<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD with MathML3 v1.3 20210610//EN"  "JATS-archivearticle1-3-mathml3.dtd"><article xmlns:ali="http://www.niso.org/schemas/ali/1.0/" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="research-article" dtd-version="1.3"><front><journal-meta><journal-id journal-id-type="nlm-ta">elife</journal-id><journal-id journal-id-type="publisher-id">eLife</journal-id><journal-title-group><journal-title>eLife</journal-title></journal-title-group><issn publication-format="electronic" pub-type="epub">2050-084X</issn><publisher><publisher-name>eLife Sciences Publications, Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">95639</article-id><article-id pub-id-type="doi">10.7554/eLife.95639</article-id><article-id pub-id-type="doi" specific-use="version">10.7554/eLife.95639.3</article-id><article-version article-version-type="publication-state">version of record</article-version><article-categories><subj-group subj-group-type="display-channel"><subject>Research Article</subject></subj-group><subj-group subj-group-type="heading"><subject>Cancer Biology</subject></subj-group></article-categories><title-group><article-title>Loss of ZNRF3/RNF43 unleashes EGFR in cancer</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Yue</surname><given-names>Fei</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6057-0393</contrib-id><email>fy2111@nyu.edu</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="fn" rid="con1"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Ku</surname><given-names>Amy T</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0001-9398-7569</contrib-id><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="con2"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Stevens</surname><given-names>Payton D</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff4">4</xref><xref ref-type="fn" rid="con3"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Michalski</surname><given-names>Megan N</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="fn" rid="con4"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Jiang</surname><given-names>Weiyu</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="con5"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Tu</surname><given-names>Jianghua</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-6745-4897</contrib-id><xref ref-type="aff" rid="aff5">5</xref><xref ref-type="fn" rid="con6"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Shi</surname><given-names>Zhongcheng</given-names></name><xref ref-type="aff" rid="aff6">6</xref><xref ref-type="fn" rid="con7"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Dou</surname><given-names>Yongchao</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="fn" rid="con8"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Wang</surname><given-names>Yi</given-names></name><xref ref-type="aff" rid="aff7">7</xref><xref ref-type="fn" rid="con9"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Feng</surname><given-names>Xin-Hua</given-names></name><xref ref-type="aff" rid="aff8">8</xref><xref ref-type="fn" rid="con10"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Hostetter</surname><given-names>Galen</given-names></name><xref ref-type="aff" rid="aff9">9</xref><xref ref-type="fn" rid="con11"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Wu</surname><given-names>Xiangwei</given-names></name><xref ref-type="aff" rid="aff10">10</xref><xref ref-type="fn" rid="con12"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Huang</surname><given-names>Shixia</given-names></name><xref ref-type="aff" rid="aff6">6</xref><xref ref-type="aff" rid="aff11">11</xref><xref ref-type="aff" rid="aff12">12</xref><xref ref-type="aff" rid="aff13">13</xref><xref ref-type="fn" rid="con13"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Shroyer</surname><given-names>Noah F</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff13">13</xref><xref ref-type="fn" rid="con14"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Bing</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff13">13</xref><xref ref-type="aff" rid="aff14">14</xref><xref ref-type="fn" rid="con15"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Williams</surname><given-names>Bart O</given-names></name><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff9">9</xref><xref ref-type="fn" rid="con16"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Liu</surname><given-names>Qingyun</given-names></name><xref ref-type="aff" rid="aff5">5</xref><xref ref-type="fn" rid="con17"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author"><name><surname>Lin</surname><given-names>Xia</given-names></name><xref ref-type="aff" rid="aff15">15</xref><xref ref-type="fn" rid="con18"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Li</surname><given-names>Yi</given-names></name><contrib-id authenticated="true" contrib-id-type="orcid">https://orcid.org/0000-0002-9976-518X</contrib-id><email>liyi@bcm.edu</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff11">11</xref><xref ref-type="aff" rid="aff13">13</xref><xref ref-type="aff" rid="aff16">16</xref><xref ref-type="fn" rid="con19"/><xref ref-type="fn" rid="conf1"/></contrib><aff id="aff1"><label>1</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Lester and Sue Smith Breast Center, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff2"><label>2</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Department of Medicine, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff3"><label>3</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00wm07d60</institution-id><institution>Department of Cell Biology, Van Andel Institute</institution></institution-wrap><addr-line><named-content content-type="city">Grand Rapids</named-content></addr-line><country>United States</country></aff><aff id="aff4"><label>4</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/05nbqxr67</institution-id><institution>Biological Sciences Department, Miami University</institution></institution-wrap><addr-line><named-content content-type="city">Oxford</named-content></addr-line><country>United States</country></aff><aff id="aff5"><label>5</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/03gds6c39</institution-id><institution>Texas Therapeutics Institute and Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff6"><label>6</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Advanced Technology Cores, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff7"><label>7</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/019bev041</institution-id><institution>State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics</institution></institution-wrap><addr-line><named-content content-type="city">Beijing</named-content></addr-line><country>China</country></aff><aff id="aff8"><label>8</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00a2xv884</institution-id><institution>Life Sciences Institute, Zhejiang University</institution></institution-wrap><addr-line><named-content content-type="city">Hangzhou</named-content></addr-line><country>China</country></aff><aff id="aff9"><label>9</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00wm07d60</institution-id><institution>Van Andel Institute, Core Technologies and Services</institution></institution-wrap><addr-line><named-content content-type="city">Grand Rapids</named-content></addr-line><country>United States</country></aff><aff id="aff10"><label>10</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/04twxam07</institution-id><institution>Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff11"><label>11</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Department of Molecular and Cellular Biology, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff12"><label>12</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Department of Education, Innovation and Technology, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff13"><label>13</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff14"><label>14</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Department of Molecular and Human Genetics, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff><aff id="aff15"><label>15</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/05m1p5x56</institution-id><institution>The First Affiliated Hospital of Zhejiang University</institution></institution-wrap><addr-line><named-content content-type="city">Hangzhou</named-content></addr-line><country>China</country></aff><aff id="aff16"><label>16</label><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02pttbw34</institution-id><institution>Department of Molecular Virology and Microbiology, Baylor College of Medicine</institution></institution-wrap><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib-group><contrib-group content-type="section"><contrib contrib-type="editor"><name><surname>Nusse</surname><given-names>Roel</given-names></name><role>Reviewing Editor</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/00f54p054</institution-id><institution>Stanford University</institution></institution-wrap><country>United States</country></aff></contrib><contrib contrib-type="senior_editor"><name><surname>Cooper</surname><given-names>Jonathan A</given-names></name><role>Senior Editor</role><aff><institution-wrap><institution-id institution-id-type="ror">https://ror.org/007ps6h72</institution-id><institution>Fred Hutch Cancer Center</institution></institution-wrap><country>United States</country></aff></contrib></contrib-group><pub-date publication-format="electronic" date-type="publication"><day>10</day><month>04</month><year>2026</year></pub-date><volume>13</volume><elocation-id>RP95639</elocation-id><history><date date-type="sent-for-review" iso-8601-date="2024-01-04"><day>04</day><month>01</month><year>2024</year></date></history><pub-history><event><event-desc>This manuscript was published as a preprint.</event-desc><date date-type="preprint" iso-8601-date="2024-01-11"><day>11</day><month>01</month><year>2024</year></date><self-uri content-type="preprint" xlink:href="https://doi.org/10.1101/2024.01.10.574969"/></event><event><event-desc>This manuscript was published as a reviewed preprint.</event-desc><date date-type="reviewed-preprint" iso-8601-date="2024-03-19"><day>19</day><month>03</month><year>2024</year></date><self-uri content-type="reviewed-preprint" xlink:href="https://doi.org/10.7554/eLife.95639.1"/></event><event><event-desc>The reviewed preprint was revised.</event-desc><date date-type="reviewed-preprint" iso-8601-date="2025-02-17"><day>17</day><month>02</month><year>2025</year></date><self-uri content-type="reviewed-preprint" xlink:href="https://doi.org/10.7554/eLife.95639.2"/></event></pub-history><permissions><copyright-statement>© 2024, Yue et al</copyright-statement><copyright-year>2024</copyright-year><copyright-holder>Yue et al</copyright-holder><ali:free_to_read/><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><ali:license_ref>http://creativecommons.org/licenses/by/4.0/</ali:license_ref><license-p>This article is distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use and redistribution provided that the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="elife-95639-v1.pdf"/><self-uri content-type="figures-pdf" xlink:href="elife-95639-figures-v1.pdf"/><abstract><p>ZNRF3 and RNF43 are closely related transmembrane E3 ubiquitin ligases with significant roles in development and cancer. Conventionally, their biological functions have been associated with regulating WNT signaling receptor ubiquitination and degradation. However, our proteogenomic studies have revealed EGFR as the protein most negatively correlated with <italic>ZNRF3/RNF43</italic> mRNA levels in multiple human cancers. Through biochemical investigations, we demonstrate that ZNRF3/RNF43 interact with EGFR via their extracellular domains, leading to EGFR ubiquitination and subsequent degradation facilitated by the E3 ligase RING domain. Overexpression of <italic>ZNRF3</italic> reduces EGFR levels and suppresses cancer cell growth in vitro and in vivo, whereas knockout of <italic>ZNRF3</italic>/<italic>RNF43</italic> stimulates cell growth and tumorigenesis through upregulated EGFR signaling. Together, these data suggest ZNRF3 and RNF43 as novel E3 ubiquitin ligases of EGFR and establish the inactivation of ZNRF3/RNF43 as a driver of increased EGFR signaling, ultimately promoting cancer progression. This discovery establishes a connection between two fundamental signaling pathways, EGFR and WNT, at the level of cytoplasmic membrane receptors, uncovering a novel mechanism underlying the frequent co-activation of EGFR and WNT signaling in development and cancer.</p></abstract><kwd-group kwd-group-type="author-keywords"><kwd>cell signaling</kwd><kwd>cancer</kwd><kwd>ubiquitination</kwd><kwd>EGFR</kwd></kwd-group><kwd-group kwd-group-type="research-organism"><title>Research organism</title><kwd>Mouse</kwd></kwd-group><funding-group><award-group id="fund1"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>CA204926</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund2"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>CA271498</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund3"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/03g2zjp07</institution-id><institution>Congressionally Directed Medical Research Programs</institution></institution-wrap></funding-source><award-id>BC191649</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund4"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/03g2zjp07</institution-id><institution>Congressionally Directed Medical Research Programs</institution></institution-wrap></funding-source><award-id>BC191646</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund5"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>T32CA203690</award-id><principal-award-recipient><name><surname>Ku</surname><given-names>Amy T</given-names></name></principal-award-recipient></award-group><award-group id="fund6"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>CA186784</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund7"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>RR024574</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund8"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/0003xa228</institution-id><institution>CPRIT</institution></institution-wrap></funding-source><award-id>RP210227</award-id><principal-award-recipient><name><surname>Huang</surname><given-names>Shixia</given-names></name></principal-award-recipient></award-group><award-group id="fund9"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>OD028648</award-id><principal-award-recipient><name><surname>Huang</surname><given-names>Shixia</given-names></name></principal-award-recipient></award-group><award-group id="fund10"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>DK56338</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund11"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>CA125123</award-id><principal-award-recipient><name><surname>Li</surname><given-names>Yi</given-names></name></principal-award-recipient></award-group><award-group id="fund12"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/02e463172</institution-id><institution>American Cancer Society</institution></institution-wrap></funding-source><award-id>PF-20-109-01</award-id><principal-award-recipient><name><surname>Stevens</surname><given-names>Payton D</given-names></name></principal-award-recipient></award-group><award-group id="fund13"><funding-source><institution-wrap><institution-id institution-id-type="ror">https://ror.org/01cwqze88</institution-id><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>K08DE3109</award-id><principal-award-recipient><name><surname>Michalski</surname><given-names>Megan N</given-names></name></principal-award-recipient></award-group><funding-statement>The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.</funding-statement></funding-group><custom-meta-group><custom-meta specific-use="meta-only"><meta-name>Author impact statement</meta-name><meta-value>Genetic and biochemical analyses show that loss of the E3 ubiquitin ligases ZNRF3 and RNF43 enhances EGFR signaling by impairing EGFR ubiquitination and degradation, revealing a new cancer-promoting mechanism.</meta-value></custom-meta><custom-meta specific-use="meta-only"><meta-name>publishing-route</meta-name><meta-value>prc</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="s1" sec-type="intro"><title>Introduction</title><p>Zinc And Ring Finger 3 (ZNRF3) and Ring Finger Protein 43 (RNF43) are two closely related single-pass transmembrane E3 ligases with significant roles in embryonic development, tissue homeostasis and regeneration, and diseases (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="bibr" rid="bib55">Planas-Paz et al., 2016</xref>; <xref ref-type="bibr" rid="bib66">Szenker-Ravi et al., 2018</xref>; <xref ref-type="bibr" rid="bib2">Basham et al., 2019</xref>; <xref ref-type="bibr" rid="bib40">Lee et al., 2020</xref>; <xref ref-type="bibr" rid="bib65">Sun et al., 2021</xref>). Extensive research has demonstrated their involvement in critical developmental processes such as limb development (<xref ref-type="bibr" rid="bib66">Szenker-Ravi et al., 2018</xref>), liver zonation (<xref ref-type="bibr" rid="bib55">Planas-Paz et al., 2016</xref>), and mammalian sex determination (<xref ref-type="bibr" rid="bib31">Harris et al., 2018</xref>). These two enzymes also function as tumor suppressors, as evidenced by the promotion of intestinal and adrenal hyperplasia (<xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="bibr" rid="bib2">Basham et al., 2019</xref>) and hepatocellular carcinogenesis (<xref ref-type="bibr" rid="bib45">Mastrogiovanni et al., 2020</xref>) in mice upon tissue-specific inactivation of <italic>Znrf3</italic>/<italic>Rnf43</italic>. Similarly, <italic>Rnf43</italic> deficiency leads to thickened mucosa, hyperplasia, and cellular atypia in the stomach (<xref ref-type="bibr" rid="bib48">Neumeyer et al., 2019</xref>), and enhanced tumor growth in a mouse model of inflammatory colorectal cancer (<xref ref-type="bibr" rid="bib19">Eto et al., 2018</xref>). Conversely, overexpression of ZNRF3 and RNF43 suppresses cancer cell proliferation, migration and invasion, and drug resistance in multiple human cancer cell lines (<xref ref-type="bibr" rid="bib34">Jiang et al., 2013</xref>; <xref ref-type="bibr" rid="bib84">Zhou et al., 2013</xref>; <xref ref-type="bibr" rid="bib57">Qiu et al., 2016</xref>; <xref ref-type="bibr" rid="bib50">Pangestu et al., 2021</xref>; <xref ref-type="bibr" rid="bib59">Radaszkiewicz et al., 2021</xref>). Importantly, in cancer patients, ZNRF3 and RNF43 are frequently inactivated by gene deletion or loss-of-function mutations (<xref ref-type="bibr" rid="bib29">Hao et al., 2016</xref>; <xref ref-type="bibr" rid="bib80">Yu et al., 2020</xref>). For instance, <italic>ZNRF3</italic> exhibits the highest rate of copy number variations in adrenocortical carcinomas (ACCs), homozygously deleted in approximately 20% of ACCs (<xref ref-type="bibr" rid="bib1">Assié et al., 2014</xref>). <italic>RNF43</italic> is mutated in approximately 15% of endometrial cancer, 12% of stomach cancer, 11% of colorectal cancer, and 7% of pancreatic cancer (<xref ref-type="bibr" rid="bib70">Tu et al., 2019</xref>). These findings highlight the clinical significance of ZNRF3/RNF43 and the importance of fully understanding the molecular mechanism(s) by which they affect development and cancer.