Fig. 2

The Exposome and Multi-Omic Interactions for GxE Interaction Analyses in the Context of NCDs. The exposome encompasses the cumulative impact of environmental influences, including external factors (e.g., urban and built environments, air and water quality, soil contaminants such as heavy metals and persistent organic pollutants), lifestyle factors (e.g., physical activity, diet, smoking, alcohol use, and sleep patterns), psychosocial factors, and social and economic determinants (e.g., socio-economic status, access to resources). It also includes occupation and residential exposures (e.g., noise pollution and indoor air quality), as well as chemical and physical agents. These diverse influences interact with multiple biological layers—genome, epigenome, transcriptome, proteome, and metabolome—triggering complex, nonlinear responses. These interactions drive the onset, progression, and development of NCDs, including cardiovascular diseases, diabetes, respiratory illnesses, and cancers. Integrating the exposome into multi-omic studies is essential to unraveling these dynamics and advancing precision medicine approaches for chronic disease prevention and management. NCD—non-communicable diseases. Schematic plot created using BioRender (https://BioRender.com)