Using integrated flow cytometry and fluorescence microscopy (Extended Data Fig. 6a), we confirmed that plasma from individuals with CHIP and MDS and older individuals induced TIFAsome formation in the TIFA-TdT THP1 cells (Fig. 3d,e and Supplementary Table 5), suggesting that circulating levels of ADP-heptose can readily activate ALPK1. Here, ALPK1 is linked to myelodysplastic syndrome.