in environ- above. By taking this comprehensive approach, the expo- mental health research, NIEHS convened a workshop in some can be implemented into environmental health 2015 to review the state of the science and develop recom- research. mendations in key domains. Takeaways from each group included: Inter- and intraindividual variability and analytical advancements Biomonitoring: Exploring cumulative exposure Many burdensome diseases are complex and result from history requires a hybrid of traditional (targeted) and a combination of hereditary and environmental factors. exposomic (untargeted) biomonitoring approaches For example, the heritability, or the phenotypic variation and utilizing advantages of both methods [8]. in the population attributable to inherited factors is on Biological response and
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