Targeting the Uneven Burden of Kidney Disease on Black Americans


“I had everything,” Malcolm said. So was Martin.

When tested, the brothers learned that they had the variants and that the variants, not lupus, most likely damaged their kidneys. They didn’t quite know how to react.

“I’m still trying to grapple with it,” Malcolm said.

But Dr. Maybe he wasn’t surprised. Researchers think the variants cause kidney disease only when there is a secondary factor. A leading candidate is interferon, the body’s own antiviral response, which is produced in abundance in people with lupus.

People with untreated HIV also have high interferon levels. collapse of your kidneys if there are variants. Other viral infections, including some that may go unnoticed, can cause fluctuations of interferon that can trigger APOL1 variants. Interferon is also used as a medicine to treat certain diseases, including cancer, and has been tested as a treatment for Covid patients.

For now, there is little Malcolm and Martin can do to control their lupus other than take medication.

Martin says he understands all this, but is glad to learn he has variants. He now knows what to expect.

“I’m a person who likes to plan,” he said. “It makes the difference.”

Dr. While Olabisi waited to begin its study, Vertex, a pharmaceutical company, made progress in its own research. But there was no agreement on how APOL1 variants cause kidney disease, so it wasn’t clear what a drug should block.

Vertex’s chief scientific officer, Dr. “If you don’t understand the mechanism, that means you can’t measure the effects in the lab,” said David Altshuler. “And if you can’t measure the effects in the lab, that means you can’t fix them.”

It was known how the APOL1 protein protects against sleeping sickness – by punching holes in the disease-causing trypanosomes, inflating them with fluid and bursting them.



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