As big data and AI step in, the game changes and many prospects are widened when it comes to how we can protect ourselves.
Lazaridis talks to Ahram Online about health, daily exposures, and preventing diseases.
Ahram Online: What is the link between environmental exposures and health?
Konstantinos Lazaridis: For the last 20 years I started studying genetics and particularly their role in two rare liver diseases.
I have come to truly believe that the environment that we create is crucially important, along with genetics, to the development of diseases.
That is why we made this area the focus of our studies at the Individualised Medicine Centre in Mayo Clinic, because we believe we can better identify exposures, and thereby better diagnose and treat accordingly.
What we are exposed to from accumulated environmental chemicals, pollutants, microbes, and particulates may be living inside each of us.
It is acquired from the air we breathe, the food we eat, products we touch, and the water we drink.
These sometimes-harmful exposures can interact with our genes to fuel disease.
We are studying lifetime environmental exposures, called the exposome, and assessing biological responses to those exposures.
Environmental factors have been linked to diseases including cancer, heart disease, lung illnesses, autoimmune diseases, and strokes.
These factors are associated with more than 80 percent of human diseases and nearly one in siz deaths worldwide.
We've made significant progress in mapping the human genome and understanding the role of genes in diseases, but genetics only accounts for approximately 10-15 percent of diseases.
Now, the key to accelerating further discoveries in individualised medicine lies in putting the exposome under the microscope.
We examine the impact of exposures over a lifetime and how those two elements (exposome and genome) interact to maintain wellness or create diseases.
AO: What is the role of big data and AI in the field and in identifying exposures?
KL: For more than a decade, we understood that genetics alone do not have all the answers.
It is important not only to gather the data, but to also analyse it in such a way that is competent with the massive information we have now, rather than relying on past conventional methods.
Identifying exposome associations to disease will require large-scale data analysis, deep-learning artificial intelligence methods, and complex multi-omics investigations, which is a combination of two or more "omics" approaches.
AO: How can people be made more aware of the kinds of pollutants and chemicals they are exposed to?
KL: Many exposures affect us through our diets and households, and unfortunately we are not aware of them.
In the past we viewed harmful exposures as things that are very toxic and obvious. But the reality is that in addition to the latter, there is the danger of being exposed to smaller day-to-day elements that we live with, which have an accumulative effect.
In a survey on 1,000 patient about exposures we found that the pesticides detected were actually banned from the US for decades, so they may have entered the bodies through imported diets. Diet and food is a vehicle of exposures that we are unaware of.
AO: How can these exposures interfere with our genes and fuel cancers and cardiovascular diseases?
KL: Our capacity today is the ability to measure exposures in compartments of blood or urine for instance.
I predict that we will reach the ability of assessing what each exposure can do to a certain body.
Every person has a unique environmental footprint that can be analysed through signatures in the blood, urine, saliva, hair, and so on.
Ultimately, we hope to understand how these exposures interact with a person's genomic profile to influence their health so we can answer why one person who is exposed to a persistent pollutant develops cancer while another with the same exposure may not.
AO: Are companies, manufacturers, and stakeholders combating this or not?
KL: They are driven by their own needs. We spend millions and decades manufacturing medicine and then identify side effects that were not known when we first tested them. So knowledge is key.
We have to empower investigators and research centres to enable them to provide knowledge about what exposures do.
We have to identify what causes what, but for the meantime I would say follow common sense.
In general, we eat something we grow in the garden versus something we buy without knowing its origin.
AO: What are the effects of environmental factors on us in light of the example you usually use, comparing us to a plant?
KL: Whatever we consume or are exposed to affects us. We live in a closed biological system, and everything affects everybody one way or another.
Think of a plant. The health and longevity of the plant are not necessarily determined by what the plant is made of.
It depends on the quality of the soil it is planted in, the cleanliness of the air that surrounds it, and the amount of chemicals and pesticides it is exposed to. It also depends on how those exposures interact with the plant's biological characteristics. The same is true for humans.
So many times a chronic disease happens not because of a single thing, but a repetitive exposure and damage that happen on daily basis.
We now understand better genetic variations and we know that there are clusters of genetic defects that affect areas of the globe. My expectation is that we will find the same with regards to exposures, which are heavy in particular parts of the world.
AO: Some people have weaker immune systems, and some offspring become immuno-compromised. Do we have tangible proof that this is really related to the ecosystem and exposures?
KL: There is no evidence that exposures make the immunity weaker. I would say that they rather irritate the immune system and make it aggressive, which can cause diseases.
But some individuals have genes that make exposures act as catalyst to perpetuate a reaction.
AO: Should we inform the public about every danger of every exposure, or can this compromise people’s psychological health?
We need to understand more the effects of the harm of exposures on us in all aspects, even psychologically. As we study further the exposome, psychological research will surely be of importance.
AO: Big data depends on research and information that is not adequate or accurate in certain parts of the world, is this a challenge to the field?
KL: This is an important point, as we are aware of the importance of incorporating our research in different parts of the world.
We need to study different exposures in different continents and be aware that even if the exposures are the same between two places, due to globalisation, the way people react to them differs.
Big data should be big enough to be relevant to everyone on the planet, otherwise we will fail.
AO: Did COVID-19 change the way this particular field of research is tackled?
KL: Absolutely. COVID showed us how we are all vulnerable because it is one planet. COVID, in my view, is a form of viral exposure, it is the same paradigm. It showed us that we all have to work together to understand the risks and how to prevent disease.