Apolipoprotein L1 risk genotypes in Ghanaian patients with systemic lupus erythematosus: a prospective cohort study

Blazer, Ashira; Dey, Ida Dzifa; Nwaukoni, Janet; Reynolds, Margaret; Ankrah, Festus; Algasas, Huda; Ahmed, Tasneem; Divers, Jasmin

doi:10.1136/lupus-2020-000460

Cited by 24 publications

(13 citation statements)

References 48 publications

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“…Dans notre série, 90% des patients avec un LES étaient diagnostiqués au décours de l´atteinte rénale. En Afrique Subsaharienne, la prévalence de l´atteinte rénale au cours du LES varie entre 31 et 69% selon les définitions utilisées [ 7 - 10 , 13 ]. Le syndrome néphrotique, l´hypertension artérielle, l´insuffisance rénale et l´hématurie sont fréquemment décrits [ 8 , 9 , 14 ]; ce qui corroborent nos résultats.…”

Section: Discussionunclassified

“…En effet, les taux de mortalité rapportés au Sénégal varient entre 9-11% contre 55% dans notre série. Une étude récente au Ghana a relevé un pronostic plus sévère du LES chez les patients qui présentaient un génotype récessif des variants à haut risque de l´apolipoprotéine L1 (APOL1) avec un risque d´IRCT multiplié par 14 et un risque de décès à 12 mois multiplié par 13,6 [ 13 ]. Cette étude présente quelques limites.…”

Section: Discussionunclassified

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Profil clinique et survie des patients avec néphrite lupique en néphrologie au Cameroun: étude monocentrique

Ebana¹,

Mahamat²,

Lekpa³

et al. 2022

Pan Afr Med J

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Introduction le pronostic de la néphrite lupique en Afrique Subsaharienne est mal connu. Notre objectif était de décrire le profil clinique et la survie des patients avec une néphrite lupique suivis en néphrologie. Méthodes nous avons mené une étude de cohorte rétrospective mono centrique sur 5 ans. Les patients avec une néphrite lupique nouvellement diagnostiquée et un suivi de plus de 3 mois ont été inclus. La néphrite lupique était définie par la présence de signes d´atteinte glomérulaire, confirmée ou non à l´histologie. Nous nous sommes intéressés aux données cliniques, à l´évolution sous traitement et à la mortalité. Résultats au total, 20 patients ont été inclus dont 17 femmes (85%). La médiane [IIQ] d´âge était de 27[18-37] ans. Le lupus érythémateux systémique était diagnostiqué concomitamment à la néphrite lupique chez 90% (n=18) des patients. Douze (60%) patients avaient un syndrome néphrotique. Les classes prolifératives actives étaient les plus fréquentes (n=5, 72%). Quinze patients (75%) ont bénéficié d´une induction et la rémission était obtenue chez 6 (30%). A 12 et 24 mois, les survies rénales et globales étaient respectivement de 68,6% et 49%; de 57,8% et 31%. L´absence de rémission était associée au mauvais pronostic. Conclusion la néphropathie lupique est un mode de révélation fréquent du lupus dans notre contexte. Son pronostic est sombre et plus de la moitié des patients décèdent ou sont en insuffisance rénale terminale dans les 24 mois.

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Section: Discussionunclassified

Profil clinique et survie des patients avec néphrite lupique en néphrologie au Cameroun: étude monocentrique

Ebana¹,

Mahamat²,

Lekpa³

et al. 2022

Pan Afr Med J

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“…Mutated alleles of APOL1 protect carriers against trypanosomiasis, which is the apparent reason for these mutations being common in some parts of Africa, but, if homozygous, make kidneys highly vulnerable to damage. 42,43 This is particularly true for lupus nephritis, where immune complex disease leads to interferon production, which in turn induces APOL1 upregulation. 44 This is at least one important explanation for why African Ancestry SLE patients are much more likely to suffer renal insufficiency after developing lupus nephritis.…”

