Advanced pancreatic ductal adenocarcinoma - Complexities of treatment and emerging therapeutic options

Figure 3 Effects on ribosome biogenesis under normal conditions and in response to nucleolar stress. Under normal conditions, p53 levels are kept at a minimum by MDM2. This allows normal cell growth and proliferation. With nucleolar stress, RPs L5 and L11 are able to bind to MDM2 as does p14ARF. This blocks the ability for MDM2 to inhibit p53. Similarly, p53 independent mechanisms also block ribosome biogenesis leading to cell cycle arrest, senescence or apoptosis.