Shedding of epidermal growth factor receptor is a regulated process that occurs with overexpression in malignant cells

Shedding of epidermal growth factor receptor is a regulated process that occurs with overexpression in malignant cells

E X PE R IM EN TA L CE L L RE S E ARCH 314 ( 20 0 8) 29 07–2 918 a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m w w w. e l s e v i e...

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a v a i l a b l e a t w w w. s c i e n c e d i r e c t . c o m

w w w. e l s e v i e r. c o m / l o c a t e / y e x c r

Research Article

Shedding of epidermal growth factor receptor is a regulated process that occurs with overexpression in malignant cells Marianela Perez-Torres a,1, Blanca L. Valle a,1, Nita J. Maihle b , Lisandra Negron-Vega a , Rene Nieves-Alicea a , Elsa M. Cora a,⁎ a b

Department of Biochemistry, University of Puerto Rico-Medical Sciences Campus, PO Box 365067 San Juan, 00936-5067 Puerto Rico Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA

A R T IC L E I N F O RM AT I O N

A B ST R AC T

Article Chronology:

Soluble isoforms of the epidermal growth factor receptor (sEGFR) previously have been identified

Received 31 May 2005

in the conditioned culture media (CCM) of the vulvar adenocarcinoma cell line, A431 and within

Revised version received 2 July 2008

exosomes of the keratinocyte cell line HaCaT. Here, we report that the extracellular domain (ECD)

Accepted 16 July 2008

of EGFR is shed from the cell surface of human carcinoma cell lines that express 7 × 105 receptors/

Available online 25 July 2008

cell or more. We purified this proteolytic isoform of EGFR (PI-sEGFR) from the CCM of MDA-MB468 breast cancer cells. The amino acid sequence of PI-sEGFR was determined by reverse-phase

Keywords:

HPLC nano-electrospray tandem mass spectrometry of peptides generated by trypsin,

EGFR

chymotrypsin or GluC digestion. The PI-sEGFR protein is identical in amino acid sequence to the

Ectodomain shedding

EGFR ECD. The release of PI-sEGFR from MDA-MB-468 cells is enhanced by phorbol 12-myristate

Soluble receptors

13-acetate, heat-inactivated fetal bovine serum, pervanadate, and EGFR ligands (i.e., EGF and TGF-

Metalloproteases

α). In addition, 4-aminophenylmercuric acetate, an activator of metalloproteases, increased PIsEGFR levels in the CCM of MDA-MB-468 cells. Inhibitors of metalloproteases decreased the constitutive shedding of EGFR while the PMA-induced shedding was inhibited by metalloprotease inhibitors, by the two serine protease inhibitors leupeptin and 3,4-dichloroisocoumarin (DCI), and by the aspartyl inhibitor pepstatin. These results suggest that PI-sEGFR arises by proteolytic cleavage of EGFR via a mechanism that is regulated by both PKC- and phosphorylation-dependent pathways. Our results further suggest that when proteolytic shedding of EGFR does occur, it is correlated with a highly malignant phenotype. Published by Elsevier Inc.

Introduction Epidermal growth factor receptor (EGFR/ErbB1) is the prototypic member of the ErbB receptor tyrosine kinase family. This family includes ErbB2 (Her2, Neu), ErbB3, and ErbB4 receptors. These receptors participate in the regulation of normal cellular growth and

differentiation [1]. EGFR is a 170-kDa transmembrane protein which is subdivided into three sub domains: a highly glycosylated extracellular domain (comprising amino acids 1–621), a single transmembrane domain (amino acids 622–644), and a cytoplasmic domain (amino acids 645–1186) which has intrinsic tyrosine kinase activity [2]. EGFR overexpression has been reported in a majority of

⁎ Corresponding author. Fax: +1 787 274 8724. E-mail address: [email protected] (E.M. Cora). Abbreviations: EGFR, epidermal growth factor receptor; PI-sEGFR, proteolytic isoform — soluble EGFR; EGF, epidermal growth factor; TGF-α, transforming growth factor alpha; HB-EGF, heparin binding EGF-like growth factor; CCM, conditioned culture media; FBS, fetal bovine serum; PMA, phorbol 12-myristate 13-acetate; PKC, protein kinase C; LPA, lysophosphatidic acid; TACE, Tumor necrosis factor alpha converting enzyme 1 These authors contributed equally to this work. 0014-4827/$ – see front matter. Published by Elsevier Inc. doi:10.1016/j.yexcr.2008.07.013

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human carcinomas, including tumors of the head and neck [3], lung [4], colon [4], breast [5] and ovary [6,7]. Furthermore, overexpression of EGFR has been correlated with loss of estrogen receptor and poor prognosis in breast cancer patients [5]. In addition to the full-length transmembrane forms of the ErbB receptors, normal and malignant cells express soluble isoforms of these receptors, which are comprised of only the extracellular domain of the receptor. These soluble receptor isoforms are generated by either limited proteolytic cleavage of the transmembrane receptor, as illustrated by ErbB2 [8] and ErbB4 [9], and more recently by EGFR [10]; or by translation of several alternative transcripts (rev. in [7]) as is the case for EGFR [11,12], ErbB2 [13], and ErbB3 [14]. Ectodomain shedding is a common process among many structurally and functionally unrelated transmembrane proteins [15–17]. This shedding is often activated by several factors, including protein kinase C (PKC) [9,18], protein phosphorylation [19,20], calcium ionophores [21,22], and serum components [23]. The shedding of the majority of integral membrane proteins is regulated by a PKC-dependent signaling mechanism [15]. In this regard, the shedding of the ErbB4 receptor in transfected fibroblasts occurs via a proteolytic cleavage event regulated by a PKC-dependent mechanism [9]. In contrast, the shedding of the ErbB2 receptor in breast cancer cells occurs by way of a PKC-independent mechanism [20], and the shedding of ErbB2 and ErbB4 receptors is dependent on phosphorylation/dephosphorylation events [19,20]. Inhibitor studies and functional experiments suggest that there is a common system for membrane ectodomain shedding involving one or more proteolytic activities sensitive to metalloprotease inhibitors [15,24]. In this regard, Peschon et al. [24] have reported that fibroblasts from TNF-α-converting enzyme (TACE) knockout mice are defective in the shedding of TNF-α and several other transmembrane proteins, including TGF-α and L-selectin. Members of two distinct metalloprotease families, i.e., MMPs (matrix metalloproteases) and the ADAMs (a disintegrin and metalloprotease), have been implicated in the shedding of most transmembrane proteins, including members of the ErbB family of receptors and the EGF-like growth factors [25,26]. Shedding of ErbB4 is dependent on ADAM17/ TACE in fibroblasts expressing ErbB4 [27], while the shedding of ErbB2 is mediated by ADAM 10 in breast cancer cells overexpressing ErbB2 [28]. TACE cleaves TGF-α [24], while ADAM 9, ADAM 12, MMP2, MMP-3, MMP-7 and MMP-9, among others, have been implicated in the shedding of HB-EGF [29–32]. Previously, it was reported that EGFR was poorly shed. In this regard, Vecchi et al. [9] did not detect proteolytic cleavage of EGFR in NIH 3T3 cells expressing the receptor after treatment of the cells with phorbol esters. Similarly, Brakebusch et al. [33] could detect small amounts of a soluble form of EGFR in the supernatant of transfected COS-7 cells, but the release of this soluble receptor was not affected by phorbol esters. However, a soluble isoform of EGFR was detectable in the human vulvar carcinoma cell line, A431 [34]. This EGFR isoform is different from the previously identified 115 kDa EGFR isoform in A431 cells [35], which is the product of an aberrant 2.8-kb transcript [2]. While this manuscript was in revision, the shedding of EGFR also has been reported within the exosomes secreted by the immortalized keratinocyte cell line HaCaT [10]. Here, we report the release of a soluble isoform of EGFR into the CCM of malignant cells that express 7 × 105 or more receptors/cell. We have characterized this shed isoform of EGFR, which here we designate as the proteolytic isoform of EGFR (i.e., PI-sEGFR), from CCM of the