</p><p>The primary known molecular function of ZNRF3/RNF43 is the regulation of WNT signaling. As transmembrane E3 ligases, they ubiquitinate the WNT signaling receptor Frizzled, targeting it for degradation, thus dampening WNT signaling (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). Conversely, R-spondins (RSPO1-4) act as antagonistic peptide ligands, binding to ZNRF3/RNF43 and promoting their auto-ubiquitination and membrane clearance, thus maintaining WNT receptor levels and potentiating WNT signaling (<xref ref-type="bibr" rid="bib6">Carmon et al., 2011</xref>; <xref ref-type="bibr" rid="bib13">de Lau et al., 2011</xref>; <xref ref-type="bibr" rid="bib26">Glinka et al., 2011</xref>; <xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="bibr" rid="bib39">Lebensohn and Rohatgi, 2018</xref>; <xref ref-type="bibr" rid="bib51">Park et al., 2018</xref>; <xref ref-type="bibr" rid="bib66">Szenker-Ravi et al., 2018</xref>; <xref ref-type="bibr" rid="bib16">Dubey et al., 2020</xref>; <xref ref-type="bibr" rid="bib52">Park et al., 2020</xref>). Furthermore, activation of WNT signaling leads to transactivation of <italic>ZNRF3</italic> and <italic>RNF43</italic> expression via β-catenin (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>), creating a negative feedback loop that tightly regulates WNT signaling during normal development and tissue homeostasis. However, in cancer cells, alterations such as recurrent <italic>RSPO</italic> gene fusion or <italic>ZNRF3/RNF43</italic> deletion or mutations disrupt this feedback loop, resulting in hyperactive WNT signaling and subsequent cancer development and progression (<xref ref-type="bibr" rid="bib64">Seshagiri et al., 2012</xref>; <xref ref-type="bibr" rid="bib29">Hao et al., 2016</xref>).</p><p>Although most molecular functions of RSPO-ZNRF3/RNF43 have been linked to their modulation of WNT signaling, emerging evidence suggests that ZNRF3 and RNF43 may possess WNT-independent functions. For instance, RSPO and WNT ligands exhibit non-equivalent roles in various processes, including mammary epithelial cell growth (<xref ref-type="bibr" rid="bib36">Klauzinska et al., 2012</xref>), mammary side branches (<xref ref-type="bibr" rid="bib24">Geng et al., 2020</xref>), intestinal stem cell self-renewal (<xref ref-type="bibr" rid="bib79">Yan et al., 2017</xref>), and cochlea development (<xref ref-type="bibr" rid="bib46">Mulvaney et al., 2013</xref>). Furthermore, loss of RNF43 function promotes mouse gastric epithelium proliferation and human gastric cancer cell xenograft growth, without detectable impact on WNT signaling activity (<xref ref-type="bibr" rid="bib48">Neumeyer et al., 2019</xref>; <xref ref-type="bibr" rid="bib49">Neumeyer et al., 2021</xref>). Additionally, the inhibitory effects of RSPO-ZNRF3 on BMP signaling are not abolished by <italic>β-catenin</italic> knockdown (<xref ref-type="bibr" rid="bib40">Lee et al., 2020</xref>). Moreover, approximately 40% of <italic>ZNRF3</italic> or <italic>RNF43</italic>-mutant colon tumors also harbor alterations in either <italic>APC</italic> or <italic>CTNNB1</italic>, suggesting the involvement of these E3 ligases beyond the regulation of WNT signaling (<xref ref-type="bibr" rid="bib7">Cerami et al., 2012</xref>; <xref ref-type="bibr" rid="bib23">Gao et al., 2013</xref>). This is further supported by a report of a hotspot <italic>RNF43</italic> G659 frameshift mutation that does not appear to affect WNT signaling (<xref ref-type="bibr" rid="bib21">Fang et al., 2022</xref>). However, the extent to which ZNRF3 and RNF43 act on other substrates, apart from WNT receptors, to influence development and cancer has been unclear.</p><p>Here, we report a new function of ZNRF3 and RNF43. Our work began with computational studies of public data identifying a strong negative correlation between <italic>ZNRF3/RNF43</italic> mRNA levels and EGFR protein expression in datasets of human ACCs and colorectal cancers. Subsequently, we investigated the impact of depleting <italic>ZNRF3</italic> or <italic>RNF43</italic> on EGFR clearance at the cell surface in mouse embryonic fibroblasts (MEFs) and human cancer cell lines, including <italic>APC</italic>-mutated colorectal cancer cells. Notably, we discovered that ZNRF3/RNF43 interacts with EGFR through their extracellular domains (ECDs), leading to EGFR ubiquitination and degradation via the E3 ligase RING domain. Additionally, we substantiated our findings in multiple cell lines, human cancer cell xenograft models, and genetically engineered mouse models, wherein the loss of <italic>ZNRF3</italic>/<italic>RNF43</italic> resulted in elevated EGFR levels and facilitated cancer progression.</p></sec><sec id="s2" sec-type="results"><title>Results</title><sec id="s2-1"><title>EGFR protein levels negatively correlate with <italic>ZNRF3/RNF43</italic> mRNA expression in multiple human cancers</title><p>To elucidate novel signaling pathways regulated by ZNRF3/RNF43 in cancer, we conducted integrative proteogenomic analyses of human cancer datasets using LinkedOmics (<xref ref-type="bibr" rid="bib71">Vasaikar et al., 2018</xref>). Given the critical role of <italic>ZNRF3</italic> in adrenal hemostasis (<xref ref-type="bibr" rid="bib2">Basham et al., 2019</xref>) and its frequent deep deletion in approximately 20% of ACCs (<xref ref-type="bibr" rid="bib1">Assié et al., 2014</xref>), our initial focus was to examine the ACC dataset from TCGA, comprising 92 samples, to identify proteins exhibiting correlations with <italic>ZNRF3</italic> mRNA levels. Among the proteins evaluated by Reverse Phase Protein Array (RPPA), our analysis revealed EGFR protein levels to be most negatively correlated with <italic>ZNRF3</italic> mRNA levels (r=–0.50 and p=4.5e-4) (<xref ref-type="fig" rid="fig1">Figure 1A</xref>, <xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1A</xref>). Notably, ACC tumors with deep deletion in <italic>ZNRF3</italic> exhibited the highest EGFR protein levels compared to ACC tumors with other alterations in the <italic>ZNRF3</italic> locus (<xref ref-type="fig" rid="fig1">Figure 1B</xref>). These findings suggest that disruption of the gene function of <italic>ZNRF3</italic> may lead to upregulation of EGFR in ACCs.</p><fig-group><fig id="fig1" position="float"><label>Figure 1.</label><caption><title>Proteogenomic analysis identifies EGFR as the top candidate protein downregulated by ZNRF3/RNF43 in cancers.</title><p>(<bold>A</bold>) Volcano plot of proteins associated with <italic>ZNRF3</italic> mRNA expression in human adrenal cortical carcinoma (ACC), using the TCGA dataset (n=92). (<bold>B</bold>) Boxplot of EGFR protein levels in human adrenal cortical carcinomas with different <italic>ZNRF3</italic> gene copy number alteration, using the TCGA dataset (n=92). (<bold>C</bold>) The top 10 proteins negatively correlated with <italic>ZNRF3/RNF43</italic> mRNA levels, ranked by Stouffer’s method, using the TCGA colorectal adenocarcinoma (CO/READ) (n=629) and the CPTAC colon adenocarcinoma (COAD) (n=110) datasets. (<bold>D</bold>) Boxplot of EGFR protein levels in human colon adenocarcinomas expressing RNF43 WT or G659Vfs*41 mutant, using the CPTAC dataset. (<bold>E</bold>) Scatterplot of EGFR protein level versus <italic>RNF43</italic> mRNA expression using microsatellite stable (MSS) colon adenocarcinoma in the CPTAC dataset. (<bold>F</bold>) Bar graph of significant associations between <italic>RNF43</italic>/<italic>ZNRF3</italic> mRNA expression and EGFR protein level in cancer datasets from TCGA PanCancer Atlas Study. *, insignificant associations were not shown.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig1-v1.tif"/></fig><fig id="fig1s1" position="float" specific-use="child-fig"><label>Figure 1—figure supplement 1.</label><caption><title>EGFR protein level is negatively associated with <italic>ZNRF3</italic>/<italic>RNF43</italic> mRNA expression in cancers.</title><p>(<bold>A</bold>) Scatterplot of EGFR protein level (signal) versus <italic>ZNRF3</italic> mRNA expression (RSEM, Log2 (Val +1)) using the TCGA adrenal cortical carcinoma (ACC) dataset. (<bold>B</bold>) Scatterplot of EGFR protein level (z-normalized) versus <italic>ZNRF3</italic> mRNA expression (z-normalized) using the TCGA colorectal adenocarcinoma (CO/READ) dataset. (<bold>C</bold>) Scatterplot of EGFR protein level (z-normalized) versus <italic>ZNRF3</italic> mRNA expression (z-normalized) using the CPTAC colon adenocarcinoma (COAD) dataset. (<bold>D</bold>) Scatterplot of EGFR protein level (z-normalized) versus <italic>RNF43</italic> mRNA expression (z-normalized) using the TCGA colorectal adenocarcinoma (CO/READ) dataset. (<bold>E</bold>) Scatterplot of EGFR protein level (z-normalized) versus <italic>RNF43</italic> mRNA expression (z-normalized) using the CPTAC colon adenocarcinoma (COAD) dataset. (<bold>F</bold>) Boxplot of EGFR protein levels (signal) in human colorectal adenocarcinomas expressing RNF43 WT or RNF43 G659Vfs*41, using the TCGA dataset. (<bold>G</bold>) Boxplot of EGFR protein levels (signal) in human stomach adenocarcinomas (STAD) expressing RNF43 WT or RNF43 G659Vfs*41, using the TCGA dataset.</p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig1-figsupp1-v1.tif"/></fig></fig-group><p>Besides frequent deletions in ACC, <italic>ZNRF3,</italic> and <italic>RNF43</italic> are also important tumor suppressors in the more commonly occurring colorectal cancer (CRC) (<xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="bibr" rid="bib5">Bond et al., 2016</xref>); thus, we next analyzed the TCGA colorectal adenocarcinoma (n=629) and CPTAC colon adenocarcinoma (n=110) datasets. By incorporating RPPA-based (TCGA CO/READ) and mass spectrometry-based (CPTAC COAD) proteomic data, we also confirmed EGFR protein to be the one most negatively correlated with <italic>ZNRF3</italic> and <italic>RNF43</italic> mRNA expression in CRC (<xref ref-type="fig" rid="fig1">Figure 1C</xref>, <xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1B–E</xref>). Of note, we utilized <italic>ZNRF3/RNF43</italic> mRNA abundances rather than protein levels due to the lack of protein measurements for these two low-abundance enzymes in the current proteomic datasets. Mutations in <italic>ZNRF3/RNF43</italic> are found in approximately 15% of CRCs overall, with high frequencies observed in the microsatellite instability-high (MSI-H) subtype (60–80%) (<xref ref-type="bibr" rid="bib25">Giannakis et al., 2014</xref>; <xref ref-type="bibr" rid="bib5">Bond et al., 2016</xref>; <xref ref-type="bibr" rid="bib70">Tu et al., 2019</xref>; <xref ref-type="bibr" rid="bib72">Vasaikar et al., 2019</xref>). In particular, the <italic>RNF43</italic> G659Vfs*41 frameshift mutation accounts for 40–50% of all <italic>RNF43</italic> mutations in multiple MSI-H cancer types (<xref ref-type="bibr" rid="bib70">Tu et al., 2019</xref>). Interestingly, CRCs harboring the <italic>RNF43</italic> G659Vfs*41 mutation exhibited significantly higher levels of EGFR protein compared to <italic>RNF43</italic> wild-type (WT) tumors (<xref ref-type="fig" rid="fig1">Figure 1D</xref>, <xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1F</xref>). A similar difference was observed in stomach cancer, which also displayed a high frequency of the <italic>RNF43</italic> G659Vfs*41 mutation (<xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1G</xref>). Additionally, in the microsatellite stable subtype of CRCs, predominantly expressing WT RNF43, we found a negative association between <italic>RNF43</italic> mRNA and EGFR protein levels (r=−0.36 and p=0.0018) (<xref ref-type="fig" rid="fig1">Figure 1E</xref>). Using cBioPortal (<xref ref-type="bibr" rid="bib7">Cerami et al., 2012</xref>; <xref ref-type="bibr" rid="bib23">Gao et al., 2013</xref>), we also detected a negative correlation between <italic>ZNRF3/RNF43</italic> expression and EGFR protein in multiple other cancer types, including prostate cancer where <italic>ZNRF3</italic> or <italic>RNF43</italic> is deleted or mutated with a rate of 5% (<xref ref-type="fig" rid="fig1">Figure 1F</xref>). Collectively, these results suggest that disruption of <italic>ZNRF3</italic> and <italic>RNF43</italic> may upregulate EGFR protein levels in human cancers.</p></sec><sec id="s2-2"><title>ZNRF3 and RNF43 downregulate the EGFR protein level</title><p>To test whether ZNRF3 and RNF43 regulate EGFR protein, we performed gain-of-function and loss-of-function experiments in several cell lines. In MDA-MB-231, a breast cancer cell line with moderate levels of ZNRF3/RNF43, overexpression of either ZNRF3 or RNF43 substantially reduced EGFR protein levels (<xref ref-type="fig" rid="fig2">Figure 2A</xref>). Remarkably, ZNRF3 and RNF43 decreased EGFR as robustly as CBL, the best-known E3 ligase of EGFR (<xref ref-type="bibr" rid="bib41">Levkowitz et al., 1998</xref>; <xref ref-type="bibr" rid="bib73">Waterman et al., 1999</xref>). Similarly, in HEK293T cells, ZNRF3/RNF43 overexpression reduced the levels of EGFR (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1A</xref>). As predicted, the phosphorylated form of EGFR declined as well (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1A</xref>). Notably, the reduction in both total EGFR and P-EGFR levels reached an extent comparable to that achieved by CBL (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1A</xref>). Consistent with their known function, ZNRF3/RNF43 overexpression reduced the level of their substrate FZD5 (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1A</xref>). Additionally, these two E3 ligases exhibited selectivity in their regulation of growth factor receptors since overexpression of ZNRF3 or RNF43 did not decrease levels of TGFβ receptor I (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1B</xref>) or FGFR1 (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1C</xref>).</p><fig-group><fig id="fig2" position="float"><label>Figure 2.</label><caption><title>ZNRF3/RNF43 downregulates EGFR protein level.</title><p>(<bold>A</bold>) Overexpression of RNF43, ZNRF3, or CBL decreases EGFR protein level compared to GFP control in MDA-MB-231 cells, shown by representative western blot images (left panel) and quantification results (right panel). Cells were infected with lentivirus expressing GFP or E3 ligases. Means ± SEMs are shown. p-Values were calculated by one-way ANOVA uncorrected Fisher’s LSD test. (<bold>B</bold>) <italic>Znrf3</italic> knockout increases P-EGFR and total EGFR levels in murine embryonic fibroblasts (MEFs) upon EGF stimulation (50 ng/ml, 10 min). (<bold>C</bold>) <italic>RNF43</italic> knockout increases P-EGFR and total EGFR levels in HT29 cells untreated or treated with recombinant EGF (50 ng/ml, 10 min). (<bold>D</bold>) <italic>RNF43</italic> knockout increases the level of mutated EGFR<sup>L858R</sup> protein in HT29 cells, as shown by representative western blot images (left panel) and quantification results (right panel). Means ± SEMs are shown. p-Values were calculated by Student’s t-test. (<bold>E, F</bold>) RSPO2 treatment (50 ng/ml, 2–4 hr) enhances EGFR protein levels in HT29 (<bold>E</bold>) and LS180 (<bold>F</bold>) cells. (<bold>G</bold>) Overexpression of RSPO2 wild-type (WT) or F105A/F109A mutant but R65A/Q70A mutant enhances EGFR protein level, shown by representative western blot images (left panel) and quantification results (right panel). Means ± SEMs are shown. p-Values were calculated by one-way ANOVA uncorrected Fisher’s LSD test. n.s., not significant.</p><p><supplementary-material id="fig2sdata1"><label>Figure 2—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig2">Figure 2</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig2-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig2sdata2"><label>Figure 2—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig2">Figure 2</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig2-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig2sdata3"><label>Figure 2—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig2">Figure 2</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig2-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig2-v1.tif"/></fig><fig id="fig2s1" position="float" specific-use="child-fig"><label>Figure 2—figure supplement 1.</label><caption><title>ZNRF3/RNF43 negatively regulates EGFR protein level.</title><p>(<bold>A</bold>) Overexpression of RNF43 or ZNRF3 decreases P-EGFR, total EGFR, and FZD5 protein levels in 293T cells. GFP, EGFR, Flag-FZD5 constructs were co-transfected with E3 ligase constructs or vector control. CBL overexpression serves as a positive control for EGFR downregulation. RNF43 or ZNRF3 was expressed with their native signal peptides or CD8 signal peptide. (<bold>B</bold>) Overexpression of RNF43 or ZNRF3 has no impact on TGF-β receptor I (TGFβRI) protein level in 293T cells. TGFβRI-Flag construct was co-transfected with RNF43, ZNRF3, or vector control. (<bold>C</bold>) Overexpression of ZNRF3 or RNF43 does not decrease FGFR1 protein level in 293T cells. Flag-FGFR1 construct was co-transfected with ZNRF3, RNF43, or vector control. (<bold>D</bold>) Expression of Cas9-CRISPR <italic>RNF43</italic> guide RNA enhances EGFR protein level in HT29 cells, shown by representative western blot images (left panel) and quantification results (right panel). Means ± SEMs are shown. p-Values were calculated by one-way ANOVA uncorrected Fisher’s LSD test. (<bold>E</bold>) Expression of Cas9-CRISPR <italic>RNF43</italic> guide RNA or <italic>ZNRF3</italic> guide RNA enhances both EGFR and HER2 protein levels in HCC1954 cells. (<bold>F</bold>) RSPO2 treatment (50 ng/ml, 2–4 hr) enhances EGFR and LRP6 protein levels in 293T cells infected with lentivirus expressing FUCGW-EGFR. (<bold>G</bold>) Overexpression of RSPO2 wild-type (WT) does not enhance EGFR protein level in HT29 <italic>RNF43</italic> knockout cells.</p><p><supplementary-material id="fig2s1sdata1"><label>Figure 2—figure supplement 1—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig2-figsupp1-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig2s1sdata2"><label>Figure 2—figure supplement 1—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig2-figsupp1-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig2s1sdata3"><label>Figure 2—figure supplement 1—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig2-figsupp1-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig2-figsupp1-v1.tif"/></fig></fig-group><p>To test the impact of <italic>ZNRF3/RNF43</italic> loss on EGFR levels, we compared WT and <italic>Znrf3</italic> knockout (KO) MEFs because the WT MEFs have significant <italic>Znrf3</italic> expression but very minimal <italic>Rnf43</italic> expression (<xref ref-type="bibr" rid="bib44">Lienert et al., 2011</xref>). We found that <italic>Znrf3</italic> KO enhanced both EGFR and P-EGFR levels, both in the absence and presence of recombinant EGF (<xref ref-type="fig" rid="fig2">Figure 2B</xref>). To test the effect of <italic>RNF43</italic> KO, we utilized HT29, a CRC cell line that expresses WT <italic>RNF43</italic> at a high level but minimal <italic>ZNRF3</italic>. CRISPR-KO of <italic>RNF43</italic> enhanced EGFR and P-EGFR levels regardless of EGF stimulation (<xref ref-type="fig" rid="fig2">Figure 2C</xref>). We validated these results using three additional independent <italic>RNF43</italic> sgRNAs (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1D</xref>). Furthermore, since EGFR is mutationally activated in some human cancers, we transfected a common mutant – EGFR L858R – into <italic>RNF43</italic> WT versus KO HT29 cells and compared the resulting protein levels. As shown in <xref ref-type="fig" rid="fig2">Figure 2D</xref>, EGFR L858R was significantly higher in <italic>RNF43</italic> KO cells than in WT cells, indicating that RNF43 can degrade both WT and mutated EGFR and its loss can enhance signaling of both WT EGFR and its oncogenic mutant. In addition, we extended our analysis to HCC1954, a breast cancer cell line that expresses the EGFR family member HER2. We found that KO of either <italic>ZNRF3</italic> or <italic>RNF43</italic> enhanced the protein levels of HER2, as well as EGFR (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1E</xref>), suggesting that ZNRF3 and RNF43 downregulate the levels of EGFR and its family members and that the loss of these E3 ligases stabilizes this family of receptor tyrosine kinases.