“…The major sphingolipid in mammalian membranes and driver of LR formation is SM, which is comprised of ceramide and phosphorylcholine, and thus SM levels are also affected by aberrant choline metabolism [212]. In fact, SM is increased in multiple cancer tissues, including prostate [213], thyroid [214, 215], cervical [216], brain [217, 218], liver [219-221], breast [222, 223], as well as in lymph node metastases [224], feces from colorectal cancer [225], and urine from bladder cancer [226] patients. Depressed or unchanged SM levels were also detected in other studies [227-230].…”