- Yu, Zhi;
- Fidler, Trevor;
- Ruan, Yunfeng;
- Vlasschaert, Caitlyn;
- Nakao, Tetsushi;
- Uddin, Md;
- Mack, Taralynn;
- Niroula, Abhishek;
- Heimlich, J;
- Zekavat, Seyedeh;
- Gibson, Christopher;
- Griffin, Gabriel;
- Wang, Yuxuan;
- Peloso, Gina;
- Heard-Costa, Nancy;
- Levy, Daniel;
- Vasan, Ramachandran;
- Aguet, François;
- Ardlie, Kristin;
- Taylor, Kent;
- Rich, Stephen;
- Libby, Peter;
- Jaiswal, Siddhartha;
- Ebert, Benjamin;
- Bick, Alexander;
- Tall, Alan;
- Natarajan, Pradeep;
- Rotter, Jerome
Clonal hematopoiesis of indeterminate potential (CHIP) is associated with an increased risk of cardiovascular diseases (CVDs), putatively via inflammasome activation. We pursued an inflammatory gene modifier scan for CHIP-associated CVD risk among 424,651 UK Biobank participants. We identified CHIP using whole-exome sequencing data of blood DNA and modeled as a composite, considering all driver genes together, as well as separately for common drivers (DNMT3A, TET2, ASXL1, and JAK2). We developed predicted gene expression scores for 26 inflammasome-related genes and assessed how they modify CHIP-associated CVD risk. We identified IL1RAP as a potential key molecule for CHIP-associated CVD risk across genes and increased AIM2 gene expression leading to heightened JAK2- and ASXL1-associated CVD risk. We show that CRISPR-induced Asxl1-mutated murine macrophages had a particularly heightened inflammatory response to AIM2 agonism, associated with an increased DNA damage response, as well as increased IL-10 secretion, mirroring a CVD-protective effect of IL10 expression in ASXL1 CHIP. Our study supports the role of inflammasomes in CHIP-associated CVD and provides evidence to support gene-specific strategies to address CHIP-associated CVD risk.