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Hamostaseologie 2021; 41(06): 443-446
DOI: 10.1055/a-1576-4059
Review Article

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

Carolin A. Ehlert
1   Department of Cardiology and Angiology I, University Heart Center Freiburg – Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Ingo Hilgendorf
1   Department of Cardiology and Angiology I, University Heart Center Freiburg – Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
2   Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg – Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
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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.

Zusammenfassung

Klonale Hämatopoese von unbestimmtem Potential (CHIP) stellt eine Überschneidung von Krebs- und kardiovaskulären Erkrankungen dar, die erst seit Kurzem Beachtung findet. CHIP entsteht infolge bestimmter erworbener somatischer Mutationen und prädisponiert für die Entwicklung von Leukämien. Aber klinisch häufiger ist die Assoziation mit einem erhöhten Risiko für kardiovaskuläre Erkrankungen und Tod. Experimentelle Studien weisen auf eine kausale Beziehung zwischen CHIP und einem verstärkten Entzündungsprozess bei kardiovaskulären Erkrankungen hin. Epidemiologische und genetische Studien suggerieren umgekehrt, dass die klassischen kardiovaskulären Risikofaktoren das Risiko für die Entwicklung somatischer CHIP-assoziierter Mutationen erhöhen und somit einen Teufelskreis antreiben könnten.

Keywords

clonal haematopoiesis - cardiovascular disease - somatic mutation

Schlüsselwörter

klonale Hämatopoese - kardiovaskuläre Erkrankung - somatische Mutation


Publication History

Received: 06 June 2021

Accepted: 11 August 2021

Article published online:
23 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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