The type I transmembrane protein with epidermal growth factor and two follistatin motifs 2 (TMEFF2) is expressed in brain and prostate and overexpressed in prostate cancer, but its role in this disease is unclear. Several studies have suggested that TMEFF2 plays a role in suppressing the growth and invasive potential of human cancer cells, whereas others suggest that the shed portion of TMEFF2, which lacks the cytoplasmic region, has a growth-promoting activity. Here we show that TMEFF2 has a dual mode of action. Ectopic expression of wild-type fulllength TMEFF2 inhibits soft agar colony formation, cellular invasion, and migration and increases cellular sensitivity to apoptosis. However, expression of the ectodomain portion of TMEFF2 increases cell proliferation. Using affinity chromatography and mass spectrometry, we identify sarcosine dehydrogenase (SARDH), the enzyme that converts sarcosine to glycine, as a TMEFF2-interacting protein. Co-immunoprecipitation and immunofluorescence analysis confirms the interaction of SARDH with full-length TMEFF2. The ectodomain does not bind to SARDH. Moreover, expression of the full-length TMEFF2 but not the ectodomain results in a decreased level of sarcosine in the cells. These results suggest that the tumor suppressor activity of TMEFF2 requires the cytoplasmic/transmembrane portion of the protein and correlates with its ability to bind to SARDH and to modulate the level of sarcosine.The transmembrane protein with an epidermal growth factor and two follistatin motifs 2 (TMEFF2) 3 is an evolutionarily conserved type I transmembrane protein expressed in the embryo (1, 2) and selectively in the adult brain and prostate (3-5). The extracellular (ecto-) domain can be cleaved from the membrane in an ADAM17/␥-secretase-dependent fashion (6, 7) and consists of an epidermal growth factor-like motif and two follistatin motifs. The cytoplasmic domain contains a potential G-protein activation motif (2). A critical role for this protein in tumorigenesis is suggested by the fact that it is upregulated in a significant fraction of primary and metastatic prostate tumors (3)(4)(5)8). In fact, ectopic expression or the addition of purified recombinant TMEFF2 ectodomain promotes neuronal cell survival (9), cell growth (6), and phosphorylation of erbB4 and ERK1/2 (2, 6). However, it has also been suggested that TMEFF2 functions as a tumor suppressor because ectopic expression of full-length TMEFF2 demonstrates in vitro antiproliferative effects (4, 10) and suppresses tumor growth in vivo in nude mouse xenografts (10). Consistent with a tumor suppressor activity, Tmeff2 has been shown to be hypermethylated in a number of cancer types (Refs. 11-16 and references therein), and the Tmeff2 promoter is repressed by c-Myc (17).Recently, sarcosine, a glycine derivative, was identified as a potential marker of prostate cancer progression (18). Sarcosine levels were highest in metastatic cancer, and in urine, its levels were higher in men with prostate cancer than in controls. Importantly, using cell ...