In this regard one recent elegant study has indicated that microbial metabolite [ADP-D-glycero-β-D-manno-heptose (ADP-heptose)], drives CH via ALPK1, suggesting that the ADP-heptose-ALPK1 axis is a promising therapeutic target to prevent progression of CH to overt leukemia and immune-related conditions (115). The gene discussed is ALPK1; the disease is cyclic hematopoiesis.