APOL1 risk variants in kidney transplantation: a modulation of immune cell function
Andrew F. Malone
Division of Nephrology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Address correspondence to: Andrew F. Malone, Division of Nephrology, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8126, St. Louis, Missouri 63110, USA. Phone: 314.362.7603; Email: amalone@wustl.edu.
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Published November 15, 2021 - More info
J Clin Invest. 2021;131(22):e154676. https://doi.org/10.1172/JCI154676.
© 2021 American Society for Clinical Investigation
APOL1 G1 and G2 variants are established risk factors for nondiabetic kidney disease. The presence of two APOL1 risk variants in donor kidneys negatively impacts kidney allograft survival. Because of evolutionary pressure, the APOL1 risk variants have become common in people from Africa and in those with recent African ancestry. APOL1 risk variant proteins are expressed in kidney cells and can cause toxicity to these cells. In this issue of the JCI, Zhang, Sun, and colleagues show that recipient APOL1 risk variants negatively affect kidney allograft survival and T cell–mediated rejection rates, independent of donor APOL1 genotype or recipient ancestry. The authors provide evidence that APOL1 risk variants play an immunomodulatory role in T cells and NK cells in the setting of kidney transplantation. These findings have important clinical implications that require further investigation.
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