Center for Genomic Medicine and Cardiovascular Research Center, Massachusetts General Hospital, Boston (P.N., S.K.).
Program in Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, MA (P.N., S.K.).
Circ Genom Precis Med. 2018 Jul;11(7):e001926. doi: 10.1161/CIRCGEN.118.001926.
The most important prognostic factor for atherosclerotic cardiovascular disease is age, independent of all other recognized risk factors. Recently, exome sequence analyses showed that somatic mutations in blood cells, a process termed clonal hematopoiesis, are common and increase in prevalence with age, with at least 1 in 10 adults older than 70 years affected. Carriers of clonal hematopoiesis have been shown to be not only at heightened risk for hematologic malignancy but also at increased risk for atherosclerotic cardiovascular disease. Here, we review the prior literature of clonal selection and expansion of hematopoietic stem cells and the evidence supporting its causal association with atherosclerotic cardiovascular disease.
动脉粥样硬化性心血管疾病最重要的预后因素是年龄，独立于所有其他公认的危险因素。最近，外显子组序列分析表明，血细胞中的体细胞突变，即所谓的克隆性造血，很常见，且随着年龄的增长而增加，至少有 1/10 的 70 岁以上成年人受到影响。已经证明，克隆性造血的携带者不仅患血液恶性肿瘤的风险增加，而且患动脉粥样硬化性心血管疾病的风险也增加。在这里，我们回顾了造血干细胞克隆选择和扩增的既往文献，并提供了支持其与动脉粥样硬化性心血管疾病因果关系的证据。
