Sphingolipid Metabolism: A Pathological Hub Linking Lipid Dysregulation and Chronic Inflammation in Atherosclerotic Cardiovascular Disease.

Atherosclerosis represents the principal pathological substrate of cardiovascular disease, and sphingolipids have emerged as critical bioactive molecules intimately involved in atherogenesis. This review provides a comprehensive overview of sphingolipid biosynthetic and metabolic pathways, underscoring their central role as a pathological hub that bridges lipid dysregulation and chronic inflammation in atherosclerotic cardiovascular disease. We place particular emphasis on the pathogenic mechanisms through which sphingolipids orchestrate endothelial dysfunction, modulate macrophage polarization, and promote plaque instability. Additionally, we summarize recent advances concerning the cardioprotective actions of active constituents derived from traditional Chinese medicine, achieved via modulation of the sphingolipid metabolic network.