2017 SOT Wednesday Daily Plenary Session: Keynote Medical Research Council (MRC) Lecture

The Exposome: Challenges and Opportunities

Lecturer: Paul Elliott, Imperial College, London, United Kingdom.

National and international variations in disease rates, and temporal trends—for example, the remarkable and rapid declines in coronary heart disease mortality in many countries over recent years, point to the overwhelming importance of environmental factors in risk of chronic diseases. The new developments in ’omics technologies, new sensor technologies and exposure assessment methods, provide an unprecedented opportunity to make real advances in understanding the links between environmental stressors, health and disease. Recently the exposome concept has been proposed as a means to gain greater understanding of the interaction between the environment and the host. The exposome captures the totality of internal (biochemical) and external exposures (and their biological imprints) from a variety of sources including chemical and biological agents, gut microbial and lifestyle/psychosocial factors, over the life course. The idea is that these factors interact at a cellular and systems level to generate molecular signatures of health or disease, providing new insights into disease etiopathogenesis that can inform both preventive strategies and new treatments. The metabolic signature can be assessed through ’omic technologies and biomarkers, encompassing a wide range of molecules, including small molecule metabolites in blood or urine (metabolomics), and downstream changes in gene expression levels and regulation (transcriptomics, epigenomics, proteomics). Metabolomics in particular is a powerful and innovative approach that captures in high-resolution direct signatures of the end products of metabolic pathways associated with a wide range of physiological and pathophysiological processes. This lecture will present some recent applications of the exposome approach, including use of the Metabolome-Wide Association Study (MWAS) concept, and discuss how these ideas may be taken forward in the future.