Every breath we take, every meal we eat, and every environment we encounter leaves a molecular fingerprint in our bodies — a hidden record of our lifelong exposures. Researchers in the field of exposomics explain how cutting-edge technologies are unlocking this biological archive, ushering in a new era of disease prevention and personalized medicine. The scientists lay out a roadmap to overcome technical and logistical challenges and realize the field's full potential.
Exposomics explores how the complex interplay of environmental factors — from pollutants in our water and food to social and psychological stressors — shapes our biology. By studying these combined exposures, researchers can uncover how they collectively influence health, from metabolism and heart function to brain health and disease risk.
The Perspectives article is led by the Banbury Exposomics Consortium — an interdisciplinary group of scientists who gathered at Cold Spring Harbor's Banbury Center in 2023 to define the core principles of this rapidly evolving field. Gary Miller, PhD, a foremost expert in exposomics and faculty member at Columbia University Mailman School of Public Health, was the lead organizer of the Consortium.
Miller, Vice Dean of Research and Innovation and Professor of Environmental Health Sciences at Columbia Mailman School, co-leads the NIH-funded national coordinating center for exposomics, NEXUS. He also leads IndiPHARM, an ARPA-H-funded initiative using exposomics to predict drug interactions and enhance medication effectiveness.
Exposomics in Action
The young field is already proving its transformative potential. Researchers analyzing molecular evidence identified a specific industrial solvent as the culprit behind kidney disease clusters among factory workers. In another study, scientists merged satellite pollution mapping with residential location information to reveal how airborne particulates prematurely age the brain. Scientists analyzing thousands of circulating molecules pinpointed TMAO, a gut microbiome metabolite produced when eating red meat and dairy, as a previously overlooked major contributor to heart attack risk.
These discoveries are made possible by cutting-edge technologies and tools such as wearable sensors that track chemical exposures in real-time, satellite imagery that maps pollution down to city blocks, and ultra-sensitive mass spectrometers that detect compounds present at just one part per trillion.
A Wider Lens on Our Health
While genetics provides our biological blueprint, it explains only a fraction of chronic disease risk. The exposome captures everything that happens to us, from industrial chemicals to social stressors. Unlike traditional studies examining single exposures in isolation, exposomics integrates advanced tools to understand how environmental, social, and psychological factors collectively interact with our biology.
This approach synergizes powerfully with other “omics” sciences. When combined with genomics, proteomics, and metabolomics, exposomics creates the first complete picture of health determinants. The authors envision a future where all major disease studies incorporate exposome analysis as standard practice.
Systematically analyzing these complex interactions can improve drug development, uncover hidden drivers of disease, and address health disparities. The approach bridges precision medicine and population health.
The Way Forward
Miller and colleagues outline critical priorities for advancing exposomics. These include the development of more sensitive technologies, such as wearable or minimally invasive tools that measure an individual's exposome; the creation of a human exposome reference to enable analysis and contextualization at the population scale; and the implementation of standardized protocols to enable AI-driven analysis of complex datasets. The field must also address ethical considerations around data privacy and the need for greater focus on the social determinants of health, the authors write.
Newly launched U.S. and European exposomics hubs now provide the infrastructure for worldwide collaboration, standardizing methods, harmonizing data, and training researchers in the cross-disciplinary skills needed to advance this field. These centers form the critical backbone for the future progress of exposomics.
“We're now building the first systematic framework to measure how all exposures — from chemical to social — interact with biology across the lifespan. Our goal is to create actionable strategies for healthier lives,” says Miller.
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