Sphingolipids in metabolic disease: The good, the bad, and the unknown

The bioactive sphingolipid metabolites ceramide and sphingosine-1-phosphate (S1P) are a recent addition to the lipids accumulated in obesity and have emerged as important molecular players in metabolic diseases. Here we summarize evidence that dysregulation of sphingolipid metabolism correlates with pathogenesis of metabolic diseases in humans. This review discusses the current understanding of how ceramide regulates signaling and metabolic pathways to exacerbate metabolic diseases and the Janus faces for its further metabolite S1P, the kinases that produce it, and the multifaceted and at times opposing actions of S1P receptors in various tissues. Gaps and limitations in current knowledge are highlighted together with the need to further decipher the full array of their actions in tissue dysfunction underlying metabolic pathologies, pointing out prospects to move this young field of research toward the development of effective therapeutics.

Automated summary

The dysregulation of sphingolipid metabolism is associated with the pathogenesis of metabolic diseases, with ceramide exacerbating metabolic diseases by regulating signaling and metabolic pathways, while its metabolite S1P and its receptors have multifaceted and sometimes opposing actions in tissues.