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. 2020 Apr 15;30(9):779–793. doi: 10.1038/s41422-020-0309-6

Fig. 7. Schematic representation of the mechanism underlying sorafenib-induced hyper-keratosis.

Fig. 7

Vascular endothelial cells release s-HBEGF upon sorafenib stimulation. s-HBEGF binds to EGFR and leads to JNK2 phosphorylation in keratinocytes. The activated JNK2 subsequently stabilizes SIRT1, which eventually results in keratinization. The classic SIRT1 inhibitor nicotinamide could effectively reverse sorafenib-induced HFSR.