Hippocrates, the father of the exposome. Dr. Domenico Pratico', MD, FCPP
- Dr. Domenico Pratico
- 1 day ago
- 4 min read
During a recent trip to the Greek island of Kos, the birthplace of Hippocrates, I rediscover some of the reasons why its most famous son is considered a giant not only for medicine, but for human civilization.
Born around 460 BC, Hippocrates is typically considered the "father of modern medicine" because he was the first to separate medicine from religion. He transformed healing from superstition into a rational, evidence-based type of science. He was a revolutionary for his time since in his teaching of medicine he emphasized principles that are still valid today: clinical observation and the external component of human diseases.
It is amazing that more than 2000 years ago, he had the courage to say: “Illnesses do not come upon us out of the blue. They are developed from small daily sins against nature. When enough sins have accumulated, illnesses will suddenly appear.”
Imagine how revolutionary it was to propose that diseases had natural causes rather than being divine punishments! Most importantly, he believed illnesses originated from external environmental factors (air, water, place), diet, and lifestyle.
Fast forward 2000 years, and today we know that many human diseases are the result of a lifetime exposure to various factors from before birth (i.e., in utero) to adulthood and old age. A concept that we now define as the “exposome”.
In my opinion, Hippocrates should be considered also the father of the “exposome”.
In general, when we think about the exposome we think as the sum of all external and internal factors that a person is exposed to throughout a lifetime. It encompasses a wide range of influences, which among others can include chemical, biological and physical exposures, lifestyle and social factors.
Here are a few examples for each category.
Regarding the chemicals: air pollutants, pesticides, toxins, and industrial chemicals. In the biological factors group, we have various microbes, viruses, and different allergens. Ultra-violet radiation, noise, and heat are some of the most common components of the physical factors group.
In addition, exposome includes the food we ingest regularly. Once again, Hippocrates recognized the importance of the diet for our health by saying” let the food be your medicine and the medicine be your food”.
Other lifestyle factors include physical activity or the amount of regular “exercise” we perform, whereas smoking and alcohol consumption both negatively influence our health.
Finally, the exposome includes also the socioeconomic status, the level of education achieved, and access to healthcare for the individual.
Because of the widespread area that the exposome encompasses and the length of time, besides having an accumulative effect it influences human health differently depending on the phase of life. In fact, it is known that some life stages can be more sensitive than others for one or more of the specific factors listed above.
It is important to note that a large proportion of the exposome factors are also modifiable risk factors of many diseases including neurological disorders. This fact underscores the role that prevention plays in the attempt to mitigate human chronic disease by significantly reducing exposure and when possible, even targeting mechanisms whereby they induce the negative effects.
Understanding and identifying the risk that the exposome represents for human health is crucial to identifying novel targets that are active contributors to the onset of chronic disorders like cardiovascular, cancer and neurodegenerative diseases.
This knowledge can help us to dissect how our genetic code, which we inherit from our parents, interacts with the various factors of the exposome. This will provide the basis for more personalized medicine with tailored interventions to reduce the risk and or the consequences of exposure-related illnesses. It can also provide vital information for public health and related policies with the goal to reduce exposure and ameliorate population health.
We must recognize that the study of the exposome and its relationship with human health presents also some challenges. Among them, the complex and dynamic nature of these interactions, the difficulty related to an accurate measurement of the “exposome”, and some ethical issues related to the collection of personal information on the exposure.
Conclusions
The idea of the exposome, as the sum of all the environmental factors influencing human health, although is gaining popularity in recent years, originally was introduced more than 2000 years ago by Hippocrates.
Investigating the exposome is central for identifying health risk factors, understanding gene-environment interactions, and developing interventions targeting public health.
More work needs to be done to overcome the challenges associated with studying the exposome and at the same time advance our understanding of how it influences human health.
And as I always say, please remember that it is never too early or never too late to follow Hippocrates's teaching and and by doing so to enjoy the full benefits for the brain and the whole body!
If you are interested in reading more of my blogs:
Check out my recent blog: The 4 Cardinal Points of Behavior Domenico Pratico', MD, FCPP
Domenico Praticò, MD, holds the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor at the Alzheimer’s Center at Temple, as well as a Professor of Neural Sciences at Lewis Katz School of Medicine at Temple University.
For more information on the research conducted by Dr. Domenico Pratico, please visit this link.
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Stay updated with the work happening at Dr. Domenico Pratico's lab by visiting the Pratico Lab website.
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