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Apolipoprotein L1 (APOL1) is a secreted protein and a minor component of high-density lipoprotein (HDL) particles. It plays a role in lipid transport and innate immunity, particularly against Trypanosoma brucei parasites. Genetic variants (G1 and G2) provide protection against African trypanosomiasis but significantly increase the risk of developing non-diabetic chronic kidney disease, especially focal segmental glomerulosclerosis (FSGS) and hypertensive nephrosclerosis, particularly among individuals of African ancestry. The pathogenic mechanisms may involve toxic gain-of-function effects, altered ion fluxes due to disrupted channel function, or dysfunctional HDL formation.
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