mammary adenocarcinoma cell line MDA-MB-468. We demonstrate that in this cell line, PI-sEGFR is generated by proteolytic cleavage of the full-length receptor. In addition, we demonstrate that shedding of EGFR in MDA-MB-468 cells is stimulated by different factors including PMA, serum, pervanadate, and the EGFR ligands EGF and TGF-α, and that this shedding is mediated, at least in part, by a metalloprotease. We provide evidence that strongly suggests that the mechanism by which EGFR shedding is regulated involves both PKC and phosphorylation.

Materials and methods Materials and reagents Fetal bovine serum (FBS), chloroquine, leupeptin, hydrogen peroxide, EDTA, glycerol, sodium orthovanadate, cycloheximide, γ-secretase inhibitor L-685, 458, N-tosyl-L-phenylalanine chloromethyl ketone (TPCK), 3,4-dichloroisocoumarin (DCI), transepoxysuccinyl-L-leucylamido-(4-guanidino) butane (E-64), phorbol 12-myristate 13-acetate (PMA), 4α-phorbol 12,13-didecanoate (α-PMA), phorbol 12,13-didecanoate (β-PMA), epidermal growth factor (EGF), and transforming growth factor alpha (TGF-α) were purchased from Sigma-Chemical Co. (St. Louis, MO). Pervanadate was freshly prepared for each experiment by mixing equal volumes of sodium orthovanadate and H2O2 to a final concentration of 100 mM, and was used within 20 min of preparation [19]. Tissue inhibitor of metalloproteinases-1 (TIMP-1), TIMP-2, TIMP-3, GM6001, Tumor necrosis factor alpha protease inhibitor-2 (TAPI2), and 2-[1-(3-dimethylaminopropyl)-5-methoxyindeol-3-yl]-3(H-indol-3-yl) maleimide (Gö6983) were obtained from Calbiochem (La Jolla, CA).

Cell culture The breast adenocarcinoma cell lines MDA-MB-468, MDA-MB-231, BT-20, MCF-7, T47D, the non-tumorigenic epithelial cell line MCF10A, the ovarian carcinoma cell line CaOV3, and the head and neck squamous carcinoma cell line Detroit-562 were obtained from ATCC. The MDA-MB-468, MDA-MB-231, CaOV3 cells were grown in DMEM, MCF-7 and MCF-10A in DMEM-F12, T47D cells were grown in RPMI-1640 and the BT-20 and Detroit-562 cells were grown in MEM. Culture media were supplemented with 10 % heat-inactivated fetal bovine serum, 2 mM L-glutamine, 50 U/mL penicillin, 50 μg/mL streptomycin, and 0.3 μg/mL fungizone. Cell cultures were maintained at 37 °C in a 5 % CO2 atmosphere. For each treatment, cells (5 × 105) were seeded in 6-well tissue culture dishes and were grown to approximately 95% confluence, followed by washing with phosphate buffered saline (PBS), and serum starvation overnight. Unless otherwise indicated, cells were treated for 8 h, the conditioned culture media (CCM) was collected, centrifuged for 15 min at 13,000 rpm at 4 °C (Biofuge Fresco Refrigerated Microcentrifuge, Kendro Laboratory Products, Asheville, NC), and the levels of PI-sEGFR determined by immunoblot analysis or acridinium-linked immunosorbent assay [36].

Cell surface biotinylation MDA-MB-468 cells were plated in 60 mm dishes and grown until 90% confluence. Cells were washed three times with cold PBS,

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incubated with freshly prepared membrane impermeable SulfoNHS-Biotin reagent (1 μg/ml; Pierce) for 30 min at 4 °C. The reaction was quenched by adding 10 mM glycine in PBS and incubating for 10 min at 4 °C. Cells were washed twice with warm serum-free DMEM, and incubated for 0, 4, 8, 24 and 48 h at 37 °C. At the end of the incubation period, CCM was collected and filtered through a 0.2 μm low-binding filter, and cell lysates were prepared. Equal amount of total protein were immunoprecipitated with streptavidin, resolved in 7.5% SDS-PAGE, followed by immunoblot analysis using the MAb-15E11, which recognizes an epitope at the extracellular domain of EGFR [37]. Bands were analyzed by densitometry.

