The clonal growth of precancerous blood cells known as CHIP (clonal hematopoiesis of indeterminate potential) occurs in 1 in 10 people over age 70. It is known to increase the risk of blood cancer and death from cardiovascular, lung and liver disease.
Last year, researchers at Harvard’s Massachusetts General Hospital reported that CHIP also dramatically increased the risk of inflammatory heart disease. Their study analyzed genomic and health records data from more than 335,000 participants in the England-based UK Biobank.
To validate these findings, Vanderbilt Health researchers analyzed data from more than 361,000 participants in two large U.S. biobanks — one of them, BioVU, based at Vanderbilt Health, and the other, part of the National Institutes of Health’s All of Us Research Program.
Their report, published March 18 in the journal JAMA Cardiology, identified a specific link between CHIP and pericarditis, a potentially life-threatening inflammation of the thin sac surrounding the heart. It suggests that treating patients for the blood condition could reduce their risk of heart inflammation.
“Both CHIP and pericarditis are thought to be a result of the same types of inflammation,” said the paper’s first author, Yash Pershad, an MD/PhD student in the lab of Alexander Bick, MD, PhD. “Targeting CHIP-associated inflammation may represent a therapeutic strategy for preventing or treating pericardial inflammation in some at-risk individuals.”
Each year in the United States, an estimated 160,000 people develop pericarditis, which can cause sharp chest pain and often requires hospitalization. The condition, which also is associated with autoimmune disease, cardiac procedures, and infections, can lead to a dangerous buildup of fluid around the heart that impairs heart function.
CHIP is thought to fuel inflammation through specific molecular pathways — including a cellular alarm system called the NLRP3 inflammasome and a signaling protein called interleukin-1beta — that are also central to pericarditis.
Drugs that block these pathways are already approved to treat recurrent pericarditis and potentially could be used as preventive therapy, Pershad noted.
Bick, the paper’s corresponding author, directs the Division of Genomic Medicine and Clinical Pharmacology at Vanderbilt Health. Other co-authors are Kun Zhao, PhD, a postdoctoral researcher in the Bick lab, and Brett Heimlich, MD, PhD, assistant professor of Medicine. The research was supported by National Institutes of Health grants DP5OD029586, R01AG088657 and K08HL171833, a Burroughs Wellcome Fund Career Award for Medical Scientists, a Pew-Stewart Scholar for Cancer Research award, and a Hevolution/AFAR New Investigator Award in Aging Biology and Geroscience Research.
