AOP-Wiki

AOP ID and Title:

AOP 460: Antagonism of Smoothened receptor leading to orofacial clefting
Short Title: Anatagonsim SMO leads to OFC

Graphical Representation

Authors

Jacob I. Reynolds1 , Brian P. Johnson1,2 

1Department of Biomedical Engineering, Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI

2Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI

Status

Author status OECD status OECD project SAAOP status
Under development: Not open for comment. Do not cite

Abstract

The Sonic Hedgehog (SHH) is a major signaling pathway of intercellular signaling during embryonic development. Disruption of SHH during critical periods of development can lead to orofacial clefts (OFCs). In canonical SHH signaling, the SHH ligand binds to the Patched1 (PTCH1) receptor and relieves its’ suppression of Smoothened (SMO) receptor. Antagonism of SMO results in disruption the downstream SHH signaling cascade. Disruption to the signaling cascade causes a decrease in the translocation of the GLI1/2 transcription factors to the nucleus resulting in a decrease in expression of the GLI1/2 target genes. This decrease in gene expression which causes a reduction in production of SHH secondary messengers, namely Fgf10 and members of the BMP family. This reduction in secondary messengers leads to a decrease in cellular proliferation in the palatal shelves. This reduction in cellular proliferation lead to a decrease in palatal shelf outgrowth which ultimately results in a cleft. This AOP is intended to serve as a tool for risk assessment for drug and chemical exposures during embryonic development when disruption to SHH through antagonism of SMO occurs.

Background

Orofacial clefts (OFCs), encompassing cleft lip with or without palate (CL/P), and cleft palate only (CPO) represent the second most common birth defect in humans with a prevalence of 1-2/1,000 births (Lidral, Moreno et al. 2008). The etiology of OFCs is complex with approximately 50% of CPO and 70% of CL/P considered non-syndromic (2011). SHH signaling is required for normal facial development and plays a critical role in the growth of the facial processes that form the upper palate and lip (Bush and Jiang 2012, Kurosaka 2015). The epithelial derived SHH drives orofacial development through an induced gradient in the underlying mesenchyme  (Lan and Jiang 2009, Kurosaka 2015). This gradient of SHH induces cellular proliferation and outgrowth of the mesenchyme (Lan and Jiang 2009). The SHH pathway is sensitive to chemical disruption and can be disrupted at multiple places along the signaling cascade during critical windows for exposure and has been shown to cause OFCs (Lipinski and Bushman 2010, Heyne, Melberg et al. 2015). The targets of this disruption include ligand modification, ligand secretion, downstream sensing, and signal transduction (Jeong and McMahon 2002, Lauth, Bergström et al. 2007, Petrova, Rios-Esteves et al. 2013). Chemical modulators of the SHH pathway have been identified including the natural alkaloid cyclopamine, both natural and synthetic pharmaceuticals, and a chemical commonly found in pesticides (Lipinski, Dengler et al. 2007, Lipinski, Song et al. 2010, Wang, Lu et al. 2012, Everson, Sun et al. 2019, Rivera-González, Beames et al. 2021).

Summary of the AOP

Events

Molecular Initiating Events (MIE), Key Events (KE), Adverse Outcomes (AO)

Sequence Type Event ID Title Short name
1 MIE 2027 Antagonism, Smoothened receptor Antagonism Smoothened
KE 2044 Decrease, Smoothend relocation and activation Decrease, SMO relocation
2 KE 2028 Decrease, GLI1/2 translocation to nucleus Decrease, GLI1/2 translocation
KE 2040 Decrease, GLI1/2 target gene expression Decrease, GLI1/2 target gene expression
KE 2043 Decrease, Sonic Hedgehog second messenger production Decrease, SHH second messenger production
KE 1821 Decrease, Cell proliferation Decrease, Cell proliferation
KE 2041 Decrease, palatal shelf outgrowth Decrease, outgrowth
AO 2042 Ororofacial clefting OFC

Key Event Relationships

Upstream Event Relationship Type Downstream Event Evidence Quantitative Understanding
Antagonism, Smoothened receptor adjacent Decrease, Smoothend relocation and activation Moderate Low
Decrease, Smoothend relocation and activation adjacent Decrease, GLI1/2 translocation to nucleus Moderate Low
Decrease, GLI1/2 translocation to nucleus adjacent Decrease, GLI1/2 target gene expression Low Low
Decrease, GLI1/2 target gene expression adjacent Decrease, Sonic Hedgehog second messenger production Low Low
Decrease, Sonic Hedgehog second messenger production adjacent Decrease, Cell proliferation Low Low
Decrease, Cell proliferation adjacent Decrease, palatal shelf outgrowth Low Low
Decrease, palatal shelf outgrowth adjacent Ororofacial clefting Moderate Low

Stressors

Name Evidence
Vismodegib High
Cyclopamine
SANT-1
SANT-2
SANT-3
SANT-4

Vismodegib

Vismodegib (GDC-0449) is small molecule modulator of the sonic hedgehog (shh) pathway. It functions as an antagonist by binding to Smoothened (SMO) blockings its’ activation and subsequent downstream signalling cascade. Vismodegib became the first agent approved to target the shh pathway in Jan. 2012 by the US FDA. It was approved by the European Medicines Agency (EMA) in July 2012 (Meiss, Andrlová et al. 2018). It has been used to identify critical periods of development for the shh pathway. Pregnant C57BL/6J mice dosed with 40mg/kg of Vismodegib between E7 and E10.0 had a peak incidence of CPO (34.38%) at E9.5(Heyne, Melberg et al. 2015). Pregnant C57/BL6J mice treated with 100mg/kg vismodegib via oral gavage at E10.5 and E12.5 displayed a 100% penetrance of complete cleft palate (Zhang, Wang et al. 2017). In a HWJSC/HPEKp spheroid fusion model 10µm vismodegib did not affect HPEKp viability or migration, did not affect in vitro fusion (Belair, Wolf et al. 2018).

 

Overall Assessment of the AOP

Domain of Applicability

Life Stage Applicability
Life Stage Evidence
Embryo High
Taxonomic Applicability
Term Scientific Term Evidence Links
mouse Mus musculus NCBI
human Homo sapiens Low NCBI
Sex Applicability
Sex Evidence
Unspecific High

References

Appendix 1

List of MIEs in this AOP

Event: 2027: Antagonism, Smoothened receptor

Short Name: Antagonism Smoothened

Key Event Component

Process Object Action
regulation of receptor activity smoothened decreased

AOPs Including This Key Event

AOP ID and Name Event Type
Aop:460 - Antagonism of Smoothened receptor leading to orofacial clefting MolecularInitiatingEvent

Biological Context

Level of Biological Organization
Molecular

Cell term

Cell term
mesenchymal cell

Domain of Applicability

Taxonomic Applicability
Term Scientific Term Evidence Links
Vertebrates Vertebrates NCBI
Life Stage Applicability
Life Stage Evidence
Embryo High
All life stages High
Sex Applicability
Sex Evidence
Unspecific
  • Sex- SMO is present in both male and females and differences in activation or antagonism between sex have not been demonstrated.  
  • Life stages- The Hedgehog pathway is a major pathway in embryonic development. Aberrant activation of HH signalling is known to cause cancer (Dahmane, Lee et al. 1997, Kimura, Stephen et al. 2005). For these reasons all stages of life are of relevance.
  • Taxonomic- SMO is conserved in both vertebrates and invertebrates. SMO signaling is dependent upon its relocation to a subcellular location. This occurs in the plasma membrane for flies (Denef, Neubüser et al. 2000) and the primary cilium (PC) in vertebrates (Huangfu and Anderson 2005).

