METHODS AND KITS FOR DETERMINING PREDISPOSITION TO DEVELOP KIDNEY DISEASES

Abstract

Provided are methods and kits for determining predisposition of a subject to develop a kidney disease, by identifying in a sample of the subject at least one APOL1 polypeptide variant which is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions; or at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3, wherein the at least one nucleotide mutation or polypeptide variant being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease.

Description

RELATED APPLICATION

[0001] This application claims the benefit of priority under 35 USC 119(e) of U.S. Provisional Patent Application No. 61/351,960 filed Jun. 7, 2010, the contents of which are incorporated herein by reference in their entirety.

FIELD AND BACKGROUND OF THE INVENTION

[0002] The present invention, in some embodiments thereof, relates to methods and kits for determining predisposition to develop kidney diseases, and, more particularly, but not exclusively, to methods of designing life style change and treatment regimens for a subject predisposed to develop a kidney disease.

[0003] Chronic Kidney Disease (CKD) is a powerful independent risk factor for cardiovascular disease and death at all stages. Most patients with CKD will succumb to cardiovascular complications rather than reach end-stage kidney disease (ESKD). Recent reports estimate that as many as 600 million people worldwide have CKD, and hence are at greatly increased risk of cardiovascular disease including hypertension [Hypertext Transfer Protocol (dot) world wide web (dot) kidney (dot) org (dot) au/NewsEvents/WorldKidneyDay/tabid/655/Default (dot) aspx].

[0004] Based on information from those countries where renal replacement therapy is available and registries are maintained, there are close to one million people with ESKD receiving dialysis treatment or a kidney transplant. In the United States, an estimated 15.5 million have stage 3 and 4 CKD, and 584,000 have ESKD. African Americans have five times greater risk for kidney disease than European Americans. Correspondingly, African-Americans also have a higher risk of mortality from cardiovascular disease than Americans of European ancestry, including death, non-fatal myocardial infarction, and stroke. Finally, it is now appreciated that hypertension, once thought to be a leading cause of CKD leading to ESKD, is the consequence of primary renal glomerular disease in certain risk populations.

[0005] Mapping by admixture linkage disequilibrium (MALD) localized an interval on chromosome 22, in a region that includes the MYH9 gene, which was shown to contain African ancestry risk variants associated with certain forms of ESKD (Kao et al. 2008; Kopp et al. 2008). This led to the new designation of MYH9 associated nephropathies. Subsequent studies identified clusters of single nucleotide polymorphisms (SNPs) within MYH9 with the largest odds ratios (OR) reported to date for the association of common variants with common disease risk (Bostrom and Freedman 2010). These MYH9 association studies were extended to earlier stage and related kidney disease phenotypes, and to population groups with varying degrees of recent African ancestry admixture (Behar et al. 2010; Nelson et al. 2010). Thus, the MYH9 has been proposed as a major genetic risk locus for a spectrum of non-diabetic ESKD. However, despite intensive efforts including re-sequencing of the MYH9 gene no suggested functional mutation has been identified (Nelson et al. 2010).

[0006] U.S. Patent Application No. 20100297660 to Winkler Cheryl et al. ("SINGLE NUCLEOTIDE POLYMORPHISMS ASSOCIATED WITH RENAL DISEASE") discloses methods for determining the genetic predisposition of a human subject to developing renal disease, such as focal segmental glomerulosclerosis (FSGS) or end-stage kidney disease by detection of one or more haplotype blocks comprising at least two tag single nucleotide polymorphisms (SNPs) in a non-coding region of a MYH9 gene or detecting the presence of at least one tag SNP in a non-coding region of a MYH9 gene.

[0007] Additional background art includes Tzur S, et al. (Missense mutations in the APOL1 gene are highly associated with end stage kidney disease risk previously attributed to the MYH9 gene) Hum. Genet. 2010, 128:345-50; Rosset S, et al. (The population genetics of chronic kidney disease: insights from the MYH9-APOL1 locus) Nat. Rev. Nephrol. May 3, 2011. [Epub ahead of print]; Genovese G, et al. (Association of trypanolytic ApoL1 variants with kidney disease in African Americans) Science 2010; 329:841-5; Behar D M, et al. (African ancestry allelic variation at the MYH9 gene contributes to increased susceptibility to non-diabetic end-stage kidney disease in Hispanic Americans) Hum. Mol. Genet. 2010 19(9):1816-27; Shlush L I, et al. (Admixture mapping of end stage kidney disease genetic susceptibility using estimated mutual information ancestry informative markers) BMC Med Genomics. 2010 3:47; and U.S. Patent Application No. 20110030078.

SUMMARY OF THE INVENTION

[0008] According to an aspect of some embodiments of the present invention there is provided a method of determining predisposition of a subject to develop a kidney disease, comprising: identifying in a sample of the subject at least one APOL1 polypeptide variant which is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions, wherein presence of the APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease, thereby determining the predisposition of the subject to develop the kidney disease.

[0009] According to an aspect of some embodiments of the present invention there is provided a method of determining predisposition of a subject to develop a kidney disease, comprising: identifying in a sample of the subject at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3 or at least one APOL1 polypeptide variant, wherein the at least one nucleotide mutation or polypeptide variant being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 nucleotide mutation or the APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease, thereby determining the predisposition of the subject to develop the kidney disease.

[0010] According to an aspect of some embodiments of the present invention there is provided a method of designing a life style change to a subject with the risk of kidney disease, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and; (b) designing the life style change based on presence or absence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation, thereby designing life style change to a subject with the risk of kidney disease.

[0011] According to an aspect of some embodiments of the present invention there is provided a method of designing a life style change to a subject with the risk of kidney disease, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and; (b) designing the life style change based on presence or absence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation, thereby designing life style change to a subject with the risk of kidney disease.

[0012] According to an aspect of some embodiments of the present invention there is provided a method of designing a nephrotoxic anti-retroviral treatment regimen to a subject infected with HIV, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and; (b) designing the nephrotoxic anti-retroviral treatment regimen based on presence or absence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation, thereby designing a nephrotoxic anti-retroviral treatment regimen to the subject infected with HIV.

[0013] According to an aspect of some embodiments of the present invention there is provided a method of determining if a subject is suitable for donating a kidney for transplantation, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop a kidney disease, and; wherein increased predisposition of the subject to develop the kidney disease indicates that the subject is not suitable for donating the kidney for transplantation, thereby determining if the subject is suitable for donating a kidney for transplantation.

[0014] According to an aspect of some embodiments of the present invention there is provided a kit for determining predisposition to a kidney disease, comprising a reagent capable of specifically detecting at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3, wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1.

[0015] According to some embodiments of the invention, the APOL1 polypeptide variant comprises a mutation in the C-terminal helix of the APOL1 polypeptide.

[0016] According to some embodiments of the invention, the APOL1 polypeptide variant has a reduced binding ability to serum resistance-associated protein (SRA) expressed by Trypanosoma brucei rhodesiense as compared to the binding ability of the APOL1 wild type polypeptide under identical assay conditions.

[0017] According to some embodiments of the invention, the APOL1 polypeptide variant comprises the amino acid sequence set forth in SEQ ID NO:1 with a mutation selected from the group consisting of G342, M384, N388-del and Y389-del.

[0018] According to some embodiments of the invention, the LD between the APOL1 nucleotide mutation and the S342G mutation is characterized by a Lewontin correlation coefficient (D') higher than 0.5.

[0019] According to some embodiments of the invention, the significance of the LD is characterized by LOD≧2.

[0020] According to some embodiments of the invention, the APOL1 nucleotide mutation is selected from the group consisting of the guanine-containing allele of single nucleotide polymorphism (SNP) rs73885319 (SEQ ID NO:6), the guanine-containing allele of SNP rs60910145 (SEQ ID NO:7), the guanine-containing allele of SNP rs9622363 (SEQ ID NO:8), the adenine-containing allele of SNP rs60295735 (SEQ ID NO:9) and the cytosine-containing allele of SNP rs58384577 (SEQ ID NO:10).

[0021] According to some embodiments of the invention, the kidney disease comprises end stage kidney disease.

[0022] According to some embodiments of the invention, the kidney disease comprises HIV-associated nephropathy (HIVAN).

[0023] According to some embodiments of the invention, the subject is infected with HIV.

[0024] According to some embodiments of the invention, the APOL1 nucleotide mutation is selected from the group consisting of the guanine-containing allele of single nucleotide polymorphism (SNP) rs73885319 (SEQ ID NO:6), the guanine-containing allele of SNP rs60910145 (SEQ ID NO:7), the guanine-containing allele of SNP rs9622363 (SEQ ID NO:8), the adenine-containing allele of SNP rs60295735 (SEQ ID NO:9) and the cytosine-containing allele of SNP rs58384577 (SEQ ID NO:10).

[0025] According to some embodiments of the invention, the reagent comprises a polynucleotide capable of specifically detecting the APOL1 nucleotide mutation.

[0026] According to some embodiments of the invention, the reagent comprises an antibody capable of specifically binding an APOL1 variant comprises the nucleotide mutation and not to the APLO1 wild type polypeptide.

[0027] According to some embodiments of the invention, the method further comprising informing the subject on the state of the predisposition to develop the kidney disease.

[0028] According to some embodiments of the invention, the nucleotide mutation creates an APOL1 protein variant.

[0029] According to some embodiments of the invention, the nucleotide mutation is detected by a DNA detection method.

[0030] According to some embodiments of the invention, the APOL1 protein variant is detected by a protein detection method.

[0031] Unless otherwise defined, all technical and/or scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the invention pertains. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of embodiments of the invention, exemplary methods and/or materials are described below. In case of conflict, the patent specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and are not intended to be necessarily limiting.

BRIEF DESCRIPTION OF THE DRAWINGS

[0032] The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0033] Some embodiments of the invention are herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of embodiments of the invention. In this regard, the description taken with the drawings makes apparent to those skilled in the art how embodiments of the invention may be practiced.

[0034] In the drawings:

[0035] FIG. 1 is a schematic view of the chromosomal region encompassing the SNPs according to some embodiments of the present study.

[0036] FIG. 2 is a linkage disequilibrium (LD) plot of the non-diabetic ESKD associated SNPs in the APOL1 and MYH9 region with their physical locations on chromosome 22. LD was calculated based on the African American control samples (n=140) and the LD plot was generated using the program HaploView (Barrett et al. 2005). The color scheme represents the pairwise linkage disequilibrium value (D'/LOD) for the 4 new SNPs outside MYH9 (2 of which are missense mutations in APOL1) and for the previously published 10 MYH9 SNPs described in Behar et al. 2010. Bright red squares presents SNPs with linkage LOD≧2 and D'=1. D' values lower than "1" are expressed in percentages;

[0037] FIGS. 3A-C are contour map depicting spatial allele frequency distributions in Africa of the ESKD risk variants. FIG. 3A--MYH9 S-1 (SNP rs5750250); FIG. 3B--MYH9 F-1 SNP (rs11912763); FIG. 3c--APOL1 S342G missense mutation (rs73885319). Maps were generated based on genotyping of 12 African populations (n=676) (Table 3, in the Examples section which follows), using Surfer V.9 (Golden Software). Populations locations are marked (red circles for Ethiopia). Risk allele frequencies in Ethiopia and in South-Ghana are indicated;

[0038] FIGS. 4A-C are predicted peptide structures of the C-terminus domain of the APOL1 gene product (amino acid positions 339-398 in SEQ ID NO:1) that contains the missense mutations S342G and I384M. All predictions were generated using the program I-TASSER (Zhang 2008, 2009), structures were edited with the program CHIMERA (Pettersen et al. 2004). All suggested predicted structures exhibit Tm values >0.5. FIG. 4A--Predicted structure and location of amino acid changes. C-terminus domain is predicted to have a bent alpha-helix structure. The mutation I384M is located on the external surface of the predicted alpha-helix, while the S342G is buried inside. FIG. 4B--Hydrophobicity of the predicted peptide surface (RED-hydrophobic amino-acids, BLUE-polar amino-acids). Hydrophobic core is predicted to stabilize the bent C-terminus helical structure. FIG. 4c--Identified binding site in the predicted structure of the APOL1 C-terminus domain (Zhang 2008, 2009), based on similarity to an analogous known binding site (Billas et al. 2003). S342G is involved in the predicted binding site domain, and is predicted to modify its binding ability.

[0039] FIGS. 5A-D are schematic pie charts depicting allele frequencies for the APOL1 SNP rs73885319 (S342G) in African Americans and Hispanic Americans ESKD cases versus controls. "G" refers to the risk allele and "A" refers to the "protective" allele; FIG. 5A--Controls African Americans; FIG. 5B (Cases African Americas); FIG. 5C (Controls, Hispanic Americans); FIG. 5D (Cases, Hispanic Americans). Note the high prevalence of the risk allele (G) among African American controls as compared to Hispanic Americans controls, and the significant increase in frequency of the risk allele among both African Americans and Hispanic Americans controls.

[0040] FIG. 6 is a gel image depicting results of restriction fragments length polymorphism (RFLP) analysis for APOL1 missense mutations SNP rs73885319 (S342G) and SNP rs60910145 (I384M). Shown are the restriction fragments resulted from digestion of DNA with the HindIII and NSPI restriction enzymes. SNP APOL1 rs73885319 A/G: The allele containing G eliminates a recognition site of endonuclease HindIII. APOL1 SNP rs60910145 T/G: The allele containing T generates a new recognition site of endonuclease NspI. The sign `+` indicates an additional cutting site in the DNA fragment due to the presence of the mutation. The sign `-` indicates no additional cutting site in the DNA fragment.

DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION

[0041] The present invention, in some embodiments thereof, relates to methods and kits for determining predisposition to develop a kidney disease, and, more particularly, but not exclusively, to methods of designing a life-style change and/or a treatment regimen in predisposed subjects.

[0042] Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not necessarily limited in its application to the details set forth in the following description or exemplified by the Examples. The invention is capable of other embodiments or of being practiced or carried out in various ways.

[0043] The present inventors have uncovered that SNPs in the APOL1 gene are highly associated with renal disease and therefore identification of the APOL1 risk alleles can be used to determine predisposition to renal diseases.

[0044] Thus, as described in the Examples section which follows, the present inventors have uncovered that two Western African specific missense mutations (S342G and I384M) in the APOL1 gene/polypeptide are more strongly associated with ESKD than previously reported MYH9 variants (Example 1, Tables 1 and 3, FIGS. 1, 2 and 5A-D). In addition, the present inventors have uncovered that the distribution of these risk variants in African populations is consistent with the pattern of African ancestry ESKD risk previously attributed to MYH9 (Example 2, Table 3, FIGS. 3A-C). These results demonstrate that the functional polymorphisms in the APOL1 protein account for the increased susceptibility of the African American population to develop renal disease such as ESKD, and suggest the use of these markers as diagnostic and prognostic markers for diagnosing renal diseases and for designing life style change and treatment regimens to subjects at risk of renal disease based on the presence or absence of the predisposition to develop the renal disease.

[0045] Thus, according to an aspect of some embodiments of the invention there is provided a method of determining predisposition of a subject to develop a kidney disease. The method comprising identifying in a sample of the subject at least one APOL1 polypeptide variant which is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions, wherein presence of the APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease, thereby determining the predisposition of the subject to develop the kidney disease.

[0046] As used herein the term "predisposition" refers to the tendency of a subject to develop a certain condition (e.g., a kidney disease).

[0047] According to some embodiments of the invention, the predisposition which is determined by the method of some embodiments of the invention is a genetic predisposition, i.e., predisposition to develop a condition due to a certain genetic background as compared to a subject devoid of such genetic background.

[0048] It should be noted that a subject who is predisposed to develop a disease (e.g., kidney disease) is more likely to develop the disease than a non-predisposed subject.

[0049] The predisposition to develop the kidney disease can be quantified by generating and using genotype relative risk (GRR) values. The GRR is the increased chance of an individual with a particular genotype to develop the disease. Thus, the GRR of the risk genotype G, with respect to the protective genotype G₀, is the ratio between the risk of an individual carrying genotype G to develop the disease, and the risk of an individual carrying genotype G₀ to develop the disease. The GRR used herein is represented in terms of an appropriate odds ratio (OR) of G versus G₀ in cases and controls. Moreover, computation of GRR of genotypes or haplotypes is based on a multiplicative model in which the GRR of an homozygote individual is the square of the GRR of an heterozygote individual. For further details see Risch and Merikangas, 1996 [The future of genetic studies of complex human diseases. Science 273: 1516-1517], which is incorporated herein by reference in its entirety.

[0050] Once calculated, the GRR can reflect the increased predisposition risk on an individual with a specific APOL1 genotype to develop the kidney disease.

[0051] As used herein the phrase "APOL1 polypeptide variant" refers to an APOL1 amino acid sequence which comprises at least one amino acid change with respect to the wild type APOL1 polypeptide set forth by SEQ ID NO:1. The amino acid change can be an amino acid(s) substitution, deletion or insertion. The amino acid substitution can be a conservative substitution, i.e., with a similar amino acid (e.g., a positively charged amino acid is replaced by another positively charged amino acid; a hydrophobic amino acid is replaced by another hydrophobic amino acid; a negatively-charged amino acid is replaced by another negatively charged amino acid), or it can be a non-conservative substitution, i.e., with an amino acid having different characteristics (e.g., a positively charged amino acid is replaced by a negatively charged amino acid; a hydrophobic amino acid is replaced by a positively-charged amino acid; a negatively-charged amino acid is replaced by a hydrophobic amino acid, etc.).

[0052] It should be noted that the amino acid change can include one or more amino acids of the APOL1 polypeptide set forth by SEQ ID NO:1.

[0053] It should be noted that the "wild type APOL1 polypeptide" comprises "S" (Serine) at amino acid position 342 in SEQ ID NO:1, "I" (Isoleucine) at amino acid position 384 in SEQ ID NO:1, "N" (Asparagine) at amino acid position 388 in SEQ ID NO:1 and "Y" (Tyrosine) at amino acid position 389 in SEQ ID NO:1.

[0054] According to some embodiments of the invention, the APOL1 variant comprises only one amino acid change with respect to the wild type APOL1 polypeptide set forth by SEQ ID NO:1.

[0055] According to some embodiments of the invention, the APOL1 variant comprises two amino acid changes with respect to the wild type APOL1 polypeptide set forth by SEQ ID NO:1.

[0056] According to some embodiments of the invention, the APOL1 variant comprises at least one amino acid change and no more than about 60 amino acid changes with respect to the wild type APOL1 polypeptide set forth by SEQ ID NO:1.

[0057] According to some embodiments of the invention, the APOL1 variant comprises about 2-20 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20) amino acid changes with respect to the wild type APOL1 polypeptide set forth by SEQ ID NO:1.

[0058] According to some embodiments of the invention, the APOL1 polypeptide variant comprises a mutation (missense, nonsense, deletion or insertion) in the C-terminal helix of the APOL1 polypeptide. According to some embodiments of the invention, the amino acid change(s) in APOL1 variant occurs in the SRA-interacting domain in the C-terminal end of the APOL1 polypeptide, between amino acids 339-398 of SEQ ID NO:1 (FIG. 1 of Lecordier et al., 2009, PLoS Pathog. December 2009; 5(12):e1000685).

[0059] According to some embodiments of the invention, the amino acid change(s) in APOL1 variant does not occur within the pore forming domain (amino acids 60-238 of SEQ ID NO:1) and/or within the membrane-addressing domain (amino acids 238-304 of SEQ ID NO:1).

[0060] As described, the APOL1 polypeptide variant which is identified by the method of some embodiments of the invention is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions.

[0061] According to some embodiments of the invention, the Trypanosoma brucei rhodesiense is resistant to lysis by the apolipoprotein present in normal human serum.

[0062] According to some embodiments of the invention, the Trypanosoma brucei rhodesiense expresses serum resistance-associated protein (SRA), also referred to as SRA-positive.

[0063] It should be noted that wild type APOL1 fails to lyse the SRA+ (positive) Trypanosoma brucei rhodesiense (See for example, FIG. 3c in Genovese G., et al. "Association of Trypanolytic APOL1 variants with kidney disease in African-Americans", Science 2010, 329: 841-845, which is fully incorporated herein by reference).

[0064] As used herein the phrase "higher trypanolytic activity" refers to at least about 10%, at least about 15%, 20%, 25%, 30%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 99% greater trypanolytic activity of the APOL1 polypeptide variant as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1.

[0065] According to some embodiments of the invention, the APOL1 polypeptide variant which exhibits a higher trypanolytic activity as compared to the APOL1 wild type polypeptide set forth by SEQ ID NO:1 is selected from the group G342, M384, N388-del and Y389-del (positions refer to the APOL1 polypeptide sequence set forth in SEQ ID NO:1).

[0066] According to some embodiments of the invention, the APOL1 polypeptide variant is APOL1 N388-del/Y389-del (numbers relate to the APOL1 polypeptide sequence set forth in SEQ ID NO:1).

[0067] The sample used according to the method of this aspect of the invention can be any biological sample (obtained from an individual, e.g., human) which comprises the APOL1 polypeptide, or a sample of a recombinant or synthetic APOL1 polypeptide. Examples of biological samples include, but are not limited to whole blood or fractions thereof, such as serum, lipoproteins [High-density lipoprotein (HDL)], body fluids and exertions, tissue samples, and the like. The sample can be at least partially isolated from the subject, and further purified, or can be a crude sample.

[0068] According to some embodiments of the invention the sample is a serum sample.

[0069] According to some embodiments of the invention the sample is plasma HDL.

[0070] The trypanolytic activity can be measured as the percentage of survival of the trypanosome in the presence of a sample containing the APOL1 polypeptide. Thus, for example, while in the presence of the wild type APOL1 polypeptide set forth in SEQ ID NO:1 the percentage of survival can be about 100%, in the presence of an APOL1 variant the percentage of survival of the trypanosome can be reduced to 80%, 60%, 40%, 20% and 0% survival, which is referred to as 20%, 40%, 60%, 80% and 100% trypanolytic activity of the APOL1 polypeptide, respectively.

[0071] Assays which can be used to measure the trypanolytic activity of a protein on Trypanosoma brucei rhodesiense are known in the art and described, for example in Lecordier L, et al. "C-terminal mutants of apolipoprotein L-I efficiently kill both Trypanosoma brucei brucei and Trypanosoma brucei rhodesiense." PLoS Pathog. December 2009; 5(12):e1000685. Epub Dec. 4, 2009; U.S. Patent Application No. 20110030078; Genovese G., et al. "Association of Trypanolytic APOL1 variants with kidney disease in African-Americans", Science 2010, 329: 841-845; and in Tomlinson, et al., "High-density-lipoprotein-independent Killing of Trypanosoma brucei brucei by Human Serum," Mol. Biochem. Parasitol. 70:131-138 (1995), each of which is hereby incorporated by reference in its entirety.

[0072] Following is a non-limiting description of an in vitro assays which can be used to determine the trypanolytic activity of the APOL1 variant. Samples containing the APOL1 polypeptide can be for example, serum samples, plasma HDL or recombinant APOL1 polypeptides. Serum samples can be obtained by simple blood drawing and separation of serum from the blood. Plasma HDLs can be prepared by density gradient centrifugation and gel filtration. Recombinant APOL1 polypeptides [wild type APOL1 (SEQ ID NO:1) or APOL1 polypeptide variants (e.g., the G342, M384, N388-del and/or Y389-del APOL1 polypeptide variant)] can be expressed from a nucleic acid construct comprising the coding sequence of APOL1 which is expressed in prokaryotic (e.g., Escherichia coli) or eukaryotic (e.g., 293T) cells essentially as described in Lecordier L, et al. 2009 (Supra).

[0073] The trypanolytic activity is determined in Trypanosoma brucei rhodesiense. There are two major types of Trypanosoma brucei rhodesiense clones: the normal human serum-resistant (SRA+) and the normal human serum-sensitive (SRA-) T. b. rhodesiense ETat 1.2 clones can be used. ETat 1.2R is resistant to normal human serum, and ETat 1.2S is sensitive to normal human serum. It should be noted that while the SRA- T. b. rhodesiense (sensitive) clone is used as a positive control for the trypanolytic activity by all forms of APOL1 polypeptides (wild type and variant APOL1 polypeptides), the SRA+ T. b. rhodesiense (resistance) is used to differentiate between the APOL1 variants which are capable of lysing the Trypanosoma brucei rhodesiense and the wild type APOL1 polypeptide set forth in SEQ ID NO:1 which is incapable of lysing the Trypanosoma brucei rhodesiense as can be determined by a survival assay as described below. The trypanosomes can be diluted into pre-warmed DMEM containing 10% fetal bovine serum (FBS). In 96-well plates, serum samples are diluted into DMEM+10% fetal calf serum (FCS) and trypanosomes are added to a final volume of 0.2 ml, containing about 2.5×10⁵/ml parasites. Killing is allowed to proceed for about 17 hours at 37° C. in a CO₂ equilibrated incubator and living trypanosomes are counted using a heamocytometer. HDL killing assays are performed for 150 minutes at 37° C. in DMEM, 0.2% BSA using aliquots of sized fractionated lipoproteins incubated with parasites (trypanosoma) diluted at a final concentration of about 5×10⁵ cells/ml. Parasite lysis can be determined using a calcein-AM fluorescence-based assay (Tomlinson et al., "High-density-lipoprotein-independent Killing of Trypanosoma brucei by Human Serum," Mol Biochem Parasitol 70: 131-8 (1995), which is hereby incorporated by reference in its entirety). Recombinant APOL1 polypeptides (e.g., about 0.1-20 μg/ml, e.g., about 0.6-10 μg/ml, e.g., about 0.6-5 μg/ml) can be incubated with the trypanosoma overnight and the survival of trypanosoma can be determined and expressed as percentage (%) survival as compared to control (e.g., FCS)

[0074] According to some embodiments of the invention, the APOL1 polypeptide variant has a reduced binding ability to serum resistance-associated protein (SRA) expressed by Trypanosoma brucei rhodesiense as compared to the binding ability of the APOL1 wild type polypeptide under identical assay conditions.