</p><p>RSPO1-4 are antagonistic ligands of ZNRF3 and RNF43 (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). They bind to both ZNRF3/RNF43 and LGR4/5/6, resulting in ZNRF3/RNF43 auto-ubiquitination and degradation (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). Approximately 18% of CRCs harbor amplification or mutations of <italic>RSPO1-4</italic> or <italic>LGR4/5/6,</italic> and 10% of CRCs show recurrent <italic>RSPO2/3</italic> gene fusions (<xref ref-type="bibr" rid="bib64">Seshagiri et al., 2012</xref>; <xref ref-type="bibr" rid="bib63">Seeber et al., 2019</xref>). These genetic alterations potentially lead to the inhibition of ZNRF3/RNF43, thereby activating WNT and EGFR signaling. Therefore, we tested whether RSPO affected EGFR protein levels in CRC. Short-term treatment with recombinant RSPO2 increased EGFR levels in two CRC cell lines (<xref ref-type="fig" rid="fig2">Figure 2E and F</xref>) and 293T cells (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1F</xref>). Further, this impact of RSPO2 depended on the presence of intact ZNRF3/RNF43, as RSPO2 failed to elevate EGFR levels further in HT29 cells knocked out for <italic>RNF43,</italic> the predominant one compared to <italic>ZNRF3</italic> (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1G</xref>). Conversely, the RSPO2 R65A/Q70A mutant, which cannot bind to ZNRF3/RNF43 (<xref ref-type="bibr" rid="bib77">Xie et al., 2013</xref>), failed to elevate EGFR levels (<xref ref-type="fig" rid="fig2">Figure 2G</xref>). On the other hand, the RSPO2 F105A/F109A mutant, which cannot bind to LGRs (<xref ref-type="bibr" rid="bib77">Xie et al., 2013</xref>), still enhanced EGFR levels similar to RSPO2 WT (<xref ref-type="fig" rid="fig2">Figure 2F</xref>). These data collectively suggest that RPSO2 regulation of EGFR does not rely on LGR-binding but requires its interaction with ZNRF3/RNF43.</p></sec><sec id="s2-3"><title>ZNRF3 and RNF43 induce EGFR ubiquitination and degradation</title><p>After demonstrating that ZNRF3 and RNF43 regulate EGFR protein levels, we next sought to elucidate the underlying mechanism. We first examined whether ZNRF3 and RNF43 regulate <italic>EGFR</italic> transcripts and found that ZNRF3/RNF43 did not impact <italic>EGFR</italic> mRNA levels in either MEFs or HT29, as determined by quantitative PCR (qPCR) (<xref ref-type="fig" rid="fig3">Figure 3A and B</xref>). Then, we studied the protein stability of EGFR in WT and <italic>RNF43</italic> KO HT29 cells. We treated cells with recombinant EGF to induce EGFR internalization/degradation and then collected cell lysates at different time points to measure EGFR protein levels by western blotting. We found that KO of <italic>RNF43</italic> delayed EGFR degradation and sustained P-EGFR levels (<xref ref-type="fig" rid="fig3">Figure 3C</xref>). Since EGFR clearance is initiated at the cell membrane and accelerated by EGF treatment, we also evaluated the impact of ZNRF3/RNF43 on EGFR levels at the cell surface. Flow cytometry revealed that <italic>ZNRF3</italic> KO in MEFs (<xref ref-type="fig" rid="fig3">Figure 3D</xref>) or <italic>RNF43</italic> KO in HT29 (<xref ref-type="fig" rid="fig3">Figure 3E</xref>) increased cell surface EGFR in both unstimulated and EGF-stimulated conditions. These data together suggest that ZNRF3 and RNF43 induce cell surface EGFR internalization and degradation, and that their inactivation leads to EGFR accumulation at the cell surface and thus enhanced EGFR signaling.</p><fig id="fig3" position="float"><label>Figure 3.</label><caption><title>Loss of ZNRF3/RNF43 delays EGFR protein degradation.</title><p>(<bold>A</bold>) Knockout of <italic>Znrf3</italic> has no impact on <italic>Egfr</italic> mRNA level in murine embryonic fibroblasts (MEFs). Means ± SEMs are shown. p-Values were calculated by Welch’s t-test. n.s., not significant. (<bold>B</bold>) Knockout of <italic>RNF43</italic> has no impact on <italic>EGFR</italic> mRNA level in HT29 cells. Means ± SEMs are shown. p-Values were calculated by Welch’s t-test. (<bold>C</bold>) <italic>RNF43</italic> knockout inhibits EGF-induced EGFR protein degradation in HT29 cells. Cells were stimulated with EGF (50 ng/ml) for indicated times. Representative western blot images (left panel) and quantification results (right panel) were shown. Means ± SEMs are shown. p-Values were calculated by two-way ANOVA uncorrected Fisher’s LSD test. (<bold>D</bold>) <italic>Znrf3</italic> knockout increases the cell surface level of EGFR protein in MEFs unstimulated or stimulated with EGF (50 ng/ml, 10 min). (<bold>E</bold>) <italic>RNF43</italic> knockout increases the cell surface level of EGFR protein in HT29 cells unstimulated or stimulated with EGF (50 ng/ml, 10 min). The cell surface EGFR levels were measured by flow cytometry. The bars mark the relative peak shifts after EGF stimulation in WT (wild-type) (black) or KO (knockout) (red) cells.</p><p><supplementary-material id="fig3sdata1"><label>Figure 3—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig3">Figure 3</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig3-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig3sdata2"><label>Figure 3—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig3">Figure 3C</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig3-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig3sdata3"><label>Figure 3—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig3">Figure 3C</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig3-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig3-v1.tif"/></fig><p>EGFR degradation is primarily mediated by ubiquitination (<xref ref-type="bibr" rid="bib22">Galcheva-Gargova et al., 1995</xref>; <xref ref-type="bibr" rid="bib41">Levkowitz et al., 1998</xref>). To examine the impact of ZNRF3 and RNF43 on EGFR ubiquitination, we performed EGFR immunoprecipitation (IP) followed by ubiquitin (Ub) immunoblotting (IB). Remarkably, RNF43 overexpression in MDA-MB-231 cells enhanced EGFR ubiquitination as potently as CBL overexpression (<xref ref-type="fig" rid="fig4">Figure 4A</xref>). Conversely, in <italic>RNF43</italic> KO HT29 cells and MDA-MB-231 cells, anti-Ub IP brought down substantially less EGFR protein (<xref ref-type="fig" rid="fig4">Figure 4B</xref>, <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1A</xref>), and anti-EGFR IP produced much less ubiquitinated forms of EGFR (<xref ref-type="fig" rid="fig4">Figure 4C</xref>), indicating that <italic>RNF43</italic> KO diminished EGFR ubiquitination. Next, we asked whether the E3 ligase activity of ZNRF3/RNF43 is needed to regulate EGFR ubiquitination. The RING domain is required for ZNRF3/RNF43 E3 Ub ligase function (<xref ref-type="bibr" rid="bib54">Pickart and Eddins, 2004</xref>). Therefore, we compared the impact of ZNRF3/RNF43 versus their RING domain deletion mutants (ΔRING) on EGFR protein levels. We found that both ΔRING mutants failed to decrease EGFR levels (<xref ref-type="fig" rid="fig4">Figure 4D and E</xref>) or HER2 levels (<xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1B</xref>). Furthermore, while WT ZNRF3 overexpression increased EGFR ubiquitination, which was detectable even in the absence of proteasome or lysosome inhibitors, the ΔRING mutant failed to induce detectable upregulation of EGFR ubiquitination even in the presence of both proteasome and lysosome inhibitors (MG132 and BAF, respectively) (<xref ref-type="fig" rid="fig4">Figure 4F</xref>). Together, these results demonstrate that ZNRF3 and RNF43 regulate EGFR ubiquitination and degradation through their E3 ligase activity.</p><fig-group><fig id="fig4" position="float"><label>Figure 4.</label><caption><title>ZNRF3/RNF43 enhances EGFR ubiquitination through the RING domain.</title><p>(<bold>A</bold>) Overexpression of RNF43 enhances EGFR ubiquitination level upon EGF (50 ng/ml) stimulation in MDA-MB-231 cells. CBL serves as a positive control. Cells were co-infected with lentivirus expressing EGFR and GFP, RNF43, or CBL. (<bold>B, C</bold>) Knockout of <italic>RNF43</italic> decreases EGFR ubiquitination in HT29 cells. (<bold>B</bold>) EGFR ubiquitination was examined by ubiquitin (Ub) immunoprecipitation (IP) followed by EGFR immunoblotting (IB). (<bold>C</bold>) HT29 cells were pretreated with 20 µM MG132 and 100 nM Bafilomycin A1 for 4 hr. EGFR ubiquitination after EGF treatment (50 ng/ml, 30 min) was examined by EGFR IP followed by Ub IB. (<bold>D, E</bold>) ZNRF3/RNF43 downregulates EGFR protein level through the RING domain. 293T cells were co-transfected with EGFR and vector, ZNRF3 WT or ΔRING mutant (<bold>D</bold>), RNF43 WT or ΔRING mutant (<bold>E</bold>). (<bold>F</bold>) ZNRF3 regulates EGFR ubiquitination through the RING domain. 293T cells were co-transfected with EGFR and vector, ZNRF3 WT or ΔRING mutant. EGFR ubiquitination after EGF treatment (50 ng/ml, 10 min) was examined by EGFR IP followed by Ub IB. Cells were pretreated with 20 µM MG132 and 100 nM Bafilomycin A1 for 4 hr.</p><p><supplementary-material id="fig4sdata1"><label>Figure 4—source data 1.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig4">Figure 4</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig4-data1-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig4sdata2"><label>Figure 4—source data 2.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig4">Figure 4</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig4-data2-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig4-v1.tif"/></fig><fig id="fig4s1" position="float" specific-use="child-fig"><label>Figure 4—figure supplement 1.</label><caption><title>RNF43 loss decreases EGFR ubiquitination.</title><p>(<bold>A</bold>) Depletion of <italic>RNF43</italic> by CRISPR/Cas9 decreases EGFR ubiquitination in MDA-MB-231 cells. EGFR ubiquitination was examined by ubiquitin (Ub) immunoprecipitation (IP) followed by EGFR immunoblotting (IB). (<bold>B</bold>) RNF43 downregulates HER2 protein level through the RING domain. 293T cells were co-transfected with HER2 and vector, RNF43 WT, or ΔRING mutant.</p><p><supplementary-material id="fig4s1sdata1"><label>Figure 4—figure supplement 1—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig4-figsupp1-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig4s1sdata2"><label>Figure 4—figure supplement 1—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig4-figsupp1-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig4s1sdata3"><label>Figure 4—figure supplement 1—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig4-figsupp1-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig4-figsupp1-v1.tif"/></fig></fig-group></sec><sec id="s2-4"><title>ZNRF3 and RNF43 form a complex with EGFR through the ECD</title><p>We next investigated whether ZNRF3 and RNF43 interact with EGFR to regulate its ubiquitination. In a co-IP experiment using lysates from MDA-MB-231 cells co-infected with lentivirus carrying EGFR and Myc-tagged ZNRF3/RNF43, anti-EGFR IP pulled down overexpressed ZNRF3/RNF43 (<xref ref-type="fig" rid="fig5">Figure 5A</xref>), indicating a complex between EGFR and ZNRF3/RNF43. Mass spectrometry of anti-EGFR immunoprecipitates identified endogenous ZNRF3 protein (<xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1A</xref>), confirming ZNRF3 as an interacting partner of EGFR. Importantly, a proximity ligation assay (PLA) provided visual confirmation of the close interaction between co-transfected ZNRF3 and EGFR in situ (<xref ref-type="fig" rid="fig5">Figure 5B</xref>). Next, we sought to determine the specific regions involved in the interaction between ZNRF3/RNF43 and EGFR. ZNRF3 and RNF43 are transmembrane proteins comprising a long ECD, a single-span transmembrane domain (TM), and a catalytic intracellular domain (ICD) (<xref ref-type="fig" rid="fig5">Figure 5C</xref>). We thus generated constructs expressing ZNRF3 ECD-TM and TM-ICD, with an N-terminal 3× Myc-tag inserted after the signal peptide for detection (<xref ref-type="fig" rid="fig5">Figure 5C</xref>). Immunofluorescence (IF) confirmed the membrane localization of these two peptides (<xref ref-type="fig" rid="fig5">Figure 5D</xref>), after which we performed co-IP using anti-Myc. EGFR was co-immunoprecipitated with Myc-tagged ZNRF3 full-length (FL) and ECD-TM, but not TM-ICD (<xref ref-type="fig" rid="fig5">Figure 5E</xref>). Conversely, anti-EGFR IP pulled down ZNRF3 FL and ECD-TM, but not TM-ICD (<xref ref-type="fig" rid="fig5">Figure 5E</xref>). Similar results were obtained when performing anti-HA IP of HA-tagged RNF43 FL and ECD-TM, which also brought down EGFR (<xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1B, C</xref>). These data collectively indicate that ZNRF3 and RNF43 interact with EGFR via their ECDs, in accordance with evidence indicating the ZNRF3/RNF43 interaction with Frizzled via ECDs (<xref ref-type="bibr" rid="bib67">Tsukiyama et al., 2015</xref>). This is in contrast with reports detecting ZNRF3/RN43 interaction with Frizzled via their ICDs and other adaptor proteins (<xref ref-type="bibr" rid="bib35">Jiang et al., 2015</xref>).</p><fig-group><fig id="fig5" position="float"><label>Figure 5.</label><caption><title>ZNRF3/RNF43 interacts with EGFR through the extracellular domain.</title><p>(<bold>A</bold>) Ectopically expressed EGFR is co-immunoprecipitated with Myc-tagged RNF43 and ZNRF3 in MDA-MB-231 cells. (<bold>B</bold>) Representative images of proximity ligation assay (PLA) in HCT116 cells co-transfected with EGFR and Myc-ZNRF3ΔRING. Red, PLA signals; blue, DAPI nuclei staining; scale bar = 20 µm. (<bold>C</bold>) Schematic diagram of tagged ZNRF3 proteins. SP, signal peptide; FL, full-length; ECD, extracellular domain; TM, transmembrane domain; ICD, intracellular domain; RING, E3 ligase RING domain. (<bold>D</bold>) Immunofluorescence staining for ZNRF3 in 293T cells expressing Myc-tagged ZNRF3 FL, ECD-TM, TM-ICD. Scale bar = 40 μm. (<bold>E</bold>) ZNRF3 extracellular domain is required for ZNRF3 interaction with EGFR. 293T cells were co-transfected with EGFR and Myc-tagged ZNRF3 constructs, and the lysate amounts were adjusted to achieve comparable levels of EGFR protein in each immunoprecipitation (IP) system (input, left panel). EGFR interaction with ZNRF3 FL, ECD-TM, or TM-ICD was examined by Myc-tag IP followed by EGFR immunoblotting (IB) (middle panel) or by EGFR IP followed by Myc-tag IB (right panel). *, IgG heavy chain.</p><p><supplementary-material id="fig5sdata1"><label>Figure 5—source data 1.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig5">Figure 5</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig5-data1-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig5sdata2"><label>Figure 5—source data 2.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig5">Figure 5</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig5-data2-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig5-v1.tif"/></fig><fig id="fig5s1" position="float" specific-use="child-fig"><label>Figure 5—figure supplement 1.</label><caption><title>ZNRF3/RNF43 interacts with EGFR.</title><p>(<bold>A</bold>) Relative abundance of the EGFR-associated proteins. BGC823 cells were starved overnight and then treated with 50 ng/ml EGF for 0 min (control) or 120 min (EGF-stimulated). Endogenous EGFR was immunoprecipitated by anti-EGFR antibodies. EGFR-associated proteins with over 10<sup>5</sup> iBAQ (intensity Based Absolute Quantification) and over twofold increase in iBAQ after EGF stimulation were plotted. The areas of the circles indicate the abundance of iBAQ of EGFR-associated proteins obtained in EGF-stimulated immunoprecipitations (IPs). The y axis indicates the fold change of iBAQ of EGFR-associated proteins identified in EGF-stimulated versus control in the log2 scale, which are arranged from low to high along the x axis. (<bold>B</bold>) Immunofluorescence staining for HA-tagged RNF43 FL and RNF43 ECD-TM in 293T cells transfected with RNF43 constructs. Scale bar = 40 μm. (<bold>C</bold>) RNF43 ECD-TM interacts with EGFR. 293T cells were co-transfected with EGFR and HA-tagged RNF43 constructs. EGFR interaction with RNF43 FL and RNF43 ECD-TM was examined by HA-tag IP followed by EGFR immunoblotting (IB).</p><p><supplementary-material id="fig5s1sdata1"><label>Figure 5—figure supplement 1—source data 1.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig5-figsupp1-data1-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig5s1sdata2"><label>Figure 5—figure supplement 1—source data 2.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig5-figsupp1-data2-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig5-figsupp1-v1.tif"/></fig><fig id="fig5s2" position="float" specific-use="child-fig"><label>Figure 5—figure supplement 2.</label><caption><title>The protease associate domain of ZNRF3/RNF43 is dispensable for EGFR interaction.</title><p>(<bold>A</bold>) Schematic diagram of tagged RNF43 wild-type and mutant proteins. SP, signal peptide; WT, wild-type; PA, protease associate domain; TM, transmembrane domain; RING, E3 ligase RING domain. (<bold>B, C</bold>) EGFR interacts with the ΔPA mutant of Myc-tagged ZNRF3 (<bold>B</bold>), and HA-tagged RNF43 (<bold>C</bold>). 293T cells were co-transfected with EGFR and ZNRF3/RNF43 WT or ΔPA constructs. (<bold>D</bold>) Overexpression of ZNRF3 WT or ΔPA mutant inhibits canonical WNT signaling in 293T cells in Super Top-Flash assay. ZNRF3 ΔRING mutant serves as a negative control. Means ± SEMs are shown. p-Values were calculated by one-way ANOVA uncorrected Fisher’s LSD test. n.s., not significant.