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Generation of the pleiotropic sphingolipid mediator ceramide by acid and neutral sphingomyelinases is a key event in many cellular pathophysiological processes including survival, death, proliferation, and differentiation, in which also the short-lived gaseous messenger nitric oxide plays a crucial role. This review describes how the outcome of these key cellular processes is finely tuned by surprising and complex interplays among nitric oxide, ceramide, and their effectors.
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