It is known that kidney transplants are spontaneously accepted across selected fully MHC-disparate barriers in mice, kidney allograft tolerance occurs spontaneously, albeit rarely, in humans, and co-transplantation of a kidney with a heart allograft in humans prolongs survival of the heart graft. The mechanisms underlying these kidney-dependent effects are not known and if better understood, could potentially be exploited to improve transplant outcomes and induce robust allograft tolerance in humans. Our new published and preliminary data support the provocative and intriguing concept that erythropoietin (EPO), a hormone produced predominantly by the kidney in adults, plays an unanticipated role in kidney allograft tolerance. Expanding beyond EPO's established role in erythrocyte development, our new data demonstrate that EPO inhibits alloreactive, conventional T cell immunity and augments regulatory T cell (Treg) induction, function and stability. The preliminary data also identify molecular mechanisms that link EPO to these effects. Our findings support the following hypothesis to be tested in this project as part of the P01: kidney-produced EPO directly and locally inhibits alloreactive nave and memory T cells, and simultaneously induces and maintains stability of donor- specific Treg, together facilitating kidney transplant survival and tolerance. We will test this hypothesis by determining the effects of kidney allograft-derived EPO on murine alloimmunity and allograft survival, deciphering the mechanisms through which EPO selectively inhibits conventional alloreactive T cells, and assessing mechanisms through which EPO promotes Treg induction and stability. The proposed work will define the role of EPO as a mediator of kidney allograft tolerance and will delineate cellular and molecular mechanisms underlying EPO's effects on conventional T cells and Treg. The insights derived from our proposed studies will synergize with and help to guide studies to be performed by our collaborators in projects 1 and 2 on Kidney Induced Cardiac Allograft Tolerance within the program project. In addition to deciphering mechanisms, the studies will provide preclinical data on the utility of EPO as a therapeutic agent for improving graft survival in animals, findings that could potentially be translated to human transplant recipients.

Public Health Relevance

These studies seek to identify mechanisms of spontaneous tolerance to kidney allografts taking advantage of inbred, and newly generated transgenic and knock out mouse strains. Mouse kidney transplants are life sustaining and have pathological features similar to humans. The proposed mechanistic experiments which cannot be done in large animals or humans, could potentially improve outcomes in kidney transplant recipients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program Projects (P01)
Project #
5P01AI123086-03
Application #
9528465
Study Section
Special Emphasis Panel (ZAI1)
Project Start
Project End
Budget Start
2018-08-01
Budget End
2019-07-31
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
Hotta, Kiyohiko; Oura, Tetsu; Dehnadi, Abbas et al. (2018) Long-term Nonhuman Primate Renal Allograft Survival Without Ongoing Immunosuppression in Recipients of Delayed Donor Bone Marrow Transplantation. Transplantation 102:e128-e136
Robinson, Kortney A; Orent, William; Madsen, Joren C et al. (2018) Maintaining T cell tolerance of alloantigens: Lessons from animal studies. Am J Transplant 18:1843-1856
Sasaki, Hajime; Oura, Tetsu; Spitzer, Thomas R et al. (2018) Preclinical and clinical studies for transplant tolerance via the mixed chimerism approach. Hum Immunol 79:258-265
Michel, S G; Madariaga, M L L; LaMuraglia 2nd, G M et al. (2018) The effects of brain death and ischemia on tolerance induction are organ-specific. Am J Transplant 18:1262-1269
Smith, R N; Adam, B A; Rosales, I A et al. (2018) RNA expression profiling of renal allografts in a nonhuman primate identifies variation in NK and endothelial gene expression. Am J Transplant 18:1340-1350
Chatterjee, Debanjana; Moore, Carolina; Gao, Baoshan et al. (2018) Prevalence of polyreactive innate clones among graft--infiltrating B cells in human cardiac allograft vasculopathy. J Heart Lung Transplant 37:385-393
Smith, R N; Matsunami, M; Adam, B A et al. (2018) RNA expression profiling of nonhuman primate renal allograft rejection identifies tolerance. Am J Transplant 18:1328-1339
Wang, Zhaohui; Louras, Nathan J; Lellouch, Alexandre G et al. (2018) Dosing optimization of CCR4 immunotoxin for improved depletion of CCR4+ Treg in nonhuman primates. Mol Oncol 12:1374-1382
Madsen, Joren C (2017) Advances in the immunology of heart transplantation. J Heart Lung Transplant 36:1299-1305
Alessandrini, Alessandro; Turka, Laurence A (2017) FOXP3-Positive Regulatory T Cells and Kidney Allograft Tolerance. Am J Kidney Dis 69:667-674

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