TNF and atherosclerosis: In conclusion, Cer has been demonstrated to be detrimental in atherosclerosis as (i) being enriched in atherosclerotic plaques, (ii) SMases being involved in formation of aortic lesions and processes involved in atherogenesis such as apoptosis or lipoprotein trapping and (iii) Cer levels being elevated in response to MMPs and TNFα—which are also elevated in atherosclerotic lesions—via SMase activation.