The pharmacokinetics and cell trafficking dynamics of 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol hydrochloride (FTY720), a novel immunosuppressive agent, were examined in cynomolgus monkeys (three males and three females). After single doses of 0.1 mg/kg p.o. or i.v. bolus and 1 mg/kg p.o. were administered to the animals, the concentrations of FTY720, and the numbers of lymphocytes, CD20ϩCD2-B cells, and CD2ϩCD20-T cells in blood were measured over 23 days. A linear three-compartment model characterized the time course of FTY720 concentrations with a terminal half-life of about 31 h, clearance of about 0.53 l/h/kg, and bioavailability of about 38%. The dynamic responses were not area under the curve (or dose) proportional for either males or females. An indirect response model with a distribution pool captured the cell trafficking data for all doses for each cell type, where initial blood counts (R 0 ) were about 7650, 2100, and 5250 cells/l; maximum fractional inhibition (I max ) about 0.88, 0.85, and 0.91; influx (k in ) about 6014, 1312, and 5662 cells/l/h; efflux (k out ) about 0.798, 0.555, and 1.08 h Ϫ1 ; intercompartmental k cp about 0.134, 0.192, and 0.082 h Ϫ1 ; and intercompartmental k pc rate constants about 3.9 ϫ 10 Ϫ4 , and 0.016 and 8.9 ϫ 10 Ϫ6 h Ϫ1 for lymphocytes, B cells, and T cells, respectively. The inhibition concentration IC 50 was about 0.48 g/l for all cells, which was remarkably low. The apparent distribution volumes of peripheral pool (V p ) were markedly larger than blood volume (V b ) for all cells. The I max for cell trafficking was achieved at doses smaller than that producing graft protection, indicating stronger central than peripheral effects of this drug. The profound cell trafficking effects of FTY720 can be readily captured and interpreted with an extended indirect response model.2-Amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol hydrochloride (FTY720), a novel immunosuppressant found in Isaria sinclairii (a fungus) metabolite (Fujita et al., 1994), protects solid organ grafts with strong potency (Kahan, 1998); acts synergistically with cyclosporin, sirolimus, or tacrolimus (Kawaguchi et al., 1996;Stepkowski et al., 1998;Hoshino et al., 1999); and prevents experimental autoimmune myocarditis, autoimmune diabetes, and arthritis (Yan et al., 1998;Kitabayashi et al., 1999;Matsuura et al., 2000). Diverse pharmacological mechanisms of action were found for FTY720: it can produce cell cycle arrest of lymphocytes (Nagahara et al., 2001), and it can alter production (Yagi et al., 2000), trafficking (Chiba et al., 1998;Brinkmann et al., 2000Brinkmann et al., , 2001Pinschewer et al., 2000), infiltration (Yanagawa et al., 2000), and apoptosis (Enosawa et al., 1996;Bohler at al., 2000;Nagahara et al., 2000) of lymphocytes. Perplexities about FTY720 regarding preclinical and clinical data include that the maximum effects of FTY720 on cell trafficking were achieved at doses smaller than those producing protection This research was supported by Novartis Pharma AG, Basel, Swi...