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Apolipoprotein E2/E5 Variants in Lipoprotein Glomerulopathy Recurred in Transplanted Kidney

TOSHIO MIYATA^*, SATOSHI SUGIYAMA, MASAOMI NANGAKU^*, DAISUKE SUZUKI^*, KEN-ICHI URAGAMI^*, REIKO INAGI^*, HIDETO SAKAI^* and KIYOSHI KUROKAWA^*

^* Molecular and Cellular Nephrology, Institute of Medical Sciences and Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
Department of Nephrology, Chukyo Hospital, Nagoya, Japan.

Correspondence to Dr. Toshio Miyata, Molecular and Cellular Nephrology, Institute of Medical Sciences and Department of Internal Medicine, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan. Phone: 81 463 93 1936; Fax: 81 463 93 1938; E-mail: t-miyata{at}is.icc.u-tokai.ac.jp

Abstract. Lipid abnormalities are associated with various disorders ranging from generalized atherosclerosis to renal diseases, including lipoprotein glomerulopathy that is characterized by glomerular lipoprotein thrombi and causes type III hyperlipoproteinemia, proteinuria, and renal failure. This study examines lipoprotein glomerulopathy, which recurred in a transplanted kidney. Molecular biologic analysis of the patient's apolipoprotein (apo) E gene demonstrated E2/E5 type variants. Immunohistochemical analysis of the diseased kidney demonstrated various lipid peroxidation-specific protein adducts, suggesting a potential role of oxidative stress in this disorder. Recurrence in the transplanted kidney suggested a pathogenic role of extraglomerular humoral component(s) resulting from abnormal lipoprotein metabolism, presumably linked to apo E and other genetic or acquired factor(s). Furthermore, the finding that the patient showed pathologic abnormalities in the transplanted kidney with no clinical signs or symptoms of renal disease indicated that lipoprotein glomerular damage progresses early before any clinical manifestations.

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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673