FTY720 (Fingolimod) is a known sphingosine-1-phosphate (S1P) receptor agonist 
that exerts strong anti-inflammatory effects and was approved as the first oral 
drug for the treatment of multiple sclerosis by the US Food and Drug 
Administration (FDA) in 2010. FTY720 is mainly associated with unique functional 
"antagonist" and "agonist" mechanisms. The functional antagonistic mechanism is 
mediated by the transient down-regulation and degradation of S1P receptors on 
lymphocytes, which prevents lymphocytes from entering the blood stream from the 
lymph node. This subsequently results in the development of lymphopenia and 
reduces lymphocytic inflammation. Functional agonistic mechanisms are executed 
through S1P receptors expressed on the surface of various cells including 
neurons, astrocytes, microglia, and blood vessel endothelial cells. These 
functions might play important roles in regulating anti-apoptotic systems, 
modulating brain immune and phagocytic activities, preserving the 
Blood-Brain-Barrier (BBB), and the proliferation of neural precursor cells. 
Recently, FTY720 have shown receptor-independent effects, including 
intracellular target bindings and epigenetic modulations. Many researchers have 
recognized the positive effects of FTY720 and launched basic and clinical 
experiments to test the use of this agent against stroke. Although the mechanism 
of FTY720 has not been fully elucidated, its efficacy against cerebral stroke is 
becoming clear, not only in animal models, but also in ischemic stroke patients 
through clinical trials. In this article, we review the data obtained from 
laboratory findings and preliminary clinical trials using FTY720 for stroke 
treatment.