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NEJM:意义未名的克隆性造血增加冠心病风险

2017-06-22 zhangfan MedSci原创

外周血意义未名的克隆性造血可成倍提高患者冠心病风险

意义未名的克隆性造血(CHIP)是指在没有其他血液系统异常的情况下出现的人身体血细胞克隆扩张,多见于老年人且与血液系统肿瘤相关。研究发现CHIP与动脉粥样硬化性心血管疾病相关,但其原因尚不明确。

研究人采集了4个大型临床研究患者样本(4726名心血管疾病患者以及3529名健康对照),使用全基因组测序检测外周血细胞CHIP并研究CHIP与冠心病之间的因果关系。同时在小鼠模型中,通过突变与克隆造血相关的TET2功能,研究克隆造血与动脉粥样硬化的关系。

前瞻性队列的控制分析发现,携带CHIP导致患者的冠心病风险提高1.9倍 (95% CI,1.4-2.7)。早发性心肌梗死病例回顾性评估发现,携带CHIP导致患者心肌梗死风险提高4倍 (95% CI,2.4-6.7)。DNMT3A, TET2, ASXL1和 JAK2突变与冠心病相关,上述基因突变的CHIP患者导致冠状动脉钙化以及硬化负荷增加。TET2敲除小鼠的主动脉根部和主动脉有较大的粥样硬化病变,TET2基因敲除小鼠巨噬细胞分析显示多种趋化因子和细胞因子的动脉粥样硬化相关基因高表达。

研究发现,外周血意义未名的克隆性造血可成倍提高患者冠心病风险。

原始出处:

Siddhartha Jaiswal et al. Clonal Hematopoiesis and Risk of Atherosclerotic Cardiovascular Disease. N Engl J Med. June 22 2017.

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    2017-11-02 aids221
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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-27 虈亣靌

    很值得期待,据说很好

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Sat Jun 24 07:05:20 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490491, encodeId=989f149049132, content=<a href='/topic/show?id=37ab2891e94' target=_blank style='color:#2F92EE;'>#克隆性造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28917, encryptionId=37ab2891e94, topicName=克隆性造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7b048776512, createdName=jinweidong, createdTime=Sat Jun 24 00:24:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494548, encodeId=817f14945488c, content=<a href='/topic/show?id=084d9499599' target=_blank style='color:#2F92EE;'>#造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94995, encryptionId=084d9499599, topicName=造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caed9138962, createdName=俅侠, createdTime=Sat Jun 24 00:24:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214354, encodeId=ad1d21435458, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Fri Jun 23 12:27:10 CST 2017, time=2017-06-23, status=1, ipAttribution=), 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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-24 guangyi1980

    学习

    0

  5. 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style='color:#2F92EE;'>#造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94995, encryptionId=084d9499599, topicName=造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caed9138962, createdName=俅侠, createdTime=Sat Jun 24 00:24:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214354, encodeId=ad1d21435458, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Fri Jun 23 12:27:10 CST 2017, time=2017-06-23, status=1, ipAttribution=), 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  6. 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style='color:#2F92EE;'>#造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94995, encryptionId=084d9499599, topicName=造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caed9138962, createdName=俅侠, createdTime=Sat Jun 24 00:24:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214354, encodeId=ad1d21435458, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Fri Jun 23 12:27:10 CST 2017, time=2017-06-23, status=1, ipAttribution=), 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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-24 俅侠
  7. 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style='color:#2F92EE;'>#造血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94995, encryptionId=084d9499599, topicName=造血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=caed9138962, createdName=俅侠, createdTime=Sat Jun 24 00:24:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=214354, encodeId=ad1d21435458, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K6uiaa8Rp49ibOhXXPica7icVOgRWzYu3UJYe0BpHicBXialCN3bbvN85QtImfQVRMgCQkfGbL4c0bv1jD/0, createdBy=f7c21673796, createdName=guangyi1980, createdTime=Fri Jun 23 12:27:10 CST 2017, time=2017-06-23, status=1, ipAttribution=), 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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-23 guangyi1980

    学习了

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1771001, encodeId=11a11e710012e, content=<a href='/topic/show?id=5572308336a' target=_blank style='color:#2F92EE;'>#冠心病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30833, encryptionId=5572308336a, topicName=冠心病风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfc938196115, createdName=hbwxf, createdTime=Wed Mar 21 03:24:00 CST 2018, time=2018-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660129, encodeId=16c516601296c, content=<a href='/topic/show?id=8d0d28912db' target=_blank style='color:#2F92EE;'>#克隆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=28912, encryptionId=8d0d28912db, topicName=克隆)], attachment=null, authenticateStatus=null, createdAvatar=null, 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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-23 明天会更好!

    感谢分享!继续关注!

    0

  9. 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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-23 ylzr123

    好文,值得点赞,更值得收藏!慢慢领会学习的。给点个赞!

    0

  10. 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CST 2017, time=2017-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213988, encodeId=c5192139883f, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Jun 22 16:18:51 CST 2017, time=2017-06-22, status=1, ipAttribution=)]
    2017-06-22 Y—xianghai

    学习了新知识

    0

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