According to scientific estimates, humans are exposed to 10,000 to 100,000 environmental and exogenous compounds in an individual lifetime. Different molecules as well as co-exposures can affect the effectiveness of the drug. Photo credit: Pixabay

Humans are exposed to various environmental or food molecules that can weaken or even increase the effects of therapeutic agents. Studies of the industrial chemical bisphenol A and the phytoestrogen genistein, for example, have shown interactions between drugs and exposomes. However, interactions between exposure and therapeutic agents have not yet been systematically investigated, conclude the chemists Benedikt Warth and Manuel Pristner from the University of Vienna in a review article in Trends in Pharmacological Sciences. The recent advances in mass spectrometry are of great benefit to the concept of systematic analysis and offer great potential to take precision medicine to an unprecedented level.

According to scientific estimates, humans are exposed to at least 10,000 to 100,000 environmental and exogenous compounds in an individual lifetime, the majority of which are ingested through our diet. “Our bodies can effectively detoxify most of these substances, but various molecules and co-exposures can impair the effectiveness of drugs,” says Benedikt Warth, deputy head of the Department of Food Chemistry and Toxicology at the Faculty of Chemistry and coordinator of the new establishment of the national Exposome research infrastructure EIRENE Austria.

Fragmented knowledge

Remember the well-known instruction not to drink alcohol in combination with antibiotics or painkillers. “Ethanol is a well-studied toxin that can change the way the active ingredient works,” says Warth. Bisphenol A (BPA) is another popular environmental toxin that virtually everyone has accumulated in their body, although it is mostly in very low concentrations that are not considered critical to human health. BPA, a critical component in plastics manufacturing, has been shown to interact with various cancer therapeutics, which can lead to drug resistance and decreased effectiveness.

Genistein, a phytoestrogen obtained from soybeans and an outstanding active ingredient in hormone medication for menopausal symptoms, can also influence various medications, in particular hormone-relevant chemotherapeutic agents for breast cancer, the researchers explain in their article. These interactions can have both negative and positive effects.

“Among the tens of thousands to hundreds of thousands of molecules humans are exposed to, countless numbers could interact with therapeutics, especially under certain conditions or during critical phases of life such as pregnancy or adolescence,” said Ph.D. Student Manuel Pristner explains.

Exposome and Health Effects

“Today’s high-resolution mass spectrometry enables us to measure a very large number of molecules in parallel. In this way, we can systematically investigate the network of relationships between the so-called exposome, ie all measurable exposures, and certain active substances,” he says. In addition, improved bioinformatic algorithms enable researchers to analyze the generated big data sets.

So far, researchers have specifically looked for the effect of a particular molecule on a particular receptor. “With the new technologies, we can broaden the approach and use not just a fishing rod but also a fishing net to implement a comprehensive screening strategy that could lead to discoveries that rational hypotheses would not have made us,” say the chemists .

Personalized medicine

There are various reasons why certain active substances work well for one person and less or not at all for another, depending on an individual genome, the presence of certain receptors, the activity of enzymes or simply chemical reactivity.

A better understanding of the interactions between exposomes and drugs could enable doctors to prescribe drugs and drug doses individually, increase their effectiveness, and minimize or even avoid side effects. Individual drugs for a patient through standardized pre-screening of their exposome “are still dreams of the future, according to Warth,” “but the systematic approach could be groundbreaking and also benefit the early stages of drug development.”

Estrogen-mimicking compounds in foods may make breast cancer treatments less effective

More information:
Manuel Pristner et al. Drug Exposome Interactions: The Next Frontier in Precision Medicine, Trends in Pharmacological Sciences (2020). DOI: 10.1016 / Provided by the University of Vienna

Quote: Environmental Exposures May Affect Therapeutics (2020, December 1), accessed December 1, 2020 at

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