But what about this problem with sphingolipids? Hasn't your competent? doctor initiated research to solve this? NO? So you DON'T have a functioning stroke doctor, do you?
Sphingolipids Contribute to Human Atherosclerotic Plaque Inflammation May 2016
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Signaling roles of sphingolipids in the ischemic brain and their potential utility as therapeutic targets
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Keywords
Ceramide
Sphingomyelin
Sphingosine-1-phosphate
Ischemic stroke
1. Introduction
1.1. Functional roles of sphingolipids
Sphingolipids
are enriched in cellular membranes, but their roles extend far beyond
their function as mere structural elements. In comparison to other
organs such as heart, spleen and liver, the concentration of the
sphingolipids is particularly high in the brain and dysregulation of the
sphingolipid metabolism is implicated in neurodegenerative disorders (Muralidharan et al., 2021; Piccinini et al., 2010).
Ceramide
is structurally one of the simplest sphingolipid and is considered to
be the most studied one. It consists of a sphingoid base, which is
linked via an amide bond to a fatty acid (Alonso and Goni, 2018).
Ceramide signaling is activated by several stress stimuli such as
radiation, UV light or inflammatory cytokines like tumor necrosis factor
(TNF) (Chatterjee and Wu, 2001; Martinez et al., 2012; Vit and Rosselli, 2003). Ceramide-rich platforms on cell membranes enable protein oligomerization in order to amplify transmembrane signaling (Stancevic and Kolesnick, 2010).
These platforms are critically involved in apoptotic events. CD95
clustering on ceramide-rich platforms for instance precedes
death-inducing signaling complex (DISC) formation and caspase activation
(Grassme et al., 2003).
In view of the importance of ceramide for pro-apoptotic pathways,
pharmacological inhibition of ceramide formation was shown to increase
cell survival under pathological conditions (Gulbins et al., 2013).
More complex ceramide derivates such as galactosylceramide are
essential components of myelin sheaths that insulate axons enabling fast
transmission of electric impulses (Zoller et al., 2008). Galactosylceramide deficiency causes demyelination which consequently leads to severe impairment of motor coordination (Coetzee et al., 1996; Zoller et al., 2005), which again emphasizes the functional relevance of sphingolipids.
After
binding to specific G protein-coupled receptors, bioactive
sphingolipids such as sphingosine-1-phosphate (S1P) function as
signaling molecules and stimulate the activation of complex cascades,
which govern cellular processes such as cell migration and angiogenesis (Blaho and Hla, 2014). Treatment with S1P increases vascular density and further amplifies VEGF-induced angiogenesis (Lee et al., 1999a). S1P also stimulates the assembly of adherens junctions on endothelial cells by activating Rac/ Rho signaling (Lee et al., 1999a). Further, S1P has been attributed an anti-apoptotic effect (Lee et al., 1999a).
Sphingolipids
are further implicated in cellular mechanisms that control the
endocytic trafficking machinery. Release of exosomes can be reduced by
inhibition of neutral sphingomyelinase (NSM)-mediated sphingomyelin
hydrolysis using GW4869, spiroepoxide or glutathione (Trajkovic et al., 2008).
Disturbed exosome release due to reduced ceramide likely occurs because
ceramide-enriched domains facilitate the sorting of cargo destined for
exosomal release into multivesicular bodies and inhibition of NSM
substantially reduces the amount of specific cargo within the endosomal
lumen (Trajkovic et al., 2008). Exosomes that are generated via this endosomal sorting complexes required for transport (ESCRT)-independent pathway typically exhibit a high ceramide content (Trajkovic et al., 2008).
Moreover, hydrolysis of sphingomyelin leads to formation of early
endocytic intermediates to which sphingosine kinase-1 is recruited, the
enzyme that catalyzes phosphorylation of sphingosine to S1P (Shen et al., 2014).
The importance of sphingosine kinase-1 for endosomal recycling is
depicted by experiments showing that its knockdown causes accumulation
of internalized transferrin, which is indicative for endosomal recycling
defects (Shen et al., 2014).
Further, sphingolipids may alter lysosomal function. Accumulation of
unmetabolized sphingolipids results in severe pathological conditions as
genetic deficiency of specific enzymes that regulate the sphingolipid
metabolism are causative for lysosomal storage disorders that lead to
dysfunctional lysosomes and impaired autophagic flux (Carsana et al., 2022; Platt et al., 2012).
Niemann-Pick disease type-A, for example, is a severe neurodegenerative
disorder associated with early childhood mortality and is caused by
inherited acid sphingomyelinase (ASM) deficiency, which leads to
accumulation of sphingomyelin in lysosomes (Horinouchi et al., 1995).
Given
the importance of sphingolipids for pivotal cellular processes, this
review aims to depict the signaling roles of prominent sphingolipids,
namely ceramide, sphingomyelin and S1P, for pathological events
following ischemic stroke. Another focus of this review is to outline
how sphingolipids may serve as targets for potential therapeutic
interventions.
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