FTY720, which does not cause generalized immunosuppression, may be a safe and benign therapeutic agent for chronic use to prevent or cure type 1 diabetes.

These studies demonstrate for the first time that cytoreduction/ablation with ALS combined with sirolimus and reconstitution with donor bone marrow induces tolerance and chimerism in a completely mismatched murine combination. The use of ALS and sirolimus, currently employed therapies in clinical transplantation, and the lack of requirement for radiation make this tolerance protocol attractive for clinical application.

FTY720 is a safe and benign therapeutic agent that may be used chronically in prediabetic individuals.

Induction of tolerance by ALS, BM, and sirolimus results in a state of donor-specific tolerance, and multilineage chimerism evolves that is permanent and associated with clonal deletion of alloreactive T cells.