Regulators of clonal hematopoiesis and physiological consequences of this condition

Eunbee Park , Megan A. Evans , Kenneth Walsh

The Journal of Cardiovascular Aging ›› 2024, Vol. 4 ›› Issue (1) : 3

PDF
The Journal of Cardiovascular Aging ›› 2024, Vol. 4 ›› Issue (1) :3 DOI: 10.20517/jca.2023.39
Review

Regulators of clonal hematopoiesis and physiological consequences of this condition

Author information +
History +
PDF

Abstract

Clonal hematopoiesis (CH) is a prevalent condition that results from somatic mutations in hematopoietic stem cells. When these mutations occur in “driver” genes, they can potentially confer fitness advantages to the affected cells, leading to a clonal expansion. While most clonal expansions of mutant cells are generally considered to be asymptomatic since they do not impact overall blood cell numbers, CH carriers face long-term risks of all-cause mortality and age-associated diseases, including cardiovascular disease and hematological malignancies. While considerable research has focused on understanding the association between CH and these diseases, less attention has been given to exploring the regulatory factors that contribute to the expansion of the driver gene clone. This review focuses on the association between environmental stressors and inherited genetic risk factors in the context of CH development. A better understanding of how these stressors impact CH development will facilitate mechanistic studies and potentially lead to new therapeutic avenues to treat individuals with this condition.

Keywords

Clonal hematopoiesis / aging / inflammation / genotoxic stress

Cite this article

Download citation ▾
Eunbee Park, Megan A. Evans, Kenneth Walsh. Regulators of clonal hematopoiesis and physiological consequences of this condition. The Journal of Cardiovascular Aging, 2024, 4(1): 3 DOI:10.20517/jca.2023.39

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Evans MA.Clonal hematopoiesis, somatic mosaicism, and age-associated disease.Physiol Rev2023;103:649-716 PMCID:PMC9639777

[2]

Jaiswal S.Clonal hematopoiesis in human aging and disease.Science2019;366:eaan4673 PMCID:PMC8050831

[3]

Loh PR,Handsaker RE.Insights into clonal haematopoiesis from 8,342 mosaic chromosomal alterations.Nature2018;559:350-5 PMCID:PMC6054542

[4]

Zekavat SM,Bick AG.Hematopoietic mosaic chromosomal alterations increase the risk for diverse types of infection.Nat Med2021;27:1012-24 PMCID:PMC8245201

[5]

Dumanski JP,Davies H.Immune cells lacking Y chromosome show dysregulation of autosomal gene expression.Cell Mol Life Sci2021;78:4019-33 PMCID:PMC8106578

[6]

Polizio AH,Walsh K.Clonal hematopoiesis: connecting aging and inflammation in atherosclerosis.Curr Atheroscler Rep2023;25:105-11 PMCID:PMC10552081

[7]

Sano S,Ogawa H.Hematopoietic loss of Y chromosome leads to cardiac fibrosis and heart failure mortality.Science2022;377:292-7 PMCID:PMC9437978

[8]

Jaiswal S,Flannick J.Age-related clonal hematopoiesis associated with adverse outcomes.N Engl J Med2014;371:2488-98 PMCID:PMC4306669

[9]

Genovese G,Handsaker RE.Clonal hematopoiesis and blood-cancer risk inferred from blood DNA sequence.N Engl J Med2014;371:2477-87 PMCID:PMC4290021

[10]

Steensma DP.Clinical consequences of clonal hematopoiesis of indeterminate potential.Blood Adv2018;2:3404-10 PMCID:PMC6258914

[11]

Evans MA,Walsh K.Clonal haematopoiesis and cardiovascular disease: how low can you go?.Eur Heart J2021;42:266-8

[12]

Assmus B,Kirschbaum K.Clonal haematopoiesis in chronic ischaemic heart failure: prognostic role of clone size for DNMT3A- and TET2-driver gene mutations.Eur Heart J2021;42:257-65

[13]

Sikking MA,Henkens MTHM.Clonal hematopoiesis has prognostic value in dilated cardiomyopathy independent of age and clone size.JACC Heart Fail2023;S2213:1779(23)00509

[14]

Steensma DP,Jaiswal S.Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes.Blood2015;126:9-16 PMCID:PMC4624443

[15]

