慢性血栓栓塞性肺高血压中未确定潜力的克隆性血液形成:一个多中心研究
Chao Liu1, Yu-Ping Zhou1, Tian-Yu Lian2
1Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (C.L., Y.-P.Z., X.-M.L., L.-H.Q., B.-C.Q., L.-Y.R., X.-Q.X., L.-F.C.), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Hypertension (Dallas, Tex. : 1979)
|December 20, 2023
概括
不确定潜力的克隆性血液形成 (CHIP) 影响9.4%的肺高血压患者,增加死亡风险. 在CTEPH中,CHIP与炎症和较差的长期结果有关.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 肺部病理学 肺部病理学
背景情况:
- 慢性血栓栓塞性肺高血压 (CTEPH) 的发病因子是多因素的,新出现的证据涉及血液学疾病.
- 不确定潜力的克隆性血液形成 (CHIP) 与血液恶性瘤和心血管疾病有关,但其在CTEPH中的作用尚不清楚.
研究的目的:
- 为了确定CTEPH患者中CHIP的患病率.
- 在CTEPH中调查CHIP和全因死亡率之间的关联.
- 探索CHIP和CTEPH中的炎症标志物之间的关系.
主要方法:
- 下一代测序被用来识别499名CTEPH患者的CHIP突变.
- CHIP的存在与全因死亡率和炎症标志物相关.
- 随访数据收集的时间平均为55个月.
主要成果:
- 在9.4%的CTEPH患者中发现了CHIP突变,最常见的是DNMT3A,TET2,RUNX1和ASXL1.
- CHIP与所有原因死亡率的增加显著相关 (HR 2.190,P=0.006).
- 在CHIP患者中,IL-1β,IL-6的含量增加,IL-4和IgG的银河系酶化减少.
结论:
- 这项研究在9.4%的CTEPH患者中发现了CHIP,与高度炎症状态相关.
- 在CTEPH患者中,CHIP存在与较差的长期预后有关.
- 在CTEPH管理中,CHIP可能代表了一个新的风险因素和治疗目标.
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