Purification of PI-sEGFR from the CCM of MDA-MB-468 cells To purify PI-sEGFR we used a previously described [38,39] immunoaffinity chromatography scheme. Briefly, MDA-MB-468 cells were grown as described above and changed to serum-free media. After 48 h, CCM was collected, supplemented with a cocktail of protease inhibitors (1 mM EDTA, 1 μg/ml Pepstatin A, 5 μg/ml Aprotinin, 1 mM PMSF, 12 nM carboxypeptidase inhibitor), and centrifuged at 4 °C for 135 min at 50,000 ×g, in a Beckman L8M Ultracentrifuge. Next, the CCM was supplemented with 20 mM HEPES, 1 mM EDTA, 6 mM 2-mercaptoethanol, 0.01% n-octylglucoside, and 10% glycerol, and filtered through a 0.45 μm membrane (Millipore, Bedford, MA). A monoclonal antibody specific for the extracellular domain of EGFR (MAb-528, Santa Cruz Biotechnologies, CA) was coupled to an agarose gel using AminoLink Plus Immobilization Kit (Pierce, Rockford, IL), according to the manufacturer's instructions. The supplemented CCM was applied onto the immunoaffinity column, and re-circulated overnight at a flow rate of 1.0 mL/min. The column was washed 3–5 times with one column volume of binding buffer (20 mM HEPES, 6 mM 2mercaptoethanol, 0.1% n-octylglucoside, 10% glycerol, 130 mM NaCl), 5 times with one column volume of binding buffer containing 1 M NaCl, and 3 times with 1 column volume of binding buffer containing 1 M urea. The soluble EGFR was eluted with binding buffer containing 6 M urea; elution fractions positive for EGFR, as shown by immunoblot analysis using a monoclonal antibody specific for the extracellular domain of EGFR (MAb15E11) [37], were pooled, dialyzed against PBS using Slide-A-Lyzer Dialysis Cassette (Pierce), and concentrated using a Centricon YM30 (Millipore, Bedford, MA). The purity of PI-sEGFR protein was assessed by Coomassie Blue Staining; the band corresponding to the soluble isoform of EGFR was excised and sent for digestion and sequence analysis to the Harvard Microchemistry Facility (Boston, MA). Sequence analysis was performed by reverse-phase HPLC nano-electrospray tandem mass spectrometry (mLC/MS/MS) on a Finnigan LCQ DECA XP quadrupole ion trap mass spectrometer.

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immunoblot analysis with a monoclonal antibody specific for the extracellular domain of EGFR (MAb-15E11) [37].

Immunoblot analysis Aliquots of CCM were mixed with 4X Laemmli sample buffer (250 mM Tris–HCl pH 6.8, 8% SDS, 40% glycerol, 20% 2mercaptoethanol, 4 mM EDTA, 0.08% bromophenol blue), separated in 10% SDS-PAGE or as indicated in each figure legend, and transferred to Immobilon-P polyvinylidene fluoride (PVDF) membrane (Millipore, Bedford, MA). Membranes were blocked with 5% non-fat dry milk (10 mM Tris–HCl pH 7.4, 150 mM NaCl, 5% non-fat dry milk, 0.04% sodium azide) overnight at 4 °C and for 1 h with Boehringer blocking solution (0.05% Boehringer blocking reagent, 10 mM Tris, 150 mM NaCl, 0.04% sodium azide) at room temperature. Membranes were incubated with a monoclonal antibody specific for the extracellular domain of EGFR (15E11) at a 1:10 dilution of CCM from hybridoma cells [37], washed three times with T-TBS (10 mM Tris–HCl pH 7.4, 150 mM NaCl, 0.1% Tween 20) and incubated with horseradish peroxidase conjugated rabbit affinity-purified antibody to mouse IgG1 (ICN Biomedicals Inc., Aurora, OH). Finally, membranes were washed 3 times in TTBS, incubated with an enhanced chemiluminescence system (ECL) from Amersham Biosciences (Piscataway, NJ), and exposed to X-ray film (XAR-2 Kodak). Bands were scanned and analyzed by imaging densitometry (ChemiDoc Gel Documentation System and Quantity One Software from BioRad).

Acridinium-linked immunosorbent assay (ALISA) To determine PI-sEGFR levels in the CCM, a sandwich-type acridinium-linked immunosorbent assay developed by Baron et al. [36] was used. Briefly, white Xenobind (Xenopore, Hawthorne, NJ) 96-well microtiter plates were coated with an affinity-purified goat anti-mouse IgG2b specific polyclonal antibody (SigmaChemical Co.) in 100 mM carbonate buffer pH 9.0 containing 0.02% sodium azide, blocked with ALISA blocking buffer (2.0% bovine serum albumin, 1 mM EGTA, 1 mM EDTA, 0.01% rabbit serum, 0.01% mouse serum) followed by incubation with: first, anti-EGFR extracellular domain-specific monoclonal antibody, EGFR.1 (Neomarkers, Fremont, CA), then either EGFR (for the standard curve) or with the samples, and finally with acridiniumlabeled anti-EGFR extracellular domain-specific monoclonal antibody, MAb-528 (Santa Cruz Biotechnology, Inc., Santa Cruz, CA). The relative light units were determined using a luminometer (MLX Microtiter Plate, Dynex Technologies, Chantilly, VA).

Results Deglycosylation of PI-sEGFR Aliquots of purified PI-sEGFR were treated with PNGase F (New England BioLabs Inc., Beverly, MA) as described by the manufacturer. Briefly, the protein was denatured in 1× denaturing buffer (0.5% SDS, 1% 2-mercaptoethanol) at 100 °C for 10 min. After denaturation, samples were supplemented with reaction buffer (50 mM sodium phosphate, pH 7.5 and 1% NP-40), followed by incubation in the presence or absence of PNGase F at 37 °C for 1 h. Treated samples were resolved in 10% SDS-PAGE, followed by

A soluble isoform of EGFR is released into the CCM by malignant cells that overexpress this receptor Previously, our group has isolated a soluble isoform of EGFR from human serum (p110 sEGFR), and has demonstrated that this isoform arises from a 3.0 kb alternative EGFR [12,39]. The breast adenocarcinoma cell line MDA-MB-468 expresses the p110 sEGFR 3.0 kb transcript [12] and also high levels of EGFR (1 × 106 per cell) [40]. Therefore, we decided to examine the CCM

