The Exposome Approach in Allergies and Lung Diseases: Is It Time to Define a Preconception Exposome?

Juan Pablo López-Cervantes ,Signe Timm ,Simone Accordini ,Ingrid Nordeide Kuiper ,Anne Mette Lund Würtz ,Matthew Darby ,Randi Jacobsen Bertelsen ,Jennifer J Koplin ,Shyamali C Dharmage ,Svein Magne Skulstad ,Gro Tjalvin ,Susanne Krauss‐Etschmann ,Barbara Hammer ,Lucia Calciano ,Jorunn Kirkeleit ,Nils Oskar Jõgi ,Vivi Schlünssen ,Ane Johannessen ,Kathrine Pape ,Francisco Gómez-Real ,Toril Mørkve Knudsen ,Marianne Lønnebotn ,Cecilie Svanes

doi:10.3390/ijerph182312684

Abstract

Emerging research suggests environmental exposures before conception may adversely affect allergies and lung diseases in future generations. Most studies are limited as they have focused on single exposures, not considering that these diseases have a multifactorial origin in which environmental and lifestyle factors are likely to interact. Traditional exposure assessment methods fail to capture the interactions among environmental exposures and their impact on fundamental biological processes, as well as individual and temporal factors. A valid estimation of exposure preconception is difficult since the human reproductive cycle spans decades and the access to germ cells is limited. The exposome is defined as the cumulative measure of external exposures on an organism (external exposome), and the associated biological responses (endogenous exposome) throughout the lifespan, from conception and onwards. An exposome approach implies a targeted or agnostic analysis of the concurrent and temporal multiple exposures, and may, together with recent technological advances, improve the assessment of the environmental contributors to health and disease. This review describes the current knowledge on preconception environmental exposures as related to respiratory health outcomes in offspring. We discuss the usefulness and feasibility of using an exposome approach in this research, advocating for the preconception exposure window to become included in the exposome concept.

Highlights

Emerging research suggests that environmental exposures, long time before conception in parents and grandparents, may contribute to the development of allergies and lung diseases
The reviewed literature strongly suggests that preconception exposures may be important for the development of asthma and lung health outcomes in future offspring
We argue that the benefits of an exposome approach in addressing complex, multiple, and concurrent lifestyles, behaviors, and exposures that interplay with each other may be important when considering the preconception environment as when addressing exposures during the life span

Summary

Introduction

Emerging research suggests that environmental exposures, long time before conception in parents and grandparents, may contribute to the development of allergies and lung diseases. There is, on the other hand, a vast body of research on how environmental factors can more directly affect these outcomes in one generation and, in the last few decades, there has been a major development in the scientific understanding of how exposures occurring during intrauterine life and early childhood may affect life-span respiratory health. This knowledge is, inadequate to fully understand the origins of asthma, allergies, and lung diseases. Human studies suggest that the transfer of environmental exposure effects across generations may take place, with relevance for the development of respiratory health and disease (Table 1)

Results

Discussion

Conclusion