Vasculitis & polymyalgia rheumatica
Clonal haematopoiesis across the age spectrum of vasculitis patients with Takayasu’s arteritis, ANCA-associated vasculitis and giant cell arteritis
Authors' conclusion
Age was more strongly associated with CH prevalence than inflammation in systemic vasculitis. Clonal profile was dominated by DNMT3A mutations which were associated with relapse in GCA.
Study context
- Population
- Patients with three forms of systemic vasculitis (TAK, antibody-associated vasculitis (AAV), giant cell arteritis (GCA)) screened for clonal haematopoiesis (CH) in peripheral blood176 patients · 151 age-matched controls
- Participants
- 70 / 47 / 59 / 151
- Exposure
- Patients with systemic vasculitis vs age-matched controls
- TAKn = 70
- AAVn = 47
- GCAn = 59
- Controlsn = 151reference
- Outcome
- Prevalence of clonal haematopoiesis (CH)
Methodological detailserror-corrected sequencing, multivariable logistic regression, age-matched controls, proteogenomic single-cell DNA sequencing
- Error-corrected sequencing
- Multivariable logistic regression
- Age-matched controls
- Proteogenomic single-cell DNA sequencing
Main finding
As reported in the abstract
CH prevalence
P < 0.01
- CH independently associated with age (standardised B)
- 0.96
- CH independently associated with vasculitis (standardised B)
- 0.46
Observational data: associations, not effects.
Further findings
Clonal trajectories and cellular activation
- Both branched and linear clonal trajectories showed myeloid-lineage bias
- CH associated with markers of cellular activation
CH in GCA: temporal artery biopsies and relapse
- Mutations detected in temporal artery biopsies
- Clinical relapse correlated with CH in a dose-dependent relationship with clone size
Original publication
Clonal haematopoiesis across the age spectrum of vasculitis patients with Takayasu’s arteritis, ANCA-associated vasculitis and giant cell arteritis. Ann Rheum Dis. Published 12 March 2024. doi:10.
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