Overexpression of Tetraspanin-8 (TSPAN8) relieves the inhibition of SMO by PTCH1 and phosphorylates SMO by promoting the binding of PTCH1 to SHH1, recruiting Ataxin-3 (ATXN3) to reduce the ubiquitination degradation of the SHH/PTCH1 complex, ultimately promoting GLI1 transcription.414 Additionally, Polypeptide N-Acetylgalactosaminyltransferase 1 (GALNT1)-mediated glycosylation of SHH in bladder cancer activates the hedgehog pathway, increasing the stemness and tumorigenicity of CSCs.415 Immunity may also play a significant role in influencing the effects of the hedgehog pathway in CSCs. This evidence concerns the gene SMO and urinary bladder cancer.