The EXACT PLAN summit in Seattle, Washington (April 30, 2025) was hosted by the Benaroya Research Institute, which has a mission to “advance the science to predict, prevent, reverse and cure diseases of the immune system.”
Dr. Chirag Patel’s presentation “Data Science Approaches to Deconvolve Exposome–Phenotype Relationships and Next-Generation Networks for Exposomics in the U.S. (NEXUS)” highlighted how exposomics can enhance understanding of the immune–disease axis.
EXACT-PLAN (EXposome in Autoimmune Disease Collaborating Teams PLAN) is a group of scientists that aims to “conducts research to discover the environmental exposures that influence disease susceptibility, onset, and outcomes and will develop a systems-level approach to understand the mechanisms underlying how exposures perturb cellular, organ, and tissue function across autoimmune diseases.”
This Summit featured presentations about the EXACT-PLAN Pilot Studies and connecting with other efforts in the field of exposomics such as NEXUS.
A primary aim of the gathering was to share NIH sponsored research to unravel the complexities of autoimmune disease risks and responses in diverse patient cohorts, including those captured in extensive electronic health record (EHR) databases. Dr Victoria Shanmugam (NIH) led off, speaking on the importance of studying complex autoimmune disorders.
Next, funded groups showcased innovative strategies leveraging epidemiological cohorts and robust clinical data resources, spearheaded by experts like Marc Natter (Boston Children’s Hospital) and Jane Buckner (Benaroya Institute). The discussions notably highlighted the potential of incorporating diverse exposure biomarkers beyond traditional geospatial data, such as PFAS chemicals (from Leda Chatzi, USC), already known for their immune-impacting properties. Imagine the insights possible when additional, broader biomarkers are systematically incorporated into these studies!
Breakout sessions revealed exciting collaborative ideas. One subgroup addressed similarities across various autoimmune conditions, aiming to standardize disease definitions and leverage shared biological pathways. Another group focused on harnessing existing cohorts, such as families enrolled through insurance programs, to maximize the insights gained from combined genetic, environmental, and clinical data. Participants discussed leveraging existing resources like MarketScan and Genomic Information Commons, alongside patient-reported outcomes and at-home biosample collection methods championed by Wilson Liao (UCSF).
In a presentation by Alison Motsinger-Reif, PhD – All of Us, Chief, Biostatistics & Computational Biology Branch at NIEHS , discussed existing NIEHS cohorts, such as the Personalized Environment and Genetics Study (PEGS), showcasing correlations between exposures and autoimmune disease. Overall, this conference fostered meaningful discussions about the future of exposomics research.
Looking forward, summit participants emphasized the critical importance of concrete exposure-wide association study (ExWAS) results to prioritize environmental factors beyond easily obtainable geospatial data. The ultimate vision includes creating comprehensive “immunotypes” by integrating untargeted screens with geospatial, chemical, biological, and clinical data. Such integrative research stands poised to fundamentally advance personalized approaches to understanding and managing autoimmune diseases.