Ceramide Signaling and p53 Pathways

Adv Cancer Res. 2018;140:191-215. doi: 10.1016/bs.acr.2018.04.011. Epub 2018 Jun 1.


Ceramides, important players in signal transduction, interact with multiple cellular pathways, including p53 pathways. However, the relationship between ceramide and p53 is very complex, and mechanisms underlying their coregulation are diverse and not fully characterized. The role of p53, an important cellular regulator and a transcription factor, is linked to its tumor suppressor function. Ceramides are involved in the regulation of fundamental processes in cancer cells including cell death, proliferation, autophagy, and drug resistance. This regulation, however, can be pro-death or pro-survival depending on cancer type, the balance between ceramide species, the rate of their synthesis and utilization, and the availability of a specific array of downstream targets. This chapter highlights the central role of ceramide in sphingolipid metabolism, its role in cancer, specific effectors in ceramide pathways controlled by p53, and coregulation of ceramide and p53 signaling. We discuss the recent studies, which underscore the function of p53 in the regulation of ceramide pathways and the reciprocal regulation of p53 by ceramide. This complex relationship is based on several molecular mechanisms including the p53-dependent transcriptional regulation of enzymes in sphingolipid pathways, the activation of mutant p53 through ceramide-mediated alternative splicing, as well as modulation of the p53 function through direct and indirect effects on p53 coregulators and downstream targets. Further insight into the connections between ceramide and p53 will allow simultaneous targeting of the two pathways with a potential to yield more efficient anticancer therapeutics.

Keywords: Cancer; Cancer therapeutics; Ceramide signaling; Metabolism; Transcriptional regulation; Tumor suppression; p53.

Publication types

  • Review

MeSH terms

  • Animals
  • Apoptosis
  • Autophagy
  • Ceramides / metabolism*
  • Humans
  • Neoplasms / etiology
  • Neoplasms / metabolism
  • Neoplasms / pathology*
  • Signal Transduction
  • Tumor Suppressor Protein p53 / metabolism*


  • Ceramides
  • Tumor Suppressor Protein p53