Key Event Description

The Smoothened (SMO) receptor is Class F G protein coupled receptor involved in signal transduction of the Sonic Hedgehog (SHH) pathway. It includes distinct functional groups including ligand binding pockets, cysteine rich domain (CRD), transmembrane helix (TM), extracellular loop (ECL), intracellular loop (ICL), and a carboxyl-terminal tail (C-term tail) (Arensdorf, Marada et al. 2016).  SMO signaling is dependent upon its relocation to a subcellular location. This occurs in the plasma membrane for flies (Denef, Neubüser et al. 2000) and the primary cilium (PC) in vertebrates (Huangfu and Anderson 2005).

In the absence of Hedgehog (HH) ligand, the Patched (PTCH) receptor suppresses the activation of SMO. When HH ligand binds to PTCH, suppression on SMO is released and SMO is  able to relocate, accumulate, and signal to intracellular effectors (Denef, Neubüser et al. 2000). This signaling to effectors results in the activation of the GLI transcription factors and the subsequent induction of HH target gene expression(Alexandre, Jacinto et al. 1996, Von Ohlen and Hooper 1997). The exact mechanism through which PTCH and SMO interact is not known.

An endogenous ligand for SMO has not been discovered although evidence for one exists and that PTCH controls SMO by controlling its’ availability or accessibility. To support this, it has been shown that PTCH and SMO do not physically interact (Chen and Struhl 1998). PTCH acts catalytically with SMO with one PTCH receptor capable of controlling many (~50) SMO receptors (Taipale, Cooper et al. 2002). Since PTCH includes a sterol sensing domain and shares characteristics of ancient bacterial transporters, a model of PTCH functioning by pumping a sterol-like MSO regulator has been proposed (Mukhopadhyay and Rohatgi 2014).  SMO is constitutively active in the absence of PTCH suggesting that the elusive molecule is an agonist (Rohatgi and Scott 2007). Conversely, the discovery that oxysterols bind to the CRD binding domain acting as positive modulators suggest that the molecule could be an agonist with PTCH functioning to sequester away or limit cellular concentration (Corcoran and Scott 2006, Nachtergaele, Mydock et al. 2012)

The activity of SMO is controlled by ligand binding (Kobilka 2007). Two separate binding pockets, one in the groove of the extracellular CRD and the other in the helices of the TMD have been identified (Nachtergaele, Mydock et al. 2012, Rana, Carroll et al. 2013, Wang, Wu et al. 2013, Byrne, Sircar et al. 2016, Huang, Zheng et al. 2018). These two binding pockets have been shown to interact in an allosteric manner (Nachtergaele, Mydock et al. 2012). The binding pocket in the helices of the TMD binds several SMO agonists including SAG as well as antagonists Vismodegib and Sonidegib. The CRD binding pocket binds cholesterol and its’ oxidized derivates (Byrne, Luchetti et al. 2018). The antagonist cyclopamine binds to the TMD binding pocket and inhibits SHH signal transduction. However, in mSMO carrying the mutations D477G/E552K that disable the TMD binding pocket, cyclopamine binds to the CRD pocket and activates the pathway (Huang, Nedelcu et al. 2016). To date several oxysterols including 20(S)-hydroxylcholesterol, 22(S)-hydroxylcholesterol, 7-keto-25-hydroxylcholesterol and 7-keto-27-hydroxylcholesterol have been identified as activators of SMO (Dwyer, Sever et al. 2007, Nachtergaele, Mydock et al. 2012, Myers, Sever et al. 2013). A binding site for 24(S),25-epoxycholesterol has been identified in the TMD pocket using cryo-EM of SMO in complex with 24(S),25-epoxycholesterol (Qi, Liu et al. 2019).

How it is Measured or Detected

Verification of binding and affinity for SMO can be measured using fluorescence binding assays and photoaffinity labeling respectively (Chen, Taipale et al. 2002). qRT-PCR can be used to determine the expression level of SMO (Lou, Li et al. 2020).  

References

 

Alexandre, C., A. Jacinto and P. W. Ingham (1996). "Transcriptional activation of hedgehog target genes in Drosophila is mediated directly by the cubitus interruptus protein, a member of the GLI family of zinc finger DNA-binding proteins." Genes Dev 10(16): 2003-2013.

Arensdorf, A. M., S. Marada and S. K. Ogden (2016). "Smoothened Regulation: A Tale of Two Signals." Trends Pharmacol Sci 37(1): 62-72.

Byrne, E. F. X., G. Luchetti, R. Rohatgi and C. Siebold (2018). "Multiple ligand binding sites regulate the Hedgehog signal transducer Smoothened in vertebrates." Current Opinion in Cell Biology 51: 81-88.

Byrne, E. F. X., R. Sircar, P. S. Miller, G. Hedger, G. Luchetti, S. Nachtergaele, M. D. Tully, L. Mydock-McGrane, D. F. Covey, R. P. Rambo, M. S. P. Sansom, S. Newstead, R. Rohatgi and C. Siebold (2016). "Structural basis of Smoothened regulation by its extracellular domains." Nature 535(7613): 517-522.

Chen, J. K., J. Taipale, M. K. Cooper and P. A. Beachy (2002). "Inhibition of Hedgehog signaling by direct binding of cyclopamine to Smoothened." Genes Dev 16(21): 2743-2748.

Chen, J. K., J. Taipale, K. E. Young, T. Maiti and P. A. Beachy (2002). "Small molecule modulation of Smoothened activity." Proc Natl Acad Sci U S A 99(22): 14071-14076.

Chen, Y. and G. Struhl (1998). "In vivo evidence that Patched and Smoothened constitute distinct binding and transducing components of a Hedgehog receptor complex." Development 125(24): 4943-4948.

Corcoran, R. B. and M. P. Scott (2006). "Oxysterols stimulate Sonic hedgehog signal transduction and proliferation of medulloblastoma cells." Proc Natl Acad Sci U S A 103(22): 8408-8413.

Dahmane, N., J. Lee, P. Robins, P. Heller and A. Ruiz i Altaba (1997). "Activation of the transcription factor Gli1 and the Sonic hedgehog signalling pathway in skin tumours." Nature 389(6653): 876-881.

Denef, N., D. Neubüser, L. Perez and S. M. Cohen (2000). "Hedgehog induces opposite changes in turnover and subcellular localization of patched and smoothened." Cell 102(4): 521-531.