Xie M,Wang J.Age-related mutations associated with clonal hematopoietic expansion and malignancies.Nat Med2014;20:1472-8 PMCID:PMC4313872

[16]

Zink F,Norddahl GL.Clonal hematopoiesis, with and without candidate driver mutations, is common in the elderly.Blood2017;130:742-52 PMCID:PMC5553576

[17]

Bowman RL,Levine RL.Clonal hematopoiesis and evolution to hematopoietic malignancies.Cell Stem Cell2018;22:157-70 PMCID:PMC5804896

[18]

Jaiswal S,Silver AJ.Clonal hematopoiesis and risk of atherosclerotic cardiovascular disease.N Engl J Med2017;377:111-21 PMCID:PMC6717509

[19]

Cremer S,Berkowitsch A.Multiple somatic mutations for clonal hematopoiesis are associated with increased mortality in patients with chronic heart failure.Circ Genom Precis Med2020;13:e003003

[20]

Honigberg MC,Niroula A.Premature menopause, clonal hematopoiesis, and coronary artery disease in postmenopausal women.Circulation2021;143:410-23 PMCID:PMC7911856

[21]

Yu B,Raffield LM.Supplemental association of clonal hematopoiesis with incident heart failure.J Am Coll Cardiol2021;78:42-52 PMCID:PMC8313294

[22]

Dorsheimer L,Rasper T.Association of mutations contributing to clonal hematopoiesis with prognosis in chronic ischemic heart failure.JAMA Cardiol2019;4:25-33 PMCID:PMC6439691

[23]

Pascual-Figal DA,Díez-Díez M.Clonal hematopoiesis and risk of progression of heart failure with reduced left ventricular ejection fraction.J Am Coll Cardiol2021;77:1747-59

[24]

Zekavat SM,Matesanz N.TP53-mediated clonal hematopoiesis confers increased risk for incident atherosclerotic disease.Nat Cardiovasc Res2023;2:144-58 PMCID:PMC10026701

[25]

Bhattacharya R,Haessler J.Clonal hematopoiesis is associated with higher risk of stroke.Stroke2022;53:788-97 PMCID:PMC8885769

[26]

Kar SP,Gu M.Genome-wide analyses of 200,453 individuals yield new insights into the causes and consequences of clonal hematopoiesis.Nat Genet2022;54:1155-66 PMCID:PMC9355874

[27]

Kessler MD,O’Keeffe S.Common and rare variant associations with clonal haematopoiesis phenotypes.Nature2022;612:301-9 PMCID:PMC9713173

[28]

Mas-Peiro S,Berkowitsch A.Long-term risk associated with clonal hematopoiesis in patients with severe aortic valve stenosis undergoing TAVR.Clin Res Cardiol2023;112:585-93 PMCID:PMC10160205

[29]

Gumuser ED,Cho SMJ.Clonal hematopoiesis of indeterminate potential predicts adverse outcomes in patients with atherosclerotic cardiovascular disease.J Am Coll Cardiol2023;81:1996-2009 PMCID:PMC10249057

[30]

Cochran JD,Thel MC.Clonal hematopoiesis in clinical and experimental heart failure with preserved ejection fraction.Circulation2023;148:1165-78 PMCID:PMC10575571

[31]

Fuster JJ,Zuriaga MA.Clonal hematopoiesis associated with TET2 deficiency accelerates atherosclerosis development in mice.Science2017;355:842-7 PMCID:PMC5542057

[32]

Sano S,Wang Y.Tet2-mediated clonal hematopoiesis accelerates heart failure through a mechanism involving the IL-1β/NLRP3 inflammasome.J Am Coll Cardiol2018;71:875-86 PMCID:PMC5828038

[33]

Wang Y,Yura Y.Tet2-mediated clonal hematopoiesis in nonconditioned mice accelerates age-associated cardiac dysfunction.JCI Insight2020;5:135204 PMCID:PMC7213793

[34]

Yura Y,Katanasaka Y.The cancer therapy-related clonal hematopoiesis driver gene ppm1d promotes inflammation and non-ischemic heart failure in mice.Circ Res2021;129:684-98 PMCID:PMC8409899

[35]

Sano S,Ogawa H.TP53-mediated therapy-related clonal hematopoiesis contributes to doxorubicin-induced cardiomyopathy by augmenting a neutrophil-mediated cytotoxic response.JCI Insight2021;6:e146076 PMCID:PMC8410064

