Somatic Mutations and Clonal Hematopoiesis: Unexpected Potential New Drivers of Age-Related Cardiovascular Disease

Circ Res. 2018 Feb 2;122(3):523-532. doi: 10.1161/CIRCRESAHA.117.312115.

Abstract

Increasing evidence shows that conventional cardiovascular risk factors are incompletely predictive of cardiovascular disease, particularly in elderly individuals, suggesting that there may still be unidentified causal risk factors. Although the accumulation of somatic DNA mutations is a hallmark of aging, its relevance in cardiovascular disease or other age-related conditions has been, with the exception of cancer, largely unexplored. Here, we review recent clinical and preclinical studies that have identified acquired mutations in hematopoietic stem cells and subsequent clonal hematopoiesis as a new cardiovascular risk factor and a potential major driver of atherosclerosis. Understanding the mechanisms underlying the connection between somatic mutation-driven clonal hematopoiesis and cardiovascular disease will be highly relevant in the context of personalized medicine, as it may provide key information for the design of diagnostic, preventive, or therapeutic strategies tailored to the effects of specific somatic mutations.

Keywords: CHIP; aging; atherosclerosis; cardiovascular disease; inflammation; risk factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aging / genetics*
  • Aging / pathology
  • Animals
  • Atherosclerosis / etiology
  • Atherosclerosis / genetics
  • Atherosclerosis / pathology
  • Atherosclerosis / therapy
  • Bone Marrow Transplantation
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / genetics
  • Cardiovascular Diseases / pathology
  • Causality
  • Clone Cells / pathology
  • DNA (Cytosine-5-)-Methyltransferases / genetics
  • DNA (Cytosine-5-)-Methyltransferases / physiology
  • DNA Methyltransferase 3A
  • DNA-Binding Proteins / deficiency
  • DNA-Binding Proteins / genetics
  • DNA-Binding Proteins / physiology
  • Dioxygenases
  • Genes, Neoplasm
  • Genetic Association Studies
  • Hematologic Neoplasms / genetics
  • Hematologic Neoplasms / pathology
  • Hematopoiesis / genetics*
  • Hematopoietic Stem Cells / pathology*
  • Humans
  • Janus Kinase 2 / deficiency
  • Janus Kinase 2 / genetics
  • Janus Kinase 2 / physiology
  • Mice
  • Mutation*
  • Population Dynamics
  • Precision Medicine
  • Proto-Oncogene Proteins / deficiency
  • Proto-Oncogene Proteins / genetics
  • Proto-Oncogene Proteins / physiology
  • Risk Factors

Substances

  • DNA-Binding Proteins
  • DNMT3A protein, human
  • Proto-Oncogene Proteins
  • Dioxygenases
  • TET2 protein, human
  • Tet2 protein, mouse
  • DNA (Cytosine-5-)-Methyltransferases
  • DNA Methyltransferase 3A
  • JAK2 protein, human
  • Janus Kinase 2