Division of Pediatric Nephrology, Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, MI.
Arkana Laboratories, Little Rock, AR.
Am J Kidney Dis. 2020 Feb;75(2):287-290. doi: 10.1053/j.ajkd.2019.07.010. Epub 2019 Oct 7.
Apolipoprotein L1 (APOL1) risk variants G1 and G2 are known to result in risk for kidney disease in patients of African ancestry. APOL1-associated nephropathy typically occurs in association with certain environmental factors or systemic diseases. As such, there has been increasing evidence of the role of interferon (IFN) pathways in the pathogenesis of APOL1-associated collapsing glomerulopathy in patients with human immunodeficiency virus (HIV) infection and systemic lupus erythematosus, 2 conditions that are associated with high IFN levels. Collapsing glomerulopathy has also been described in patients receiving exogenous IFN therapy administered for various medical conditions. We describe a patient with a genetic condition that results in an increased IFN state, stimulator of IFN genes (STING)-associated vasculopathy with onset in infancy (SAVI), who developed collapsing glomerulopathy during a flare of his disease. The patient was found to have APOL1 G1 and G2 risk variants. This case supports the role of IFN in inducing APOL1-associated collapsing glomerulopathy.
载脂蛋白 L1(APOL1)风险变异 G1 和 G2 已知会导致非洲裔患者的肾脏疾病风险。APOL1 相关的肾病通常与某些环境因素或系统性疾病有关。因此,越来越多的证据表明干扰素(IFN)途径在人类免疫缺陷病毒(HIV)感染和系统性红斑狼疮患者中与 APOL1 相关的局灶节段性肾小球硬化症的发病机制中起作用,这两种疾病与高水平的 IFN 有关。在接受各种医疗条件的外源性 IFN 治疗的患者中也描述了局灶节段性肾小球硬化症。我们描述了一名患有遗传疾病的患者,该疾病导致 IFN 状态增加,干扰素基因刺激物(STING)相关血管病在婴儿期发病(SAVI),在疾病发作期间发生局灶节段性肾小球硬化症。该患者被发现携带 APOL1 G1 和 G2 风险变异。该病例支持 IFN 在诱导 APOL1 相关局灶节段性肾小球硬化症中的作用。