DDIT3 and neuroblastoma: 4-HPR is also found to upregulate ceramide level and metabolism of ceramide to gangliosides via glucosylceramide synthase and GD3 synthase leading to activation of ROS signaling pathway via 12-LOX resulting in oxidative stress and neuroblastoma cell death by induction of the transcription factor GADD153 and the Bcl-2-related Bak protein [74].