[0075] Assays of measuring the binding ability of the APOL1 polypeptide to Trypanosoma brucei rhodesiense SRA are known in the art and are described for example, in Genovese G., et al. "Association of Trypanolytic APOL1 variants with kidney disease in African-Americans", Science 2010, 329: 841-845, which is hereby incorporated herein by its entirety.

[0076] Determination of predisposition of a subject to develop a kidney disease can be also performed by single nucleotide polymorphism detection methods.

[0077] According to an aspect of some embodiments of the invention there is provided a method of determining predisposition of a subject to develop a kidney disease, comprising: identifying in a sample of the subject at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3 (chr22:36,622,000-36,677,000 in NCBI37.1/hg19 assembly) or at least one APOL1 polypeptide variant, wherein the at least one nucleotide mutation or polypeptide variant being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of the APOL1 nucleotide mutation or the APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease, thereby determining the predisposition of the subject to develop the kidney disease.

[0078] The sample according to some embodiments of the invention is a DNA or protein sample.

[0079] The DNA sample can be obtained from any source of cells of the individual, including, but not limited to, peripheral blood cells (obtained using a syringe), skin cells (obtained from a skin biopsy), saliva or mouth epithelial cells (obtained from a mouth wash), and body secretions such as urine and tears, and from biopsies, etc. Alternatively, nucleic acid tests can be performed on dry samples (e.g. hair or skin). The sample may contain genomic DNA, cDNA or RNA. Methods of preparing genomic DNA or cDNA and RNA are well known in the art.

[0080] According to some embodiments of the invention, the DNA sample is obtained from a peripheral blood sample. Methods of extracting DNA from blood samples are well known in the art.

[0081] Once obtained, the DNA sample is preferably characterized for the presence or absence of at least one or more of the APOL1 nucleotide mutations in a homozygous or a heterozygous form in the sample of the subject.

[0082] The term "absence" as used herein in regard to the nucleotide or protein mutation describes the negative result of a specific genotype determination test. For example, if the genotype determination test is suitable for the identification of guanine nucleotide--containing allele of SNP rs73885319 (encoding APOL1 G342), and the individual on which the test is performed is homozygote for the adenosine nucleotide--containing allele of SNP rs73885319 (encoding APOL1 S342), then the result of the test will be "absence of nucleotide or protein mutation".

[0083] The terms "homozygous" or "heterozygous" refer to two identical or two different alleles, respectively, of a certain mutation or polymorphism.

[0084] The phrases "APOL1 nucleotide mutation" or "APOL1 single nucleotide polymorphism (SNP)", which are interchangeably used herein, refer to a substitution, deletion, insertion or inversion of a nucleotide sequence in the APOL1 genomic sequence with respect to the wild type genomic sequence set forth in SEQ ID NO:3.

[0085] It should be noted that the APOL1 mutation can be a substitution, deletion, insertion or inversion of a nucleotide sequence in the APOL1 coding sequence with respect to the wild type APOL1 mRNA sequence set forth in SEQ ID NO:2 (GenBank Accession No. NM_--001136540.1); or it can be a missense, nonsense, deletion or insertion resulting in a mutant APOL1 polypeptide with respect to the wild type polypeptide sequence set forth in SEQ ID NO:1 (GenBank Accession No. NP_--003652.2).

[0086] It should be noted that "wild type APOL1 mRNA sequence" comprises "A" (adenosine nucleotide) at nucleotide position 1231 in SEQ ID NO:2, "T" (thymidine nucleotide) at position 1359 in SEQ ID NO:2, "ATT" at nucleotide positions 1369-1371 in SEQ ID NO:2, "ATA" at nucleotide positions 1372-1374 in SEQ ID NO:2, and "T" (thymidine nucleotide) at nucleotide position 2538 in SEQ ID NO:2.

[0087] It should be noted that the "wild type APOL1 genomic sequence" comprises "A" (adenosine nucleotide) at nucleotide position 34556 in SEQ ID NO:3, "A" (adenosine nucleotide) at nucleotide position 39907 in SEQ ID NO:3, "T" (thymidine nucleotide) at nucleotide position 40035 in SEQ ID NO:3, "AAT" at nucleotide positions 40045-40047 in SEQ ID NO:3, "TAT" at nucleotide positions 40048-40050 in SEQ ID NO:3, "T" (thymidine nucleotide) at nucleotide position 41214 in SEQ ID NO:3, and "G" (guanine nucleotide) at nucleotide position 45155 in SEQ ID NO:3.

[0088] The APOL1 mutation can be a missense mutation (i.e., a mutation which changes an amino acid residue in the protein with another amino acid residue), a nonsense mutation (i.e., a mutation which introduces a stop codon in a protein), a frameshift mutation (i.e., a mutation, usually, deletion or insertion of nucleic acids which changes the reading frame of the protein, and may result in an early termination or in a longer amino acid sequence), a readthrough mutation (i.e., a mutation which results in an elongated protein due to a change in a coding frame or a modified stop codon), a promoter mutation (i.e., a mutation in a promoter sequence, usually 5' to the transcription start site of a gene, which result in up-regulation or down-regulation of a specific gene product), a regulatory mutation (i.e., a mutation in a region upstream or downstream, or within a gene, which affects the expression of the gene product), a deletion (i.e., a mutation which deletes coding or non-coding nucleic acids in a gene sequence), an insertion (i.e., a mutation which inserts coding or non-coding nucleic acids into a gene sequence), an inversion (i.e., a mutation which results in an inverted coding or non-coding sequence), and a duplication (i.e., a mutation which results in a duplicated coding or non-coding sequence).

[0089] According to some embodiments of the invention, the at least one mutation comprises no more than about 100, no more than about 90, no more than about 80, no more than about 70, no more than about 60, no more than about 50, no more than about 40, no more than about 30, no more than about 20, no more than about 15, no more than about 10, e.g., no more than 9, 8, 7, 6, 5, 4, 3, 2 nucleotide mutations in the APOL1 genomic sequence with respect to the wild type genomic sequence set forth in SEQ ID NO:3.

[0090] According to some embodiments of the invention, the at least one mutation comprises no more than about 100, no more than about 90, no more than about 80, no more than about 70, no more than about 60, no more than about 50, no more than about 40, no more than about 30, no more than about 20, no more than about 15, no more than about 10, e.g., no more than 9, 8, 7, 6, 5, 4, 3, 2 nucleotide mutations in the APOL1 coding sequence with respect to the wild type coding sequence set forth in SEQ ID NO:2.

[0091] According to some embodiments of the invention, the at least one mutation comprises no more than about 100, no more than about 90, no more than about 80, no more than about 70, no more than about 60, no more than about 50, no more than about 40, no more than about 30, no more than about 20, no more than about 15, no more than about 10, e.g., no more than 9, 8, 7, 6, 5, 4, 3, 2 amino acid mutations in the APOL1 genomic sequence with respect to the wild type polypeptide sequence set forth in SEQ ID NO:1.

[0092] As described, the nucleotide mutation is in linkage disequilibrium with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, which is encoded by the A→G (adenosine to guanine) substitution at position 1231 of the APOL1 mRNA (coding sequence) set forth by SEQ ID NO:2.

[0093] The phrase "linkage disequilibrium" (LD) is used to describe the statistical correlation between two neighboring polymorphic genotypes. Typically, LD refers to the correlation between the alleles of a random gamete at the two loci, assuming Hardy-Weinberg equilibrium (statistical independence) between gametes. LD is quantified with either Lewontin's parameter of association (D') or with Pearson correlation coefficient (r) [Devlin B, Risch N. (1995). A comparison of linkage disequilibrium measures for fine-scale mapping. Genomics. 29: 311-322.]. Two loci with a LD value of 1 are the to be in complete LD. At the other extreme, two loci with a LD value of 0 are termed to be in linkage equilibrium. Linkage disequilibrium is calculated following the application of the expectation maximization algorithm (EM) for the estimation of haplotype frequencies [Slatkin M, Excoffier L. (1996). Testing for linkage disequilibrium in genotypic data using the Expectation-Maximization algorithm. Heredity. 76: 377-83.]. Preferably, LD values according to the present invention for neighboring genotypes/loci are selected above 0.1, preferably, above 0.2, more preferable above 0.5, more preferably, above 0.6, still more preferably, above 0.7, preferably, above 0.8, more preferably above 0.9, ideally about 1.0.

[0094] In the D-Prime Plot, each diagonal represents a different SNP, with each square representing a pairwise comparison between two SNPs. SNPs are numbered sequentially, 5' to 3', and their relative location is indicated along the top. Red squares indicate statistically significant (LOD>2) allelic association (linkage disequilibrium, LD) between the pair of SNPs, as measured by the D' statistic; darker colors of red indicate higher values of D', up to a maximum of 1. White squares indicate pairwise D' values of <1 with no statistically significant evidence of LD. Blue squares indicate pairwise D' values of 1 but without statistical significance.

[0095] According to some embodiments of the invention, the LD between the APOL1 nucleotide mutation and the S342G mutation is characterized by a Lewontin correlation coefficient (D') higher than about 0.5, e.g., higher than about 0.6, higher than about 0.7, higher than about 0.8, higher than about 0.9, higher than about 0.91, higher than about 0.92, higher than about 0.93, higher than about 0.94, higher than about 0.95, higher than about 0.96, higher than about 0.97, higher than about 0.98, higher than about 0.99, e.g., about 1.0.

[0096] According to some embodiments of the invention, the significance of the LD is characterized by LOD≧2, e.g., LOD≧3, LOD≧4, LOD≧5, LOD≧6, LOD≧7.

[0097] As shown in FIG. 2, and described in Example 1 of the Examples section which follows, and based on the 1000-genomes-project (Hypertext Transfer Protocol://World Wide Web (dot)1000genomes(dot)org/) the present inventors have uncovered that the rs9622363, rs58384577, rs73885319 and rs60910145 SNPs are in complete LD (D'/LOD=100), and that the rs60295735 SNP is in tight linkage disequilibrium with each of them [i.e., D'/LOD (in percentages)=91 (with rs9622363), 95 (with rs73885319) and 97 (with rs60910145)].

[0098] According to some embodiments of the invention, the APOL1 nucleotide mutation is selected from the group consisting of the guanine-containing allele of single nucleotide polymorphism (SNP) rs73885319 (SEQ ID NO:6), the guanine-containing allele of SNP rs60910145 (SEQ ID NO:7), the guanine-containing allele of SNP rs9622363 (SEQ ID NO:8), the adenine-containing allele of SNP rs60295735 (SEQ ID NO:9) and the cytosine-containing allele of SNP rs58384577 (SEQ ID NO:10).

[0099] According to some embodiments of the invention, the nucleotide mutation creates an APOL1 protein variant.

[0100] The SNPs of some embodiments of the invention can be identified using a variety of approaches suitable for identifying sequence alterations. One option is to determine the entire gene sequence of a PCR reaction product. Alternatively, a given segment of nucleic acid may be characterized on several other levels. At the lowest resolution, the size of the molecule can be determined by electrophoresis by comparison to a known standard run on the same gel. A more detailed picture of the molecule may be achieved by cleavage with combinations of restriction enzymes prior to electrophoresis, to allow construction of an ordered map. The presence of specific sequences within the fragment can be detected by hybridization of a labeled probe, or the precise nucleotide sequence can be determined by partial chemical degradation or by primer extension in the presence of chain-terminating nucleotide analogs.

[0101] Following is a non-limiting list of SNPs detection methods which can be used to identify one or more of the SNPs of some embodiments of the invention.

[0102] Restriction fragment length polymorphism (RFLP): This method uses a change in a single nucleotide (the SNP nucleotide) which modifies a recognition site for a restriction enzyme resulting in the creation or destruction of an RFLP. Single nucleotide mismatches in DNA heteroduplexes are also recognized and cleaved by some chemicals, providing an alternative strategy to detect single base substitutions, generically named the "Mismatch Chemical Cleavage" (MCC) (Gogos et al., Nucl. Acids Res., 18:6807-6817, 1990). However, this method requires the use of osmium tetroxide and piperidine, two highly noxious chemicals which are not suited for use in a clinical laboratory.

[0103] Allele specific oligonucleotide (ASO): In this method, an allele-specific oligonucleotide (ASO) is designed to hybridize in proximity to the polymorphic nucleotide, such that a primer extension or ligation event can be used as the indicator of a match or a mis-match. Hybridization with radioactively labeled allelic specific oligonucleotides (ASO) also has been applied to the detection of specific SNPs (Conner et al., Proc. Natl. Acad. Sci., 80:278-282, 1983). The method is based on the differences in the melting temperature of short DNA fragments differing by a single nucleotide. Stringent hybridization and washing conditions can differentiate between mutant and wild-type alleles.

[0104] Denaturing/Temperature Gradient Gel Electrophoresis (DGGE/TGGE): Two other methods rely on detecting changes in electrophoretic mobility in response to minor sequence changes. One of these methods, termed "Denaturing Gradient Gel Electrophoresis" (DGGE) is based on the observation that slightly different sequences will display different patterns of local melting when electrophoretically resolved on a gradient gel. In this manner, variants can be distinguished, as differences in melting properties of homoduplexes versus heteroduplexes differing in a single nucleotide can detect the presence of SNPs in the target sequences because of the corresponding changes in their electrophoretic mobilities. The fragments to be analyzed, usually PCR products, are "clamped" at one end by a long stretch of G-C base pairs (30-80) to allow complete denaturation of the sequence of interest without complete dissociation of the strands. The attachment of a GC "clamp" to the DNA fragments increases the fraction of mutations that can be recognized by DGGE (Abrams et al., Genomics 7:463-475, 1990). Attaching a GC clamp to one primer is critical to ensure that the amplified sequence has a low dissociation temperature (Sheffield et al., Proc. Natl. Acad. Sci., 86:232-236, 1989; and Lerman and Silverstein, Meth. Enzymol., 155:482-501, 1987). Modifications of the technique have been developed, using temperature gradients (Wartell et al., Nucl. Acids Res., 18:2699-2701, 1990), and the method can be also applied to RNA:RNA duplexes (Smith et al., Genomics 3:217-223, 1988).

[0105] Limitations on the utility of DGGE include the requirement that the denaturing conditions must be optimized for each type of DNA to be tested. Furthermore, the method requires specialized equipment to prepare the gels and maintain the needed high temperatures during electrophoresis. The expense associated with the synthesis of the clamping tail on one oligonucleotide for each sequence to be tested is also a major consideration. In addition, long running times are required for DGGE. The long running time of DGGE was shortened in a modification of DGGE called constant denaturant gel electrophoresis (CDGE) (Borrensen et al., Proc. Natl. Acad. Sci. USA 88:8405, 1991). CDGE requires that gels be performed under different denaturant conditions in order to reach high efficiency for the detection of SNPs.

[0106] A technique analogous to DGGE, termed temperature gradient gel electrophoresis (TGGE), uses a thermal gradient rather than a chemical denaturant gradient (Scholz, et al., Hum. Mol. Genet. 2:2155, 1993). TGGE requires the use of specialized equipment which can generate a temperature gradient perpendicularly oriented relative to the electrical field. TGGE can detect mutations in relatively small fragments of DNA therefore scanning of large gene segments requires the use of multiple PCR products prior to running the gel.

[0107] Single-Strand Conformation Polymorphism (SSCP): Another common method, called "Single-Strand Conformation Polymorphism" (SSCP) was developed by Hayashi, Sekya and colleagues (reviewed by Hayashi, PCR Meth. Appl., 1:34-38, 1991) and is based on the observation that single strands of nucleic acid can take on characteristic conformations in non-denaturing conditions, and these conformations influence electrophoretic mobility. The complementary strands assume sufficiently different structures that one strand may be resolved from the other. Changes in sequences within the fragment will also change the conformation, consequently altering the mobility and allowing this to be used as an assay for sequence variations (Orita, et al., Genomics 5:874-879, 1989).

[0108] The SSCP process involves denaturing a DNA segment (e.g., a PCR product) that is labeled on both strands, followed by slow electrophoretic separation on a non-denaturing polyacrylamide gel, so that intra-molecular interactions can form and not be disturbed during the run. This technique is extremely sensitive to variations in gel composition and temperature. A serious limitation of this method is the relative difficulty encountered in comparing data generated in different laboratories, under apparently similar conditions.

[0109] Dideoxy fingerprinting (ddF): The dideoxy fingerprinting (ddF) is another technique developed to scan genes for the presence of mutations (Liu and Sommer, PCR Methods Appli., 4:97, 1994). The ddF technique combines components of Sanger dideoxy sequencing with SSCP. A dideoxy sequencing reaction is performed using one dideoxy terminator and then the reaction products are electrophoresed on nondenaturing polyacrylamide gels to detect alterations in mobility of the termination segments as in SSCP analysis. While ddF is an improvement over SSCP in terms of increased sensitivity, ddF requires the use of expensive dideoxynucleotides and this technique is still limited to the analysis of fragments of the size suitable for SSCP (i.e., fragments of 200-300 bases for optimal detection of mutations).

[0110] In addition to the above limitations, all of these methods are limited as to the size of the nucleic acid fragment that can be analyzed. For the direct sequencing approach, sequences of greater than 600 base pairs require cloning, with the consequent delays and expense of either deletion sub-cloning or primer walking, in order to cover the entire fragment. SSCP and DGGE have even more severe size limitations. Because of reduced sensitivity to sequence changes, these methods are not considered suitable for larger fragments. Although SSCP is reportedly able to detect 90% of single-base substitutions within a 200 base-pair fragment, the detection drops to less than 50% for 400 base pair fragments. Similarly, the sensitivity of DGGE decreases as the length of the fragment reaches 500 base-pairs. The ddF technique, as a combination of direct sequencing and SSCP, is also limited by the relatively small size of the DNA that can be screened.

[0111] Pyrosequencing® analysis (Pyrosequencing, Inc. Westborough, Mass., USA): This technique is based on the hybridization of a sequencing primer to a single stranded, PCR-amplified, DNA template in the presence of DNA polymerase, ATP sulfurylase, luciferase and apyrase enzymes and the adenosine 5' phosphosulfate (APS) and luciferin substrates. In the second step the first of four deoxynucleotide triphosphates (dNTP) is added to the reaction and the DNA polymerase catalyzes the incorporation of the deoxynucleotide triphosphate into the DNA strand, if it is complementary to the base in the template strand. Each incorporation event is accompanied by release of pyrophosphate (PPi) in a quantity equimolar to the amount of incorporated nucleotide. In the last step the ATP sulfurylase quantitatively converts PPi to ATP in the presence of adenosine 5' phosphosulfate. This ATP drives the luciferase-mediated conversion of luciferin to oxyluciferin that generates visible light in amounts that are proportional to the amount of ATP. The light produced in the luciferase-catalyzed reaction is detected by a charge coupled device (CCD) camera and seen as a peak in a pyrogram®. Each light signal is proportional to the number of nucleotides incorporated.

[0112] Acycloprime® analysis (Perkin Elmer, Boston, Mass., USA): This technique is based on fluorescent polarization (FP) detection. Following PCR amplification of the sequence containing the SNP of interest, excess primer and dNTPs are removed through incubation with shrimp alkaline phosphatase (SAP) and exonuclease I. Once the enzymes are heat inactivated, the Acycloprime-FP process uses a thermostable polymerase to add one of two fluorescent terminators to a primer that ends immediately upstream of the SNP site. The terminator(s) added are identified by their increased FP and represent the allele(s) present in the original DNA sample. The Acycloprime process uses AcycloPol®, a novel mutant thermostable polymerase from the Archeon family, and a pair of AcycloTerminators® labeled with R110 and TAMRA, representing the possible alleles for the SNP of interest. AcycloTerminator® non-nucleotide analogs are biologically active with a variety of DNA polymerases. Similarly to 2',3' -dideoxynucleotide-5'-triphosphates, the acyclic analogs function as chain terminators. The analog is incorporated by the DNA polymerase in a base-specific manner onto the 3'-end of the DNA chain, and since there is no 3'-hydroxyl, is unable to function in further chain elongation. It has been found that AcycloPol has a higher affinity and specificity for derivatized AcycloTerminators than various Taq mutant have for derivatized 2',3'-dideoxynucleotide terminators.

[0113] Reverse dot blot: This technique uses labeled sequence specific oligonucleotide probes and unlabeled nucleic acid samples. Activated primary amine-conjugated oligonucleotides are covalently attached to carboxylated nylon membranes. After hybridization and washing, the labeled probe, or a labeled fragment of the probe, can be released using oligomer restriction, i.e., the digestion of the duplex hybrid with a restriction enzyme. Circular spots or lines are visualized colorimetrically after hybridization through the use of streptavidin horseradish peroxidase incubation followed by development using tetramethylbenzidine and hydrogen peroxide, or via chemiluminescence after incubation with avidin alkaline phosphatase conjugate and a luminous substrate susceptible to enzyme activation, such as CSPD, followed by exposure to x-ray film.

[0114] It will be appreciated that advances in the field of SNP detection have provided additional accurate, easy, and inexpensive large-scale SNP genotyping techniques, such as dynamic allele-specific hybridization (DASH, Howell, W. M. et al., 1999. Dynamic allele-specific hybridization (DASH). Nat. Biotechnol. 17: 87-8), microplate array diagonal gel electrophoresis [MADGE, Day, I. N. et al., 1995. High-throughput genotyping using horizontal polyacrylamide gels with wells arranged for microplate array diagonal gel electrophoresis (MADGE). Biotechniques. 19: 830-5], the TaqMan system (Holland, P. M. et al., 1991. Detection of specific polymerase chain reaction product by utilizing the 5'→3' exonuclease activity of Thermus aquaticus DNA polymerase. Proc Natl Acad Sci USA. 88: 7276-80), as well as various DNA "chip" technologies such as the GeneChip microarrays (e.g., Affymetrix SNP chips) which are disclosed in U.S. Pat. No. 6,300,063 to Lipshutz, et al. 2001, which is fully incorporated herein by reference, Genetic Bit Analysis (GBA®) which is described by Goelet, P. et al. (PCT Appl. No. 92/15712), peptide nucleic acid (PNA, Ren B, et al., 2004. Nucleic Acids Res. 32: e42) and locked nucleic acids (LNA, Latorra D, et al., 2003. Hum. Mutat. 22: 79-85) probes, Molecular Beacons (Abravaya K, et al., 2003. Clin Chem Lab Med. 41: 468-74), intercalating dye [Germer, S. and Higuchi, R. Single-tube genotyping without oligonucleotide probes. Genome Res. 9:72-78 (1999)], FRET primers (Solinas A et al., 2001. Nucleic Acids Res. 29: E96), AlphaScreen (Beaudet L, et al., Genome Res. 2001, 11(4): 600-8), SNPstream (Bell P A, et al., 2002. Biotechniques. Suppl.: 70-2, 74, 76-7), Multiplex minisequencing (Curcio M, et al., 2002. Electrophoresis. 23: 1467-72), SnaPshot (Turner D, et al., 2002. Hum Immunol. 63: 508-13), MassEXTEND (Cashman J R, et al., 2001. Drug Metab Dispos. 29: 1629-37), GOOD assay (Sauer S, and Gut I G. 2003. Rapid Commun. Mass. Spectrom. 17: 1265-72), Microarray minisequencing (Liljedahl U, et al., 2003. Pharmacogenetics. 13: 7-17), arrayed primer extension (APEX) (Tonisson N, et al., 2000. Clin. Chem. Lab. Med. 38: 165-70), Microarray primer extension (O'Meara D, et al., 2002. Nucleic Acids Res. 30: e75), Tag arrays (Fan J B, et al., 2000. Genome Res. 10: 853-60), Template-directed incorporation (TDI) (Akula N, et al., 2002. Biotechniques. 32: 1072-8), fluorescence polarization (Hsu T M, et al., 2001. Biotechniques. 31: 560, 562, 564-8), Colorimetric oligonucleotide ligation assay (OLA, Nickerson D A, et al., 1990. Proc. Natl. Acad. Sci. USA. 87: 8923-7), Sequence-coded OLA (Gasparini P, et al., 1999. J. Med. Screen. 6: 67-9), Microarray ligation, Ligase chain reaction, Padlock probes, Rolling circle amplification, Invader assay (reviewed in Shi M M. 2001. Enabling large-scale pharmacogenetic studies by high-throughput mutation detection and genotyping technologies. Clin Chem. 47: 164-72), coded microspheres (Rao K V et al., 2003. Nucleic Acids Res. 31: e66) and MassArray (Leushner J, Chiu N H, 2000. Mol Diagn. 5: 341-80).