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from MDA-MB-468 cells for the presence of p110 sEGFR expression. When the CCM of these cells was analyzed by immunoblot analysis using a monoclonal antibody specific for the extracellular domain of EGFR, we detected a soluble isoform of EGFR of approximately 110 kDa as assessed by SDS-PAGE (Fig. 1). However, a polyclonal antibody that recognizes an epitope unique to the alternate p110 sEGFR isoform [41] did not detect this protein (Fig. 5B). These results suggested that the protein in the CCM of MDA-MB-468 cells was distinct from the EGFR, but was different from p110 sEGFR isoform. This soluble isoform of EGFR was detected in the CCM of MDA-MB-468 cells as early as 50 min (data not shown) and increased over a 24-hour time course (Fig. 1). The release of this soluble EGFR isoform was not the result of serum protease activity, since these experiments were performed under serum-free conditions. Zhen et al. [34] have identified a soluble isoform of EGFR in the CCM of another cancer cell line (i.e. A431) that also overexpressses EGFR. To determine if this apparent shedding of EGFR was a phenotype common among cells, which overexpress full-length EGFR we examined the CCM of different cancer cell lines, which express varying levels of the full-length receptor. Cells that express 7 × 105 receptors/cell or more released soluble EGFR into the CCM (Table 1). The soluble isoform of EGFR was detected in the CCM of MDA-MB-468 cells (Fig. 1 and Table 1), BT-20 cells (Fig. 1 and Table 1) and Detroit-562 cells (Table 1). However, no soluble isoform of EGFR was detected in the CCM of MCF-7, MCF-10A, MDA-MB-231, T47D, or CaOV3 cells (Table 1). Together, these results suggest that the release of soluble EGFR into the CCM occurs in cells, which express high levels of EGFR.

The soluble isoform of EGFR detected in the CCM of MDA-MB-468 cells arises from the cell surface full-length receptor The soluble EGFR isoform detected in the CCM of MDA-MB-468 cells was not the proteolytic product of the alternately spliced sEGFR transcript, therefore we investigated if it arises via processing of the full-length EGFR. We labeled the cell surface proteins of MDA-MB468 with a membrane impermeable biotin-reagent and chased the fate of the biotin-labeled EGFR into the cell lysates and CCM. The results of these experiments showed a decrease in the biotin-labeled full-length EGFR in the cell lysate with a simultaneous increase in biotin-labeled sEGFR in the CCM over time (Fig. 2). The shedding of cell surface EGFR in MDA-MB-468 cells is approximately 60% after 24 h, and more than 90% after 48 h (Fig. 2). These results suggest that the protein identified in the CCM of MDA-MB-468 cells is a soluble isoform of EGFR that arises by proteolytic cleavage of the full-length receptor. We have designated this protein the proteolytic isoformsoluble EGFR (PI-sEGFR). To further characterize this novel soluble isoform of EGFR detected in MDA-MB-468 cells, we isolated and purified this protein by immunoaffinity chromatography using a monoclonal antibody specific for the extracellular domain of EGFR, MAb-528. The purity of the isolated protein was higher than 95% as assessed by Coomassie Blue Staining (Fig. 3A, lane 1). A monoclonal antibody specific for the extracellular domain of EGFR (MAb-15E11) [37] recognized the purified protein by immunoblot analysis (Fig. 3A, lane 2). This EGFR isoform was excised from a preparative SDS-PAGE gel and was enzymatically digested with trypsin or with chymotrypsin and GluC. The resulting peptides were analyzed by reverse-phase HPLC nano-

electrospray tandem mass spectrometry (mLC/MS/MS). These results showed that the amino acid sequences of 203 of 206 tryptic peptides analyzed share identity with the extracellular domain of human EGFR (data not shown). Similarly, when the protein was digested with chymotrypsin and Glu C, the amino acid sequence of the six peptides analyzed share identity with the extracellular domain of EGFR (Fig. 3B). Two of these peptides (G611-G625), corresponded to part of the juxtamembrane domain of EGFR, with the last carboxy-terminal four amino acid residues coincident with the putative transmembrane domain of the full-length receptor (Figs. 3B and C). The C-terminal amino acid of each of these peptides is glycine residue 625, which is not the cleavage site for either chymotrypsin or GluC. Collectively, these results suggest that EGFR may in certain cell types, be shed from the cell surface releasing the extracellular domain in the form of PI-sEGFR. To further characterize PI-sEGFR, the purified protein was treated with N-glycosidase F (PNGase F), an enzyme that removes complex oligosaccharides from N-linked glycoproteins, followed by analysis by SDS-PAGE and Western blot. The deglycosylated protein showed a relative molecular weight of approximately 70 kDa (Fig. 3D). This value is consistent with the theoretical molecular weight of the deglycosylated amino acids sequence 1 to 625 of EGFR (68.9 kDa) [42].

PMA stimulates the release of PI-sEGFR in malignant cells that express high levels of EGFR Phorbol esters, potent activators of PKC, activate the shedding of many cell surface proteins [15] including growth factor receptors, e.g. TNF-α receptor [43] and ErbB4 [9]. To determine if the proteolytic cleavage of EGFR was mediated by PKC, we treated cells with PMA, a potent PKC activator. PMA enhanced the shedding of EGFR in MDA-MB-468 cells (Fig. 1), BT-20 cells (Fig. 1), and Detroit-562 cells (data not shown). In contrast, the shedding of EGFR was not detected in PMA stimulated MCF-7, MCF-10A, MDAMB-231, T47D, or CaOV3 cells (data not shown). PMA induced the

Fig. 1 – A soluble isoform of EGFR is detected in the CCM of MDA-MB-468 and BT-20 cells. Cells were grown in media supplemented with 10% FBS until approximately 90% confluence, and starved for 24 h at 37 °C under 5% CO2 atmosphere, followed by treatment with 1 μM PMA. At the indicated times, the CCM was removed, clarified by centrifugation for 15 min at 13,000 rpm at 4 °C, and analyzed by immunoblot analysis using a monoclonal antibody specific for the extracellular domain of EGFR (MAb-15E11). The immunoblots shown are replicas from each of three experiments.

