Drug–Exposome Interactions: The Next Frontier in Precision Medicine

Drug–drug interactions are a known concern during medical treatment. However, in addition to therapeutic drugs, humans are exposed to thousands of environment- and food-related chemicals on a daily basis. The exposome (i.e., the total measure of environmental factors on the human body) is an emerging concept in the field of environmental health. Many chemicals have the potential to interact with drugs and subsequently influence health outcomes. To date, this concept has not been systematically investigated. Nevertheless, adverse effects have been observed between environmental, dietary, and microbiome-derived xenobiotics and a number of drugs, including chemotherapeutics. Recent technological advances in mass spectrometry-based metabolomics and the establishment of omic-scale exposure assessment will enable a broader and systemic investigation of these interactions. As a complement to pharmacogenomics and pharmacometabolomics, research on drug–exposome interactions holds immense potential to elevate precision medicine to an unprecedented level.