SMPD3 and atherosclerosis: It is also reported that there is excessive accumulation of cholesterol in the arterial wall with dysregulation of ceramide metabolism in patients with atherosclerosis (Chambers et al., 2019; Zhang et al., 2019), and sphingomyelin phosphodiesterase 3 (SMPD3) serves as a key enzyme that promotes the sphingomyelin to hydrolyze into ceramide (Liang et al., 2021).