We know some things about how environmental factors (like sun and air quality) and exposures (like viruses and chemicals) impact our health. Asbestos can cause an aggressive cancer called mesothelioma. Living in an urban place increases the risk of asthma. Smoking cigarettes can lead to heart and lung disease.

But the link between what people are exposed to and autoimmune disease remains a mystery. 

The researchers’ first step is to unravel a huge question: How exactly do we study the sum total of everything a person has been exposed to in their entire life?

“We’re thinking about everything from where a person lives geographically to social determinants of health,” Dr. Speake says. “We’re thinking about how a virus during childhood might impact if that person develops autoimmunity decades later. It’s a big challenge!”

BRI is working with the National Institutes of Health (NIH) to break down the best ways to study these factors. The first step is mapping out what we already know about exposures and autoimmune diseases. From there, they’ll explore the best questions to ask and how to find answers.

Dr. Speake is thinking critically about which diseases might provide the most insight into the connection between the exposome and autoimmunity. Her team is also forming partnerships with experts from different fields — genetics, bioinformatics, environmental science — to help determine the best ways to measure various exposures and their impact on health. 

Dr. Speake is particularly excited about one question: How does wildfire smoke impact rheumatoid arthritis (RA)? Her team already identified changes in immune system cells in times of peak wildfire smoke, thanks to data they collected in the Sound Life Project, a research effort studying healthy immune systems. Now, they want to learn more about if and how wildfire smoke impacts the immune system in people with autoimmune disease.

“We know that smoking cigarettes is associated with autoimmune diseases and RA in particular, and we want to see if wildfire smoke may cause some of the same problems,” Dr. Speake says.

This is one of many important questions the team hopes to answer over the next several years as they carry out this research.

“There is still a lot we don’t know about how and why autoimmune diseases develop,” Dr. Speake says. “This study will be pivotal in helping us better understand the role of environmental factors, which is a crucial piece of the puzzle.”