[36]

Buscarlet M,Zada YF.DNMT3A and TET2 dominate clonal hematopoiesis and demonstrate benign phenotypes and different genetic predispositions.Blood2017;130:753-62

[37]

Miller PG,Rojas-Quintero J.Association of clonal hematopoiesis with chronic obstructive pulmonary disease.Blood2022;139:357-68 PMCID:PMC8777202

[38]

Dawoud AAZ,Tapper WJ.Clonal myelopoiesis promotes adverse outcomes in chronic kidney disease.Leukemia2022;36:507-15 PMCID:PMC8807385

[39]

Vlasschaert C,Chong M.Association of clonal hematopoiesis of indeterminate potential with worse kidney function and anemia in two cohorts of patients with advanced chronic kidney disease.J Am Soc Nephrol2022;33:985-95 PMCID:PMC9063886

[40]

Pasupuleti SK,Burns SS.Obesity-induced inflammation exacerbates clonal hematopoiesis.J Clin Invest2023;133:e163968 PMCID:PMC10231999

[41]

Wong WJ,Bick AG.Clonal haematopoiesis and risk of chronic liver disease.Nature2023;616:747-54

[42]

Kim PG,Shkolnik V.Dnmt3a-mutated clonal hematopoiesis promotes osteoporosis.J Exp Med2021;218:e20211872 PMCID:PMC8552148

[43]

Agrawal M,Cunin P.TET2-mutant clonal hematopoiesis and risk of gout.Blood2022;140:1094-103 PMCID:PMC9461470

[44]

Bolton KL,Foote MB.Clonal hematopoiesis is associated with risk of severe Covid-19.Nat Commun2021;12:5975 PMCID:PMC8514469

[45]

Bick AG,Thorball CW.Increased prevalence of clonal hematopoiesis of indeterminate potential amongst people living with HIV.Sci Rep2022;12:577

[46]

Dharan NJ,Bloch M.HIV is associated with an increased risk of age-related clonal hematopoiesis among older adults.Nat Med2021;27:1006-11

[47]

Hecker JS,Rivière J.CHIP and hips: clonal hematopoiesis is common in patients undergoing hip arthroplasty and is associated with autoimmune disease.Blood2021;138:1727-32

[48]

Zhang CRC,Gregory M.Inflammatory cytokines promote clonal hematopoiesis with specific mutations in ulcerative colitis patients.Exp Hematol2019;80:36-41.e3 PMCID:PMC7031927

[49]

Cumbo C,Zagaria A.Clonal hematopoiesis at the crossroads of inflammatory bowel diseases and hematological malignancies: a biological link?.Front Oncol2022;12:873896 PMCID:PMC9039212

[50]

Nachun D,Bick AG.Clonal hematopoiesis associated with epigenetic aging and clinical outcomes.Aging Cell2021;20:e13366 PMCID:PMC8208788

[51]

Robertson NA,McCartney DL.Age-related clonal haemopoiesis is associated with increased epigenetic age.Curr Biol2019;29:R786-7

[52]

Kleppe M,Wen HY.Somatic mutations in leukocytes infiltrating primary breast cancers.NPJ Breast Cancer2015;1:15005 PMCID:PMC5515194

[53]

Hong W,Liu Y.Clonal hematopoiesis mutations in patients with lung cancer are associated with lung cancer risk factors.Cancer Res2022;82:199-209 PMCID:PMC8815061

[54]

Young AL,Birmann BM.Clonal haematopoiesis harbouring AML-associated mutations is ubiquitous in healthy adults.Nat Commun2016;7:12484 PMCID:PMC4996934

[55]

Robertson NA,Terradas-Terradas M.Longitudinal dynamics of clonal hematopoiesis identifies gene-specific fitness effects.Nat Med2022;28:1439-46 PMCID:PMC9307482

[56]

Uddin MM,Bick AG.Longitudinal profiling of clonal hematopoiesis provides insight into clonal dynamics.Immun Ageing2022;19:23 PMCID:PMC9128083

[57]

Busque L,Figueroa ME.Recurrent somatic TET2 mutations in normal elderly individuals with clonal hematopoiesis.Nat Genet2012;44:1179-81 PMCID:PMC3483435

