# Project 3: The Role of Erythropoietin in Kidney Transplant Tolerance

> **NIH NIH P01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $444,090

## Abstract

PROJECT SUMMARY / ABSTRACT
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 naïve 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.

## Key facts

- **NIH application ID:** 9987475
- **Project number:** 5P01AI123086-05
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Peter Scott Heeger
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $444,090
- **Award type:** 5
- **Project period:** 2016-08-05 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9987475

## Citation

> US National Institutes of Health, RePORTER application 9987475, Project 3: The Role of Erythropoietin in Kidney Transplant Tolerance (5P01AI123086-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9987475. Licensed CC0.

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