Figure 3
From: Role of ceramide in diabetes mellitus: evidence and mechanisms
Schematic representation of mechanism of beta-cell apoptosis caused by ceramide. Details of the processes and abbreviations are described in the text. Briefly, cellular ceramide can be formed by de novo biosynthesis from precursor palmitate and by the activation of extrinsic pathway of apoptosis by FasL or TNF-α binding to the Fas and TNF receptor (TNFR) respectively. Ceramide acts on the mitochondria and causes the release of ROS/RNS and cytochrome c and activates intrinsic apoptotic pathway. Increased ROS can further increase ceramide generation. Ceramide can act on the ER and cause ER stress mediated apoptosis. Ceramide also inhibits insulin gene expression.