[0115] For example, as described under "GENERAL MATERIALS AND EXPERIMENTAL METHODS" in the Examples section which follows, determination of the SNPs was performed using the KasPar methodology (Petkov et al. 2004), as well as by PCR-RFLP [for SNP RS73885319 (S342G) and SNP RS60910145 (I384M)].

[0116] The protein sample can be obtained from any source of cells, tissues or body fluids of the individual. According to some embodiments of the invention, the protein sample is obtained from a blood sample (serum or plasma) of the individual. Methods of extracting proteins from blood samples are well known in the art. Once extracted, determination of the APOL1 polypeptide variants can be accomplished directly, by analyzing the protein gene products of the APOL1 gene, or portions thereof. Such a direct analysis is often accomplished using an immunological detection method.

[0117] Immunological detection methods: The immunological detection methods used in context of the present invention are fully explained in, for example, "Using Antibodies: A Laboratory Manual" [Ed Harlow, David Lane eds., Cold Spring Harbor Laboratory Press (1999)] and those familiar with the art will be capable of implementing the various techniques summarized hereinbelow as part of the present invention. All of the immunological techniques require antibodies specific to at least one of the two APOL1 alleles (the wild type allele and the APOL1 variant allele). Immunological detection methods suited for use as part of the present invention include, but are not limited to, radio-immunoassay (RIA), enzyme linked immunosorbent assay (ELISA), western blot, immunohistochemical analysis, and fluorescence activated cell sorting (FACS).

[0118] Radio-immunoassay (RIA): In one version, this method involves precipitation of the desired substrate, APOL1 in this case and in the methods detailed hereinbelow, with a specific antibody and radiolabelled antibody binding protein (e.g., protein A labeled with I¹²⁵) immobilized on a precipitable carrier such as agarose beads. The number of counts in the precipitated pellet is proportional to the amount of substrate.

[0119] In an alternate version of the RIA, a labeled substrate and an unlabelled antibody binding protein are employed. A sample containing an unknown amount of substrate is added in varying amounts. The decrease in precipitated counts from the labeled substrate is proportional to the amount of substrate in the added sample.

[0120] Enzyme linked immunosorbent assay (ELISA): This method involves fixation of a sample (e.g., fixed cells or a proteinaceous solution) containing a protein substrate to a surface such as a well of a microtiter plate. A substrate specific antibody coupled to an enzyme is applied and allowed to bind to the substrate. Presence of the antibody is then detected and quantitated by a colorimetric reaction employing the enzyme coupled to the antibody. Enzymes commonly employed in this method include horseradish peroxidase and alkaline phosphatase. If well calibrated and within the linear range of response, the amount of substrate present in the sample is proportional to the amount of color produced. A substrate standard is generally employed to improve quantitative accuracy.

[0121] Western blot: This method involves separation of a substrate from other protein by means of an acrylamide gel followed by transfer of the substrate to a membrane (e.g., nylon or PVDF). Presence of the substrate is then detected by antibodies specific to the substrate, which are in turn detected by antibody binding reagents. Antibody binding reagents may be, for example, protein A, or other antibodies. Antibody binding reagents may be radiolabelled or enzyme linked as described hereinabove. Detection may be by autoradiography, colorimetric reaction or chemiluminescence. This method allows both quantitation of an amount of substrate and determination of its identity by a relative position on the membrane which is indicative of a migration distance in the acrylamide gel during electrophoresis.

[0122] Immunohistochemical analysis: This method involves detection of a substrate in situ in fixed cells by substrate specific antibodies. The substrate specific antibodies may be enzyme linked or linked to fluorophores. Detection is by microscopy and subjective evaluation. If enzyme linked antibodies are employed, a colorimetric reaction may be required.

[0123] Fluorescence activated cell sorting (FACS): This method involves detection of a substrate in situ in cells by substrate specific antibodies. The substrate specific antibodies are linked to fluorophores. Detection is by means of a cell sorting machine which reads the wavelength of light emitted from each cell as it passes through a light beam. This method may employ two or more antibodies simultaneously.

[0124] The antibody used in the method of the present invention is selected differentially interactable with at least one form of a APOL1 protein encoded by an APOL1 allele having an SNP rs73885319 (S342G, i.e., the 5342 polymorph or the G342 polymorph) and SNP rs60910145 (I384M, i.e., the I384 polymorph or the M384 polymorph) and can differentiate between polymorphs of the APOL1 protein via differential antibody interaction. Antibodies useful in context of this embodiment of the invention can be prepared using methods of antibody preparation well known to one of ordinary skills in the art, using, for example, synthetic peptides derived from the two different forms of the APOL1 protein for vaccination of antibody producing animals and subsequent isolation of antibodies therefrom. Monoclonal antibodies specific to each of the APOL1 variants can also be prepared as is described, for example, in "Current Protocols in Immunology" Volumes I-III Coligan J. E., Ed. (1994); Stites et al. (Eds), "Basic and Clinical Immunology" (8th Edition), Appleton & Lange, Norwalk, Conn. (1994); Mishell and Shiigi (Eds), "Selected Methods in Cellular Immunology", W. H. Freeman and Co., New York (1980).

[0125] The term "antibody" as used in the present invention includes intact molecules as well as functional fragments thereof, such as Fab, F(ab')₂, and Fv that are capable of binding to macrophages. These functional antibody fragments are defined as follows: Fab, the fragment which contains a monovalent antigen-binding fragment of an antibody molecule, can be produced by digestion of whole antibody with the enzyme papain to yield an intact light chain and a portion of one heavy chain; Fab', the fragment of an antibody molecule that can be obtained by treating whole antibody with pepsin, followed by reduction, to yield an intact light chain and a portion of the heavy chain; two Fab' fragments are obtained per antibody molecule; (Fab')₂, the fragment of the antibody that can be obtained by treating whole antibody with the enzyme pepsin without subsequent reduction; F(ab')₂ is a dimer of two Fab' fragments held together by two disulfide bonds; Fv, defined as a genetically engineered fragment containing the variable region of the light chain and the variable region of the heavy chain expressed as two chains; and single chain antibody ("SCA"), a genetically engineered molecule containing the variable region of the light chain and the variable region of the heavy chain, linked by a suitable polypeptide linker as a genetically fused single chain molecule.

[0126] Methods of making these fragments are known in the art. See for example, Harlow and Lane, Antibodies: A Laboratory Manual, Cold Spring Harbor Laboratory, New York, 1988, incorporated herein by reference.

[0127] Antibody fragments according to the present invention can be prepared by proteolytic hydrolysis of the antibody or by expression in E. coli or mammalian cells (e.g. Chinese hamster ovary cell culture or other protein expression systems) of DNA encoding the fragment.

[0128] Antibody fragments can be obtained by pepsin or papain digestion of whole antibodies by conventional methods. For example, antibody fragments can be produced by enzymatic cleavage of antibodies with pepsin to provide a 5S fragment denoted F(ab')₂. This fragment can be further cleaved using a thiol reducing agent, and optionally a blocking group for the sulfhydryl groups resulting from cleavage of disulfide linkages, to produce 3.5S Fab' monovalent fragments. Alternatively, an enzymatic cleavage using pepsin produces two monovalent Fab' fragments and an Fc fragment directly. These methods are described, for example, by Goldenberg, U.S. Pat. Nos. 4,036,945 and 4,331,647, and references contained therein, which patents are hereby incorporated by reference in their entirety. See also Porter, R. R., Biochem. J., 73: 119-126, 1959. Other methods of cleaving antibodies, such as separation of heavy chains to form monovalent light-heavy chain fragments, further cleavage of fragments, or other enzymatic, chemical, or genetic techniques may also be used, so long as the fragments bind to the antigen that is recognized by the intact antibody.

[0129] Fv fragments comprise an association of V_H and V_L chains. This association may be noncovalent, as described in Inbar et al., Proc. Nat'l Acad. Sci. USA 69:2659-62, 1972. Alternatively, the variable chains can be linked by an intermolecular disulfide bond or cross-linked by chemicals such as gluteraldehyde. Preferably, the Fv fragments comprise V_H and V_L chains connected by a peptide linker. These single-chain antigen binding proteins (sFv) are prepared by constructing a structural gene comprising DNA sequences encoding the V_H and V_L domains connected by an oligonucleotide. The structural gene is inserted into an expression vector, which is subsequently introduced into a host cell such as E. coli. The recombinant host cells synthesize a single polypeptide chain with a linker peptide bridging the two V domains. Methods for producing sFvs are described, for example, by Whitlow and Filpula, Methods, 2: 97-105, 1991; Bird et al., Science 242:423-426, 1988; Pack et al., Bio/Technology 11:1271-77, 1993; and Ladner et al., U.S. Pat. No. 4,946,778, which is hereby incorporated by reference in its entirety.

[0130] Another form of an antibody fragment is a peptide coding for a single complementarity-determining region (CDR). CDR peptides ("minimal recognition units") can be obtained by constructing genes encoding the CDR of an antibody of interest. Such genes are prepared, for example, by using the polymerase chain reaction to synthesize the variable region from RNA of antibody-producing cells. See, for example, Larrick and Fry, Methods, 2: 106-10, 1991.

[0131] Once the predisposition to develop the kidney disease has been determined, the information regarding predisposition can be presented to the individual and/or to the treating physician. This is particularly important in case of a positive prediction of kidney disease in a subject (i.e., when there is predisposition to develop kidney disease according to the methods described hereinabove), in order to take actions, which might prevent or delay the development of the kidney disease before its onset.

[0132] It should be noted that upon the onset (or occurrence) of the kidney disease, the subject's general health can deteriorate, and the subject can become severely ill, without cure, leading to death.

[0133] On the other hand, absence of predisposition to develop a kidney disease may be of a great relief to a subject being at risk thereof based on family history and/or presence of other disease(s).

[0134] Thus, according to some embodiments of the invention, the method further comprising informing the subject on the state of the predisposition to develop the kidney disease.

[0135] As used herein, the term "subject" includes mammals, preferably human beings at any age which suffer from a pathology (kidney disease) or is at risk of developing a pathology (kidney disease).

[0136] According to some embodiments of the invention, the kidney disease comprises an end stage kidney disease.

[0137] According to some embodiments of the invention, the kidney disease is not a diabetic-associated or diabetic-related kidney disease.

[0138] It should be noted that determination of the predisposition of the subject to develop a kidney disease can affect the subject's life style, such that the subject is aware of the risk to develop the disease and takes action(s) in order to prevent the kidney disease, which actions were otherwise not been taken.

[0139] For example, a subject who is predisposed to develop a kidney disease may be put on a restrictive diet for preventing overload of protein or salt on the kidney, and/or be treated with suitable medications which prevent or delay onset of the kidney disease.

[0140] According to an aspect of some embodiments of the invention there is provided a method of designing a life style change to a subject with the risk of kidney disease, comprising:

[0141] (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation,

[0142] (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions;

[0143] (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1,

[0144] wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and;

[0145] (b) designing the life style change based on presence or absence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation,

[0146] thereby designing life style change to a subject with the risk of kidney disease.

[0147] As mentioned, the knowledge of presence or absence or the predisposition to develop the kidney disease can be used to design a suitable treatment regimen to a subject having a certain disease and being at risk of developing also a kidney disease. Non-limiting examples of such subjects include those infected with HIV which causes AIDS, patients who have a single kidney, a past episode of acute kidney injury, have donated a kidney or otherwise lost a kidney, recurrent urinary infections, childhood reflux disease, exposure of kidney toxic medications, patients with hypertensive nephrosclerosis, non-monogenic focalsegmental glomerulosclerosis, a patient with sickle-cell kidney disease and the like.

[0148] It should be noted that HIV-infected subjects are at risk to develop HIV-associate nephropathy (HIVAN). However, the threshold for introducing an antiretroviral therapy in patients with HIV does not currently take into account the patient's risk of HIV-related kidney disease. Such risk could potentially be accounted for by a management algorithm that includes the effects of APOL1 genotype. Thus, determining the etiology of kidney dysfunction in a patient with AIDS who is receiving potentially nephrotoxic antiretroviral therapy may be assisted by APOL1 genotyping.

[0149] According to some embodiments of the invention, the subject is infected with HIV.

[0150] According to some embodiments of the invention, the kidney disease comprises HIV-associated nephropathy (HIVAN).

[0151] Thus, according to an aspect of some embodiments of the invention there is provided a method of designing a nephrotoxic anti-retroviral treatment regimen to a subject infected with HIV, comprising:

[0152] (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation,

[0153] (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions;

[0154] (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1,

[0155] wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and;

[0156] (b) designing the nephrotoxic anti-retroviral treatment regimen based on presence or absence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation,

[0157] thereby designing a nephrotoxic anti-retroviral treatment regimen to the subject infected with HIV.

[0158] For example, the clinician might decide to press on with therapy to alleviate the kidney injury in an HIV-infected patient carrying APOL1 risk alleles, or might choose not to implement such therapy in an HIV-infected patient who does not carry APOL1 risk alleles.

[0159] Similarly, determination of the predisposition to develop a kidney disease may have important considerations for both living kidney donors and recipients. For example, subjects having increased predisposition to develop a kidney disease may not be eligible to donate a kidney. Similarly, a subject having an increased predisposition to develop a kidney disease may not benefit from a kidney transplantation. Thus, the APOL1 genotyping may well be added to the battery of tests undertaken prior to living kidney donation, for the benefit of both donor and recipient.

[0160] Thus, according to an aspect of some embodiments of the invention, there is provided a method of determining if a subject is suitable for donating a kidney for transplantation, comprising:

[0161] (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation,

[0162] (i) wherein the variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on the Trypanosoma brucei rhodesiense under identical assay conditions;

[0163] (ii) wherein the APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1,

[0164] wherein presence of the APOL1 polypeptide variant or the APOL1 nucleotide mutation indicates increased predisposition of the subject to develop a kidney disease, and;

[0165] wherein increased predisposition of the subject to develop the kidney disease indicates that the subject is not suitable for donating the kidney for transplantation,

[0166] thereby determining if the subject is suitable for donating a kidney for transplantation.

[0167] Current guidelines for the management of hypertension suggest that African Americans as a group do not enjoy renal benefit from antihypertensive therapy, and moreover the recommendations for use of specific antihypertensive drug categories in African American patients are influenced by which African subpopulation they belong to. The presence or absence of the APOL1 risk alleles for predisposition to a kidney disease may be also used to improve the individualization of therapy in the African American group of patients, such that those without APOL1 risk alleles might be expected to enjoy a substantial renal benefit from antihypertensive regimens, similar to those that have proven effective in patients of European ancestry.

[0168] It will be appreciated that the reagents utilized by the methods for determining predisposition to develop kidney disease according to some embodiments of the invention and which are described hereinabove can form a part of a kit.

[0169] Such a kit includes at least one reagent for determining a presence or absence in a homozygous or heterozygous form, of at least one APOL1 nucleotide mutation or APOL1 protein variant.

[0170] According to an aspect of some embodiments of the invention there is provided a kit for determining predisposition to a kidney disease, comprising a reagent capable of specifically detecting at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3, and/or a reagent capable of specifically detecting at least one APOL1 nucleotide mutation in the APLO1 coding sequence set forth in SEQ ID NO:2, wherein the at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, and/or a reagent capable of specifically detecting at least one APOL1 polypeptide variant, wherein said APOL1 polypeptide variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on said Trypanosoma brucei rhodesiense under identical assay conditions.

[0171] According to some embodiments of the invention, the APOL1 nucleotide mutation is selected from the group consisting of the guanine-containing allele of single nucleotide polymorphism (SNP) rs73885319 (SEQ ID NO:6), the guanine-containing allele of SNP rs60910145 (SEQ ID NO:7), the guanine-containing allele of SNP rs9622363 (SEQ ID NO:8), the adenine-containing allele of SNP rs60295735 (SEQ ID NO:9) and the cytosine-containing allele of SNP rs58384577 (SEQ ID NO:10).

[0172] According to some embodiments of the invention, the reagent comprises a polynucleotide capable of specifically detecting the APOL1 nucleotide mutation by any of the mutation and/or SNP detection methods described hereinabove.

[0173] According to some embodiments of the invention, the reagent comprises an antibody capable of specifically binding an APOL1 variant comprises the nucleotide mutation and not to the APLO1 wild type polypeptide.

[0174] According to preferred embodiments the APOL1 polypeptide variant which is detected by the reagent comprised in the kit has a mutation selected from the group consisting of G342, M384, N388-del and Y389-del with respect to the wild type amino acid sequence set forth in SEQ ID NO:1.

[0175] According to preferred embodiments the kit further comprising packaging material packaging at least one reagent and a notification in or on the packaging material. Such a notification identifies the kit for use in determining if an individual is predisposed to develop a kidney disease, and/or suitable to donate a kidney for transplantation, and/or suitable for receiving kidney transplantation, and/or for designing a life style change and/or for designing a treatment regimen for a subject.

[0176] The kit also includes the appropriate instructions for use and labels indicating FDA approval for use in vitro.

[0177] As used herein the term "about" refers to ±10%.

[0178] The terms "comprises", "comprising", "includes", "including", "having" and their conjugates mean "including but not limited to".

[0179] The term "consisting of means "including and limited to".

[0180] The term "consisting essentially of" means that the composition, method or structure may include additional ingredients, steps and/or parts, but only if the additional ingredients, steps and/or parts do not materially alter the basic and novel characteristics of the claimed composition, method or structure.

[0181] As used herein, the singular form "a", "an" and "the" include plural references unless the context clearly dictates otherwise. For example, the term "a compound" or "at least one compound" may include a plurality of compounds, including mixtures thereof. Throughout this application, various embodiments of this invention may be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.

[0182] Whenever a numerical range is indicated herein, it is meant to include any cited numeral (fractional or integral) within the indicated range. The phrases "ranging/ranges between" a first indicate number and a second indicate number and "ranging/ranges from" a first indicate number "to" a second indicate number are used herein interchangeably and are meant to include the first and second indicated numbers and all the fractional and integral numerals therebetween.

[0183] As used herein the term "method" refers to manners, means, techniques and procedures for accomplishing a given task including, but not limited to, those manners, means, techniques and procedures either known to, or readily developed from known manners, means, techniques and procedures by practitioners of the chemical, pharmacological, biological, biochemical and medical arts.

[0184] It is appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention, which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable subcombination or as suitable in any other described embodiment of the invention. Certain features described in the context of various embodiments are not to be considered essential features of those embodiments, unless the embodiment is inoperative without those elements.

[0185] Various embodiments and aspects of the present invention as delineated hereinabove and as claimed in the claims section below find experimental support in the following examples.

EXAMPLES

[0186] Reference is now made to the following examples, which together with the above descriptions illustrate some embodiments of the invention in a non limiting fashion.

[0187] Generally, the nomenclature used herein and the laboratory procedures utilized in the present invention include molecular, biochemical, microbiological and recombinant DNA techniques. Such techniques are thoroughly explained in the literature. See, for example, "Molecular Cloning: A laboratory Manual" Sambrook et al., (1989); "Current Protocols in Molecular Biology" Volumes I-III Ausubel, R. M., ed. (1994); Ausubel et al., "Current Protocols in Molecular Biology", John Wiley and Sons, Baltimore, Md. (1989); Perbal, "A Practical Guide to Molecular Cloning", John Wiley & Sons, New York (1988); Watson et al., "Recombinant DNA", Scientific American Books, New York; Birren et al. (eds) "Genome Analysis: A Laboratory Manual Series", Vols. 1-4, Cold Spring Harbor Laboratory Press, New York (1998); methodologies as set forth in U.S. Pat. Nos. 4,666,828; 4,683,202; 4,801,531; 5,192,659 and 5,272,057; "Cell Biology: A Laboratory Handbook", Volumes I-III Cellis, J. E., ed. (1994); "Current Protocols in Immunology" Volumes I-III Coligan J. E., ed. (1994); Stites et al. (eds), "Basic and Clinical Immunology" (8th Edition), Appleton & Lange, Norwalk, Conn. (1994); Mishell and Shiigi (eds), "Selected Methods in Cellular Immunology", W. H. Freeman and Co., New York (1980); available immunoassays are extensively described in the patent and scientific literature, see, for example, U.S. Pat. Nos. 3,791,932; 3,839,153; 3,850,752; 3,850,578; 3,853,987; 3,867,517; 3,879,262; 3,901,654; 3,935,074; 3,984,533; 3,996,345; 4,034,074; 4,098,876; 4,879,219; 5,011,771 and 5,281,521; "Oligonucleotide Synthesis" Gait, M. J., ed. (1984); "Nucleic Acid Hybridization" Hames, B. D., and Higgins S. J., eds. (1985); "Transcription and Translation" Hames, B. D., and Higgins S. J., Eds. (1984); "Animal Cell Culture" Freshney, R. I., ed. (1986); "Immobilized Cells and Enzymes" IRL Press, (1986); "A Practical Guide to Molecular Cloning" Perbal, B., (1984) and "Methods in Enzymology" Vol. 1-317, Academic Press; "PCR Protocols: A Guide To Methods And Applications", Academic Press, San Diego, Calif. (1990); Marshak et al., "Strategies for Protein Purification and Characterization--A Laboratory Course Manual" CSHL Press (1996); all of which are incorporated by reference as if fully set forth herein. Other general references are provided throughout this document. The procedures therein are believed to be well known in the art and are provided for the convenience of the reader. All the information contained therein is incorporated herein by reference.

General Materials and Experimental Methods

[0188] Sample sets--The non-diabetic ESKD sample set is a sub-set of a larger ESKD cohort previously reported (Behar et al. 2010). The designation of MYH9 associated nephropathies included hypertension affiliated chronic kidney disease, HIV-associated nephropathy (HIVAN), and non-monogenic forms of focal segmental glomerulosclerosis (Bostrom and Freedman 2010). The sample includes 430 non-diabetic ESKD cases and 525 controls, all of whom are self-identified as either African American or Hispanic American. The present inventors have already reported the African, European and Native American ancestry admixture proportions for these samples, based on a set of 40 genome wide Ancestry Informative Markers, and also the association and risk parameters for a set of 42 SNP polymorphic markers in the MYH9 genetic locus in the entire sample set (Behar et al. 2010).

[0189] The African populations sample set consists of 676 samples from 12 African populations, including Cameroon (2 ethnic groups), Congo, Ethiopia (4 ethnic groups), Ghana (2 groups), Malawi, Mozambique, Sudan with details provided in Table 2 hereinbelow. Whole Genome Amplification of extracted DNA was carried out as previously reported (van Eijk et al. 2010).

[0190] All sampling and testing was conducted with institutional review board approval for human genetic studies on anonymized samples, with informed consent.

[0191] SNP Genotyping--Genotyping of the novel six SNPs reported herein and in Tzur et al. 2010, i.e., SNPs rs73885319, rs60910145, rs9622363 [APOL1], rs60295735 [near APOL1], rs56767103 [FOXRED2], rs11089781 [APOL3], was performed with the KasPar methodology (Petkov et al. 2004). In addition PCR and RFLP reactions were designed for the APOL1 SNPs as follows. DNA fragments containing the both APOL1 SNPs [SNP rs73885319 (S342G) and SNP rs60910145 (I384M)] were generated by PCR amplification of genomic DNA using the following primers: forward primer: 5'-ACA AGC CCA AGC CCA CGA CC-3' (SEQ ID NO:4) and the reverse primer: 5'-CCT GGC CCC TGC CAG GCA TA-3' (SEQ ID NO:5). PCR reaction mix included 30 ng template DNA with 7.5 pmol of each primer and the Red Load Taq Master (Larova). PCR conditions were 95° C. for 3 minutes followed by 40 cycles of denaturation at 95° C. for 30 seconds, annealing 65° C. for 20 seconds, and elongation 72° C. for 1 minute. The resulting amplicon was digested with both endonucleases HindIII and NspI and was run on a 2% agarose gel. SNP APOL1 rs73885319 A/G: The allele containing G eliminates a recognition site of endonuclease HindIII. APOL1 SNP rs60910145 T/G: The allele containing T generates a new recognition site of endonuclease NspI. An example for RFLP genotyping of APOL1 rs73885319 A/G and APOL1 SNP rs60910145 T/G is shown in FIG. 6. SNP validation was performed by Sanger sequencing.

Example 1

Search for Sequence Variants Associated with ESKD

[0192] In order to detect functional mutations which are significantly more associated with ESKD than all previously reported SNPs in MYH9, the present inventors have re-examined the MALD interval surrounding MYH9, and detected novel missense mutations with predicted functional effects in the neighboring loci such as the APOL1 gene.

[0193] Identification of candidate non-synonymous SNPs related to ESKD--To search for variants possibly associated with ESKD, the present inventors analyzed 119 whole genome sequences recently released by the 1000 Genomes Project [world wide web (dot) 1000 genomes (dot) org] and examined in these genomes a 1.55 Mbp interval surrounding MYH9, spanning nucleotide positions 34,000,000 to 35,550,000 (NCBI36 assembly). Of the 119 whole genome sequences, 60 are of European origin (HapMap CEU cohort), and 59 are of West-African origin (HapMap YRI cohort) yielding a total of 7,479 SNPs in the 1.55 Mbp chromosome 22 interval. Filtering criteria were applied to identify candidates for further consideration and analysis, based on: (1) low allele frequency in CEU but not in YRI, and (2) LD patterns with the previously identified leading MYH9 risk variants. From the 7,479 SNPs, the present inventors have selected for further examination all SNPs which complied with the following conditions:

[0194] (1) Minor allele frequency in the CEU cohort not exceeding 7.5% (9/120 chromosomes). This minor allele was designated as a putative "risk state" for this SNP.

