In a large majority of non-communicable diseases (NCDs), including the immune-mediated diseases (IMDs), complex gene-environmental interactions contribute to the onset and development of disease through the modulation of biological pathways. IMDs are characterized by abnormal immune responses, have limited therapeutic options and require lifelong treatment if not detected during the preclinical stage. EXPOSIM will provide a strong evidence base to better understand the impact of combined environmental stressors on immune health, with a focus on air pollution, noise and hazardous waste in urban areas. More specifically, we will investigate the impact of environmental stressors – the external exposome – on IMDs and immune health at different stages in life (pregnancy, childhood and adulthood). We will identify biological pathways and molecular mechanisms mediating the effect of combined exposures on IMDs. Through case studies and topical reviews, we will demonstrate the effectiveness of exposure-reducing and health-promoting interventions, with a focus on vulnerable and highly exposed individuals. This knowledge will be translated into policy recommendations and informed decision-support tools. Moreover, the project emphasises on scientific collaborations and stakeholder engagement, involving co-creation of health-promoting actions, education, training and communication. EXPOSIM will build a user-friendly toolbox for regional, national and EU policymakers, health professionals, researchers and citizens. To reach its ambitious objectives, EXPOSIM brings together a geographically balanced, experienced interdisciplinary consortium (active in PARC, EXIMIOUS, EHEN, METEOR) of ten European partners with complementary expertise in exposome research, epidemiology, immunology, omics, novel data analytics, health economics and social sciences and humanities. Ultimately, EXPOSIM will contribute to a healthy environment and healthy lives for all EU citizens.

Immune-mediated, non-communicable diseases, such as autoimmune diseases, allergic diseases and asthma, are chronic disorders in which the interaction between exposome and immune system plays a pivotal role. As prevalence and societal costs of these diseases are rising in the EU, a holistic approach is needed. The EXIMIOUS consortium—gathering high-level experts in immunology, toxicology, clinical medicine, environmental hygiene, epidemiology, bioinformatics and sensor development—will bring about a new way of assessing the human exposome by linking innovative ways of characterizing and quantifying multiple and combined environmental exposures (exposomics) with high-dimensional immunophenotyping and -profiling platforms to map the (early) immune effects induced by these exposures (immunomics). In several cohorts—covering the entire lifespan, including prenatal life—we will extensively map exposome, immune system (immunome), other omics and clinical and socio-economic data, using two main methodologies—one starting from the exposome, the other starting from health effects—that ‘meet in the middle’. Novel bioinformatics tools, based on systems immunology and machine learning, will be used to integrate and analyse these huge datasets and to construct ‘immune fingerprints’ that reflect a person’s lifetime exposome and identify ‘immune fingerprints’ that are early signs of poor health and predictors of disease at the individual level. We will build a multifaceted toolbox for researchers, policy makers, clinicians and the general public containing the exposome/immunome tools developed during the project to help assess the impact of the exposome on the immune system at the level of individuals and populations. This will allow policy makers to grasp the components of the exposome that needs to be prioritized to be able to design targeted preventive policies to reduce healthcare and socioeconomic costs, leading to greater wellbeing for the EU population. EXIMIOUS will work together with the other projects (EXPANSE, HEAP, ATHLETE, EQUAL-LIFE, LONGITOOLS, EPHOR, REMEDIA and HEDIMED) funded within the Human Exposome programme call H2020-SC1-BHC-2018-2020, in order to achieve collaboration and synergy.