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Latest ‘omics’ technology studies the environment’s influence on drug response
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Pharmacoexposomics is an emerging field of research focused on understanding how environmental exposures influence a person's response to medication. This new "omics" technology lies at the intersection of pharmacology, exposure science and personalized medicine.
Pharmacology is the study of drugs and their effects, while exposomics is the study of the exposures and other variable factors a person encounters over a lifetime, including chemical exposures, pollutants, diet and lifestyle. The combination of the two disciplines—pharmacoexposomics—explores external factors, including non-medical factors called social determinants of health, affecting how drugs work in people.
"It is an enhancement to pharmacogenomics, which only examines how genetic variation affects responses to medicines," says Konstantinos Lazaridis, M.D., the Carlson and Nelson Endowed Executive Director for Mayo Clinic's Center for Individualized Medicine. "Genes and the environment are two sides of the same coin, and together they hold valuable information for optimizing drug therapy."
For example, variation in a gene called CYP2D6 can influence whether a person is a slow or a fast metabolizer of drugs like antidepressants and opioids. Similarly, exposure to high levels of pollutants such as per- and polyfluoroalkyl substances (PFAS) can affect liver function, altering a person's ability to process certain drugs. Even dietary habits like drinking grapefruit juice can block enzymes that metabolize certain drugs, increasing the risk of adverse effects and modifying their therapeutic effect.
"But these factors do not act in isolation," says Dr. Lazaridis. "We are exposed to millions of naturally occurring and man-made substances that could have a positive or negative impact on our biology. Ultimately, we hope to understand how all these environmental exposures interact with our genomic profiles to influence drug responses."
Dr. Lazaridis and other researchers are using various "omics" technologies to look for unique signatures of environmental exposures in biospecimens such as blood, urine and saliva that could help to guide therapy. For example, they can look for changes in gene expression from air pollution or measure levels of metabolites that result from the metabolism of specific drugs. By considering environmental factors alongside genetic data, pharmacoexposomics seeks to enhance personalized medicine, tailoring treatment for every patient.
