The Hedgehog (Hh) signaling pathway is essential for development and organ physiology. In the canonical pathway, the morphogen Hedgehog binds to the membrane cholesterol permease PTCH conducing to a relief in the inhibition of Smoothened (SMO), which in turn will activate a signalling cascade, required for proper development. There is increasing evidence pointing to the existence of Hh pathway independent of SMO activity, however the co-existence with the canonical pathway has undermined the efforts to characterize it. C. elegans lacks SMO, nevertheless the PTCH homolog PTC-3 is essential for the worm, thereby providing an excellent model to study Smo-independent Hh pathway. Here we show that PTC-3 mediates cholesterol efflux, thus showing that the function of PTCH is conserved in C. elegans. Moreover, by measuring sterol levels through mass spectrometry (MS) and in vivo cholesterol detection we demonstrated that
ptc-3(RNAi) lead to accumulation of intracellular cholesterol. Further analysis of lipid metabolism using MS-lipidomics revealed a reduction in acyl chain length and desaturation suggesting structural defects upon the loss of PTC-3. Indeed, we observed through electron microscopy defects in ER structure and lipid droplet formation. In addition to a structural role, cholesterol is known to mediate signalling cascades, particularly through nuclear hormone receptors (NHR). We found that NHR-181 expression levels undergo a two-fold increase upon
ptc-3(RNAi). Finally, we show that reduction of dietary cholesterol in
ptc-3 (RNAi) animals rescued all described phenotypes consequently improving development and survival. In sum, we have uncovered cholesterol efflux as the essential role of PTC-3, at the same time we have shown how the Hh pathway can operate in a Smo-independent manner.