[HTML][HTML] Strong protective effect of the APOL1 p.N264K variant against G2-associated focal segmental glomerulosclerosis and kidney disease

Y Gupta, DJ Friedman, MT McNulty, A Khan… - Nature …, 2023 - nature.com
Y Gupta, DJ Friedman, MT McNulty, A Khan, B Lane, C Wang, J Ke, G Jin, B Wooden…
Nature communications, 2023nature.com
African Americans have a significantly higher risk of developing chronic kidney disease,
especially focal segmental glomerulosclerosis-, than European Americans. Two coding
variants (G1 and G2) in the APOL1 gene play a major role in this disparity. While 13% of
African Americans carry the high-risk recessive genotypes, only a fraction of these
individuals develops FSGS or kidney failure, indicating the involvement of additional
disease modifiers. Here, we show that the presence of the APOL1 p. N264K missense …
Abstract
African Americans have a significantly higher risk of developing chronic kidney disease, especially focal segmental glomerulosclerosis -, than European Americans. Two coding variants (G1 and G2) in the APOL1 gene play a major role in this disparity. While 13% of African Americans carry the high-risk recessive genotypes, only a fraction of these individuals develops FSGS or kidney failure, indicating the involvement of additional disease modifiers. Here, we show that the presence of the APOL1 p.N264K missense variant, when co-inherited with the G2 APOL1 risk allele, substantially reduces the penetrance of the G1G2 and G2G2 high-risk genotypes by rendering these genotypes low-risk. These results align with prior functional evidence showing that the p.N264K variant reduces the toxicity of the APOL1 high-risk alleles. These findings have important implications for our understanding of the mechanisms of APOL1-associated nephropathy, as well as for the clinical management of individuals with high-risk genotypes that include the G2 allele.
nature.com