Fingolimod

Fingolimod (rINN, codenamed FTY720) is a novel immunosuppressant drug that causes lymphopenia by preventing egress of lymphocytes from lymph nodes. It is a sphingosine-1-phosphate receptor 1 modulator.

It is a chemical modification of the Myriocin (ISP-1) metabolite of the fungus Isaria sinclairii (Dong Chong Xia Cao). It is a structural analogue of sphingosine and gets phosphorylated by sphingosine kinases in the cell (most importantly sphingosine kinase 2). The molecular biology of this biological function lies in FTY720's activity at one of the five sphingosine-1-phosphate receptors, S1P1. ] It is currently in phase III clinical trials as monotherapy for relapsing-remitting multiple sclerosis. In a previous phase III trial of kidney transplantation, FTY720 was found to be no better than the existing standard of care.