Table 1.

ASM effects on immune-system cells.

Cell Type	Effect of ASM	References
Macrophages	Induces/amplifies inflammatory signals with cytokine production. Promotes proper fusion of late phagosomes with lysosomes. Promotes macrophage apoptosis.	[34,35,36,37,38], [41]
NK Cells	Influences these cells function via CD161. Leads to activation of NK cell signaling pathways. Is involved in NK cell apoptosis.	[45,46]
B Cells	Mediates CD40 clustering and in this way mediates B cell activation. Is involved with plasma membrane damage repair. Important for autophagic function.	[48,51], [52,53]
CD4+ T Cells	Involved in TCR mediated activation. Involved with polarization into subtypes Th1, Th2 and Th17. Acts a negative regulator of Tregs.	[54,58,59,60], [62]
CD8+ T Cells	Involved in the cellular membrane’s biophysical properties inducing the extrusion of lytic granules from the cells by promoting secretory granules contraction.	[64]
iNKT Cells	Involved in iNKT cell development and activation. ASM substrate sphingomyelin impedes CD1d access to antigenic lipids, thus reducing iNKT activation.	[33]