Increased stem cell proliferation in atherosclerosis accelerates clonal hematopoiesis
Open accessAbstract
Clonal hematopoiesis, a condition in which individual hematopoietic stem cell clones generate a disproportionate fraction of blood leukocytes, correlates with higher risk for cardiovascular disease. The mechanisms behind this association are incompletely understood. Here, we show that hematopoietic stem cell division rates are increased in mice and humans with atherosclerosis. Mathematical analysis demonstrates that increased stem cell proliferation expedites somatic evolution and expansion of clones with driver mutations. The experimentally determined division rate elevation in atherosclerosis patients is sufficient to produce a 3.5-fold increased risk of clonal hematopoiesis by age 70. We confirm the accuracy of our theoretical framework in mouse models of atherosclerosis and sleep fragmentation by showing that expansion of competitively transplanted Tet2-/- cells is accelerated under conditions of chronically elevated hematopoietic activity. Hence, increased hematopoietic stem cell proliferation is an important factor contributing to the association between cardiovascular disease and clonal hematopoiesis.
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These cytokines display overlapping features, such as inducing cell cycle entry of HSCs and their differentiation, frequently toward the granulo-monocytic lineage.
“These cytokines display overlapping features, such as inducing cell cycle entry of HSCs and their differentiation, frequently toward the granulo-monocytic lineage 1,4-6,12-15 .”
From Type 1 interferon perturbates clonal competition by reshaping human blood development (2026) · cites this paper as [5]
The Introduction (page unavailable) says increased cytokine levels may drive hematopoietic activity, and the Results section on sleep fragmentation describes CSF1-dependent proliferation with increased HSC cycling. The paper also reports increased granulocyte/monocyte progenitor activity in atherosclerosis, but it does not establish that the cytokines induce HSC differentiation frequently toward that lineage. (LLM, conf=0.81)
Experimental — accuracy not yet measuredThe disease process itself has been suggested to reciprocally accelerate CH.
“The disease process itself has been suggested to reciprocally accelerate CH [41] (Figure 1).”
From Clonal hematopoiesis and inflammation – the perpetual cycle (2023) · cites this paper as [41]
Isolated effects of individual inflammatory cytokines, including type 1 interferons (IFNa/b), type 2 IFN (IFNg), TNFa, and IL-1, have been well-documented in mouse hematopoietic development.
“The isolated effects of individual inflammatory cytokines, including type 1 interferons (IFNa/b) 1-3 , type 2 IFN (IFNg) 4-6 , TNFa 7,8 , and IL-1 9-11 , have been well-documented in mouse hematopoietic development.”
From Type 1 interferon perturbates clonal competition by reshaping human blood development (2026) · cites this paper as [5]
The Introduction says that increased cytokine levels may drive hematopoietic activity, but it does not identify TNFα or document its isolated effects in mouse hematopoiesis. Searches for TNF and tumor necrosis factor found no passage addressing the TNFα-specific claim. (LLM, conf=0.72)
Experimental — accuracy not yet measuredWhile clonal expansion during normal ageing has not yet been observed in mice, it has been reported in mouse models for disease and in physiologically aged macaques.
“While clonal expansion during normal ageing has not yet been observed in mice, it has been reported in mouse models for disease61 and in physiologically aged macaques62.”
From Ageing and rejuvenation of tissue stem cells and their niches (2023) · cites this paper as [61]
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- Authors
- Heyde, A., Rohde, D., McAlpine, C. S., Zhang, S., Hoyer, F. F., Gerold, J. M., Cheek, D., Iwamoto, Y., Schloss, M. J., Vandoorne, K., Iborra-Egea, O., Muñoz-Guijosa, C., Bayes-Genis, A., Reiter, J. G., Craig, M., Swirski, F. K., Nahrendorf, M., Nowak, M. A., & Naxerova, K.
- Affiliations
- Harvard University (US)
- Hospital Universitari Germans Trias i Pujol (ES)
- Stanford University (US)
- Centre Hospitalier Universitaire Sainte-Justine (CA)
- Corresponding author
- Naxerova, Kamila
- ORCID
- Heyde, Alexander
- Rohde, David
- McAlpine, Cameron S.
- Zhang, Shuang
- Hoyer, Friedrich F.
- Gerold, Jeffrey M.
- Cheek, David
- Iwamoto, Yoshiko
- Schloss, Maximilian J.
- Vandoorne, Katrien
- Iborra-Egea, Oriol
- Muñoz-Guijosa, Christian
- Reiter, Johannes G.
- Craig, Morgan
- Swirski, Filip K.
- Nahrendorf, Matthias
- Nowak, Martin A.
- Naxerova, Kamila
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 184
- Issue
- 5
- Pages
- 1348-1361.e22
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC8109274
- OpenAlex
- W3130296909
- Cited by
- 267
- References
- 64
- Citations by year
- 2026: 33 · 2025: 48 · 2024: 45 · 2023: 47 · 2022: 61 · 2021: 33
- FWCI
- 31.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (vor, 368 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Cell (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Science Foundation
- National Heart, Lung, and Blood Institute
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- clonal hematopoiesis, atherosclerosis, hematopoietic stem cell proliferation, somatic evolution, driver mutations, cardiovascular risk, TET2, sleep fragmentation, hematopoietic stem cell transplantation
- MeSH terms
- Clonal Hematopoiesis, Aging, Animals, Apolipoproteins E, Bone Marrow, Disease Models, Animal, Female, Hematopoietic Stem Cells, Humans, Mice, Inbred C57BL, Models, Biological, Sleep Deprivation, Cell Proliferation, Atherosclerosis, Mice, Clonal Evolution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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