Clonal haematopoiesis of indeterminate potential (CHIP) is emerging as a significant area of investigation within the context of age-related diseases, particularly those affecting the hematological system and chronic inflammatory conditions. As the global population ages, understanding the mechanisms driving CHIP is essential for deciphering its role in pathology. CHIP is characterized by the presence of a dominant clone of blood cells that originate from a single mutated hematopoietic stem cell (HSC). This phenomenon has garnered increasing attention due to its intricate relationship with age-associated morbidity and mortality.
The mutation in HSCs that gives rise to CHIP can be driven by various genetic alterations that accumulate over time. These somatic mutations often affect genes involved in crucial cellular processes such as proliferation and differentiation, which may not only promote clonal expansion but also confer survival advantages under certain stress conditions. Inflammation, a hallmark of aging, creates an environment that can selectively favor the expansion of CHIP clones, thus supporting the theory that CHIP might serve as an adaptive response to the challenges posed by chronic inflammation.
Emerging evidence indicates that individuals with CHIP have an elevated risk of developing hematological malignancies, including acute myeloid leukemia and myelodysplastic syndromes. The connection between CHIP and these malignancies is multifaceted, involving the interplay of tumor suppressor pathways and pro-oncogenic signaling cascades that are modified by the inflammatory milieu. This not only underscores the potential of CHIP as a biomarker for cancer risk but also highlights the need for further clinical investigation of patients exhibiting this condition.
In addition to hematological malignancies, CHIP’s influence extends to various chronic diseases, most notably cardiovascular disorders. The presence of CHIP-associated clones has been linked to increased inflammatory markers, suggesting a causal relationship between clonal expansion and the development of cardiovascular pathologies. This inflammatory state may be driven by the activity of mutant HSCs, which become hyper-responsive to inflammatory signals and contribute to an overall state of chronic, low-grade inflammation termed “inflammageing.”
Inflammageing is characterized by a gradual increase in systemic inflammation, which is thought to contribute to the decline in organ function observed in older adults. The relationship between CHIP and inflammageing is particularly intriguing, as it raises questions about the potential for CHIP mutations to either exacerbate or mitigate the effects of chronic inflammation on normal HSC function. While normal HSCs are often inhibited by inflammatory signals, evidence suggests that CHIP-mutant HSCs may not only withstand these detrimental effects but may also benefit from them, thus promoting their own expansion.
In the context of inflammageing and cellular aging, CHIP may act as a double-edged sword. On one hand, the clonal expansion of mutant HSCs provides a reservoir of functionally altered cells that could contribute to enhanced blood cell production in response to inflammatory stressors. On the other hand, this process could compromise the function and regenerative potential of the normal HSC pool, leading to diminished hematopoietic resilience over time. The challenge lies in delineating these complex interactions, as an in-depth understanding is crucial for developing targeted therapeutic interventions for older adults.
As the research landscape continues to evolve, there is a growing recognition of the need for longitudinal studies that track the progression of CHIP and its clinical consequences. The identification of specific biomarkers associated with CHIP could facilitate early detection and risk stratification for patients predisposed to hematological malignancies and other age-related diseases. Additionally, exploring the therapeutic potential of targeted interventions that address the inflammatory component of CHIP may reveal novel strategies to alter disease trajectories in at-risk populations.
The translational implications of the CHIP and inflammageing interplay extend beyond hematopoietic malignancies and cardiovascular diseases. Researchers are beginning to uncover potential links between CHIP and other organ systems, including neurodegenerative diseases and metabolic disorders. Understanding how these interactions manifest at the cellular and molecular levels could pave the way for holistic approaches to treat and prevent a range of diseases that commonly afflict the aging population.
Current advancements in single-cell genomic technologies are revolutionizing our ability to investigate the heterogeneity of clonal blood populations and their interactions with the microenvironment. These cutting-edge techniques allow for detailed characterization of mutated clones and their functional capacities, providing insights that might inform personalized treatment strategies. As our understanding deepens, it is likely that we will see a paradigm shift in the way we approach diseases associated with aging, with a stronger focus on the role of clonal hematopoiesis and its broader implications on health.
Moreover, the engagement of the immune system in inflammageing and its relationship with CHIP cannot be overlooked. Immune cells, particularly those of the myeloid lineage, play pivotal roles in shaping the inflammatory environment and influencing HSC behavior. Investigating how CHIP-mutant HSCs communicate with immune cells within the bone marrow niche can yield important insights into the maintenance of hematopoietic homeostasis and the potential disruption of this delicate balance in pathological states.
As we look towards the future, interdisciplinary collaboration between researchers, clinicians, and public health officials will be essential to harness the knowledge gained from CHIP studies effectively. By integrating findings from molecular biology, genetics, immunology, and epidemiology, we can develop comprehensive models that address the multifactorial nature of diseases associated with ageing. Such collaborative efforts will enable us to envision innovative solutions that not only target the molecular drivers of CHIP but also tackle the systemic inflammatory processes that underpin many age-related conditions.
In conclusion, the interplay between clonal haematopoiesis of indeterminate potential and inflammageing presents a critical avenue for research and therapeutic exploration. As our understanding of the underlying mechanisms continues to evolve, we are better equipped to address the challenges posed by aging and its associated diseases, ultimately improving health outcomes for the aging population. More research is needed to investigate the clinical implications of these findings, with the hope that targeted interventions will pave the way for a healthier ageing process.
Subject of Research: Clonal haematopoiesis of indeterminate potential and its relationship with inflammageing and its impact on age-related diseases.
Article Title: Inflammageing and clonal haematopoiesis interplay and their impact on human disease.
Article References: Hajishengallis, G., Chavakis, T. Inflammageing and clonal haematopoiesis interplay and their impact on human disease.
Nat Rev Mol Cell Biol (2026). https://doi.org/10.1038/s41580-025-00936-y
Image Credits: AI Generated
DOI: 10.1038/s41580-025-00936-y
Keywords: Clonal haematopoiesis, inflammageing, hematopoietic stem cells, somatic mutations, chronic inflammation, ageing diseases, cardiovascular disorders, hematological malignancies, immune system interactions.