Section: Toward More Fully Understanding the Pathogenesis Of Slementioning

confidence: 99%

A glimpse into the future of systemic lupus erythematosus

Aringer

Alarcón‐Riquelme

Clowse

et al. 2022

Therapeutic Advances in Musculoskeletal

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This viewpoint article on a forecast of clinically meaningful changes in the management of systemic lupus erythematosus (SLE) in the next 10 years is based on a review of the current state of the art. The groundwork has been laid by a robust series of classification criteria and treatment recommendations that have all been published since 2019. Building on this strong foundation, SLE management predictably will take significant steps forward. Assessment for lupus arthritis will presumably include musculoskeletal sonography. Large-scale polyomics studies are likely to unravel more of the central immune mechanisms of the disease. Biomarkers predictive of therapeutic success may enter the field; the type I interferon signature, as a companion for use of anifrolumab, an antibody against the common type I interferon receptor, is one serious candidate. Besides anifrolumab for nonrenal SLE and the new calcineurin inhibitor voclosporin in lupus nephritis, both of which are already approved in the United States and likely to become available in the European Union in 2022, several other approaches are in advanced clinical trials. These include advanced B cell depletion, inhibition of costimulation via CD40 and CD40 ligand (CD40L), and Janus kinase 1 (Jak1) and Tyrosine kinase 2 (Tyk2) inhibition. At the same time, essentially all of our conventional therapeutic armamentarium will continue to be used. The ability of patients to have successful SLE pregnancies, which has become much better in the last decades, should further improve, with approaches including tumor necrosis factor blockade and self-monitoring of fetal heart rates. While we hope that the COVID-19 pandemic will soon be controlled, it has highlighted the risk of severe viral infections in SLE, with increased risk tied to certain therapies. Although there are some data that a cure might be achievable, this likely will remain a challenge beyond 10 years from now.

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“…193–197 Over the last decade, cumulative clinical and epidemiological studies have associated APOL1 with a broad spectrum of kidney diseases, most strikingly among many different viral infections, including HIV-associated nephropathy (OR, 29–89), idiopathic focal segmental glomerulosclerosis (OR, 17), hypertension-attributed kidney failure (OR, 7–11), lupus-associated collapsing glomerulopathy (OR, 5), lupus-associated kidney failure (OR, 2.5–14), and iatrogenic interferon use. 198–202…”

Section: High Risk Apol1 Genotype and Virusesmentioning

confidence: 99%

Emerging Viral Infections and the Potential Impact on Hypertension, Cardiovascular Disease, and Kidney Disease

Savedchuk

Raslan

Nystrom

et al. 2022

Circulation Research

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Viruses are ubiquitous in the environment and continue to have a profound impact on human health and disease. The COVID-19 pandemic has highlighted this with impressive morbidity and mortality affecting the world’s population. Importantly, the link between viruses and hypertension, cardiovascular disease, and kidney disease has resulted in a renewed focus and attention on this potential relationship. The virus responsible for COVID-19, SARS-CoV-2, has a direct link to one of the major enzymatic regulatory systems connected to blood pressure control and hypertension pathogenesis, the renin-angiotensin system. This is because the entry point for SARS-CoV-2 is the ACE2 (angiotensin-converting enzyme 2) protein. ACE2 is one of the main enzymes responsible for dampening the primary effector peptide Ang II (angiotensin II), metabolizing it to Ang-(1-7). A myriad of clinical questions has since emerged and are covered in this review. Several other viruses have been linked to hypertension, cardiovascular disease, and kidney health. Importantly, patients with high-risk apolipoprotein L1 ( APOL1 ) alleles are at risk for developing the kidney lesion of collapsing glomerulopathy after viral infection. This review will highlight several emerging viruses and their potential unique tropisms for the kidney and cardiovascular system. We focus on SARS-CoV-2 as this body of literature in regards to cardiovascular disease has advanced significantly since the COVID-19 pandemic.

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Apolipoprotein L1 risk genotypes in Ghanaian patients with systemic lupus erythematosus: a prospective cohort study

Cited by 24 publications

References 48 publications

Profil clinique et survie des patients avec néphrite lupique en néphrologie au Cameroun: étude monocentrique

Profil clinique et survie des patients avec néphrite lupique en néphrologie au Cameroun: étude monocentrique

A glimpse into the future of systemic lupus erythematosus

Emerging Viral Infections and the Potential Impact on Hypertension, Cardiovascular Disease, and Kidney Disease

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