[0195] (2) Risk state in the YRI cohort at allele frequency exceeding 17.5% (21/118 chromosomes).

[0196] (3) A minimal level of LD with the MYH9 S-1 SNP rs5750250 (FIG. 2). The criterion used was a chi-square test p-value not exceeding 0.15 for the 3*3 genotype table comparing each candidate SNP to the S-1 SNP in the YRI cohort.

[0197] All candidate SNPs which passed these requirements (total 250) were inspected in order to identify non-synonymous exonic SNPs, indicating a possible functional role. These were again examined for consistency with association patterns in the leading MYH9 risk variants S-1 (rs5750250) and F-1 (rs11912763) (Nelson et al. 2010) to confirm higher prevalence of the African "risk" state in the YRI cohort, and rarity of the risk state in the S-1 protective state (G:G), given the high attributable risk of S-1, especially for HIVAN (Winkler et al. 2010), indicating that the causative variant should be extremely rare in the presence of the S-1 protective state. This yielded four candidate non-synonymous exonic SNPs for genotyping: The first two (rs73885319 and rs60910145) are missense mutations in the last exon of the APOL1 gene (S342G and I384M) which is the neighboring gene, located 14 kbp 3' downstream from MYH9. A third SNP (rs11089781) is a nonsense mutation (Q58X) in the APOL3 gene located 110 kbp further 3' downstream. The fourth SNP (rs56767103) is a missense mutation (R71C) in the gene FOXRED2 located 100 kbp upstream to the 5' side of MYH9 (FIG. 1). Of note the two variants located 128 bp apart in APOL1 are in almost perfect LD (237 out of 238 chromosomes from the 1000 Genomes Project).

[0198] These four variants were genotyped in a previously reported sample set of African American and Hispanic American cases and controls (n=955) (Behar et al. 2010). Associations of these candidates with ESKD phenotypes previously attributed to MYH9, were determined using logistic regression, with correction for global and local ancestry, and considering three major modes of inheritance as previously reported (Behar et al. 2010).

[0199] Association analysis--For determining the association of each SNP with ESKD in the dataset, the present inventors performed logistic regression with ESKD status (Cases/Control) as the response, and included covariates for local and global ancestry as well as for cohort (African American/Hispanic American). Ancestry estimates were calculated as previously described (Behar et al. 2010). In addition to the four exonic SNPs described above, two additional SNPs in the APOL1 region were chosen for genotyping, including SNP rs9622363 located in intron 3, and SNP rs60295735 located in the inter-genic region between the genes APOL1 and MYH9. These SNPs were chosen using the same criteria as those applied to the exonic SNPs, as described above.

TABLE-US-00001 TABLE 1 Association with non-diabetic ESKD of non-synonymous SNPs in APOL1, APOL3 and FOXRED2 in the MALD peak and comparison with leading MYH9 SNPs Chr22 YRI risk CEU risk rs number Gene Type Location^a Alleles^b frequency^c frequency Mode^d OR P value rs73885319^e APOL1 exon 5 36661906 A/G 46% 0% Recessive 6.7 2.71E-06 S342G Additive 2.22 2.38E-08 missense Dominant 2.23 8.11E-06 rs60910145 APOL1 exon 5 36662034 T/G 45% 0% Recessive 6.74 9.89E-06 1384M Additive 2.28 3.00E-08 missense Dominant 2.32 4.75E-06 rs11089781 APOL3 exon 1 36556768 G/A 31% 0% Recessive 6.62 2.82E-03 Q58X Additive 2.18 3.79E-06 nonsense Dominant 2.22 3.23E-05 rs56767103 FOXRED2 exon 1 36902259 G/A 18% 0% Recessive 1.33 6.83E-01 R71C Additive 1.52 5.19E-02 missense Dominant 1.66 3.64E-02 rs11912763 MYH9 intron 33 36684722 G/A 48% 0% Recessive 2.38 2.86E-02 F-1 Additive 1.96 4.05E-05 designation Dominant 2.28 4.20E-05 rs5750250 MYH9 intron13 36708483 A/G 66% 6% Recessive 2.48 4.29E-05 S-1 Additive 1.78 6.68E-05 designation Dominant 1.55 4.97E-02 ^aLocation on Chromosome 22 in NCB137.1/hg19 assembly. ^bAfrican ESKD "risk" state in bold. ^cFrequencies according to available 1000genome data. ^dAssociation results were derived using logistic regression, correcting for global and local African ancestry, and combining the Hispanic and African American cohorts. ^eSee FIGS. 5A-D for allele frequency pie-charts in cases versus controls.

[0200] The APOL1 Missense Variants (rs73885319 and rs60910145) are More Strongly Associated with ESKD Risk than the Leading MYH9 Risk Variants

[0201] Table 1 hereinabove shows the association results for the combined dataset of the African American and Hispanic American cohorts. For comparison, the present inventors include the results from the two previously reported leading MYH9 risk variants (S-1 rs5750250, F-1 rs11912763) (Nelson et al. 2010). The APOL1 missense variants (rs73885319 and rs60910145) are more strongly associated with ESKD risk than the leading MYH9 risk variants, both in terms of OR and p values (Table 1 above). The lower allele frequency and OR, with a higher p value for the APOL3 nonsense variant, and the weak association for the FOXRED2 missense mutation, render these variants unlikely candidates to explain the risk attributed to this genomic region. The results for combined and meta-analysis of the two separate cohort-based results are congruent (Table 2, below).

[0202] For determining whether the APOL1 SNP rs73885319 explains the association of ESKD with MYH9 SNPs, the present inventors performed a logistic regression with the same covariates, but included both the APOL1 SNP and an MYH9 SNP in the analysis. To avoid committing to a specific mode of inheritance, the present inventors included the SNPs as categorical variables with three values (three possible genotypes), and then performed an analysis of deviance on the results (Hastie and Pregibon 1992), first adding the APOL1 SNP, and then the MYH9 SNP, and performing a chi-square test for the null hypothesis that the MYH9 SNP does not add to the ability to explain ESKD status.

[0203] Analysis of deviance of the combined logistic regression indicates that LD with APOL1 SNP rs73885319 accounted for much or all the statistical association previously attributed to the leading MYH9 variants with ESKD. In this regard, the present inventors also examined two non-coding variants in the APOL1 region which are in high LD with the APOL1 missense mutations, and as expected, both showed significant disease risk association (FIG. 2 and Table 2, below).

[0204] Three major modes of association (recessive, additive, dominant) were tested through definition of appropriate dummy variables in the regression. In addition to this combined analysis, the regression analysis was performed in each cohort separately, and the resulting p-values were combined using Fisher's meta-analysis. Results are shown in Table 2 below.

TABLE-US-00002 TABLE 2 Association of the examined SNPs in the MALD peak with non-diabetic ESKD in African and Hispanic Americans YRI CEU Chr22 risk risk Hispanic American rs number Location Gene Type Alleles freq. freq. Mode OR lower rs73885319 36661906 APOL1 exon 5 A/G 0.457 0 Recessive 15.48 3.99 S342G Additive 3.59 2.21 missense Dominant 3.47 1.95 rs60910145 36662034 APOL1 exon 5 T/G 0.449 0 Recessive 12.80 3.28 1384M Additive 3.54 2.17 missense Dominant 3.56 2.00 rs60295735 36667154 Intergenic Intergenic G/A 0.432 0 Recessive 12.79 3.28 (APOL1- Additive 3.43 2.10 MYH9) Dominant 3.32 1.87 rs9622363 36656555 APOL1 intronic A/G 0.711 0 Recessive 5.11 2.36 Additive 2.80 1.79 Dominant 2.03 1.15 rs56767103 36902259 FOXRED2 exon 1 G/A 0.177 0 Recessive Inf 0.00 R71C Additive 2.75 1.40 missense Dominant 2.69 1.33 rs11089781 36556768 APOL3 exon 1 G/A 0.305 0 Recessive 2.30 0.42 Q58X Additive 2.57 1.55 nonsense Dominant 2.87 1.66 rs4821480 36695247 MYH9 intron23 T/G 0.763 0.058 Recessive 3.37 1.56 E-1 Additive 1.67 1.06 designation Dominant 1.14 0.66 rs5750250 36708483 MYH9 intron31 A/G 0.661 0.058 Recessive 3.82 1.67 S-1 Additive 1.50 0.96 designation Dominant 1.02 0.60 rs11912763 36684722 MYH9 intron33 G/A 0.48 0 Recessive 4.31 1.21 F-1 Additive 3.02 1.80 designation Dominant 3.64 1.97 Association of the examined SNPs in the MALD peak with non-diabetic ESKD in African and Hispanic Americans Meta- Combined Hispanic American African American analysis analysis rs number upper p-value OR lower upper p-value p-value OR p-value rs73885319 60.00 8.8E-04 4.86 2.35 10.06 3.5E-04 4.9E-06 6.70 2.7E-06 5.83 1.5E-05 1.90 1.46 2.48 5.9E-05 2.0E-08 2.22 2.4E-08 6.16 3.7E-04 1.89 1.34 2.67 2.2E-03 1.2E-05 2.23 8.1E-06 rs60910145 49.94 2.1E-03 11.13 5.05 2.29 7.4E-04 2.2E-05 6.74 9.9E-06 5.78 2.3E-05 1.94 1.48 2.56 7.3E-05 3.5E-08 2.28 3.0E-08 6.33 3.0E-04 1.95 1.37 2.76 1.8E-03 8.1E-06 2.32 4.8E-06 rs60295735 49.92 2.1E-03 2.99 1.56 5.73 5.8E-03 1.5E-04 4.27 1.2E-04 5.60 3.6E-05 1.76 1.35 2.31 5.6E-04 3.8E-07 2.10 4.6E-07 5.91 5.9E-04 1.87 1.31 2.66 3.5E-03 2.9E-05 2.22 1.5E-05 rs9622363 11.06 5.2E-04 3.68 2.46 5.52 1.2E-07 1.5E-09 3.92 6.3E-10 4.53 4.2E-04 2.34 1.79 3.06 1.8E-07 1.8E-09 2.49 2.6E-10 3.60 4.1E-02 2.26 1.41 3.61 4.3E-03 1.7E-03 2.20 3.2E-04 rs56767103 Inf 9.9E-01 1.02 0.33 3.17 9.8E-01 1.0E+00 1.33 6.8E-01 5.41 1.4E-02 1.23 0.84 1.82 3.7E-01 3.3E-02 1.52 5.2E-02 5.46 2.1E-02 1.33 0.85 2.10 3.0E-01 3.9E-02 1.66 3.6E-02 rs11089781 12.44 4.2E-01 13.06 2.43 70.14 1.2E-02 3.1E-02 6.62 2.8E-03 4.24 2.0E-03 2.01 1.45 2.78 4.2E-04 1.3E-05 2.18 3.8E-06 4.96 1.5E-03 1.93 1.32 2.82 4.3E-03 8.2E-05 2.22 3.2E-05 rs4821480 7.29 9.6E-03 1.82 1.24 2.69 1.1E-02 1.1E-03 2.05 6.6E-04 2.63 6.4E-02 1.64 1.223 2.19 4.4E-03 2.6E-03 1.65 6.5E-04 1.99 6.9E-01 1.92 1.10 3.36 5.6E-02 1.6E-01 1.47 1.0E-01 rs5750250 8.73 7.5E-03 2.29 1.54 3.43 6.7E-01 6.7E-05 2.48 4.3E-05 2.34 1.4E-01 1.92 1.45 2.54 1.3E-04 2.1E-04 1.78 6.7E-05 1.74 9.5E-01 2.28 1.37 3.81 7.8E-03 4.4E-02 1.55 5.0E-02 rs11912763 15.34 5.9E-02 1.95 0.95 3.99 1.3E-01 4.4E-02 2.38 2.9E-02 5.08 4.7E-04 1.67 1.23 2.27 5.8E-03 3.8E-05 1.96 4.1E-05 6.75 5.7E-04 1.90 1.29 2.79 6.2E-03 4.8E-05 2.28 4.2E-05 Location on Chromosome 22 in NCBI37.1/hg19 assembly. Provided are the results of the association studies performed on SNPs in the APOL1, MYH9, FOXRED2 and APOL3 genes. The Table also demonstrates similarity between the p values obtained from combining the p values from the separate cohort based analyses (African American, Hispanic American) in a meta analysis, and the p values obtained directly from a combined analysis of both cohorts including an indicator for cohort. This demonstrates the robustness of the statistical conclusions to variations in methodology.

[0205] Residual associations of MYH9 SNPs beyond LD with APOL1 missense mutations--As described above, the present inventors performed analysis of deviance tests of the hypothesis that the APOL1 missense mutation rs73885319 can account for the statistical association between MYH9 SNPs and ESKD status. Analysis of deviance shows that the associations of the E-1 and F-1 haplotype SNPs are satisfactorily explained by this mutation (p>0.5 for F-1, p>0.1 for E-1). For the S-1 SNP rs5750250, the present inventors obtained a borderline p-value of 0.01, indicating the possibility that the S-1 SNP carries an association signal beyond its LD with rs73885319.

Example 2

Distribution and Frequencies of the APOL1 Risk Allele in African Populations

[0206] HIV-associated nephropathy (HIVAN) has been considered as the most prominent non-diabetic form of kidney disease within what has been termed the MYH9-associated nephropathies (Kopp et al. 2008). Behar et al. 2006, reported absence of HIVAN in HIV infected Ethiopian.

[0207] The APOL1 S342G missense mutation is absent in certain African populations--To test whether genomic factors are associated with the absence of HIVAN in Ethiopian population, the present inventors have examined the allele frequencies of the APOL1 missense mutations, as well as the leading MYH9 risk variants in 676 individuals from 12 African populations, including 304 Ethiopians and the results are presented in Table 3, hereinbelow.

TABLE-US-00003 TABLE 3 Distribution of the rs73885319 (S342G) risk allele among various African populations rs73885319 Sample risk allele Country Population Size Latitude Longitude frequency Ghana Bulsa 22 10.7 -1.3 11% Ghana Asante 35 5.8 -2.8 41% Cameroon Somie 65 6.45 11.45 16% Congo COG 55 -4.25 15.28 11% Malawi MWI 50 -13.95 33.7 12% Mozambique Sena 51 -17.45 35 12% Sudan Kordofan 30 13.08 30.35 0% Cameroon Far-North- 64 12.5 14.5 1% CMR/Chad Ethiopia Afar 76 12 41.5 0% Ethiopia Amhara 76 11.5 38.5 0% Ethiopia Oromo 76 9 38.7 0% Ethiopia Maale 76 7.6 37.2 0% Table 3: Frequency of the risk allele for rs73885319 (S342G) in APOL1 among the African populations sample set (total n = 676), according to the location of each population. The samples analyzed and presented in this Table form part of the collection of DNA maintained by The Centre for Genetic Anthropology at University College London. Buccal cells were collected with informed consent and institutional ethics approval from anonymous donors unrelated at the paternal grandfather level, classified by self declared ethnic identity.

[0208] A reduced frequency of the APOL1 missense mutations (Table 3), and of the MYH9 risk variants is shown in North-East Africa populations (e.g., Sudan, Chad and Ethiopia), with the complete absence of the APOL1 missense mutations (as well as the F-1 risk variant) in Ethiopia (FIGS. 3A-C).

[0209] Analysis and Discussion

[0210] The present inventors have uncovered that the two missense mutations S342G and I384M in the APOL1 protein can explain the increased risk for kidney disease in African Americans. The kidney diseases include: 1) Primary non-monogenic focal segmental glomerulosclerosis (FSGS), 2) Hypertension-attributed kidney disease (hypertensive nephrosclerosis), and 3) HW-associated nephropathy (HIVAN).

[0211] The associations of these diseases with APOL1 mutations have an odds-ratio (OR) between 7-10, the highest OR ever reported for complex disease. These allelic variants are common in African continental heritage populations in the United States, such as the African and Hispanic-American populations, as well as West African immigrant communities in New York City. It is estimated that ˜13% of the African American population have a homozygous or compound heterozygous state of the APOL1 risk alleles that dramatically increase their risk for CKD and attendant cardiovascular and cerebrovascular disease [Tzur S, et al. Hum Genet 2010 128:345-50; Rosset S, et al. Nat Rev Nephrol. May 3, 2011. [Epub ahead of print]; and Genovese G, et al., Science 2010; 329:841-5].

[0212] Functional role of the APOL1 S342G missense mutation in Trypanosoma brucei rhodesiense infection--The APOL1 gene encodes apolipoprotein L-1, whose known activities include powerful trypanosomolysis (Lecordier et al. 2009). Trypanosoma brucei rhodesiense transmitted by tsetse flies prevalent in central and western Africa is a cause of human African trypanosomiasis, and shows resistance to this trypanosomolytic effect, by virtue of expressing serum resistance-associated protein (SRA), which interacts with the C-terminal domain of apolipoprotein L-1 (Lecordier et al. 2009). The S342G variant is predicted to modify the binding site of the C-terminal domain of the APOL1 gene product (FIGS. 4A-C).

[0213] With respect to kidney disease risk, APOL1 is also prominently involved in authophagic pathways (Zhaorigetu et al. 2008), and a recent study has provided compelling evidence for the role of well preserved authophagy in the integrity of renal glomerular podocytes (Hartleben et al. 2010). Moreover, apolipoproteins have also been identified as circulating inhibitors of glomerular proteinuria (Candiano et al. 2001).

[0214] Functional studies, combined with clinical and genetic evidence--point to a "gain-of-injury" model, as opposed to a "loss-of-function" model for the mechanism of APOL1 mediated risk. Moreover, preliminary results indicate that the mechanistic distinction between the risk (African risk variant states) and non-risk (non-African protective states) of the gene, relate to access to its target of injury.

[0215] The APOL1 genetic markers can be useful in the clinical setting. For example, the threshold for introducing antiretroviral therapy in patients with HIV does not currently take into account the patient's risk of HW-related kidney disease. Such risk could potentially be accounted for by a management algorithm that includes the effects of APOL1 genotype. So too, determining the etiology of kidney dysfunction in a patient with AIDS who is receiving potentially nephrotoxic antiretroviral therapy may be assisted by APOL1 genotyping. For example, the clinician might decide to press on with therapy to alleviate the kidney injury in a patient carrying APOL1 risk alleles, or might choose not to implement such therapy in a patient who does not carry APOL1 risk alleles.

[0216] With regard to transplantation, APOL1 genotype may have important considerations for both living kidney donors and recipients. African American kidney donors have poorer long-term renal function than European American donors. If this observation turns out to be restricted to the subgroup of donors who are in the APOL1 risk category, APOL1 genotyping may well be added to the battery of tests undertaken prior to living kidney donation, for the benefit of both donor and recipient.

[0217] New insights may also be forthcoming with regard to the recurrence of focal segmental glomerulosclerosis following kidney transplantation. One these studies, implicated apolipoproteins among the circulating factors that govern recurrent proteinuria following transplantation in focal segmental glomerulosclerosis. Thus advance knowledge of genotype might guide preparatory therapy (e.g. plasmapheresis) for this possible outcome, or suggest new preventive or therapeutic approached.

[0218] Current guidelines for the management of hypertension suggest that African Americans as a group do not enjoy renal benefit from antihypertensive therapy, and moreover the recommendations for use of specific antihypertensive drug categories in African American patients are influenced by which African subpopulation they belong to. APOL1 genotyping may improve the individualization of therapy in this very large group of patients, such that those without APOL1 risk alleles might be expected to enjoy a substantial renal benefit from antihypertensive regimens, similar to those that have proven effective in patients of European ancestry.

[0219] Indeed, APOL1 seems to offer a particularly enlightening example of a gene with DNA sequence variants that are common in the population, and which confer an advantage under one set of environmental conditions (trypanosomiasis epidemics) but may have deleterious effects in the face of a different set of environmental conditions (such as HIV infection and increased life expectancy). This interplay is part of the emerging discipline of evolutionary medicine and validates in the clinical setting the maxim of the eminent geneticist Theodosius Dobzhansky, "Nothing in biology makes sense except in the light of evolution".

[0220] Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims.

[0221] All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention. To the extent that section headings are used, they should not be construed as necessarily limiting.

