# CpG and B cells, pretreated ex-vivo with natural IgM, protect against renal IRI

> **NIH NIH R01** · UNIVERSITY OF VIRGINIA · 2021 · $363,375

## Abstract

Summary/Abstract
Acute kidney injury (AKI) is a common problem and associated with increased morbidity and mortality and
development of chronic kidney disease (CKD) and in some cases end stage renal disease (ESRD). There are no
FDA approved drugs to prevent AKI, and this is in part related to systemic side effects of these drugs. In this
application we propose two approaches to prevent AKI. Firstly, we propose the pre-emptive use of ex-vivo
induced regulatory B cell infusion to prevent AKI. We have shown that isolated B cells, pretreated ex-vivo with
IgM or CpG, develop into regulatory B cells (Bregs), which when intravenously infused into mice, 24 hours
before renal ischemia, protect mice from renal ischemia induced AKI and we show that protection is mediated
by inhibiting the ischemia induced inflammatory response (IIR) which is primarily responsible for AKI. We
show that the infused Bregs interact and regulate in-vivo NKT-1 cell, which normally amplify the IIR. We
would like to also examine how IgM or CpG pretreatments switch B cells into Bregs. Secondly, we propose that
CpG ,when pre-emptively administered to mice, prevents AKI. Others have shown that CpG when
administered 3 or 4 days or 1 hour before the ischemic event in murine hearts or brain, protects these mice from
ischemia induced damage. CpG,when administered 1 hour before the ischemic event, protects by enhancing
tolerance of non-immune cells (i.e cardiomyocytes, neurons) to ischemia induced cell injury/death. However,
we do not understand how CpG protects against ischemic damage when given 3 or 4 days before ischemia and
there are no studies on the protective effect of CpG in AKI. We propose that CpG when given at -3 or -4 days
induces production of high in-vivo natural IgM, which we have shown is broadly anti-inflammatory and protects
kidneys by inhibiting IIR. We would like, in this application, to investigate the mechanism for CpG induced
protection and evaluate if CpG and Bregs, when combined is more protective. We will use two murine models
of AKI i.e ischemia and LPS induced sepsis to determine if Bregs and/or CpG inhibit innate inflammation. This
project has a good chance for translation into humans as CpG is currently used in vaccines and we induced ex-
vivo human Bregs with IgM and CpG pretreatment. Both Bregs and/or CpG can be used to prevent AKI in high
risk cardiac surgery and in deceased organ donors or recipients.

## Key facts

- **NIH application ID:** 10120676
- **Project number:** 5R01DK114366-04
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** PETER LOBO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $363,375
- **Award type:** 5
- **Project period:** 2018-05-02 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10120676

## Citation

> US National Institutes of Health, RePORTER application 10120676, CpG and B cells, pretreated ex-vivo with natural IgM, protect against renal IRI (5R01DK114366-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10120676. Licensed CC0.

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