Pathology As a bioactive lipid, ceramide has been implicated in a variety of physiological functions including
apoptosis, cell growth arrest, differentiation, cell
senescence, cell migration and adhesion. Several distinct ceramides potently predict
major adverse cardiovascular events (MACE), namely C16:0, C18:0, and C24:1, although C24:0 has an inverse relationship. Dietary intake of
saturated fat has been shown to increase serum ceramide and increase
insulin resistance.
Unsaturated fat does not have this effect. Aggregation of
LDL cholesterol by ceramide causes LDL retention in arterial walls, leading to
atherosclerosis. Ceramides cause
endothelial dysfunction by activating
protein phosphatase 2 (PP2A). In mitochondria, ceramide suppresses the
electron transport chain and induces production of
reactive oxygen species.
Apoptosis One of the most studied roles of ceramide pertains to its function as a proapoptotic molecule.
Apoptosis, or Type I
programmed cell death, is essential for the maintenance of normal cellular homeostasis and is an important physiological response to many forms of cellular stress. Ceramide accumulation has been found following treatment of cells with a number of apoptotic agents, including ionizing radiation,
UV light,
TNF-alpha, and
chemotherapeutic agents. This suggests a role for ceramide in the biological responses of all these agents. Because of its apoptosis-inducing effects in cancer cells, ceramide has been termed the "tumor suppressor lipid". Several studies have attempted to define further the specific role of ceramide in the events of cell death and some evidence suggests ceramide functions upstream of the
mitochondria in inducing apoptosis. However, owing to the conflicting and variable nature of studies into the role of ceramide in apoptosis, the mechanism by which this lipid regulates apoptosis remains elusive.
Skin The
stratum corneum is the outermost layer of the
epidermis. It is composed of terminally differentiated and enucleated
corneocytes that reside within a lipid matrix, like "bricks and mortar." Together with
cholesterol and free fatty acids, ceramides form the lipid mortar, a water-impermeable barrier that prevents evaporative water loss. As a rule of thumb, the epidermal lipid matrix is composed of an equimolar mixture of ceramides (~50% by weight), cholesterol (~ 25% by weight), and free fatty acids (~15% by weight), with smaller quantities of other lipids also being present. The lipid barrier also protects against the entry of microorganisms.
Hormonal Inhibition of ceramide synthesis with
myriocin in obese mice may lead to both improved
leptin signaling and decreased
insulin resistance by decreasing
SOCS-3 expression. An elevated level of ceramide can cause insulin resistance by inhibiting the ability of insulin to activate the
insulin signal transduction pathway and/or via the activation of
JNK. ==Substances known to induce ceramide generation==