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Sequence CWU 1

101398PRTHomo sapiensmisc_feature(342)..(342)Can be S or G 1Met Glu Gly Ala Ala Leu Leu Arg Val Ser Val Leu Cys Ile Trp Met1 5 10 15Ser Ala Leu Phe Leu Gly Val Gly Val Arg Ala Glu Glu Ala Gly Ala 20 25 30Arg Val Gln Gln Asn Val Pro Ser Gly Thr Asp Thr Gly Asp Pro Gln 35 40 45Ser Lys Pro Leu Gly Asp Trp Ala Ala Gly Thr Met Asp Pro Glu Ser 50 55 60Ser Ile Phe Ile Glu Asp Ala Ile Lys Tyr Phe Lys Glu Lys Val Ser65 70 75 80Thr Gln Asn Leu Leu Leu Leu Leu Thr Asp Asn Glu Ala Trp Asn Gly 85 90 95Phe Val Ala Ala Ala Glu Leu Pro Arg Asn Glu Ala Asp Glu Leu Arg 100 105 110Lys Ala Leu Asp Asn Leu Ala Arg Gln Met Ile Met Lys Asp Lys Asn 115 120 125Trp His Asp Lys Gly Gln Gln Tyr Arg Asn Trp Phe Leu Lys Glu Phe 130 135 140Pro Arg Leu Lys Ser Glu Leu Glu Asp Asn Ile Arg Arg Leu Arg Ala145 150 155 160Leu Ala Asp Gly Val Gln Lys Val His Lys Gly Thr Thr Ile Ala Asn 165 170 175Val Val Ser Gly Ser Leu Ser Ile Ser Ser Gly Ile Leu Thr Leu Val 180 185 190Gly Met Gly Leu Ala Pro Phe Thr Glu Gly Gly Ser Leu Val Leu Leu 195 200 205Glu Pro Gly Met Glu Leu Gly Ile Thr Ala Ala Leu Thr Gly Ile Thr 210 215 220Ser Ser Thr Met Asp Tyr Gly Lys Lys Trp Trp Thr Gln Ala Gln Ala225 230 235 240His Asp Leu Val Ile Lys Ser Leu Asp Lys Leu Lys Glu Val Arg Glu 245 250 255Phe Leu Gly Glu Asn Ile Ser Asn Phe Leu Ser Leu Ala Gly Asn Thr 260 265 270Tyr Gln Leu Thr Arg Gly Ile Gly Lys Asp Ile Arg Ala Leu Arg Arg 275 280 285Ala Arg Ala Asn Leu Gln Ser Val Pro His Ala Ser Ala Ser Arg Pro 290 295 300Arg Val Thr Glu Pro Ile Ser Ala Glu Ser Gly Glu Gln Val Glu Arg305 310 315 320Val Asn Glu Pro Ser Ile Leu Glu Met Ser Arg Gly Val Lys Leu Thr 325 330 335Asp Val Ala Pro Val Xaa Phe Phe Leu Val Leu Asp Val Val Tyr Leu 340 345 350Val Tyr Glu Ser Lys His Leu His Glu Gly Ala Lys Ser Glu Thr Ala 355 360 365Glu Glu Leu Lys Lys Val Ala Gln Glu Leu Glu Glu Lys Leu Asn Xaa 370 375 380Leu Asn Asn Asn Tyr Lys Ile Leu Gln Ala Asp Gln Glu Leu385 390 39522924DNAHomo sapiensmisc_feature(1231)..(1231)can be A or G 2gactttcact ttccctttcg aattcctcgg tatatcttgg ggactggagg acctgtctgg 60ttattataca gacgcataac tggaggtggg atccacacag ctcagaacag ctggatcttg 120ctcagtctct gccaggggaa gattccttgg aggagcacac tgtctcaacc cctcttttcc 180tgctcaagga ggaggccctg cagcgacatg gagggagctg ctttgctgag agtctctgtc 240ctctgcatct ggatgagtgc acttttcctt ggtgtgggag tgagggcaga ggaagctgga 300gcgagggtgc aacaaaacgt tccaagtggg acagatactg gagatcctca aagtaagccc 360ctcggtgact gggctgctgg caccatggac ccagagagca gtatctttat tgaggatgcc 420attaagtatt tcaaggaaaa agtgagcaca cagaatctgc tactcctgct gactgataat 480gaggcctgga acggattcgt ggctgctgct gaactgccca ggaatgaggc agatgagctc 540cgtaaagctc tggacaacct tgcaagacaa atgatcatga aagacaaaaa ctggcacgat 600aaaggccagc agtacagaaa ctggtttctg aaagagtttc ctcggttgaa aagtgagctt 660gaggataaca taagaaggct ccgtgccctt gcagatgggg ttcagaaggt ccacaaaggc 720accaccatcg ccaatgtggt gtctggctct ctcagcattt cctctggcat cctgaccctc 780gtcggcatgg gtctggcacc cttcacagag ggaggcagcc ttgtactctt ggaacctggg 840atggagttgg gaatcacagc cgctttgacc gggattacca gcagtaccat ggactacgga 900aagaagtggt ggacacaagc ccaagcccac gacctggtca tcaaaagcct tgacaaattg 960aaggaggtga gggagttttt gggtgagaac atatccaact ttctttcctt agctggcaat 1020acttaccaac tcacacgagg cattgggaag gacatccgtg ccctcagacg agccagagcc 1080aatcttcagt cagtaccgca tgcctcagcc tcacgccccc gggtcactga gccaatctca 1140gctgaaagcg gtgaacaggt ggagagggtt aatgaaccca gcatcctgga aatgagcaga 1200ggagtcaagc tcacggatgt ggcccctgta ngcttctttc ttgtgctgga tgtagtctac 1260ctcgtgtacg aatcaaagca cttacatgag ggggcaaagt cagagacagc tgaggagctg 1320aagaaggtgg ctcaggagct ggaggagaag ctaaacatnc tcaacaataa ttataagatt 1380ctgcaggcgg accaagaact gtgaccacag ggcagggcag ccaccaggag agatatgcct 1440ggcaggggcc aggacaaaat gcaaactttt ttttttttct gagacagagt cttgctctgt 1500cgccaagttg gagtgcaatg gtgcgatctc agctcactgc aagctctgcc tcccgtgttc 1560aagcgattct cctgccttgg cctcccaagt agctgggact acaggcgcct accaccatgc 1620ccagctaatt tttgtatttt taatagagat ggggtttcac catgttggcc aggatggtct 1680cgatctcctg acctcttgat ctgcccacct tggcctccca aagtgctggg attacaggcg 1740tgagccatcg cttttgaccc aaatgcaaac attttattag ggggataaag agggtgaggt 1800aaagtttatg gaactgagtg ttagggactt tggcatttcc atagctgagc acagcagggg 1860aggggttaat gcagatggca gtgcagcaag gagaaggcag gaacattgga gcctgcaata 1920agggaaaaat gggaactgga gagtgtgggg aatgggaaga agcagtttac tttagactaa 1980agaatatatt ggggggccgg gtgtagtggc tcatgcctgt aatccgagca ctttgggagg 2040ccaaggcggg cggatcacga ggtcaggaga tcgagaccat cctggctaac acagtgaaac 2100cccgtctcta ctaaaaatac aaaaaattag ccgggcatgg tggcgggcgc ctgtagttcc 2160agctaactgg gcggctgagg caggagaatg gcgtgaacct gggaggtgga gcttgcagtg 2220agccgagata tcgccactgc actccagcct gggtgacaga gcgagactcc atctcaaaaa 2280aaaaaaaaaa aagaatatat tgacggaaga atagagagga ggcttgaagg aaccagcaat 2340gagaaggcca ggaaaagaaa gagctgaaaa tggagaaagc ccaagagtta gaacagttgg 2400atacaggaga agaaacagcg gctccactac agacccagcc ccaggttcaa tgtcctccga 2460agaatgaagt ctttccctgg tgatggtccc ctgccctgtc tttccagcat ccactctccc 2520ttgtcctcct gggggcanat ctcagtcagg cagcggcttc ctgatgatgg tcattggggt 2580ggttgtcatg tgatgggtcc cctccaggtt actaaagggt gcatgtcccc tgcttgaaca 2640ctgaagggca ggtggtgggc catggccatg gtccccagct gaggagcagg tgtccctgag 2700aacccaaact tcccagagag tatgtgagaa ccaaccaatg aaaacagtcc catcgctctt 2760acccggtaag taaacagtca gaaaattagc atgaaagcag tttagcattg ggaggaagct 2820cagatctcta gagctgtctt gtcgccgccc aggattgacc tgtgtgtaag tcccaataaa 2880ctcacctact catcaagctg gaaaaaaaaa aaaaaaaaaa aaaa 2924351060DNAHomo sapiensmisc_feature(34556)..(34556)can be A or G 3tcctggcatc tcctttcatt tttcctttct tcccaaatta acctctttcc aacacagcac 60ttcaagttcc cctggaactt catcggtcca tcggtgtccc ctggtctgga agagcaccga 120ccacttgcca aggcccccac cactctgctg ccatcacaac caccatcacc accattacga 180gaaaaacttg agactgatgg cccccaaagc ttagaaggag ctgagagacc aaagaatgac 240tcgaacaagt ccagcttggt gagtaggtga gtttattggg acttacacac aggtcaatcc 300tgggcagcga caggacagct ctagagatct gtgcttcctc ccaatgctaa actgctttca 360tgctaatctt ctgactgttt acttaccggc taagagcgat gggactgttt tcattggttg 420gttctcagat actctctggg aagtttgggt tctcagggac acctgctcct cagctgggga 480ttgtggccat ggcctaccac ctgcctctca gggttcaagc aggggacatg caccctttag 540taacctggag gggacccgtc acatgacaac caccccaacc accatcatga agaagccact 600ggctgactgt gatacacccc cagaaggaca agggagagtg gatgctggaa agacagagcg 660agagaccatc accagggaaa gactttattc ttggaaggac atcaaacctg ggggggggtc 720ggtagtggag ctgctgtttc ttctcctgta tccaacagtt ctaactctgg ttttctccat 780tttcagctct ttcttttcct ggccttctca ttgctggttc ctgcaagctc cccctctatt 840cttcgcccaa tatattcttt agtccaaagt aaactacttc ttcccattcc ccacactctc 900cagtcctctc tcctccctta ttgcaggctc cagtgttcct gccttctcct tggtgcactt 960gccatctgca ttaacccctc ccttgctgtg ctcagctaca caaatgccaa agtcactaac 1020actcagttcc ataagcttta ccttgccctc cttatccccc taataaaatg tctgcatttt 1080ggccaggcgc ggtggctcac gcctgtaatc ccagcacttt gggaggccga ggtgggcaga 1140tcacgaggtc aggagatgga gaccatcgtg gctaacacag tgaaaccccg tctccagtga 1200aaatacaaaa aaattagccg ggcgtggtgg caggtgcctg tagtcccagc tactcgggag 1260actgaggccg gagaatggtg tgaacccggg aggcggagtt tgcagtgagc cgagattgag 1320ccactgcact ccatcctggg cgatagagcg agactccatc tcaaaaaaaa aaaaaaaaaa 1380aaaaaaaagt ctgcattttg tcctggcctg tgcccggcat ttctgccctg gtggctgcac 1440tgctctgggg tcattggtct tggcctggct gcagcatctc atggatcttg gtgagaaagt 1500tgagcttccc ctccagctcc tgagcccgct tcttcagctc ctcagctgac tctgactttg 1560ccccctcaag caagtgcttt gactcatatg caaggctgac cacatccagc agaagcaaga 1620tgcctccagt ggctgcaccc acgatcatgg ttcctctgct cattgcctgg gcggggcctt 1680caacaaccct ctcaacctgt tcaccgcctt cagctgagat tcgcccaatg atatgcgggg 1740gtggggcata cgctcctaac tgagggttgg ctctggctcg tctgatggca cggatgttcc 1800tcccaatccc ttgtgtgact tggtaccaat tgtcaactaa ggtaagaaca ttgggtgtgt 1860tcccacccac aaactccttc atcacctttg ctacattggt gccgctttgg tccaagttgc 1920gggcttgggc tcgtgcccgc aatttgttta ctagttctac cacactgcag gtaatcccag 1980ccacagcagc tgctgctccc agacccatgc cagtgtccaa gagcacaaaa ctgattcctt 2040ctgtgaaggg tgccagaccc aggccgagga gggtcaggat gccagaggta gtgccaacag 2100agttggacac cacattggca atggtggtgc ctctgtggac ctgctcaacc tcctctgcaa 2160gggcacggag cttccttatg tgatcctcaa gctccctttt caaccgagga aactctttca 2220aaaaccactg cctgtgctgc tggtctttat cgtggcggtt tttgtccttc atgaccatgt 2280gacttgcaag cttgttcaga gctttacgga gctcatctgc ctcatccctg cacaaggaaa 2340ggttaaagga ttaagaaatg cagtttccct atctgtgaaa tgagctccat gcgatctcta 2400tcctgtgtaa attgcagagc tttcactatc aatcaaatag aaacaaattt tacaaatgga 2460attaattatc tttcaaactc aaacacattt tgttcatcat agatattcct cagtacttat 2520tccatatgga aataaatatc ttaaaggcac ctcagatgct ctttcatggt aggtgtttga 2580taaagatgcc tcctcactca agggcaggtc aacaccgtga ctgccaaagt gtttggagag 2640ggaaaactct gcagatgaac aaagagcagt gagagtgaga caaagagacc ttattaccag 2700gatggcagga aagtgaagca tgaactttac ccaaagagag gccttccctt tgtcctcagc 2760tcctgggaag tgatctccag gcccctggaa tgtcctgcct ggtaggaaca tctttctttg 2820cctggtgatt tggccacggg acagtatagc gatgtgatgg atgatagggt ttggggctat 2880ttggtgtctt tcctgacttc cagaggactt ggggactaaa ggtgtgagat ctcagggaag 2940ggctggagac tctagccatg agggcagctt gtgatccagc cccagcagat actctggaca 3000ctaaggcatg ggttgagaaa gaaggacttt ctccttgacc aactccagct gggctcttca 3060gagcttcttc tccactaggc gccgaccttg gccttccaca ctcacccact gctttctgga 3120cttgcaccac cttggctcag caagaatctc cccaaatcag tttagggagg gtcctccccg 3180cttgctgtct gagcaccgtt tgttatctga tcatgctcct cacccccacc actggtggtt 3240gagggtctga cctgcctttg gcgagaatcc tgttaggcca gtttagcagg aaccccccac 3300tctggcgtct cctgtcagtc ctgttccatc tcccgccccc accctggtgt tggctgtgac 3360tccccctctg tctttactat atttggagct gggctcagtc tccctcccct gtaacaacaa 3420tcctgaataa aggcttcatt tctggtttaa tgtgattcac aggaattttt ccttaactgg 3480gtgagcttcc ctggttggca acaccgcatg tgttttgtcc cacattcaca caggagaaca 3540cagcctcctg aggacaatga agattcacac ctgaaatcct cccagactct gccctgtgtg 3600tctcttcctt aggctgattt taatctgtgt tctttccctg tgataaacca caatcgtgca 3660atagcagttt tcagtgagtt acgtgagtcc ttctagtgaa ttataaaatc taaggatgat 3720tttaggaatc cccatagatt tgcaggtggt gtcaaaggta agggtgccct cagacattgc 3780agtctggcta tctctgagta ctttgaattc aaacaaaaac aaaacctcag aaagacagga 3840gatcactttg cctggcatct gctcccttcc aatgcctcat gccctttcac ctggctgaag 3900gctactgggt gcggccactg ccccagctga ctggagtggg agatctggct attcattctg 3960gctccacatg gacgctccag ccaccttact gcctcctgac ctaccacctg cacccccaac 4020cttccaggtc tcactcgcag gtgtcaccag cctaactgat gccttagcag tgacagcttc 4080acctgtgtgc acagcaaggc catgtgcaat tttatggaac cactagaaga ctcaagacac 4140tttcagaacc atctatataa attgctaatg ctgaaaagac ctgaatttgg tcaagatggt 4200agaggaagtg ttttcctcct cggttgggac tttgtgagtc tgctcagtac ccctgaaatt 4260acacaaattg gcagcaactc attctacttt ggaaatggtc actaaggcat gccatggtaa 4320ggagcttctc tgtgtagaag agaagaaggt ctgaaagggt agtccagaac tcaccagttc 4380caaggcatgg ggtgagagac acaggctacc atgaccctgt atgcccatga gtgttgggat 4440catccagaca gggaagaaat atccctctcc cactcacatg tcctctgcaa gttcatgacc 4500tccttaagtt tcaagccctt ggtgcctctc tttccacacc ctagtcccag ccctggtgcc 4560ccagccttcc tgcttgtcct accaaaccaa ggctgactct tactccatcc tgactccagg 4620ctctgacact ggtcccggtc tctctgggcc tttgagcagg atcttagtcc ttggttcccc 4680acctttgacc tggagttgcc tctaaggcct tcaccacact cctatgacat tgaattgcta 4740ttcctattgg acagaagaca gttccaagtc tccatgacat aagcccagag cccaggaact 4800aggcctctca ggatcctgga ccagcagaag ggtcctgctg tgtttgtgga attcttcaga 4860tgagaaaaaa ggccccagcc agcatcccca ggaacacata ttgtttaggt taggattttt 4920ctgacttttc ccaaaggaag tcctgctggg ctcccatctt caagaagaag atccttaacc 4980ctggtctctt tccaccaagc ttgtaagatg ttaacgttaa ctgtgcacct actatgtgtc 5040agtcattatg ctaagcactt tacatgcatg atctcatttt tctcataata aaactccatt 5100gatgaagaaa ggctgaaagt gagaaagtaa ctggcaaagt tcccatcacc agcagatggc 5160agaaatgacc ctgttcctgt gggcttccta tcccctcagc ctgaggctac tcactgccag 5220cgaaggacat ggaggaaata ttcctcctgg agtgccgaga aggtcatcct caagcccagc 5280agagggggct gcctggagga ggtgtgcctg tcagggacaa ccagcccagg ggagatctga 5340gtggcatcgc tggggcgccc catggagtta accccatgga gcttacctgg gcagttcagc 5400agcagccacg aatccattcc aggcttcatc atcagtcagc agttgtagca gattctctct 5460gctcacttgg tcctggaaat acttaaggta atcctcaata aagatactgc tctctagttg 5520gaaagaagaa aggataaggt tggaggatag tgtaggggag cataacagcc attgcacatt 5580aggtggttac atgttaattt ttcctggaca actgtgatgt gggacatgtt tgatggagtc 5640atcagtgcta tagagggatt gtgtgccccc aaaattcata tgctgaagcc ctaaactcga 5700gtgactatat ttgaagattg ggcctttaag gaagcaatta agactgaatg agatcacaag 5760ggtagggctc taatcctact agagggctag tgtcctattg taagaagaga aagagaaaca 5820ataaggccag gtaagcacac agcgcaaagg cagctgccgc aagccagcaa gagagtcctc 5880ccaaggctcc aaccccttaa tttaataaac catcaaagac agaaacccca aaccccactg 5940ggcccaactg gctcttctga gtccacctgc acttccatcc ctgagcctgt gcttctgctt 6000tgcagctgat ttgttttttc tttgactcaa attttttctc tcagtggagt caaaaacctg 6060gacaaggcta aggtctggtc tctcctggat tcggagaact tcctaaaccc accagcacca 6120atgtgaccag gaattttcca aaaaggtaaa tcaaaacagg cagttttgta actgcaacca 6180atcaaataat gtccttattg cagtttcata tttactcgat aaatacttgt ctctgacact 6240ttttcatcat aacatgaagc ctcttccagt ttggttttct caattcatga attccttctt 6300attcaaataa atgttactgt gcctcagatt tttctttgac aaggggtatc tgagatcatg 6360ggaatgaggc cctgcctgag gcagtcatcc ctggtcagca ggtgcttgtg atgggcagtg 6420cagggcgggt gccctaacac agatgagggg actgggtggc ttccacctgg aatcaacagg 6480ggatagatag aggagataga ggggatgcaa actaattctt agggaggccc tactgtgtgg 6540caggctttgg ccaggccagg tacccttata atatttaatc ttcgtgacaa catggggaaa 6600tattattttc atggtacacg agaggggagg taaggagctc caggtcacac agaagggact 6660tggaaaaggc cagaccgggg tccatttaag ttggaagctg ggtcaagcat gatacattcc 6720catagggcca ctcagaacag aggggctggt gcagggcaag agctggaggg aggggaccgg 6780cctgtgctgg aaaaaaccct gggtcagcag ggagaagagc ggtagataag agatcagggc 6840tgcaggtcaa cctcctctcc cacccctccc ctcctcctgg accctgctct tcccccactc 6900ccctctcttg cttgttccac ttcctcatgg ctgtcctgcc ccacttgagt catctgctgg 6960gtgacagggt agggaggaag tgggcacctg ggccgtgtca ccccgaggag aggtcaggat 7020gcagatgacc cccagacccc tgggtcgggg gactccacgt gacctcttct gctgctcggg 7080gcagactcat tggcctccta gtccatctgg gttcttctgg ggctcactca gctgtggagg 7140tgccaccctc cattctaggt gcgagtagga actagccagg aaagaggaag cgagcctacc 7200tgggttcatg gtgccagcgg ctgggttacc gaggggcttt ccttggagct ctccagtcac 7260tgtccagact ggaaggtttt ccttaaccct tgagaacgag aaaacaaatt gtgggatcga 7320aggtgagcct cctgtgtaca gagggaggct ggaggggctg ggtctttgca gatccctctg 7380tggtagcagc aaatgtccag agtgtttatc tcctggggcc ctgccagcta gtatttacag 7440aaactcacct cgttccagct tcctcttccc tcactctcac accaaggcag ggtcctcttg 7500tcctgtaggg gtatgagaag aagataatca gaggaggggc agccatctga tcattacaga 7560aactacagag tctatacaca ggaatagaga tgggagggaa cattctgaca atgacctggg 7620cctgggaaca tgtatgataa ctagttgatg atagccagtg tgtattgtgt gtctgtgatg 7680tgcatggcct ctgacatgta tctcattcga tgatcacaca caggacagga gatgggtacc 7740actttcccat ttgaacacag aggaatccac aaaagttagg gaacttatgg gtgttttcac 7800aatagtgcta gagccaggac ttctgcttca atcccatgtc ttcaattact gtgctctact 7860cccttaaata tacaatattg agtcatgtat acacgctcat ggtaaatgac tcctcattgc 7920aaatccctgt ctcacactct gtgctcaact cttcgtcttg gtgaactcac tggtgctgca 7980gtggacagcc tgtgtccccg ttgcttctct aagattcttt gtcccacaaa gacctggatc 8040ctgctagatg ccggcccagc ccctgctgtg gctgccgagc cctcctgatg cttccccgtc 8100ccctctgctg tcctccccta gctgatggac cttagggtgt ttctaattct tcatataaat 8160tatgctacaa agaatatcct ccctcacgta aaactgctca catttgagat tatttcctta 8220agatactttt aagagtagaa tgactaggtc aaaagctatt aacatctcaa aagtttttat 8280acctagagcc actctgtatg aaaactgtac aaattcacac tcaaactaac aggatatgaa 8340gatgtccatt ctttcagtct tactggctct cagtagtctt ttcttcagga aaacaaaaca 8400aaacaaaaca ttattccttg agacaaggtc tcactcctag tatgcagccc aggctgctgg 8460caaaatcctg gccttagggg atcctcccac cctgccctct aaagtgctgg attacaaaca 8520tgagccacga cacccggcct gaataaatgc tgatctttat atagaggaaa gttcttcaca 8580ttctgctcct gattatctta ccctgggagg tgagggaaaa tagcaaatgt taatcatatt 8640aatcatcttt aggcactgtt ttaagaagac agaagagcat ttatcaacct cccctcctga 8700gatcaaacta cagccatagt caaggcactt acaggtataa tggcacttaa tgttaatgtg 8760ggcaaacatt ggtggatttt gcaccactaa ttgctctaag atgttataaa tagtaactca 8820cagaactctt ccaagaacct aggaagtgtg taccattggt atttccattt tcaggtaaga 8880aaactgaaac agatgttcag tgacttgccc aagctcagaa tctactacgt ggtaaagact 8940gggttcccac ccagacagac ggactcaaga actcacgcac tgcctctgca ccctctgctg 9000ccaatgaaaa tttaaatgag ggcaacagga gatcagagat gccaagagat gttggaaaac 9060agaactggct gaagaaatga caactgaata aagaggggtg aagggagctg tgaaccacag 9120caatgccaag agggcatcca gccaggcaga gtggtctact aggcagagcc tcagagaggg 9180gaggagttca ccaggcccac gtgccatatg ggattcatgc cagccttgag tctacaccag 9240tgaaaaaaat cagagagttc atgactgaag caatatgccc cagaaataat atctttgtat 9300tctgacactt cagtgggttc ccattcaatc accctacagg gaagactgcc agtagacctg 9360ccccccaccc cgttcaatat gaatagatct aggatcagaa attggagaaa ggtgaaagtg 9420gggaaacaga ccaagatgac caaatacaaa aggagtccag aacaaacaag taatttttta 9480aatctcaaac ccatgtcctc agggagatta aaaaatattt tattcataaa cttaaaacaa 9540gatatataga aaagaagaaa

