Clonal Hematopoiesis and Biological Aging: An Emerging Biomarker for Longevity Medicine

Chronological age does not fully capture the substantial interindividual variability in aging, prompting growing interest in biomarkers that reflect biological aging and susceptibility to age-related disease.Clonal hematopoiesis of indeterminate potential (CHIP), characterized by the age-related expansion of hematopoietic clones carrying somatic mutations in the absence of an overt hematologic malignancy, has emerged as a potential link between somatic evolution, chronic inflammation, and age-related disease.This narrative review examines the biological mechanisms linking clonal hematopoiesis to aging, evaluates the evidence supporting CHIP as an emerging biomarker of biological aging, and discusses its potential implications and current limitations in longevity medicine.CHIP becomes increasingly prevalent with age and reflects the interplay between somatic mutation accumulation, clonal selection, and an aging inflammatory microenvironment.Growing evidence links CHIP to epigenetic age acceleration, with associations influenced by the mutated gene, clone size, and clonal architecture.Beyond its established risk of progression to myeloid malignancy, CHIP is associated with cardiovascular disease, heart failure, and increased mortality.Experimental and clinical data suggest that clone-dependent inflammatory pathways, particularly IL-1β signaling in TET2-mutated clonal hematopoiesis, may contribute to cardiovascular complications.However, the clinical significance of CHIP is highly heterogeneous, and its detection alone does not currently justify population-wide screening or CHIP-specific pharmacologic intervention.CHIP therefore represents a promising biomarker at the intersection of biological aging, inflammation, and agerelated disease, but it should not yet be considered an established clinical biomarker of longevity.Future longitudinal studies and randomized interventional trials are needed to determine whether integrating clonal characteristics with epigenetic, inflammatory, cardiovascular, and functional biomarkers improves risk stratification and, importantly, whether CHIP-guided interventions can improve health span or survival.