An Integrated Approach to the Exposome: Rappaport and Lioy Respond

Abstract

Vol. 120, No. 3 CorrespondenceOpen AccessAn Integrated Approach to the Exposome: Rappaport and Lioy Respondis accompanied byExposure Science and the Exposome: An Opportunity for Coherence in the Environmental Health Sciencesis companion ofAn Integrated Approach to the Exposome Stephen M. Rappaport and Paul J. Lioy Stephen M. Rappaport Search for more papers by this author and Paul J. Lioy Search for more papers by this author Published:1 March 2012https://doi.org/10.1289/ehp.1104719RCited by:1AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit We welcome the remarks of van Tongeren and Cherrie regarding our recent editorial (Lioy and Rappaport 2011) and see no particular differences in our positions. As originally conceived, the exposome concept promoted investigations of disease etiology, that is, finding unknown causes of disease (Wild 2005). This requires an untargeted study design so that important, but as yet unrecognized, exposures will not be missed (Rappaport and Smith 2010). Such untargeted designs lend themselves to omic characterization of biospecimens (of the top-down type), as has been demonstrated in recent metabolomic investigations (e.g., Wang et al. 2011). Many external measurements of exposure focus on specific chemicals or classes of agents, but van Tongeren and Cherrie offer examples of untargeted designs (e.g., mining records of household food purchases). In any case, as measurements of external phenomena become less targeted, they become more exposomic (of the bottom-up type). The real issue is to recognize the underlying reasons for estimating exposure levels. If measurements are intended to find unknown sources of disease, then they are consistent with the exposome concept. If they are intended for other purposes (e.g., dose response, risk assessment/management, source characterization), then they follow more traditional lines of exposure assessment/science. As we emphasized in our editorial (Lioy and Rappaport 2011), both approaches have merit, and a combination of the two offers particular advantages for both identifying and preventing hazardous exposures, and thereby mitigating diseases.The authors declare they have no actual or potential competing financial interests.ReferencesLioy PJ, Rappaport SM. 2011. Exposure science and the exposome: an opportunity for coherence in the environmental health sciences. [Editorial]Environ Health Perspect 119:A466-A46722171373. Link, Google ScholarRappaport SM, Smith MT. 2010. Environment and disease risks.Science 330(6003):460-46120966241. Crossref, Medline, Google ScholarWang Z, Klipfell E, Bennett BJ, Koeth R, Levison BS, Dugar Bet al.. 2011. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.Nature 472(7341):57-6321475195. Crossref, Medline, Google ScholarWild CP. 2005. Complementing the genome with an “exposome”: the outstanding challenge of environmental exposure measurement in molecular epidemiology.Cancer Epidemiol Biomarkers Prev 14(8):1847-185016103423. Crossref, Medline, Google ScholarFiguresReferencesRelatedDetailsCited by Harper M, Weis C, Pleil J, Blount B, Miller A, Hoover M and Jahn S (2015) Commentary on the contributions and future role of occupational exposure science in a vision and strategy for the discipline of exposure science, Journal of Exposure Science & Environmental Epidemiology, 10.1038/jes.2014.91, 25:4, (381-387), Online publication date: 1-Jul-2015. Related articlesExposure Science and the Exposome: An Opportunity for Coherence in the Environmental Health Sciences1 November 2011Environmental Health PerspectivesAn Integrated Approach to the Exposome1 March 2012Environmental Health Perspectives Vol. 120, No. 3 March 2012Metrics About Article Metrics Publication History Originally published1 March 2012Published in print1 March 2012 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.