aatcaatgaa acaaacaaaa aaagagattt tctagaaact 9600aaaaggtgat gatcaaataa acaagtctag agagaccatg tgaaagaaag tcacggaaat 9660cctccagaaa ataaaccaaa aagatgacag aggaaaagga gctatatggg gaatagaaaa 9720gttaccaggc acagggtcac agggtgttct aagaaagcta cttgagaatg agccaccggg 9780aggaagaaag ggtgggtggg tgggtgtgtg tgtgtgtgtg tgtgtgtgtg tgtgtatgtg 9840ttgtgcatcc atggagggca ggtggggata accaagaaag aaaaagacat gggatccaga 9900aaacaggaaa atcaacccag agagaaggga atctgaggat cacagtggga catgcagtag 9960gcctacaaaa cgaccagtcc aggatggaat aaaaagggaa tggttctgtg ggaaaaaggg 10020actcaataga atacctcaaa ggattcacag tttgagagaa actgaggaaa tgaagaaggc 10080aagcagtaca agggaggaaa aaaaacaaag gcaattagaa acatcaggaa aaagtaaagc 10140tgtgccacaa aacatgtgca aacatggtgt acaactcagc tccacagtaa atagtattta 10200aaacatcaca aaatgtaaac actcttgatt gatttttaac tttgagaaca gaacagagca 10260tataaatatg agaactaaat atacttgtta ccgattagta caaacttaaa gcacaaaggt 10320agcagttggg atgtgaagca ctgaacgaag gagaaggagg attaatattg tcatctttta 10380aagaggggag tcaagaaata ctaggtaaaa ctgagagtat aagaaagaaa gttgtaagta 10440aattgtttac agctacaaag ttgctaatgg aggacataaa actggtgata caatattagg 10500aaaaggtgga gaggagagat agagggagtg tacaaacaag atgaaaatga ctaataatga 10560cactataagt aataatgata ataccgattc aggcccatcc cagttagggg cggctccaaa 10620atcaccattg ttcttttctc accttgtgtc tctgcgcact ccccggcaca cccacttcca 10680gcagctggtc tttgtttgca gactttattt taacagctca gtggttcccg ggcatcctcc 10740agctcttata caaaagcccc ctcctcaaaa gccactcgcc tccctctttc cacttcccac 10800ctctgtttca gggtcgaggc atccagatat ctgtcttctg gggcccctac gcagcaagac 10860taaaaggggg acccagtcct gggcagcagt tcaccagggg agtatgcaga ggggcatctg 10920gacacttctt gctgtaaggg acggggtgac gggagggggt cttcccttcc ccttcttcct 10980gctttgttca ctctgtgaca ccctaggcca ggggagctgt ctcaacgcca tctcatgagc 11040catgagaacc aggaggacca ggagggagaa gaggagcagg agggcagaca gagctggggc 11100ctcggacctg cccaatactt gtgaggagct gcatccagga tcccatcctc ctgggtcatt 11160gttggcctgg ctcccacctt tgtctggagc ctctgctggg ggttgaggct ggatactgcc 11220cctcaggctt gactaggaca cagtgtgtac tccatgggtg agcctgcagg ctggtcaatt 11280ccggtgtcca actgagcgac ctggaagagg agccctccct cccacctcag ctctgagcca 11340agctctccag atgcagagga cagggactct cagcaaagca tctccctcca agtggttgtg 11400gggcatcctc cttgggcagg gaaagaggag tcgaaatgat ttcctgagaa atcgtcattt 11460tcattttatt tttgagaaac tgtcttgctc tgtcacccag tctggagtgc tttggggcta 11520tcacagcttg ctgtagccta gagcccctgg gctcaagtga tccttctgcc tcagccttcc 11580aggtagctgg gactacaggc acacggcacc atgcaggact aatttgttaa tttttcattt 11640cagagagaca gcatctcctg tgttgcccaa gctgtcttga gctcctagca tcatgtgatt 11700ctcccgcctc tgcctcccac agcactgaat tacaggcctc agccgtggca ctgcaccctt 11760ctgaggaatc ttcagtgaaa agccacggtc aagttcaaac cccatagcag ggcacacagg 11820ccctctgatg ctctggaccc caccttcctc accgctccct gccaccacag tcaccttagg 11880tccaggcacc cactgacgcc ctgcttcggt gcctcctgga gcccatctac tcctcccact 11940cccatcccca gcctcaggcc ttcactcagc tgctccctcg ccctggaatg tcccccccac 12000tgtccccacc atgtgcaagt cacctgtcct cagagaccca cccaaagctg cctggtccat 12060gcggcggccc ccaaccctcc ccaggctccc tgagcactct gctttccaga gggagctcta 12120cctgtatgtg gctctttggg cctctgtctc ccctttagac tctgaacatt caatggggac 12180actgttgtgt tcccagctgc accccctacg actgacctgg atgccctccg ccctccctgg 12240cacagcctgg ctgaaatccc aggtgcagga ggcattactt gaactaaaag caaccagcct 12300ctggatgaca tggcccagct tcagtttcac tttcagttga gaaattgaat ttaatttttc 12360tttctatctt gatgggcatc tctttttggt gaagaacaaa taagaccatg actcatattt 12420cacagaaatt acccccctga tttcatggac ttttggcagc tctatcaagt tttttagagg 12480ggaaaaatct taggctggga ggggaggtga cttgcccaga gtcacacagc tcttggaggg 12540cagaggggag gccaacatct gcccttgtga ctctgatatt gaagcaaaaa tgggtgattt 12600taataatcca acagtgtcca ggtttgattc tgcttctaca aacacagaga cctaagctct 12660cactcctgta gttatactca caattccaca gtgtggcttt tgaatctcat gattgcaaag 12720ctggcatcat gccacaggta ccattctgca atgcgacctt ctcactcccc tgtctcagcc 12780atgtttccca ttagggacac agcacagcct gtttcttctc tatcagctca gaggtctgaa 12840cagagggaca gaggtgaggg ccagagacgt gaagtcctat gatctgcctg ctcagcctcc 12900tgacacggga ccctggcaag tcattcccct cccagggcct cagtttcccc acagggcctg 12960gcacaagtag gtgctcagac tcagggtgag tgagacaacc tctgagttcc ttgtgtctca 13020aaagaaatct gttgttccca ttgggcttca gcagcagcac cctggggcca gcctgggtgt 13080ggcccggcca caaggacatg ccgggctcca ggtcacctcc cctcctccac cttctttgat 13140tccttcaaat ttcccaaaga gatgggcacc cccaacacct acctttcttc tggggtcagc 13200tggccgtgtc tgagggtgtc agaaccagag ctgagcccgg ggagctttgt gaacccatct 13260aagctgtttt ccccacctct ctctacagtt tacccgccca gcaggaggga gggagcaatc 13320agactcaagc ctgggtgcaa atcccggctc tgccactgct ttcctgtctg atctgaacca 13380gctacctaac ctctctgagc ttatctacaa aagctgaatg atccttccct tatagagcta 13440ttgcaagaat aaggacatgg gggtagatca cactatcccc aacttaccaa gggatcttcc 13500tctgacagag actgagcaag atccaactgt tctgagctgt gtggatccca cgtccagctg 13560tgcatctgtg taataaccag acacgtcctc cggcctccca gatataccct ggaattcgaa 13620agggaaagtg aaagtcacaa cttcccagca gctcatgacc aagcacagta aacacgctgc 13680tccccagcac cacctgcagt ccaggcccag cctccttgct gctgcactta gaggagcagc 13740cgcagaccag acatccgggt ccctctcatc caacccacct gcctcacatc ctcaggattc 13800aaggtctgct gtgtcagctg cccatgtctc aggcagtcag aaccagagtt gagcctgggg 13860agttttttga acccatctga gccgcttgcc ccccaacccc cgccccgatc tctgcagttt 13920aagggcacag caggtggggg agagaagtca gactcaagcc tcagtgcaat tccaggctct 13980gcccctgttt tactgtctga tctgaactag ttacctaacc tttctgagct caagaaagac 14040ctgccactga ctgaccgtgg ggctctccag attactcccc gtccttccgt tcccccacat 14100tcctcagatg cctgccttac tcccacacat gccatcagca tcagcacagt cccccacaca 14160tgctgggtgg atgcttattg catatttatt gtaatgcttc tgaggttatg ttttctgtta 14220tgtttttgat atagagtctt gctctgtagc ccaggctgga gagcagtggc acaatcatag 14280ctacttcaag tggcacaatc aagccatcct cccatctcag cttccgagta gctgggatta 14340caggtgcctg ccactacacc cagctaattt tttgtaattt tagtagagat ggggtttcac 14400catcttggcc aggctggtct tgaactcctg acctcaagtg atccacctgc cttggcctcc 14460caaagtgctg ggattacagg tgtgagccac ggcgcccagc ccattgtatc cttcttgtga 14520ctttgtgtct tcatagctta gctcctacta ataaatgaga acatacaata tttggttttc 14580cattcctgag ttacttcact cagaataatg gtgtccaact tcatccagat tgttacggat 14640gccattattc ccttcctttt tacagctgag taatattcca tggcatatac atatataggg 14700gtgtgtgtgt gtgtgtgtgt gtgtgtatat acacacacat tttcttcatc cacttgttgg 14760ctgatgagca tttaggttgg ttccatattt tttcggttgc aaattatgca gctataaaca 14820tgcatgtgcg agtatctttt ttatataata acttttctcc tctgggtaga tacccggtag 14880tgggattact ggatcaaatg gtattctact tttagttttt taaggagttg ccatactgtt 14940ttccatagtg gttgtactag tttacattcc caccaccagt gtaaaagttt tcccttgtca 15000ccatattcac accattttag ctaggctggt cttgaactcc tgacctcaag tgatccacct 15060gctttggcct cccaaagtgc tgggattaca ggtgtgagcc actgcaccct tctattcttc 15120tttgattttt aaattatggc cattcttgca ggagtaaggt ggcaacttat tgcagtttta 15180atttgcattt ctctgataat tagtgacgtt gagcacattt tcatattttt ttggccattt 15240cattttgtat atcttctttt gagaattgtc tattcatgtc ctttgcccac tttttgatgg 15300gattattttt tttttcttgc tgatttgttt gagttccttg tagaaactgg atattagtcc 15360tttgtcaaat gcacagtttg caaatatttt ctcccacttt gagggttgtc tgttttctct 15420gctgattatt tattttgctg tgcagaagct ttttacttta attaggtccc atctctttat 15480ttttgttttc gttgcattta tttttgggtt cttggtcctg aattctttgc ctaagccaat 15540gtctggagga gtttttccga tgttatcttc tagaattttt atggtttcag gttttagatt 15600taagtctttg atccatcttg agttgatttt tgtatgagga tactgtttca ttcttctaca 15660tgtggcttgc caattatcct ggcaccattt gttgaatagg gtgtcctttc cgcactatac 15720gtttttcttt gctttgtcaa agactagtta gctgaaagta tttggcttta tttctgggtt 15780ctctattctg ttcccttgat ctatgtgcct atttttatac cggtaccatt ctgccattat 15840gtaccttttt tttttttttt tttttttttt tttgagatgg agtctctctc tgtcacccaa 15900gctggagtgc agtggtgcga tcttggctcg ctgcaagctc cacctcctgg gttcatgcta 15960ttctcctgcc tcagcctccc gagtagctgg gactacaggc gcccaccacc acacctggct 16020aatttttttt tttttttttt tttgtatttt agtagagatg gggtttcact gtgttagcca 16080ggatggtctc gatctcctga cctcgtgatc tgcctgcctt agcctcccaa ggtgctggga 16140ttacagatgt gagccactgc acccagccct tgtacctttt aagtgaacca tttagcccat 16200tttcattcaa tgttagtatt gagatataaa gtgctgttct attcatcagg caagttgttg 16260cctaaatacc ttattttttt cattgtgtta ttgttttata ggccctaagg cttataaaac 16320aatatgctgt aaggaggttc tattttggtg tatttcgagg ttttgtttca agacttagaa 16380ctccgtttag catttcttgt agtactggct tggtagtggc gaattctttc agcatttgtt 16440tgtctgaaaa agactttatc tctccttcat ttatgaagct tggttttgct ggatacaaaa 16500ttcttgacta acaattattt tgtttaagga ggctaacaac aggactccag tcccttctgg 16560cttgtatggt ttctgctgat aaattagctg ttaatctcat agattttcct ttacaggtta 16620ccttatgctt ttgtctcaca gctcttaaga ttatttcctt cttcttgact ttagataccc 16680tgatgacatg tgcctaggtg aggatcattt tgtgatgaat ttcccagatg ttctttgaac 16740ttcttgtatc tggatatcta gatctctagc aaggccaagg aagttttcct caattattcc 16800ctcaaataag ttttccaaac ttttagattt ctcttcatcc tcagcaacac caattattct 16860taaatttggc catttaacat aatctcaaat ttcttggagg ctttgctcat tttttaaaat 16920tcttttttct ttgtctttgt ctgattgggt taatttgaaa gctgtgtctt caagctctga 16980agttctttct tctacttgtt ctagtctatt gttgaaactt tccagtgcct tttgtatttc 17040tttcagtgtg tctttcattt ccagaagctg tgattgtttt ttctttgtga tatctatttc 17100tctggagaat tttcatccat attctgtatt ttttaaaatt tctttaagtt ggttttcacc 17160ttcctctgct atctccttga atagcttaat aatcaacctt ctaaattctt tatatggcaa 17220ttcagagatt ttttgttggc ttgtatctat tgctggggag ctagcaatag ctttgggggg 17280tgttatagaa atatgttttg tcatattacc agaattactt ttccggttcc ttctcatttg 17340ggtagactat ttcagtggaa agatctgaaa ctcaactcct tctgttcagg ttcttttgtc 17400ccacgggtta ttccttgatg tggtactctc cttctcctag gaatagggct tcctgagagc 17460cagactgcag tgattgttat tgctcttctg ggtatagcca cccactgggg ctataccagc 17520ctttgggttg gtgctgggga atgtctgcaa agagtcctgt gatgtgatca tcttctggtc 17580tcctagccat ggataccagc acctactctg gtgtaggtga caggcgagtg aagtagactc 17640cgtgagagtc attggttgta gttctcttta gtgtgctgtt ttctccaatg ctggttatgc 17700tagcagtgaa gctgtcatgt ggagagactg aggacctctg gtcagtcagg atgttgcggg 17760cagtggtatt agctcttgtc ttctccttcc tgggaatagg gttattctgt catgagttgc 17820tgtaatggcc tgagttggtt ggtctccagc caggaagtgg cactttcaag agagcaccag 17880ctgcggtagt agaagggaga tacaagcttg ccctaggttg accagggtaa gtattctagt 17940ttctcaggtg attggcaggg ccataaagct cccacgagtt tatgtctttt gtgttcagct 18000accaggataa gtagagaaat accatcaggt ggagggcagg gttagctggg tctgagctca 18060gactttcctt aagcagggct tgctgcggcc actgtgaggg atgcagattg tcctaaggcc 18120aatggggttt gttacagagg ggattatggc tgcctctgct gtgccatata gttcgccagg 18180gaagtggggg atagctggca gcgagaggcc tcacccagat cacatgcagt tggcaaggct 18240ggccttgctc ccgcagtgcc ccactaacaa tgccaagttt agattcaggc agcctgtgcg 18300cagaactcag accttgtccc aggccataag cttctccact gagaaagcaa gcatggcttt 18360caggccttgc ctctccccat ctgcccacag tgtcagtggt ggctcctggg ctcatatttg 18420cagaagttcc tgttctcccc ctggattctg ctcaagaaaa ttcaagccca gtagaaatta 18480ttagaaaatc catctggaag cttctttcac cctgtgaccc ctcccaaatt ctgctggctg 18540ctttccccaa aggcctctgt gagataccgc cagggatggt gccctgggct tgagctggac 18600actgggaatg cctacaggat tcttcccact tctgcttcta cttttacatt ttgcatggtt 18660ctctgaatcc atttcagcta tgggtaaggt taaatccctc tcctgtaatc tggattttca 18720gattccccag gggcgatgtg tgtttggagg cagattttcc ctccctcaca ctttgggaac 18780tcccagtttt ttgcctgtct catagaattg gcaaggagca tgccacttct ttcaaaggat 18840ctgtgaattc tttcagtttt cctggtacat tcctgtggtg gttcttggca cacattatta 18900catgatgtgg gtctccacat gctgtccggt ccttccaagt gggagctgca tgttagccct 18960gtctcctatc tgccatcttc ctcagacttc taacattaac ttttaaaaag cttggtggga 19020agagaccagg gccaaagttc tccttcttgg agatgaaagc caagaagcac ttcctttggg 19080acaagtcaga aaaatcctga ccaaatcaat gtgtgttcct ggcgattctg gcccaggcct 19140atttcctccc catctgagga attgcacaaa cacagcagaa cccttctgct ggcccaggac 19200atggagaggc tggagtgaag ttgatcagag ctgggatgga tcctggcttc tgtccctgca 19260cagctgtggg cctctaggat tatgccttgg agactggcat ctggcgtctg gcatctgtcc 19320aatgggaata gtaattcaat catataggag gatggtgaag gccttagagt gaactccagg 19380tcaaaggtgg gggaccaagt accatgatcc tgccgaaaag tccagataga cctggaccag 19440gggcagaacc aggggtcagg atgggcataa gtgggcctaa ttggaaggta agtaggaagg 19500ctgggacacc agggccagga ctagggtgag aggagggagg caccaaggac accaaacgta 19560aggaggtcat tgacttgcag aggacacatg agtgggagag ggatatttct tccctccctg 19620atttgatccc atcagtgatt ggcatagtgg gccgtgagtg acggtttccc ccacaccaag 19680cctgagaact gtgagaactg tggagttttt gcgtgccctt tgggaccctc ttgtgttcta 19740catagagtag cccctgaccc tgggaaagca gtgtggctta gtgaccactt ccggagtcag 19800aatgggtggc tgccaatttt tgtaatttca ggggttctga ggaaacccat aagttgccaa 19860ccaaagagga aaacacttcg tctaccatct tgtccaaatt caggtctttt cagcattagc 19920aatttatata gatggttctg aaagtgtctt gagtcttcta gaggctccat aaaattgcac 19980atggccttgg caagcacaga ggtgaagcca tcactcctta ggcatcgatt aggctggtga 20040catctgaaag tgagacctgg aaggttggag gtgcaggtgg taggtcagga ggcagtaagg 20100tggctggaga atccatgtgg actctccaaa actaatagcc aggtctcctc ctccagtcaa 20160ctggtgcggt gcttggaacc agtgaccatc agtcagaagg tcaaagggca tgaggcattg 20220gaagagagca gatgccaggc aaagtgatct tgtgtaggtc tgtttttggt tttgtttgaa 20280ttctgagtac tcagagttac caaaactgca atgtctgagg gcacccttat ctttgacact 20340aactgcaaat ttaaggggat tcctaaatcc gtccttagat tttataattc actagaggaa 20400ttcacgtaac tcactgaaaa ctgttattgc atgactgtgg tttatcacag ggaaaaaaca 20460caggttaaaa tcagcctaag gaagacacac agggcagagt ctaggagggt ttcaggtgtg 20520aagcttcgtt gtcctcagga ggctgcgttc tcctgtgtca atgtgggaca aaacacatgg 20580ggtgttgcca accagggaag ctcacccagt taaggaaaaa ttcctgtgaa tcacattaaa 20640tcaggaagaa agcctttatt caggattgtt gttacagggg agggagactg agcccagctc 20700ccaatacagt aaagacagag ggggagtcac agccaacacc agagtgaggg gcagcagatg 20760gaacaggact gacaggaggc accagagtcg ggggttcatg ctaaactggc ctaacaggat 20820tttccctaaa ggcaggtcag acactcaccc atcaaggggc aggtgaggag agtgatcaga 20880tagcaagtgt gctcagacag taagaaggga ggaccctccc taaactgact cggggggatt 20940cttgctgagc cagggttgtg caggcccagc aagcacggga tgggcatgga aggccaaggt 21000tggtgcctag aggagaagag gctcagaaga gcccaactgg agtctggtca aacagaaagt 21060ctttctcaac ccatgcctta gtgtccagag tgtttgctgg ggcttgacca caggctgcac 21120tcatggctga cctggagttt ccagcccctc cctgaggtct cacaccttta gtccccagat 21180cctctggtgg tgagaagaga tacccaatag ccccaaaccc ccatcatcca tcacatttgc 21240tatactgtcc tgtagccaaa ccaccaggga aacaaagaca ttcctaccag gcagggcatt 21300ccaggggcct ggagatcact tcgcaggggt aggggacaat gggaagacct ctcctgggat 21360aaagttaatt cttcactgcg caattgtagt gcagtgaaga ttctattccc agaggccggg 21420gaaggtttgc aattgctttg gtgcagtggg gcatgggtaa acttgcacct tagctataac 21480agcagacaga acaaccatag tacaaataca ggtagtcagt tgtgcaactg tgtattggta 21540gacacaatga cagcacatca ccggctaacc ccacaatatg gggtgactac ctgtacaaca 21600atgtcaccaa gcccttgggt taagcaatga tacatggctg ggttggtaga ataagtctct 21660gcatatgggt gcctaccaat ccccatggag atggagatgg ctgtgggcct gtgtcaccca 21720cccttggcct tatttgccat tcaactggac tggcagatgc atctcagggc atccttaatt 21780gccacagtat atagttcccc atttagacac gacccccagt aactggaaaa cggtaaaagc 21840tagagattac cagatatgtg catactggtg gttctacccc ttggccatct ttgcctccaa 21900agtggcaact gtaaatgcag agctgcaatt cgtgtgctgg ctaaacacac agctgcagcc 21960ttcaatgata ctcaccatcg ttttacactt cccaatcaag aaaccaccca gatcaggcat 22020gttcctctgc aaaatcgtat gacccaaaat catacaactg ctgcccatgg tggagcttgt 22080gcattaatta aaacaaaatg ttgtgtatat agccctcatt actctcataa cataacacag 22140gctctgctga cgttagatac ccagagtcca gccacagagt ctttgtctta tgatcttatc 22200acctcatggt ttaatcaact cccagacacg tggagaaact ttgtatctag cgtaattgca 22260attgcgttca taatcctttg ttgaggttag tgttgctgct ggggtgtctg gctgcaatgc 22320tcttccacaa aactggcccc aggaaaatca cagaaaaaca gtgtgatgag attgtgaggg 22380ccattcaagg ctatgcaggg gtgtggagag catggtgggc atgtcccgtc agacagcaat 22440aactgaagca tcccctaaga ataaccctac attccttggt gaatttttgc tcagtgttcc 22500aaggtatgga tcccgggaat ggccaatcca gatgtttaca tcatacttat gaagaactct 22560gttccttgga tcagaggttg tgcaaggaat caagaccttt tgttttgggc taggtggagg 22620tttcctggca gaggtgctaa gtggaggttg ctctgggaag aatatcatat aacctgcatg 22680catttgacaa acaggagggg atttcttgtc ttgcctgctg ctcctgggca acctgtacat 22740aagctccctg aataaagctt atgtctcacc tgctgtctcc aggtcttttc ttctgtctct 22800ccaagtctgt gtcctgtcag ctcattagca taggggtcca gcatgacaaa tataaaacgg 22860tgtttaacat tctttggatt atgtttatat aaatgtgtta ttaatatgtg ttccaaaatt 22920gtacgagatt ctataggtct aatatgtctt ggcatatgtt atcagaaact attattatta 22980ttatgttaag tagttgtttg ccacagaaat aaagtaattt ccttgtcgaa tgtgtcttta 23040ccaatgctgt tctcatactt ttgttatctg caaaaagtgt ttactttaca tctcaaaaaa 23100cagtttatga tcagctacag attgtgccat cggactaaga aaaaaataaa tcttccagga 23160ctgtaattca aaagttgatg tggtcatgaa gattgctaac ccaatatcaa gtggaagaag 23220gttattacat gggaatgaat taatggagaa caaaaataaa tttttaatga ctttttgttt 23280aatatacgac tgattctttt gttttgtttt tcttagtcaa gaaaacttct ttttcccttt 23340gggctccatg tagcttttaa caattgaata aagtatactc ttgtgagcaa aatttgaagc 23400atatttcttt ctcactatct gatttctcca gaatttggaa actatttgtg agtattctta 23460gttcatggca atagagttat ttgcataagt tcagttggaa tctgttttct ttcataacag 23520gacacaacta gagacactgg ttattttacc aaggctttga ctggcatggc atatttccac 23580atgtacgtag gctgctttga gtaatggtgg ctggcttata gagccgatga aagcctcttt 23640gaaaaatttt cctcaaactt tgcctataca gttcctttac agggttcctg tcctgtggta 23700agtaaagaat gtcactttct gacaggccca ggaagcccaa gttaccttgg gaccttgagg 23760agaaaggaac tcacctaata tatataggca tctgcaggca aatataaatc actggctgag 23820cttgagattt taaaaggcct actctgagat atcttatgaa aaagaaaata ttgtagcaaa 23880gtcaatttcc aaaaggagcc catatgccaa ataagtattc ttgctgcact ttatacaaat 23940gatcaggcca agaaccatca gactaaaact tctgttgcaa ataaattagc cctactatga 24000tttgtctttg gtagaaatac aggactagag agagaaaagg tatgtttcaa aagaaactag 24060agaatgcctg ttattggatt ctagctttct ccattgtttt ctagccgtat tgtttgtcca 24120cagtttatct ggactacata ctgaattctt tcctggccac aagtctccaa actaatattt 24180tgcttttctt tttctctcat ttttctgact tggaatcacc agaaatccaa actgtgcttt 24240tcttaaagtc ctgcaaactg aagcttgaaa actgtgttat agtgaaggaa gagaaagacc 24300ctctcatatt atttttatat tgttttgtac tcagtacctg ttttaagaaa aaacaacaag 24360gaagtaaaac caaagacagg cagcccggcg ccaggcccga aaccaggcct gggcccgcct 24420ggcctaaacc cattagttaa aaatcaactt atgattcaga agccgatgtt attcatagat 24480tccttacatt atgtagaaga acattgtgaa actccctgcc ctgttctgtt cccccctgac 24540gacctgtgta tgcagcccct gtcacgtacc gcctgcttgc tcaaatcaat catgaccctt 24600tcgtgtgaaa tctttagtgt

