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The plasma membrane can compensate for mechanical stress by multiple mechanisms such as unfolding and by increasing lipid trafficking to the plasma membrane [ 64].

CFSs are extended over hundreds of kilobases and their instability is induced by multiple mechanisms such as paucity of replication origins, fork stalling at AT-rich DNA sequences, late replication timing, and collision of replication and transcription, which are all associated with perturbation of DNA replication5,44.

Aluminum adjuvants activate NLRP3 by multiple mechanisms such as by causing damage and rupture of the phagolysosomes, generating reactive oxygen species, inducing K+ efflux and via release from injured tissues of molecules that constitute danger-associated molecular patterns (DAMPs) such as uric acid and ATP.

Drugs in this class are insulinotropic but lower blood glucose by multiple mechanisms such that effects on β-cell function can be difficult to discern by conventional measures.

Indeed, hypotension has been described as a physiologic response to intubation caused by multiple mechanisms, such as induction-associated sympatholysis and the effects of positive pressure ventilation [30].

Electrical charges in tissues are transferred by multiple mechanisms such as the migration of ions, membrane capacitance, and rotation of polar molecules [47], [48], [49].

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Ghrelin may exert its protective effects through multiple mechanisms, such as by attenuating systemic HMGB1 release and by facilitating bacterial elimination (Ref. 122).

Studies suggest that the cytotoxicity of triapine involved multiple mechanisms, such as by forming complexes with both Fe2+ and Fe3+, and by inhibiting both RRM2 and p53R2 (Enyedy et al., 2011; Zhang et al., 2014).

Thus, multiple mechanisms such as somatic mutations, LOH, and epigenetic silencing might be utilized by different cancer types to inactivate SPOP.

Indeed, there are inherent and acquired resistances conferred by multiple mechanisms (Zhang et al, 2012) such as the lack of expression of the DNA repair enzyme O6-guanine-DNA-methyl transferase, deficiencies in DNA mismatch repair and initiation of the base excision repair system (Johannessen and Bjerkvig, 2012).

In the present study, since ceramide induces apoptosis by multiple mechanisms in diabetes and its complication such as nephropathy, we aimed to investigate whether SGK-1 may protect even against apoptosis induced by ceramide in kidney cells.

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