Dwyer, J. R., N. Sever, M. Carlson, S. F. Nelson, P. A. Beachy and F. Parhami (2007). "Oxysterols are novel activators of the hedgehog signaling pathway in pluripotent mesenchymal cells." J Biol Chem 282(12): 8959-8968.

Heyne, G. W., C. G. Melberg, P. Doroodchi, K. F. Parins, H. W. Kietzman, J. L. Everson, L. J. Ansen-Wilson and R. J. Lipinski (2015). "Definition of critical periods for Hedgehog pathway antagonist-induced holoprosencephaly, cleft lip, and cleft palate." PLoS One 10(3): e0120517.

Huang, P., D. Nedelcu, M. Watanabe, C. Jao, Y. Kim, J. Liu and A. Salic (2016). "Cellular Cholesterol Directly Activates Smoothened in Hedgehog Signaling." Cell 166(5): 1176-1187.e1114.

Huang, P., S. Zheng, B. M. Wierbowski, Y. Kim, D. Nedelcu, L. Aravena, J. Liu, A. C. Kruse and A. Salic (2018). "Structural Basis of Smoothened Activation in Hedgehog Signaling." Cell 174(2): 312-324.e316.

Huangfu, D. and K. V. Anderson (2005). "Cilia and Hedgehog responsiveness in the mouse." Proc Natl Acad Sci U S A 102(32): 11325-11330.

Incardona, J. P., W. Gaffield, R. P. Kapur and H. Roelink (1998). "The teratogenic Veratrum alkaloid cyclopamine inhibits sonic hedgehog signal transduction." Development 125(18): 3553-3562.

Kimura, H., D. Stephen, A. Joyner and T. Curran (2005). "Gli1 is important for medulloblastoma formation in Ptc1+/- mice." Oncogene 24(25): 4026-4036.

Kobilka, B. K. (2007). "G protein coupled receptor structure and activation." Biochimica et Biophysica Acta (BBA) - Biomembranes 1768(4): 794-807.

Lou, H., H. Li, A. R. Huehn, N. I. Tarasova, B. Saleh, S. K. Anderson and M. Dean (2020). "Genetic and Epigenetic Regulation of the Smoothened Gene (SMO) in Cancer Cells." Cancers (Basel) 12(8).

Meiss, F., H. Andrlová and R. Zeiser (2018). "Vismodegib." Recent Results Cancer Res 211: 125-139.

Mukhopadhyay, S. and R. Rohatgi (2014). "G-protein-coupled receptors, Hedgehog signaling and primary cilia." Semin Cell Dev Biol 33: 63-72.

Myers, Benjamin R., N. Sever, Yong C. Chong, J. Kim, Jitendra D. Belani, S. Rychnovsky, J. F. Bazan and Philip A. Beachy (2013). "Hedgehog Pathway Modulation by Multiple Lipid Binding Sites on the Smoothened Effector of Signal Response." Developmental Cell 26(4): 346-357.

Nachtergaele, S., L. K. Mydock, K. Krishnan, J. Rammohan, P. H. Schlesinger, D. F. Covey and R. Rohatgi (2012). "Oxysterols are allosteric activators of the oncoprotein Smoothened." Nature Chemical Biology 8(2): 211-220.

Nachtergaele, S., L. K. Mydock, K. Krishnan, J. Rammohan, P. H. Schlesinger, D. F. Covey and R. Rohatgi (2012). "Oxysterols are allosteric activators of the oncoprotein Smoothened." Nat Chem Biol 8(2): 211-220.

Qi, X., H. Liu, B. Thompson, J. McDonald, C. Zhang and X. Li (2019). "Cryo-EM structure of oxysterol-bound human Smoothened coupled to a heterotrimeric Gi." Nature 571(7764): 279-283.

Rana, R., C. E. Carroll, H.-J. Lee, J. Bao, S. Marada, C. R. R. Grace, C. D. Guibao, S. K. Ogden and J. J. Zheng (2013). "Structural insights into the role of the Smoothened cysteine-rich domain in Hedgehog signalling." Nature Communications 4(1): 2965.

Rohatgi, R. and M. P. Scott (2007). "Patching the gaps in Hedgehog signalling." Nat Cell Biol 9(9): 1005-1009.

Sharpe, H. J., W. Wang, R. N. Hannoush and F. J. de Sauvage (2015). "Regulation of the oncoprotein Smoothened by small molecules." Nat Chem Biol 11(4): 246-255.

Sinha, S. and J. K. Chen (2006). "Purmorphamine activates the Hedgehog pathway by targeting Smoothened." Nat Chem Biol 2(1): 29-30.

Taipale, J., M. K. Cooper, T. Maiti and P. A. Beachy (2002). "Patched acts catalytically to suppress the activity of Smoothened." Nature 418(6900): 892-896.

Von Ohlen, T. and J. E. Hooper (1997). "Hedgehog signaling regulates transcription through Gli/Ci binding sites in the wingless enhancer." Mech Dev 68(1-2): 149-156.

Wang, C., H. Wu, T. Evron, E. Vardy, G. W. Han, X. P. Huang, S. J. Hufeisen, T. J. Mangano, D. J. Urban, V. Katritch, V. Cherezov, M. G. Caron, B. L. Roth and R. C. Stevens (2014). "Structural basis for Smoothened receptor modulation and chemoresistance to anticancer drugs." Nat Commun 5: 4355.

Wang, C., H. Wu, V. Katritch, G. W. Han, X. P. Huang, W. Liu, F. Y. Siu, B. L. Roth, V. Cherezov and R. C. Stevens (2013). "Structure of the human smoothened receptor bound to an antitumour agent." Nature 497(7449): 338-343.

 

 

List of Key Events in the AOP

Event: 2044: Decrease, Smoothend relocation and activation

Short Name: Decrease, SMO relocation

Key Event Component

Process Object Action
protein localization to cilium smoothened decreased

AOPs Including This Key Event

Biological Context

Level of Biological Organization
Cellular

Cell term

Cell term
cell

Domain of Applicability

Taxonomic Applicability
Term Scientific Term Evidence Links
Vertebrates Vertebrates NCBI
Life Stage Applicability
Life Stage Evidence
Embryo
Sex Applicability
Sex Evidence
Unspecific
  • Sex- SMO and cilia are present in both male and females and differences in gene expression has not been demonstrated.   
  • Life stages- The Hedgehog pathway is a major pathway in embryonic development.
  • Taxonomic-SMO relocation to the tip of primary cilia occurs in vertebrates Huangfu and Anderson 2005)   

 

Key Event Description

The Smoothened (SMO) receptor is Class F G protein coupled receptor involved in signal transduction of the Sonic Hedgehog (SHH) pathway. It includes distinct functional groups including ligand binding pockets, cysteine rich domain (CRD), transmembrane helix (TM), extracellular loop (ECL), intracellular loop (ICL), and a carboxyl-terminal tail (C-term tail) (Arensdorf, Marada et al. 2016).  SMO signaling is dependent upon its relocation to a subcellular location. This relocation occurs in the primary cilium (PC) in vertebrates (Huangfu and Anderson 2005). Relocation of SMO to the PC typically occurs within ~20 minutes of agonist stimulation (Arensdorf, Marada et al. 2016).