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Table 1 – Soluble EGFR is released into the CCM of cancerderived cell lines Cell line A431 BT-20 MDA-MB-468 Detroit-562 MCF-10A MDA-MB-231 MCF-7 T47D CaOV3

EGFR/cell 6

2 × 10 2 × 106 1.9 × 106 7 × 105 3 × 105 2 × 105 3 × 103 7 × 103 7 × 102

Soluble EGFR in the CCM a

Reference b

+ + + +/− – – – – –

[66] [75] [40] [76] [77] [78] [77] [77] [78]

+ = detectable. − = non-detectable. +/− = detectable at low level. a Soluble EGFR, measured by immunoblot analysis using an antibody specific to the extracellular domain of EGFR and by ALISA. b Reference for the number of EGFR/cell.

cleavage of EGFR in MDA-MB-468 cells, in a dose-dependent manner, with a maximal activation at 500 nM (Fig. 4A). Similarly, when MDA-MB-468 cells were treated with β-PMA, an active analog of PMA, the shedding of EGFR was enhanced with a maximal stimulation at 500 nM (Fig. 4A). However, when cells were treated with 4α-phorbol 12,13-didecanoate (α-PMA), an inactive analog of PMA, no effect was observed in EGFR shedding (Fig. 4A). PMA enhanced the shedding of EGFR in MDA-MB-468 cells by 2.2- to 5fold. This effect was observed at 2 h of incubation and increased continuously throughout the 24-hour incubation period (Fig. 1). Moreover, the PKC inhibitor Gö6983 blocked the shedding of EGFR in MDA-MB-468 cells (Fig. 4B). Together, these results suggest that the proteolytic cleavage of EGFR is regulated and is dependent on activation of PKC. Ectodomain shedding of transmembrane proteins generally does not require de novo protein biosynthesis [9,17,44]. To determine whether the PMA-induced shedding of EGFR requires new protein biosynthesis, cells were treated with the protein synthesis inhibitor cycloheximide in the presence of PMA. Cycloheximide modestly decreased the levels of PI-sEGFR in the CCM of MDA-MB-468 cells but this reduction was not statistically significant (Fig. 4C). In addition, when MDA-MB-468 cells were treated with PMA in the presence of different metalloprotease inhibitors, the levels of PI-sEGFR detected in the CCM decreased relative to the level observed in cells treated with PMA alone (Table 2). Therefore, these results suggest that the PMA-induced shedding of EGFR is due mainly to activation of proteolysis and not to overall changes in protein expression.

Heat-inactivated fetal bovine serum (FBS) stimulates the release of PI-sEGFR in MDA-MB-468 cells Serum induces ectodomain shedding of many transmembrane proteins including, TGF-α [45], the stem cell factors KL-1 and KL-2 [46], and angiotensin converting enzyme (ACE) [47]. We examined the effect of heat-inactivated FBS on the shedding of EGFR in MDAMB-468 cells. The shedding of EGFR was enhanced by FBS with a maximal stimulation achieved at 2.5% FBS (Fig. 5A). Because the serum used in these studies was heat-inactivated, the serum activation of EGFR shedding was likely not the result of serum

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proteases. Notwithstanding, serum contains growth factors such as EGF and TGF-α that might affect the shedding of EGFR.

EGF or TGF-α stimulates the release of PI-sEGFR in MDA-MB-468 cells Growth factor stimulation of ectodomain shedding has been proposed as a general phenomenon [44,48], perhaps as one mechanism of receptor down regulation. To determine if the serum-induced shedding of EGFR in MDA-MB-468 cells is mediated by growth factors, we examined the effect of two EGF family ligands on receptor shedding. MDA-MB-468 cells were treated with EGF or TGF-α at a concentration of 20 ng/mL for a time period (8 h) that does not inhibit cell proliferation or induce programmed cell death [40,49,50]. EGF increased the shedding of EGFR by 2-fold when compared to the control (Fig. 5B, lanes 4 and 2, respectively) and this EGF-stimulated shedding was higher compared to PMA-induced shedding (Fig. 5B lanes 4 and 3, respectively). Furthermore, PMA increased the amount of EGFR shedding over that observed with EGF treatment alone (Fig. 5B lanes 5 and 4, respectively). A similar, but less pronounced effect was observed when cells were treated with TGF-α (Fig. 5B, lane 6 and 2, respectively). These results, together with the results of the PMA studies, strongly suggest that the mechanism by which PIsEGFR is released in MDA-MB-468 cells is via a proteolytic cleavage of full-length transmembrane EGFR, and that like many other proteins susceptible to ectodomain shedding, the cleavage of EGFR is a regulated process.

Fig. 2 – The soluble isoform of EGFR detected in the CCM of MDA-MB-468 cells arises from shedding of full-length EGFR. Cells were grown in DMEM supplemented with 10% FBS until approximately 90% confluence, washed twice with cold PBS and proteins at the cell surface were labeled with biotin as described under Materials and methods. % Shedding = [Band intensityPI-sEGFR / (Band intensityPI-sEGFR + Band intensityEGFR)] × 100. The results represent the average of three independent experiments ± S.E.M.; T-test was used for statistical analysis; results are compared to 0-min time point.

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Pervanadate enhances the release of PI-sEGFR in MDA-MB-468 cells Pervanadate, a potent inhibitor of protein tyrosine phosphatases (PTPases), enhances the shedding of two other members of the ErbB family of tyrosine kinase receptors, i.e., ErbB2 [20] and ErbB4 [19]. To determine if the phosphotyrosine content of the cell affects the release of PI-sEGFR, cells were treated with pervanadate. As controls, cells were treated with either H2O2 or sodium orthovanadate, which slightly inhibit PTPases [51]. Pervanadate significantly induced the release of PI-sEGFR in MDA-MB-468 cells by 5.5-fold when compared to untreated cells or cells treated with H2O2 or sodium orthovanadate (Fig. 6). Moreover, the pervanadate-induced release of PI-sEGFR was both dose- and timedependent (data not shown). These results suggest that the release of PI-sEGFR in MDA-MB-468 cells is regulated by the tyrosine phosphorylation of one or more yet to be identified proteins.

4-aminophenylmercuric acetate (APMA) stimulates the release of PI-sEGFR in MDA-MB-468 cells The proteolytic activity involved in the shedding of the majority of the membrane-anchored proteins is mediated by metalloproteases [15,16,52]. In this regard, Merlos-Suarez et al. [53] have demon-

strated that APMA, a potent activator of matrix metalloproteases, activates the shedding of several transmembrane proteins including pro-TGF-α, pro-HB-EGF, and beta amyloid precursor protein (β-APP). To determine if a metalloprotease activity participates in the release of PI-sEGFR in MDA-MB-468 cells, we incubated the cells with APMA. The levels of PI-sEGFR significantly increased, in a dose-dependent manner, in the CCM of MDA-MB-468 cells after treatment with APMA (Fig. 7). These results suggest that a metalloprotease is involved in the release of PI-sEGFR in MDAMB-468 cells. Moreover, these results strongly suggest that PIsEGFR is generated by proteolytic cleavage of the full-length receptor.

