Department of Medicine III, Saarland University Hospital, Homburg, Saarland, Germany.
Department of Medicine I, University of Würzburg, Würzburg, Bavaria, Germany.
Curr Cardiol Rep. 2022 Aug;24(8):1049-1058. doi: 10.1007/s11886-022-01724-2. Epub 2022 Jun 3.
Clonal hematopoiesis of indeterminate potential (CHIP) has been identified as a novel cardiovascular risk factor. Here we review the relationship of lifestyle and environmental risk factors predisposing to somatic mutations and CHIP and provide an overview on age-related cardiovascular outcomes.
CHIP has been associated with accelerated atherosclerosis and cardiovascular disease in both epidemiological and experimental studies. The most commonly mutated candidate driver genes are DNMT3A, TET2, JAK2, and ASXL1. The underlying mechanisms appear predominantly related to inflammatory pathways. Although age is the dominant risk factor for developing CHIP, emerging evidence suggests that other factors such as smoking, obesity/type 2 diabetes, or an unhealthy diet play a role in the occurrence of somatic mutations. Evidence suggests a strong link between vascular risk factors, somatic hematopoietic mutations, and age-related cardiovascular disease. Further studies on CHIP biology are required to identify targeted interventions for risk reduction in patients with CHIP and inform the utility of screening strategies.
不定潜能的克隆性造血（CHIP）已被确定为一种新的心血管危险因素。在此，我们回顾了导致体细胞突变和 CHIP 的生活方式和环境危险因素，并概述了与年龄相关的心血管结局。
CHIP 与流行病学和实验研究中的动脉粥样硬化加速和心血管疾病有关。最常见的突变候选驱动基因是 DNMT3A、TET2、JAK2 和 ASXL1。潜在的机制主要与炎症途径有关。尽管年龄是发生 CHIP 的主要危险因素，但新的证据表明，其他因素，如吸烟、肥胖/2 型糖尿病或不健康饮食，在体细胞突变的发生中起作用。有证据表明，血管危险因素、体细胞造血突变和与年龄相关的心血管疾病之间存在密切联系。需要进一步研究 CHIP 的生物学特性，以确定针对 CHIP 患者的降低风险的靶向干预措施，并为筛查策略的效用提供信息。
