What Clonal Hematopoiesis Can Teach Us About MDS.

What Clonal Hematopoiesis Can Teach Us About MDS.
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DOI:
10.3389/fonc.2022.794021
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发表时间:
2022
影响因子:
4.7
通讯作者:
Bolton KL
Bolton KL
中科院分区:
医学3区
文献类型:
--
作者:
Chan ICC;Wiley BJ;Bolton KL

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克隆造血(CH)被定义为突变的造血干细胞和祖细胞(HSPC)的克隆扩增,是一种常见的衰老过程。 CH 是发生血液系统恶性肿瘤的危险因素,最常见的是髓系肿瘤 (MN),包括急性髓系白血病 (AML)、骨髓增生异常综合征 (MDS) 和骨髓增殖性肿瘤 (MPN)。最近的工作阐明了 CH 的发育和细胞适应性如何受到衰老、环境暴露和个体种系(遗传)遗传背景的影响。这反过来又为包括 MDS 在内的 MN 发病机制提供了宝贵的见解。在这篇综述中,我们讨论了 CH 的遗传起源、影响 CH 的环境压力因素以及 CH 对包括 MDS 在内的健康结果的影响。由于 MN 具有共同的风险因素和基础生物学,因此我们关于 CH 影响的大部分讨论一般都围绕着 MN,而不是专门关注 MDS。我们总结了未来的方向和研究领域,包括 CH 的干预研究如何为未来的 MN 治疗方法(包括 MDS)提供信息。
Clonal hematopoiesis (CH), defined as the clonal expansion of mutated hematopoietic stem and progenitor cells (HSPCs), is a common aging process. CH is a risk factor for the development of hematologic malignancies, most commonly myeloid neoplasms (MNs) including acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and myeloproliferative neoplasm (MPN). Recent work has elucidated how the development and cellular fitness of CH is shaped by aging, environmental exposures, and the germline (inherited) genetic background of an individual. This in turn has provided valuable insights into the pathogenesis of MNs including MDS. Here, in this review, we discuss the genetic origins of CH, the environmental stressors that influence CH, and the implications of CH on health outcomes including MDS. Since MNs have shared risk factors and underlying biology, most of our discussion regarding the implications of CH surrounds MN in general rather than focusing specifically on MDS. We conclude with future directions and areas of investigation including how intervention studies of CH might inform future therapeutic approaches to MN including MDS.
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