Important Genes in the Pathogenesis of 5q- Syndrome and Their Connection with Ribosomal Stress and the Innate Immune System Pathway

Figure 2

Ribosomal stress in 5q-syndrome. On the top is schematically shown normal erythroid cell with normal ribosome biogenesis and p53 levels. On the bottom is erythroid cell where p53 is activated by ribosomal stress secondary to RPS14 haploinsufficiency. Ribosomal proteins RPL5, 11, 23, and RPS27L bind HDM2 and activate p53. The ribosomal protein S27-like (RPS27L) is induced by p53-activating signals and promotes apoptosis [53, 54]. To date, the role of oxidative stress in MDS has not been fully elucidated [55–57].