CERS4 and lymphangioma: CerS4-derived ceramides inhibited metastasis by promoting the binding between TβRI and its inhibitor Smad7, hence preventing TβRI from localizing in primary cilia to activate the sonic hedgehog signaling pathway.50 In this study, Cer(d18:0/24:0) and Cer(d18:0/24:1), which were significantly increased in the FA2H-knockdown LM cells, markedly attenuated spread to the lung and suppressed growth to some extent.