Intracerebral hemorrhage (ICH) is a devastating disease, which accounts for ≈10% to 15% of strokes with high mortality and morbidity.1,2 Effective treatments for ICH remain sparse.1 Accumulating evidence has demonstrated that brain inflammation provoked by microglia and infiltrating lymphocytes exacerbates ICH-induced brain injury.3 After ICH, brain-intrinsic microglia are the first immune responder and followed by inflammatory infiltrates such as neutrophils, monocytes, macrophages, and subsets of lymphocytes. 4,5 Activation of these cellular components together with factors they produce and cell death products, further contribute to brain inflammation, which results in the development of perihematomal edema.3-7 Perihematomal edema can aggravate the mass effect and secondary brain injury through subsequent oligemia and inflammatory insults.1,8 Edema, as a surrogate marker for inflammation in ICH, 1,9,10 and the persistence of perihematomal edema after ictus makes it amenable for intervention.1 Thus, targeting inflammation could be a viable approach for treating ICH.Sphingosine-1-phosphate (S1P) is a ligand for 5 G-proteincoupled receptors: S1P receptors 1 to 5 (S1PR1-5) are responsible for numerous cell-intrinsic and extrinsic activities. 11,12 Fingolimod (FTY720, Glenya), an oral therapy for multiple sclerosis (MS), is a S1PR modulator that binds to S1PR1, 3, 4, and 5. The beneficial effects of fingolimod in MS may be mediated by S1PR1 expressed on lymphocytes, vascular endothelia, neurons, and glia.11 Recent preclinical and clinical studies have demonstrated that fingolimod can attenuate neurodeficits and brain edema in ICH. [13][14][15][16][17][18] However, it remains unclear whether immune modulations via S1PR1 are sufficient for fingolimod to provide Background and Purpose-Preclinical studies and a proof-of-concept clinical study have shown that sphingosine-1-phosphate receptor (S1PR) modulator, fingolimod, improves the clinical outcome of intracerebral hemorrhage (ICH). However, the specific subtype of the S1PRs through which immune modulation provides protection in ICH remains unclear. In addition, fingolimod-induced adverse effects could limit its use in patients with stroke because of interactions with other S1PR subtypes, particularly with S1PR3. RP101075 is a selective S1PR1 agonist with superior cardiovascular safety profile. In this study, we investigated the impact of RP101075 treatment in a mouse model of ICH. Methods-ICH was induced by injection of autologous blood in 294 male C57BL/6J and Rag2 −/− mice. ICH mice randomly received vehicle, RP101075, or RP101075 plus S1PR1 antagonist W146 by daily oral gavage for three consecutive days, starting from 30 minutes after surgery. Neurodeficits, brain edema, brain infiltration of immune cells, blood-brain barrier integrity, and cell death were assessed after ICH. Results-RP101075 significantly attenuated neurological deficits and reduced brain edema in ICH mice. W146 blocked the effects of RP101075 on neurodeficits and brain edema. RP101075 reduced th...