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Protein / target

Protein smoothened

Encoded bySMOQ99835Homo sapiensSwiss-Prot
Clinically validated
Therapeutic maturity
5
Approved medicines
Open Targets target-level
View by indication →
30
Clinical trials
Small-molecule tractable
Druggability
Approved Drug

Protein at a glance

Biological role

CAMP-dependent protein kinase inhibitor

Strongest disease association

Osteoarthritis, Hip

Via encoding gene SMO · Genetic evidence · score 0.76

Therapeutic position

Established drug target

Small molecules

Derived from structured UniProt, Open Targets and literature data on this page.

Protein profile

UniProt 2026_02

Canonical identity and biological annotation from UniProt.

Function overview

G protein-coupled receptor, which transduces the smoothened signaling pathway.

View complete UniProt function annotation

G protein-coupled receptor, which transduces the smoothened signaling pathway (PubMed:19592253, PubMed:27437577, PubMed:28344083, PubMed:31168089, PubMed:32929279, PubMed:36202993). Activated by cholesterol in response to hedgehog (DHH, IHH or SHH) morphogens (PubMed:27437577, PubMed:28344083, PubMed:32929279). In absence of hedgehog, SMO is inactivated by patched protein (PTCH1 or PTCH2), which prevents SMO access to cholesterol (PubMed:28344083). In response to hedgehog-binding to pathched, inhibition is relieved, promoting SMO translocation to primary cilium and activation by cholesterol: cholesterol causes a conformation change that triggers signaling via G protein G(i), mediating inhibition of adenylate cyclase activity and decreassed production of cAMP (PubMed:28344083, PubMed:31168089). Decreased cAMP levels then inhibit protein kinase A (PKA) and promote release of GLI (GLI1, GLI2 and GLI3) transcription factors, which activate expression of target genes (PubMed:31168089). Active SMO also directly inhibits PKA by sequestering its catalytic subunit, PRKACA, at the cell membrane, preventing PRKACA-mediated phosphorylation and subsequent processing of GLI transcription factors (PubMed:36202993, PubMed:39138140). Active SMO also promotes the removal of GPR161, a key inhibitor of the smoothened signaling pathway, from primary cilia (By similarity)

Subcellular location

Cell membraneCell projection, cilium membrane
Domains and Gene Ontology detail (46)

Domains & features

FZ

Gene Ontology

  • C9+0 non-motile cilium
  • Ccentriole
  • Cciliary membrane
  • Cciliary tip
  • Ccilium
  • Cdendrite
  • Cendocytic vesicle membrane
  • Cendoplasmic reticulum
  • Cendoplasmic reticulum-Golgi intermediate compartment
  • Cextracellular exosome
  • CGolgi apparatus
  • Clate endosome

787 aa · 86 kDa

Biological roles

What this protein does, drawn together from its UniProt function, Gene Ontology terms and Reactome pathways.

Lipid & lipoprotein metabolismUniProt · GOCell migrationGOTranscriptional regulationUniProt · GOKinase signallingUniProt · GOG protein-coupled signallingUniProt · GO
View supporting evidence

Lipid & lipoprotein metabolism

  • ·G protein-coupled receptor, which transduces the smoothened signaling pathway (PubMed:19…
  • ·oxysterol binding
  • ·cellular response to cholesterol

Cell migration

  • ·positive regulation of cell migration

Transcriptional regulation

  • ·G protein-coupled receptor, which transduces the smoothened signaling pathway (PubMed:19…
  • ·negative regulation of DNA-templated transcription
  • ·negative regulation of gene expression
  • ·positive regulation of gene expression

Kinase signalling

  • ·G protein-coupled receptor, which transduces the smoothened signaling pathway (PubMed:19…
  • ·cAMP-dependent protein kinase inhibitor activity
  • ·protein kinase A catalytic subunit binding

G protein-coupled signalling

  • ·G protein-coupled receptor, which transduces the smoothened signaling pathway (PubMed:19…
  • ·G protein-coupled receptor activity

Concepts derived from UniProt GO Reactome — each badge above shows which sources supported that role.

Approved medicines with mapped indications

1 medicine · 1 area

Approved therapies targeting this protein, grouped by what they are approved to treat — the disease-first view of the medicines below. Relationships come from the canonical approved-indication graph (ChEMBL phase-4), the same source as the drug cards.

Neoplasms1 medicine

5 medicines meet Open Targets' target-level approved-medicine definition; the 1 shown here are those on this page with a canonical approved disease indication in the graph. Approved indications from ChEMBL (phase-4), via the canonical drug→disease graph.

Drugs targeting this protein

1

How approved and investigational drugs engage this protein — mechanism and action type, direct vs complex targeting, and how broadly each acts across other targets. A drug-first view (the section above groups the approved ones disease-first); direct binders with few recorded targets are listed first.

vismodegib
Narrow target profileApprovedInhibitor

Smoothened homolog inhibitor

Indicated for Neoplasms

Direct interaction with this protein · Only this protein recorded as a target

ChEMBL mechanism, action type, target identity and approved indications. Open Targets clinical status.

Translational evidence

Open Targets 26

Why this target matters therapeutically, strongest evidence first. Disease associations are gene-level (via the gene that encodes this protein) and open into the full confidence synthesis; the development universe, tractability and safety annotations are target-level, from Open Targets.

Strongest disease associations · via encoding gene SMO

Gene-level evidence surfaced through the gene SMOthat encodes this protein — not a direct protein–disease relationship. Ranked by Forefront's causal-directness weighting, so genetically- and clinically-evidenced diseases lead over ones that merely share the literature.

