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The controversial role of the Hedgehog pathway in normal and malignant hematopoiesis

Leukemia volume 25, pages 1665–1673 (2011)Cite this article

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Abstract

Hedgehog (Hh) is a developmental signaling pathway in which Hh ligands bind Patched (Ptch), which relieves its inhibition of Smoothened (Smo), allowing the Gli family of transcription factors to translocate to the nucleus and activate Hh target genes. The role of Hh signaling in hematopoiesis is controversial and ill defined. Although some groups observed self-renewal defects with decreased replating and reduced efficiency of secondary murine transplants, other groups reported no hematopoietic phenotypes, which may be related to the timing of Hh abrogation. In malignant hematopoiesis, most attention has been focused on the role of Hh signaling in chronic myeloid leukemia (CML), considered by many to be a stem cell disorder that bears the constitutively active BCR-ABL tyrosine kinase. Despite the elimination of most leukemia cells through BCR-ABL inhibition, most patients remain PCR positive, suggesting that the putative CML stem cell may be resistant to kinase antagonism. Groups are now exploring the Hh pathway as an alternate pathway supporting CML stem cell survival. Knockdown or inhibition of Smo abrogates or delays the appearance of CML in several in vitro and in vivo models. These data have lead to clinical trials using BCR-ABL kinase and novel Smo inhibitors in combination.

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Acknowledgements

We thank the Smoothened team and Yao Yung-mae at Novartis for stimulating discussions and critical reading of the manuscript. IA is supported by the National Institutes of Health (RO1CA133379, RO1CA105129, R21CA141399 and RO1CA149655 to IA), the Leukemia & Lymphoma Society and the American Cancer Society (RSG0806801 to IA). IA is a Howard Hughes Medical Institute Early Career Scientist.

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  1. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    B G Mar

  2. Department of Oncology, Novartis Institutes for Biomedical Research, Cambridge, MA, USA

    D Amakye & S Buonamici

  3. Howard Hughes Medical Institute and Department of Pathology, NYU School of Medicine, New York, NY, USA

    I Aifantis

  4. Helen and Martin S Kimmel Stem Cell Center, NYU School of Medicine, New York, NY, USA

    I Aifantis

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Mar, B., Amakye, D., Aifantis, I. et al. The controversial role of the Hedgehog pathway in normal and malignant hematopoiesis. Leukemia 25, 1665–1673 (2011). https://doi.org/10.1038/leu.2011.143

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