Increases in S1P synthesis mediated by sphingosine kinase, the use of S1P1 receptor agonists, such as FTY720 (an unselective S1P receptor agonist) and SEW2871 (a selective S1P1 receptor agonists) or by SPHK1 gene delivery were shown to protect from renal ischemia reperfusion injury (109–112), which is associated with increased ceramide expression (113–115), from DKD (108), and from various forms of glomerulonephritis (116–118) (Table 1). The gene discussed is MBTPS1; the disease is diabetic kidney disease.