</p><p><supplementary-material id="fig5s2sdata1"><label>Figure 5—figure supplement 2—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig5-figsupp2-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig5s2sdata2"><label>Figure 5—figure supplement 2—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig5-figsupp2-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig5s2sdata3"><label>Figure 5—figure supplement 2—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig5-figsupp2-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig5-figsupp2-v1.tif"/></fig></fig-group><p>The protease-associated (PA) domain is the only part conserved between the extracellular fragments of ZNRF3 and RNF43 (<xref ref-type="bibr" rid="bib69">Tsukiyama et al., 2021</xref>). Therefore, we tested whether this domain is necessary for the interaction between ZNRF3/RNF43 with EGFR. We created PA domain-deletion mutants of ZNRF3/RNF43 (<xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2A</xref>) and found that these deletion mutants (ΔPA) also interacted with EGFR (<xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2B and C</xref>), indicating that the PA domain is dispensable for ZNRF3/RNF43 interaction with EGFR. In accordance with previous reports that the PA domain is dispensable for suppression of WNT signaling (<xref ref-type="bibr" rid="bib35">Jiang et al., 2015</xref>; <xref ref-type="bibr" rid="bib58">Radaszkiewicz and Bryja, 2020</xref>), we found that ΔPA ZNRF3 retained the ability to suppress the Top-Flash WNT reporter (<xref ref-type="fig" rid="fig5s2">Figure 5—figure supplement 2D</xref>).</p></sec><sec id="s2-5"><title>Loss of ZNRF3 and RNF43 unleashes EGFR-mediated cell growth in 2D culture and organoids</title><p>EGFR is an important tyrosine kinase that mediates many cellular activities, especially cell growth (<xref ref-type="bibr" rid="bib75">Wieduwilt and Moasser, 2008</xref>; <xref ref-type="bibr" rid="bib81">Yue et al., 2021</xref>). To study the biological consequence of ZNRF3/RNF43 downregulating EGFR, we first compared cell growth of WT and <italic>ZNRF3/RNF43</italic>-depleted cells. <italic>Znrf3</italic> KO in MEFs led to the upregulation of EGFR (<xref ref-type="fig" rid="fig2">Figure 2B</xref>) and increased cell growth (<xref ref-type="fig" rid="fig6">Figure 6A</xref>), without affecting canonical WNT signaling activity based on qPCR for WNT target genes (<italic>Sox2</italic>, <italic>Axin2</italic>, <italic>Ccnd1</italic>) (<xref ref-type="fig" rid="fig6">Figure 6B</xref>). EGF and EGFR signaling are also critical for the culture and maintenance of organoids derived from <italic>Apc-</italic>deficient mouse intestinal adenomas (<xref ref-type="bibr" rid="bib61">Sato et al., 2011</xref>), which exhibit constitutively canonical WNT signaling that is no longer modulated by the RSPO-ZNRF3/RNF43 control at the membrane receptor level (<xref ref-type="bibr" rid="bib68">Tsukiyama et al., 2020</xref>; <xref ref-type="bibr" rid="bib69">Tsukiyama et al., 2021</xref>). Therefore, we established intestinal tumor organoids using the intestinal polyps from the <italic>Apc</italic><sup>min</sup> mice (<xref ref-type="bibr" rid="bib20">Evans et al., 1992</xref>) and supplemented RSPO1 in the organoid culture medium to investigate the effect of ZNRF3/RNF43 deactivation on organoid growth and EGFR. Remarkably, the addition of RSPO1 increased the size of <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoids (<xref ref-type="fig" rid="fig6">Figure 6C and D</xref>) in agreement with a previous report (<xref ref-type="bibr" rid="bib38">Lähde et al., 2021</xref>) although it did not significantly affect the frequency of organoids detected (<xref ref-type="fig" rid="fig6">Figure 6E</xref>). IB analysis confirmed elevated EGFR levels after RSPO1 treatment (<xref ref-type="fig" rid="fig6">Figure 6F</xref>) while qPCR showed no significant increase of <italic>Egfr</italic> nor WNT target genes, including <italic>Axin2</italic>, <italic>Myc</italic>, <italic>Sox2</italic>, and <italic>Cd44</italic> (<xref ref-type="fig" rid="fig6">Figure 6G</xref>). Furthermore, we performed functional assays in HT29 cells, which contain a mutated <italic>APC</italic>. Overexpression of ZNRF3 in HT29 substantially inhibited cell growth (<xref ref-type="fig" rid="fig6">Figure 6H</xref>) and reduced EGFR levels (<xref ref-type="fig" rid="fig6">Figure 6I</xref>). Conversely, KO of <italic>RNF43</italic> in HT29 activated multiple EGFR downstream effectors, as RPPA detected increased levels of P-AKT, P-ERK, P-GSK3, P-STAT1, and P-PRAS40 (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1</xref>). Importantly, treatment with the EGFR activity inhibitor erlotinib, which abolished EGFR phosphorylation (<xref ref-type="fig" rid="fig6">Figure 6J</xref>), blocked the growth gain caused by <italic>RNF43</italic> KO (<xref ref-type="fig" rid="fig6">Figure 6K</xref>). We also treated WT and <italic>Znrf3</italic> KO MEF cells with erlotinib, the WNT inhibitor Wnt-C59 (a small molecule that suppresses porcupine, which is required for palmitoylation and secretion of Wnt; <xref ref-type="bibr" rid="bib56">Proffitt et al., 2013</xref>), or their combination. Neither inhibitor impacted WT MEF cell growth. In contrast, erlotinib, but not WNT-C59, significantly blocked the growth gain caused by <italic>Znrf3</italic> KO (<xref ref-type="fig" rid="fig6">Figure 6L</xref>), suggesting <italic>Znrf3</italic> KO induced MEF growth primarily via EGFR signaling rather than WNT signaling. Together, these data indicate that loss of <italic>ZNRF3</italic> and <italic>RNF43</italic> can promote tumor cell growth through EGFR signaling, sometimes even without substantially engaging canonical WNT signaling.</p><fig-group><fig id="fig6" position="float"><label>Figure 6.</label><caption><title>ZNRF3/RNF43 inhibits EGFR-mediated cell growth.</title><p>(<bold>A</bold>) Knockout (KO) of <italic>Znrf3</italic> enhances murine embryonic fibroblast (MEF) cell growth, as measured by cell counting at the indicated time points. p-Values were calculated by two-way ANOVA uncorrected Fisher’s LSD test. (<bold>B</bold>) Quantitative PCR (qPCR) analysis for WNT target genes in WT and <italic>Znrf3</italic> KO MEFs. Means ± SEMs are shown for this and other graphs. p-Values were calculated by Welch’s t-test. n.s., not significant. (<bold>C–E</bold>) Supplementing RSPO1 promotes <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoid growth. The equal number of single cells from <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoids was embedded in Matrigel and cultured without or with 10% RSPO1 conditioned medium for 8 days. Representative images (<bold>C</bold>), and quantification of the size (<bold>D</bold>) and number (<bold>E</bold>) of formed <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoids are shown. Scale bar = 500 μm. p-Values were calculated by Welch’s t-test. (<bold>F</bold>) Supplementing RSPO1 enhances EGFR protein level in <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoids. Representative images (left panel) and quantification (right panel) of EGFR protein level are shown. p-Values were calculated by Welch’s t-test. (<bold>G</bold>) qPCR analysis for <italic>Egfr</italic> and WNT target genes in <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoids cultured with or without RSPO1 supplements. Genes with no significant changes after RSPO1 treatment were plotted in gray, genes significantly downregulated after RSPO1 treatment were plotted in blue. p-Values were calculated by Welch’s t-test. **, p-value&lt;0.01. (<bold>H</bold>) Overexpression of ZNRF3 inhibits HT29 cell growth. HT29 cells stably overexpressing GFP or ZNRF3 were seeded in equal numbers and measured by confluence percentage using Incucyte. p-Values were calculated by two-way ANOVA uncorrected Fisher’s LSD test. (<bold>I</bold>) Overexpression of ZNRF3 reduces EGFR protein level in HT29 cells. (<bold>J</bold>) Erlotinib treatment blocks EGFR phosphorylation in WT and <italic>RNF43</italic> KO HT29 cells. Cells were treated with 5 μM erlotinib for 48 hr. (<bold>K</bold>) Erlotinib treatment inhibits cell growth in <italic>RNF43</italic> KO HT29 cells. p-Values were calculated by one-way ANOVA uncorrected Fisher’s LSD test. (<bold>L</bold>) Erlotinib treatment inhibits cell growth in <italic>Znrf3</italic> KO MEF cells. <italic>Znrf3</italic> KO and WT MEF cells were treated with 0.5 μM erlotinib, or 0.1 μM WNT-C59 or both for 96 hr, and the growth was determined by CCK-8 assay. Means ± SEMs are shown. p-Values were calculated by two-way ANOVA, and the significance is presented by compact letter display. Columns marked by the same letter exhibit significant differences.</p><p><supplementary-material id="fig6sdata1"><label>Figure 6—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig6">Figure 6</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig6-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig6sdata2"><label>Figure 6—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig6">Figure 6</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig6-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig6sdata3"><label>Figure 6—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig6">Figure 6</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig6-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig6-v1.tif"/></fig><fig id="fig6s1" position="float" specific-use="child-fig"><label>Figure 6—figure supplement 1.</label><caption><title>Reverse Phase Protein Array (RPPA) identifies EGFR downstream signaling molecules upregulated by <italic>RNF43</italic> knockout in HT29 cells.</title><p><supplementary-material id="fig6s1sdata1"><label>Figure 6—figure supplement 1—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig6-figsupp1-data1-v1.xlsx"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig6-figsupp1-v1.tif"/></fig><fig id="fig6s2" position="float" specific-use="child-fig"><label>Figure 6—figure supplement 2.</label><caption><title>Quantitative PCR (qPCR) analysis for TGF-β signaling relevant genes in <italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoids cultured with or without RSPO1 supplements.</title><p>Genes with no significant changes after RSPO1 treatment were plotted in gray; genes significantly downregulated after RSPO1 treatment were plotted in blue.</p><p>Means ± SEMs are shown. Welch’s t-test was used to assess statistical significance. **, p-Value&lt;0.01.</p><p><supplementary-material id="fig6s2sdata1"><label>Figure 6—figure supplement 2—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig6s2">Figure 6—figure supplement 2</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig6-figsupp2-data1-v1.xlsx"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig6-figsupp2-v1.tif"/></fig></fig-group></sec><sec id="s2-6"><title>ZNRF3/RNF43 inactivation enhances EGFR and promotes tumor growth in vivo</title><p>To demonstrate the function of the ZNRF3/RNF43-EGFR signaling pathway in vivo, we first xenografted luciferase-labeled HT29 cells overexpressing either GFP or ZNRF3 into NSG mice by flank injection and monitored tumor growth by bioluminescence imaging (<xref ref-type="fig" rid="fig7">Figure 7A</xref>). We found that overexpression of ZNRF3 significantly inhibited tumor growth (<xref ref-type="fig" rid="fig7">Figure 7A</xref>). These tumors exhibited decreased EGFR and P-EGFR levels compared to WT tumors (<xref ref-type="fig" rid="fig7">Figure 7B</xref>). However, canonical WNT signaling, based on levels of active-β-catenin (non-phosphorylated at Ser33/37/Thr41; <xref ref-type="fig" rid="fig7">Figure 7B</xref>), remained unaffected, suggesting that ZNRF3 suppresses tumor growth through downregulation of EGRF signaling without substantial involvement of canonical WNT signaling.</p><fig-group><fig id="fig7" position="float"><label>Figure 7.</label><caption><title>ZNRF3/RNF43 loss enhances EGFR signaling and promotes tumorigenesis.</title><p>(<bold>A</bold>) Overexpression of ZNRF3 suppresses HT29 tumor growth in vivo. Representative bioluminescence images (top panel) and quantification (bottom panel) of flank-injected HT29 cells expressing either GFP or Myc-tagged ZNRF3. p-Values were calculated by two-way ANOVA uncorrected Fisher’s LSD test. (<bold>B</bold>) Overexpression of ZNRF3 inhibits P-EGFR and total EGFR levels in HT29 tumors. Representative images (left panel) and quantification of P-EGFR (right-top panel) and total EGFR (right-bottom panel) protein levels are shown. Means ± SEMs are shown. p-Values were calculated by Welch’s t-test (<bold>B</bold>). (<bold>C</bold>) Representative H&amp;E images of prostate tissues from wild-type (WT) or prostate-specific <italic>Znrf3</italic>/<italic>Rnf43</italic> knockout mice. Prostate tissue or tumor samples were collected at 1 year of age. Scale bar = 300 μm. (<bold>D</bold>) Total pathological scores of prostate tissues from WT or prostate-specific <italic>Znrf3</italic>/<italic>Rnf43</italic> knockout mice. n=6 mice per group. p-Values were calculated by Mann-Whitney. (<bold>E</bold>) Representative images of immunochemistry staining for EGFR, P-EGFR, and active-β-catenin in prostate tissues from WT or prostate-specific <italic>Znrf3</italic>/<italic>Rnf43</italic> knockout mice. Scale bar = 40 μm.</p><p><supplementary-material id="fig7sdata1"><label>Figure 7—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig7">Figure 7</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig7-data1-v1.xlsx"/></supplementary-material></p><p><supplementary-material id="fig7sdata2"><label>Figure 7—source data 2.</label><caption><title>PDF files containing the original, labeled blots and gels to <xref ref-type="fig" rid="fig7">Figure 7</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig7-data2-v1.zip"/></supplementary-material></p><p><supplementary-material id="fig7sdata3"><label>Figure 7—source data 3.</label><caption><title>TIF files of the raw blots and gels to <xref ref-type="fig" rid="fig7">Figure 7</xref>.</title></caption><media mimetype="application" mime-subtype="zip" xlink:href="elife-95639-fig7-data3-v1.zip"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig7-v1.tif"/></fig><fig id="fig7s1" position="float" specific-use="child-fig"><label>Figure 7—figure supplement 1.</label><caption><title>Pathological assessment on eccentric thickened wall (<bold>A</bold>), dysplasia (<bold>B</bold>), micro-invasion (<bold>C</bold>), and frank invasion (<bold>D</bold>) of wild-type (WT) and <italic>Znrf3</italic>/<italic>Rnf43</italic> knockout (KO) mouse prostate tissues.</title><p><supplementary-material id="fig7s1sdata1"><label>Figure 7—figure supplement 1—source data 1.</label><caption><title>Excel file providing the numerical source data to <xref ref-type="fig" rid="fig7s1">Figure 7—figure supplement 1</xref>.</title></caption><media mimetype="application" mime-subtype="xlsx" xlink:href="elife-95639-fig7-figsupp1-data1-v1.xlsx"/></supplementary-material></p></caption><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-fig7-figsupp1-v1.tif"/></fig></fig-group><p>Furthermore, we validated ZNRF3/RNF43-EGFR signaling in prostate cancer, one of the several other tumors in patients besides CRC that showed a negative correlation between <italic>ZNRF3</italic>/<italic>RNF43</italic> mRNA and EGFR protein levels (<xref ref-type="fig" rid="fig1">Figure 1F</xref>). Specifically, we tested whether ZNRF3/RNF43 loss affects EGFR signaling and promotes prostate tumorigenesis in vivo. By breeding mice that contain cre-inactivatable alleles of <italic>Znrf3</italic> and <italic>Rnf43</italic> (<xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>) with mice transgenic for Probasin-Cre (<xref ref-type="bibr" rid="bib76">Wu et al., 2001</xref>), we generated prostate-specific <italic>Znrf3/Rnf43</italic> KO mice. At 1 year of age, these mice exhibited multi-focal prostatic dysplasia and multifocal invasive tumors, as shown by the H&amp;E images (<xref ref-type="fig" rid="fig7">Figure 7C</xref>) and pathological scores (<xref ref-type="fig" rid="fig7">Figure 7D</xref>, <xref ref-type="fig" rid="fig7s1">Figure 7—figure supplement 1A–D</xref>). Immunohistochemical staining revealed elevated levels of both EGFR and P-EGFR in <italic>Znrf3/Rnf43</italic> KO prostatic dysplasia and tumors, compared to WT prostate tissues (<xref ref-type="fig" rid="fig7">Figure 7E</xref>), indicating EGFR signaling activation as a result of <italic>Znrf3/Rnf43</italic> KO. We also observed more intense β-catenin staining in KO tissues and tumors than in WT mice, although the β-catenin signals were largely excluded from the nucleus in both WT and <italic>Znrf3/Rnf43</italic> KO mouse prostate tissues and tumors (<xref ref-type="fig" rid="fig7">Figure 7E</xref>). Together, these results suggest that loss of <italic>ZNRF/RNF43</italic> elevates EGFR levels and signaling, promoting tumor development, sometimes in conjunction with Wnt signaling activation and other times independent of Wnt signaling.</p></sec></sec><sec id="s3" sec-type="discussion"><title>Discussion</title><p>The two homologous E3 Ub ligases, ZNRF3 and RNF43, and their antagonistic ligand RSPO have been extensively studied as WNT signaling modulators during normal development and diseases (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="bibr" rid="bib55">Planas-Paz et al., 2016</xref>; <xref ref-type="bibr" rid="bib66">Szenker-Ravi et al., 2018</xref>; <xref ref-type="bibr" rid="bib2">Basham et al., 2019</xref>; <xref ref-type="bibr" rid="bib40">Lee et al., 2020</xref>; <xref ref-type="bibr" rid="bib65">Sun et al., 2021</xref>). Their primary role has been attributed to negatively regulating Frizzed receptors through ubiquitination and degradation (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>), and the early mass spectrometry analysis of 293T cells following inducible expression of RNF43 only detected downregulation of Frizzled and LRP5 (<xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). However, subsequent reports suggested that ZNRF3/RNF43 might also regulate other substrates and exert distinct functions in context-dependent manners. For instance, ZNRF3/RNF43 may induce degradation of BMP receptor BMPR1A (<xref ref-type="bibr" rid="bib40">Lee et al., 2020</xref>), maternal dorsal determinant Huluwa (<xref ref-type="bibr" rid="bib85">Zhu et al., 2021</xref>), non-canonical WNT component VANGL2 (<xref ref-type="bibr" rid="bib59">Radaszkiewicz et al., 2021</xref>), and the cell adhesion protein E-cadherin (<xref ref-type="bibr" rid="bib83">Zhang et al., 2019</xref>) in different physiological or pathological conditions. In the context of cancer, <italic>ZNRF3</italic> and <italic>RNF43</italic> are frequently inactivated by gene deletion, mutation, or other means (<xref ref-type="bibr" rid="bib64">Seshagiri et al., 2012</xref>; <xref ref-type="bibr" rid="bib29">Hao et al., 2016</xref>). Therefore, our study focused on elucidating ZNRF3/RNF43-regulated signaling pathways in cancer. We discovered that EGFR is the protein most negatively associated with <italic>ZNRF3</italic>/<italic>RNF43</italic> expression using proteogenomic data of cancer patients, and that ZNRF3/RNF43 interacts with EGFR and downregulates EGFR through ubiquitination and degradation. Using multiple cell lines and animal models, we demonstrated that loss-of-function changes of ZNRF3/RNF43 elevate EGFR signaling activity to promote cancer progression.