Sphingolipid metabolism ceramides, which are considered the central hub of sphingolipid metabolism, are synthesised via three different pathways (de novo biosynthesis, sphingomyelinase pathway and salvage pathway). They are then incorporated into various complex sphingolipids or broken down by ceramidases into sphingosine and dihydrosphingosine with subsequent production of sphingosine-1-phosphate and dihydrosphingosine-1-phosphate. CERK, ceramide kinase; CerS, ceramide synthase; DHCD, dihydroceramide desaturase; GCS, glucosylceramide synthase; KDHSR, 3-keto-dihydrosphingosine reductase; LCS, lactosylceramide synthase; SK, sphingosine kinase; SMase, sphingmyelinase; SMS, sphingomyelin synthase; SPT, serine palmitoyltransferase.