{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T02:54:51Z","timestamp":1787540091701,"version":"build-2736575974"},"reference-count":53,"publisher":"American Society for Clinical Investigation","issue":"7","license":[{"start":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T00:00:00Z","timestamp":1681084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007338","name":"Foundation for Barnes-Jewish Hospital","doi-asserted-by":"crossref","award":["5151"],"award-info":[{"award-number":["5151"]}],"id":[{"id":"10.13039\/100007338","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Cancer Institute","award":["K12 CA167540"],"award-info":[{"award-number":["K12 CA167540"]}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["K01HL155231,R25 HL105400"],"award-info":[{"award-number":["K01HL155231,R25 HL105400"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["P01AI116501,R01HL094601,P01 CA101937"],"award-info":[{"award-number":["P01AI116501,R01HL094601,P01 CA101937"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Cellular stressors influence the development of clonal hematopoiesis (CH). We hypothesized that environmental, inflammatory, and genotoxic stresses drive the emergence of CH in lung transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We performed a cross-sectional cohort study of 85 lung transplant recipients to characterize CH prevalence. We evaluated somatic variants using duplex error-corrected sequencing and germline variants using whole exome sequencing. We evaluated CH frequency and burden using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      and Poisson regression, and we evaluated associations with clinical and demographic variables and clinical outcomes using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      , logistic regression, and Cox regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      CH in DNA damage response (DDR) genes\n                      <jats:italic>TP53<\/jats:italic>\n                      ,\n                      <jats:italic>PPM1D<\/jats:italic>\n                      , and\n                      <jats:italic>ATM<\/jats:italic>\n                      was increased in transplant recipients compared with a control group of older adults (28% versus 0%, adjusted OR [aOR], 12.9 [1.7\u2013100.3],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0002). Age (OR, 1.13 [1.03\u20131.25],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.014) and smoking history (OR 4.25 [1.02\u201317.82],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.048) were associated with DDR CH. Germline variants predisposing to idiopathic pulmonary fibrosis were identified but not associated with CH. DDR CH was associated with increased cytomegalovirus viremia versus patients with no (OR, 7.23 [1.95\u201326.8],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.018) or non-DDR CH (OR, 7.64 [1.77\u201332.89],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.024) and mycophenolate discontinuation (aOR, 3.8 [1.3\u201312.9],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>CH in DDR genes is prevalent in lung transplant recipients and is associated with posttransplant outcomes including cytomegalovirus activation and mycophenolate intolerance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>FUNDING<\/jats:title>\n                    <jats:p>NIH\/NHLBI K01HL155231 (LKT), R25HL105400 (LKT), Foundation for Barnes-Jewish Hospital (LKT), Evans MDS Center at Washington University (KAO, MJW), ASH Scholar Award (KAO), NIH K12CA167540 (KAO), NIH P01AI116501 (AEG, DK), NIH R01HL094601 (AEG), and NIH P01CA101937 (DCL).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1172\/jci.insight.165609","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T12:00:50Z","timestamp":1677585650000},"source":"Crossref","is-referenced-by-count":11,"title":["Increased clonal hematopoiesis involving DNA damage response genes in patients undergoing lung transplantation"],"prefix":"10.1172","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6243-1901","authenticated-orcid":true,"given":"Laneshia K.","family":"Tague","sequence":"first","affiliation":[{"name":"Division of Pulmonary & Critical Care Medicine 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USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4540-7184","authenticated-orcid":true,"given":"Hephzibah","family":"Anthony","sequence":"additional","affiliation":[{"name":"Division of Pulmonary & Critical Care Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kreisel","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C.","family":"Link","sequence":"additional","affiliation":[{"name":"Division of Oncology, Section of Stem Cell Biology, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA."},{"name":"Department of Pathology & Immunology, Washington University in St. Louis, St. Louis, Missouri, 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