</p><p>In CRC, <italic>ZNRF3</italic> and <italic>RNF43</italic> mutations occur frequently (<xref ref-type="bibr" rid="bib25">Giannakis et al., 2014</xref>; <xref ref-type="bibr" rid="bib5">Bond et al., 2016</xref>; <xref ref-type="bibr" rid="bib70">Tu et al., 2019</xref>; <xref ref-type="bibr" rid="bib72">Vasaikar et al., 2019</xref>) and have been mainly associated with the potentiation of WNT signaling (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>; <xref ref-type="bibr" rid="bib29">Hao et al., 2016</xref>). However, our findings suggest that ZNRF3/RNF43 deactivation may unleash other key oncogenic pathways in CRC, especially in the context of APC/CTNNB1 co-mutations that bypass the need for WNT receptor activation for pathway activation (<xref ref-type="bibr" rid="bib7">Cerami et al., 2012</xref>; <xref ref-type="bibr" rid="bib23">Gao et al., 2013</xref>). We provide evidence that in human CRC cells with a hyperactive WNT pathway due to <italic>APC</italic> mutations, KO of <italic>RNF43</italic> promotes cancer cell growth by activating EGFR signaling. Additionally, we found that the <italic>RNF43</italic> G659Vfs*41 mutant, a hotspot frameshift mutation in human colorectal tumors that may not potentiate WNT signaling (<xref ref-type="bibr" rid="bib70">Tu et al., 2019</xref>; <xref ref-type="bibr" rid="bib43">Li et al., 2020</xref>), elevates EGFR protein levels, suggesting that this mutation may exert its oncogenic role in cancer through EGFR upregulation. Our data also have clinical implications, as germline polymorphisms and tumor gene expression levels of ZNRF3/RNF43 and RSPO may be related to tumor response to anti-EGFR monoclonal antibody cetuximab-based treatment in CRC patients (<xref ref-type="bibr" rid="bib3">Battaglin et al., 2020</xref>; <xref ref-type="bibr" rid="bib18">Elez et al., 2022</xref>), providing insights into understanding the interplay between RSPO-ZNRF3/RNF43 and EGFR protein levels and anti-EGFR activity in CRC treatment.</p><p>By identifying ZNRF3/RNF43 as crucial regulators linking EGFR and WNT signaling at the membrane receptor level, our work reveals a novel mechanism of EGFR and WNT co-activation, which is commonly observed in human cancers (<xref ref-type="bibr" rid="bib33">Hu and Li, 2010</xref>). Further work should explore the extent to which EGFR and WNT receptors (Frizzled and LRP5/6) each transmit the effect of ZNRF3/RNF43 deactivation at different cancer stages and investigate the efficacy of blocking both EGFR and WNT signaling in the treatment of ZNRF3/RNF43-deactivated tumors. Our findings also have implications for organoid culture and normal development. For example, while RSPO and EGF are both required for organoid growth and maintenance, our data suggest that RSPO can both help sustain surface EGFR levels by deactivating ZNRF3/RNF43 and synergize with EGF to boost EGFR signaling activity. Comparative studies on ZNRF3/RNF43 regulation of EGFR versus WNT receptors in terms of substrate abundance, enzyme-substrate binding affinity, in vivo ligand availability, and temporal and spatial regulatory mechanisms can provide a comprehensive understanding of the RSPO-ZNRF3/RNF43-regulated signaling network. Lahde et al. reported that RSPO1 addition to <italic>Apc-</italic>deficient mouse intestinal organoids led to an increased size but a decreased number, and their studies implicated abnormal recruitment of the TGF-β/SMAD pathway via LGR5/TGFBRII heterodimers as a mechanism (<xref ref-type="bibr" rid="bib38">Lähde et al., 2021</xref>). We did not detect enhanced TGF-β signaling in our <italic>Apc</italic><sup>min</sup> mouse intestinal tumor culture treated by RSPO1 for 2 or 8 days (<xref ref-type="fig" rid="fig6s2">Figure 6—figure supplement 2</xref>). Furthermore, we did not observe an impact of ZNRF3/RNF43 overexpression on TGFβ receptor I protein levels in our 293T culture studies (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1B</xref>), although our bioinformatic analysis of patient CRCs revealed that SMAD4, a crucial transcription factor downstream of TGF-β receptors, was among the proteins downregulated by ZRNF3/RNF43 (<xref ref-type="fig" rid="fig1">Figure 1C</xref>). Therefore, whether TGFβ signaling is directly affected by the RSPO-ZNRF3/RNF43-regulated signaling network needs to be further investigated.</p><p>Structural studies have identified the key amino acids and motifs mediating ZNRF3/RNF43 binding with their peptide ligand RSPO (<xref ref-type="bibr" rid="bib9">Chen et al., 2013</xref>; <xref ref-type="bibr" rid="bib53">Peng et al., 2013</xref>; <xref ref-type="bibr" rid="bib82">Zebisch et al., 2013</xref>) and also suggested that RSPO has the closest structural homology with EGFR (domain IV) and insulin receptor (domain II) (<xref ref-type="bibr" rid="bib9">Chen et al., 2013</xref>). Our co-IP data indicate that ZNRF3/RNF43 interact with EGFR through their ECDs. It would also be interesting to determine further the specific domains and amino acids that are responsible for ZNRF3/RNF43 and EGFR interaction and to study whether clinically relevant point mutations at the ECDs of ZNRF3/RNF43 and/or EGFR hinder their binding affinity, thereby enhancing EGFR signaling to promote cancer initiation and progression.</p><p>RSPO1-4 bind to both ZNRF3/RNF43 and LGR4/5/6, resulting in ZNRF3/RNF43 auto-ubiquitination and degradation (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). RSPO2/3 can also inhibit ZNRF3/RNF43 independently of LGR4/5/6 (<xref ref-type="bibr" rid="bib39">Lebensohn and Rohatgi, 2018</xref>; <xref ref-type="bibr" rid="bib51">Park et al., 2018</xref>; <xref ref-type="bibr" rid="bib66">Szenker-Ravi et al., 2018</xref>) because RSPO2/3 can bind to RNF43/ZNRF3 with relatively high affinity, especially in the presence of heparan sulfate proteoglycans (HSPGs) (<xref ref-type="bibr" rid="bib16">Dubey et al., 2020</xref>). Approximately 18% of CRCs harbor amplification or mutations of <italic>RSPO1-4</italic> or <italic>LGR4/5/6,</italic> while 10% of CRCs have recurrent <italic>RSPO2/3</italic> gene fusions (<xref ref-type="bibr" rid="bib64">Seshagiri et al., 2012</xref>). These genetic alterations potentially lead to enhanced inhibition of ZNRF3/RNF43, activating WNT and EGFR signaling (<xref ref-type="bibr" rid="bib63">Seeber et al., 2019</xref>). While the involvement of each co-receptor (LGR4/5/6; HSPGs) in regulating RSPO-ZNRF3/RNF43 degradation of EGFR requires more investigation, LGR4/5/6 may be dispensable for RSPO2-ZNRF3/RNF43 regulation of EGFR because we found that RSPO2 mutant that cannot bind to LGR4/5/6 still enhanced EGFR protein levels. It is worth noting that LGR4/5/6 may have a parallel mechanism controlling EGFR levels as we have previously observed that LGR4 can enhance EGFR signaling independently of WNT activation (<xref ref-type="bibr" rid="bib81">Yue et al., 2021</xref>).</p><p>Our work also uncovers a new mechanism of regulating EGFR levels in cancer. Hyperactivation of EGFR in cancer has been attributed to activating mutations, gene amplification, aberrant gene expression, and defective endocytosis/degradation (<xref ref-type="bibr" rid="bib47">Nakai et al., 2016</xref>). However, these mechanisms cannot account for all the 60–80% of CRC cases whose EGFR levels are upregulated (<xref ref-type="bibr" rid="bib11">Cohen, 2003</xref>). ZNRF3/RNF43 loss-mediated EGFR stabilization represents a novel mechanism of EGFR upregulation, explaining the elevated EGFR protein levels observed in many human cancers without EGFR gene amplification or overexpression. In our study, ZNRF3/RNF43 can regulate EGFR levels under basal culture conditions, as well as with EGF ligand stimulation, but the commonly known EGFR E3 ligase, CBL, mediates ligand-dependent EGFR ubiquitination and degradation (<xref ref-type="bibr" rid="bib4">Batzer et al., 1994</xref>; <xref ref-type="bibr" rid="bib41">Levkowitz et al., 1998</xref>; <xref ref-type="bibr" rid="bib42">Levkowitz et al., 1999</xref>; <xref ref-type="bibr" rid="bib73">Waterman et al., 1999</xref>; <xref ref-type="bibr" rid="bib74">Waterman et al., 2002</xref>; <xref ref-type="bibr" rid="bib27">Grøvdal et al., 2004</xref>; <xref ref-type="bibr" rid="bib15">Duan et al., 2011</xref>). Therefore, future studies should investigate whether ZNRF3/RNF43 and CBL regulate EGFR ubiquitination and degradation differently, whether ZNRF3/RNF43 regulate both ligand-independent and ligand-dependent EGFR ubiquitination/degradation and consequently affecting different downstream signaling pathways, and whether different EGFR ligands or ligand concentrations direct EGFR to ZNRF3/RNF43 versus CBL for ubiquitination and degradation (<xref ref-type="bibr" rid="bib30">Harris et al., 2003</xref>; <xref ref-type="bibr" rid="bib60">Roepstorff et al., 2009</xref>). In addition, a feedback regulation often contributes to tight controls of signaling activation (<xref ref-type="bibr" rid="bib8">Chandarlapaty, 2012</xref>). In accordance, ZNRF3/RNF43 regulation of WNT signaling is feedback-controlled by <italic>ZNRF3/RNF43</italic> as WNT target genes (<xref ref-type="bibr" rid="bib28">Hao et al., 2012</xref>; <xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). Whether and how EGFR signaling may affect levels and activities of ZNRF3/RNF43 and their partners including RSPOs and LGRs as a feedback regulation remain to be understood.</p><p>In conclusion, our study unveils a novel ZNRF3/RNF43-EGFR signaling axis in cancer and provides critical insights into RSPO-ZNRF3/RNF43 signaling during cancer progression. Understanding how ZNRF3/RNF43 regulates EGFR and the crosstalk between EGFR and WNT receptors may offer potential therapeutic targets for cancer treatment. Additionally, our findings have implications in organoid culture and normal development, highlighting the significance of RSPO-ZNRF3/RNF43 signaling in various physiological processes. Further research on ZNRF3/RNF43 regulation of EGFR versus WNT receptors in different cancer stages can contribute to a comprehensive understanding of RSPO-ZNRF3/RNF43 signaling in cancer progression and provide valuable knowledge for potential therapeutic interventions.</p></sec><sec id="s4" sec-type="materials|methods"><title>Materials and methods</title><sec id="s4-1"><title>Animal studies</title><p>All experiments using mice were performed utilizing procedures approved by the Institutional Animal Care and Use Committees at Baylor College of Medicine and the Van Andel Institute. The <italic>Rnf43</italic>-flox; <italic>Znrf3</italic>-flox were obtained from the laboratory of Hans Clevers (<xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>). CMV-Cre animals were ordered from Jackson Laboratories (JAX stock #006054) (<xref ref-type="bibr" rid="bib62">Schwenk et al., 1995</xref>). C57Bl/6J used for backcrossing were ordered from Jackson Laboratories (JAX stock #000664). Probasin-Cre animals were developed in the laboratory of Pradip Roy-Burman (<xref ref-type="bibr" rid="bib76">Wu et al., 2001</xref>). NOD.Cg-Prkdc scid Il2rg tm1Wjl/SzJ (NSG) mice were purchased from Jackson Laboratories (JAX stock #005557) and bred in-house.</p></sec><sec id="s4-2"><title>Cell lines</title><p>MDA-MB-231, MDA-MB-468, and HEK293T cells were purchased from ATCC. HT29 and LS180 cells were provided by Q Liu; HCT116 cells were provided by N Shroyer; MEF cells were generated from e12.5 embryos using standard methods (<xref ref-type="bibr" rid="bib32">Herrera et al., 1996</xref>). MDA-MB-231, MDA-MB-468, HT29, HCT116, HEK293T, and MEF cells were cultured in DMEM (Corning, 10-013-CV) with 10% FBS and 1% penicillin/streptomycin. LS180 cells were cultured in RPMI1640 (Corning, 10-013-CV) with 10% FBS and 1% penicillin/streptomycin. All cell lines were routinely tested for mycoplasma contamination.</p></sec><sec id="s4-3"><title>Constructs</title><p>Plasmids expressing Flag-FZD5, RNF43, HA-RNF43, or HA-RNF43 (CD8 sp) were provided by Q Liu. Plasmids expressing Myc-RNF43, Myc-ZNRF3, or Myc-ZNRF3 ΔRING were provided by F Cong. Plasmids for Myc-ZNRF3-ECD-TM, Myc-ZNRF3-TM-ICD, Myc-ZNRF3 ΔPA, HA-RNF43 ΔPA, HA-RNF43 ΔRING, HA-RNF43-ECD-TM were constructed by subcloning using In-Fusion (TaKaRa, 639642). Plasmids were further constructed for lentiviral expression by subcloning into pBobi vector by In-Fusion. Flag-EGFR (L858R) is PCR-amplified and subcloned into FUCGW vector at EcoRI site for lentiviral expression.</p></sec><sec id="s4-4"><title>Generation of <italic>RNF43</italic> or <italic>ZNRF3</italic> KO cancer cell lines</title><p>HT29 <italic>RNF43</italic> KO cells were provided by Q Liu (guide RNA sequence, g0: 5’-<named-content content-type="sequence">GGCTGCTGATGGCTACCCTGC</named-content>-3’). Other CRISPR guide sequences for knocking out <italic>RNF43</italic> were designed by <ext-link ext-link-type="uri" xlink:href="http://crispr.mit.edu">http://crispr.mit.edu</ext-link> and cloned into lentiCRISPR v2 (Addgene 52961). Sequences were as follows: g1: 5’-<named-content content-type="sequence">TGGACGCACAGGACTGGTAC</named-content>-3’; g2: 5’-<named-content content-type="sequence">CAGAGTGATCCCCTTGAAAA</named-content>-3’; g3: 5’-<named-content content-type="sequence">GGGCAGCCAGCTGCAGCTGG</named-content>-3’. Lentiviral construct for knocking out <italic>ZNRF3</italic> was provided by Q Liu (guide RNA sequence, 5’- <named-content content-type="sequence">AGGACTTGTATGAATATGGC</named-content>-3’) (<xref ref-type="bibr" rid="bib35">Jiang et al., 2015</xref>; <xref ref-type="bibr" rid="bib70">Tu et al., 2019</xref>). Cancer cells were infected with lentivirus-carrying CRISPR constructs or vector, and then selected in the culture medium containing 2 µg/ml puromycin (InvivoGen, ant-pr-1).</p></sec><sec id="s4-5"><title>Generation of <italic>Znrf3</italic> KO MEFs</title><p>Global null alleles of <italic>Rnf43</italic> and <italic>Znrf3</italic> were generated in vivo by crossing <italic>Rnf43</italic>-flox; <italic>Znrf3</italic>-flox mice (<xref ref-type="bibr" rid="bib37">Koo et al., 2012</xref>) with CMV-Cre (<xref ref-type="bibr" rid="bib62">Schwenk et al., 1995</xref>). The resulting mice were backcrossed to C57Bl/6J animals to remove the Cre transgene and generate global deletion mouse colonies. Global deletions were confirmed using allele-specific PCR for both <italic>Rnf43</italic> and <italic>Znrf3</italic>. MEFs were generated using standard protocols (<xref ref-type="bibr" rid="bib17">Durkin et al., 2013</xref>). Briefly, <italic>Rnf43</italic><sup>KO/+</sup>; <italic>Znrf3</italic><sup>KO/+</sup> mice were crossed, and embryos were collected at E12.5. Yolk sacs were collected for genotyping, and embryo heads and internal organs were removed. The remaining tissue was minced using a razor blade and 0.5 ml 0.05% Trypsin-EDTA was added. The suspension was incubated at 37°C for 30 min, then cultured in MEF media (DMEM, 10% FBS, 1× PenStrep) for subsequent experiments.</p></sec><sec id="s4-6"><title>Chemicals</title><p>Erlotonib (Selleck Chemicals) was dissolved in ethanol, and Wnt-C59 (Cellagen Technology) was dissolved in DMSO.</p></sec><sec id="s4-7"><title>Cell proliferation assay</title><p>MEF cells were seeded at 5000 cells in 96-well and the media was refreshed with drugs the next day. On day 4 post-drug treatments, cells were incubated with Cell Counting Kit-8 (CCK-8) reagents (ApexBio) for 4 hr, and the growth was determined at 450 nm by spectrophotometer.</p></sec><sec id="s4-8"><title><italic>Apc</italic><sup>min</sup> mouse intestinal tumor organoid culture</title><p>Intestinal polyps from 6-month-old female <italic>Apc</italic><sup>min</sup> mice (<xref ref-type="bibr" rid="bib20">Evans et al., 1992</xref>) were isolated and maintained using previously described protocols (<xref ref-type="bibr" rid="bib61">Sato et al., 2011</xref>; <xref ref-type="bibr" rid="bib78">Xue and Shah, 2013</xref>), embedded in Matrigel (Corning, 356231), and cultured in basal culture medium (advanced Dulbecco’s modified Eagle medium/F12 [Invitrogen, 12634-028], penicillin/streptomycin [Invitrogen, 15140-122], 10 mmol/l HEPES [Invitrogen, 15630-080], 2 mM GlutaMAX [Invitrogen, 35050-061], 1×N2 [Invitrogen, 17502-048], 1×B27 [Invitrogen, 17504-044], 1 mmol/l N-acetylcysteine [Sigma-Aldrich, A9165-5G]) supplemented with 50 ng/ml mouse recombinant EGF (Invitrogen, PMG8043). The organoids were trypsinized with 0.05% Trypsin-EDTA (Invitrogen, 25300054) to obtain single cells, counted, and embedded into Matrigel in equal numbers, cultured in basal culture medium supplemented with EGF or basal culture medium supplemented with EGF and 10% RSPO1 conditioned medium for 8 days. The organoids were imaged using a Leica DMi8 Inverted Microscope and then harvested for immunoblot analysis.</p></sec><sec id="s4-9"><title>RNA extraction and qPCR</title><p>Cells were lysed with TRIzol reagent (Invitrogen, 15596-026). Total RNA was extracted by chloroform and isopropanol precipitation. cDNA was obtained using the SuperScript III First-Strand Synthesis System (Invitrogen, 18080-051). qPCR analyses were performed with primers listed below using SsoAdvanced Universal SYBR Green Supermix (Bio-Rad, 1725270) with at least duplicate samples in three independent experiments. Plotted are data normalized to <italic>ACTB</italic> or <italic>Actb</italic> and relative to the control. The following primers were used: <italic>ACTB</italic>: 5’-<named-content content-type="sequence">ACTCTTCCAGCCTTCCTTCC</named-content>-3’, 5’-<named-content content-type="sequence">CAGTGATCTCCTTCTGCATCC</named-content>-3’; <italic>EGFR</italic>: 5'-<named-content content-type="sequence">TGCCCATGAGAAATTTACAGG</named-content>-3', 5'-<named-content content-type="sequence">ATGTTGCTGAGAAAGTCACTGC</named-content>-3'; <italic>Actb</italic>: 5’- <named-content content-type="sequence">CATTGCTGACAGGATGCAGAAGG</named-content>-3’, 5’-<named-content content-type="sequence">TGCTGGAAGGTGGACAGTGAGG</named-content>-3’; <italic>Egfr</italic>: 5′- <named-content content-type="sequence">GGACTGTGTCTCCTGCCAGAAT</named-content>-3′, 5′-<named-content content-type="sequence">GGCAGACATTCTGGATGGCACT</named-content>-3′; <italic>Axin2</italic>: 5’-<named-content content-type="sequence">ATGGAGTCCCTCCTTACCGCAT</named-content>-3’, 5’-<named-content content-type="sequence">GTTCCACAGGCGTCATCTCCTT</named-content>-3’; <italic>Sox2</italic>: 5’-<named-content content-type="sequence">AACGGCAGCTACAGCATGATGC</named-content>-3’, 5’-<named-content content-type="sequence">CGAGCTGGTCATGGAGTTGTAC</named-content>-3’; <italic>Ccnd1</italic>: 5’- <named-content content-type="sequence">GCAGAAGGAGATTGTGCCATCC</named-content>-3’, 5’-<named-content content-type="sequence">AGGAAGCGGTCCAGGTAGTTCA</named-content>-3’. The primer sequences for <italic>Tgfbr1</italic>, <italic>Tgfbr2</italic>, <italic>Smad4</italic>, <italic>Ep300</italic>, <italic>Bach1</italic> were from OriGene.</p></sec><sec id="s4-10"><title>Flow cytometric analysis</title><p>Cells were trypsinized and resuspended in antibody dilution buffer (0.5% BSA in PBS). 5×10<sup>5</sup> cells were incubated with EGFR (D1D4J) XP Rabbit antibody (PE Conjugate) (Cell Signaling Technology, 48685) for 1 hr at 4°C. Cells were then washed with antibody dilution buffer and resuspended in antibody dilution buffer. The cells were then subjected to flow cytometry using a BD FACSCanto II (BD, NJ, USA). The resulting data were analyzed using the BD FACSDiva software.</p></sec><sec id="s4-11"><title>Immunofluorescence</title><p>HEK293T cells were seeded on poly-D-lysine-coated chamber slides (Corning, 354632) and transfected with empty vector, or constructs expressing WT or fragments of RNF43 or ZNRF3. 48 hr after transfection, cells were fixed in 3.2% paraformaldehyde in PBS at RT for 15 min, permeabilized in 3% BSA/0.1% saponin (Sigma-Aldrich, 47036) in PBS at RT for 30 min, and then incubated in the secondary antibody anti-Rabbit Alex 488 (Invitrogen, A32731) at RT for 1 hr. Afterward, the cells were stained with DAPI (Thermo Fisher Scientific, 62248) and mounted.