Kidney failure is a real problem within America, andother parts of the world as well. It is a problem that does not have a lot ofresearch and there is not much known about it as it has to deal with the presenceof a gene called APOL1. APOL1 stands for apolipoprotein 1, which is a minorapoprotein component of high density lipoprotein. This protein is synthesizedin the liver and found in arterial tissue. APOL1 synthesized with a haptoglobinrelated protein to circulate blood, and has a main role in inflammatoryresponses.
The APOL1 gene is present in people of African descent mostly. Trypanosomalillness is caused by infection of the Trypanosomal brucei. When trypanosomestake in APOL1 through endocytosis, pores are formed on the membranes of lysosomesof the trypanosomes, which work as channels as chloride ions influx, causingswelling of the lysosomes and then eventually causes lysis of the trypanosomes.The presence of APOL1 creates immunity to trypanosomal illness.
4 APOL1 alsohas links to kidney disease. When the gene is present so is pore formation, cellular injury, and programmed cell death inrenal injury. The disease is mainly present in African ancestry as well, “TheUnited States Renal Data System Report demonstrates a consistent, yearlyincrease in the incidence of end-stage kidney disease(ESKD) among individuals of African ancestry that is 3.5- to 5-fold that ofindividuals of European ancestry” 1. The issue here is that people who havethe APOL1 gene, do not have problems with sleep apnea however they acquire thekidney disease.
The question is how do we solve the kidney disease problemwhile retaining the lack of sleep apnea. If the whole APOL1 gene was to bereplaced it would knock out the kidney disease however the sleep apnea wouldstart to become a problem. Possible solutions would have to target the symptomsof the kidney disease, or target the gene directly. It is hard to understand as there is not much researchbeing done on this, and there is no cure for this kidney disease epidemic.