PI-sEGFR arises by proteolytic cleavage of the full-length receptor To examine if PI-sEGFR arises from proteolytic cleavage of the fulllength receptor, MDA-MB-468 cells were treated with protease inhibitors representative of each family of proteases (Table 2). We have demonstrated that APMA significantly increased the levels of PIsEGFR in the CCM of MDA-MB-468 cells (Fig. 7). Therefore, we first determined whether metalloproteases are involved in the cleavage of EGFR using the broad-spectrum metalloprotease inhibitors TAPI-2 and EDTA. Treatment of MDA-MB-468 cells with TAPI-2 or with the

Fig. 3 – PI-sEGFR arises by proteolytic cleavage of EGFR. (A) Cells were grown in 175 cm2 flasks, until 95% confluence, and then changed to serum-free media. After 48 h, the CCM was collected, supplemented with a cocktail of protease inhibitors, and the protein purified as described under Materials and methods. Protein purity was assessed by Coomassie Blue Staining (A, Lane 1). The soluble isoform of EGFR was identified by immunoblot analysis using a monoclonal antibody specific for the extracellular domain of EGFR (MAb-15E11) (A, lane 2). (B) Peptides detected after chymotrypsin and GluC digestion. The band corresponding to the soluble isoform of EGFR (A, lane 1) was excised and sent for digestion with chymotrypsin and GluC, followed by sequence analysis at the Harvard Microchemistry Facility. Sequence analysis was performed by reverse-phase HPLC nano-electrospray tandem mass spectrometry (mLC/MS/MS) on a Finnigan LCQ DECA XP quadrupole ion trap mass spectrometer, C⁎ = propionamido cysteine (gel artifact) (C) Diagrams representing the full-length EGFR, PI-sEGFR and p110 sEGFR; the amino acid sequence corresponding to residues 601 to 681 of EGFR is shown; the box encloses the EGFR transmembrane domain. The C-terminal sequence of PI-sEGFR is illustrated; the peptide detected after chymotrypsin and GluC digestion is underlined. The 78 C-terminus unique amino acids of p110 sEGFR are shown in bold. (D) The purified PI-sEGFR was denatured, treated with PNGase F, separated in a 10% SDS-PAGE, and analyzed by immunoblot analysis using MAb-15E11.

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468 cells with the matrix metalloprotease inhibitors TIMP-1, TIMP-2, and TIMP-3. TIMP-2 and TIMP-3 inhibit all members of the MMP family, whereas TIMP-1 inhibits the secreted-type MMPs but is inefficient against the membrane-type MMPs [55,56]. In addition, TIMP-3 also inhibits several members of the ADAM family including ADAM10, ADAM12, ADAM17/ TACE, and ADAM 19 [55,57]. Treatment of MDA-MB-468 cells with TIMP-1 modestly, but consistently, inhibited both the constitutive and PMA-induced release of PIsEGFR, while TIMP-2 had no effect and TIMP-3 increased the constitutive and PMA-induced release of PI-sEGFR (Table 2). In addition, treatment of MDA-MB-468 cells with GM6001, another MMP inhibitor, decreased the constitutive and PMA-induced release of PI-sEGFR by approximately 20% (Table 2). Together, these results demonstrate that PI-sEGFR is generated by proteolytic cleavage of the full-length receptor and strongly suggest a role for metalloproteases in this process. Moreover, these results suggest that ADAM17/TACE does not cleave EGFR in MDA-MB-468 cells, but rather a MMP family member(s), probably from the secreted-type, might mediate at least in part the constitutive and PMA-induced shedding of EGFR.

Table 2 – Effect of protease inhibitors on the constitutive and PMA-induced shedding of EGFR in MDA-MB-468 cells Protease inhibitor Fig. 4 – PMA stimulates the release of PI-sEGFR in MDA-MB-468 cells. (A) Cells were grown in DMEM supplemented with 10% FBS until approximately 95% confluence, washed with PBS, and changed to serum-free culture medium. After overnight starvation, cells were treated with different concentrations of PMA, β-PMA and α-PMA and incubated for 8 h at 37 °C in 5% CO2 atmosphere. After treatment, the CCM was collected, clarified by centrifugation for 15 min at 13,000 rpm at 4 °C, and analyzed by immunoblot analysis using MAb-15E11. (B) Cells were incubated for 8 h in the absence or presence of the PKC inhibitor Gö6983, and then, the CCM was analyzed by immunoblot analysis using MAb-15E11. (C) Cells were grown as described in (A), after overnight serum deprivation, cells were incubated with 10 μg/ml cycloheximide for 30 min at 37 °C in an atmosphere of 5% CO2 followed by 500 nM PMA or the vehicle only, ethanol (Control), for 6.5 additional hours. The levels of PI-sEGFR in the CCM were analyzed by immunoblot using MAb-15E11. The lower panel shows the densitometric analysis of the same immunoblots. Results are the average of three independent experiments. The statistical analysis was performed using One-way ANOVA followed by Tukey's multiple comparison post-test (Prism Graphpad software), ⁎⁎P < 0.01. The immunoblots shown are replicas from at least three experiments.

metal chelator EDTA decreased both the constitutive and PMAinduced release of PI-sEGFR by approximately 50% when compared to untreated cells (Table 2). Members of the matrix metalloprotease (MMP) and a disintegrin and metalloprotease (ADAM) families are enzymes involved in the ectodomain shedding of many transmembrane proteins [25,26,54]. To determine whether a member of the matrix metalloprotease family cleaves EGFR, we treated MDA-MB-

EDTA (10 mM) TAPI-2 (50 μM) GM6001 (25 μM) TIMP-1 (75 nM) TIMP-2 (85 nM) TIMP-3 (100 nM) Leupeptin (10 μM) DCI (10 μM) Aprotinin (2 μM) E-64 (1 μM) TPCK (10 μM) Pepstatin (1 μM) L-685, 458 (10 μM) a

% Inhibition constitutive shedding a, b

% Inhibition PMA-induced shedding c

Metalloproteases

42 ± 16

56 ± 19

Metalloproteases

51 ± 10

60 ± 18

Matrix metalloproteases Matrix metalloproteases Matrix metalloproteases Matrix metalloproteases/ TACE Serine/cysteine

18 ± 8

23 ± 14

28 ± 11

21 ± 15

0

0

Inhibitor specificity

Serine Serine

Activation

0 0 Activation

Activation

27 ± 12 34 ± 19 Activation

Cysteine

0

0

Chymotrypsin/ some cysteine Aspartyl

0

0

0

21 ± 7

γ-secretase

0

0

PI-sEGFR levels in the CCM of MDA-MB-468 cells were determined by immunoblot analysis using an antibody specific for the extracellular domain of EGFR. Densitometric analysis of the immunoblots was performed using Quantity One software (Quemidoc equipment, BioRad). Results are the average of at least three independent experiments (mean ± SD). b The % inhibition of constitutive shedding = (Band intensityuntreated − Band intensityinhibitor treated) / Band intensityuntreated. c The % inhibition of the PMA-induced shedding=(Band intensityPMA- treated − Band intensityPMA + inhibitor-treated)/Band intensityPMA-treated.