In the absence of SHH ligand, the Patched (PTCH) receptor suppresses the activation of SMO. When HH ligand binds to PTCH, suppression on SMO is released and SMO can relocate, accumulate, and signal to intracellular effectors (Denef, Neubüser et al. 2000, Rohatgi and Scott 2007). It has been shown that SMO localization to the tip of the primary cilia is essential for the SHH signaling cascade in vertebrates (Corbit, Aanstad et al. 2005, Rohatgi, Milenkovic et al. 2007, Rohatgi, Milenkovic et al. 2009). This relocation then leads to signaling to effectors resulting in the activation of the GLI transcription factors and the subsequent induction of HH target gene expression (Alexandre, Jacinto et al. 1996, Von Ohlen and Hooper 1997). The exact mechanism through which PTCH and SMO interact is not known.

While we know that entry to the cilia is tightly controlled, the exact mechanism of SMO ciliary trafficking is not fully understood. The PC is separated from the plasma membrane by the ciliary pockets and the transition zone which function together to regulate the movement of lipids and proteins in and out of the organelle (Goetz, Ocbina et al. 2009, Rohatgi and Snell 2010). The SHH receptor PTCH contains a ciliary localization sequence in its’ carboxy tail. Localization of PTCH to the PC is essential for inhibition of SMO as deletion of the CLS in PTCH prevents PTCH localization as well as inhibition of SMO (Kim, Hsia et al. 2015) (53). SMO also contains a CLS, but only accumulates in the PC upon ligand binding (Corbit, Aanstad et al. 2005). The entry of SMO into the PC is thought to occur either laterally through the ciliary pockets or internally via recycling endosomes (Milenkovic, Scott et al. 2009). Once inside the PC, SMO can diffuse freely, however it will usually accumulate in specific locations depending upon its’ activation state. Inactive SMO will accumulate more at the base of the PC while active SMO will accumulate in the tip of the PC (Milenkovic, Weiss et al. 2015).

How it is Measured or Detected

  • Fluorescent proteins can be used tag SMO, cilia and the plasma membrane to determine if SMO has relocated to the cilia (Filipova, Diaz Garcia et al. 2020).
  • Fluorescent binding assay can be used to verify if a compound binds to SMO (Chen, Taipale et al. 2002).
  • Cell lines can be engineered to express Myc-tagged SMO. This gives a user friendly readout of SMO activation. (Corbit, Aanstad et al. 2005).

References

Alexandre, C., A. Jacinto and P. W. Ingham (1996). "Transcriptional activation of hedgehog target genes in Drosophila is mediated directly by the cubitus interruptus protein, a member of the GLI family of zinc finger DNA-binding proteins." Genes Dev 10(16): 2003-2013.

Arensdorf, A. M., S. Marada and S. K. Ogden (2016). "Smoothened Regulation: A Tale of Two Signals." Trends Pharmacol Sci 37(1): 62-72.

Chen, J. K., J. Taipale, M. K. Cooper and P. A. Beachy (2002). "Inhibition of Hedgehog signaling by direct binding of cyclopamine to Smoothened." Genes Dev 16(21): 2743-2748.

Corbit, K. C., P. Aanstad, V. Singla, A. R. Norman, D. Y. R. Stainier and J. F. Reiter (2005). "Vertebrate Smoothened functions at the primary cilium." Nature 437(7061): 1018-1021.

Denef, N., D. Neubüser, L. Perez and S. M. Cohen (2000). "Hedgehog induces opposite changes in turnover and subcellular localization of patched and smoothened." Cell 102(4): 521-531.

Filipova, A., D. Diaz Garcia, J. Dvorak, S. Filip, M. Jelicova and Z. Sinkorova (2020). "Simple Detection of Primary Cilia by Immunofluorescence." J Vis Exp(159).

Goetz, S. C., P. J. Ocbina and K. V. Anderson (2009). "The primary cilium as a Hedgehog signal transduction machine." Methods Cell Biol 94: 199-222.

Huangfu, D. and K. V. Anderson (2005). "Cilia and Hedgehog responsiveness in the mouse." Proc Natl Acad Sci U S A 102(32): 11325-11330.

Kim, J., E. Y. Hsia, A. Brigui, A. Plessis, P. A. Beachy and X. Zheng (2015). "The role of ciliary trafficking in Hedgehog receptor signaling." Sci Signal 8(379): ra55.

Milenkovic, L., M. P. Scott and R. Rohatgi (2009). "Lateral transport of Smoothened from the plasma membrane to the membrane of the cilium." J Cell Biol 187(3): 365-374.

Milenkovic, L., L. E. Weiss, J. Yoon, T. L. Roth, Y. S. Su, S. J. Sahl, M. P. Scott and W. E. Moerner (2015). "Single-molecule imaging of Hedgehog pathway protein Smoothened in primary cilia reveals binding events regulated by Patched1." Proc Natl Acad Sci U S A 112(27): 8320-8325.

Rohatgi, R., L. Milenkovic, R. B. Corcoran and M. P. Scott (2009). "Hedgehog signal transduction by Smoothened: pharmacologic evidence for a 2-step activation process." Proc Natl Acad Sci U S A 106(9): 3196-3201.

Rohatgi, R., L. Milenkovic and M. P. Scott (2007). "Patched1 regulates hedgehog signaling at the primary cilium." Science 317(5836): 372-376.

Rohatgi, R. and M. P. Scott (2007). "Patching the gaps in Hedgehog signalling." Nat Cell Biol 9(9): 1005-1009.

Rohatgi, R. and W. J. Snell (2010). "The ciliary membrane." Curr Opin Cell Biol 22(4): 541-546.

Von Ohlen, T. and J. E. Hooper (1997). "Hedgehog signaling regulates transcription through Gli/Ci binding sites in the wingless enhancer." Mech Dev 68(1-2): 149-156.

