Gastroenterology

Gastroenterology

Volume 142, Issue 7, June 2012, Pages 1403-1404
Gastroenterology

Comment from the Editor
Within You, Without You: Is Gastroenterology Ready to Embrace the “Exposome”?

https://doi.org/10.1053/j.gastro.2012.04.029Get rights and content

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    Data from more studies and investigation of sources of heterogeneity are warranted to better understand the role of the remaining factors and IBD, especially those assessed in meta-analyses including few studies and disease cases or showing unexplained heterogeneity and multiple biases. Regarding future research, high-quality prospective studies should be complemented by an analysis of the exposome (eg, exploring exposures through the analysis of the internal milieu of an individual as reflected in the blood or tooth matrix109 using “-omics” technologies) of patients with new-onset IBD to ascertain the causality of these associations and clarify the underlying mechanisms.110 As other researchers have pointed out, more widespread use of standardized definitions for outcomes and exposures,111 the adoption of the Strengthening the Reporting of Observational Studies in Epidemiology (ie, STROBE) reporting guidelines,112 and registration of hypothesis-testing observational studies113 may help improve the evidence.

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    The concept of the exposome was initially proposed as a framework to complement the genome, accounting for an individual's nongenetic/environmental risk factors for malignancy.49 It has since been refined and applied more broadly to environmental epidemiology and exposure assessment in the context of other disease processes, including type 2 diabetes, inflammatory bowel disease, and addiction.50–54 The exposome characterizes all cellular processes in a framework where the “environment” can be conceptualized as the individual's internal environment and “exposures” include all biologically active chemicals within this internal environment.54

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