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Because early detection can reverse symptoms before permanent nerve damage occurs, a clinical workup is warranted if a patient exhibits any of the signs below

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The unfolded protein response (UPR) marker protein kinase RNA-like ER kinase (PERK), as a key sensor in the UPR, is activated when endoplasmic reticulum stress occurs and phosphorylates its downstream transcription factor ATF4, ATF4 directly binds upstream of the xCT promoter and promotes its transcription, ensuring sufficient cystine uptake and maintaining intracellular redox homeostasis

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The residues Val 55, Phe 57 and Met 84, mutated in HPV-16 E7 Mut, are highlighted by the white clouds