Event: 2028: Decrease, GLI1/2 translocation to nucleus

Short Name: Decrease, GLI1/2 translocation

Key Event Component

Process Object Action
protein import into nucleus, translocation zinc finger protein GLI1 decreased
protein import into nucleus, translocation zinc finger protein GLI2 decreased

AOPs Including This Key Event

Biological Context

Level of Biological Organization
Molecular

Cell term

Cell term
cell

Domain of Applicability

Life Stage Applicability
Life Stage Evidence
Embryo High
All life stages High
Sex Applicability
Sex Evidence
Unspecific
  • Sex- The Gli family of transcription factors is present in both male and females and differences in activation or antagonism between sex have not been demonstrated.  
  • Life stages- The Hedgehog pathway is a major pathway in embryonic development. Aberrant activation of HH signalling is known to cause cancer (Dahmane, Lee et al. 1997, Kimura, Stephen et al. 2005). For these reasons all stages of life are of relevance.
  • Taxonomic-HH signalling including the Gli transcription factors is present in vertebrates and some invertebrates inclubind flies (Denef, Neubüser et al. 2000, Huangfu and Anderson 2005)  

Key Event Description

The Glioma-associated onocogene (Gli) family of zinc finger transcription factors (Gli1, Gli2, Gli3) are the primarily downstream effectors of the Hedgehog (HH) signaling cascade. When HH ligand binds to Patched (PTCH), its’ inhibition on SMO is relieved. SMO this then able to accumulate to the tip of primary cilium in its’ active form (Corbit, Aanstad et al. 2005, Rohatgi, Milenkovic et al. 2007, Kim, Kato et al. 2009). SMO causes the GLI family to become dislodged from their complex with the negative regulator of HH signaling, Suppressor of Fused (Sufu) (Kogerman, Grimm et al. 1999, Pearse, Collier et al. 1999, Stone, Murone et al. 1999, Tukachinsky, Lopez et al. 2010). The GLI-Sufu complex maintains retention of Gli in the cytosol allowing for exposure to phosphorylation via protein kinase A (PKA) which inhibits downstream signal transduction  (Tuson, He et al. 2011). When SMO is activated the GLI2/3-Sufu complex is dismantled allowing for retrograde transport of GLI back into the nucleus (Kim, Kato et al. 2009).

The GLI family is found in both a long activator form (GliA) or a proteolytically cleaved repressor form (GliR). Current understanding is that Gli3 functions primarily as a repressor while Gli1 and Gli2 function mainly as activators of the pathway and that recruitment of SMO to the cilium leads to a increase in the ratio of GliA:GliR (Hui and Angers 2011, Liu 2016).

How it is Measured or Detected

  • A nuclear translocation assay (NTA) can be applied to determine the amount of protein that translocate into the nucleus (Dixon and Lim 2010).
  • Nuclear protein extracts can be analysed to determine if the protein of interest (GLI1/2) translocated to the nucleus (Kim, Kato et al. 2009).
  • Immunofluorescence and microscopy can be used to determine how much of a protein has translocated to the nucleus. Primary antibodies can be used to tag GLI in combination with a secondary stain for the nucleus (Blotta, Jakubikova et al. 2012).

References

Blotta, S., J. Jakubikova, T. Calimeri, A. M. Roccaro, N. Amodio, A. K. Azab, U. Foresta, C. S. Mitsiades, M. Rossi, K. Todoerti, S. Molica, F. Morabito, A. Neri, P. Tagliaferri, P. Tassone, K. C. Anderson and N. C. Munshi (2012). "Canonical and noncanonical Hedgehog pathway in the pathogenesis of multiple myeloma." Blood 120(25): 5002-5013.

Corbit, K. C., P. Aanstad, V. Singla, A. R. Norman, D. Y. R. Stainier and J. F. Reiter (2005). "Vertebrate Smoothened functions at the primary cilium." Nature 437(7061): 1018-1021.

Dahmane, N., J. Lee, P. Robins, P. Heller and A. Ruiz i Altaba (1997). "Activation of the transcription factor Gli1 and the Sonic hedgehog signalling pathway in skin tumours." Nature 389(6653): 876-881.

Denef, N., D. Neubüser, L. Perez and S. M. Cohen (2000). "Hedgehog induces opposite changes in turnover and subcellular localization of patched and smoothened." Cell 102(4): 521-531.

Dixon, A. S. and C. S. Lim (2010). "The nuclear translocation assay for intracellular protein-protein interactions and its application to the Bcr coiled-coil domain." Biotechniques 49(1): 519-524.

Huangfu, D. and K. V. Anderson (2005). "Cilia and Hedgehog responsiveness in the mouse." Proc Natl Acad Sci U S A 102(32): 11325-11330.

Hui, C. C. and S. Angers (2011). "Gli proteins in development and disease." Annu Rev Cell Dev Biol 27: 513-537.

Kim, J., M. Kato and P. A. Beachy (2009). "Gli2 trafficking links Hedgehog-dependent activation of Smoothened in the primary cilium to transcriptional activation in the nucleus." Proc Natl Acad Sci U S A 106(51): 21666-21671.

Kimura, H., D. Stephen, A. Joyner and T. Curran (2005). "Gli1 is important for medulloblastoma formation in Ptc1+/- mice." Oncogene 24(25): 4026-4036.

Kogerman, P., T. Grimm, L. Kogerman, D. Krause, A. B. Undén, B. Sandstedt, R. Toftgård and P. G. Zaphiropoulos (1999). "Mammalian suppressor-of-fused modulates nuclear-cytoplasmic shuttling of Gli-1." Nat Cell Biol 1(5): 312-319.

Liu, K. J. (2016). "Craniofacial Ciliopathies and the Interpretation of Hedgehog Signal Transduction." PLoS Genet 12(12): e1006460.

Pearse, R. V., 2nd, L. S. Collier, M. P. Scott and C. J. Tabin (1999). "Vertebrate homologs of Drosophila suppressor of fused interact with the gli family of transcriptional regulators." Dev Biol 212(2): 323-336.

Rohatgi, R., L. Milenkovic and M. P. Scott (2007). "Patched1 regulates hedgehog signaling at the primary cilium." Science 317(5836): 372-376.

Stone, D. M., M. Murone, S. Luoh, W. Ye, M. P. Armanini, A. Gurney, H. Phillips, J. Brush, A. Goddard, F. J. de Sauvage and A. Rosenthal (1999). "Characterization of the human suppressor of fused, a negative regulator of the zinc-finger transcription factor Gli." J Cell Sci 112 ( Pt 23): 4437-4448.

Tukachinsky, H., L. V. Lopez and A. Salic (2010). "A mechanism for vertebrate Hedgehog signaling: recruitment to cilia and dissociation of SuFu-Gli protein complexes." J Cell Biol 191(2): 415-428.

Tuson, M., M. He and K. V. Anderson (2011). "Protein kinase A acts at the basal body of the primary cilium to prevent Gli2 activation and ventralization of the mouse neural tube." Development 138(22): 4921-4930.

