Addressing Exposome: An Innovative Approach to Environmental Determinants in Pediatric Respiratory Health

Abstract

Developmental age is particularly vulnerable to impacts of environmental exposures. Until recent years, the field of environment and child health has predominantly relied on the study of single exposure–health effect relationships. The exposome is an emerging concept in epidemiology, encompassing the totality of the exposures experienced by an individual throughout life and their changes over time. This innovative approach provides a risk profile instead of individual predictors. Exposome research may contribute to better understand the complex relationships between environmental exposures and childhood respiratory health, in order to implement prevention strategies and mitigate adverse health outcomes across the life span. Indeed, an accurate assessment of the exposome needs several measurements as well as different technologies. High-throughput “omics” technologies may be promising tools to integrate a wide range of exposures. However, analyzing large and complex datasets requires the development of advanced statistical tools. This narrative review summarizes the current knowledge on exposome-based approaches in pediatric respiratory health. Further, it explores practical implementation, associated evidence gaps, research limitations and future research perspectives.

Oxidative Stress, Environmental Pollution, and Lifestyle as Determinants of Asthma in Children

“…Epithelial cells respond to these external insults by activating innate responses (by Toll-like receptors (TLRs)), releasing defensins and mucus, coordinating local inflammation and the immune response through release of cytokines and chemokines, activating antioxidant responses, and maintaining overall tissue homeostasis [12]. Exposure of the airway epithelium to environmental insults in early life may lead to permanent changes in structure and function that underlie development of asthma [33,34]. At birth, the epithelial barrier is formed but the immune system is immature, so, in the first years of life, children are more vulnerable to external insults [35].…”

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“…The Kingston Allergy Birth Cohort (KABC), a prenatally recruited cohort with a wide range of environmental exposures, served as the basis for the first study to examine respiratory health in early childhood through the lens of the exposome. The guardians of 235 2year-old children with respiratory symptoms were questioned [23]. The EXPOsOMICS project seeks to develop a new method for assessing environmental exposures, with a particular emphasis on air pollution and water contaminants, and to link these exposures to biochemical and molecular variations in the body.…”

Influence of epigenetics and microbiota in early‑life development: A possible role for exosomes (Review)

“…Until recently, the aforementioned factors were studied in a single effect-health result manner, an imprecise approach, since it does not take fully into consideration the numerous interactions between the environmental factors and genes themselves. Thus, the concept of the exposome, i.e., the totality of exposures from external and internal stimuli throughout the lifespan of an organism, was proposed as a more inclusive method of studying early-life environment-gene interactions (2). The mechanisms that consolidate the effect of these numerous stimuli are epigenetic modifications, such as DNA methylation, histone modifications and regulation by non-coding RNAs (ncRNAs), while one of the main interfaces between the external exposome and the human host is the gut microbiota (3).…”