Page 1383 - Veterinary Immunology, 10th Edition

When given with cyclosporine, mycophenolate mofetil prevents
VetBooks.ir renal allograft rejection between unrelated mongrel dogs. It has

been reported to be effective in controlling canine diseases such as
immune-mediated thrombocytopenia and hemolytic anemia,

meningoencephalitis, polymyositis, and pemphigus foliaceus, as
well as systemic histiocytosis (Chapter 10). It is well tolerated by
dogs.

Leflunomide

Leflunomide is an antiinflammatory agent that inhibits pyrimidine
synthesis. It may induce production of Treg cells. It has been used
for the prevention of allograft rejection in dogs. It has also been
applied to several canine autoimmune and inflammatory diseases,

especially in cases refractory to corticosteroid treatment or in which
corticosteroids are contraindicated.

Intravenous Immunoglobulin Therapy

Although immunoglobulin replacement is appropriate for animals
with antibody deficiencies, intravenous immunoglobulin (IVIG)
therapy is immunosuppressive and antiinflammatory. Human IVIG
has been used to treat autoimmune and inflammatory diseases in

domestic animals. This is a pooled IgG preparation derived from a
large number of healthy donors. Administered intravenously, its
beneficial effects are probably mediated by IgG molecules with
sialic acid on their Fc region. These bind to the integrin DC-SIGN

on myeloid cells. This in turn stimulates IL-33 production, which
then promotes IL-4 production, which in turn upregulates the
inhibitory receptor FcγR2b on effector macrophages and dendritic
cells. This then inhibits the activities of autoantibodies. In addition,

administration of IVIG has been shown to increase production of
transforming growth factor-β (TGF-β) and IL-10 by Treg cells and
numerous other activities (Fig. 41.6). In dogs, it may act by
saturating Fc receptors such as CD16 and CD32 on monocytes. IVIG

may also interfere with CD95-mediated apoptosis.

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