Just as genes and genomics have become key elements for research and development of personalized medicinethe study of the exposome will be essential to achieve novel diagnoses and treatments.
Although it seems like a novelty, the term ‘exposome’ is not new. It was coined in 2005 by molecular epidemiologist Christopher P. Wild, to refer to all the exposures that a person receives during their life and their interaction with chronic diseases. And it is not only the environment, but the diet we follow, the behavior and other processes.
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El Comercio spoke with Dr. Konstantinos Lazaridis, a gastroenterologist and researcher at personalized medicine of the mayo clinic (Rochester, Minnesota), to learn more about how health care will change in less than a decade.
— How much will health care change?
We think about the future, about how exposure to these elements will affect health. Without a doubt, it will be a different attention. The patient will receive a box, collect samples from their own biospecimens, use some devices to make their measurements and the results will be analyzed on a digital platform, so that when they arrive at your consultation they can be given a diagnosis and therapy. personalized.
— How expensive will personalized treatments be?
There is a major study underway, which is sequencing the exome of 100,000 patients to find cancer early. We believe that this type of study will allow savings, since these tests cost between US$200 and US$300 in the United States, which is much cheaper than other invaded procedures to detect whether there is cancer or not. In addition, these tests detect many other things.
“We need artificial intelligence to understand what the millions of data from a single patient mean.”
— How do you know that studying exposure may be the key to designing the medicine of the future?
The key is that if we know what type of exposure contributes to the onset of a disease, we can take preventive measures. For example, by smoking we know that there are chemicals that cause diseases. Through blood and urine samples, we can detect the presence of that chemical element or something that should not be exposed to and we seek to eliminate it from the bloodstream, using medication or in other ways.
— How important is technology in this new health paradigm?
We need to do many tests, from the genome to the elements of the environment. We collect a lot of patient data, and for us, using artificial intelligence allows us to better understand the amount of specific information collected. 10 or 15 years ago a patient generated 100 data points; today he can generate 100 million. That’s why technology is so important to us, because we cannot do the same analysis that we did then. We need artificial intelligence to understand what that data means.
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— Are there particular factors in Latin America related to the number of cancer cases?
In my opinion, what happens in Latin America is not different from other parts of the world. There may be differences, but the general ones are exposure to the environment, what we breathe, what we touch, what we eat, what we have at home. The natural environment is also critical. We don’t have enough evidence yet.
— Is it necessary to do other types of studies?
There are many exposures that we are not measuring. In epidemiological studies, questionnaires are answered and better data would be obtained by taking samples of blood, feces and other biological specimens. When we have that information, we will better understand the influence of exposure.
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