 

Event: 2040: Decrease, GLI1/2 target gene expression

Short Name: Decrease, GLI1/2 target gene expression

Key Event Component

Process Object Action
gene expression zinc finger protein GLI1 decreased
gene expression zinc finger protein GLI2 decreased

AOPs Including This Key Event

Biological Context

Level of Biological Organization
Cellular

Cell term

Cell term
cell

Domain of Applicability

Life Stage Applicability
Life Stage Evidence
All life stages
Sex Applicability
Sex Evidence
Unspecific
  • Sex- The GLI family of transcription factors is present in both male and females and differences in gene expression has not been demonstrated.   
  • Life stages- The Hedgehog pathway is a major pathway in embryonic development. Aberrant activation of HH signalling is known to cause cancer (Dahmane, Lee et al. 1997, Kimura, Stephen et al. 2005). For these reasons all stages of life are of relevance.
  • Taxonomic-HH signalling including the GLI transcription factors is present in vertebrates and some invertebrates including flies (Denef, Neubüser et al. 2000, Huangfu and Anderson 2005)  

 

Key Event Description

The Glioma-associated onocogene (GLI) family of zinc finger transcription factors (Gli1, Gli2, Gli3) are the primarily downstream effectors of the Hedgehog (HH) signaling cascade. When HH ligand binds to Patched (PTCH), its’ inhibition on SMO is relieved. SMO this then able to accumulate to the tip of primary cilium in its’ active form (Corbit, Aanstad et al. 2005, Rohatgi, Milenkovic et al. 2007, Kim, Kato et al. 2009). SMO causes the GLI family to become dislodged from their complex with the negative regulator of HH signaling, Suppressor of Fused (Sufu) (Kogerman, Grimm et al. 1999, Pearse, Collier et al. 1999, Stone, Murone et al. 1999, Tukachinsky, Lopez et al. 2010). The GLI-Sufu complex maintains retention of Gli in the cytosol allowing for exposure to phosphorylation via protein kinase A (PKA) which inhibits downstream signal transduction  (Tuson, He et al. 2011). When SMO is activated the GLI2/3-Sufu complex is dismantled allowing for retrograde transport of GLI back into the nucleus (Kim, Kato et al. 2009). Following translocation into the nucleus, the GLI family of transcription factors initiates transcription of a variety of genes. The genes transcribed by activation of the SHH pathway are cell type dependent but commonly include GLI1 and PTCH1 (Stamataki, Ulloa et al. 2005, Cohen, Kicheva et al. 2015, Tickle and Towers 2017). During development of the neural tube SHH is associated with NKX6.1, OLIG2, NKX2.2 and the FOXA2 genes (Vokes, Ji et al. 2007, Kutejova, Sasai et al. 2016). Other genes have are known targets of GLI transcription include PTCH2, HHIP1, MYCN, CCND1, CCND2, BCL2, CFLA, FOXF1, FOXFL1, PRDM1, JAG2, GREM1, FOXB2, FOXA2, FOXB2, FOXC1, FOXC2, FOXD1, FOXE1, FOXF1, FOXF2, FOXL1 and follistatin (Katoh and Katoh 2009, Everson, Fink et al. 2017).

How it is Measured or Detected

  • Changes in gene expression can be measured using serial analysis of gene expression (SAGE), rapid analysis of gene expression (RAGE), RT-PCR, Northern/Southern blotting, differential display, and DNA microarray assay.

References

Cohen, M., A. Kicheva, A. Ribeiro, R. Blassberg, K. M. Page, C. P. Barnes and J. Briscoe (2015). "Ptch1 and Gli regulate Shh signalling dynamics via multiple mechanisms." Nature Communications 6(1): 6709.

Corbit, K. C., P. Aanstad, V. Singla, A. R. Norman, D. Y. R. Stainier and J. F. Reiter (2005). "Vertebrate Smoothened functions at the primary cilium." Nature 437(7061): 1018-1021.

Dahmane, N., J. Lee, P. Robins, P. Heller and A. Ruiz i Altaba (1997). "Activation of the transcription factor Gli1 and the Sonic hedgehog signalling pathway in skin tumours." Nature 389(6653): 876-881.

Denef, N., D. Neubüser, L. Perez and S. M. Cohen (2000). "Hedgehog induces opposite changes in turnover and subcellular localization of patched and smoothened." Cell 102(4): 521-531.

Everson, J. L., D. M. Fink, J. W. Yoon, E. J. Leslie, H. W. Kietzman, L. J. Ansen-Wilson, H. M. Chung, D. O. Walterhouse, M. L. Marazita and R. J. Lipinski (2017). "Sonic hedgehog regulation of Foxf2 promotes cranial neural crest mesenchyme proliferation and is disrupted in cleft lip morphogenesis." Development 144(11): 2082-2091.

Huangfu, D. and K. V. Anderson (2005). "Cilia and Hedgehog responsiveness in the mouse." Proc Natl Acad Sci U S A 102(32): 11325-11330.

Katoh, Y. and M. Katoh (2009). "Hedgehog target genes: mechanisms of carcinogenesis induced by aberrant hedgehog signaling activation." Curr Mol Med 9(7): 873-886.

Kim, J., M. Kato and P. A. Beachy (2009). "Gli2 trafficking links Hedgehog-dependent activation of Smoothened in the primary cilium to transcriptional activation in the nucleus." Proc Natl Acad Sci U S A 106(51): 21666-21671.

Kimura, H., D. Stephen, A. Joyner and T. Curran (2005). "Gli1 is important for medulloblastoma formation in Ptc1+/- mice." Oncogene 24(25): 4026-4036.

Kogerman, P., T. Grimm, L. Kogerman, D. Krause, A. B. Undén, B. Sandstedt, R. Toftgård and P. G. Zaphiropoulos (1999). "Mammalian suppressor-of-fused modulates nuclear-cytoplasmic shuttling of Gli-1." Nat Cell Biol 1(5): 312-319.

Kutejova, E., N. Sasai, A. Shah, M. Gouti and J. Briscoe (2016). "Neural Progenitors Adopt Specific Identities by Directly Repressing All Alternative Progenitor Transcriptional Programs." Dev Cell 36(6): 639-653.

Pearse, R. V., 2nd, L. S. Collier, M. P. Scott and C. J. Tabin (1999). "Vertebrate homologs of Drosophila suppressor of fused interact with the gli family of transcriptional regulators." Dev Biol 212(2): 323-336.

Rohatgi, R., L. Milenkovic and M. P. Scott (2007). "Patched1 regulates hedgehog signaling at the primary cilium." Science 317(5836): 372-376.

Stamataki, D., F. Ulloa, S. V. Tsoni, A. Mynett and J. Briscoe (2005). "A gradient of Gli activity mediates graded Sonic Hedgehog signaling in the neural tube." Genes Dev 19(5): 626-641.

Stone, D. M., M. Murone, S. Luoh, W. Ye, M. P. Armanini, A. Gurney, H. Phillips, J. Brush, A. Goddard, F. J. de Sauvage and A. Rosenthal (1999). "Characterization of the human suppressor of fused, a negative regulator of the zinc-finger transcription factor Gli." J Cell Sci 112 ( Pt 23): 4437-4448.

Tickle, C. and M. Towers (2017). "Sonic Hedgehog Signaling in Limb Development." Front Cell Dev Biol 5: 14.

Tukachinsky, H., L. V. Lopez and A. Salic (2010). "A mechanism for vertebrate Hedgehog signaling: recruitment to cilia and dissociation of SuFu-Gli protein complexes." J Cell Biol 191(2): 415-428.

Tuson, M., M. He and K. V. Anderson (2011). "Protein kinase A acts at the basal body of the primary cilium to prevent Gli2 activation and ventralization of the mouse neural tube." Development 138(22): 4921-4930.

Vokes, S. A., H. Ji, S. McCuine, T. Tenzen, S. Giles, S. Zhong, W. J. Longabaugh, E. H. Davidson, W. H. Wong and A. P. McMahon (2007). "Genomic characterization of Gli-activator targets in sonic hedgehog-mediated neural patterning." Development 134(10): 1977-1989.