</p></sec><sec id="s4-12"><title>Immunohistochemistry</title><p>Immunochemistry staining was performed using the Vectastain Elite ABC system (Vector Laboratories, Burlingame, CA, USA) and developed using DAB as chromogen (Agilent Dako, Santa Clara, CA, USA). Primary antibodies used in the study included EGFR (D1P9C) rabbit antibody (Mouse Preferred, Cell Signaling Technology, 71655), P-EGFR (Y1068) XP rabbit antibody (Cell Signaling Technology, 2234), non-phospho (Active) β-catenin (Ser33/37/Thr41) (D13A1) rabbit antibody (Cell Signaling Technology, 8814).</p></sec><sec id="s4-13"><title>Proximity ligation assay</title><p>HCT116 cells were seeded onto poly-D-lysine-coated chamber slide (Corning) and co-transfected with Myc-ZNRF3ΔR and EGFR. Two days after transfection, the cells were processed following the standard protocol provided by Sigma-Aldrich (Duolink In Situ Red Starter Kit Mouse/Rabbit). The primary antibodies, EGFR (D38B1) XP rabbit antibody (Cell Signaling Technology, 4267) and Myc-tag (9B11) mouse antibody (Cell Signaling Technology, 2276), were used to detect ZNRF3 and EGFR interaction. For negative control, no primary antibody was used. DAPI was used to stain nuclei. The stained cells were imaged using Leica DMi8 Fluorescence Microscope.</p></sec><sec id="s4-14"><title>Western blot</title><p>Cells were lysed on ice using RIPA lysis buffer supplemented with protease inhibitors (Sigma-Aldrich, P8340) and phosphatase inhibitors (Sigma-Aldrich, P5726 and P0044). Cell lysates were then centrifuged at 14,000 rpm for 15 min at 4°C. Supernatant was collected, and the concentration of protein lysate was quantified by BCA assay (Thermo Fisher Scientific, 23225). Cell lysates were mixed with Laemmli sample buffer (Bio-Rad, 1610747) and β-mercaptoethanol (Thermo Fisher Scientific, 21985023) before boiling for 5 min at 95°C. Equal amounts of protein lysates were loaded and run in 8–12% SDS-PAGE gel. Gels were transferred onto nitrocellulose membrane (Thermo Fisher Scientific, 88018) at 100 V for 90 min at 4°C. Membranes were then blocked with 5% non-fat milk in TBST at RT for 1 hr, incubated with primary antibodies overnight at 4°C and secondary antibodies at RT for 1 hr, and scanned using the Odyssey LI-COR imaging system. Primary antibodies used in the study included EGFR (D38B1) XP rabbit antibody (Cell Signaling Technology, 4267), EGFR (A-10) mouse antibody (Santa Cruz, sc-373746), EGFR (D1P9C) rabbit antibody (Mouse Preferred, Cell Signaling Technology, 71655), P-EGFR (Y1068) XP rabbit antibody (Cell Signaling Technology, 3777), HA-tag mouse antibody (BioLegend 901501), HA-tag (C29F4) rabbit antibody (Cell Signaling Technology, 3724), Myc-tag (9B11) mouse antibody (Cell Signaling Technology, 2276), Myc-tag (71D10) rabbit antibody (Cell Signaling Technology, 2278), Flag-tag M2 mouse antibody (Sigma-Aldrich, F1804), Ub (P4D1) mouse antibody (Santa Cruz, sc-8017), CBL mouse antibody (Santa Cruz, sc-1651), non-phospho (Active) β-catenin (Ser33/37/Thr41) (D13A1) rabbit antibody (Cell Signaling Technology, 8814), β-catenin mouse antibody (BD Biosciences, 610153), GAPDH rabbit antibody (Santa Cruz, sc-25778), β-actin (Sigma, A5441), and α-tubulin mouse antibody (Sigma-Aldrich, T9026). Secondary antibodies used included anti-Mouse IRDye 680RD (LI-COR, 926-68070) and anti-Rabbit IRDye 800CW (LI-COR, 926-32211).</p></sec><sec id="s4-15"><title>IP assay</title><p>Cells were lysed on ice using NP-40 or RIPA lysis buffer supplemented with protease inhibitors (Sigma-Aldrich, P8340). Cell lysates were then centrifuged at 14,000 rpm for 15 min at 4°C. Supernatant was collected, and the concentration of protein lysate was quantified by BCA. Protein lysates were incubated with either EGFR (Ab-13) mouse antibody (Thermo Fisher Scientific, MS-609-P1) or Ub (P4D1) mouse antibody (Santa Cruz, sc-8017), and Protein G Sepharose beads (GE Healthcare, 17061801) overnight at 4°C. Beads were washed with NP-40 or RIPA lysis buffer. Whole-cell lysates and immunoprecipitates were analyzed by western blot analysis.</p></sec><sec id="s4-16"><title>IP and mass spectrometry</title><p>The IP-MS experiments were performed as previously described (<xref ref-type="bibr" rid="bib10">Chen et al., 2019</xref>). BCG823 cells were starved overnight and then treated with 50 ng/ml EGF for 120 min before sample collection. For each IP experiment, 1 mg protein lysate was incubated with 5 µg EGFR (Ab-13) antibody for 2 hr at 4°C and cleared by ultracentrifugation (100,000×<italic>g</italic>, 15 min). The supernatant was then incubated with 30 µl 50% protein A-Sepharose slurry (GE Healthcare, 17-0780-01) for 1 hr at 4°C. The bead-bound complexes were washed four times with NETN buffer (20 mM Tris pH 7.5, 1 mM EDTA, 0.5% NP-40, 150 mM NaCl) and eluted with 20 µl 2× Laemmli buffer and heated at 95°C for 10 min. IP samples were resolved on a NuPAGE 10% Bis-Tris gel (Life Technologies, WG1201BX10) in 1× MOPS running buffer; the gel was cut into 3 molecular weight regions plus the IgG heavy and light chain bands. Each band was in-gel digested overnight with 100 ng of trypsin, which cleaves peptide chains at the C-termini of lysine or arginine in 20 µl of 50 mM NH<sub>4</sub>HCO<sub>3</sub> at 37°C. Peptides were extracted with 350 µl of 100% acetonitrile and 20 µl of 2% formic acid, and dried in a Savant Speed-Vac. Digested peptides were dissolved in 10 µl of loading solution (5% methanol containing 0.1% formic acid) and subjected to LC-MS/MS assay as described previously (<xref ref-type="bibr" rid="bib14">Dharmat et al., 2018</xref>).</p></sec><sec id="s4-17"><title>Reverse phase protein array</title><p>RPPA assays were carried out as described previously with minor modifications (<xref ref-type="bibr" rid="bib12">Creighton and Huang, 2015</xref>). Protein lysates were prepared with modified TPER buffer supplemented with a cocktail of protease and phosphatase inhibitors. Protein lysates at 0.5 mg/ml of total protein were denatured in SDS sample buffer containing 2.5% β-mercaptoethanol at 100°C for 8 min. The Aushon 2470 Arrayer (Aushon BioSystems) with a 40 pin (185 μm) configuration was used to spot samples and control lysates onto nitrocellulose-coated slides (Grace Bio-labs) using an array format of 960 lysates/slide (2880 spots/slide). The slides were probed with a set of 216 antibodies against total and phospho-proteins using an automated slide stainer Autolink 48 (Dako). Each slide was incubated with one specific primary antibody, and a negative control slide was incubated with antibody diluent instead of primary antibody. Primary antibody binding was detected using a biotinylated secondary antibody followed by streptavidin-conjugated IRDye680 fluorophore (LI-COR Biosciences). Total protein content of each spotted lysate was assessed by fluorescent staining with Sypro Ruby Protein Blot Stain according to the manufacturer’s instructions (Molecular Probes). Fluorescence-labeled slides were scanned on a GenePix 4400 AL scanner, along with accompanying negative control slides, at an appropriate PMT to obtain optimal signal for this specific set of samples. The images were analyzed with GenePix Pro 7.0 (Molecular Devices). Total fluorescence signal intensities of each spot were obtained after subtracting the local background signal for each slide and were then normalized for variation in total protein, background, and non-specific labeling using a group-based normalization method. For each spot on the array, the background-subtracted foreground signal intensity was subtracted by the corresponding signal intensity of the negative control slide (omission of primary antibody) and then normalized to the corresponding signal intensity of total protein for that spot. Each image and its normalized data were evaluated for quality through manual inspection and control samples. Antibody slides that failed the quality inspection were either repeated at the end of the staining runs or removed before data reporting. Samples (in four biological replicates) were extracted from the normalized data and then log2 transformed. The median value of the three technical replicates was used for statistical analysis. Welch’s t-tests were used for group comparisons. FDR-adjusted p-value&lt;0.05 was considered statistically significant.</p></sec><sec id="s4-18"><title>Subcutaneous xenograft tumor model and IVIS imaging</title><p>5×10<sup>5</sup> luciferase-labeled HT29 cells were suspended in 0.1 ml serum-free DMEM and injected into the right back flank of 21- to 24-week-old NSG mice. Bioluminescence was measured once a week, by injection of 100 µl 15 mg/ml D-luciferin (LUCNA-1G, Goldbio) via the intra-orbital sinus. Mice were imaged using IVIS Lumina II (Advanced Molecular Vision). The acquired bioluminescence signals were normalized to the day 0 bioluminescence intensity.</p></sec><sec id="s4-19"><title>Statistics</title><p>All statistical analyses in our study were conducted using GraphPad Prism or R. Two-tailed t-test without equal variation assumption was used for data comparison between two experimental groups. For data comparison with at least three groups, one-way ANOVA test was performed first to assess the overall difference among groups. If differences existed, uncorrected Fisher’s LSD test was performed to assess the significance of differences between two groups. Two-way repeated measures ANOVA and uncorrected Fisher’s LSD test were used to assess the difference between datasets with time series measurements, including growth curves of cell proliferation and in vivo BLI signals. p-Values less than 0.05 were considered significant.</p></sec></sec></body><back><sec sec-type="additional-information" id="s5"><title>Additional information</title><fn-group content-type="competing-interest"><title>Competing interests</title><fn fn-type="COI-statement" id="conf1"><p>No competing interests declared</p></fn></fn-group><fn-group content-type="author-contribution"><title>Author contributions</title><fn fn-type="con" id="con1"><p>Conceptualization, Data curation, Formal analysis, Validation, Methodology, Writing – original draft, Writing – review and editing</p></fn><fn fn-type="con" id="con2"><p>Data curation</p></fn><fn fn-type="con" id="con3"><p>Data curation</p></fn><fn fn-type="con" id="con4"><p>Data curation</p></fn><fn fn-type="con" id="con5"><p>Data curation</p></fn><fn fn-type="con" id="con6"><p>Data curation</p></fn><fn fn-type="con" id="con7"><p>Data curation</p></fn><fn fn-type="con" id="con8"><p>Data curation</p></fn><fn fn-type="con" id="con9"><p>Data curation</p></fn><fn fn-type="con" id="con10"><p>Supervision</p></fn><fn fn-type="con" id="con11"><p>Data curation</p></fn><fn fn-type="con" id="con12"><p>Resources</p></fn><fn fn-type="con" id="con13"><p>Resources</p></fn><fn fn-type="con" id="con14"><p>Supervision</p></fn><fn fn-type="con" id="con15"><p>Supervision</p></fn><fn fn-type="con" id="con16"><p>Supervision, Writing – review and editing</p></fn><fn fn-type="con" id="con17"><p>Supervision, Writing – review and editing</p></fn><fn fn-type="con" id="con18"><p>Conceptualization, Supervision, Writing – review and editing</p></fn><fn fn-type="con" id="con19"><p>Conceptualization, Resources, Supervision, Funding acquisition, Project administration, Writing – review and editing</p></fn></fn-group></sec><sec sec-type="supplementary-material" id="s6"><title>Additional files</title><supplementary-material id="mdar"><label>MDAR checklist</label><media xlink:href="elife-95639-mdarchecklist1-v1.docx" mimetype="application" mime-subtype="docx"/></supplementary-material></sec><sec sec-type="data-availability" id="s7"><title>Data availability</title><p>All data are available in the main text or the supplementary materials.</p></sec><ack id="ack"><title>Acknowledgements</title><p>We thank Dr. Feng Cong for the generous gifts of reagents. We also thank Dr. Xuan Wang from the BCM Antibody-based Proteomics Core/Shared Resource for her technical assistance in performing reverse phase protein array; Ms. Xi-Lei Zeng and Ms. Xiaomin Yu from the Texas Medical Digestive Diseases Center (DDC) GEMS core for assistance in organoid culture; Ms. Cassandra Diegel from the Van Andel Institute for assistance. This work was financially supported by NIH/NCI (R01 CA204926 and CA271498 to YL), DOD-CDMRP (BC191649 and BC191646 to YL), and NIH-T32 grant (#1T32CA203690-01A1 to AK under Dr. Suzanne Fuqua). This project was also supported by the Breast Center Pathology Core as part of the SPORE program (P50 CA186784), Cytometry and Cell Sorting Core with funding from CPRIT (RP180672) and NIH (S10 RR024574), Antibody-based Proteomics Core with funding from CPRIT (RP210227) and NIH (S10 OD028648 to SH), DDC GEMS core with funding from NIH/NIDDK (DK56338), and resources from the Dan L Duncan Cancer Center with funding from NIH/NCI (P30 CA125123). The Van Andel Institute (VAI) provided additional support, including contributions from the VAI Vivarium (RRID:<ext-link ext-link-type="uri" xlink:href="https://identifiers.org/RRID:SCR_023211">SCR_023211</ext-link>) and VAI Pathology and Biorepository Core (RRID:<ext-link ext-link-type="uri" xlink:href="https://identifiers.org/RRID:SCR_022912">SCR_022912</ext-link>). PDS was supported by a post-doctoral fellowship from the American Cancer Society (PF-20-109-01), and MNM is supported by the NIH/NIDCR (K08DE3109).</p></ack><ref-list><title>References</title><ref id="bib1"><element-citation publication-type="journal"><person-group 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RNF43, two E3 ubiquitin ligases, leads to dysregulation of EGFR signaling in cancer. The authors propose that EGFR is a direct substrate of ZNRF3/RNF43. While the authors provide immunoprecipitation data showing increased detection of ubiquitinated species, this evidence does not definitively establish that EGFR itself is ubiquitinated by RNF43/ZNRF3. The absence of direct evidence for EGFR ubiquitination is a major limitation, although the findings are <bold>useful</bold> as they may provide novel insights into the mechanisms underlying EGFR-driven cancers and open new therapeutic avenues.</p></body></sub-article><sub-article article-type="referee-report" id="sa1"><front-stub><article-id pub-id-type="doi">10.7554/eLife.95639.3.sa1</article-id><title-group><article-title>Reviewer #1 (Public review):</article-title></title-group><contrib-group><contrib contrib-type="author"><anonymous/><role specific-use="referee">Reviewer</role></contrib></contrib-group></front-stub><body><p>Summary:</p><p>In this manuscript, the authors provide strong evidence that the cell surface E3 ubiquitin ligases RNF43 and ZNRF3, which are well known for their role in regulating cell surface levels of WNT receptors encoded by FZD genes, also target EGFR for degradation. This is newly identified function for these ubiquitin ligases beyond their role in regulating WNT signaling. Loss of RNF43/ZNRF3 expression leads to elevated EGFR levels and signaling, suggesting a potential new axis to drive tumorigenesis, whereas overexpression of RNF43 or ZNRF3 decreases EGFR levels and signaling. Furthermore, RNF43 and ZNRF3 directly interact with EGFR through their extracellular domains.</p><p>Strengths:</p><p>The data showing that RNF43 and ZNRF3 interact with EGFR and regulate its levels and activity are thorough and convincing, and the conclusions are largely supported.</p><p>Weaknesses:</p><p>Prior work established a clear role for RNF43 and ZNRF3 in regulating cell surface levels of FZD, a class of WNT receptors. These new findings that these E3 ubiquitin ligases also target EGFR add a new layer of complexity, and it remains unclear to what extent WNT signaling versus EGFR signaling are impacted in cancer settings. The authors acknowledge this gap in our understanding, which will likely be the topic of follow-up studies.</p><p>Comments on revisions:</p><p>The authors addressed my main concerns in this revised version and in their rebuttal comments. I have no further critiques to add.</p></body></sub-article><sub-article article-type="referee-report" id="sa2"><front-stub><article-id pub-id-type="doi">10.7554/eLife.95639.3.sa2</article-id><title-group><article-title>Reviewer #2 (Public review):</article-title></title-group><contrib-group><contrib contrib-type="author"><anonymous/><role specific-use="referee">Reviewer</role></contrib></contrib-group></front-stub><body><p>1st Public review:</p><p>Using proteogenomic analysis of human cancer datasets, Yu et al, found that EGFR protein levels negatively correlate with ZNFR3/RNF43 expression across multiple cancers. Interestingly, they found that CRC harbouring the frequent RNF43 G659Vfs*41 mutation exhibit higher levels of EGFR when compared to RNF43 wild-type tumors. This is highly interesting since this mutation is generally not thought to influence Frizzled levels and Wnt-bcatenin pathway activity. Using CRISPR knockouts and overexpression experiments, the authors show that EGFR levels are modulated by ZNRF3/RNF43. Supporting these findings modulation of ZNRF3/RNF43 activity using Rspondin also leads to increased EGFR levels. Mechanistically, the authors, show that ZNRF3/RNF43 ubiquitinate EGFR and lead to degradation. Finally, the authors present functional evidence that loss of ZNRF3/RNF43 unleashes EGFR-mediated cell growth in 2D culture and organoids and promote tumor growth in vivo.</p><p>Overall, the conclusions of the manuscript are well supported by the data presented, but some aspects of the mechanism presented need to be re-enforced to fully support the claims made by the authors. Additionally, the title of the paper suggests that ZNRF3 and RNF43 loss leads to hyperactivity of EGFR and that its signalling activity contribute to cancer initiation/progression. I don't think the authors convincingly showed this in their study.</p><p>Major points:</p><p>(1) EGFR ubiquitination. All of the experiments supporting that ZNFR3/RNF43 mediate EGFR ubiquitination are performed under overexpression conditions. A major caveat is also that none of the ubiquitination experiments are performed under denaturing conditions. Therefore, it is impossible to claim that the ubiquitin immunoreactivity observed on the western blots presented in Fig.4 corresponds to ubiquitinated-EGFR species.</p><p>Another issue is that in Figure 4A, the experiments suggest that the RNF43-dependent ubiquitination of EGFR is promoted by EGF. However, there is no control showing the ubiquitination of EGFR in the absence of EGF but under RNF43 overexpression. According to the other experiments presented in Figures 4B, 4C and 4F, there seems to be a constitutive ubiquitination of EGFR upon overexpression. How do the authors reconcile the role of ZNRF3/RNF43 vs c-cbl?</p><p>(2) EGFR degradation vs internalization. In Figure 3C, the authors show experiments that demonstrate that RNF43 KO increases steady state levels of EGFR and prevents its EGF-dependent proteolysis. Using flow cytometry they then present evidence that the reduction in cell surface levels of EGFR mediated by EGF is inhibited in the absence of RNF43. The authors conclude that this is due to inhibition of EGF-induced internalization of surface EGF. However, the experiments are not designed to study internalization and rather merely examine steady state levels of surface EGFR pre and post treatment. These changes are an integration of many things (retrograde and anterograde transport mechanisms presumable modulated by EGF). What process(es) is/are specifically affected by ZNFR3/RNF43? Are these processes differently regulated by c-cbl? If the authors are specifically interested in internalization/recycling, the use of cell surface biotinylation experiments and time courses are needed to examine the effect of EGF in the presence or absence of the E3 ligases.