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Fig. 5 – Heat-inactivated FBS and EGF stimulate the release of PI-sEGFR in MDA-MB-468 cells. Cells were grown in DMEM supplemented with 10% FBS until approximately 95% confluence, washed with PBS, and changed to serum-free culture medium. After overnight serum starvation, (A) cells were treated with different concentrations of heat-inactivated FBS for 8 h or (B) cells were treated with 20 ng/ml EGF or 20 ng/ml TGF-α for 7 h followed by 500 nM PMA or vehicle only (0.09% ethanol) for 1 additional hour. All incubations were done at 37 °C in 5% CO2 atmosphere. After treatment, the CCM was removed, clarified by centrifugation for 15 min at 13,000 rpm at 4 °C, and analyzed by immunoblot using MAb-15E11 (upper panel). This same membrane was stripped and re-probed with a polyclonal antibody that recognize an epitope present in the 78-unique amino acids of p110 sEGFR (lower panel), lane 1 = cell lysate from CHO cells expressing p110 sEGFR as positive control. The immunoblots shown are replicas from each of two experiments.

Since, the amino acid sequence at the luminal region of the EGF receptor shares similarity to the cleavage site proposed for the well-studied serine proteases rhomboids (Fig. 3C) [58–64], we sought to determine if human rhomboids are the proteases that

Fig. 7 – 4-aminophenylmercuric acetate (APMA) stimulates the release of PI-sEGFR in MDA-MB-468 cells. Cells were grown in DMEM supplemented with 10% FBS until approximately 95% confluence, washed with PBS and changed to serum-free culture medium. After overnight starvation, cells were treated with different concentrations of APMA (as indicated) followed by incubation for 8 h at 37 °C. The CCM was collected, clarified by centrifugation at 13,000 rpm for 15 min at 4 °C, separated in 7.5% SDS-PAGE, and analyzed by immunoblot analysis using MAb-15E11. The immunoblot shown is a replica from each of three experiments.

cleave EGFR. MDA-MB-468 cells were treated with the serine protease inhibitors DCI, leupeptin (at a concentration that does not inhibit the lysosomal function), aprotinin, and TPCK. The results showed that at the experimental conditions used, with the exception of aprotinin, none of these inhibitors affected the constitutive shedding of EGFR (Table 2). DCI and leupeptin inhibited the PMA-induced shedding of EGFR by approximately 30% while aprotinin increased both the constitutive and the PMAinduced shedding (Table 2). Together, these results suggest that rhomboid proteases do not cleave EGFR constitutively. Additional studies will be necessary to define the participation of rhomboid serine proteases in the PMA-induced shedding of EGFR. In summary, these inhibitor studies show that only the metalloprotease inhibitors decreased the constitutive shedding of EGFR whereas PMA-induced shedding was inhibited by metalloprotease inhibitors, by the two serine protease inhibitors leupeptin (at a concentration that does not inhibit the lysosomal function) and DCI, and by the aspartyl inhibitor pepstatin (Table 2). The specific inhibitor of mammalian Presenilins [65], L-685,458, had not effect on the shedding of EGFR in MDA-MB-468 cells (Table 2). Interestingly, the matrix metalloprotease inhibitor TIMP-3 and the serine protease inhibitor aprotinin increased both the constitutive and the PMA-induced shedding of EGFR (Table 2). Together, these results demonstrate that EGFR is proteolytically cleaved at the plasma membrane producing PI-sEGFR, and that this process can be regulated by PKC as well as perhaps by other signaling pathways.

Discussion Fig. 6 – Pervanadate enhances the release of PI-sEGFR in MDA-MB-468 cells. Cells were grown in DMEM supplemented with 10% FBS until approximately 95% confluence, washed with PBS, and changed to serum-free culture medium. After overnight starvation, cells were treated either with 100 µM hydrogen peroxide, 100 µM sodium orthovanadate, or 100 µM pervanadate (freshly prepared and used within 20 min), followed by incubation for 8 h at 37 °C. CCM was collected, clarified by centrifugation at 13,000 rpm for 15 min at 4 °C, separated in 7.5% SDS-PAGE, and analyzed by immunoblot analysis using MAb-15E11. The immunoblot shown represents one replica for each of three experiments.

Previous reports have indicated that EGFR does not undergo proteolytic cleavage [9,33]. Notwithstanding, Zhen et al. [34] have identified a soluble isoform of EGFR in the CCM from the human vulvar carcinoma cell line A431. Recently, while this manuscript was in revision, Sanderson et al. [10] also reported the identification of two soluble isoforms of EGFR of 150 and 100 kDa within the exosomes isolated from the CCM of the keratinocyte cell line HaCaT. The release of these two soluble EGFR isoforms within the exosomes is activated by EGF, calcium ionophores and APMA but not by PMA. In addition, the treatment of HaCaT cells with the metalloprotease inhibitor GM6001 decreased the calcium ionophore-induced release of the EGFR 150 kDa isoform while the