Event: 2043: Decrease, Sonic Hedgehog second messenger production

Short Name: Decrease, SHH second messenger production

Key Event Component

Process Object Action
second-messenger-mediated signaling decreased

AOPs Including This Key Event

Biological Context

Level of Biological Organization
Cellular

Cell term

Cell term
cell

Domain of Applicability

Taxonomic Applicability
Term Scientific Term Evidence Links
Vertebrates Vertebrates NCBI
Life Stage Applicability
Life Stage Evidence
Embryo
Sex Applicability
Sex Evidence
Unspecific
  • Sex- Secondary messenger production of the SHH pathway is present in both male and females and differences in gene expression has not been demonstrated.   
  • Life stages- The Hedgehog pathway is a major pathway in embryonic development.
  • Taxonomic-HH signalling, and its’ secondary messenger production is present in vertebrates and some invertebrates including flies (Denef, Neubüser et al. 2000, Huangfu and Anderson 2005) 

 

Key Event Description

During normal Sonic Hedgehog (SHH) signaling, GLI target gene expression regulates several other signaling pathways. Expression of FOXF1 and FOXL1 upregulate BMP4, BMP 2, and FGF10 in the mesenchyme (Katoh and Katoh 2009, Lan and Jiang 2009). Induction of FGF10 in the mesenchyme is able to induce SHH in the adjacent epithelium via a positive feedback loop with FGFR2 (Cobourne and Green 2012). SHH signaling also upregulates BCL2 and CFLAR to promote cell survival (Katoh and Katoh 2009).

How it is Measured or Detected

  • Changes in gene expression can be measured using serial analysis of gene expression (SAGE), rapid analysis of gene expression (RAGE), RT-PCR, Northern/Southern blotting, differential display, and DNA microarray assay.
  • Antibody staining of tissue sections can be used to determine location and amounts of BMP4, BMP2, FGF10

References

Cobourne, M. T. and J. B. Green (2012). "Hedgehog signalling in development of the secondary palate." Front Oral Biol 16: 52-59.

Denef, N., D. Neubüser, L. Perez and S. M. Cohen (2000). "Hedgehog induces opposite changes in turnover and subcellular localization of patched and smoothened." Cell 102(4): 521-531.

Huangfu, D. and K. V. Anderson (2005). "Cilia and Hedgehog responsiveness in the mouse." Proc Natl Acad Sci U S A 102(32): 11325-11330.

Katoh, Y. and M. Katoh (2009). "Hedgehog target genes: mechanisms of carcinogenesis induced by aberrant hedgehog signaling activation." Curr Mol Med 9(7): 873-886.

Lan, Y. and R. Jiang (2009). "Sonic hedgehog signaling regulates reciprocal epithelial-mesenchymal interactions controlling palatal outgrowth." Development 136(8): 1387-1396.

 

Event: 1821: Decrease, Cell proliferation

Short Name: Decrease, Cell proliferation

Key Event Component

Process Object Action
cell proliferation cell decreased

AOPs Including This Key Event

Stressors

Name
2,4-Dinitrophenol
Carbonyl cyanide-p-trifluoromethoxyphenylhydrazone
Carbonyl cyanide m-chlorophenyl hydrazone
Pentachlorophenol
Triclosan
Emodin
Malonoben

Biological Context

Level of Biological Organization
Cellular

Cell term

Cell term
cell

Domain of Applicability

Taxonomic Applicability
Term Scientific Term Evidence Links
zebrafish Danio rerio High NCBI
human Homo sapiens High NCBI
rat Rattus norvegicus High NCBI
mouse Mus musculus High NCBI
Life Stage Applicability
Life Stage Evidence
Embryo High
Juvenile High
Sex Applicability
Sex Evidence
Unspecific High

Taxonomic applicability domain

This key event is in general applicable to all eukaryotes, as most organisms are known to use cell proliferation to achieve growth.

 

Life stage applicability domain

This key event is in general applicable to all life stages. As cell proliferation not only occurs in developing organisms, but also in adults.

 

Sex applicability domain

This key event is sex-unspecific, as both genders use the same cell proliferation mechanisms.

Key Event Description

Decreased cell proliferation describes the outcome of reduced cell division and cell growth. Cell proliferation is considered the main mechanism of tissue and organismal growth (Conlon 1999). Decreased cell proliferation has been associated with abnormal growth-factor signaling and cellular energy depletion (DeBerardinis 2008).

How it is Measured or Detected

Multiple types of in vitro bioassays can be used to measure this key event:

  • ToxCast high-throughput screening bioassays such as “BSK_3C_Proliferation”, “BSK_CASM3C_Proliferation” and “BSK_SAg_Proliferation” can be used to measure cell proliferation status.
  • Commercially available methods such as the well-established 5-bromo-2’-deoxyuridine (BrdU) (Raza 1985; Muir 1990) or 5-ethynyl-2’-deoxyuridine (EdU) assay. Both assays measure DNA synthesis in dividing cells to indicate proliferation status.

References

Conlon I, Raff M. 1999. Size control in animal development. Cell 96:235-244. DOI: 10.1016/s0092-8674(00)80563-2.

DeBerardinis RJ, Lum JJ, Hatzivassiliou G, Thompson CB. 2008. The biology of cancer: metabolic reprogramming fuels cell growth and proliferation. Cell Metabolism 7:11-20. DOI: https://doi.org/10.1016/j.cmet.2007.10.002.

Muir D, Varon S, Manthorpe M. 1990. An enzyme-linked immunosorbent assay for bromodeoxyuridine incorporation using fixed microcultures. Analytical Biochemistry 185:377-382. DOI: https://doi.org/10.1016/0003-2697(90)90310-6.

Raza A, Spiridonidis C, Ucar K, Mayers G, Bankert R, Preisler HD. 1985. Double labeling of S-phase murine cells with bromodeoxyuridine and a second DNA-specific probe. Cancer Research 45:2283-2287.

Event: 2041: Decrease, palatal shelf outgrowth

Short Name: Decrease, outgrowth

Key Event Component

Process Object Action
palatal shelves fail to meet at midline primary palate decreased
abnormal palatal shelf fusion at midline secondary palate decreased

AOPs Including This Key Event

Biological Context

Level of Biological Organization
Tissue

Domain of Applicability

Taxonomic Applicability
Term Scientific Term Evidence Links
Vertebrates Vertebrates High NCBI
Life Stage Applicability
Life Stage Evidence
Embryo High
Sex Applicability
Sex Evidence
Unspecific
  • Sex- There are no known differences in palatal outgrowth in terms of sex.
  • Life stages- The palate develops early in embryonic development. This begins between the 6th and 12th week of pregnancy in humans and between day 10.0 and 15 in mice (Okuhara and Iseki 2012).
  • Taxonomic- Palatal outgrowth is required for proper palate formation in all vertebrates.

