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During initiation, structures within 5\u2032 untranslated regions modulate ribosome association with mRNA and the balance between translation of the main open reading frame and use of upstream or alternative start sites. During elongation, structures in the coding sequence govern ribosome pausing in ways that can either protect mRNA stability or trigger decay. During termination, structures downstream of primary stop codons promote readthrough to generate protein isoforms in a tissue-specific manner. mRNA structures are remodeled by helicase expression, post-transcriptional modifications, and translational programming to provide additional layers of regulation. We review recent advances illuminating diverse mechanisms by which RNA structure modulates translation.<\/jats:p>","DOI":"10.1021\/acs.biochem.6c00561","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:02:29Z","timestamp":1790791349000},"page":"3144-3150","source":"Crossref","is-referenced-by-count":0,"title":["mRNA Structure\nRegulates Translation at Every Step"],"prefix":"10.1021","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4137-0035","authenticated-orcid":true,"given":"Alexandra","family":"Khitun","sequence":"first","affiliation":[{"name":"University of North Carolina , , , ,","place":["Chapel Hill, North Carolina, United States, 27599-3290"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6748-9985","authenticated-orcid":true,"given":"Kevin M.","family":"Weeks","sequence":"additional","affiliation":[{"name":"University of North Carolina , , , ,","place":["Chapel Hill, North Carolina, United States, 27599-3290"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2026102007163858900_cit1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/0092-8674(86)90384-3","article-title":"Multiple\nupstream AUG codons mediate translational\ncontrol of GCN4","volume":"45","author":"Mueller","year":"1986","journal-title":"Cell"},{"key":"2026102007163858900_cit2","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/S1097-2765(03)00105-9","article-title":"An integrated stress\nresponse regulates amino acid metabolism and\nresistance to oxidative stress","volume":"11","author":"Harding","year":"2003","journal-title":"Mol. 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