</p><p>(3) RNF43 G659fs*41. The authors make a point in Figure 1D that this mutant leads to elevated EGFR in cancers but do not present evidence that this mutant is ineffective in mediated ubiquitination and degradation of EGFR. As this mutant maintains its ability to promote Frizzled ubiquitination and degradation, it would be important to show side by side that it does not affect EGFR. This would perhaps imply differential mechanisms for these two substrates.</p><p>(4) &quot;Unleashing EGFR activity&quot;. The title of the paper implies that ZNRF3/RNF43 loss leads to increased EGFR expression and hence increased activity that underlies cancer. However, I could find only one direct evidence showing that increased proliferation of the HT29 cell line mutant for RNF43 could be inhibited by the EGFR inhibitor Erlotinib. All the other evidence presented that I could find is correlative or indirect (e.g. RPPA showing increased phosphorylation of pathway members upon RNF43 KO, increased proliferation of a cell line upon ZNRF3/ RNF43 KO, decreased proliferation of a cell line upon ZNRF3/RNF43 OE in vitro or in xeno...). Importantly, the authors claim that cancer initiation/ progression in ZNRF3/RNF43 mutant may in some contexts be independent of their regulation of Wnt-bcatenin signaling and relying on EGFR activity upregulation. However, this has not been tested directly. Could the authors leverage their znrf3/RNF43 prostate cancer model to test whether EGFR inhibition could lead to reduced cancer burden whereas a Frizzled or Wnt inhibitor does not?</p><p>More broadly, if EGFR signaling were to be unleashed in cancer, then one prediction would be that these cells would be more sensitive to EGFR pathway inhibition. Could the authors provide evidence that this is the case? Perhaps using isogenic cell lines or a panel of patient derived organoids (with known genotypes).</p><p>Comments on revisions:</p><p>The most important criticism of this manuscript that I raised in my original review has not been addressed. Indeed, the authors claim that EGFR is a direct substrate of the RNF43/ZNFR3 E3 ligase. This has not been directly demonstrated. Indeed, showing increased detection of ubiquitinated species in an immunoprecipitate could mean that a protein is directly modified. However, an alternative explanation is that a protein that is co-immunoprecipitated with the target protein is ubiquitinated (such as several EGFR adapters and interacting partners). Performing these experiments under denaturing conditions is one way to determine that EGFR is the substrate. Alternatively, a quantitative MS approach to quantify an increase in ubiquitinated peptides would also enable the authors to conclude that EGFR is indeed a substrate.</p><p>In addition, one of the main conclusions of the authors is that EGFR activity is unleashed in cancer following ZNRF3 and/or RNF43 loss (as the title suggests). There is still no direct evidence in the manuscript that this is the case. I appreciate the new data showing that MEF with knockout of RNF43/ZNRF3 are sensitive to EGFR inhibitor (and not porcupine inhibitor) but what is the data supporting that EGFR activity is &quot;unleashed&quot; in cancer? The authors still claim that ZNRF3 and RNF43 loss could impact cancer initiation/development in a Wnt-independent fashion (see lines 341-343). I believe this conclusion is based on correlative staining of nuclear bcatenin (which is in itself not a reliable readout of active sginaling) and not on functional data.... I suggested in my original review that the authors should test the efficacy of EGFR inhibitor and Wnt inhibitor in the prostate cancer model that they present in Figure 7 that would have enabled them to firmly conclude about their relative contribution. This was largely handwaved in their rebuttal letter... Doing experiment in WT cells is not the same as addressing this question in the context of cancer.</p><p>Finally, the authors use CRISPR KO experiments, without assessing editing or KO efficiencies throughout the manuscript and simply assume that the gRNA work. In my opinion this is an unacceptable practice.</p></body></sub-article><sub-article article-type="author-comment" id="sa3"><front-stub><article-id pub-id-type="doi">10.7554/eLife.95639.3.sa3</article-id><title-group><article-title>Author response</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Yue</surname><given-names>Fei</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Ku</surname><given-names>Amy T</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Stevens</surname><given-names>Payton</given-names></name><role specific-use="author">Author</role><aff><institution>Miami University</institution><addr-line><named-content content-type="city">Oxford</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Michalski</surname><given-names>Megan N</given-names></name><role specific-use="author">Author</role><aff><institution>Van Andel Institute</institution><addr-line><named-content content-type="city">Grand Rapids</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Jiang</surname><given-names>Weiyu</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Tu</surname><given-names>Jianghua</given-names></name><role specific-use="author">Author</role><aff><institution>The University of Texas Health Science Center at Houston</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Shi</surname><given-names>Zhongcheng</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Dou</surname><given-names>Yongchao</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Wang</surname><given-names>Yi</given-names></name><role specific-use="author">Author</role><aff><institution>Beijing Proteome Research Center</institution><addr-line><named-content content-type="city">Beijing</named-content></addr-line><country>China</country></aff></contrib><contrib contrib-type="author"><name><surname>Feng</surname><given-names>Xin-Hua</given-names></name><role specific-use="author">Author</role><aff><institution>Zhejiang University</institution><addr-line><named-content content-type="city">Hangzhou</named-content></addr-line><country>China</country></aff></contrib><contrib contrib-type="author"><name><surname>Hostetter</surname><given-names>Galen</given-names></name><role specific-use="author">Author</role><aff><institution>Van Andel Institute</institution><addr-line><named-content content-type="city">Grand Rapids</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Wu</surname><given-names>Xiangwei</given-names></name><role specific-use="author">Author</role><aff><institution>University of Texas</institution><addr-line><named-content content-type="city">Texas</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Huang</surname><given-names>Shixia</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Shroyer</surname><given-names>Noah</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Bing</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Williams</surname><given-names>Bart</given-names></name><role specific-use="author">Author</role><aff><institution>Van Andel Research Institute</institution><addr-line><named-content content-type="city">Grand Rapids</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Liu</surname><given-names>Qingyun</given-names></name><role specific-use="author">Author</role><aff><institution>Brown Foundation Institute of Molecular Medicine, University of Texas Medical School at Houston</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Lin</surname><given-names>Xia</given-names></name><role specific-use="author">Author</role><aff><institution>First Affiliated Hospital Zhejiang University</institution><addr-line><named-content content-type="city">Hangzhou</named-content></addr-line><country>United States</country></aff></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Yi</given-names></name><role specific-use="author">Author</role><aff><institution>Baylor College of Medicine</institution><addr-line><named-content content-type="city">Houston</named-content></addr-line><country>United States</country></aff></contrib></contrib-group></front-stub><body><p>The following is the authors’ response to the original reviews.</p><disp-quote content-type="editor-comment"><p><bold>Public Reviews:</bold></p><p><bold>Reviewer #1 (Public Review)</bold>:</p><p>Summary:</p><p>In this manuscript, the authors provide strong evidence that the cell surface E3 ubiquitin ligases RNF43 and ZNRF3, which are well known for their role in regulating cell surface levels of WNT receptors encoded by FZD genes, also target EGFR for degradation. This is a newly identified function for these ubiquitin ligases beyond their role in regulating WNT signaling. Loss of RNF43/ZNRF3 expression leads to elevated EGFR levels and signaling, suggesting a potential new axis to drive tumorigenesis, whereas overexpression of RNF43 or ZNRF3 decreases EGFR levels and signaling. Furthermore, RNF43 and ZNRF3 directly interact with EGFR through their extracellular domains.</p><p>Strengths:</p><p>The data showing that RNF43 and ZNRF3 interact with EGFR and regulate its levels and activity are thorough and convincing, and the conclusions are largely supported.</p><p>Weaknesses:</p><p>While the data support that EGFR is a target for RNF43/ZNRF3, some of the authors' interpretations of the data on EGFR's role relative to WNT's roles downstream of RNF43/ZNRF3 are overstated. The authors, perhaps not intentionally, promote the effect of RNF43/ZNRF3 on EGFR while minimizing their role in WNT signaling. This is the case in most of the biological assays (cell and organoid growth and mouse tumor models). For example, the conclusion of &quot;no substantial activation of Wnt signaling&quot; (page 14) in the prostate cancer model is currently not supported by the data and requires further examination. In fact, examination of the data presented here indicates effects on WNT/b-catenin signaling, consistent with previous studies.</p><p>Cancers in which RNF43 or ZNRF3 are deleted are often considered to be &quot;WNT addicted&quot;, and inhibition of WNT signaling generally potently inhibits tumor growth. In particular, treatment of WNT-addicted tumors with Porcupine inhibitors leads to tumor regression. The authors should test to what extent PORCN inhibition affects tumor (and APC-min intestinal organoid) growth. If the biological effects of RNF43/ZNRF3 loss are mediated primarily or predominantly through EGFR, then PORCN inhibition should not affect tumor or organoid growth.</p></disp-quote><p>We thank the reviewer’s appreciation of the key strength of our study. We fully agree with the reviewer that RNF43/ZNRF3 play key roles in restraining WNT signaling and their deletions activate WNT signaling that leads to cancer promotion, as discussed and cited in our manuscript (Hao et al, 2012; Koo et al, 2012). We have revised the language in this manuscript to avoid any confusion or appearance of downplaying this known signaling pathway in cancer progression.</p><p>What we would like to highlight in this work is that our study uncovered an effect of RNF43/ZNRF3 on EGFR, leading to biological impact in multiple model systems. In particular, we included the APC-mutated human cancer cell line HT29 and Apc min mouse intestinal tumor organoids. In the context of APC mutations, β-catenin stabilization and the activation of WNT target genes are essentially decoupled from upstream WNT ligand binding to WNT receptors, thus we could primarily focus on the effect of RNF43/ZNRF3 on EGFR. Our statement of “no substantial activation of WNT signaling” as cited by the reviewer was made in describing the data in Fig. 7E where we did not observe β-catenin accumulation in the nucleus and reasoned no substantial activation of canonical WNT signaling. We agree that further examination would help strengthen the conclusion and appreciate the reviewer’s suggestion of PORCN inhibition experiments. While PORCN inhibition is a valuable experiment in models with abundance of WNT ligands/receptors and non-mutationally activated regulators of WNT signaling (Yu et al, 2020), in biological scenarios with existing APC mutations, another group has previously demonstrated that PORCN inhibition had no observable effect on WNT signaling in APC-deficient cells (PMID: 29533772). In our initial submission, we confirmed this predicted low response to manipulation of WNT signaling components upstream of a mutated APC. We showed that addition of RSPO1 <italic>in Apc min</italic> mouse intestinal tumor organoids failed to further activate WNT target expression (Fig. 6G). Furthermore, in this revised manuscript, we added new data on EGFR inhibition and PORCN inhibition in WT and <italic>Znrf3</italic> KO MEFs (Fig. 6L). PORCN inhibition had no impact on cell growth in neither WT nor <italic>Znrf3</italic> KO MEFs, suggesting that <italic>Znrf3</italic> KO promoting MEF growth is WNT independent. In contrast, inhibition of EGFR downstream signaling components (Fig. 6L) significantly blocked MEF growth and abolished the impact of <italic>Znrf3</italic> KO in MEF growth. This new evidence further supports our main conclusion that RNF43/ZNRF3 controls EGFR signaling to regulate cell growth.</p><disp-quote content-type="editor-comment"><p><bold>Reviewer #2 (Public Review):</bold></p><p>Using proteogenomic analysis of human cancer datasets, Yu et al, found that EGFR protein levels negatively correlate with ZNFR3/RNF43 expression across multiple cancers. Interestingly, they found that CRC harbouring the frequent RNF43 G659Vfs*41 mutation exhibits higher levels of EGFR when compared to RNF43 wild-type tumors. This is highly interesting since this mutation is generally not thought to influence Frizzled levels and Wnt-bcatenin pathway activity. Using CRISPR knockouts and overexpression experiments, the authors show that EGFR levels are modulated by ZNRF3/RNF43. Supporting these findings, modulation of ZNRF3/RNF43 activity using Rspondin also leads to increased EGFR levels. Mechanistically, the authors, show that ZNRF3/RNF43 ubiquitinate EGFR and leads to degradation. Finally, the authors present functional evidence that loss of ZNRF3/RNF43 unleashes EGFR-mediated cell growth in 2D culture and organoids and promotes tumor growth in vivo.</p></disp-quote><p>Overall, the conclusions of the manuscript are well supported by the data presented, but some aspects of the mechanism presented need to be reinforced to fully support the claims made by the authors. Additionally, the title of the paper suggests that ZNRF3 and RNF43 loss leads to the hyperactivity of EGFR and that its signalling activity contributes to cancer initiation/progression. I don't think the authors convincingly showed this in their study.</p><p>We thank the reviewer commenting that our “conclusions of the manuscript are well supported by the data presented.” We address the concerns raised by this reviewer in an itemized way as detailed below:</p><disp-quote content-type="editor-comment"><p>Major points:</p><p>(1) EGFR ubiquitination. All of the experiments supporting that ZNFR3/RNF43 mediates EGFR ubiquitination are performed under overexpression conditions. A major caveat is also that none of the ubiquitination experiments are performed under denaturing conditions. Therefore, it is impossible to claim that the ubiquitin immunoreactivity observed on the western blots presented in Figure 4 corresponds to ubiquitinated-EGFR species. Another issue is that in Figure 4A, the experiments suggest that the RNF43-dependent ubiquitination of EGFR is promoted by EGF. However, there is no control showing the ubiquitination of EGFR in the absence of EGF but under RNF43 overexpression. According to the other experiments presented in Figures 4B, 4C, and 4F, there seems to be a constitutive ubiquitination of EGFR upon overexpression. How do the authors reconcile the role of ZNRF3/RNF43 vs c-cbl?</p></disp-quote><p>We agree with this reviewer of the limitation of overexpression experiments. In this manuscript, we actually leveraged both overexpression and knockout systems to demonstrate that ZNRF3/RNF43 regulates EGFR ubiquitination: in Fig 4A, we showed that overexpression of RNF43 increased EGFR ubiquitination; in Fig 4B&amp;C and Fig S3A, we showed that RNF43 knockout decreased EGFR ubiquitination; in Fig 4F, we showed that overexpression of ZNRF3 WT increased EGFR ubiquitination but overexpression of ZNRF3 RING domain deletion mutant failed to increase EGFR ubiquitination.</p><p>We also appreciate the rigor with which the reviewer has approached our methodology. We acknowledge that denaturing conditions can provide additional validation, but the technical challenges associated with denaturing conditions include the potential disruption of epitope structures recognized by these antibodies. Our methodology was chosen to balance the need for accurate detection with the preservation of protein structure and function, which are crucial for understanding the biological implications of EGFR ubiquitination. Moreover, our immunoprecipitation and subsequent Western blotting were stringent with high SDS and 2-ME, optimized to minimize non-specific binding and enhance the specificity of detection. We believe that the data presented are robust and contribute significantly to the existing body of knowledge on EGFR ubiquitination.</p><p>CBL is a well-known E3 ligase of EGFR, and it induces EGFR ubiquitination upon EGF ligand stimulation. Therefore, in order to have a fair comparison of RNF43 and CBL on EGFR ubiquitination, we designed Fig 4A and related experiments in the setting of EGF stimulation. We observed that RNF43 overexpression increased EGFR ubiquitination as potently as CBL did. Following this result, we further demonstrated that knockout of <italic>RNF43</italic> decreased endogenous ubiquitinated EGFR level in the unstimulated/basal condition (Fig 4B) as well as in the EGF-stimulated condition (Fig 4C). We acknowledge the importance and interest in fully understanding how ZNRF3/RNF43 interplays with the functions of CBL in regulating EGFR ubiquitination. This line of investigation indeed holds the potential to uncover novel regulatory mechanisms in detail. However, the primary focus of the current study was to establish a foundational understanding of ZNRF3/RNF43 role in regulating EGFR ubiquitination. We look forward to exploring further in future work.</p><disp-quote content-type="editor-comment"><p>(2) EGFR degradation vs internalization. In Figure 3C, the authors show experiments that demonstrate that RNF43 KO increases steady-state levels of EGFR and prevents its EGF-dependent proteolysis. Using flow cytometry they then present evidence that the reduction in cell surface levels of EGFR mediated by EGF is inhibited in the absence of RNF43. The authors conclude that this is due to inhibition of EGF-induced internalization of surface EGF. However, the experiments are not designed to study internalization and rather merely examine steady-state levels of surface EGFR pre and post-treatment. These changes are an integration of many things (retrograde and anterograde transport mechanisms presumable modulated by EGF). What process(es) is/are specifically affected by ZNFR3/RNF43? Are these processes differently regulated by c-cbl? If the authors are specifically interested in internalization/recycling, the use of cell surface biotinylation experiments and time courses are needed to examine the effect of EGF in the presence or absence of the E3 ligases.