Effect of Korean Red Ginseng on Plasma Ceramide Levels in Postmenopausal Women with Hypercholesterolemia: A Pilot Randomized Controlled Trial

Roles and therapeutic targeting of ceramide metabolism in cancer

BACKGROUND

Ceramides are sphingolipids that act as signaling molecules involved in regulating cellular processes including apoptosis, proliferation, and metabolism. Deregulation of ceramide metabolism contributes to cancer development and progression. Therefore, regulation of ceramide levels in cancer cells is being explored as a new approach for cancer therapy.

SCOPE OF THE REVIEW

This review discusses the multiple roles of ceramides in cancer cells and strategies to modulate ceramide levels for cancer therapy. Ceramides attenuate cell survival signaling and metabolic pathways, while activating apoptotic mechanisms, making them tumor-suppressive. Approaches to increase ceramide levels in cancer cells include using synthetic analogs, inhibiting ceramide degradation, and activating ceramide synthesis. We also highlight combination therapies such as use of ceramide modulators with chemotherapies, immunotherapies, apoptosis inducers, and anti-angiogenics, which offer synergistic antitumor effects. Additionally, we also describe ongoing clinical trials evaluating ceramide nanoliposomes and analogs. Finally, we discuss the challenges of these therapeutic approaches including the complexity of ceramide metabolism, targeted delivery, cancer heterogeneity, resistance mechanisms, and long-term safety.

MAJOR CONCLUSIONS

Ceramide-based therapy is a potentially promising approach for cancer therapy. However, overcoming hurdles in pharmacokinetics, specificity, and resistance is needed to optimize its efficacy and safety. This requires comprehensive preclinical/clinical studies into ceramide signaling, formulations, and combination therapies. Ceramide modulation offers opportunities for developing novel cancer treatments, but a deeper understanding of ceramide biology is vital to advance its clinical applications.

Positive Correlation of Triacylglycerols with Increased Chain Length and Unsaturation with ω-O-Acylceramide and Ceramide-NP as Well as Acidic pH in the Skin Surface of Healthy Korean Adults

Triacylglycerols (TG) play an important role in skin homeostasis including the synthesis of ω-O-acylceramides (acylCER) required for skin barrier formation by providing linoleic acid (C18:2n6). However, the overall relationships of TG species with various ceramides (CER) including CER-NP, the most abundant CER, ω-O-acylCER, and another acylCER, 1-O-acylCER in human SC, remain unclear. Therefore, we investigated these relationships and their influence on skin health status in healthy Korean adults. Twelve CER subclasses including two ω-O-acylCER and two 1-O-acylCER were identified with CER-NP consisting of approximately half of the total CER. The ω-O-acylCER species exhibited positive relationships with TG 52:4 and TG 54:2 containing C18:2, while interestingly, 1-O-acylCER containing ester-linked C14:0 and C16:0 demonstrated positive relationships with TG 46-50 including C14:0 and C16:0, respectively. In addition, CER-NP and CER-NH showed positive correlations with TG 52-54 containing C18:2 or C18:3. A lipid pattern with higher levels of CER including CER-NP and ω-O-acylCER with TG 54 and TG with 5-6 double bonds was related to good skin health status, especially with acidic skin pH. Collectively, TG with increased chain length and unsaturation seemed to improve CER content, and profiles such as higher acylCER and CER-NP improved skin health status by fortifying skin barrier structure.