Redefining environmental exposure for disease etiology

a Inputs to the blood exposome from endogenous sources (G, genome; GE, epigenome; R, transcriptome; P, proteome; M, metabolome), exogenous exposures (E), post-translational modifications (PTMs) and gene–environment interactions (G？×？E). b Pathways connecting the blood exposome to disease processes (causal pathways) and subsequent feedback to G, GE, R, and P (via reactive pathways