Key Event Description

For humans and other mammals, the palate serves as a barrier between the mouth and nasal cavity allowing for simultaneous breathing and eating. The palate consists of an anterior bony hard palate and a posterior muscular soft palate that closes the nasal airways for swallowing and directs airflow to help in generation of speech (Li, Lan et al. 2017). The palate is divided into primary and secondary portions. The primary palate contains the philtrum and the upper incisor region anterior to the incisive foramen while the secondary palate encompasses the remainder of the hard and soft palate (Bush and Jiang 2012).  The secondary palate arises during embryonic development as bilateral outgrowths from the maxillary processes. In mammals, these shelves grow first vertically down the tongue before elevating to a position above the dorsum of the tongue where the two shelves meet and fuse to form an intact palate (Ferguson 1988).  

How it is Measured or Detected

  • Palatal shelf outgrowth can be quantified using imaging techniques such as 3D CT scans during development. Insufficient palatal outgrowth will result in cleft palate. The distance between palatal shelves corelating with outgrowth can be measured and quantified for these individuals.

References

Bush, J. O. and R. Jiang (2012). "Palatogenesis: morphogenetic and molecular mechanisms of secondary palate development." Development 139(2): 231-243.

Ferguson, M. W. (1988). "Palate development." Development 103 Suppl: 41-60.

Li, C., Y. Lan and R. Jiang (2017). "Molecular and Cellular Mechanisms of Palate Development." J Dent Res 96(11): 1184-1191.

Okuhara, S. and S. Iseki (2012). "Epithelial integrity in palatal shelf elevation." Japanese Dental Science Review 48(1): 18-22.

List of Adverse Outcomes in this AOP

Event: 2042: Ororofacial clefting

Short Name: OFC

Key Event Component

Process Object Action
Cleft palate increased
cleft upper lip increased

AOPs Including This Key Event

Biological Context

Level of Biological Organization
Individual

Domain of Applicability

Taxonomic Applicability
Term Scientific Term Evidence Links
Vertebrates Vertebrates NCBI
Life Stage Applicability
Life Stage Evidence
Embryo High
Sex Applicability
Sex Evidence
Unspecific
  • Sex- OFC can occur for all sexes. Differences in incidence between males and females have been found however a clear understanding of what causes this difference is not understood. Cleft lip with or without cleft palate is more common in males while cleft palate only is more common for females (Barbosa Martelli, Machado et al. 2012).
  • Life stages- Orofacial development and any disruption leading to clefting occurs early in embryonic development. This begins between the 6th and 12th week of pregnancy in humans and between day 10.0 and 15 in mice (Okuhara and Iseki 2012).
  • Taxonomic- Orofacial development occurs in all vertebrates.  

 

Key Event Description

Orofacial clefts (OFC) are one of the most common birth defects. Orofacial clefts are commonly divided on the anatomy they affect by clefts of the lip and/or palate (CL/P) and those of the palate only (CPO) (Murray 2002). Clefts can also be classified as either syndromic when they occur with other physical or developmental anomalies or nonsydromic in the absence of other symptoms (Stanier and Moore 2004). Like most births, the etiology of OFCs are complex and include a combination of genetic and chemical factors (Lipinski and Bushman 2010, Heyne, Melberg et al. 2015). Orofacial development is tightly regulated by multiple signaling pathways and genes including: fibroblast growth factors (Fgfs), Sonic Hedgehog (shh), bone morphogenic protein (Bmp), transforming growth factor beta (Tgf- β) and transcription factors including Dlx, Pitx, Hox, Gli and T-box (Stanier and Moore 2004). Orofacial development requires precise cell migration, growth, differentiation and apoptosis to create the needed orofacial structures from the oropharyngeal membrane (Jugessur and Murray 2005).  During the sixth week of human embryogenesis the medial nasal prominences merge to form the primary palate and the upper lip. The mandibular prominences merge across the midline to produce the lower jaw and lip. Development of the secondary palate begins in the sixth week where the palatal shelves extend internally to the maxillary processes. The shelves then elevate above the tongue and grow towards each other until contact occurs. During weeks 7-8 the medial edges of the palatal shelves fuse through as series of epithelial-mesenchyme transition (EMT) and apoptosis(Jugessur and Murray 2005, Zhang, Tian et al. 2016). Disruption to the complex processes required for proper orofacial development can occur both through genetic factors and environmental (i.e. chemical) exposure by causing disruption to one or multiple steps of orofacial development resulting in OFC.

How it is Measured or Detected

  • OFC can be visually observed both in humans and in animals. It can be classified by which tissues (e.g.cleft lip and palate) are effected and its’ severity (complete/incomplete, unilateral/bilateral). Techniques such as the revised Smith-modified Kernahan ‘Y’ classification can be used describe the type, location, and extent of OFC deformities (Khan, Ullah et al. 2013).

Regulatory Significance of the AO

OFC is one of the most common birth defects occurring in approximately 1 in 700 live births. The etiology of OFC is poorly understood and is believed to be a combination of genetic and environmental factors. Understanding the genetic and environmental factors that can lead to OFC is the first step in preventing this birth defect.

References

 

Barbosa Martelli, D. R., R. A. Machado, M. S. Oliveira Swerts, L. A. Mendes Rodrigues, S. N. de Aquino and H. M. Júnior (2012). "Non sindromic cleft lip and palate: relationship between sex and clinical extension." Brazilian Journal of Otorhinolaryngology 78(5): 116-120.

Heyne, G. W., C. G. Melberg, P. Doroodchi, K. F. Parins, H. W. Kietzman, J. L. Everson, L. J. Ansen-Wilson and R. J. Lipinski (2015). "Definition of critical periods for Hedgehog pathway antagonist-induced holoprosencephaly, cleft lip, and cleft palate." PLoS One 10(3): e0120517.

Jugessur, A. and J. C. Murray (2005). "Orofacial clefting: recent insights into a complex trait." Curr Opin Genet Dev 15(3): 270-278.

Khan, M., H. Ullah, S. Naz, T. Iqbal, T. Ullah, M. Tahir and O. Ullah (2013). "A revised classification of the cleft lip and palate." Can J Plast Surg 21(1): 48-50.

Lipinski, R. J. and W. Bushman (2010). "Identification of Hedgehog signaling inhibitors with relevant human exposure by small molecule screening." Toxicol In Vitro 24(5): 1404-1409.

Murray, J. C. (2002). "Gene/environment causes of cleft lip and/or palate." Clin Genet 61(4): 248-256.

Okuhara, S. and S. Iseki (2012). "Epithelial integrity in palatal shelf elevation." Japanese Dental Science Review 48(1): 18-22.

Stanier, P. and G. E. Moore (2004). "Genetics of cleft lip and palate: syndromic genes contribute to the incidence of non-syndromic clefts." Hum Mol Genet 13 Spec No 1: R73-81.

Zhang, J., X.-J. Tian and J. Xing (2016). "Signal Transduction Pathways of EMT Induced by TGF-β, SHH, and WNT and Their Crosstalks." Journal of clinical medicine 5(4): 41.

Appendix 2

List of Key Event Relationships in the AOP