tgtgagccct taaaagggac agaaattgtg cactcaggga 24660gctcggattt taaggcagta gcttgccgat gctcccagct gaataaagcc cttccttcta 24720ctactcggtg tctgagaggt tttgtctgca gctcgtcctg ctacaataga attcagacca 24780aactcgtgac cagagactca tttgcttcta cagtgttttg tccaaaagat gttgaagaac 24840ggccaggcgc agtggctcac gcctgtaatc ccagcgcttt cggaggccga ggcaggcaga 24900tcacaacgcc aagagatcga gaccatgctg gccaagatgg tgaaacgctg tctgtactaa 24960aaatacaaaa attagctggg cttggtggtg cgtgcctgta gtcccagcta cttgggaggc 25020tgaggcagga gaatcacttg aacccgggag gtggaggttg cagtgagccg agatcacaac 25080actgcactcc agcctggcaa cagagcaaga atctgtcaaa aaaaaaaaaa aaaaaaaagt 25140tgttgaagaa caaggagaaa acgtgaaagg aaaatcaaat cttgggaccc caaaactcac 25200tggaaacagt taagcttaga aacggagtca ctccaaaacc tgcctttgtt tttgcttcta 25260agcagatatt tgcgaagaca aaaggcaaca tgttccccag gtagcctcct tcacaaattg 25320ctcacaagga aactccttgt gggtcccagc agtttttacc ctgaggcaga ctttgtgtaa 25380tttcattgtg acaatgcaaa ttagcaactt atctttactg gtacatgata aataacaaga 25440cttctgccca ccctcagaaa aatgcacata tgcctgcttc ctctactcta tgttcatttt 25500tatcttatat aaaatgtaga cgaactgtgc atgagacgaa tgaataattg actgttcctc 25560taccccctcc tttcatagac aacctgtgga ttcaaggagg gctaatcaaa gcttcacaag 25620aatgtgacca ctcacctcat tacctatcct gtcttttttc ctttcctcct tccactcctg 25680cctgatttta cacatttaaa tactggaggc ctcaaaaccc tctgtgaaaa acgagtggac 25740cccagaacct cctgtgactt gtgtgacttt ttcctgggtg catcctcaac cttggcagag 25800taaacatcta aactgactga gacgtgtccc agaccctctt tggtttacaa gtcttgcctc 25860ctccctgagt tgctggatga aagcaacgtc ctctcttctt gcctcagttt cctcatctgc 25920aaaatcagat cataatcctg gcccattgag gggatgatta taaaactcaa tcaaatggag 25980aagcatttgc aaatggaatg tattgcaaag tgtattgtgc agtccctgtg taatcaccat 26040tctcttcctg cctcataagc tggtgtgtgt gtgtgtatgg gtggggtgag gtggacacga 26100tgcccccaga gatgtttgct caggatgaaa taggccccca tggaagggtc aggttggctt 26160ctgtggttta gctgcctttg aggcccttct gcctggggca aagcacaaaa gtccaatagc 26220aatctggttg catgacttcc tagtcatgga agtgtggctg agcagtggtc tctagtccct 26280ccaccctgtg tgcctcggga gtggaacacg gggcagtggc ctctgctggg gaggatgctg 26340ggggatctct gaaaggaggc aatgcctgat tttgtcactg aacgatgagc atgatttttc 26400caggcggtgg aagcaggtgc tcccggcaga agaccccata taagcaaata tctagaagcc 26460acaaggcatg gccttcaaca agagcaggcc tggtgcggtg gctcatgcca aggtgggagg 26520atcacttgag gcctggagtt caagagtagc ccagtcaata tagtgaggca ccatctctaa 26580tataattttt ttaaaaatta gctgggtggt tggctgatac ctgtagaacc agctactcag 26640gaggctgagg tggggggatg gcttaagccc aggggtttga agctgctgtg cgcgatgact 26700gtggcactgc aattcagtct tggtgacaga ctgagaccct gtctcaaaaa cataaccaaa 26760ataaccccaa cggcattaca ataaatatac aataagcatc cacaaggcat gtgtgggaga 26820ctgtgcttat gccgatggca cgggcaggag taaggcaggc atcaggggaa tgtggatgca 26880cgggaggatg gggagtaatc tgcagggtcc catagtatgt cagtggcagg tctttctcct 26940tgagaccaca gcagaccccc agccctgagg atgcgaggca ggtgggttgg atgagaggga 27000tctggatgtc tggtctcagg ctgctcctct aagggcagca gcaaggaggg tggggctgga 27060ctgaaggtgg aggggagcgt gtttgctgtg cttggtcatg agctgctggg aagttgtgac 27120tttcactttc cctttcgaat tcctcggtat atcttgggga ctggaggacc tgtctggtta 27180ttatacagac gcataactgg aggtgggatc cacacagctc agaacagctg gatcttgctc 27240agtctctgcc aggggaagat tccttggtaa gttggggaca gttgacctgc ctccatctta 27300ttctcacagc ttttgtagat aagctgggag aggttaggtg actggttcag atagacagga 27360aagtagcggc aaagcctgga tttgcaccca ggcttgagtc tgattgcttc ccctctcctg 27420ctgggctctt aaactataga gggttgggga aacagctcag atgggttcac aaagctccct 27480gggctcagcc ctggttttga ctgctgagac acgactgagt gaacccagaa ggaaggtttg 27540tgttgggggt gcccatctct ttgggaaatt tgaaggaacc aaagaaggtg gaggagagga 27600ggtgacccag atcccagcct gttcttatgg ccaggccaca ccaaggctgg ccccagggtg 27660ctgctgctga ggcccaatgg gggcaacaga attttttttc aggtacaagg agttcagagg 27720tcatctcacc caccctgagt ctgagcacca acttgtgcca ggccctgtgg ggaaactgag 27780gccctgggag cggaatgact tgcccagggt cccgtgtcag gaggctgagc aggtagatca 27840taggactcca cgtctctggc cctcacctct gtccctctgt tcagacttct ggggtgatgg 27900agaagaaaca ggctgtgctg tgtccctaat gggaaacgtg gctgagacag gggagtgaga 27960agggtgcgtt gcagaatggt gcctgtggca tgatgccagc tttgcaatca tgagattcaa 28020aagccacact gtggaattgt gagtataact acaggagtga gagcttagat ctctgtgttc 28080atagaaggag aatcaaacct ggaaactttt ggattattaa aatcaaacat ttttgcttca 28140atattagagt cacaagggca gatgttggcc tcccctctgc cctccaagag ctgtgtgact 28200ctgggaaatt cacctcccct cccagcctga gtattttccc ctgtaaaaaa cctgatagag 28260ctgccaaaag tccatgaaat caggggggta atttctgtga aatctgagtc atggtcttat 28320ttgttcttca ccaaaaagag atgatgaagc ctgtaacccc agtgctgtgg gaggcagagg 28380cgggaggatg acttgaggcc aggagttcaa gacagcctgg gaaacacagg agatgctgtc 28440tctatgaaat caaaaattaa caaattagcc cagcatggta gtgtgtacct gtagtcccag 28500ctactcagaa ggttgaagga ggcggatcac ttgagcccaa cagatctagg ctgcaatgag 28560ctaggatggt gtcaaagccc tgcagcctgg gtgacagagc aaaactgttt attaaaaact 28620aaacgaaagg ccgggcgcgg tggctcacgc ctgtaatccc agcactttgg gaggccaaga 28680caggtggtca cgaggtcagg atatcgagac catcctggct aacatggtga aaccctgtct 28740ctactaaaaa tacaaaaaaa ttagccgggt gtcgtggcgg gcacctgtag tcccagctac 28800tcgggaggct gaggcaggag aatggcgtga acccgggagg cagagcttgt agcgagccta 28860gatcgcccca ctgcactcca gcctgggtga tagagcgaga ctccatttca aaaaaaaaat 28920gaaatgaaaa tggtgatttc tcaggaggag cacactgtct caacccctct tttcctgctc 28980aaggaggagg ccctgcagcg acatggaggg agctgctttg ctgagagtct ctgtcctctg 29040catctggtga gcttggctca gagccctgag gcgggaggga gggctccctg tctgggctgc 29100acaattggac tgggcttggg ctgggccagg gccatctggg cttcttctag gaaccaaagt 29160cacttcccgg aattgaccaa ccggcagact cgcccaggga ggacccgctg tatcctagtt 29220gaggctaacg gtcaatatcc ggcctcaata ttcagcagag gctccaggtc agggtctgag 29280ccaggccaac aatgaccaag gaggatggga tccagggtgc agctcctcac aagtgtcggg 29340ggaatccgag gcaccagctc tctctaccct cctgctcctc tgctctctcc tggtcctcct 29400gtgtcctcat ggctcatgag atggtgttga gatggctccc ctggcctagg ggatcacaca 29460gtgaacaaag caggaagaag gcgaagggat gcccctctcc tgtcaccctt gtcccttaca 29520gcaagaaggg cccagacgcc cctctgcata ctcccctggt gaactgctgc ccaggactgg 29580gtcccccttt tacccttgct gcatggagtc cccagaagac aaacatctgt gtgtctgaac 29640cctgagacaa aggcaggaaa gggaaagagg gaggcgagtg gcttttgagg agggggcttt 29700agtatgagag ctggaggatg gaaccccatc agggggcccg ggaaccactg agctgttaaa 29760ataaagtctg caaacaaaga ccagctgctg gaagtgggtg tgccagggag tgcgcagaga 29820cacacggtga gaaaagaaca atggtaatgc ttggagccgc ccctaactgg gatgggcctg 29880aaatggtatt gttattattt atagtatcat tattagtcat tttcatctta tttgtaccct 29940ccctctatct ctcctctcca ccttttccta acattctatc accagtttta tgtcttccat 30000tagcaacttt gtagctgtaa ataatttact tacaactttc atataccctc agttgtaccc 30060agtatttctt aacttccctc tttaaaaaaa tgataatatt aatcctcctt ctccttcgtt 30120cagtgcttca catcccaact gctacctttg tgctttaaat tttgtactaa ttggtgttga 30180taacaagtat atttagttct catatttata tgttgtgtat atgttttggt ttttttttgt 30240cttaaacaag agactactga gagccagtaa gactgaaaga aagggcatct tcatatactg 30300ctagtttgag tgtgaattgg tacaatttgc ctgcagtgtg gctctaggta taaagccttt 30360tgagttgttg atagcctctg acctgctcat tctactccta caaatatctt aaggaaataa 30420tctcaaatgt gggcaaagtt ttatgcgaag aaggatgttc tttgtagcat aatttatatg 30480aggaattaga aacaccctga ggtccatcag ctagggaaag acagcagagg ggacagggca 30540gcaccaggag ggcttggcag ccacagcagg ggctgggctg gcatctggca agatccaggt 30600ctttgtggga caaagaatct tagagaagca acggggacac aggctgtcca gtgcagcacc 30660agtgaattca ccaagatgaa gagttgagca cagagtgtga gacaaggatt tgcaatgagg 30720agtcatttac catgagcgtg tatacatgac tcaatattgt atatttaagg gagtagagca 30780cagtcattga aaacatgggg ttgaagcaga agtcctggct ctagcactat tgtaaaaaca 30840ctggcaagtt ccctaacttt tgtggattcc tctgtgtttg aatgggaaag tggtacccat 30900ctcctggcct gtgtgtgatc atcgaatgag acacatgtaa gaggctctgc acatcgcaga 30960catgcaatac acactggcta tcaccagcta gttatcacac atgctcccag gccctggtca 31020ttgtcagaac cttcctcccc atctctattt ctgtgtatag actctgtagt ttctgtaatg 31080atcagatggc tgcccgtcct ctgattatct tctcctcata ccccaacagg atgagtgcac 31140ttttccttgg tgtgggagtg agggcagagg aagctggagc gaggtgagtg tctgcaaata 31200gcagatgatg ggggctcagt gatagacaaa caatctggtt taggttggtc ttggtgtttg 31260cttccacccc agagagattt gcagagcccc ggctgctcaa gcaagcctcc ctctgtccac 31320tggtggctca catttgatcc cacaatttgt tttctcctcc tcaagggtgc aacaaaacgt 31380tccaagtggg acagatactg gagatcctca aagtaagccc ctcggtgact gggctgctgg 31440caccatggac ccaggtaggc tcacctcctc ttccctgctg gttcctactc gcacttagaa 31500tggagggtgg cacctccaca gctgagtgag ccccagaaga acccggatgg actaggaggc 31560caatgagtct gcccaaagca gcagaagagg tcacgtggag tcccccgacc caggggtctg 31620ggggtcatct gcatcctgac ctctccttag ggtgacacgg cccaggtgcc cacttcctcc 31680ctaccctggc acctagcaaa tgactcaagt ggggcaggac atccttgggg aagtggaatc 31740agcggggggg ggggggagtg tggggagagc agggtccagg aggagaggag ggctgggaga 31800ggaggttgac cagcagcccc gacctgtcac ctcccgctct gctccaagct gaccctgggg 31860tgtttccacc tgaggctggt cccctccctc cagctcttgc cctgccctag cccctttgct 31920ctgagtggcc ctgtgggaat gtatcgggcc tgattcagct tccagcttaa ctggaccccg 31980gtctgtcctt tgccacatcc cctctgtgtg acctggcgct ccttacctcc cttctcctgt 32040accatgagaa taatatttcc ccatgttgtc ttgaggatca aatataacac ggctacctgg 32100cctggccagt gcctgccaca caatagggcc tccctaaggg ctggttccca tcccctctac 32160tggtcccctg ttgattccag gtggaagcca ccccgtcccc ccccagctgt gttagggcac 32220ccgccctgcc ctgcccatca caagcacctg cttaccaggg atgactgcct caggcagggg 32280ctgagttcag tcatctaaaa tacccccggt caaagaaaaa tctgaggccc aatagaattt 32340taaagagtta attgagtaag aaaggattgc tgaattggga aacagcaaac tggaggaggc 32400ttcgtgctat ggtgaaaaag tgtcggagac aaggtttatc gggtgaatat gaaactgcag 32460taaggacatt atttgattgg ttgcacttac aaaactgcct gtttgggttt accttgttgg 32520aaaatccctg gtcacgttgg tgccagtgtg agtttaggga ggtctccgaa tacaggtgag 32580accggaactt agccttgccc aggtttttga tgctgaagag agaaaaaagt caaagcaaaa 32640gcaaatcagc ttttagtgca aaacagaagt gcaggctcag gggtgggagt gcaggcggac 32700tcagaagagc cagtcgggcc cagtggagtt tggggttctt gtctttgctg gtttattaaa 32760ttaaggtgtg gagtaagcat aaggatttct gggaagaggt ggggatttct tggaattggg 32820agggcaatgc agttttgtac caaacatggg catacatgga acggctgtgg tgcgggtggg 32880tgtggggttt agtgagacaa ggagggtatg attgagtgtg aggcaaaacg tgggtcagac 32940ccagcgccga gttggatctc actggtctta gctgaattgg ccacttcctg tttgtcagga 33000tcctgtgggc ccatcccctc cccctgtccc tacaggtggt ttcagcaact ccttctgtgt 33060ctgtcatgtg aacctgctgc ctggagttct tgtttcttct gtgacctccc agtatccaca 33120tctcagcatg gccctctgtc agctggcttt aagttttgtt tgtatctaac agaagtaccc 33180atctgatatg accccagttg agtttcccat agcttgcagt ttcagggggt tacagctgtt 33240ctaaaggcct cgtaggtatt gcctgtccag gaatgtttca gggctggttt ttgttttaat 33300tttgctttta tatccaccag ccccaccaca tcaagaaata cacagattta gtgccagagg 33360ttccttccat ccaaacctgg gtttccttcc tccttttggt gaagaaggaa aaagaaaaaa 33420caagacaatc gctcgcccag ccaagtcagc attgcgttca tttccctaag ccccatttcc 33480tcaggagggc ttcctcccct tacagagttg ccacggcaac caagtcagct ctgctcagga 33540gccgccctgg acagcaaact gggctgtgct gagtcctgtc caagacgagg ggagggcagg 33600gaagattaga agccgagagc actcagccga ccccggaatc cttacgaagg gctgggctgg 33660gggactgagg aaaaactctc cccccaaaac aagatgatct gtggtttaat aacaggccca 33720gctgggtcca gaggtgacag tggagagccg tgtaccctga gaccagcctg cagaggacag 33780aggcaacatg gaggtgcctc aaggatcagt gctgagggtc ccgcccccat gccccgtcga 33840agaaccccct ccactgccca tctgagagtg cccaagacca gcaggaggaa tctcctttgc 33900atggtagttg tactcaatgc tgtggagttt gagacattat ttttaaactt taaatagccc 33960cacaggtaag ctataaggga gaatgcagag accacaggca ttttcaaaac ataaggagtt 34020ttaatgttaa ggagtttaag gagaatgtca aagaaacatt ggccttggag tcaaatcctg 34080agcttcctgc ttgatggttt tgggcggtga ctctcgctgt ctggatttta ctttcttcat 34140ctgtgaatta agaatgaggt ggccgggcac tgtggctcac gcctgtaatc ccaacatttg 34200ggaggccgag gcgggcagat cacaaggtca ggagatcgag acgatcctgt ctaacacgat 34260gaaaccctgt ctctactaaa aatacaaaaa aaattaccag gcctggtggc aggcgcctgt 34320agtcccagct actcaggagg ctgaggcagg agaatggcat gaacccagga ggcagagctt 34380gcagtgagcc aagatcgcac cactgcactc cagcctgggt gagagagcaa gactccatcc 34440ccccaaaaaa aagaatgagg tctcttgtgt gtgcacggca agaaacaatt ttacatcatg 34500cctcagtgca cacacaaata catactggtc cccagttcct tatctgcaat tccatnattc 34560ccagatccct gcaaaccaca cgttttggtg gcagctgact tcaggagtaa tcctgctctg 34620tactgacttg agttctttgt agacctacca ttatttttta catttaatgt gaatatttgc 34680ttgtttcact gttgaaacat gtgtgggtgt gattacaggg agcagtccag cctctgctgg 34740gaatggtcag gaatatacca tatgcacccc gtgtcctttc taaaatagtg gaaattctga 34800atgcctaaac acatctggat tccaggaatt tacattaagg gatatatatt tgaaataacc 34860cacaaaaaca atactcaccc ctgctacgct tggtacactc tgatattttc aaattgattt 34920tctttttaaa atgctgcttt tgaaccaata atttcataac ccaatgatgt gttgatattc 34980acattttgaa gacactggta taaagtgttt gacccaacag gcatgtggca gatggaagtg 35040atcactggga tgtttccact tccttggcct ggaaggctca cttcatgttg gtgctgagct 35100gaaaaggatt cattcctctc caaagcacca tggcactccc ctggtgtttc aatgttctca 35160ggctgccata gtaaaatatc acaggctggg tgacttcaac atctggcttt tattttctca 35220cagatccaga ggcaagaagt ccaaggtgaa ggtgccaaaa gggttggagt ctggggagga 35280ctctcttgct ggcttatgga agctgccttt gcactgtgtg ctcacacagt cttcttgtgt 35340ccctttctgt tcttacaata ggacactagc cctctaatag aattagagcc ctacccttgt 35400gatctcattc agtcttaatt gcttccttaa aggccagatc tccaaatgta gtcacctgag 35460tttaaagctt cagcatatga attttggggg cacacaattc cctctatagc actaatgact 35520ccataaaaca agtcccacat cacagctgtc caggaaaatt aacatgtagt catctcttat 35580gcaatggctg ttatgcactc ccacactttc ctccaacctt atcctttctt ctttccaact 35640agagagcagt atctttattg aggatgccat taagtatttc aaggaaaaag tgagcacaca 35700gaatctgcta ctcctgctga ctgataatga ggcctggaac ggattcgtgg ctgctgctga 35760actgcccagg taagctccat ggggttacct ccattgggca ctccggcgat gccacccagc 35820tctcccctgg gctagttttc cctgacaggc acacctcctc caggcagccc cctctgctgg 35880gcttgaggat gaccttcttg gcactccagg aagaatattt cctccatgtc cttcgctggc 35940agtgagtagc ctcaggctga ggggatagga agcccacagg aacagggtca tttctgccat 36000ctgctggtga tgggaacttt gccagttact ttctcacttt cagcctttct tcatcaatgg 36060agttttattg tgagaaaaat gagatcgtgc atgtaaagtg cttagcataa tgactgacac 36120acagtaggtg cacagttaac gttaacatct tacaagcttg gtggaaacag aaccagggtt 36180aaggatcttc ttcttgaaga tgggagccca gcaggacttg acctttggga caagtcagaa 36240aaatcctgac ctaaccaatg tgtgttcctg gggatgctgg ctggagccct ttttctcatc 36300tgaggaattc cataaacacg gcaggaccct tctgctggtc caggatgccg agaggctgga 36360gtggagttgc acagcgctgg gtctctttcc agctctgtct gtgtccagtc cctgggctct 36420gggcttatgt cagagactgg aaactgtcat cagtctaata ggaatagcaa ctcaatgtga 36480taggagtgtg gtgaaggcct tagaggcaac tccaggtcaa aggtggggaa ccaacaccaa 36540gatcctgccc aaaggcccag agagaccggg atcagcgtca gagcctggag tcaggatgga 36600gcaagagtca gccttggttg taggacaagc aggaaggctg gggcaccagg gctgggacta 36660gggtgtggaa agagaggcac caagggcttg aaacttaagg aggtcatgaa cttgcagagg 36720acatgtgagt gggagaggga tatttcttcc ctgtctggat gatcccaaca ctcatgggca 36780tatagggtca tggttgcctg tgtctctcac accacgcctt ggaactggca agttctgggc 36840taccctttga gaccttcttc tcttctacac agagaaaccc ctgacattga caagcagtat 36900gtcttagtga ccattttcat agtagaatta gttgctgcca atttgtgtaa tttcagggat 36960actgagcaga ctcacaactt cccaaccaag gaggaaaaca cttcctctac catcttgtcc 37020aaattcaggt cttttcagca ttagcaattt atataggtgg ttctgaaagt gttttgaatc 37080ttctagaggt tccataaaat tgcaaatggc cttggtgtgc acacaggtga agctgtcact 37140actaaggcat cagttaggct ggtgacacct gcgagtgaga cctggaaggt tgggggtgca 37200ggtggtaggt caggaggcag taaggtggct ggagcgtcca tgtggagcca gaatgaatag 37260ccagatctcc cactccagtc agctggggca gtggccagaa ccagtagcct tcagccaggt 37320gaaagggcat gaggcattgg aagggagcag atgccaggca aagtgaactc ctgtctctcc 37380ggggttttgt ttttgtttga attcaaagta ctcagagata gccagactgc aatgtctgag 37440ggcaccctta cctttgacac cacctgcaaa tttaagggga tttctaaatc catcctttga 37500ttttgtaatt cactggaagg actcacataa ctcactgaaa actgctattt cacaattgtg 37560gttgatcaca cggaaagaac acagattaaa atcagcctaa gaaagagaca cacggggcag 37620agtttgggag ggttttaagt gtgaagcttc attgtcctca ggacgctgtg ttctcctgtg 37680tgaatgtggg acaaaacaca tgcggtgttg ccaaccaggg aagctcaccc agttaaggaa 37740aaattcctgt gaatcacatt aaaccagaaa tgaagccttt tttcaggatt gttgttacag 37800gggagggaga ctgagcccag ctccaaatat agtaaagaca gagggggagt cacagccaac 37860accagggtgg gggcgggaga tggaacagga ctgataggag acaccagagt ggggggttcc 37920tgctaaattg gcctaacagg attctcacta aaggcaggtc agacactcac ccatcaatgg 37980tgggggtgaa gagcataatc agatagcaaa gcgtaatcag acagcaaggg gggaagaccc 38040tccctaaact gacttgggga gattcttgct gagctgggtg gtgcaggtcc agcaagcagt 38100gggtggctgt ggaaggccaa ggtcggcgcc tagtggagaa gaggctcaga agagcccagc 38160tggagttggt caaggagaaa gtccttcttt ctcaacccat gccttagtgt ccagagtatc 38220tgctggggct ggatcacaag ctgccctcat ggctgacctg gagtctccag cccctccctg 38280aggtctaacc cctttagtcc ccgggtcctc tgggatcagg aaagacacca aatagcccca 38340aaccccatca tccatcagat tcctatacgg tcccgtggcc aaatcaccag gcaaagacag 38400atgttcctac caggcaggac attccagggg cctggagatc acttcccagg agctgaggac 38460aaagggaagg cctctctttg ggtaaagttc atgcttcact ttcctgccat cctgggaata 38520aggtctcttt gtctcactct cactgctctt tgttcatctg cagagttttc cctctccaaa 38580cactttggca gtcacggtgt tgacctgccc ttgaatgagg aggcatcttt atcaaacacc 38640taccatgaaa gagcatctga gatgccttta agatatttat ttccatatgg aataaatatt 38700gaggagtatc tatgatgaac aaaatgtgtt tgagtttgaa agataattaa ttccatttgt 38760aaaatttgtt tctatttgat cgatagtgaa agctctgcaa tttacacagg atagagatca 38820catggagctc atttcacaga cagggaaact gcatttcttt tttttttttt tttttttgag 38880ttggagtctt gctctgtcgc ccaagctgga gtgcagtggc gcgatctcgg ctcactgcaa 38940gctctgcctc ccggttcaag caattctcct gcctcagcct cctgagtagc tgggactaca 39000ggcgcccacc accacgcccg gctaattttt tgaatttttg gtagagacag ggtttcaccg 39060tattagtcag gatggtctca atctcctgac cttgtgatcc acccgccttg gcctcccaaa 39120gtgctgggat tacaggtgtg agccaccaca ccgagccaaa actgcatttc ttaatccttt 39180aacctttcct tgtgcaggaa tgaggcagat gagctccgta aagctctgga caaccttgca 39240agacaaatga tcatgaaaga caaaaactgg cacgataaag gccagcagta cagaaactgg 39300tttctgaaag agtttcctcg gttgaaaagt gagcttgagg ataacataag aaggctccgt 39360gcccttgcag atggggttca gaaggtccac aaaggcacca ccatcgccaa tgtggtgtct 39420ggctctctca gcatttcctc tggcatcctg accctcgtcg gcatgggtct ggcacccttc 39480acagagggag gcagccttgt actcttggaa cctgggatgg agttgggaat cacagccgct 39540ttgaccggga ttaccagcag taccatggac tacggaaaga agtggtggac acaagcccaa 39600gcccacgacc tggtcatcaa aagccttgac aaattgaagg aggtgaggga gtttttgggt 39660gagaacatat ccaactttct

