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Clonal hematopoiesis in Alzheimer's brain: Protective, pathogenic, and context-dependent?
Hong Zhao1, Katherine Y King2, Stephen T Wong1
1Systems Medicine and Bioengineering Department, Houston Methodist Neal Cancer Center, Houston, TX, USA; School of Engineering Medicine, Texas A&M University, Houston, TX, USA; Department of Medicine, Houston Methodist Hospital and Weill Cornell Medicine, New York, NY, USA.
Trends in Molecular Medicine
|July 2, 2026
Summary
Clonal hematopoiesis, where mutated myeloid cells affect the brain, is a newly discovered factor in Alzheimer's disease progression. Their impact varies based on genetic mutations, clone size, and disease stage.
Area of Science:
- Neuroscience
- Immunology
- Hematology
Background:
- Clonal hematopoiesis (CH) involves the expansion of hematopoietic stem cells with somatic mutations.
- Emerging evidence links CH to various age-related diseases, including cardiovascular disease and cancer.
- The role of CH in neurodegenerative diseases, particularly Alzheimer's disease (AD), is not well understood.
Purpose of the Study:
- To investigate the emerging role of clonal hematopoiesis as a modifier of Alzheimer's disease.
- To explore the potential mechanisms by which mutant myeloid cells may influence AD pathogenesis.
- To propose factors that may determine the net effect of CH on AD progression.
Main Methods:
- Review of recent scientific literature on clonal hematopoiesis and Alzheimer's disease.
- Analysis of proposed mechanisms for myeloid cell interaction with the brain in AD.
- Synthesis of findings to hypothesize the modulatory effects of CH in AD.
Main Results:
- Mutant myeloid cells, arising from CH, may infiltrate or proliferate within the brain parenchyma.
- These myeloid cells can adopt diverse functional phenotypes, including inflammatory and reparative states.
- The specific mutation, clone size, timing of occurrence, brain microenvironment, and AD stage influence the cellular behavior and impact.
Conclusions:
- Clonal hematopoiesis represents a novel and complex modifier of Alzheimer's disease.
- The ultimate effect of CH on AD is context-dependent, influenced by a multifactorial interplay.
- Further research is warranted to elucidate the precise mechanisms and therapeutic implications of CH in AD.
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