A) Transient exogenous expression of SK1 in DNC8 cells leads to upregulation of cyclin D1 transcription relative to cells expressing the cognate empty vector (left). Conversely, transient exogenous expression of a dominant negative SK mutant in DNC8 cells negatively affects RA-induced cyclin D1 transcription (right). B) RA-induced DNC8 proliferation is significantly decreased by treatment with a SK inhibitor. C) RA upregulates the S1P level (spots in the upper insert) in DNC8 cells. D) Scheme showing that RA action mediated through RARĪ± results in upregulation of nSMase-generated CER sythesis, concomitant with downregulation of SK1 transcription/activity. These concerted antiproliferative metabolic changes concur to inhibit cell proliferation. Consequent to an impaired RA-RARĪ± signaling, these concerted antiproliferative metabolic changes do not occur, thus cells survive in the presence of RA. Moreover, RA, through alternate, non-RAR (genomic or non-genomic) target(s), activates pro-survival signaling pathways, including the SK signaling pathway, thus leading to the expansion of the RA-resistant cell pool.