Taken together, these data suggest that ROS-induced ceramide activates proinflammatory cytokines, p38MAPK/SAPK/JNK/NF-κB, p53, Ca2+-dependent calpain, PLA2/COX-2/AA, TIMP-1, PP2A and LMK-1, leading to apoptosis, while ERK, VEGF, MMP-1, SGK-1 and the PI3K/Akt/CREB/PKC pathway prevent ceramide-induced apoptosis in oxidant-induced kidney injury. Here, PTGS2 is linked to kidney injury.