ttccttagct ggcaatactt accaactcac acgaggcatt 39720gggaaggaca tccgtgccct cagacgagcc agagccaatc ttcagtcagt accgcatgcc 39780tcagcctcac gcccccgggt cactgagcca atctcagctg aaagcggtga acaggtggag 39840agggttaatg aacccagcat cctggaaatg agcagaggag tcaagctcac ggatgtggcc 39900cctgtangct tctttcttgt gctggatgta gtctacctcg tgtacgaatc aaagcactta 39960catgaggggg caaagtcaga gacagctgag gagctgaaga aggtggctca ggagctggag 40020gagaagctaa acatnctcaa caataattat aagattctgc aggcggacca agaactgtga 40080ccacagggca gggcagccac caggagagat atgcctggca ggggccagga caaaatgcaa 40140actttttttt ttttctgaga cagagtcttg ctctgtcgcc aagttggagt gcaatggtgc 40200gatctcagct cactgcaagc tctgcctccc gtgttcaagc gattctcctg ccttggcctc 40260ccaagtagct gggactacag gcgcctacca ccatgcccag ctaatttttg tatttttaat 40320agagatgggg tttcaccatg ttggccagga tggtctcgat ctcctgacct cttgatctgc 40380ccaccttggc ctcccaaagt gctgggatta caggcgtgag ccatcgcttt tgacccaaat 40440gcaaacattt tattaggggg ataaagaggg tgaggtaaag tttatggaac tgagtgttag 40500ggactttggc atttccatag ctgagcacag caggggaggg gttaatgcag atggcagtgc 40560agcaaggaga aggcaggaac attggagcct gcaataaggg aaaaatggga actggagagt 40620gtggggaatg ggaagaagca gtttacttta gactaaagaa tatattgggg ggccgggtgt 40680agtggctcat gcctgtaatc cgagcacttt gggaggccaa ggcgggcgga tcacgaggtc 40740aggagatcga gaccatcctg gctaacacag tgaaaccccg tctctactaa aaatacaaaa 40800aattagccgg gcatggtggc gggcgcctgt agttccagct aactgggcgg ctgaggcagg 40860agaatggcgt gaacctggga ggtggagctt gcagtgagcc gagatatcgc cactgcactc 40920cagcctgggt gacagagcga gactccatct caaaaaaaaa aaaaaaaaga atatattgac 40980ggaagaatag agaggaggct tgaaggaacc agcaatgaga aggccaggaa aagaaagagc 41040tgaaaatgga gaaagcccaa gagttagaac agttggatac aggagaagaa acagcggctc 41100cactacagac ccagccccag gttcaatgtc ctccgaagaa tgaagtcttt ccctggtgat 41160ggtcccctgc cctgtctttc cagcatccac tctcccttgt cctcctgggg gcanatctca 41220gtcaggcagc ggcttcctga tgatggtcat tggggtggtt gtcatgtgat gggtcccctc 41280caggttacta aagggtgcat gtcccctgct tgaacactga agggcaggtg gtgggccatg 41340gccatggtcc ccagctgagg agcaggtgtc cctgagaacc caaacttccc agagagtatg 41400tgagaaccaa ccaatgaaaa cagtcccatc gctcttaccc ggtaagtaaa cagtcagaaa 41460attagcatga aagcagttta gcattgggag gaagctcaga tctctagagc tgtcttgtcg 41520ccgcccagga ttgacctgtg tgtaagtccc aataaactca cctactcatc aagctggact 41580tgttcgagtc attctttggt ctctcagctc tttccaagct ttgggggcca tcagtctcaa 41640gtttttctcg taatggtggt gatggtggtt gtgatggcag cagagtggtg ggggccttgg 41700caagtggtcg gtgctcttcc agaccagggg acaccgatgg accgatgaag ttccagggga 41760acttgaagtg ctgtgttgga aagaggttaa tttgggaaga aaggaaaaat gaaaggagat 41820gccaggaaca ggtcaaggaa ccttgaggtg tgtccaggag ttcaaccccg cttgtggtca 41880cgagacctcg cctctctgag cctcagtttc ctcatcagct gtagaagggt acctggacaa 41940ggtgatgtct caggtccacc cagctctccc catcttgtgt cctggagact tgggtccaat 42000cagcactgac tgatggctgt gcctttgtgg tgccgatgga ggctcccctg ggctctgggt 42060gcctgacttc ccttcctcat gatccttctt ccagggtctc gggaaacgag gcttccatgg 42120cccctcctgc ttgctcactg gactctcact ttcccagctg gtcatttccc tgagacctca 42180aaaccccacc aaccccactg gggcacccac agaaagcttg tacatgtctg gctctggctg 42240agcacaggtg tggtttccat ctgcgagtca gagcccggga ttgacatggg acgctcgagg 42300ctgactagtg tcagaggggc ctgtgtgcag attgggagaa gattatcgag taatagaggg 42360gcaaagaggg acatccagac agcaaacacc cccatccagt ctgtcctcac gttttgccca 42420gactcctgca agaacttcca gaatggtctt ccatgtgcaa ctgcccgtcc ctgcccatgt 42480cctggatcat tctccacact gcgccaggtt gggctttaac aagatcatgt tttgggtttt 42540tgggggtttt ttgtttgttt gtttggtctc actctgttgt gaggctggcg tcccgtggca 42600tgagcatggc tcactgcatc ttggacctcc cggcctcaaa ctacccttcc accttgaccc 42660cctgagtagc tgggaccatc cgtgtgtgcc acattgccca ggctggtctc aaactcctga 42720gttcaggtga tctgttcgcc ttggcattcc aatgggctgc aattacagac acgagccacc 42780gtgcccacct aagaacatag atttgatcga gcacccactt ctgaccattc aatggcttcc 42840cattactctt agcacaaaga tgtaggccat gatgctgcct aaagtagcct gttgcggcct 42900ggggtcctgt gaaggaagag ccagaggcaa cgttctggtg cagagggttt ctaggaagtg 42960attctaggag cagaactgag gatccaggag ggaaggagga aacgttgata caagaagttt 43020ttgaatgggc catccatatg ggcaatgaga ccttctgagg tgccttcaag gagcgtcctc 43080agaatctttg tttccaggga ggagacatgg aggcctttat ccactgcttt agctgtgtcc 43140caggggttct ggtacattgt gtctttgttc tcattggttt caaagaactt cttgatttct 43200gccttaattt tgttatttac ccagtaatca ttcaggaaca cgttgttcaa tttccatgta 43260gttgtgcggt ttttagtgag tttcttaatc ctgagttcta atttgattgc actgtggtct 43320gagacactgt ttgttatgat ttccattctt ttgcatttgc tgaggaatgt tttacttcca 43380attatgtggt cgactttaga ataagtgtta tacggtgctg agaagaaagt atattctgtt 43440gatttgggac ggagagttct gtagatgtct gttaggtcca ctcagtccag ggctgagttc 43500aagtcctgaa catccttgtt aattttctgt ctcgttgacc tgtctaatat tgacagtggg 43560gtgttaaagt ctcccactgc tattgtgtgg gagtctaagt ctctttgtag gtctctaaga 43620acttgtttta tgaatctgcg tgctcccgta ttgggtgcat atatatttag gatagttagc 43680tcttcttgtt gcactgatgt ttgttggttt aaaagatctt ttttgatctt tgttggttta 43740aagtctgttt tatcagagac taggattgca acccctgctt ttttgtttgt ttgtttgttt 43800gtttgttttg ctttccattt gcttggtaaa tgttcctcca tccctttatt ttcagcctat 43860gtgtgttttt gcacatgaga tgggtctcct gaatacagta catcaacggg tcttgacttt 43920atccaatttg ccagtctgtc tgttttaatt ggggcattta gcccatttac atttaaggtt 43980catattgtta tgtgtgaatt tgatcctgtc atcatgatgc tagctgatta ttttgcacat 44040tagttgatgc agtttcttca tggtatcatt ggtctttata ttttggtgtg gttttgcagt 44100gtctggtact ggtttttcct ttccatattt agtgcttcct tcaggagctc atgtaaggcc 44160ggcctggtgg tgacaaaatc cctcagcatt tgcttgtctg gaaaggattt tatttctcct 44220ttgcttatga agcttagttt ggctggatat gaaattctgg gttgaaaatt cttttcttta 44280agaatgttga atattggtcc ccactctctt ccagcttata tagggtttct gcagagagat 44340ccactgttag tctgatgggc ttcccttcgt aggtaacgtg atctttctct ctggctgccc 44400ttaacatttt ttccttcgtt tcaaccttgg agaatctgat gattatgtgt cttggggttg 44460ctcttcttga agagtatctt agtggtgttc tctgtatttc ctgaatttga atgttggcct 44520ggcttgctgg ttggggaagt tctcctggat aatatcctaa agtgtgtttt ccagcttgtt 44580tccgttctcc ccatcacttt caggtacacc aatcaattgt aggtttaatc ttttcacata 44640gtcccatatt tcttggaggc tttatttgtt ccattgtcat tcttttttct ctaattttgt 44700cttcacacat tgtttcagta agttgatctt caatctttga tattccgctt gatcaatttg 44760gctattgata gttgtgtatc cttcacgaag ttctcatgct gtgtttttca gctccatcag 44820gtcatttacg ttcttctcta aactggttat tctagttagc agctcctgta acctttcatc 44880aaggttctta gcttccttgc attgggttac aacatgctcc tttagctcag aggagtttct 44940cattacccat cttctgaagc ctacttctgt caattcgtca aattcattct ccatccagtt 45000ttgtgccctt gctggagagg agttgcaatc atttggagaa gagacattct ggtctttgga 45060attttcagcg tttttgtgct ggtttttcct tatcttcatg aatttatctt tgatctttga 45120ggatgatgac cttcggatgg gcttttgggg gaggngaggt ccttttagtt gatcttgatg 45180ttattgcttt ctgtttgtta gtttttcatc taataatcag gcccctctgc tgcaggtctg 45240ctgcagtttg ctggaggttc actccagacc ttttttgcct gggtatcacc agcagaggct 45300acagaacagc aaagatagct gcctgctcct tcctctggaa gcttcgttcc agaggggcac 45360tgacttgata tcagccagag ctctcctgta tgaggtgtct ccctcaggag gcacgggagt 45420cagggaccca cttgaggagg cagtctgtcc cttagtagtg cttgagcgct gtgctgggaa 45480atgcgctgct ctcttcagag ccagcaggca ggaacgttta agtccactga agttgcgccc 45540acagctgccc cttcccctag gtgccctctc tgtccgggga gatgggagtt ttatctataa 45600gcccctgact ggggctgctg cctttctttc agagatgccc tgccagtgag gaggaatcta 45660gagaggcagt ctggccacag ccgctttgct gtgctgtggt gagttccgcc cagtccgaac 45720tccccaccct ccttagcact gtcagggaaa agctacctac tcaagcctca gtaatggcgg 45780atgcccctct ctctaccaag ctctagtggc ccaggtcaac ttcaggctgc tgtgctggag 45840cgagaatttc aagccagtgt ttcttagctt gctgggctcc gtgggagtgg gacctgctga 45900gcaagaccac ttggctccct ggcttcagcc ctctttccag gggagtgaac ggttctgtct 45960tgctggggtt ccaggcgcca ctggggtaca aaaaaaaaat tcctgcagct agctcagtgt 46020ctttcccaaa cagccaccca gttttgtgct tgaaacccag ggccctggtg gtgtaggcac 46080atgagggaat ctcctggtct gtggattgca aaaactggga aatgcatagt atctggactg 46140gatagcacag tccctcatgg tttcccttgg ctgggggagg gaggcccccg gctccttgca 46200cttcctgggt gaggcaacac cccaccctga ttctgctcgc cctccgtggg ctgtacccac 46260tgcctaacca gtcccaatga gatgaactgg gtacctccgt tggaaatgca gaaatcactc 46320gccttctgtg ttgatcttgc tgggagctgc agtctggagc tgttcctatt cagccatctt 46380gccagatctc ccctctatct tctttttttt tttttttttt ttgagacaga gtcttgctct 46440gtctcccagg ctggagtgca gtagcacaat ctcggctcac tgcaagctcc gcctcccgag 46500ttcacgccat tctcctgcct cagcctcctg agtagcggac tacaggctcc tgcttttttg 46560ttttgttttt tgtattttta gtagagacag ggtttcacca tgttagccag gatggtctcg 46620atctcatgac ctcatgatcc gcccgcctca gcctcccata gtgctgggat tacaggcgtg 46680agccaccacg tctggccgat ctcaccctat cttaagctat ttccagaaac agaatgacta 46740ggtcagaggg tattaacatc gaaaaatgtt tccataccta gaaccacatc gttatgcaaa 46800taaattgtat caatttacac tcacaccagc tttacaggag ggtgttcatt ccttcagtct 46860taagaattct cagtattctt tctctttaaa aagaaaaaca gatctttaca cggagaaaag 46920tttttcaagt tcggcttgtg attatcctgc ctgcaaagat gagggaaaag agcgaaagtt 46980gatcatgttt aggcattact ttaagaagac aaaagagcat ttttcaacca ccccttctga 47040gaccagacta aaatcacagt caaggcactt ataggtataa tagcagctga tatggcttgg 47100ggctgggtcc ctgcccaaat ctcacatcaa actgtaatcc ccagcattga tggtgatgcc 47160tgctggaagg caactgggtt atgggagtgg atttcccctt tggtgctatt ctcttgatag 47220tgagttccct tcaccttctg ccatgattgg aagttccctg aggcctcccc agaagctgat 47280accaccatgc ttcctgtaca gcccgcagaa ctgtgagcca attaagcccc ttttctttat 47340aaattaccca gtctcaggta tttcttttca gtagtgtgag aatggactaa tacagcaact 47400aatgctaata gtggcgaaca atgtgtggac tttactttgc accactaact gctctaagat 47460gttagaaaaa actcaccgta ctctttcaag aacctctgaa gtgtgtatca tttgtaccac 47520cattaacaga taaggaaact gaaacagatg ttcaatgact tggccaaggt cagaaatcta 47580ctgatggcta aagactcggt tccgacccag tcatatggat tccagaactc acacattgcc 47640ttggtaccct ctctgctgac aaaaaacttg aatgagacca acaggagatc agagatttca 47700acagctattt agaagacaga actgactgaa gaaatgacaa ccgaataaag atgggtgaag 47760gcagctgcga tccacagcaa tatggagagg acatccagcc aagaagaatc acctgctagg 47820cagagcctca gagagaggag aagttcacca gccccatgac ccatatagga ttcaaggcag 47880cctcgagtct acaccaatga aaaaatcaga gagttcatga ctcaatcaaa aagccccaga 47940aataatatcc ttgtattctg acactttagg gggttcccat ccaatcaccc cacaggtaag 48000cctgccagtg gacttgtctt cctcctacat aggaatggat ctaggatcag atatatgaga 48060aagacaaaat aaggaaaaga gaccaagact aacaaatgca aaatgagtcc agaagaaatg 48120aataattttg aaaatggaca ataattttga aaaaatcaaa ctcatgtcct tggagagatt 48180taaactcacg ctggccgggt gcagtgactc acacctgtaa tcccagcact ttgggaggcc 48240gaggcaggca gatcacctga agtcgggagt ttgagaccag ccttaccaac atggagaaac 48300ccctgtctct actaaaaata caaaattagc tgggcatggt ggcgcatgcc tgtaatccca 48360gctactcggg aggctgagac aggagaatcg cttaaacctg ggaggcggag gttacggtga 48420cctgagttcg tgccattgca ctccagcctg ggcaacaaga gtgaaactct gtttcaaaat 48480aaaataaaat tgtatgcttg agaacaagat gtactgaaaa gaagggggaa acaatagaac 48540aaaaaaaaat tcttgggaat taaatgattg acaaaataaa caactcaaga gagggttgaa 48600aaagtctaga aaagcttcca gaaaataaac tagaaagatg acaggagaaa tggagctaaa 48660gcggaattga aatgttacca tacatcatga cttcctggaa agctacttga gaaagagcta 48720cagagggagt gggaaggacg tgcgtgtgtg tgcacgtgtg tgcacccatg gtgagtgggt 48780ggggataacc aagagagaaa aagacatggg atccaggaaa caagcaactc aacccagtga 48840gaagggaatc caaggatcac ggctgagcat gcagcaggcc taaagaacaa ccagtccagg 48900atggaataag aagggaaggg ttctgtgggg acttcacaga gtacctcata tgattcacaa 48960tttgagggaa gctgaggaaa tcatgaaggc aaacagtgca agggggggga aaacaaaggc 49020aattagaaac atcaggaaaa actaaagctg tgccacaaag catgtgcagc catattgtac 49080aactcaactc tatagtaaac agtatttaaa acatcacaaa aatgtaaaca cgcttgtttg 49140atttttaact ttgagcacaa aacagaacat ttaaatatga gaaccaaata aacttgttgc 49200caatcagtac caaaattaaa gtacaatggt agtgcttggg aagggaggca ctgaaaagga 49260agattaatat cctcgtttta taaaatgggg agtcaagaaa cactggccat agtgagggcg 49320taagaaaaac attgcaagta aattgtttac aaagtttcta atggggatta taaaactagc 49380gatataatat tagaagaagg tggggagggg agttagaagt gtaaagataa cttaataata 49440ataaataaat aataagtaat gaataaaaat attaataata aaaatagtaa taaaaaaatt 49500atatcctaat aggaagcaaa taaatagtga tgtctaaatt tcaaaatgga gaaaaataaa 49560aatgcaatag cttatattta ttgaccatct gctttgcacc aggaaccttc taaatgcttt 49620gcaggcatta acttattttt agttctcaca acaactgtta gaaagatact attatcacct 49680gcatgcttca gatgaggaaa ctgaagctca gagaagttaa gctagtgaca gcacctaact 49740agtgacaccc ggaattcaaa ctcaggcttc ctatctccag agcatgcact ctcactattt 49800catgtcccag cataagaaaa ttatttaaat atatttattt actccctaaa gaaaaagcta 49860gggccgggcg tggtggctca cacctgtaat cccagcactt tgggaggctg aggtgggtgg 49920atcacctgag gtcaggagtt caagaccagc ctgggcaaca tggtgaaacc ccgtctctac 49980taaaagtaca aaaattagct gggcacagtg gcatgtgcct gtaatcccag ttactcggga 50040ggctgaggca ggagaatcgc ttaagccagg gaggtggagg ttgcagtgag ccaagatcgc 50100gccactgcac tccagcctgg gtgacagagg gagactccgt ctcaaaaaaa aaaaaaaaaa 50160gaaaaaagaa aaagctaaaa ttgggactaa ttgctcttaa tttgggtaag tggagccgtc 50220tgtactaatt gattgattga ttgggaaggg gtaagtagag ccctctgtac taattgattg 50280gtcttaacca tctgctgcac tcacttatta ctttattttt ttaatttaag aggacagaat 50340tcagtttata gtagttagta actgctaacc tcaatagcaa gttaggttct ggtgtcacct 50400tccttgaagg ttatggagca atgtgaacat gtgccagtga gaaataagcc tgcctctgat 50460atggaagtgc tgggaaggga agcatgtagt ccctttaaat gatatggatc ccacctctgg 50520gaggcctgta atcccagcac ctgtaatccc agcactttgg gaggccaagg cggatagagc 50580acaaggtcag gagttcgaga ccggcctggc caatatggtg aaaccccgtc tctactaaaa 50640atacaaaaat tagctgggca tcgtggtggg tgcctgtagt cccagctact cgggaggctg 50700aggcaggaga attgcttgaa cccgggaggc agaggttgcc gtgagccatg attacaccac 50760tgcaccccag cctggagaca gagtgagact ttgtctcaaa gaaaaaaaaa gaaaagaagt 50820gggggcctca cacacagttt cctggataac aggaactatt gtaagagatc ccaccaaacc 50880acaaccatgc agaatgaatc acagccctgc acaaaggcca cctctatgag gacatctgcc 50940caacaactgt ctgtttaacc ttgagctaag gtgacccttg ttattaattc ttgtacctag 51000ggatcattat ttaaaataac ttacataatt ctccccattt tggctttaaa aacctctgct 51060420DNAArtificial sequenceSingle strand DNA oligonucleotide 4acaagcccaa gcccacgacc 20520DNAArtificial sequenceSingle strand DNA oligonucleotide 5cctggcccct gccaggcata 20652DNAHomo sapiensmisc_feature(27)..(27)N can be A or G 6tcaagctcac ggatgtggcc cctgtangct tctttcttgt gctggatgta gt 52752DNAHomo sapiensmisc_feature(27)..(27)N can be G or T 7caggagctgg aggagaagct aaacatnctc aacaataatt ataagattct gc 52852DNAHomo sapiensmisc_feature(27)..(27)N can be A or G 8ccccagttcc ttatctgcaa ttccatnatt cccagatccc tgcaaaccac ac 52952DNAHomo sapiensmisc_feature(27)..(27)N can be A or G 9accttcggat gggcttttgg gggaggngag gtccttttag ttgatcttga tg 521052DNAHomo sapiensmisc_feature(27)..(27)N can be C or T 10cactctccct tgtcctcctg ggggcanatc tcagtcaggc agcggcttcc tg 52

Claims

1. A method of determining predisposition of a subject to develop a kidney disease, comprising: identifying in a sample of the subject at least one APOL1 polypeptide variant which is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on said Trypanosoma brucei rhodesiense under identical assay conditions, wherein presence of said APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease, thereby determining the predisposition of the subject to develop the kidney disease.

2. A method of determining predisposition of a subject to develop a kidney disease, comprising: identifying in a sample of the subject at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3 or at least one APOL1 polypeptide variant, wherein said at least one nucleotide mutation or polypeptide variant being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of said APOL1 nucleotide mutation or said APOL1 polypeptide variant indicates increased predisposition of the subject to develop the kidney disease, thereby determining the predisposition of the subject to develop the kidney disease.

3. The method of claim 1, wherein said APOL1 polypeptide variant comprises a mutation in the C-terminal helix of said APOL1 polypeptide.

4. The method of claim 1, wherein said APOL1 polypeptide variant has a reduced binding ability to serum resistance-associated protein (SRA) expressed by Trypanosoma brucei rhodesiense as compared to the binding ability of said APOL1 wild type polypeptide under identical assay conditions.

5. The method of claim 1, wherein said APOL1 polypeptide variant comprises the amino acid sequence set forth in SEQ ID NO:1 with a mutation selected from the group consisting of G342, M384, N388-del and Y389-del.

6. The method of claim 2, wherein said LD between said APOL1 nucleotide mutation and said S342G mutation is characterized by a Lewontin correlation coefficient (D') higher than 0.5.

7. The method of claim 6, wherein a significance of said LD is characterized by LOD≧2.

8. The method of claim 2, wherein said APOL1 nucleotide mutation is selected from the group consisting of the guanine-containing allele of single nucleotide polymorphism (SNP) rs73885319 (SEQ ID NO:6), the guanine-containing allele of SNP rs60910145 (SEQ ID NO:7), the guanine-containing allele of SNP rs9622363 (SEQ ID NO:8), the adenine-containing allele of SNP rs60295735 (SEQ ID NO:9) and the cytosine-containing allele of SNP rs58384577 (SEQ ID NO:10).

9. The method of claim 1, wherein said kidney disease comprises end stage kidney disease.

10. The method of claim 1, wherein said kidney disease comprises HIV-associated nephropathy (HIVAN).

11. A method of designing a life style change to a subject with the risk of kidney disease, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein said variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on said Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein said APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein said at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of said APOL1 polypeptide variant or said APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and; (b) designing the life style change based on presence or absence of said APOL1 polypeptide variant or said APOL1 nucleotide mutation, thereby designing life style change to a subject with the risk of kidney disease.

12. The method of claim 11, wherein said subject is infected with HIV.

13. A method of designing a nephrotoxic anti-retroviral treatment regimen to a subject infected with HIV, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein said variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on said Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein said APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein said at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of said APOL1 polypeptide variant or said APOL1 nucleotide mutation indicates increased predisposition of the subject to develop the kidney disease, and; (b) designing the nephrotoxic anti-retroviral treatment regimen based on presence or absence of said APOL1 polypeptide variant or said APOL1 nucleotide mutation, thereby designing a nephrotoxic anti-retroviral treatment regimen to the subject infected with HIV.

14. A method of determining if a subject is suitable for donating a kidney for transplantation, comprising: (a) identifying in a sample of the subject at least one APOL1 polypeptide variant or at least one APOL1 nucleotide mutation, (i) wherein said variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on said Trypanosoma brucei rhodesiense under identical assay conditions; (ii) wherein said APOL1 nucleotide mutation is included in the APLO1 genomic sequence set forth in SEQ ID NO:3, and wherein said at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, wherein presence of said APOL1 polypeptide variant or said APOL1 nucleotide mutation indicates increased predisposition of the subject to develop a kidney disease, and; wherein increased predisposition of the subject to develop said kidney disease indicates that the subject is not suitable for donating the kidney for transplantation, thereby determining if the subject is suitable for donating a kidney for transplantation.

15. A kit for determining predisposition to a kidney disease, comprising a reagent capable of specifically detecting at least one APOL1 nucleotide mutation in the APLO1 genomic sequence set forth in SEQ ID NO:3, wherein said at least one nucleotide mutation being in linkage disequlibrium (LD) with the S342G mutation in the APOL1 polypeptide set forth in SEQ ID NO:1, and/or a reagent capable of specifically detecting at least one APOL1 polypeptide variant, wherein said APOL1 polypeptide variant is characterized by a higher trypanolytic activity on Trypanosoma brucei rhodesiense as compared to the trypanolytic activity of wild type APOL1 polypeptide as set forth in SEQ ID NO:1 on said Trypanosoma brucei rhodesiense under identical assay conditions.

16. The kit of claim 15, wherein said APOL1 nucleotide mutation is selected from the group consisting of the guanine-containing allele of single nucleotide polymorphism (SNP) rs73885319 (SEQ ID NO:6), the guanine-containing allele of SNP rs60910145 (SEQ ID NO:7), the guanine-containing allele of SNP rs9622363 (SEQ ID NO:8), the adenine-containing allele of SNP rs60295735 (SEQ ID NO:9) and the cytosine-containing allele of SNP rs58384577 (SEQ ID NO:10).

17. The kit of claim 15, wherein said reagent comprises a polynucleotide capable of specifically detecting said APOL1 nucleotide mutation.

18. The kit of claim 15, wherein said reagent comprises an antibody capable of specifically binding an APOL1 variant comprises said nucleotide mutation and not to said APLO1 wild type polypeptide.

19. The kit of claim 15, wherein said APOL1 polypeptide variant comprises the amino acid sequence set forth in SEQ ID NO:1 with a mutation selected from the group consisting of G342, M384, N388-del and Y389-del.

20. The method of claim 1, further comprising informing the subject on the state of the predisposition to develop the kidney disease.

21. The method of claim 2, further comprising informing the subject on the state of the predisposition to develop the kidney disease.

22. The method of claim 2, wherein said nucleotide mutation creates an APOL1 protein variant.

23. The method of claim 2, wherein said nucleotide mutation is detected by a DNA detection method.

24. The method of claim 22, wherein said APOL1 protein variant is detected by a protein detection method.

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