Basal cell carcinoma
0.88Well supported

Clinical evidence dominant · Open Targets 0.74

Leukemia, Myeloid, Acute
0.79Well supported

Clinical evidence dominant · Open Targets 0.62

Osteoarthritis, Hip
0.76Well supported

Genetic evidence dominant · Open Targets 0.46

Medulloblastoma
0.68Moderately supported

Somatic mutation evidence dominant · Open Targets 0.55

Neoplasms
0.66Moderately supported

Clinical evidence dominant · Open Targets 0.52

View evidence synthesis (5)
Basal cell carcinomaWell supported
0.88
agreement 0.770.98
Clinical51%Somatic mutation30%Pathway17%Literature2%

Open Targets aggregate 0.74 · 4 independent evidence families

Leukemia, Myeloid, AcuteWell supported
0.79
agreement 0.670.91
Clinical64%Somatic mutation28%Literature7%

Open Targets aggregate 0.62 · 3 independent evidence families

Osteoarthritis, HipWell supported
0.76
agreement 0.620.90
Genetic100%Literature0%

Open Targets aggregate 0.46 · 2 independent evidence families

MedulloblastomaModerately supported
0.68
agreement 0.570.79
Somatic mutation47%Pathway26%Clinical15%Literature12%

Open Targets aggregate 0.55 · 4 independent evidence families

NeoplasmsModerately supported
0.66
agreement 0.500.81
Clinical87%Literature13%

Open Targets aggregate 0.52 · 2 independent evidence families

The evidence agreement range shows how closely the independent evidence families agree — it is not a statistical confidence interval, and nothing here is fitted to outcome data. Derived from Open Targets evidence types under Forefront weighting; the per-type scores above show the calculation.

Show all associations
Basal cell carcinoma0.74
Leukemia, Myeloid, Acute0.62
Medulloblastoma0.55
Neoplasms0.52
Hirschsprung disease0.46
Osteoarthritis, Hip0.46
Microcephaly0.40
Meningioma0.39

Drug development

10 compounds recorded · 5 approved · 5 in clinical development

Open Targets' development universe — every compound recorded against the target at any stage, not all approved medicines. Distinct from the 1 drug that targets this protein in Forefront's canonical graph (1 with a mapped approved indication, shown above): these count different sets and are not a subset relation.

View all recorded compounds (10)
SONIDEGIBApproval
TALADEGIBPhase 2
SONIDEGIB PHOSPHATEApproval
BMS-833923Phase 2
GLASDEGIBApproval
TAK-441Phase 1
VISMODEGIBApproval
GLASDEGIB MALEATEApproval
LEQ506Phase 1
PATIDEGIBPhase 3

Open Targets known-drugs universe. Drug name and highest clinical stage only — the disease relationship is NOT read from this slice (it carries trial-context noise); approved indications come from the canonical graph above.

Tractability

Small moleculesStrong

Approved Drug and Structure with Ligand support this modality.

AntibodiesEmerging

Feasibility evidence (go cc high conf and uniprot loc med conf) — no clinical-stage drug of this modality recorded.

Protein degradersEmerging

Feasibility evidence (small molecule binder) — no clinical-stage drug of this modality recorded.

View underlying tractability evidence (8)
SM · Approved DrugSM · Structure with LigandSM · High-Quality LigandSM · Druggable FamilyAB · GO CC high confAB · UniProt loc med confAB · UniProt SigP or TMHMMPR · Small Molecule Binder

Raw Open Targets tractability assessment buckets, by modality.

Clinical trials

30

Trials of drugs that target this protein — reached indirectly through those drugs, so a trial listed here studies the drug, not the protein. Ranked by active status, then clinical phase and recency, and spread across the targeting drugs.

View all trials (26)

ACTIVE_NOT_RECRUITING · via vismodegib · NCT02465060

ACTIVE_NOT_RECRUITING · via vismodegib · NCT01878617

ACTIVE_NOT_RECRUITING · via vismodegib · NCT01267955

RECRUITING · via vismodegib · NCT05651828

ACTIVE_NOT_RECRUITING · via vismodegib · NCT00878163

COMPLETED · via vismodegib · NCT02436408

ClinicalTrials.gov via the drug-target graph.

What's happening now

3

Recent therapeutic activity around this target — regulatory actions, clinical trials and safety signals for a drug that targets this protein, plus publications where such a drug is a genuine subject. Every item is reached indirectly through the drug, not the protein itself; incidental mentions (a paper that merely measures a drug) and press items are excluded.

  1. New publication2016-11-08
    Pharmacodynamic study of the oral hedgehog pathway inhibitor, vismodegib, in patients with metastatic castration-resistant prostate cancer.

    Cancer chemotherapy and pharmacology · 2016 · 25 citations · Europe PMC · via vismodegib

  2. New publication2014-06-11
    An investigator-initiated open-label clinical trial of vismodegib as a neoadjuvant to surgery for high-risk basal cell carcinoma.

    Journal of the American Academy of Dermatology · 2014 · 95 citations · Europe PMC · via vismodegib

  3. Regulatory approval2013-07-12

    Approval: Erivedge (EMA)

    ema · regulatory · ema · via vismodegib

Objective event titles are shown unmodified; the event kind and significance line are derived from structured fields. Forefront AttentionEvent stream aggregating Europe PMC Regulatory filings ClinicalTrials.gov.