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. 2024 Feb 21;60(5):449–465. doi: 10.1007/s11626-024-00855-w

Figure 6.

Figure 6.

Diverse roles of RNF43 mutations in multistep carcinogenesis. Transient Wnt activation induces wild-type RNF43 in normal cells. RNF43 starts to suppress Wnt signaling via Fzd degradation, but it also suppresses the p53 pathway simultaneously (upper left, diagram). Attenuated Wnt signal reduces RNF43 expression to release p53 suppression, then returns to the resting state. Stem cells can self-renew only in the small window with hi-Wnt and low-p53 state (upper left, graph). Meanwhile, initial Wnt activation in CRCs even weakly induces oncogenic RNF43 and accelerates/amplifies Wnt signaling by forming positive feedback (upper right, diagram). Excess Wnt signal activity and p53 suppression may cause cells to proliferate out of biological control since these oncogenic RNF43 still suppress p53 (upper right, graph). Therefore, the oncogenic mutations of RNF43 in MSI-Hi CRC may simultaneously take the place of two mutations of APC and TP53 of MSS CRC (bottom). mtOnco, oncomutant.