The Hematopoietically Expressed Homeobox protein (HHEX), encoded by the HHEX gene (also known as PRH), is an evolutionarily conserved transcription factor critical for embryonic development, organogenesis, and hematopoiesis . It functions as both a transcriptional activator and repressor, depending on cellular context and interacting partners . HHEX is indispensable for survival, as knockout mice embryos die by gestational day 13–16 due to severe developmental defects in the liver, thyroid, forebrain, and hematopoietic systems .
The HHEX gene spans four exons on human chromosome 10 (chromosome 19 in mice) and encodes a 270-amino-acid protein containing a homeodomain for DNA binding .
Pancreas: HHEX drives pancreatic endoderm differentiation by regulating NKX6.1, PTF1A, ONECUT1, and ONECUT3. Knockdown reduces β-cell differentiation efficiency, linking it to type 2 diabetes risk .
Liver and Thyroid: Essential for hepatic bud formation and thyroid morphogenesis .
Vasculature: Represses VEGFA to stabilize endothelial cells during embryogenesis .
HHEX maintains hematopoietic stem cell (HSC) self-renewal and lymphopoiesis:
B-cell Development: Deletion in mice abolishes B-cell progenitors (pre-pro-B, pro-B) but spares mature recirculating B cells .
Myeloid Regulation: Interacts with HOXA9 and eIF4E to balance myeloid proliferation and differentiation .
Transcriptional Regulation:
Protein Interactions:
Type 2 Diabetes: GWAS identifies HHEX locus variants (e.g., rs7923837) as risk factors .
Leukemia: Hypomethylation of HHEX occurs in trisomy 8 acute myeloid leukemia (AML), suggesting diagnostic utility 100.
Cancer Duality: Acts as a tumor suppressor in AML but as an oncogene in thyroid and colorectal cancers .
The Hematopoietically Expressed Homeobox (HHEX) gene, also known as HEX, PRH (Proline-Rich Homeodomain), or XHEX in Xenopus, is a non-clustered homeobox gene that plays a crucial role in various biological processes. This gene is evolutionarily conserved across species, including fish, amphibians, birds, mice, and humans .
HHEX is a transcriptional repressor involved in several critical developmental processes:
HHEX has been identified as a promising candidate gene for type 2 diabetes through genome-wide association studies . Polymorphisms in the HHEX gene, such as rs1111875, rs5015480, and rs7923837, have been associated with an increased risk of type 2 diabetes . Additionally, HHEX is implicated in various hematological malignancies and other diseases .
The recombinant form of HHEX (Human Recombinant) is used in research to study its functions and potential therapeutic applications. Understanding the role of HHEX in various biological processes and diseases can lead to the development of targeted therapies for conditions such as diabetes, hematological malignancies, and endocrine disorders .