Role of fingolimod in acute respiratory distress syndrome.


  • Sarwat Jahan Northwest School of Medicine, Peshawar.
  • Manzoor Khan Khyber Teaching Hospital, Peshawar.
  • Salman Zahir Northwest General Hospital and Research Centre, Peshawar.
  • Khansa Khan Northwest General Hospital, Peshawar.
  • Sarah Saleem Islamabad Medical and Dental College, Islamabad.



COVID-19, Fingolimod, Respiratory Distress Syndrome, Sphingosine 1 Phosphate


Objective: Sphingosine 1 Phosphate (S1P) is a key regulator of inflammation, angiogenesis, vessel permeability, and immune processes, acting through S1P receptors. Fingolimod (FTY720), an S1P receptor analog Fingolimod, was initially approved for multiple sclerosis treatment and has shown potential for application in infectious and inflammatory disorders, including COVID-19. Study Design: Comprehensive Literature Review. Setting: Northwest School of Medicine. Period: 1st March 2023 to 3rd July 2023. Methods: Examining S1P pathways, S1P receptor analogs, and their potential in treating inflammatory and infectious disorders, particularly COVID-19, utilizing Fingolimod. Results: S1P analogs have demonstrated therapeutic benefits in autoimmune diseases. In COVID-19, these analogs modulate the inflammatory response, reduce tissue damage, and promote viral clearance. Fingolimod, in particular, affects S1PR1, S1PR4, and S1PR5, blunting the inflammatory response and mitigating lung tissue injury. Early administration may prevent excessive inflammation without interfering with viral clearance. Potential risks include disturbance of cytokine homeostasis and delayed administration. Limited human studies and concerns about off-target effects need addressing. Conclusion: Fingolimod shows promise in treating COVID-19 by reducing inflammation and lung damage. Further research is needed to address limitations and ensure safety for clinical application. Sphingosine 1 Phosphate (S1P) plays a key role in regulating inflammation and immune responses, with Fingolimod being a potential treatment option.

Author Biographies

Sarwat Jahan, Northwest School of Medicine, Peshawar.

MBBS, M.Phil, CHPE, Associate Professor Pharmacology, 

Manzoor Khan, Khyber Teaching Hospital, Peshawar.

MBBS, FCPS Trainee Cardiology Resident, 

Salman Zahir, Northwest General Hospital and Research Centre, Peshawar.

MBBS, CHR, House Officer, 

Khansa Khan, Northwest General Hospital, Peshawar.

MBBS, House Officer, 

Sarah Saleem, Islamabad Medical and Dental College, Islamabad.

MBBS, MCPS, M.Phil, Scholar Pharmacology,