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constitutive release was not affected [10]. Similarly, here, we have demonstrated that the release of PI-sEGFR into the CCM of MDAMB-468 cells is activated by EGF and APMA and is reduced by the metalloprotease inhibitor GM6001. In contrast, we have demonstrated that the release of PI-sEGFR in MDA-MB-468 cells is activated by PMA. Moreover, we have demonstrated that PIsEGFR is generated by proteolytic cleavage of EGFR at the plasma membrane. Therefore, the shedding of EGFR in MDA-MB-468 vs. HaCaT cells appears to be mediated through different mechanisms. Here, we report that the proteolytic cleavage of EGFR occurs in malignant cell lines that express 7 × 105 receptors/cell or higher. However, we did not detect shedding of EGFR in the malignant cell line MDA-MB-231, which express 2 × 105 receptors/cell or importantly, in CHO cells transfected with a cDNA expression construct for EGFR (data not shown), even though these cells express levels of the protein that if shed could be easily detected by the ALISA assay. Similarly, the cell lines used by Zhen et al. [34] and Sanderson et al. [10] express high levels of EGFR [66–68]. However, we do not exclude the possibility that in cells that express very low levels of the EGFR, like in the malignant ovarian cell line CaOV3, EGFR shedding, if it occurs, would be undetectable. Together, these findings suggest that the mechanism of proteolytic cleavage of EGFR at the plasma membrane may be activated in malignant cells that overexpress the full-length receptor. In this regard, the shedding of another member of the ErbB family of receptor tyrosine kinases, ERBB2, occurs in human breast cancer cell lines that overexpress this receptor [20]. Given the growth regulatory role of the proteolytically truncated ERBB2 receptor in breast cancer cells [69], additional studies are clearly warranted to determine if the shedding of EGFR in cells overexpressing this receptor confers upon them an additional growth advantage, such as ligand-independent receptor activation, as seen with ERBB2. We have demonstrated that the soluble isoform detected in the CCM of MDA-MB-468 cells is generated by proteolytic cleavage of the membrane bound receptor. The C-terminal amino acid of two of the six peptides recovered after digestion of the PI-sEGFR with chymotrypsin or GluC is residue glycine 625, which is not the cleavage site for either of these enzymes. These results strongly suggest that the cleavage of EGFR occurs at the luminal phase of the transmembrane domain between the amino acid residues gly625 and met-626. Consistently, NMR spectroscopy studies and conformational energy analysis of the transmembrane domain of EGFR (or mutant EGFR) have demonstrated greater conformational flexibility and a lower probability of α-helical conformations in the first five amino acids of the TMD ([70] and [71], respectively). Furthermore, conformational energy analyses using normal and mutant EGFR peptides have demonstrated that the presence of Gly at position 625 appears to contribute additional flexibility to the luminal face of the TMD. This same conformational flexibility was not observed when similar experiments were done using normal and mutant peptides of the corresponding ERBB2 TMD [71]. Therefore, it is reasonable to speculate that the cleavage site of EGFR is at the amino acid residue Gly-625 based on its structural accessibility. Mutational analyses will need to be performed to directly test this hypothesis. We have demonstrated that the shedding of EGFR in MDA-MB468 cells not only occurs but that it is a regulated process. In this regard, activation of PKC by phorbol esters as well as important physiological factors including the ligands of EGFR, EGF and TGFα, and the protein phosphorylation state of the cell increase the

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release of PI-sEGFR. PKC regulates the ectodomain shedding of several unrelated proteins [15]. The specific pathway activated by PKC as well as the PKC isoforms that participate in EGFR cleavage in MDA-MB-468 cells are currently unknown. Previous studies have shown that the PMA activation of PKC [72], as well as growth factors stimulate ectodomain shedding of several transmembrane proteins via activation of the Erk MAP kinase pathway [73]. However, PMA-activated PKC-δ stimulates HB-EGF shedding by direct phosphorylation of the metalloprotease MDC9 [29]. Therefore, the PMA-, TGFα- and EGF-induced activation of EGFR shedding in MDA-MB-468 cells may be mediated via a MAP kinase-dependent signaling pathway. Experiments are in progress in our laboratory to test this hypothesis. Our experiments using protease inhibitors have demonstrated that PI-sEGFR is generated by proteolytic cleavage of EGFR in MDAMB-468 cells. In addition, we have demonstrated that APMA significantly increased the levels of PI-sEGFR in the CCM of these cells. However, the protease or proteases responsible for the proteolytic processing of EGFR is (are) unknown. Nevertheless, our results suggest that more than one protease activity participates in the shedding of EGFR. In this regard, the constitutive and PMAinduced shedding of EGFR in MDA-MB-468 cells was inhibited more when the broad-spectrum metalloprotease inhibitors EDTA and TAPI-2 were used than when specific inhibitors for the different metalloprotease family members were used. Furthermore, these results suggest that a MMP family member(s), probably of the secreted-type, may be implicated in the shedding of EGFR while members of the ADAM family are not. In addition, the constitutive shedding of EGFR appears to be mediated by metalloproteases only since inhibitors of other families of proteases do not affect the shedding. Consistent with these findings, different metalloproteases have been implicated in the shedding of HB-EGF including ADAM 9, ADAM 12, MMP-2, MMP-7 and MMP-9 [29–32]. Conversely, the PMA-induced shedding of EGFR in MDA-MB468 cells may require more than one proteolytic activity, perhaps independently, generating PI-sEGFR isoforms of similar molecular weights, which we were unable to resolve in our assays. In this regard, the PMA-induced shedding of EGFR was inhibited by metalloprotease inhibitors, by the two serine protease inhibitors leupeptin and DCI, and by the aspartyl inhibitor pepstatin. These results suggest that a metalloprotease might cleave EGFR in the juxtamembrane domain while a serine protease of the rhomboid family (or an aspartyl protease) might cleave EGFR at the TMD. In this regard, the amino acid sequence in the luminal region of the EGFR shares similarity to the cleavage site proposed for the wellstudied rhomboids [59,61–64] (Fig. 3C). By analogy, Drosophila Delta, a ligand for Notch, is cleaved either in the juxtamembrane domain or in the transmembrane domain by either a metalloprotease of the ADAM family, or by a yet to be identified intramembranous aspartyl protease, respectively to generate extracellular domain products of similar relative molecular weights [74]. Experiments are in progress in our laboratory to test the relevance of this model to EGFR. In summary, while the physiological significance of ectodomain shedding of EGFR is still unknown, here we demonstrate that EGFR shedding is regulated by physiological factors. Moreover, given the precedent established for cell growth regulation by proteolysis of other ERBB family members, such as ERBB2 and ERBB4, we believe this observation merits further investigations. Our results further

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suggest that the shedding of EGFR may be correlated with a highly malignant phenotype. Further studies to elucidate the role of this interesting new soluble EGFR isoform in cell growth and proliferation in both normal and malignant cells are clearly warranted.

Acknowledgments The authors thank Dr. Jill Reiter (Yale School of Medicine, New Haven, CT) for her helpful suggestions and advice, Trace Christensen (Mayo Clinic, Rochester, MN) for his skilled technical support and Ti Badri for her editing support. The work described in this report was funded by the NIH/NCI (CA73859 and CA85133), the UPR-MSC MBRS-RISE Program (R25GM61838), UPR-MSC MBRS-SCORE Program (S06GM08225), NIH CA 096297 and NIH (COBRE P20RR016439).

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