[58]

Busque L,Mattioli J.Nonrandom X-inactivation patterns in normal females: lyonization ratios vary with age.Blood1996;88:59-65

[59]

Mitchell E,Williams N.Clonal dynamics of haematopoiesis across the human lifespan.Nature2022;606:343-50 PMCID:PMC9177428

[60]

Florez MA,Wathan TK,Pietras EM.Clonal hematopoiesis: mutation-specific adaptation to environmental change.Cell Stem Cell2022;29:882-904 PMCID:PMC9202417

[61]

Fabre MA,Fiorillo E.The longitudinal dynamics and natural history of clonal haematopoiesis.Nature2022;606:335-42 PMCID:PMC9177423

[62]

Matteini F,Florian MC.Aging of the hematopoietic stem cell niche: new tools to answer an old question.Front Immunol2021;12:738204 PMCID:PMC8631970

[63]

Coombs CC,Devlin SM.Therapy-related clonal hematopoiesis in patients with non-hematologic cancers is common and associated with adverse clinical outcomes.Cell Stem Cell2017;21:374-82.e4 PMCID:PMC5591073

[64]

Wong TN,Jotte MRM.Cellular stressors contribute to the expansion of hematopoietic clones of varying leukemic potential.Nat Commun2018;9:455 PMCID:PMC5792556

[65]

Bolton KL,Gao T.Cancer therapy shapes the fitness landscape of clonal hematopoiesis.Nat Genet2020;52:1219-26

[66]

Hsu JI,Tovy A.PPM1D mutations drive clonal hematopoiesis in response to cytotoxic chemotherapy.Cell Stem Cell2018;23:700-13.e6 PMCID:PMC6224657

[67]

Wong TN,Young AL.Role of TP53 mutations in the origin and evolution of therapy-related acute myeloid leukaemia.Nature2015;518:552-5 PMCID:PMC4403236

[68]

Bondar T.p53-mediated hematopoietic stem and progenitor cell competition.Cell Stem Cell2010;6:309-22 PMCID:PMC2872065

[69]

Young K,Bell R.Decline in IGF1 in the bone marrow microenvironment initiates hematopoietic stem cell aging.Cell Stem Cell2021;28:1473-82.e7 PMCID:PMC8349778

[70]

Doan PL,Helms K.Epidermal growth factor regulates hematopoietic regeneration after radiation injury.Nat Med2013;19:295-304 PMCID:PMC3594347

[71]

Itkin T,Gradus B.FGF-2 expands murine hematopoietic stem and progenitor cells via proliferation of stromal cells, c-Kit activation, and CXCL12 down-regulation.Blood2012;120:1843-55

[72]

Cao X,Frassica D.Irradiation induces bone injury by damaging bone marrow microenvironment for stem cells.Proc Natl Acad Sci USA2011;108:1609-14

[73]

Pinho S.Haematopoietic stem cell activity and interactions with the niche.Nat Rev Mol Cell Biol2019;20:303-20 PMCID:PMC6483843

[74]

Tikhonova AN,Hu H.The bone marrow microenvironment at single-cell resolution.Nature2019;569:222-8 PMCID:PMC6607432

[75]

Garrett-Bakelman FE,Green SJ.The NASA twins study: a multidimensional analysis of a year-long human spaceflight.Science2019;364:eaau8650

[76]

Mencia-Trinchant N,Chin C.Clonal hematopoiesis before, during, and after human spaceflight.Cell Rep2020;33:108458 PMCID:PMC9398182

[77]

Brojakowska A,Thel MC.Retrospective analysis of somatic mutations and clonal hematopoiesis in astronauts.Commun Biol2022;5:828 PMCID:PMC9385668

[78]

Meisel M,Pacis A.Microbial signals drive pre-leukaemic myeloproliferation in a Tet2-deficient host.Nature2018;557:580-4 PMCID:PMC6238954

[79]

Cai Z,Ramdas B.Inhibition of Inflammatory signaling in Tet2 mutant preleukemic cells mitigates stress-induced abnormalities and clonal hematopoiesis.Cell Stem Cell2018;23:833-49.e5 PMCID:PMC6317370

[80]

Abegunde SO,Wells RA.An inflammatory environment containing TNFα favors Tet2-mutant clonal hematopoiesis.Exp Hematol2018;59:60-5

