Activation of the hedgehog pathway in chronic myelogeneous leukemia patients

The aim of this study was to determine the expression of Hedgehog signaling molecules in Chronic Myelogeneous Leukemia (CML) patients and normal people by semiquantitative polymerase chain reaction (PCR) and to correlate mRNA expression to patients' clinical data.Here, we showed that Sonic hedgehog (Shh), Smoothened (Smo), and Gli1 genes of Hh signaling were significantly upregulated in CML patients when compared with normal people (P < 0.001). The levels of Shh, Smo mRNA in chronic phase of CML patients were obviously lower than that in blast crisis (p < 0.05). There were no significant differences of Shh, Ptch1, Smo, Gli1 mRNA expression found when comparing CML patients of chronic phase(CP) with imatinib(IM) treated or not(p > 0.05).These findings suggested that activation of the Hh pathway maybe associated with CML progression. Treatment of CML with imatinib, a selective inhibitor of the BCR-ABL tyrosine kinase inhibitor, has no significant influence on the inhibition of Hh pathway of CML-CP patients.Chronic myelogeneous leukemia (CML) is a clonal disease that originates from a single transformed hematopoietic stem cell (HSC) or multipotent progenitor cell harboring a chromosomal translocation between chromosome 9 and 22 [t(9;22)(q34;q11)], resulting in the formation of Philadelphia(Ph) chromosome and at the molecular level, a chimeric gene known as BCR-ABL responsible for CML initiation. CML often initiates in a chronic phase, and without intervention, eventually progresses to a terminal blastic phase. The introduction of imatinib mesylate, has revolutionized the disease management. However, imatinib does not cure CML, and one of the reasons is that imatinib does not kill leukemia stem cells (LSCs) in CML [1,2]. Recent studies suggest that developmental pathway like Hedgehog signaling pathway played a role during the expansion of BCR-ABL-positive leukemic stem cells [3,4]. Hedgehog ligands (Sonic hedgehog [Shh], Indian hedgehog [Ihh], and Desert hedgehog [Dhh])