Number 4
The fourth best papers are based on a landmark study by Genovese et al Martin Pollak's group published 2010 in Science. I've chosen 2 related studies that address the role of ApolL1 in predicting prognosis in patient's with HIV associated kidney disease.
The first study by Fine et al published in JASN is titled "APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease."
They examined 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy and used survival analysis to determine time to ESRD associated with APOL1 genotype. They report:
They conclude: " these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients."
The second study by Atta et al (from the same group of investigators) published in KI is titled "HIV-associated nephropathy patients with and without apolipoprotein L1 gene variants have similar clinical and pathological characteristics."
They conclude: "our study suggests that although the majority of African-American patients with HIVAN have two APOL1 risk alleles other as yet unknown factors in the host, including genetic risk variants and environmental or viral factors, may influence the development of this disorder in those with zero or one APOL1 risk allele."
The fourth best papers are based on a landmark study by Genovese et al Martin Pollak's group published 2010 in Science. I've chosen 2 related studies that address the role of ApolL1 in predicting prognosis in patient's with HIV associated kidney disease.
The first study by Fine et al published in JASN is titled "APOL1 risk variants predict histopathology and progression to ESRD in HIV-related kidney disease."
They examined 98 HIV-infected African Americans with non-HIVAN kidney disease on biopsy and used survival analysis to determine time to ESRD associated with APOL1 genotype. They report:
- Among the 29 patients with two APOL1 risk alleles, the majority (76%) had FSGS and 10% had hypertensive nephrosclerosis.
- Among the 54 patients with one APOL1 risk allele, 47% had immune-complex GN as the predominant lesion and only 23% had FSGS.
- Among the 25 patients with no APOL1 risk allele, 40% had immune-complex GN and 12% had FSGS. In 310 person-years of observation, 29 patients progressed to ESRD.
- In adjusted analyses, individuals with two APOL1 risk alleles had a nearly three-fold higher risk for ESRD compared with those with one or zero risk alleles (P=0.03)
They conclude: " these data demonstrate an association between APOL1 variants and renal outcomes in non-HIVAN kidney disease, suggesting a possible use for APOL1 genotyping to help guide the care of HIV-infected patients."
The second study by Atta et al (from the same group of investigators) published in KI is titled "HIV-associated nephropathy patients with and without apolipoprotein L1 gene variants have similar clinical and pathological characteristics."
- They examined 76 patients with HIVAN, 60 were successfully genotyped for APOL1 G1 and G2 polymorphisms. In this cohort, 37 had two risk alleles, 18 were heterozygous, and 5 had neither risk variant. They report:
- There were no differences in the pathological findings of HIVAN and the number of APOL1 risk alleles.
- Further, the progression to end-stage kidney disease or death did not differ by the number of risk alleles.
- Median renal survival was 9.3 months in patients with zero or one risk allele compared to 11.7 months in patients with two APOL1 risk alleles.
They conclude: "our study suggests that although the majority of African-American patients with HIVAN have two APOL1 risk alleles other as yet unknown factors in the host, including genetic risk variants and environmental or viral factors, may influence the development of this disorder in those with zero or one APOL1 risk allele."