[81]

Zeng H,Guo L.Antibiotic treatment ameliorates Ten-eleven translocation 2 (TET2) loss-of-function associated hematological malignancies.Cancer Lett2019;467:1-8 PMCID:PMC6945766

[82]

Caiado F,Gonullu NG,Boettcher S.Aging drives Tet2+/- clonal hematopoiesis via IL-1 signaling.Blood2023;141:886-903 PMCID:PMC10651783

[83]

Liao M,Yang Y.Aging-elevated inflammation promotes DNMT3A R878H-driven clonal hematopoiesis.Acta Pharm Sin B2022;12:678-91 PMCID:PMC8897035

[84]

Hormaechea-Agulla D,Le DT.Chronic infection drives Dnmt3a-loss-of-function clonal hematopoiesis via IFNγ signaling.Cell Stem Cell2021;28:1428-42.e6 PMCID:PMC8349829

[85]

Heyde A,McAlpine CS.Increased stem cell proliferation in atherosclerosis accelerates clonal hematopoiesis.Cell2021;184:1348-61.e22 PMCID:PMC8109274

[86]

Avagyan S,Mannherz WP.Resistance to inflammation underlies enhanced fitness in clonal hematopoiesis.Science2021;374:768-72

[87]

Ko M,An J.Ten-eleven-translocation 2 (TET2) negatively regulates homeostasis and differentiation of hematopoietic stem cells in mice.Proc Natl Acad Sci USA2011;108:14566-71 PMCID:PMC3167529

[88]

Li Z,Cai CL.Deletion of Tet2 in mice leads to dysregulated hematopoietic stem cells and subsequent development of myeloid malignancies.Blood2011;118:4509-18 PMCID:PMC3952630

[89]

Moran-Crusio K,Shih A.Tet2 loss leads to increased hematopoietic stem cell self-renewal and myeloid transformation.Cancer Cell2011;20:11-24 PMCID:PMC3194039

[90]

Zhang Q,Shen Q.Tet2 is required to resolve inflammation by recruiting Hdac2 to specifically repress IL-6.Nature2015;525:389-93 PMCID:PMC4697747

[91]

Sano S,Wang Y,Sano M.CRISPR-mediated gene editing to assess the roles of Tet2 and Dnmt3a in clonal hematopoiesis and cardiovascular disease.Circ Res2018;123:335-41 PMCID:PMC6054544

[92]

Bick AG,Nandakumar SK.Inherited causes of clonal haematopoiesis in 97,691 whole genomes.Nature2020;586:763-8 PMCID:PMC7944936

[93]

Svensson EC,Campbell CD.TET2-driven clonal hematopoiesis and response to canakinumab: an exploratory analysis of the CANTOS randomized clinical trial.JAMA Cardiol2022;7:521-8 PMCID:PMC8988022

[94]

Lusis AJ.A vicious cycle in atherosclerosis.Cell2021;184:1139-41

[95]

Sánchez-Cabo F.Clonal haematopoiesis and atherosclerosis: a chicken or egg question?.Nat Rev Cardiol2021;18:463-4

[96]

Fuster JJ,Zorita V.TET2-loss-of-function-driven clonal hematopoiesis exacerbates experimental insulin resistance in aging and obesity.Cell Rep2020;33:108326 PMCID:PMC7856871

[97]

Jeong M,Celik H.Loss of Dnmt3a immortalizes hematopoietic stem cells in vivo.Cell Rep2018;23:1-10 PMCID:PMC5908249

[98]

Rauch PJ,Gopakumar J.Loss-of-function mutations in Dnmt3a and Tet2 lead to accelerated atherosclerosis and convergent macrophage phenotypes in mice.Blood2018;132:745

[99]

Zhang CR,Kukhar O.Txnip enhances fitness of Dnmt3a-mutant hematopoietic stem cells via p21.Blood Cancer Discov2022;3:220-39 PMCID:PMC9414740

[100]

Oh J,Wagers AJ.Stem cell aging: mechanisms, regulators and therapeutic opportunities.Nat Med2014;20:870-80 PMCID:PMC4160113

[101]

Geiger H,Florian MC.The ageing haematopoietic stem cell compartment.Nat Rev Immunol2013;13:376-89

[102]

