The Potential Capacities of FTY720: Novel Therapeutic Functions, Targets, and Mechanisms against Diseases

As an antagonist of sphingosine-1-phosphate (S1P), FTY720 works by binding to S1P receptors (S1PRs) other than S1PR2 and was granted permission for multiple sclerosis by the Food and Drug Administration (FDA) in 2010. As the first non-selective oral agonist for S1PRs, the diversity and systemic expression of FTY720 receptors often cause alterations in various signaling pathways and multi-systems, making FTY720 a hot drug in current research. Recent studies have identified FTY720 has a wide range of novel or potential functions beyond targeting multiple sclerosis, involving studies ranging from the blood-brain barrier (BBB), the vascular system, organelles, cell death, and synaptic transmission, to organ transplantation diseases, immune disorders, oncological disorders, neurological and psychiatric disorders, virus infection, and more. Based on these studies, this paper reviews the novel roles, targets, and mechanisms of FTY720 that have the potential for clinical utility. In addition, this review summarises the FTY720 derivation and development process, clinical safety, future dilemmas, and coping strategies. Collecting these summaries and insights greatly enriches our comprehension and appreciation of FTY720's profound clinical potential and therapeutic applicability.