Veratrum alkaloids and distal inhibitors of cholesterol biosynthesis h
ave been studied for more than 30 years as potent teratogens capable o
f inducing cyclopia and other birth defects. Here, it is shown that th
ese compounds specifically block the Sonic hedgehog (Shh) signaling pa
thway. These teratogens did not prevent the sterol modification of Shh
during autoprocessing but rather inhibited the response of target tis
sues to Shh, possibly acting through the sterol sensing domain within
the Patched protein regulator of Shh response.