“…A number of extracellular stimuli, not only various cytokines including tumor necrosis factor (TNF)-a, interferon-g (Kim et al, 1991;Dressler et al, 1992), interleukin-1b (Ballou et al, 1992), nerve growth factor (Dobrowsky et al, 1994), and activators of Fas receptor (Cifone et al, 1994), but also physical stresses including heat shock, irradiation and chemotherapeutic drugs (Verheij et al, 1996;Santana et al, 1996;Ja rezou et al, 1996) are shown to cause sphingomyelin (SM) hydrolysis via sphingomyelinase (SMase), leading to elevation of intracellular ceramide, although several recent reports have questioned the role of ceramide in apoptosis induced by Fas or TNF-a (Sillence and Allen, 1997; Hsu et al, 1998;Watts et al, 1997Watts et al, , 1999a. The addition of exogenous ceramide has been associated with several antiproliferative responses including cell di erentiation, apoptosis, and cell cycle arrest (Okazaki et al, 1990;Kolesnick and Hannun, 1999).…”