</p></disp-quote><p>We agree that our study design primarily assesses EGFR levels on the cell surface before and after EGF treatment and does not comprehensively measure the whole internalization process. In response to the reviewer’s comments, we have revised the relevant sections of manuscript to clarify that our current findings are focused on changes in cell surface EGFR and do not extend to the detailed mechanisms of EGF-induced internalization or recycling.</p><disp-quote content-type="editor-comment"><p>(3) RNF43 G659fs*41. The authors make a point in Figure 1D that this mutant leads to elevated EGFR in cancers but do not present evidence that this mutant is ineffective in mediated ubiquitination and degradation of EGFR. As this mutant maintains its ability to promote Frizzled ubiquitination and degradation, it would be important to show side by side that it does not affect EGFR. This would perhaps imply differential mechanisms for these two substrates.</p></disp-quote><p>Fig 1D is based on bioinformatic analysis of colon cancer patient samples, showing that RNF43 G659Vfs*41 mutant tumors exhibited significantly higher levels of EGFR protein compared to RNF43 WT tumors. Following this lead, we investigated whether this <italic>RNF43 G659fs*41</italic> hotspot mutation lost its role in downregulating EGFR. To this end, we transfected the same amount of control vector, RNF43 WT, RING deletion mutant, G659fs*41 mutant DNA into 293T cells and measured the level of EGFR (co-transfected). As shown in Author response image 1, overexpression of RNF43 WT decreased EGFR level while overexpression of RING deletion mutant had no impact on EGFR level as compared with the Vector group, which is consistent with our findings in the manuscript. Cells transfected with the RNF43 G659Vfs*41 mutant exhibited nearly normal levels of EGFR; however, we also observed that RNF43 G659Vfs*41 was less expressed than WT, even though the same amounts of DNA were transfected. Therefore, the insubstantial impact on EGFR levels could be attributed to both functional loss or compromised stability of <italic>RNF43 G659Vfs*41</italic> mRNA or protein. Further investigation on <italic>RNF43 G659Vfs*41</italic> mRNA and protein stability vs. RNF43 G659Vfs*41 protein function is needed to draw a solid conclusion.</p><fig id="sa3fig1" position="float"><label>Author response image 1.</label><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-sa3-fig1-v1.tif"/></fig><disp-quote content-type="editor-comment"><p>(4) &quot;Unleashing EGFR activity&quot;. The title of the paper implies that ZNRF3/RNF43 loss leads to increased EGFR expression and hence increased activity that underlies cancer. However, I could find only one direct evidence showing that increased proliferation of the HT29 cell line mutant for RNF43 could be inhibited by the EGFR inhibitor Erlotinib. All the other evidence presented that I could find is correlative or indirect (e.g. RPPA showing increased phosphorylation of pathway members upon RNF43 KO, increased proliferation of a cell line upon ZNRF3/ RNF43 KO, decreased proliferation of a cell line upon ZNRF3/RNF43 OE in vitro or in xeno...). Importantly, the authors claim that cancer initiation/ progression in ZNRF3/RNF43 mutants may in some contexts be independent of their regulation of Wnt-bcatenin signaling and relying on EGFR activity upregulation. However, this has not been tested directly. Could the authors leverage their znrf3/RNF43 prostate cancer model to test whether EGFR inhibition could lead to reduced cancer burden whereas a Frizzled or Wnt inhibitor does not?</p><p>More broadly, if EGFR signaling were to be unleashed in cancer, then one prediction would be that these cells would be more sensitive to EGFR pathway inhibition. Could the authors provide evidence that this is the case? Perhaps using isogenic cell lines or a panel of patient-derived organoids (with known genotypes).</p></disp-quote><p>We appreciate the reviewer’s suggestion to provide more direct evidence demonstrating the importance of the ZNRF3/RNF43-EGFR axis in cancer cell proliferation. In this revised manuscript, we further studied this issue in the WT vs. <italic>Znrf3</italic> KO MEF cells. We observed that treatment with the EGFR inhibitor erlotinib did not affect WT MEF but stunted the growth advantage of <italic>Znrf3</italic> KO MEF cells (Fig. 6L). On the other hand, treatment with the porcupine inhibitor C59 did not impact either WT or <italic>Znrf3</italic> KO MEF cells (Fig. 6L), suggesting a more important role of the ZNRF3/RNF43-EGFR axis in mediating the enhanced cell growth of MEF caused by <italic>Znrf3</italic> knockout. Furthermore, considering EGFR is often mutated in human cancer, to increase the clinical relance of our study, we also tested the effect of RNF43 knockout on EGFR L858R (Fig. 2D), a common oncogenic EGFR mutant, and found that <italic>RNF43</italic> knockout in HT29 boosted levels of this EGFR mutant detected by its FLAG tag, suggesting that RNF43 degrades both WT and mutated EGFR and its loss can enhance signaling of both WT EGFR and its oncogenic mutant . However, we emphasize again that this manuscript is in no way written to diminish the proven importance of ZNRF3/RNF43-WNT-β-catenin axis in cancer and development.</p><disp-quote content-type="editor-comment"><p><bold>Recommendations for the authors:</bold></p><p><bold>Reviewer #1 (Recommendations For The Authors):</bold></p><p>The main conclusion that EGFR is targeted for degradation by RNF43 and ZNRF3 is well supported and documented. Figures 1-5 and associated supplemental figures contain largely convincing data. Figures 6 and 7, however, require some modifications, as follows in order of appearance:</p><p>Figure 6C: Growth of intestinal tumor organoids from Apcmin mice does not require Rspo, however, the authors show that these organoids grow larger in the presence of Rspo, an effect they attribute to increased EGFR activity, rather than increased WNT activity. While this conclusion may be correct, the authors should address this possibility by treating the organoids with PORCN inhibitor. The prediction would be that Rspo treatment still increases organoid size in the presence of PORCN inhibition. A further prediction would be that blocking EGFR (e.g. with Cetuximab) will abrogate the RSPO1 effect.</p></disp-quote><p>Yes, we attributed the impact of Rspo on Apc min organoid growth to enhanced EGFR activity because we observed increased EGFR levels (Fig 6F) but no detectable increase in eight WNT target genes assayed. We agree that further pharmacologic experiments would further boost our conclusion, but our few attempts at treating organoids encountered technical difficulties. Hence, we switched to testing PORCN inhibition vs EGFR inhibition in WT and <italic>Znfr33</italic> KO MEFs. As shown in the revised Fig. 6L, EGFR inhibition significantly reversed the growth advantage caused by <italic>Znrf3</italic> KO but C59 did not.</p><disp-quote content-type="editor-comment"><p>Figure 6G: It is unclear why the authors provide &quot;8-day RSPO1 treatment&quot; data. Here, EGFR mRNA appears to be elevated 2-fold (perhaps not statistically significant), and the Wnt targets Lef1 and Axin2 are decreased, as indicated by the statistical significance. What point is being made here?</p></disp-quote><p>Our observation of increased size of APC min mouse intestinal tumor organoids and increased the EGFR protein levels were at 8 days of RSPO1 treatment. Therefore, we measured mRNA levels at the same time point with the 2-day time point also included for comparison. The goal of this qPCR experiment was to detect the contribution of WNT signaling, and we did not detect an increased transcriptional readout. We included EGFR mRNA levels for comparison, and we did not detect a statistically significant increase, consistent with our experiments concluding that ZNRF3/RNF43 regulate EGFR at the protein level. As stated in the preceding response, these data led us to attribute the impact of Rspo on Apc min organoid growth to enhanced EGFR activity.</p><disp-quote content-type="editor-comment"><p>Figure 7A: This requires quantitation. How many mice were used per cell line? The data shown is not particularly convincing, with ZNRF3 overexpressing HT29 cells growing detectably. Showing representative mice is fine, but this should be supplemented with quantitation of all mice.</p></disp-quote><p>We had provided this data. The BLI signal quantification was shown below the representative BLI images. Seven mice were used per cell line, as annotated at the top of the graph.</p><disp-quote content-type="editor-comment"><p>Figure 7B: The authors assert that &quot;canonical WNT signaling, based on levels of active-β-Catenin (non-phosphorylated at Ser33/37/Thr41; Figure 7B), remained unaffected&quot;. As shown, 2 of the 3 Myc-Znrf3 tumors have increased active-b-catenin signal over the GFP tumors. This indicates to me that canonical Wnt signaling was affected. The authors either need to present quantitative data that supports this claim or modify their conclusions. As presented, I don't think it is appropriate to decouple the effect of Znrf3 overexpression on EGFR from its effect on WNT.</p></disp-quote><p>As requested, we have quantified the level of non-phospho β-Catenin at Ser33/37/Thr41 and found no significant differences (p &gt; 0.05) between the control group vs. ZNRF3 overexpression group. We once again note that our manuscript was not meant to dispute the proven signaling and biological significance of WNT signaling regulation by ZNRF3/RNF43, and we have proof-read the manuscript multiple times to ensure that we did not make any generalized or misleading statements in this aspect.</p><fig id="sa3fig2" position="float"><label>Author response image 2.</label><graphic mimetype="image" mime-subtype="tiff" xlink:href="elife-95639-sa3-fig2-v1.tif"/></fig><disp-quote content-type="editor-comment"><p>Figure 7E: Here the authors assert that &quot;no substantial activation of canonical Wnt signaling&quot; in the Z&amp;R KO tumors, however, the figure shows a substantial increase in active b-catenin staining. The current resolution is insufficient to claim that there is no increase in nuclear b-catenin. The authors' claim that WNT signaling is not involved here is not supported by the data presented here. One way to demonstrate that this effect is through EGFR activation and not through WNT activation is to treat mice with PORCN inhibitor. WNT-addicted tumors, such as by Rnf43 or Znrf3 deletion, regress upon PORCN inhibition. In this case, if the effect of Z&amp;R KO is mediated through EGFR rather than WNT, then there should be no effect on tumor growth upon PORCN inhibition. This is a critical experiment in order to make this point.</p></disp-quote><p>We appreciate the reviewer’s comments and suggestion of experiments. We based our initial statement on insubstantial nuclear β-catenin staining, but we agree that immunohistochemical staining lacks the resolution suitable for quantification. We could not generate the adequate number of KO animals for these in vivo experiments in the window of time planned for this revision. Rather, as shown in the newly added Fig. 6L, we tested EGFR inhibition and PORCN inhibition in <italic>Znrf3</italic> KO MEFs and obtained strong data further supporting EGFR in mediating <italic>Znrf3</italic> KO promotion of MEF growth. Notwithstanding, we have carefully revised our description of the in vivo data in Fig 7E to avoid any confusion or over-interpretation.</p><disp-quote content-type="editor-comment"><p>Minor points:</p><p>Figure 2A: provide quantitation of this immunoblot.</p></disp-quote><p>We have revised manuscript with quantification result shown next to the immunoblot.</p><disp-quote content-type="editor-comment"><p>Figure 2B: provide more detail in the figure legend and in the Materials and Methods section on how the KO MEFs were generated. Confirmation that Znrf3 (or in cases of Rnf43 KO) expression is lost in KO would be advisable.</p></disp-quote><p>We have confirmed <italic>Znrf3</italic> KO by genotyping and <italic>RNF43</italic> KO by immunofluorescent staining. We have also tested multiple commercial anti-ZNRF3 antibodies and anti-RNF43 antibodies for Western blotting, but they all failed.</p><disp-quote content-type="editor-comment"><p>Figure 4C is a little misleading. The schematic indicates that ECD-TM and TM-ICD truncations were analyzed for both ZNRF3 and RNF43. However, Figure 4 only shows data for ZNRF3, and the corresponding Figure S4 lacks data for the TM-ICD of Rnf43. A recommendation is to show only those schematics for which data is presented in that figure. On a related topic, the results using the deltaRING constructs (Figure S5) are not mentioned/described in the text.</p></disp-quote><p>We think that the reviewer meant Fig 5C. We have revised the Fig 5C by removing the RNF43 label, and we confirm that Results section does include the data in Fig S5.</p><disp-quote content-type="editor-comment"><p>Figure S4A: Only ZNRF3 is indicated in this figure. Please explain why RNF43 is not represented here. Also, indicate what is plotted along the x-axis.</p></disp-quote><p>We only detected the endogenous ZNRF3-EGFR interaction, possibly because the RNF43 protein level is relatively low in the cell line we used for the mass spec experiment. X-axis is the proteins ordered based on Y-axis values as detailed in the figure legend -- each data point was arranged along the x axis based on the fold change of iBAQ of EGFR-associated proteins identified in EGF-stimulated vs. control in the log2 scale, from low to high (from left to right on x axis). We have added the phrase “Proteins detected by Mass-Spec” for X-axis.</p><disp-quote content-type="editor-comment"><p><bold>Reviewer #2 (Recommendations For The Authors):</bold></p><p>Minor Points.</p><p>(1) In Figure 2B, the authors claim that Znrf3 KO enhanced both EGFR and p-EGFR levels both in the absence and presence of EGF. Although it is clear in the presence of EGF, the increased in p-EGFR in the absence of EGF is less than clear.</p></disp-quote><p>We have revised the manuscript to more clearly state the result in Fig 2B.</p><disp-quote content-type="editor-comment"><p>(2) Importantly the authors validated their findings using three independent RNF43 gRNA (fig S2D) but they do not show the editing efficiency obtained with the gRNA.</p></disp-quote><p>We did not include RNF43 IB in this Figure due to lack of specific antibodies for detecting RNR43 in IB. We have no reasons to doubt adequate efficiency of knockout since EGFR was increased compared to the control group. As a result, we did not perform deep sequencing to validate knockout efficacy.</p><disp-quote content-type="editor-comment"><p>(3) In S2E, the authors show that KO of either ZNRF3 or RNF43 enhance HER2 levels. This suggests that there is no redundancy between these E3 ligases, at least in this context. How do the authors reconcile that?</p></disp-quote><p>The reviewer raised an interesting issue. Due to the lack of WB antibodies for these two proteins, we would not easily assess the feedback impact of knockout of either gene on the protein levels of the other gene. We speculate that there may be a threshold level of the sum of the two proteins that is needed for adequate degradation of HER2, leading to HER2 increase when either gene is knocked out. Detailed studies of this issue is beyond the scope of this current work.</p><disp-quote content-type="editor-comment"><p>(4) Experiments performed in Fig 3C are performed in only one clone. The authors need to repeat in an additional clone or rescue this phenotype using a RNF43 cDNA.</p></disp-quote><p>Our RNF43 KO HT29 line is a pool of KO cells, not a single clone.</p><disp-quote content-type="editor-comment"><p>(5) In Figure 7E, the authors suggest that the absence of nuclear bcatenin means that canonical Wnt signaling is unaffected. It is widely known that nuclear bcatenin is often not correlating with pathway activity.</p></disp-quote><p>As stated above, we have revised the manuscript to avoid confusion and misinterpretation.</p><disp-quote content-type="editor-comment"><p>(6) What is the nature of the error bars in Fig 3c? Are the differences statistically significant?</p></disp-quote><p>As mentioned in the figure legend, the error bars are SEM. The result is statistically significant, and p-value is noted in the graph.</p><disp-quote content-type="editor-comment"><p>(7) In the Figure legends, it should be stated clearly how many biological replicates were performed for each experiment and single data points should be plotted where applicable (e.g. qPCR data). It would be helpful if the uncropped and unprocessed Western blot membranes and replicates that are not shown would be accessible to allow the reader a more comprehensive view of the acquired data, especially for blots that were quantified (e.g. Figure 2F, Figure 3C, there is clearly some defect on the blot).</p><p>For WB representation, it would be helpful to include more size markers on the Western blots (especially on the Ips that show ubiquitin smear) and in general to use a reference protein (GAPDH, Actin, Vinculin) that is closer to the protein being accessed.</p><p>More details should be added in the Methods section to explain how protocols were performed in detail. For example, it should be explained how the viruses used for infecting cells were produced (which plasmids were transfected using which transfection reagent, how long was the virus collected for, etc). Then, it should be stated how long the cells were undergoing selection before being harvested. Because the expression of the viral constructs potentially has an effect on cell proliferation through EGFR, this information is quite relevant. This is just an example, there are details missing in nearly every section (Flow: washing protocols, gating protocols (Live/dead stain?), WB: RIPA lysis buffer composition? How much protein was loaded on blots? How was protein quantification done? IP: how were washes performed and how often repeated?)</p><p>Missing: antibody dilutions for IF, IHC, and WB, plasmid backbones, sequences and availability, qPCR primer sequences from Origene.</p><p>Incucyte experiments are not described.</p></disp-quote><p>We have revised the relevant sections to include more details.</p><disp-quote content-type="editor-comment"><p>(8) Line 141: revise text: 2x mRNA abundance in the same sentence.</p><p>Line 162: define intermediate expression better.</p><p>Line 197/198: revise text ('the predominant one'?).</p><p>Line 218/219: revise text (Internalisation of surface EGFR?).</p><p>Line 245: clarify in text that it is endogenous EGFR that is being pulled down.</p><p>Line 264: typo: conserved instead of conservative.</p><p>Line 324: revise text (What does 'unknown significance' mean).</p><p>Line 396/397: revise text: 2x Co-IP in the same sentence.</p><p>Figure 3 D/E: more details on the Method in the figure legend.</p></disp-quote><p>We have revised them accordingly.</p></body></sub-article></article>