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具有不确定潜能的克隆性造血与心血管疾病之间的恶性循环。

A Vicious Circle of Clonal Haematopoiesis of Indeterminate Potential and Cardiovascular Disease.

机构信息

Department of Cardiology and Angiology I, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany.

出版信息

Hamostaseologie. 2021 Dec;41(6):443-446. doi: 10.1055/a-1576-4059. Epub 2021 Dec 23.

Abstract

Clonal haematopoiesis of indeterminate potential (CHIP) represents a recently identified overlap between cancer and cardiovascular disease (CVD). CHIP develops as a result of certain acquired somatic mutations that predispose to leukaemia, but clinically even more prevalent, associate with increased risk for CVD and CVD-related death. Experimental studies suggest a causal role for CHIP aggravating inflammatory processes in CVD, and recent epidemiologic and genetic studies indicate that classical CVD risk factors may increase the risk of acquiring CHIP driver mutations, thus fuelling a vicious circle. The potential mechanism underlying the associative link between CHIP and CVD and mortality has been the focus of a few recent excellent experimental and observational studies which are summarized and discussed in this concise non-systematic review article. These data support a pathomechanistic view of a spiralling vicious circle in which CHIP aggravates the inflammatory immune response in CVD, and CVD-driven elevated haematopoietic activity promotes CHIP development.

摘要

不定潜能的克隆性造血 (CHIP) 代表了癌症和心血管疾病 (CVD) 之间最近确定的重叠。CHIP 是由于某些获得性体细胞突变而发展的,这些突变易导致白血病,但在临床上更为普遍,与 CVD 风险增加和 CVD 相关死亡相关。实验研究表明,CHIP 在 CVD 中的炎症过程中起因果作用,最近的流行病学和遗传研究表明,经典的 CVD 风险因素可能会增加获得 CHIP 驱动突变的风险,从而加剧恶性循环。CHIP 与 CVD 和死亡率之间的关联的潜在机制一直是少数最近的优秀实验和观察研究的重点,本文对这些研究进行了总结和讨论。这些数据支持了一种病理机制观点,即 CHIP 加剧 CVD 中的炎症免疫反应,而 CVD 驱动的升高的造血活性促进 CHIP 发展,从而形成一个螺旋式的恶性循环。

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