Klingenberg Roland, Leiherer Andreas, Dobrev Dobromir, Kaski Juan C, Levkau Bodo, März Winfried, Sossalla Samuel, von Eckardstein Arnold, Drexel Heinz
Department of Cardiology, Kerckhoff-Klinik, Campus of the University of Giessen, Benekestr. 2-8, D-61231 Bad Nauheim, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Benekestr. 2-8, D-61231 Bad Nauheim, Germany.
Cardiovasc Res. 2025 Aug 14;121(9):1345-1358. doi: 10.1093/cvr/cvaf093.
Ceramides are bioactive lipid mediators involved in apoptosis, inflammation, and fibrosis. This narrative review provides a concise overview of the emerging role of ceramides in cardiovascular disease with an emphasis on atherosclerotic vascular disease and heart failure, suggesting the potential use of ceramides in risk stratification and as putative therapeutic targets. Recent developments based on observational evidence and genetic associations, including Mendelian randomization studies in humans, are summarized and put into context with experimental evidence for the role of ceramides in human and animal models of disease. Emerging scores composed of ceramides and phosphatidylcholines that are based on the length and desaturation of the N-acyl chains are discussed in the light of novel data demonstrating age- and sex-specific differences. Also reviewed is the structural heterogeneity of the sphingoid bases, including non-conventional sphingolipids that are increasingly recognized for their importance in health and disease. Lastly, novel targets and potential modalities for tissue-specific transfer of drugs are discussed.
神经酰胺是参与细胞凋亡、炎症和纤维化的生物活性脂质介质。这篇叙述性综述简要概述了神经酰胺在心血管疾病中的新作用，重点是动脉粥样硬化性血管疾病和心力衰竭，提示神经酰胺在风险分层中的潜在用途以及作为假定的治疗靶点。基于观察性证据和基因关联的最新进展，包括人类孟德尔随机化研究，进行了总结，并与神经酰胺在人类和动物疾病模型中的作用的实验证据相结合。根据显示年龄和性别特异性差异的新数据，讨论了由基于N-酰基链长度和去饱和作用的神经酰胺和磷脂酰胆碱组成的新兴评分。还综述了鞘氨醇碱基的结构异质性，包括越来越被认识到在健康和疾病中具有重要性的非常规鞘脂。最后，讨论了药物组织特异性转运的新靶点和潜在方式。
