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Association between DNMT3A-driven clonal hematopoiesis, trained immunity and immune cell function in obesity

Bahrar, H.; Tercan, H.; Cossins, B.; Rother, N.; van deuren, R.; Hoischen, A.; Joosten, L. A.; Netea, M.; Bekkering, S.; Riksen, N. P.

2026-08-23 cardiovascular medicine
10.64898/2026.08.20.26360882 medRxiv
Show abstract

Trained immunity and clonal hematopoiesis are two newly identified immunological phenomena that contribute to the pathophysiology of atherosclerotic cardiovascular disease. These two phenomena share some convergent molecular mechanisms, such as IL-1{beta} being a central regulator and involvement of epigenetic enzymes. Therefore, we hypothesize that presence of clonal hematopoiesis driver mutations (CHDMs) can predispose to an increased capacity to build trained immunity. We previously characterized how the presence of CHDMs relates to immune cell function and vasculometabolic complications in a cohort of older individuals with overweight and obesity. From this cohort we now selected 17 individuals with CH due to DNMT3A mutations and 15 without any known CHDMs. We performed in depth immune characterization via flow cytometry, functional assays with monocytes and neutrophils, and we measured the capacity to build trained immunity using {beta}-glucan and oxLDL as stimuli. We corroborated our previous findings of lower ex vivo cytokine production capacity of PBMCs from individuals with DNMT3A mutations. Importantly, presence of DNMT3A CHDMs associated with higher trained immunity response. Moreover, we demonstrated that individuals with DNMT3A mutations were characterized with higher CD10+ mature neutrophils and a lower neutrophil MPO release upon TLR2 stimulation. In conclusion, presence of DNMT3A CHDMs is associated with increased susceptibility to build a hyperresponsive trained monocyte phenotype. The exact molecular mechanisms behind this phenomena requires further investigation.

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