Bringing Lifestyle Factors into Precision Medicine

Investigators at Feinberg and the Ann & Robert H. Lurie Children’s Hospital of Chicago propose new nomenclature for social and environmental influences on health in an article in Clinical and Translational Science.

“Although where a child lives and goes to school often has more bearing on his or her health than the genetic code, social and environmental factors get far less attention than the genetic influences in precision medicine research,” said lead author Matthew Davis, MD, chief of Academic General Pediatrics and Primary Care in the Department of Pediatrics. “We hope that the broader and more consistent terminology we propose will facilitate more collaboration across scientific disciplines. Whenever we open new lines of communication between fields that rarely talk with one another, the possibility of advancing understanding and improving health grows exponentially.”

The authors suggest a naming system that expands the “-omes” discussed in precision medicine, such as the “genome” or “proteome,” which describe factors within an individual’s body that impact disease or wellness. They call these internal domains the “endome.” Similarly, they refer to influences on health that come from outside the individual as the “ectome.” For example, health-related aspects of a person’s social support network are called the “philome” and diet-related factors fall into the “nutriome,” while health-affecting components of water sources belong in the “hydrome.”

Matthew Davis, MD, chief of Academic General Pediatrics and Primary Care in the Department of Pediatrics

“By adding the social and environmental ‘-omes’ we hope to expand the precision medicine paradigm and encourage more comprehensive data collection in efforts to understand and prevent disease,” says co-author Thomas Shanley, MD, chair of Pediatrics and Founders’ Board Centennial Professor. “We need a common language and inclusion of all the known determinants of human health to push the field of precision medicine forward.” To advance these concepts and develop a repository of rigorous measures for the different “-omes,” the authors have launched a website:

“We hope that will serve as an online forum for scientists, spurring conversation and innovative ideas,” says Davis, who is also the A Todd Davis, MD Professor of General Academic Pediatrics. “We welcome experts in different fields to suggest the most appropriate objective measures for the various social and environmental impacts on health.”

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute.