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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Front+Microbiol
2015 ; 6
(ä): 571
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English Wikipedia
Apolipoprotein L1 (APOL1) Variants (Vs) a possible link between Heroin-associated
Nephropathy (HAN) and HIV-associated Nephropathy (HIVAN)
#MMPMID26106375
Lan X
; Rao TK
; Chander PN
; Skorecki K
; Singhal PC
Front Microbiol
2015[]; 6
(ä): 571
PMID26106375
show ga
In 1970s, Heroin-associated Nephropathy (HAN), one form of focal and segmental
glomerulosclerosis (FSGS), was a predominant cause of End-stage Kidney Disease
(ESKD) in African-Americans (AAs). In 1980s, with the surge of Acquired Immune
Deficiency Syndrome (AIDS) in AAs, HAN more or less disappeared, and the
incidence of Human Immunodeficiency Virus associated Nephropathy (HIVAN) markedly
increased. Recent studies in AAs have identified APOL1 variants (Vs) as a major
risk factor for the development and progression of non-diabetic kidney diseases
including idiopathic FSGS and hypertension-attributed nephrosclerosis. These
observations have also offered partial insights into the mechanisms of
development, and higher rate of occurrence of both HAN and HIVAN in AAs. AAs with
APOL1Vs develop idiopathic FSGS at four-fold higher rate compared to European
Americans (EAs). Similarly, HIV infected AAs with APOL1Vs (if not on antiviral
therapy), risk a 50% (10-fold greater) chance of developing HIVAN. It has been
suggested that APOL1Vs expression may render podocytes more vulnerable to various
types of injury: bacterial, viral, and others. However, in addition to genetic
variants, additional factors such as persistence of a second hit may determine
the nature and severity of glomerular disease. In patients with HAN, heroin or
contaminants may have been the offending second insult(s) which caused renal
disease in susceptible AA patients. In the 80's, since heroin-induced second hit
was neither consistent nor sustained (depending on drug availability in the
street), the disease was masked or replaced HIV infected patients (especially in
untreated subjects), by an overwhelming second hit by the virus which was both
intense as well as persistent. It appears that APOL1Vs may be one of the links
between the disappearance of HAN and emergence of HIVAN in AA patients.