Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine.
National Cerebral and Cardiovascular Center, Osaka, Japan.
Curr Opin Cardiol. 2023 May 1;38(3):201-206. doi: 10.1097/HCO.0000000000001032. Epub 2023 Feb 22.
Somatic mutations, described as noninherited changes in DNA that arise and are passed on to descendant cells, are well known to cause cancers; however, it is increasingly appreciated that the propagation of somatic mutations within a tissue may have a role in causing nonneoplastic disorders and abnormalities in elderly individuals. The nonmalignant clonal expansion of somatic mutations in the hematopoietic system is termed clonal hematopoiesis. This review will briefly discuss how this condition has been linked to various age-related diseases outside the hematopoietic system.
Clonal hematopoiesis, resulting from leukemic driver gene mutations or mosaic loss of the Y chromosome in leukocytes, is associated with the development of various forms of cardiovascular disease, including atherosclerosis and heart failure, in a mutation-dependent manner.
Accumulating evidence shows that clonal hematopoiesis represents a new mechanism for cardiovascular disease and a new risk factor that is as prevalent and consequential as the traditional risk factors that have been studied for decades.
体细胞突变是指在 DNA 中发生的非遗传性变化，并传递给后代细胞，这些突变众所周知会导致癌症；然而，人们越来越认识到，在组织内传播体细胞突变可能在导致老年个体的非肿瘤性疾病和异常方面发挥作用。造血系统中体细胞突变的非恶性克隆扩增称为克隆性造血。本文将简要讨论这种情况如何与造血系统以外的各种与年龄相关的疾病相关联。
克隆性造血是由白血病驱动基因突变或白细胞中 Y 染色体镶嵌性缺失引起的，与各种形式的心血管疾病的发展有关，包括动脉粥样硬化和心力衰竭，这种关联具有突变依赖性。
越来越多的证据表明，克隆性造血代表了心血管疾病的一种新机制，是一种新的风险因素，其普遍性和后果与已经研究了几十年的传统风险因素一样重要。
