Clonal hematopoiesis sees Twin Peaks

摘要

Clonal hematopoiesis (CH) is a fundamental process in the aging of the blood system; however, it remains enigmatic why some individuals of the same age carry mutations, whereas others do not or carry different mutations with different variant allele frequencies (VAF). In this issue of Blood, Fabre et al(1) and Hansen et al(2) address the differential roles of nature (genotype/heritability) vs nurture (environment) in the evolution of age-related clonal hematopoiesis (ARCH).(3) In these studies, twin concordance analysis was used to determine the germline contribution to ARCH.(4) In both studies, no hereditary component of ARCH could be detected. Therefore, it is most likely that the variability of ARCH in the population can be explained by differential environmental exposures. Although such a conclusion is reasonable, a few specific aspects of the nature vs nurture dilemma in CH need to be considered.