Amorim JA,Rolo AP,Ross JM.Mitochondrial and metabolic dysfunction in ageing and age-related diseases.Nat Rev Endocrinol2022;18:243-58 PMCID:PMC9059418

[103]

Itokawa N,Koide S.Epigenetic traits inscribed in chromatin accessibility in aged hematopoietic stem cells.Nat Commun2022;13:2691 PMCID:PMC9110722

[104]

Li X,Zhang W,Qian P.Inflammation and aging: signaling pathways and intervention therapies.Signal Transduct Target Ther2023;8:239 PMCID:PMC10248351

[105]

Ho YH.Microenvironmental contributions to hematopoietic stem cell aging.Haematologica2020;105:38-46 PMCID:PMC6939521

[106]

Cobo I,Chandra Mangalhara K.DNA methyltransferase 3 alpha and TET methylcytosine dioxygenase 2 restrain mitochondrial DNA-mediated interferon signaling in macrophages.Immunity2022;55:1386-401.e10 PMCID:PMC9718507

[107]

Ouchi N,Lugus JJ.Adipokines in inflammation and metabolic disease.Nat Rev Immunol2011;11:85-97 PMCID:PMC3518031

[108]

Nakamura-Ishizu A,Suda T.Hematopoietic stem cell metabolism during development and aging.Dev Cell2020;54:239-55 PMCID:PMC7418032

[109]

Bowers E.Obesity-induced inflammation: the impact of the hematopoietic stem cell niche.JCI Insight2021;6:145295 PMCID:PMC7934850

[110]

Benova A.Obesity-induced changes in bone marrow homeostasis.Front Endocrinol2020;11:294 PMCID:PMC7235195

[111]

Kim MJ,Koh Y.Clonal hematopoiesis as a novel risk factor for type 2 diabetes mellitus in patients with hypercholesterolemia.Front Public Health2023;11:1181879 PMCID:PMC10345505

[112]

Tobias DK,Wessel J.Clonal hematopoiesis of indeterminate potential (CHIP) and incident type 2 diabetes risk.Diabetes Care2023;46:1978-85 PMCID:PMC10620536

[113]

Andersson-Assarsson JC,Kristensson FM.Evolution of age-related mutation-driven clonal haematopoiesis over 20 years is associated with metabolic dysfunction in obesity.EBioMedicine2023;92:104621 PMCID:PMC10209127

[114]

Bhattacharya R,Uddin MM.Association of diet quality with prevalence of clonal hematopoiesis and adverse cardiovascular events.JAMA Cardiol2021;6:1069-77 PMCID:PMC8190703

[115]

Haring B,Liu J.Healthy lifestyle and clonal hematopoiesis of indeterminate potential: results from the women’s health initiative.J Am Heart Assoc2021;10:e018789 PMCID:PMC8174283

[116]

Zioni N,Chapal-Ilani N.Inflammatory signals from fatty bone marrow support DNMT3A driven clonal hematopoiesis.Nat Commun2023;14:2070 PMCID:PMC10097668

[117]

Ambrosi TH,Graja A.Adipocyte accumulation in the bone marrow during obesity and aging impairs stem cell-based hematopoietic and bone regeneration.Cell Stem Cell2017;20:771-84.e6 PMCID:PMC5459794

[118]

Verovskaya EV,Passegué E.Losing sense of self and surroundings: hematopoietic stem cell aging and leukemic transformation.Trends Mol Med2019;25:494-515 PMCID:PMC7657013

[119]

Dawoud AAZ,Cross NCP.Clonal myelopoiesis in the UK Biobank cohort: ASXL1 mutations are strongly associated with smoking.Leukemia2020;34:2660-72

[120]

Chen J,Wang X.Enriched clonal hematopoiesis in seniors with dietary vitamin C inadequacy.Clin Nutr ESPEN2021;46:179-84

[121]

Nakao T,Taub MA.Mendelian randomization supports bidirectional causality between telomere length and clonal hematopoiesis of indeterminate potential.Sci Adv2022;8:eabl6579

[122]

Weinstock JS,Burugula BB.Aberrant activation of TCL1A promotes stem cell expansion in clonal haematopoiesis.Nature2023;616:755-63 PMCID:PMC10360040

AI Summary AI Mindmap
PDF

158

Accesses

0

Citation

Detail

Sections
Recommended

AI思维导图

/