First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
Mol Biol Rep. 2021 Apr;48(4):3785-3798. doi: 10.1007/s11033-021-06370-5. Epub 2021 May 13.
Age and inflammation are powerful drivers of cardiovascular disease. With the growing recognition that traditional cardiovascular risk factors are not fully accurate predictors of cardiovascular disease, recent studies have revealed the prevalence of positive selection of somatic cell mutations in hematopoietic stem cells in the elderly population, which can cause clonal hematopoiesis. Interestingly, clonal hematopoiesis is not only associated with cancer and death, but also closely related to the risk of increased cardiovascular disease due to mutations in TET2, DNMT3A, ASXL1, and JAK2. However, the mechanism of the interaction of clonal hematopoiesis and cardiovascular disease is only partially understood. In mice, somatic mutations have led to significantly increased expression of inflammatory genes in innate immune cells, which may explain the relationship between mutations and cardiovascular disease. Here, we further discuss the association between inflammatory signaling, clonal hematopoiesis, and cardiovascular disease,and using two hypotheses to propose a feedback loop between inflammatory signaling and clonal hematopoiesis for getting insight into the pathogenesis of cardiovascular diseases in depth. Therapies targeting mutant clones or increased inflammatory mediators may be useful for ameliorating the risk of cardiovascular disease.
年龄和炎症是心血管疾病的强大驱动因素。随着人们越来越认识到传统的心血管危险因素不能完全准确地预测心血管疾病,最近的研究揭示了老年人群中造血干细胞体细胞突变阳性选择的普遍性,这可能导致克隆性造血。有趣的是,克隆性造血不仅与癌症和死亡有关,而且还与由于 TET2、DNMT3A、ASXL1 和 JAK2 突变导致心血管疾病风险增加密切相关。然而,克隆性造血与心血管疾病相互作用的机制仅部分被理解。在小鼠中,体细胞突变导致固有免疫细胞中炎症基因的表达显著增加,这可能解释了突变与心血管疾病之间的关系。在这里,我们进一步讨论了炎症信号、克隆性造血和心血管疾病之间的关联,并提出了两个假说,以提出炎症信号和克隆性造血之间的反馈回路,深入了解心血管疾病的发病机制。针对突变克隆或增加炎症介质的治疗方法可能有助于降低心血管疾病的风险。